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A&P II IPAP 3-17 > Respiratory > Flashcards

Respiratory Flashcards

1
Q

What branch of medicine deals with diseases of the ears, nose, and throat (ENT)?

A

Otorhinolaryngology

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2
Q

What branch of medicine deals with diseases of the lungs?

A

Pulmonology

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3
Q

Excessive CO2 in the body leads to what?

A

Acidosis

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4
Q

What are some additional functions above and beyond O2 CO2 exchange the Respiratory system is involved in?

A
  • Blood pH Regulation
  • Contains Receptors for sense of smell
  • Filters Inspired Air
  • Helps Produce Sounds
  • Rids body of heat and water through exhalation
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5
Q

What is the Respiratory macro anatomy?

A 
Nose
Pharynx (throat)
Larynx (Voice box)
Trachea (windpipe)
Bronchi
Lungs
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6
Q

What is the structural anatomy of the Upper Respiratory System?

A

Nose
Nasal Cavity
Pharynx
Associated Structures

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7
Q

What is the structural anatomy of the Lower Respiratory System?

A

Larynx
Trachea
Bronchi
Lungs

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8
Q

What is the Conducting Zone of the Functional Anatomy?

A

Where these Occur:

  • Filtration
  • Warming
  • Moistening of air
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9
Q

What are the respiratory anatomy parts that make up the Conducting Zone?

A 
Nose
Nasal Cavity
Pharynx
Larynx
Trachea
Bronchi
Bronchioles
Terminal Bronchioles
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10
Q

What is the Respiratory Zone of the Functional Anatomy?

A

Tubes and Tissues within the lungs where gas exchange occurs

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11
Q

What are the respiratory anatomy parts that make up the Respiratory Zone?

A

Respiratory Bronchioles
Alveolar Ducts
Alveolar Sacs
Alveoli

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12
Q

What forms the bony framework of the Nasal Anatomy?

A

Nasal Bone

Maxillae Bone

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13
Q

What forms the Cartilaginous Framework of the Nasal Anatomy?

A

Septal Nasal Cartilage
Lateral Nasal Cartilage
Alar Cartilage

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14
Q

The Cartilaginous Framework makes up what portion of the nose?

A

External Nose Flexible

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15
Q

What is the name of the openings of the nose seen on the face?

A

External Nares

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16
Q

What is the large space in the anterior skull that lies inferior to nasal bone and superior to maxilla?

A

Nasal Cavity (Internal Aspect of Nasal Anatomy)

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17
Q

The Nasal Cavity communicates with what Posteriorly and Anteriorly?

A

Posteriorly: Pharynx
Anteriorly: External Nose

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18
Q

What is the name of the two openings the Nasal Cavity communicates through to the Pharynx?

A

Internal Nares (Choanae)

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19
Q

What drains into the Nasal Cavity?

A

Paranasal Sinuses

Nasolacrimal Ducts

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20
Q

What are the names of the Paranasal Sinuses?

A

Maxillary
Frontal
Sphenoidal
Ethmoidal

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21
Q

What makes up the Roof of the nasal Cavity?

A

Ethmoid Bone

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22
Q

What makes up the floor of the nasal cavity?

A

Palatine Bones

Palatine processes of Maxillae

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23
Q

What makes up the Lateral walls of the nasal cavity?

A 
Ethmoid Bone
Maxillae Bone
Lacrimal Bone
Palatine Bone
Inferior Nasal Conchae Bones
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24
Q

What is the Anterior portion of the nasal cavity inside the nostrils surrounded by cartilage?

A

Nasal Vestibule

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25
Q

What is the vertical partition in the nasal cavity, made up mostly of hyaline cartilage?

A

Nasal Septum

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26
Q

The Nasal Septum is formed from what parts of the Nasal Anatomy?

A
  • Perpendicular plate of the ethmoid bone
  • Septal (quadrangular) cartilage
  • Vomer Bone
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27
Q

What clinical correlation is indicated from a septum that does not run along midline of nasal cavity?

A

Deviated Nasal Septum

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28
Q

A Deviated Nasal Septum usually occurs at what junction?

A

Vomer Bone and Septal Cartilage

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29
Q

What does air first enter into when breathing through the nose?

A

Nasal Vestibules

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30
Q

In the Nasal Passageway air pass over these structures that arise from the lateral walls toward the septum?

A

Turbinates (Nasal Conchae Bones)

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31
Q

What are the names of the turbinates in each nostril?

A

Inferior
Middle
Superior

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32
Q

What is the space in between the turbinates Called?

A

Meatuses (groove-like passageways)

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33
Q

What lines the conchae which help catch water droplets on exhalation?

A

Mucous Membranes

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34
Q

What is contained in the mucous membranes?

A

Goblet Cells

Cilia

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35
Q

What do the turbinates help do to the air as it passes them?

A

Larger Surface Area

  • Warm air
  • Moisten air (Mucous)
  • Filter air (Cilia)
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36
Q

What is the funnel shaped tube that begins at the internal nares and extends to the level of the cricoid cartilage?

A

Pharynx

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37
Q

The wall of the pharynx is what type of muscle?

A

Skeletal Muscle

  • Inner Layer: Longitudinal
  • Outer Layer: Circular
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38
Q

What does relaxation and contraction of the muscle of the pharynx cause?

A

Relaxation: Patent
Contraction: Assists in deglutition

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39
Q

What are some of the functions of the pharynx?

A
  • Passageway for air and food
  • Helps resonate speech/sound
  • House tonsils
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40
Q

What are the three anatomical regions of the Pharynx?

A

Nasopharynx
Oropharynx
Layngopharynx/
Hypopharynx

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41
Q

What are the five openings found in the Nasopharynx?

A

Two Internal Nares
Two Eustachian Tube
Opening into Oropharynx

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42
Q

What tonsils are contained in the Nasopharynx?

A

Adenoids (Pharyngeal Tonsils)

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43
Q

This is the intermediate portion of the pharynx, extends from soft palate inferiorly to the level of hyoid bone and only has one opening, the fauces (mouth)?

A

Oropharynx

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44
Q

What tonsils are found in the Oropharynx?

A

Palatine

Lingual (Singluar)

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45
Q

This portion of the pharynx begins at the level of hyoid bone, Inferior end opens into esophagus posteriorly or larynx anteriorly, and has respiratory and digestive functions?

A

Layngopharynx/Hypopharynx

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46
Q

Inflammation of any portion of the pharynx (usually oropharynx), with symptoms of sore throat, erythema, enlarged tonsils, clinically indicates what?

A

Pharyngitis

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47
Q

What are some causes of Pharyngitis?

A

-Bacterial (Strep,
N. Gocoonrhea/Chlamydia)
-Viral
-Allergic

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48
Q

This is cellular debris deposited on tissue, usually white, byproduct of bacterial activity in the region?

A

Exudate

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49
Q

Caused by capillary bleeding under the skin, mucous membrane, etc… (Strep, CMV, Mono)?

A

Petechiae

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50
Q

What are the individual parts that make up the Larynx?

A 
Epiglottis
Supraglottis
Vocal Cord
Glottis
Subglottis
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51
Q

What lies midline in the neck, anterior to 4th-6th cervical vertebrae and esophagus, beginning at inferior hypopharynx and includes space superior to trachea?

A

Larynx

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52
Q

what are the functions of the Larynx?

A
  • Open: Breathing
  • Partially Open: Phonation/Speaking
  • Closed: Deglutition
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53
Q

How many pieces of Cartilage make up the Larynx?

A

9

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54
Q

Name the singular pieces that are part of the Larynx?

A

Thyroid
Epiglottis
Cricoid

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55
Q

Name the Paired pieces of cartilage (for moving vocal cords)?

A

Arytenoid
Corniculate
Cuneiform

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56
Q

Name all nine pieces that make up the cartilage pieces of the Larynx?

A 
Thyroid 
Epiglottis
Cricoid
Arytenoid (Pair, vocal)
Corniculate (Pair, vocal)
Cuneiform (Pair, vocal)
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57
Q

Which cartilage piece gives the larynx a triangular shape (Adam’s Apple)?

A

Thyroid Cartilage

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58
Q

What gives the “point” shape of the Adam’s Apple?

A

Laryngeal Prominence

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59
Q

What cartilaginous piece attaches to posterior aspect of thyroid cartilage by thyroepiglottic ligament and base connects to posterior surface of thyroid cartilage?

A

Epiglottis

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60
Q

This cartilaginous piece of the Laryngeal anatomy is leaf-shaped, elastic cartilage that hovers and closes over the glottis?

A

Epiglottis

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61
Q

What Cartilaginous piece of the Larynx is a ring of hyaline cartilage that forms the inferior wall and is the only “true” ring (Circumferential)?

A

Cricoid Cartilage

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62
Q

The Thyroid cartilage is connected to this structure via the cricothyroid ligament and inferior thyroid cartilage horns?

A

Cricoid Cartilage

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63
Q

What are the two sets of arteries that supply the lungs with blood?

A

Pulmonary Arteries

Bronchial Arteries

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64
Q

What are the only arteries in the body to carry deoxygenated blood and come from the right ventricle?

A

Pulmonary Arteries

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65
Q

What arteries branch off from the aorta and deliver oxygenated blood to the lungs that perfuses into the muscular walls of the bronchi and bronchioles?

A

Bronchial Arteries

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66
Q

What vessel returns oxygenated blood to the left atrium? 2 vessels from each lung

A

Pulmonary veins

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67
Q

Pulmonary blood vessels constrict during what times?

A

Hypoxia (only blood vessels to do this)

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68
Q

What are the three basic steps of respiration?

A
  • Pulmonary Ventilation (breathing)
  • External Respiration
  • Internal Respiration
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69
Q

Which step of respiration involves the inhalation and exhalation of air and exchange of air between atmosphere and alveoli?

A

Pulmonary Ventilation (Breathing)

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70
Q

Which step of respiration involves the exchange of gases between alveoli and blood in pulmonary capillaries, blood gains O2 and loses CO2?

A

External Respiration

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71
Q

Which step of respiration involves the exchange of gases between systemic capillaries and tissue cells?

A

Internal Respiration

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72
Q

What is occurring at the cellular level of internal respiration?

A

-Blood loses O2 and gains CO2

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73
Q

What is the metabolic reaction that consumes O2 and gives off CO2 within the cells?

A

Cellular Respiration

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74
Q

What influences the rate of airflow and effort needed for breathing?

A
  • Alveolar Surface tension (Surfactant)
  • Compliance of lungs (fibrosis)
  • Airway resistance (asthma)
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75
Q

What is the Pressure between two layers of pleural cavity called?

A

Intrapleural (Intrathoracic) Pressure

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76
Q

What is the pressure inside the lungs called?

A

Alveolar (Intrapulmonic) Pressure

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77
Q

Prior to the start of inhalation pressure in the lungs is equal to what?

A

atmospheric pressure (760mmHg or 1atm)

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78
Q

Boyles Law states?

A

Pressure of a gas in a closed container is inversely proportional to the volume of the container

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79
Q

What are the main muscles of inhalation used to expand the lungs thus decreasing the pressure within the thoracic cavity allowing for air to move into the lungs?

A

Diaphragm

External Intercostals

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80
Q

What is the most important muscle of inhalation?

A

Diaphragm

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81
Q

The Diaphragm is innervated by what/which nerves?

A

Phrenic Nerves (C3/C4/C5)

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82
Q

During normal inhalation the diaphragm descends approximately how far?

A

1cm

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83
Q

This diaphragmatic contraction during normal inhalation produces a pressure difference of how many mmHg and causes how many mL’s of air to be inhaled?

A
  • Decreases pressure 1-3mmHG

- Inhale 500mL

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84
Q

During strenuous breathing the diaphragm may descend up to how much?

A

10cm

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85
Q

This diaphragmatic contraction during strenuous breathing produces a pressure difference of how many mmHg and causes how many mL’s of air to be inhaled?

A
  • Decrease pressure 100mmHg

- Inhale 2-3L

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86
Q

The contraction of the diaphragm is responsible for what percentage of air that enters the lungs during normal breathing?

A

75%

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87
Q

What are three other factors that contribute to the rate of airflow and ease of pulmonary ventilation?

A
  • Surface tension of alveolar fluid
  • Compliance of the lungs
  • Airway Resistance
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88
Q

What is surface tension?

A

Air-water interface due to polar water molecules being strongly attracted to each other rather than to gases

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89
Q

What role does Surface tension play within the lungs?

A
  • Causes alveoli to assume smallest diameter (around gas inside)
  • Must be overcome to expand the lungs (inhalation)
  • Accounts for 2/3 of elastic recoil during exhalation
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90
Q

What apparatus is used to measure volume of air exchanged during breathing and the respiratory rate?

A

Spirometer/Respirometer

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91
Q

The record of measurements from a spirometer is called?

A

Spirogram

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92
Q

How is Inhalation and Exhalation recorded on a spirogram?

A
  • Inhalation: Upward Deflection

- Exhalation: Downward Deflection

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93
Q

What is the equation for the Alveolar Vent Rate?

A

Alveolar Vent Rate= 70% (resp zone) X breaths/min

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94
Q

The Alveolar Vent Rate represents what?

A

Volume that actually reaches respiratory zone in one minute

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95
Q

What is Inspiratory Reserve Volume?

A

Additional Air Inhaled by taking a very deep breath.

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96
Q

What is Inspiratory capacity?

A

Tidal Volume + Inspiratory Reserve Volume

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97
Q

What is Functional Residual Capacity?

A

Residual Volume + Expiratory Reserve Volume

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98
Q

What is Vital Capacity?

A

Inspiratory Reserve Volume + Tidal Volume + Expiratory Reserve Volume

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99
Q

What is Total Lung Capacity?

A

Vital Capacity + Residual Volume

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100
Q

What is the Vital Capacity for male and females?

A

Male: 4800mL
Female: 3100mL

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101
Q

What is the Total Lung Capacity for male and female?

A

Male: 6000mL
Female: 4200mL

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102
Q

What is Dalton’s Gas Law (Dalton’s Law of partial Pressures)?

A

A mixture of non-reacting gases, the total pressure exerted is equal to the sum of the partial pressures of the individual gases

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103
Q

What is Dalton’s Gas Law (Dalton’s Law of partial Pressures)?

A

A mixture of non-reacting gases, the total pressure exerted is equal to the sum of the partial pressures of the individual gases

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104
Q

What is PaO2 a measurement of?

A

Partial pressure of dissolved (free) oxygen in arterial blood (the only oxygen that exerts pressure)

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105
Q

What type of blood draw is a PaO2 obtained from?

A

Arterial Blood Draw

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106
Q

What does SaO2 measure?

A

Measurement of Oxygen that is bound to hemoglobin (saturation) in arterial blood

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107
Q

What does SpO2 Measure?

A

Measurement of the oxygen that is bound to hemoglobin peripherally

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108
Q

What does a Pulse oximeter use to provide measurements?

A

Colorimetric Measurements

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109
Q

What gas has a much higher affinity for hemoglobin than oxygen?

A

Carbon Monoxide (CO)

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110
Q

More oxygen detached from the hemoglobin results in what?

A

Increase dissolved O2—> Increases PaO2

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111
Q

More CO attached to hemoglobin results in what?

A

Decrease attached O2—> Decrease SaO2

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112
Q

How many mL’s of oxygen is used each minute by the body at rest?

A

200mL

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113
Q

During exercise oxygen use increase by how many times?

A

15-20 times (3,000-4,000mL/min)

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114
Q

Under normal conditions, each 100mL of deoxygenated blood contains what amount of CO2?

A

53mL

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115
Q

What are the three forms CO2 is transported as within the body?

A
  • Dissolved CO2
  • Carbamino Compounds
  • Bicarbonate Ion
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116
Q

Which form of CO2 transport is makes up the smallest percentage (7%) and is exhaled from the lungs?

A

Dissolved CO2

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117
Q

What form of CO2 transport accounts for about 23%, combines w/ amino acids and proteins (hemoglobin most prevalent protein), which most is bound to hemoglobin (Carbaminohemoglobin)?

A

Carbamino Compounds

118
Q

This form of CO2 transports account for the majority 70%?

A

Bicarbonate Ions

119
Q

Elite endurance athletes may see how large of an increase in Oxygen use per minute?

A

30 times

6,000mL/min

120
Q

By age 70 respiratory Vital Capacity can decrease by what percentage?

121
Q

What else decreases as the body ages regarding the respiratory system?

A
  • Blood O2
  • Alveolar macrophage
  • Ciliary Action of Epithelium
122
Q

What Pulmonary disorders become more prevalent as people age?

A

Pneumonia
Bronchitis
Emphysema
etc….

123
Q

What influence does the Limbic system have on the respiratory system?

A

Sends impulses to inspiratory area when stimulated

124
Q

How does Temperature influence the respiratory system?

A
  • Temp increases causes increase respiration

- Temp Decrease causes Decrease respiration

125
Q

A sudden shock of cold may bring on what?

A

Temporary Apnea (Take your breath away)

126
Q

What effects can pain have on the Respiratory system?

A
  • Sudden, Sever: Apnea
  • Prolonged Somatic: Increases Respiration
  • Visceral Pain: Slow Respiration Rate
127
Q

What type of influences does stretching the anal sphincter have on the respiratory system?

A

Increases respiratory rate

-Can be used to stimulate breathing

128
Q

A cessation of breathing followed by a Cough or Sneeze may be caused by?

A

Irritation of airways (Physical or Chemical Irritation)

129
Q

The Carotid and/or Aortic Baroreceptors detect a drop in blood pressure what influence will this have on the Respiratory system?

A

Increases the Respiration Rate

130
Q

The Carotid and/or Aortic Baroreceptors detect a sudden rise in BP what influence will this have on the Respiratory system?

A

Decreases the Respiration Rate

131
Q

The voluntary ability to hold your breath is limited by what and due to what?

A

Inspiratory Center becoming strongly stimulated due to increasing CO2 and H+

132
Q

What chemicals provide stimuli to the Chemoreceptors?

133
Q

Where are the Chemoreceptors located?

A
  • Central: In/Near Medulla Oblongata

- Peripheral: In Aortic and Carotid Bodies

134
Q

The Central Chemoreceptors respond to changes in what Chemicals?

A

H+ and CO2

135
Q

The Peripheral Chemoreceptors respond to changes in what chemicals?

A

H+, CO2, and O2

136
Q

These receptors can cause a change in heart rate and depth of breathing before changes in Po2, Pco2, H+ in anticipation of changes in chemical composition?

A

Proprioceptors

137
Q

What is the name of the Respiratory Center area whose function is to control basic rhythm of respiration?

A

Medullary Rhythmicity

138
Q

What Respiratory areas helps control transition between inhalation and exhalation?

A

Pneumotaxic Area in the Pons

Apneustic Area in the Pons

139
Q

What is a major function of the Pneumotaxic Area?

A

Inhibit inspiratory area before lungs become too full.

Shorten duration of inhalation as needed

140
Q

What is a major effect of the Apneustic Area?

A

Prolong inhalation or provide deep inhalation

141
Q

What area of Respiration will override the Apneuistic Area when it is active (stimulated)?

A

Pneumotaxic Area in the Pons

142
Q

What is an Oxygen-Hemoglobin Dissociation Curve?

A

Graphical representation depicting the relationship between the % saturation of hemoglobin and Po2 (Partial Pressure of O2)

143
Q

What effect of hemoglobin O2 affinity is seen when Po2 increases and decreases?

A

Increase: O2 affinity to Hemoglobin increases
Decrease: O2 affinity to Hemoglobin decreases

144
Q

What are four factors that affect the affinity of O2?

A

Acidity (pH)
PCO2
Temperature
2,3-bisphosphoglycerate (BPG)

145
Q

A decrease in pH (more acidic) has what affect on O2 Affinity?

A

Decreases O2 Affinity, O2 dissociates from hemoglobin more readily

146
Q

What kind of shift will be seen on the Oxygen-Hemoglobin Dissociation Curve with decreased pH (More acidic)?

A

Right Shit

147
Q

A Right shift due to lower pH on the Oxygen-Hemoglobin Dissociation Curve indicates what regarding Po2?

A

At Higher Po2, saturation of hemoglobin is less than if the pH were normal

148
Q

An increase in pH (more alkaline) has what affect on O2 affinity?

A

Increases O2 affinity, O2 dissociates from hemoglobin less readily (More difficult for dissociation)

149
Q

What kind of shift will be seen on the Oxygen-Hemoglobin Dissociation Curve with an increase of pH (More Alkaline)?

A

Left Shift

150
Q

A Left shift due to higher pH on the Oxygen-Hemoglobin Dissociation Curve indicates what regarding Po2?

A

At Higher Po2, saturation of hemoglobin is higher than if the pH were normal

151
Q

What affect does an increase of PCO2 have on O2 Affinity?

A

Increase CO2: pH decreases (more acidic)–> Decreased O2 Affinity (Right Shift)
(Same Curve as pH since CO2 affects pH)

152
Q

What affect does an decrease of PCO2 have on O2 Affinity?

A

Decrease CO2: pH increases (more Alkaline)–> Increased O2 Affinity (Left Shift)
(Same Curve as pH since CO2 affects pH)

153
Q

What affect does Temperature have on O2 Affinity?

A

-Inverse relationship
Increase Temp: Decrease O2 Affinity
Decrease Temp: Increase O2 Affinity
(Similar curve to CO2 and pH but wider spread)

154
Q

At rest a healthy adult averages how many breathes a minute and moves how much air with each inhalation and exhalation?

A

12 breaths a minute

500mL

155
Q

What is Tidal Volume (Vt)?

A

Volume of one breath - normal 500mL

156
Q

What is Minute Volume (MV)?

A

Total volume of air inhaled and exhaled each minute

157
Q

How is minute volume calculated?

A

Respiratory Rate x Tidal Volume

158
Q

How much air in a typical adult reaches the respiratory zone? Where is the rest of the air sitting?

A
  • 70% of tidal volume (350ml) reach respiratory zone

- 30% (150mL) remains in conducting zone

159
Q

The 30% (150mL) of tidal volume sitting in the conducting zone is in an area called what because no gas exchange can occur here?

A

Anatomic Dead Space

160
Q

What is Expiratory Reserve Volume?

A

Amount of air over the tidal volume that is exhaled, usually by forcefully exhaling using accessory muscles

161
Q

What is Residual Volume?

A

Air that cannot be exhaled (alveoli would collapse) and air in non-collapsible airways.

162
Q

What volume cannot be determined by spirometry?

A

Residual Volume

163
Q

What factors influence Alveolar Air?

A
  • Composition of inspired air
  • Alveolar Ventilation
  • Concentration of Dissolved gases in mixed venous blood
164
Q

What is the composition of Atmospheric air?

A

79% Nitrogen
21% Oxygen
<1% other gases

165
Q

What is occurring as air is inspired into the respiratory tract?

A
  • Warms to body temp
  • Humidified (saturated with water)
  • Composition of alveolar air changes in respiratory zone and gas exchange occurs
166
Q

Partial Pressures of gases determine the movement of O2 and CO2 between what?

A

Atmosphere and Lungs
Lungs and Blood
Blood and Tissue Cells

167
Q

What effect does higher partial pressure have on gas movement?

A

The higher partial pressure (or gradient) the faster the gas moves from higher to lower pressure space

168
Q

What is Henry’s Law?

A

The quantity of gas that will dissolve in a liquid is proportional to the partial pressure of the gas and it’s solubility

169
Q

How does Henry’s Law apply to the human body and body fluids?

A

Gas in body fluids ability to stay in solution is greater when it’s partial pressure is higher and when it’s solubility in water is higher

170
Q

What gas is dissolved at higher concentrations in blood plasma?

A

CO2 (Solubility is 24times greater than O2)

171
Q

What is occurring during External Respiration during Pulmonary Gas Exchange?

A
  • Diffusion of O2 from air in alveoli into blood in pulmonary capillaries
  • Diffusion of CO2 from pulmonary capillaries into alveoli and then exhaled
  • Deoxygenated blood to Oxygenated blood
172
Q

During External Respiration diffusion continues until pressures are equal, What are the pressures for O2 in the Alveolar air and Capillary blood?

A

Alveolar air - PO2 = 105mmHg
Capillary blood - PO2 = 40mmHg
-O2 will move from high (Alveolar) pressure to lower (Capillary) pressure

173
Q

During External Respiration pressures for CO2 in the Alveolar air and Capillary Blood are what?

A

Capillary blood - PCO2 = 45mmHg
Alveolar air - PCO2 = 40mmHg
-CO2 will move from blood to alveolar air

174
Q

What is Systemic gas exchange during internal respiration?

A

-Diffusion of O2 from blood in capillaries to the tissue cells
-Diffusion of CO2 from tissue cells to blood capillaries
(Oxygenated blood in capillaries diffuses O2 into tissue and becomes Deoxygenated by picking up CO2 from tissue cells)

175
Q

Internal Respiration: O2 moves from Systemic capillary to tissues cells, what are the pressures in the systemic capillaries and Tissue Cells of O2?

A

Systemic Capillaries - PO2 = 100mmHg

Tissue Cells - PO2 = 40mmHg

176
Q

Internal Respiration: CO2 moves from Tissue cells to Systemic Capillaries, what are the pressures in the Tissue Cells and Capillaries?

A

Tissue Cells - PCO2 = 45mmHg

Systemic Capillaries - PCO2 = 40mmHg

177
Q

What role does surface area play in the ability of gas exchange?

A

Larger surface area = faster and easier gas exchange

178
Q

How does Emphysema impact gas exchange?

A

Causes decrease in surface area reducing rate of gas exchange

179
Q

How does diffusion distance affect gas exchange?

A

Increase of fluid in the lungs increase diffusion time.

180
Q

Approx. how much inhaled O2 dissolves into blood plasma and how much is bound to Hemoglobin?

A
  1. 5% dissolved into blood plasma (can diffuse)

98. 5% bound to hemoglobin (cannot diffuse)

181
Q

What is the most important factor that determines how much O2 is bound to hemoglobin?

A

Partial Pressure of O2

182
Q

Higher PO2 means what regarding O2 bound to hemoglobin?

A

Higher PO2 = More O2 Bound to Hemoglobin

183
Q

These are triangular pieces of mostly hyaline cartilage located at the posterior, superior border of the cricoid cartilage and for synovial joint w/ cricoid cartilage allowing for mobility of the vocal cords?

A

Arytenoid Cartilage (gives rise to true vocal cords)

184
Q

The Arytenoid Cartilage and the synovial joints w/ cricoid cartilage play what role in sound?

A

Influence change in vocal cords position and tension to produce sound

185
Q

What cartilage of the Larynx has a horn shape, very small, and sits atop the arytenoid cartilage?

A

Corniculate Cartilage

186
Q

The Corniculate Cartilage gives rise to what?

A

Vestibular/Ventricular ligaments (FALSE VOCAL CORDS)

187
Q

What Cartilage of the larynx is non-articulating, sits anterolateral and superior to corniculate cartilage, moves w/both corniculate and arytenoid cartilages, supporting movement of both vocal folds?

A

Cuneiform Cartilage

188
Q

The lining of the larynx (larynx Histology) inferior to the vocal cords consists of what type of tissue?

A

Pseudostratified Ciliated Columnar Epithelium

189
Q

The Pseudostratified Ciliated Columnar Epithelium of the larynx inferior to the vocal cords also contains what cells? What do the cells provide/produce?

A
  • Ciliated Columnar Cells: Move particles up to pharynx
  • Goblet Cells: Produce mucus to help trap dust
  • Basal Cells: Provides structure and Strength
190
Q

What are the Two pairs of folds found in the Larynx that are structures of sound production?

A

Vestibular/Ventricular Folds

Vocal Folds

191
Q

Which fold is considered the False vocal Cords?

A

Vestibular/Ventricular Folds

192
Q

Which fold is the inferior pair of the two folds in the larynx for sound production?

A

Vocal Folds

193
Q

The True vocal cords are which pair of structural folds in the larynx?

A

Vocal Folds

194
Q

Which pair of folds is the superior pair in the Larynx?

A

Vestibular/Ventricular Folds

195
Q

These folds close together to help hold the breath against pressure in the thoracic cavity?

A

Vestibular/Ventricular folds

196
Q

What is the principal structure of normal voice production?

A

Vocal (Inferior, true) Folds

197
Q

The elastic ligaments for the true vocal cords are stretched between which rigid cartilage segments?

A

Thyroid Cartilage

Arytenoid Cartilage

198
Q

When the rima glottidis is narrowed due to the contracting of the laryngeal muscles what is occurring regarding the vocal cords?

A

Vocal Cords are Adducted

199
Q

Air passing over the cords produces what?

A

Sound/ Phonation (speaking) by vibrating the cords

200
Q

What occurs with the produced sound with greater air pressure?

A

Louder sound is produced

201
Q

A tight vocal cord produces what pitch sound?

A relaxed vocal cord produces what pitch sound?

A

Tight: Higher Pitch
Relaxed: Lower Pitch

202
Q

What is occurring during Whispering?

A
  • Closing of all but posterior portion of rima glottidis

- Cords don’t vibrate

203
Q

How is intelligible speech formed?

A

Changing the shape of oral cavity as we enunciate (resonance quality changes)

204
Q

What structures help with voice production by acting as resonating chambers?

A

Pharynx, mouth, nasal cavity, and paranasal sinuses

205
Q

What sounds are made by constricting/relaxing muscles in the wall of the pharynx?

A

Vowel Sounds

206
Q

Consonant sounds are made by movement of what?

207
Q

What helps in enunciation of both vowels and consonants?

A

Muscles of the face, lips, and tongue

208
Q

What is the typical difference between male and female vocal cords and what provides the difference?

A

Male: Thicker, longer–> Slower vibration, lower pitch
Female: Thinner, shorter–> faster vibration, higher pitch
-Androgen influence on males

209
Q

What is the name of the tubular passageway for air that lies anterior to esophagus and is apporx. 5 inches long and 1 inch in diameter?

210
Q

The trachea typically extends from where to where?

A

Larynx to superior border of T5

211
Q

At the level of T5 what typically occurs to the trachea?

A

Divides into right and left primary bronchi

212
Q

Name the layers of the Trachea from exterior to lumen?

A
  1. Adventitia
  2. Hyaline Cartilage
  3. Submucosa
  4. Mucosa
213
Q

The Hyaline Cartilage rings characteristics?

A
  • 16-20 horizontal rings stacked, “C-shape”, incomplete
  • Opening posterior, facing esophagus
  • Semi-rigid, prevents collapse
214
Q

The posterior opening of the tracheal rings characteristics.

A
  • Fibromuscular membrane
  • Trachealis Muscle: inside membrane, smooth transverse muscle
  • Elastic connective tissue allows diameter change
215
Q

The submucosa consist of what type of tissue and contains what?

A

Areolar connective tissue

Seromucous glands and ducts

216
Q

Mucosa layer of the trachea consists of what tissue?

A

Pseudostratified ciliated columnar epithelium (dust protector)

217
Q

Give the Bronchial Tree Flow Chart for Right and Left Lungs?

A 
Primary Bronchus:  1 R and 1 L
Secondary (Lobar) Bronchi: 3 R and 2 L
Tertiary (Segmental) Bronchi: 10 R and 10 L
Lobular bronchioles
Terminal Bronchioles
Respiratory bronchioles
Alveolar Ducts
Alveolar Sacs
Alveolus
218
Q

State the histology of the Bronchi (1,2,3 degrees)?

A
  • Hyaline Cartilage: incomplete ring
  • Pseudostratified ciliated columnar epithelium (dust protector)
  • Goblet secretory cells
  • Serous/mucous glands
219
Q

The bronchioles to terminal bronchioles have what type of epithelium and secretory cells?

A
  • Simple Column Ciliated

- Goblet & Exocrine (Clara/Club)

220
Q

Describe what is occurring to the cartilage as the bronchi transition down to the bronchioles?

A

Bronchi: Rings turn into plates
Bronchi (Tertiary, terminal, respiratory): smaller plate
Bronchioles: Complete smooth muscle, no cartilage

221
Q

What represents the end of the conducting zone of the respiratory system?

A

Terminal Bronchioles

222
Q

What function do the Bronchioles have?

A

Exocrine Function: Contain Clara(club) cells

  • Columnar, non-ciliated cells interspersed
  • Protect against toxins and carcinogens
  • Produce/secrete: surfactant (liquid/mucous)
  • Stem Cells (reserve cells): give rise to cells in epithelium
223
Q

Describe what is occurring in the bronchioles when there is sympathetic stimulation, such as in exercise?

A
  • Release of epi and norepi from adrenal medulla
  • Cause relaxation of smooth muscles in bronchioles
  • Allows more O2 to alveoli, improved ventilation
  • More O2 to muscle tissue
224
Q

Describe what is occurring in the bronchioles when there is parasympathetic stimulation, such as at rest?

A
  • Release of Ach from Postganglionic fibers
  • Cause contraction of smooth muscles
  • Reduces ventilation
225
Q

What is a chronic respiratory disease, characterized by episodic bronchoconstriction and mucous secretion, resulting in increased airway resistance and dyspnea?

226
Q

What separates the two pleural cavities that contain the lungs?

A

Mediastinum

-Heart, Aorta, Thymus Gland, Chest Portion of Trachea, Esophagus, Lymph nodes, Nerves

227
Q

What encloses and protects each lung?

A

Pleural Membrane: double layered serous membrane

  • Parietal Pleura: Superficial thoracic cavity wall lining
  • Visceral Pleura: Deep layer covers lungs
228
Q

What is the Pleural Cavity?

A

Space between Parietal Pleura and Visceral Pleura

  • Smooth movement between layers
  • Contains 8-10 mL of fluid
229
Q

Describe the Pleural fluid and what it provides?

A

2-10cc in cavity space

  • 100cc per/hr made parietal layer and drained at visceral layer and lymphatics
  • Provides surface tension (Layers “Adhere” and slide)
230
Q

What term describes increased fluid in the pleural cavity?

A

Pleural Effusion

231
Q

What term describes decreased fluid in the pleural cavity?

232
Q

What may inflammation of either or both layers of the pleura cause?

A

Reduced surface tension

-Pain with breathing, chest wall pain

233
Q

Air trapped in the pleural cavity may cause what? This allows what to occur to the lung? What must be done?

A

Pneumothorax

  • Loss of surface tension: Lung deflates
  • Remove air to inflate lung
234
Q

What is collapse of a part/whole lung called?

A

Atelectasis

235
Q

Name some causes of Atelectasis?

A

Air, Blood, Pus, Obstruction

  • Reduced breathing depth (Elderly, fractures)
  • Typically in distal portions
236
Q

Name the number of lobes and segments for each for the right and left lungs?

A 
Right: 3 Lobes
Superior Lobe: 3 Segments
Middle Lobe: 2 Segments
Inferior Lobe: 5 Segments
Left: 2 Lobes
Superior Lobe: 5 Segments
Inferior Lobe: 5 Segments
237
Q

What is the medial projection of the inferior aspect of the superior left lobe called?

A

Lungula (Helps Protects the heart)

238
Q

Where is the only place the lung is able to be palpated?

A

Supraclavicular Space: the apex of the lung

239
Q

Which lung is thicker and broader but shorter?

A

Right lung due to Liver

240
Q

Which lung is thinner and slightly smaller?

A

Left lung due to cardiac notch (10%)

241
Q

What is the anterior portion of the lungs that lie against the ribs?

242
Q

The Oblique (Major) Fissure separates what in the left lung?

A

Superior and Inferior Lobes

243
Q

The Oblique (Major) Fissure separates what in the right lung?

A

-Inferior and Middle Lobes, small portion of lateral aspect of superior and inferior lobes

244
Q

The Horizontal (minor) fissure separates what in the right lung?

A

Superior and middle lobe

245
Q

What is a Bronchopulmonary segment? How many per lung?

A

Segment of lung tissue supplied by one tertiary bronchus

-10 ea Lung

246
Q

The Segments are broken down into compartments called what?

247
Q

What is contained in each lobule and describe the tissue?

A
  • Lymphatic Vessel
  • Arteriole
  • Venule
  • Branch of terminal Bronchiole
  • Wrapped in elastic connective tissue
248
Q

The terminal Bronchioles in the Lobules of the Bronchopulmonary segments further divided into what?

A

Respiratory Bronchioles (multiple)

249
Q

What is significant of the respiratory bronchioles?

A

Alveoli begin budding

  • Gas exchange begins
  • Respiratory Zone starts at Respiratory bronchioles
250
Q

How many levels of branching occur from Trachea to Alveolar Ducts?

251
Q

What portion of the lung anatomy makes up the microscopic airways?

A 
Terminal Bronchioles
Respiratory Bronchioles
Alveolar Ducts
Alveolar Sacs
Alveoli
252
Q

Describe an Alveolar sac and give another name it may be called.

A

Two or more alveoli sharing same alveolar duct (grapes)

-ACINUS

253
Q

What is a cup-shaped out-pouching from alveolar duct?

254
Q

Alveolar Fluid is a complex mixture of what?

A

Phospholipids and Lipoproteins that contains surfactant

255
Q

What releases surfactant?

A

Clara/club cells in terminal bronchioles

256
Q

What is the function/role of surfactant?

A

-Lowers surface tension of alveolar fluid
-Reduces tendency of alveoli to collapse (patency)
(Reduces inward pressure pulling alveoli walls together)
-Allows alveoli to open w/less air pressure (increases compliance)

257
Q

Where is high surface tension important?

A

Pleural Cavity: keep the parietal and visceral layers together (keep lungs inflated)

258
Q

Where is low surface tension important?

A

Alveoli to keep layers apart

259
Q

Where does diffusion take place of O2 and CO2?

A

Alveolar and Capillary Walls

260
Q

The respiratory membrane (Alveolar and Capillary Walls) are how thick?

A

0.5 micrometers thick (1/16th of an RBC)

Allows for rapid diffusion

261
Q

What is the estimated amount of alveoli the lungs contain and what is the approx. surface area?

A

300 million

750ft^2

262
Q

Describe what occurs when the External Intercostal Muscles contract.

A
  • Elevate the ribs
  • Increase anteroposterior and lateral diameters of chest cavity
  • Account for 25% of inspired air
263
Q

What is the approx. pleural pressure just before inhalation?

264
Q

The Parietal and visceral pleurae adhere tightly because of what?

A

Subatmostpheric pressure

Surface tension

265
Q

What are the accessory muscles of inhalation and what do they move?

A

Sternocleidomastoids: Elevate Sternum
Scalenes: Elevate first two ribs
Pectoralis Minors: Elevate 3-5 ribs

266
Q

When are accessory muscles used?

A

Deep, forceful inhalation

267
Q

What makes inhalation an active process?

A

Muscular Contraction

268
Q

What makes normal exhalation a passive process?

A

Does not include muscular contraction

269
Q

Elastic Recoil occurs from what two inwardly directed forces?

A

Recoil of elastic fibers during inhalation

Inward pull of surface tension of the film of alveolar fluid

270
Q

When does exhalation begin?

A

Relaxation of inspiratory muscles

271
Q

At the beginning of exhalation the alveolar (intrapulmonic) pressure increases to what?

272
Q

State the Law of Laplace.

A

Pressure inside a spherical (curved) surface is inversely proportional to its radius

273
Q

What is the formula expressing the Law of Laplace

A 
P = 2T/r
P=Pressure
T=Tension
r=radius
(explains why smaller alveoli have higher pressure)
274
Q

What syndrome is found in premature newborns born before their lungs have capability of producing surfactant, alveoli collapse easier, reduces breathing capability?

A

Respiratory Distress Syndrome (RDS)

Typically enough surfactant production by 35 weeks

275
Q

What is caused by anything that causes alveoli to collapse (Ventilated, constrictive pressure, Pneumonia, Neuromuscular disease), or is a partial or complete collapse of the lung?

A

Atelectasis

276
Q

What does Compliance of the lungs refer to?

A

Measure of how much effort is required to stretch the lungs and chest wall

277
Q

What is high compliance?

A

Lungs and chest wall expand easily

278
Q

What is low compliance?

A

Lungs and chest wall resist expansion

279
Q

What determines compliance? Why do lungs normally have high compliance?

A

Elasticity and Surface Tension

-Elastic fibers in lung tissue and surfactant in surface tension

280
Q

Name some causes that will decrease compliance of the lungs?

A
  • Scarred lung tissue (tuberculosis)
  • Fluid filled lung tissue (Pulmonary edema)
  • Surfactant deficiency
  • Impediment of lung expansion (paralysis of intercostal)
  • Destruction of elastic fibers (emphysema)
281
Q

Airway resistance is especially found in the walls of what portion of the airway?

A

Bronchioles

282
Q

What decreases and increases airway resistance?

A

Decrease:
-Lung expansion- bronchiole walls expand
Increase:
-Lung recoil- bronchiole walls shrink

283
Q

What else plays a role in bronchodilation and decreasing airway resistance?

A

Sympathetic ANS stimulation of smooth muscle in walls

284
Q

What is Eupnea?

A

Normal pattern of quiet breathing

can consist of shallow, deep, or combined breathing

285
Q

What is Costal Breathing?

A
  • Pattern of shallow (chest) breathing

- Upward and outward movement of chest due to contraction of external intercostal muscles

286
Q

Describe Diaphragmatic Breathing?

A

Pattern of deep breathing

-Outward movement of abdomen due to constriction and descent of diaphragm

287
Q

What occurs in the blood by increasing the pressure of O2 above that of the atmosphere, such as in a hyperbaric chamber?

A

Increases the amount of O2 dissolved in blood

288
Q

What can a Hyperbaric Chamber be used to treat?

A 
Anaerobic Bacterial Infections
Certain heart Disorders
Carbon Monoxide Poisoning
Gas Embolisms
Cerebral Edema
Smoke Inhalation, Asphyxia
289
Q

If labs were drawn on a patient with CO poisoning what values may be seen?

A
  • Normal or elevated PaO2
  • SaO2 Decrease
  • SpO2: false normal reading due to colormetric (red)
290
Q

What lab should be drawn and what is the treatment for CO Poisoning?

A

Serum Carboxyhemoglobin Level

100% O2

A&P II IPAP 3-17 (12 decks)

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