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Pathophysiology Exam 2 > Respiratory Physiology Part 1 > Flashcards

Respiratory Physiology Part 1 Flashcards

1
Q

Basic tubular anatomical design of Respiratory System

A

Epithelial inner lining
Middle layer with both muscle and connective tissue
Adaptations for gas transport and exchange with the external environment (O2 and CO2)

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2
Q

What are the Respiratory functions of the respiratory system?

A

Provide Oxygen to the blood
Eliminates carbon dioxide from the blood

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3
Q

Non-Respiratory Functions of Respiratory System

A

Regulates the blood’s hydrogen ion concentration (pH) in coordination with the kidneys

Forms speech sounds (phonation)

Defends against inhaled microbes

Influences arterial concentrations of chemical messengers by removing some from pulmonary capillary blood and producing and adding others to this blood

Traps and dissolves blood clots arising from sytemic veins such as those in the legs

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4
Q

Components of the Upper Airway

A

Nase
Nasal cavity
Pharynx
Associated Structures (tonsils + adenoids)
Larynx

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5
Q

Components of the Conducting Airway

A

Trachea
Bronchi - terminal bronchioles

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6
Q

Alveolar Airway

A

Respiratory Bronchioles
Alveolar Ducts
Alveolar Sacs

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7
Q

What are the 2 functional components of the respiratory system

A

Conducting zone
Respiratory Zone

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8
Q

Where does the Conducting Zone begin?

A

at the trachea and branches dichotomously
first 16 branch generations transporting gas to and from upper airway

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9
Q

What does the Conducting Zone do?

A

filters, warms, and moistens air AND performs conduction of air into the lungs

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10
Q

Where does the Respiratory Zone begin?

A

Begins at respiratory bronchioles
and is the last 7 branch generations performing gas exchange

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11
Q

What does the Respiratory Zone do?

A

performs gas exchange between air and blood

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12
Q

Why are you prone to nasal allergies?

A

Because your nose is a portal of entry exposed to tons of microbes making it very sensitive.

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13
Q

Function of the nose in the respiratory system

A

It is one of the two openings to the respiratory system within the head to receive or expel air

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14
Q

What is the nasopharynx lined with?

A

Mucosal epithelium

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15
Q

What does the internal nose (nasal cavity) merge with?

A

the external nose - anteriorly
the pharynx - posteriorly

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16
Q

what nasal bones divide the nasal cavity? and into how many parts?

A

Superior Concha
Middle Concha
Inferior Concha
so 3

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17
Q

Which ducts and sinuses drain into the nasal cavity?

A

all four paranasal sinuses
nasal lacrimal duct

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18
Q

Function of the nasal cavity

A

detect olfactory stimuli
warm, moisten, and filter incoming air
modifying speech vibrations

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19
Q

Anatomy of the Pharynx (throat)

A

Funnel shaped tube which courses from the internal nares to the level of the cricoid cartilage.

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20
Q

What are the walls of the pharynx comprised of?

A

skeletal muscle

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21
Q

What is the pharynx lined with

A

Mucous Membrane

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22
Q

Functions of the Pharynx

A

Passageway for air and food
resonating chamber for speech and sounds
Immunity

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23
Q

What three regions is the pharynx divided into

A

nasopharynx
oropharynx
laryngopharynx

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24
Q

Does both food and air pass through the pharynx?

A

Yes air from the mouth and nose travel through pharynx to the trachea
and food travels through pahrynx to esophagus

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25
Q

What is the Larynx most commonly known as

A

Voice box

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26
Q

How many cartiilages does the larynx consist of

A

9

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27
Q

What is the function of the larynx?

A

Connects pharynx with the trachea
causes movement of vocal cords for vocal production

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28
Q

What is the trachea also known as

A

The windpipe (this is where conduction starts)

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29
Q

Is the trachea anterior or posterior to esophagus

A

Anterior

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30
Q

What are the four layers of the trachea

A

mucosa
submucosa
fibromusculocartilaginous
adventitia

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31
Q

What does the submucosa of the trachea contain?

A

glands and ducts

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32
Q

Describe the fibromusculocartilaginous

A

C-shaped cartilage rings
smooth muscle
elastic connective tissue

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33
Q

What is the adeventitia and what does it do?

A

Connective tissue that attaches the trachea to surrounding tissues

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34
Q

Where is the branching point of the bronchi?

A

At the Carina

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35
Q

What do the bronchi branch into at the carina

A

Right Main
Left main

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36
Q

Which bronchus is wider, more vertical, and shorter?

A

Right main bronchus

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37
Q

When Intubating, why do you not want to push the tube past the carina?

A

Because the tube will most likely go into the right bronchus and only inflate it. We intubate so that we can inflate both lungs. You could potentially cause lots of damage to the left lung if you are not perfusing air there.

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38
Q

What is the pathway beyond the bronchi?

A

Bronchi –> Bronchioles (no cartilage) –> Terminal Bronchioles –> Respiratory Bronchioles –> alveolar Ducts –> Alveolar Sacs

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39
Q

What is the leading cause of death in both men and women?

A

Lung Cancer

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40
Q

Why is mortality so high with lung cancer? and how soon do most die?

A

By the time of diagnosis, it has probably already advanced with 55% of patients having distant metastasis

Most die within the year of diagnosis

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41
Q

___ % of all causes of lung cancer is due to ______ ________

A

85%
Cigarette Smoking

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42
Q

How much more common is lung cancer in smokers than the average person?

A

10-30x

43
Q

What is a precursor to lung cancer? and is secondhand smoking a risk factor?

A

Emphysema

Yes

44
Q

What is the most common type of lung cancer and where does it start?

A

Bronchogenic carcinoma

starts in the epithelium of the bronchial tubes

45
Q

What are the symptoms of bronchogenic carcinoma?

A

chronic cough, spitting up blood, SOB, wheezing, chest pain, hoarseness, difficulty swallowing, bone pan, unintentional weight loss, HA, anemia, etc

46
Q

Why are there respiratory symptoms with cronchogenic carcinoma?

A

because you are blocking the bronchioles, so it is harder to get air in and out

47
Q

Why would you cough up blood with bronchogenic carcinoma?

A

Because the bronchioles are very close to the vasculature of the lungs.

48
Q

What space in the body due lungs almost fill up?

A

Thoracic cavity

49
Q

What are lungs surrounded by?

A

Pleura: protective, double layered serous membrane

50
Q

What are the anatomical descriptions of location on the lungs?

A

Apex
Base
Hilum

51
Q

How many lobes and fissures does each the right lung and the left lung have respectively?

A

R: 3 lobes divided by 2 fissures
L: 2 lobes divided by one fissure

52
Q

What is special about the superior lobe of the Left lung?

A

it has a lingula (point at the base of the superior lobe

53
Q

Each lobe of the lung receives its own ______ bronchus, which gives rise to segmental bronchi

A

Lobar

54
Q

How many segmented bronchi are in each lung?

A

10

55
Q

Each lung contains many compartments (lobules) which includes a _______ vessel, __________, _________ and branch from a terminal bronchioles

A

lymphatic vessel, arteriole, venule

56
Q

Why is it important clinically to know what lobules contain?

A

because during a lung resection, we need to make sure we close off all of these to prevent bleeding

57
Q

Epithelium from the nose to the respiratory bronchioles is ________

A

cilated

58
Q

where is “beating” cilia found in the epithelium?

A

mucus layer

59
Q

What does the ciliated epithelium do?

A

allows for entrapment of foreign particles and transport out

60
Q

Describe the membrane of the trachea/bronchus

A

Pseudostratified layer with submucosal glands

61
Q

Secretory glands of the trachea/bronchus secrete mucins, antimicrobial substances, and fluid. What are these important for?

A

for hydrating layer and killing airborne pathogens

62
Q

Within the trachea/bronchus what is interspersed throughout the connective tissue?

A

Cartilage

63
Q

What type of epithelium is found in the bronchioles?

A

cuboidal epithelium

64
Q

What is ABSENT in the bronchioles?

A

Secretory epithelium - NO MORE GLANDS

65
Q

Since secretory epitheliums is absent in the bronchioles, what plays a more prominent role in constricting/dilating bronchioles?

A

smooth muscle

66
Q

What in the bronchioles serve as progenitor cells after injury?

A

Club cells - regenerate tissue

67
Q

What type of epithelium is found in the alveolus?

A

Squamous - has pneumocytes

No cartilage, no smooth muscle, club cells, etc

68
Q

How would you describe Alveoli structure

A

Cup shaped out-pouching lined by simple squamous epithelium

69
Q

______________ consists of 2+ alveoli which share a common opening

A

Alveolar sac

70
Q

What does the alveolar wall contain?

A

alveolar macrophages called “dust cells”

71
Q

What are “dust cells” (alveolar macrophage)

A

Wandering phagocytes which removed fine dust particles and other debris

72
Q

Which type of cell is predominant in alveoli?

A

Type 1

73
Q

Describe Type 1 Alveolar cell’s epithelium and what do they make up?

A

Flat epithelial cells that make up most of the air facing surfaces of the alveolar wall

74
Q

Describe the epithelium of Type 2 alveolar cells and their function

A

Thicker epithelial cells
T2 secretes alveolar fluid which contains surfactant

75
Q

What is the function of alveolar surfactant?

A

keeps alveoli open by maintaining patency
reduces surface tension

76
Q

Again, obviously this is important… What type of cells is surfactant produced by?

A

Type 2 alveolar cells

77
Q

What role does surfactant play?

A

helps maintain alveolar structure by reducing surface tension

78
Q

surface tension is ______ proportional to the surfactant concentration per unit area

A

inversely

79
Q

When surfactant gets further apart in inspiration what happens to surface tension?

A

it goes up

80
Q

Without surfactant what happens to surface tension

A

it increases exponentially

81
Q

What are the 4 layers of the respiratory membrane from the alveolar sir space to the blood plasma

A
  1. alveolar wall (T1/T2)
  2. Epithelial basement membrane
  3. capillary basement membrane (usually fused with epithelial BM)
  4. endothelial cells of the capillary wall
82
Q

Where does O2/CO2 exchange occur in alveoli?

A

respiratory membrane

83
Q

The respiratory membrane is very thin. What does that mean for diffusion?

A

rapid diffusion and gas exchange

84
Q

300 million aveoli in the lungs = _____m^2 total area of alveolar wall in contact with lungs

A

70m^2

85
Q

What is pneumonia? it is the most common________cause of death in the US

A

an acute infection/inflammation of the alveoli

INFECTIOUS

86
Q

What is the most common type of pneumonia?

A

streptococcus pneumoniae

87
Q

who is most susceptible to getting pneumonia?

A

elderly, infants, immunocompromised, smokers, copd

88
Q

What consequences will result if inflammation causes a buildup of fluid in the alveoli and interstitial spaces? what does this look like clinically?

A

PULMONARY EDEMA

increased surface tension, decreased gas exchange dur to decreased diffusion due to increased fluid
S/S dychipnea + SOB (fast breathing)

89
Q

What is pneumonia preceded by typically?

A

Viral URI that may begin to improve then worsens

90
Q

S/S of pneumonia

A

fever, chills, productive or dry cough, malaise, chest pain, and sometimes dyspnea or hemoptysis due to inflammation

91
Q

Treatment of pneumonia

A

antibiotics
bronchodilators
oxygen therapy
increased fluds and even chest physiotherapy (incentive spirometry)

92
Q

Blood is __________ by pulmonary arteries and _______ by pulmonary veins

A

received
drained

93
Q

what type of blood do pulmonary arteries recieve from the pulmonary trunk of the heart?

A

deoxygenated

94
Q

pulmonary arteries cause _____________ with localized hypoxia (low o2 levels)

A

vasoconstriction

95
Q

Vasoconstriction of the pulmonary arteries is unique in that it allows for what?

A

more efficient gas exchange by diverting deoxygenated blood from poorly ventilated areas of the lung to more ventilated areas

96
Q

what arteries ranch off the aorta to deliver O2 rich blood to the tissue - especially the muscular walls of the bronchi and bronchioles?

A

Bronchial arteries

97
Q

What returns oxygenated blood to the heart via draining into the left atrium?

A

pulmonary veins

98
Q

what is the parasympathetic nerve supply within the pulmonary plexus?

A

Vagus (CN X)

99
Q

What is the sympathetic nerve supply of the pulmonary plexus?

A

post-ganglionic fibers of the 2nd-5th thoracic paravertebral ganglia of the sympathetic trunk

100
Q

How does the parasympathetic ANS control breathing?

A

slows breathing rate, constricts bronchial tubes, and dilates pulmonary blood vessels

101
Q

How does the sympathetic ANS control breathing?

A

increases breathing rate, dilates bronchial tubes, and constricts pulmonary vessels

102
Q

What are considered a non-respiratory function of the respiratory sysem?

A

provides defense against inhaled microbes
a gas reservoir used to generate turbulent airflow for speech

103
Q

While a patient is standing and eating rock-candy, the crown of a carious tooth suddenly fractures and a fragment of the tooth is inhaled. The fragment is most likely to enter which lung and why?

A

Right lung because the right main bronchus is wider and more vertical than the left.

104
Q

On exam: Which of the following statements is true of the respiratory membrane separating air in the alveolus from blood in the capillary?

A

the thin layer allows for rapid exchange of O2, and CO2 via diffusion

Pathophysiology Exam 2 (5 decks)

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