Respiratory - Class 1 Flashcards
The space between the lungs is the __________ . It separates the right from left lung and houses the heart, great blood vessels, esophagus, thymus, lymph nodes, Vagus and Phrenic nerves.
mediastinum
The lungs are the functional unit of the ________ system.
respiratory
Each lung has an _____ (top) and a _____ (bottom).
apex
base
The right lung has 3 lobes. Name them?
superior, middle and inferior.
The right lung has ___ lobes
3
The 2 fissures that separate the 3 lobes are the _______ (separating the superior and middle lobes), and the__________ (separating the middle and inferior lobes).
oblique
horizontal
T/F The left lung has 2 lobes – superior & inferior with 1 oblique fissure separating the lobes.
TRUE
A unique feature of the left lobe is the _____ _____.
cardiac notch
Carry deoxygenated blood from the right ventricle of the heart, to the lungs for oxygenation
Pulmonary Artery
Carry oxygenated blood from the lungs, to the left atrium of the heart.
Pulmonary Veins
___________ blood is sent from the left ventricle to the aorta which then pumps the blood to the body’s arterial network to disperse to the tissues.
Oxygenated
The _______ ________ arise from the thoracic aorta and provide the lung tissues with nutrients and oxygen.
bronchial arteries
The primary function of the respiratory system is ______ ________
gas exchange
Gas exchange takes place in the respiratory airways at the ________ level.
alveolar
Involves exchange of gases across the respiratory membrane
Pulmonary respiration
The respiratory system can be structurally classified into two zones: Name them?
Upper Respiratory Tract Lower Respiratory Tract
all structures of the respiratory system lying above the level of the larynx.
Upper Respiratory Tract
Nasal cavity, mouth, pharynx, larynx, trachea, bronchi, bronchioles
Upper Respiratory Tract
all structures of the respiratory system from below the level of the larynx.
Lower Respiratory Tract
Larynx, trachea, bronchi, bronchioles, respiratory bronchioles, alveolar ducts, alveoli
Lower Respiratory Tract
The respiratory system can be functionally classified into two zones:
Conducting Zone
Respiratory Zone
the structures that make up the physical passageway of air into the body
Conducting Zone
Nasal passages, mouth, pharynx, larynx, trachea, bronchi, bronchioles
Conducting Zone
where gas exchange takes place
Respiratory Zone
Respiratory bronchioles, alveolar ducts, alveoli
Respiratory Zone
T/F The trachea and bronchi branch as they progress into the lungs. The branching occurs in the following order, from most deep to superficial?
FALSE
IT’S SUPERFICIAL TO DEEP
Conducting Zone
1. The_________ bifurcates into the left and right _______ bronchi (at the level of T__). The Left and right primary bronchi enter the lungs through slits called the _______ (hilum plural).
trachea
primary
T4
hilus
Conducting Zone
2. The primary bronchi branch into the _______ bronchi (______ bronchi), inside the lung.
secondary
lobar
Conducting Zone
3. The secondary bronchi divide into ________ bronchi (________ bronchi).
tertiary
segmental
Conducting Zone
4. The tertiary bronchi branch into_______, and finally the _______ bronchioles, which are the last structure within the conducting zone, and then the respiratory zone begins.
bronchioles
terminal
the last structure within the conducting zone, and then the respiratory zone begins?
terminal bronchioles
This is the region of the lungs where gas exchange occurs?
Respiratory Zone
Respiratory Zone
1. This is the region of the lungs where gas exchange occurs, beginning with the respiratory ________, which progress to form the _______ ducts, which then have _______ sacs.
Respiratory Zone
bronchioles
alveolar X2
This is the region of the lungs where gas exchange occurs, beginning with the respiratory bronchioles, which progress to form the alveolar ducts, which then have alveolar sacs.
Respiratory Zone
Respiratory Zone
The alveoli and the corresponding terminal bronchiole, form a functional unit, called an ______. There are about 5-7 acini per pulmonary _______.
acinus
lobule
Respiratory Zone
T/F Cartilage INCREASES from the level of the trachea until it disappears at the level of the bronchioles.
FALSE IT DECREASES
Respiratory Zone
The bronchioles are encircled by spiralling layer of smooth muscle tissue, which decreases down to the level of the alveoli. WHY?
To allow for greater tissue permeability
are comprised of simple squamous epithelium (to allow for gas diffusion), and are supported by an elastic basement membrane?
Alveoli
T/F There are 2 types of alveolar cells?
FASLE 3 TYPES OF ALVEOLAR CELLS
Simple squamous epithelium walls with fibroblasts, Septal cells, Macrophages
3 types of alveolar cells
3 types of alveolar cells
Simple squamous epithelium walls with fibroblasts, Septal cells, Macrophages
Type 1of 3 of Alveolar Cells
Simple squamous epithelium walls with fibroblasts
Producing elastic reticular fibres. They are designed to provide efficient surface for gas exchange. Overall, they provide a surface area of roughly 160m2
Simple squamous epithelium walls with fibroblasts
Type 2 of 3 of Alveolar Cells
Septal cells
metabolically active cells that secrete surfactant. Surfactant decreases surface tension and prevents the collapse of the alveoli, contributing to overall stability of the alveolar units.
Septal cells
TYPE 3 OF 3 of ALVEOLAR CELLS
Macrophages
large phagocytic cells that engulf foreign material
Macrophages
Air moves into and out of the lungs via the conducting zone. Remember, no gas exchange is occurring here.
There are 2 main events that occur when breathing:
Inhalation
Exhalation
Mechanics of pulmonary ventilation
T/F Air moves into and out of the lungs via the conducting zone. This is where gas exchange occurs
FASLE
Remember, no gas exchange is occurring here!!!
There are 2 main events that occur when breathing:
Inhalation
Exhalation
Inhalation
The diaphragm concentrically contracts, pulling the central tendon of the diaphragm inferiorly. As a result, the dome of the diaphragm descends toward the abdomen, and thoracic volume ________, while intra-thoracic pressure ________. This creates a vacuum, resulting in an influx of air into the lungs.
increases
decreases
T/F Diaphragmatic movement also assists with venous return, by way of “pumping” the vena cava.
TRUE
during this process, intra-abdominal pressure increases, causing the stomach to move outward?
Inhalation
During normal quiet breathing, the diaphragm alone produces most of the effort required to _______ thoracic volume. The remainder is accomplished by ________ inspiratory muscles.
increase
accessory
This process is normally passive during quiet breathing. During this phase of the breath cycle, the diaphragm ascends.
Exhalation
During this process, thoracic volume _______ as the diaphragm ascends, and pulmonary pressure _______. These events lead to the movement of air out of the lungs, into the atmosphere.
Exhalation
decreases
increases
Diaphragm and External intercostal muscles
Primary Respiratory muscles of inhalation
This muscle descends downward during inhalation, increasing thoracic volume
Diaphragm
lift the ribs during inhalation, increasing internal thoracic volume
External intercostal muscles
Scalenes Sternocleidomastoid Pectoralis minor
Accessory muscles of inspiration
activate to lift the upper 2 ribs, increasing thoracic volume
Scalenes
activate to lift the sternum and clavicle, increasing thoracic volume
Sternocleidomastoid
activate to elevate ribs 3-5, increasing thoracic volume
Pectoralis minor
The _______ ascends (returns to resting position) as it relaxes, resulting in decreased thoracic volume, and a natural out-flow of air from the lungs.
Diaphragm
The elastic properties of the lung tissue …….. explain
…….. allow then to recoil, which pulls the visceral pleura back in as it follows the lung tissue. The visceral layer separates from the parietal layer, creating more negative pressure. The parietal layer follows the visceral layer, assisting the ribs moving back to their resting position.
this action involves the contraction of the internal intercostal muscles
Forced expiration
Forced expiration action involves the contraction of the _______ ________ muscles
internal intercostal
Forced expiration – involves the contraction of the internal intercostal muscles (that ……
bring the ribs together, decreasing thoracic volume, and increasing thoracic pressure
Forced expiration – involves the contraction of the internal intercostal muscles (that bring the ribs together, decreasing thoracic volume, and increasing thoracic pressure), in addition to the ________ , ________ _________ ________ , and the _____________
QL, serratus posterior inferior, and the abdominals
These muscles are recruited during heavy exercise, coughing, sneezing, etc.
internal intercostals, QL, serratus posterior inferior, and the abdominals
Contraction of these muscles increases intra-abdominal pressure, forcing the diaphragm upward. This decreases thoracic volume and increases pulmonary pressure, causing air to be expelled from the lungs.
internal intercostals, QL, serratus posterior inferior, and the abdominals
- Surface Tension of the Alveolar Fluid
- Compliance of Lung
- Airway Resistance
- Function/ Innervation of Respiratory Muscles
- Air Pressure Differential of Pleural Cavity
Factors that Affect PULMONARY VENTILATION
During inhalation, surface tension must be overcome in order for the alveoli to expand. Surface tension accounts for 2/3 of the lungs recoil.
Surface Tension of the Alveolar Fluid
How much effort is required to expand the lungs and chest wall; lungs with high compliance will expand more easily. Related to surface tension of alveoli and elasticity of lung tissue.
Compliance of Lung
Relates to diameter of airway; decreased diameter of airway = more resistance. Diameter is regulated by smooth muscle in walls of airway.
Airway Resistance
Due to spinal cord injury, damage to phrenic nerve, etc.
Function/ Innervation of Respiratory Muscles
Punctured lung will cause a pneumothorax (lung will collapse).
Air Pressure Differential of Pleural Cavity
A double-layered serous membrane encapsulating the lungs.
Pleura
lines the walls of the thoracic cavity; pain sensitive (has intercostal and phrenic nerve innervation)
Parietal Pleura
adheres to the surface of the lungs
Visceral Pleura
T/F During Inhalation air moves into the lungs when the alveolar pressure is less than atmospheric pressure
TRUE
T/F During exhalation air moves out of the lungs when the alveolar pressure is greater than atmospheric.
TRUE
Non-respiratory air movements, are those that do not aid with the process of respiration but exist to (2)
Clear air passages (coughing, sneezing)
Express emotions (laughing, crying, etc.)
T/F Non-respiratory movements are mostly reflex driven (eg. yawning, sneezing, coughing) but can sometimes be initiated voluntarily (laughing, crying, a cough even can be triggered consciously).
TRUE
Clears the lower respiratory tract.
Coughing
Clears the upper respiratory tract
Sneezing
produces expectorant
Productive Cough
adequate strength and co-ordination, but may or may not be productive (i.e. strong but dry cough – may still be effective in loosening secretions for eventual expulsion).
Effective Cough
This reflex is usually initiated by a mild irritation of the receptors in the lining of the nasal cavity, carried via what CN?
Sneezing
CN V
trigeminal nerve
CN V
CN V
trigeminal nerve
Shortness of breath is a normal symptom of heavy exertion. It is considered pathological if it occurs in unexpected situations.
Dyspnea
asthma
pneumonia
cardiac ischemia
interstitial lung disease
congestive heart failure (CHF)
chronic obstructive pulmonary disease (COPD)
psychogenic causes (eg. panic disorder, anxiety, etc.)
In 85% of cases, shortness of breath is due to
This can also occur when cellular respiration exceeds alveolar respiratory capacity, as in oxygen debt.
Dyspnea
When attempting to compensate for dyspnea, one can take on the
“Breathlessness Position.”
Pulmonary System
Cardiovascular System
Musculoskeletal System Nervous System
Factors contributing to respiratory dysfunction
