Respiratory Anatomy and Physiology Flashcards
1
Q
The movement of gases across a cell membrane
A
Respiration
2
Q
Between the alveoli and the capillaries
A
External respiration
3
Q
Between the capillaries and the cells
A
Internal respiration
4
Q
Mechanical movement of air in and out of your lungs
A
Ventilation
5
Q
Superior most portion of the sternum
A
Manubrium
6
Q
Largest part of the sternum
A
Sternal body
7
Q
Cartilage, inferior most portion of the sternum
A
Xiphoid process
8
Q
At what manubriosternal joint does the trachea biferaction occur under?
A
Angle of Louis
9
Q
_____ runs on the inferior aspect of each rib
A
Neurovascular bundle
10
Q
Musculature (I-IV)
A
Diaphragm, intercostals, innermost layer, accessory muscles
11
Q
In an adult, the diaphragm povides ___% of the effort of breathing. In children the diaphragm provides __% of the effort of breathing.
A
60, 75
12
Q
The diaphragm consists of what muscle type?
A
Involuntary (smooth) and voluntary (skeletal)
13
Q
What nerve controls the diaphgram?
A
Phrenic nerve
14
Q
Types of intercostal muscles
A
External intercostals-run anteriorly/inferiorly (towards the front and downwards)
Internal intercostals-run posteriorly/inferiorly
15
Q
Why do the intercostals run in a criss cross orientation?
A
To lift the rib cage
16
Q
Innermost layer is arragned_____
A
Vertically
17
Q
The innermost layer cause the ribcage to get____. Used in _____
A
Smaller
Forced exhalation
18
Q
Accessory muscles
A
Pectorial, abdominal, neck muscles, sternocledomastoid
19
Q
The angle of louis iat as the ___ rib attachment point
A
Second
20
Q
What is the line of demarcation for the upper and lower airways
A
Vocal cords
21
Q
Increases surface area in the nasal cavity
A
Turbinates
22
Q
Turbinates contain___ and they are _____. Both of these items contribute to them filtering, warming and humidifying
A
Ciliated goblet cells
Vascular
23
Q
Purpose of the turbinates
A
- Filters
- Warm air (because vascular)
- Humidifies (goblet cells keep things moist)
24
Q
Purpose of sinuses
A
Drainage-drains fluid from the nasopharynx
Resonance
Lightens skull
25
Four sinus areas
1. Frontal sinus
2. Ethmoid sinus
3. Spenoid sinus
4. Maxillary sinus
26
What two sinus areas give one a headache when one has a sinus infection?
Ethmoid and sphenoid sinuses
27
What connects the middle ear with the sinuses?
Eustachian tubes
28
Superior most portion of the larynx (really in the pharynx), leaf shaped, protects the airway located in the hypopharynx
Epiglottis
29
Largest portion of the larynx, most prominant, known as the "voice box" ecause it houses vocal cords
Thyroid cartilage
30
Circular cartilage, inferior most part of the larynx. Anchor for the trachea
Cricoid cartilage
31
What do you put pressure on if there is gastric distension. If you push on it, it will close off the esophagus
Cricoid cartilage
32
When vocal cords snap shut and prevent air from getting in
laryngospasm
33
Landmark for surgical airways
Cricothyroid membrane
34
Three parts of the pharynx
Nasopharynx, oropharynx, hypopharynx
35
Upper and lower airway is made of the:
Pharynx and larynx
36
______ are embedded in the epithelial lining of the smooth muscle of the trachea
Epithelial goblet cells
37
Purpose of goblet cells in the trachea?
Create mucus and trap debris to filter out debris
38
Where are the epithelial cells in the trachea?
The lining of the lumen
39
Double layered reflecting serous membrane that covers the lung
Pleura
40
Means produces fluid
Serous
41
Covers the lining of the lung itself
Visceral pleura
42
Layer of the serous membrane that covers the chest wall
Parietal pleura
43
Thin layer of secretion between the visceral and parietal pleura creates _____ that allows the lung to attach to the chest wall
Surface tension
44
What issues may lead to the collapse of the lung due to a lack of surface tension?
Chest trauma such as a tension pneumothorax
45
Difference between left and right lungs
Right has a larger diameter (feeding three lobes) and at less of an angle. Left is more horizontal because heart is in the way
46
If you aspirate, which lung will the item most likely go into?
The right lung
47
Space between the hemithoraxes
Mediastenum
48
Each lung is located in a _____
Hemithorax
49
Items within the mediastenum
Esophagus, heart, great vessels, part of the trachea
50
The great vessels consist of
Aorta, pulmonary artery, superior/inferior vena cava, pulmonary viens
51
What we inhale (i.e. room air) consists of:
21% oxygen
76% nitrogen
3% other
52
What we exhale consists of:
16% oxygen
76% nitrogen
CO2
53
What is the point at which the atmosphere will not support us, deficient in oxygen (i.e. you need to use a breathing apparatus)?
19.5%
54
Movement of gases is based on____
Diffusion, i.e. a concentration gradient
55
Diffusion occurs until you achieve ____
Equilibrium
56
How do we reset the CO2 concentration gradient?
Exhaling
57
For respiration, when a steady state is achieved, need to re-set the system. The O2 concentration gradient is re-set when?
Whenever the heart beats
58
Cells in the aveoli where gas exchange occurs
Type I cells
59
Type I cells have ____that allow gas exchange to occur more easily between type 1 cells and capilliary walls. Makes them more permeable
Repiratory membranes
60
Cells in the aveoli that produce surfactant
Type II cells
61
Surfactant serves as a ____ for water. Prevents ____
Dispersal agent
| Surface tension
62
Surface tension in the aveoli will cause ____
Atelectasis
63
When is surfactant produced?
In the last month of gestation
64
Air that you move in a resting ventillation
Tidal volume
65
Minute volume
Tidal volume (volume/breath) x Respiratory rate (breath/minute)
66
Average adult minute volume
500cc/breath x 16 breaths/minute=8L/minute
67
Areas not in aveoli, where there is no gase exchange
Dead space
68
Two types of dead space
Anatomic dead space
| Physiological dead space
69
Non-aveolar space (trachea, pharynx, etc), approximately 150 cc
Anatomic dead space
70
Non functioning aveoli (COPD, pulmonary edema)
Physiological dead space
71
Additional reserve air that you can bring in
Inspiratory reserve volume
72
Additional air that you can exhale
Expiratory reserve volume
73
Air left over after a forced exhalation. Can be around 2L
Residual volume
74
Vital capacity+residual volume
Total lung capacity
75
IRV+VT+ERV
Vital capacity
76
What do we see decrease with air. Makes it more difficult to compenstate when there is an issue, i.e. trauma
Vital capacity
77
Factors that increase the work of breathing:
Resistence in the respiratory system (bronchoconstriction)
Compliance-loss of elasticity
Surface tension-atelectasis
78
Fraction of inspired O2
FiO2 (i.e. FiO2 from air is 0.21)
79
FiO2 if nasal cannula at 3l/m
4% per liter/minute->.04x3=.12+FiO2RA .21=.33
80
FiO2 for non-rebreather mask
0.95
81
FiO2 for BVM + O2 tank
1
82
Receptors that help us mediate breathing are a type of:
Neurological control
83
Receptors that help us mediate breathing:
Irritant
Stretch receptors
J receptors
84
Receptors that are embedded in the airways. When detects irritant, stimulate a cough. Triggers parasympathetic response
Irritant
85
Receptors that are embedded in the aveoli. Designed to prevent overinflation.
Stretch receptors
86
What will stretch receptors do if activated?
Cause reduction in respiratory rate
| Reduce tidal volume
87
Associated with capillary beds. Do not want perfusion as a baby in womb (because lungs filled with liquid), so need to tell brain
J receptors
88
What is responsible for regulating breathing
Brainstem-pons and medulla
89
The medulla contains the ____ and _____, which are responsible for regulating breathing
Dorsal respiratory group (DRG)
| Ventral respiratory group (VRG)
90
Responsible for normal breathing. Sends out nerve impulses at intervals (2 blasts stimulation, 3 second inactivity)
Dorsal respiratory group (DRG)
91
Why does the DRG send out nerve impulses at a ration of 2/3
Pressure decreases and openig airways. When breath out, airway closes, so spend more time exhaling because the airways are more constricted
92
Inactive during normal respiration. Supplements the DRG
Ventral respiratory group (VRG)
93
When stimulate the VRG no longer exhale ____ because accessory muscles activate
Passively
94
Inspiratory neurons that help with inspiration
VRGi
95
Expiratory neurons that help with expiration
VRGe
96
Centers in the pons that helps with breathing:
Apneustic center
| Pneumotaxic center
97
Stimulated when you are in extremis. Stimulates DRG and VRGi. Purely inspirational
Apneustic center
98
Inhibits apneustic center, stimulates VRGe, prevents overinflation
Pneumotaxic center
99
The pneumotaxic center is triggered by _____
Stretch receptors that feed into the medulla
100
Why may the pons and medulla's ability to interact be compromised
Increasing ICP will push down on brainstem
101
What sort of breathing may result from increasing ICP inhibiting the pons and medulla from interacting properly
Cheynes-stokes (cyclic pattern, crescendo like breathing followed by a period of apnea)
Apneustic breathing-heightened inspiration, shortened respiration-gasping because lungs are now overinflated. Usually leads to respiratory arrest
Biot's breathing-irregular breathing
102
Intercostal nerves exit the spinal cord where?
T1-T11
103
Phrenic nerves exit the spinal cord where?
C3-C5
104
Chemoreceptors-CO2 drive
Hypercarbic drive/hypercapnic drive
105
____ changes in CO2 which result in ___ changes in H+ to create _____large changes in respiration rate
Small
Small
Large
106
CO2 goes through the ____ and is then dissolved in ___.
Blood brain barrier
| CSF
107
The CO2 becomes _____ to create H+. As CO2 increases, the ___ in the blood increases.
Carbonic acid
| acidity
108
O2 drive
Hypoxic drive
109
Is the O2 drive more or less sensitive than the hypercarbic drive?
Less
110
At what point are the hypercarbic and hypoxic drive most sensitive?
When the are working together
111
Aeorbic equation
Glucose+02=energy+CO2+H2O
112
During the first step of metabolism, glucose and 02 react to form:
Energy and pyruvate
113
Where do pyruvate and O2 react to form energy+CO2+H20
Mitochondria
114
What carries 97% of O2? What happens to the remainign 3%?
Hemoglobin
| The remaining 3% dissolves in plasma
115
Where does CO2 go?
23% binds to hemoglobin
7% is dissolved in plasma
70% dissolved in red blood cells in cytosol
116
Chemical reaction that allows red blood cells to carry CO2 around (dissolved in cytosol)
CO2+H20->H2CO3->H+ + HCO3
117
1-14 acid versus basic
1=acid
| 14=basic
118
Blood is what on the pH scale?
7.32-7.45 (kind of basic)
119
Respiratory acidosis
increased [CO2]+ increased [H+]->increased RR
| Trying to blow off more CO2
120
Why does blowing off CO2 make the blood less acidic?
To reduce H+ can reduce CO2. Creates room for the reaction to go in the opposite direction, which reduces the H+
121
Metabolic acidosis occurs with
ASA, DKA, OD, lactic acid
| Also trying to blow of CO2 to reduce acidity
122
If you hyperventillate, what issue may arise when it comes to the hypercarbic drive?
Respiratory aklylotic
If you hyperventillate without a respiratory pathology, it will cause the amount of CO2 in your blood ot drop, and will cause the amount of H+ to drop and make you alkaladic (more basic)
increase RR->decrease [CO2] + decrease [H+]
123
[CO2]+[H+]->RR is a ____ equation
Buffer
