Respiratory Flashcards
1
Q
What is the function of the nose?
A
adjusts temperature and humidity of inspired air, traps and removes particles and olfaction
2
Q
What are the Nasal cavity regions?
A
Olfactory
Respiratory
Nasal Vestibule
3
Q
What is a nasal concha and what do they do?
A
several thin, scroll-shaped bony elements forming the upper chambers of the nasal cavities.
They increase the surface area of these cavities, thus providing for rapid warming and humidification of air as it passes to the lungs
4
Q
What is inside the nasal cavity?
A
Meatuses Superior nasal meatus Middle nasal meatus Inferior nasal meatus Spheno ethmoidal recess
5
Q
What is the innervation of the nose?
A
Olfactory nerve which provides the sense of smell.
6
Q
What is the paranasal sinuses?
A
group of four paired air-filled spaces that surround the nasal cavity.
Opens into nasal cavities to allow drainage of mucus
Functions – lightening the skull, resonance and absorbing shock
7
Q
Name the four paranasal sinuses?
A
Maxillary
Frontal
Ethmoidl
Sphenoisal
8
Q
What is paranasal Sinuses Drainage?
A
Mucus produced by mucous membrane moved by ciliary action and by siphon action created during blowing of your nose
9
Q
What is the pharynx?
A
- body cavity that connects the nasal and oral cavities with the larynx and esophagus
- referred to as the throat
- function in the process of swallowing
- pathway for the movement of food from the mouth to the esophagus
10
Q
What is the larynx?
A
- houses the vocal folds
- manipulates pitch and volume essential for phonation
- situated just below where the tract of the pharynx splits into the trachea and the esophagus.
11
Q
What are the three parts to the pharynx?
A
nasopharynx
oropharynx
larygopharyx
12
Q
Name the muscles of the pharynx
A
· Superior constrictor · Middle constrictor · Inferior constrictor · Pharyngeal raphe · Oesophagus
13
Q
What is a eustachian tube?
A
· A tube that links the nasopharynx to the middle ear
· Normally tube is collapsed but opens during swallowing and with positive pressure
14
Q
What are tonsils?
A
· Collections of lymphoid tissue in mucosa of pharynx
15
Q
Location of the larynx…
A
below the trachea
16
Q
Function of larynx…
A
· Functions as a valve to close the lower respiratory tract and instrument to produce sound
17
Q
Describe the strucutre of larynx
A
· Three large unpaired cartilages – epiglottis, thyroid and cricoid
· Three smaller cartilages – cuneiform, corniculate and arytenoid
· Suspended from hyoid bone – highly mobil
18
Q
What is the innervation of the Larynx
A
· Branches of the vagus nerve (CN10)
· Sensory above the vocal cords is the superior laryngeal
· Sensory below the vocal cords is the recurrent laryngeal
o Left nerve loops under aortic arch the upwards
o Right nerve loops under right subclavian artery then upwards
· Motor supply to all muscles except cricothyroid (superior laryngeal) via recurrent laryngeal
19
Q
The upper respiratory tract is made up of ….
A
masal cavity
pharynx
larynx
20
Q
The lower respiratory tract is made up of….
A
Trachea
R+L main Bronchus
Bronchioles and remainder of the lungs
21
Q
Which artery does not go through the diaphram?
A
Subclavian artery
22
Q
What nerve is responsible for innervating the diaphram?
A
Phrenic Nerve
23
Q
What cannot be measured by spirometry?
A
Residual Volume
24
Q
Describe the simple airflow?
A
Air comes into nasal cavity
then oral cavity
down the trachea
and into the lungs
25
Anatomy of the lower respiartoyr tract
```
trachea
right main bronchus
Left main bronchus
Secondary/ lobar bronchus
tetiary/segmental bronchus
terminal bronchus
bronchiole
```
26
Characteristics of right main bronchus are....
wider
shorter
more vertical
27
Characteristics of left main bronchus are....
Narrower
longer
more horional
28
How many lobes does the secondary bronchus have?
Right: 3
Left:2
29
What is the carina?
the middle bit just before the split into right and left main bronchus.
This happens in T5
30
How many segments do the tertiary bronchus have?
Right: 10
Left:8
31
What are the fissures called in the lungs
Oblique and horizontal
| left only has oblique
32
What is the role of surfactants?
Reduce lung surface tension
33
What is responsible for the control of breathing?
Medulla Oblongata
34
What do the phrenic and intercoastal nerves do?
They stimulate the diaphram and external intercostal muscles respectively
35
Respiration is the result of.....
Pressure/volume changes in the thorax which are driven by muscle contraction and relaxation.
36
Air will always move from an area of _____ pressure to an area of ____ pressure.
higher
| lower
37
Describe what happens at inspiration
the diaphram contracts (flattens) and the rib cage moves up and out when the external intercostals contract
38
Describe what happens at expiration
The diaphram and external intercoastal relax
| The ling has elastic recoil.
39
What muscles are involved in forced inspiration?
accessory muscles (eg pectoralis major and scalene and sternocleidomastoid ) . These contract
40
What are the muscles involved in expiration
internal intercostals, rectus abdominis, transversus abdominis, internal oblique and external oblique . Also internal intercoastal
41
What is spirometry?
measurement of breathing.
| Simple and safe test that results in a graphical display to give an estimation of lung function
42
What can spirometry diagnose?
COPD
Asthmas
other restrictive diseases (ILD)
43
What does spirometry specifically measure?
FVC- amount of air expekked in a maximun expiration
| FEV1- amount of air forcefully expelled in one second
44
If the spirometry reading is below 0.7, it is.........
obstructive
45
If the spirometry reading is between 0.7-0.8 it is.........
normal
46
If the spirometry reading is above 0.8, it is.........
restrictive
47
Define expiratory reserve capacity ERV
The maximum volume of air that can be voluntarily exhaled
48
Define inspiratory reserve capacity IRC
the maximum volume that can be inhaled above the tidal volume
49
Define residual volume RV
Volume always lefr in the lungs after a maximal expiratory effort (cannot ever be exhaled)
50
Define vital capacity VC
the maximum volume that can be inhaled and exhaled
51
Define total lung capacity TLC
the entire volme of the lung. Approx 5 litres
52
What is minute ventilation and how do you work it out?
THe volume of air moved in and out of the lungs within 1 minute
Minute ventilation = tidal volume x breathing frequency
53
When might minute ventilation increase?
excerise
54
What is diffusion capacity?
Measures the ability of th elungs ti extract oxygen from inhaled air to pulmonary capillaries
55
Which factors determine the diffusion capacity?
Hb levels and how well gas diffuses
56
What is the Graham's law ?
The rate of diffusion is directly proportional to the solubility coefficient of the gas and inversely proportional to the square root of its molecular weight
57
How do you apply Graham's law to breathing?
Carbon dioxide is 22 times more soluble than oxygen and is much larger in size. Relevant to gas exchange at the alveoli
58
What is Fick's law?
The amount of gas diffusing in unit time through the resistance of a barrier is inversley proportional to the thickness of the barrier and directly proportional to the surface area of the barrier, the diffusion constant and the partial pressure difference of each side
59
How do you apply Fick's law to breathing?
The thicker the barrier, the harder it is for something to dissolve through it. The greater the surface area of the barrier, the easier it is for something to dissolve through it.
60
What is Henry's law?
The solubility of a gas in a liquid is dependent upon the partial pressure odf the gas in th eair and the solubility coeffivient of the gas in the liquid.
61
How do you apply Henry;s law to breathing .
To increase the solubility of CO2 in fizzy drinks, the bottle is sealed under high pressure.
To avoid the bends, the tanks used bu scuba divers are filled with air diluted by helium.
62
What is Dalton's law?
The total pressures is equal to the sum of the partial pressures.
(the partial pressure of a gas in a gas mixture is the pressure that gas would exert id it occupied the total volume of th emixture in the absence of the other components)
63
What is Boyle's law?
The pressure of given mass of an ideal gas is inversly proportional to its volume ata aconstant temperature.
64
What is pulmonary ventilation?
The volume of air that moves in (or out) of the lungs per minute.
65
What is alveolar ventilation?
(tidal vol - dead space) x breaths per min
66
What is dead space?
Volume of gas contained in the conduction airways and alveoli that does not participate in gas exchange. There is no gaseous exchange in dead space.
67
What is the role of surfacant?
* Stabilising alveolar size
* Laplace Law (prevents the alveoli collapsing under the pressure during expiration)
* Increases lung compliance. Prevents small alveoli joining to form larger alveoli.
* Keeping lungs dry (by absorbing water from nearby bronchioles)
* Reduce surface tension
68
What are the lung defence mechanisms?
```
Mucociliary escalator and Airway surface liquid
Cough reflex (lower RT) and sneeze reflex (upper RT)
Innate and adaptive immune defence
```
69
What happens when the lung defence mechanisms stop working?
It can cause cystic fibrosis and other airway pathophysiology
70
What is the mucociliary escalator?
Made up of ciliated airway epithelial cells and airway surface liquid.
The ASL can be further subdivided into an upper gel layer (made oof mucins) and a lower peri-ciliary solo layer (made up of liquid)
71
We always keep ASL a level of ____
7um
72
Where are alveolar macrophages derived from.....
circulationg moncytes
73
What is the function of alveoar marcophages
They dispose of dead cells, cell debris, particulate matter and invading micro-organisms by phagocytosis.
74
What do central chemoreceptors do?
Central chemoreceptors detect changes in the H+ level in the CSF. (Co2 diffuses into the CSF. The Co2 then transforms into bicarbonate and hydrogen ions in the CSF which are detected.)
75
What do cartoid chemoreceptors do?
detect changes in the PaO2.PaCO2 and pH
76
WHat do aortic chemoreceptors do?
detect chanes in PaO2 and PaCO2
77
What is the Hamburger shift?
HCO3- are exchanhed for Cl-
| this maintains electical balance in red blood cell and plasma
78
WHat is the Bohr effect?
Hydrogen ions cause HbO2 to give up O2
79
What is the Haldane Effect
Co2 binds better to HbH than the HbO2
80
On a Oxygen Hemoglobin dissciation curve a shift t to the LEFT would result in.....
Increased affinity for O2
- Dec in pCO2
- Dec in H+ (inc pH)
- Dec 2,3-DPG
- Dec Temp
81
On a Oxygen Hemoglobin dissciation curve a shift t to the RIGHT would result in.....
Decreased affinity for O2
- Inc in pCO2
- Inc in H+ (dec pH)
- Inc 2,3-DPG
- Inc Temp
82
What is the effect of high altitude on breathing?
- The % composition of air does not change
- pp of the constituents all fall with decreasung barometric pressure during ascent
- falling PaO2 reduces the partial pressure gradient driving O2 uptake and causes hypoxia (low O2 levels)
83
What does hypoxia lead to
sensory and cognitive functions to decline.
84
Adverse Effects to Hypoxia
Acute – headache, irritability, insomnia, dyspnoea, dizziness and nausea
Chronic – bronchoconstriction stresses right side of heart – causing heart failure and pulmonary oedema
85
What is the response on diving?
External hydrostatic pressure increases with increased depth
| REMEMBER water is denser than air, so pressure rises quickly with increased depth
86
What are the effects of depth?
- Water squeezes and compresses the body from all sides
- Compresses gas within the alveoli – increases the partial pressures of all gases and decreases the alveolar volume
- At seas level, only O2 and CO2 can dissolve in the blood to a signifcant extent.
- Diving increases the partial pressure of all gases- meaning all gases can dissolve into our blood leading to potential lethal effects.
87
Does nitrogen have any signifcant effect on body functions at sea level?
No- it does noy dissolve into our tissues
88
At what point can nitrogen rise to which it dissolves in celll membranes in amounts that are sufficient to disruot ion channel function
at depths of 40m or more
| Nitrogen nacrosis
89
What are high nitrogen effects similiar to?
ethanol
90
At depths of 40m or more what do divers breath in?
a mix of helium and oxygen called heliox
91
What happens when divers breath in heliox?
Helium replaves nitrohen because it dissolves in the body tissues less readily and is therefore less narcotic and helium is less dense than N2.
92
When divers ascend too quickly they form...
pure nitorgen bubbles
93
What doe pure nitrogen bubbles do ?
they block blood vessels causesing dependent tissues to become ischaemic (pain in joints and limb muscles)
94
What is it called when diveres produces pure nitorgen bubles?
the bends
95
What happens to breathing when excersing?
* Muscle cell respiration increases - more oxygen is used up and levels of CO2 rise
* The brain detects increasing level of CO2 - a signal is sent to the lungs to increase breathing
* Breathing rate and the volume of air in each breath increases.
* This means that more gaseous exchange is taking place
* The brain also tells the heart to beat faster so that more blood is pumped to the lungs for gaseous exchange
* More oxygenated blood gets to the muscles and more CO2 is removed
96
Respiration is pregnancy?
* Mechanics of respiration change - ribs flare outwards and diaphragm moves upwards by 4cm
* Tidal volume increases by 200ml, resulting in a 5% increase in vital capacity and a 20% decrease in residual volume
* Respiratory rate does not change
* The end result is an increase in minute ventilation and a decrease in PaCO2
* The PaO2 is essentially unchanged
* A compensatory decrease in bicarbonate ions enables the pH to remain unchanged
* Pregnancy therefore represents a compensated respiratory alkalosis
97
What is Asthma?
an inflammatory disease of the airways to the lungs. It makes breathing difficult and can make some physical activities challenging or even impossible
98
What is Tuberculosis Tb?
potentially serious infectious disease that mainly affects your lungs. The bacteria that cause tuberculosis are spread from one person to another through tiny droplets released into the air via coughs and sneezes.
99
What is Pneumonia ?
form of acute respiratory infection that affects the lungs. The lungs are made up of small sacs called alveoli, which fill with air when a healthy person breathes. When an individual has pneumonia, the alveoli are filled with pus and fluid, which makes breathing painful and limits oxygen intake
100
What is Lung cancer ?
a condition that causes cells to divide in the lungs uncontrollably. This causes the growth of tumors that reduce a person's ability to breathe.
101
What is Cystic fibrosis ?
an inherited condition that causes sticky mucus to build up in the lungs and digestive system. This causes lung infections and problems with digesting food.
102
What is Thromboembolic disease?
, blood clots (thrombi) form in blood vessels. An embolus is a blood clot that travels through the bloodstream and blocks an artery. Common cause of death in women.
103
What is Pneumothorax?
when air leaks into the space between your lung and chest wall. This air pushes on the outside of your lung and makes it collapse.
