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Section 4 Exam > Respiratory Lecture notes 1 > Flashcards

Respiratory Lecture notes 1 Flashcards

1
Q

What is the Primary Function of Respiratory system?

A

Provide O2 for tissue metabolism and remove CO2

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2
Q

What are Secondary Functions of respiratory system?

A
  • Sense of Smell
  • Speech Production
  • Fluid Balance
  • Acid Base Balance
  • Thermoregulation
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3
Q

Upper Respiratory Tract includes:

A
  • Nose
  • Sinuses
  • Oral Cavity
  • Pharynx
  • Larynx
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4
Q

Lower Respiratory Tract Includes:

A
  • Trachea
  • Main stem Bronchi
  • Bronchioles
  • Alveoli
  • Lungs
  • Blood Supply to Lungs
  • Chest Wall Structures
  • Accessory Muscles of Respiration
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5
Q

What is the Main stem Bronchi anatomy?

A

Two main stem bronchi:
• Right slightly shorter, wider, and more vertical than left – aspiration more likely to occur in right bronchi
• Subdivides into lobar, segmental, sub segmental bronchi down to form the bronchioles

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6
Q

How do the Bronchioles work?

A
  • Branch into smaller tubes – terminal and respiratory bronchioles
  • Depend on elastic recoil to remain open
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7
Q

What do alvelor cells do?

A

• Provide structure
• Secrete Surfactant – reduces surface tension and contributes to the elastic properties of lungs. Prevents the alveoli from collapsing during expiration.
Alveoli

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8
Q

What is the function of Pulmonary Circulation?

A

•Provides lungs with blood for gas exchange

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9
Q

What is the function of Bronchial circlulation?

A

• Provides O2 to the bronchi and other pulmonary tissue

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10
Q

What is the function of Pleura?

A

 Pleura join and form closed, double walled sac

 Filled with thin film of 20 – 25 mL fluid – provides lubrication

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11
Q

What is the function of Diaphragm?

A
  • Separates thoracic cavity from the abdomen

* Contracts on inspiration to push the abdominal contents down

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12
Q

What is the function of External Intercostals?

A

• Contract on inspiration = ↑ size of thoracic cavity

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13
Q

Ventilation is controlled by:

A

Central Nervous System

- The RR is the ventilation rate

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14
Q

What happens with inspiration?

A
  • Active process requiring energy
  • Diaphragm contracts
  • Intercostal muscles contract
  • Scalene muscles contract
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15
Q

What is the function of the Scalene muscles?

A
  • Muscle movements increase volume of the thoracic cavity

* Decreases intrathoracic pressure

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16
Q

What happens with expiration?

A
  • Passive process
  • Intrathoracic pressure increases causing air to move out of the lungs
  • Elastic recoil of lungs and chest wall enable the chest to passively return to its normal position
  • During labored respirations scalene muscles and sternocleidomastoid muscles assist with expiration
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17
Q

What is elastic recoil?

A

∗ Tendency for lungs to recoil after being stretched

• Elasticity due to elastin fibers in alveolar walls and muscles around the bronchioles and capillaries

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18
Q

What is compliance?

A

∗ Measure of the elasticity of the lungs (ease at which the lungs can expand) and thorax

19
Q

What happens when compliance ↓ ?

A

(2° fluid, or condition that effects chest wall compliance) lungs are more difficult to inflate

20
Q

What happens when compliance ↑ ?

A

(destruction of alveolar walls and loss of tissue elasticity) lungs are more easily inflated

21
Q

What happens to compliance of lungs with age?

A

• With age compliance of lungs ↑ as a result of aging (2° loss elastin) and chest wall compliance ↓

22
Q

What is diffusion?

A

Process by which O2 and CO2 move across alveolar-capillary membrane from an area of higher concentration to an area of lower concentration until equilibrium achieved

23
Q

How is oxygen carried in the blood?

A
  • O2 dissolved in arterial blood (PaO2) expressed mm Hg (normal value > 80 mm Hg)
  • O2 bound to hemoglobin (SaO2/ SpO2) – measurement is compared with the amount of O2 the hemoglobin can carry. It is expressed as a percentage (normal value > 95%)
  • Oxyhemoglobin Association and Dissociation
24
Q

What is the Oxyhemoglobin Dissociation Curve?

A

∗ The curve illustrates the relationship between the partial pressure of O2 dissolved in the plasma (PaO2) and the O2 saturation (SaO2) of hemoglobin, Is useful in guiding the amount of supplemental O2 given to patients

25
Q

Why is a segment of the Oxyhemoglobin Dissociation Curve flat?

A

because partial pressure changes of O2 (PaO2) between 60 – 100 mm Hg do not significantly alter the O2 saturation of hemoglobin

26
Q

What must the parital pressure of dissolved Oxygen in plasma (PaO2) be kept at to ensure adequate O2 available to cells?

A

50

27
Q

What are ABG’s (arterial blood gas) and why are they used?

A

∗ Measured to determine oxygenation and acid-base balance

∗ Can indicate if problem is primarily pulmonary or metabolic

28
Q

What controls respirations?

A
  • Chemorecptors

- Mechanical Receptors

29
Q

What are chemoreceptors?

A

∗ Central chemoreceptors located in medulla respond to changes in the hydrogen ion concentration
∗ Peripheral chemoreceptors located in carotid bodies, bifurcation of carotid arteries, and in aortic bodies respond to ↓ in PaO2
∗ In a healthy person an ↑ in PaCO2 or ↓ in pH causes immediate ↑ in RR

30
Q

What are mechanical receptors?

A

∗ Located in lungs, upper airways, chest wall, and diaphragm
∗ Stimulated by: irritants, muscle stretching, and alveolar wall distortion
∗ Pulmonary stretch receptors activate inspiratory center to inhibit further lung expansion

31
Q

What is the Respiratory Defense Mechanisms?

A
  • Filtration of Air
  • Mucociliary Clearance System
  • Cough Reflex
  • Reflex Bronchoconstriction
  • Alveolar Macrophages
32
Q

What happens with filtration of air?

A

∗ Nasal hairs filter air
∗ Changes in airflow direction in pharynx and larynx cause turbulence that makes large particles stick to mucosa
∗ Primarily removes particles larger than 5 mcg in size

33
Q

What is the Mucocillary Clearance System?

A

∗ Mucus secreted by goblet cells (100 mL/day) form a mucus blanket, trapping particles from distal airways
∗ Mucus contains immunoglobulin A (IgA) that protects against bacteria and viruses
∗ Cilia cover the airways from the trachea to the bronchioles. Cilia beat rhythmically moving mucus toward the mouth. The lower down the tree the slower the beat
∗ Dehydration, smoking, infection, alcohol, & recreational drugs impair ciliary action

34
Q

What is a cough reflex?

A

∗ Backup for mucociliary clearance
∗ Clears the airway by a high-pressure, high-velocity flow of air
∗ Only removes secretions in the large or main airways
∗ Lower secretions must be moved upward by the mucociliary mechanism or postural drainage before they can be removed by coughing

35
Q

What is a relflex Bronchoconstriction?

A

∗ Bronchi constrict to prevent entry of irritants
∗ In asthma airways are hyperactive and constriction can occur with cold air, laughing, fragrances, or other strong odors

36
Q

What do Alveolar Macrophages?

A

∗ Engulf and destroy inhaled foreign particles

∗ Impaired by cigarette smoke

37
Q

What happens in the Alveoli with aging?

A 
∗	↓ Surface Area
∗	↓ Diffusion Capacity
∗	↓ Elastic Recoil
∗	Bronchioles and Alveolar Duct Dilate
∗	↓ Ability to Cough 
∗	Airways Close Early
38
Q

What happens in lungs with aging?

A

∗ ↑ Residual Volume
∗ ↓ Vital Capacity
∗ ↓ Efficiency of O2 and CO2 exchange
∗ ↓ Elasticity

39
Q

What happens to exercise tolerance with aging?

A

∗ ↓ Response to hypoxia and hypercapnia (↑ CO2 levels)

40
Q

What happens to muscle strength with aging?

A

∗ ↓ Strength of Diaphragm and Intercostals

41
Q

What happens with susceptibility to infection with aging?

A

∗ ↓ Immunoglobulin A (IgA)
∗ ↓ Cilia Function
∗ ↓ Cough Force
∗ ↓ Alveolar Macrophage Function

42
Q

What happens to the chest wall with aging?

A

∗ ↑ Anteroposterior Diameter
∗ ↓ Chest Wall Compliance (elasticity)
∗ Osteoporosis is possible

43
Q

What are the most common S&S r/t Respiratory system?

A

∗ Dyspnea
∗ Cough
∗ Sputum production
∗ Chest pain or discomfort

Section 4 Exam (10 decks)

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