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Year 2 NSF > Respiratory System > Flashcards

Respiratory System Flashcards

1
Q

What is ventilation?

A

The movement of air through the airways

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2
Q

Which of the following species has the most pliable nares: Sheep, Dog, Pig, Horse?

A

Horse

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3
Q

What comprises the respiratory portion of the lung?

A

Respiratory bronchioles, alveolar ducts and sacs

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4
Q

When does gas exchange occur at the alveolus?

A

During the whole respiratory cycle

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5
Q

From which embryonic structure do the lungs develop ?

A

Foregut

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6
Q

Why do premature neonates often experience respirator distress after birth?

A

Not enough surfactants

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7
Q

Does increased airway diameter increase or reduce airway resistance?

A

Bronchodilation reduces airway resistance

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8
Q

What part of the respiratory system is least turbulent

A

Bronchiole

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9
Q

Where are peripheral chemoreceptors located?

A

Carotid and aortic sinuses

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10
Q

What do central chemoreceptors in the respiratory system detect changes in?

A

PaCO2

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11
Q

What is the pH range of mammals ECF?

A

7.35- 7.45

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12
Q

What happens to the acid:base balance with respiratory obstruction?

A

Respiratory acidosis

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13
Q

What might cause respiratory efficiency decrease during anaesthesia?

A

Drugs
Recumbancy
Equipment

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14
Q

How do drugs cause a decrease in respiratory efficiency?

A

Direct effect on medulla oblongata- reduces inputs to respiratory centre- chemoreceptors, irritant receptors

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15
Q

Why may recumbency be a problem duding anaesthetic respiration?

A

Lateral recumbancy- atelectasis of dependent lung
Dorsal recumbancy- abdominal contents compromise diaphragm
Build up of mucous

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16
Q

How does equipment effect respiration efficiency during anaesthesia?

A 
Endotracheal tube, connectors, circuit, machine, monitors
Increase dead space
Increased resistance to airflow 
Potential rebreathing/inadequate O2
Air not humidified
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17
Q

What is the potential result of reduced respiratory efficiency during anaesthesia?

A

Va:q ration- the amount of air that reaches alveoli divided by the amount of blood flow in capillaries
High CO2/ Low O2

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18
Q

What are the consequences of deranged respiratory function?

A

Acidosis- respiratory increases H+, metabolic- anaerobic respiration increases lactic acid
Prolonged hypoxia- irreversible brain damage
Hypercapnia- vasodilation, raised intracranial pressure

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19
Q

How is respiration monitored during anaesthesia?

A

Pulse oximeter
Capnography
Arterial/venous blood gas measurements

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20
Q

Where is a pulse oximeter attached, how does it work, what does it measure?

A

Clipped on to a vascular non-pigmented area
Red and inferred light beamed through tissue and differential absorption measured
Measures O2 saturation of haemoglobin/pulse

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21
Q

At what PaO2 does the level of Hb saturation start to decline significantly in the normal animal?

A

Below 75%

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22
Q

What could effect the result of pule oximeter?

A

Vasoconstriction of the region measured
Abnormal haemoglobin
Equipment factors- movement, light

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23
Q

What does capnography measure?

A

Measure the concentration/pp of CO2 in expired air via the breathing system

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24
Q

What results does capnography produce?

A

Produces a curve

Gives a measurement of end-tidal CO2 (ETCo2)

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25
Q

What PCO2 would you expect in a normal animal?

A

40

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26
Q

What could cause raised ETCo2?

A

Inadequate ventilation
Increases metabolic rate
Increased cardiac output
Rebreathing of expired air

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27
Q

What is the gold standard for monitoring respiratory parameters?

A

Blood gas analysis

28
Q

What does blood gas analysis measure and what kind od sample does it need?

A

Measure PO2 and PCo2 directly
Needs either arterial/venous sample
Can also measure- pH, HCO3-, lactate, electrolytes

29
Q

What PaO2/PCO2 would you expect in an artery and venous samples?

A

Artery- PaO2- 100, Co2- 40

Vein- PaO2- 70-80, Co2- 45

30
Q

When should respiratory monitoring stop after anaesthesia?

A

Once conscious

31
Q

How are large particles prevented form entry to the respiratory tract?

A

Nares, nasal cavity, pharynx, larynx

32
Q

How is inhaled air ‘cleaned’?

A

Hair and mucous lining the nasal cavity

33
Q

What is the mucociliary escalator and what does it do?

A

Constantly moves secretions from submucosal glands and goblet cell cranially towards pharynx, then swallowed or expectorated

34
Q

What size particles can reach the alveoli and how are they removed?

A

Under 5um

Phagocytosed by alveolar macrophages

35
Q

What are the three types of airway receptors?

A

Rapidly adapting receptors
Slowly adapting receptors
C-fibres

36
Q

Where are rapidly adapting receptors found, what do they respond to?

A

Intrapulmonary airways

Respond mainly to changes in airway mechanical properties

37
Q

What causes RAR to become more active and what is their response?

A

More active as rate and volume of lung inflation increases during normal inspiration
Can cause bronchoconstriction and mucus secretion via parasympathetic pathways

38
Q

Where are slowly adapting receptors found, what are they sensitive to, when does their activity increase?

A

Found- around bronchioles and alveoli
Sensitive- to mechanical forces
Activity increases during respiration, decreases during expiration

39
Q

What are SARs the afferent fibres for?

A

Hering-breur reflex

40
Q

What do C-fibres respond to ?
What activates them?
What does their stimulation cause?

A

Respond to noxious chemical and mechanical stimuli
Directly activates by bradykinin and capsaicin
Stimulation causes bronchoconstriction, mucus secretion, apnoea

41
Q

What causes a cough reflex?

A

A mixture of all three receptor types

42
Q

Where are the mixture of three receptors which cause the cough reflex found?

A

Throughout conduction airways

Concentrated at birfurcation of airways

43
Q

How is a cough stimulated?

A

Stimulation of cough receptors
Impulses carried via values to cough centre in medulla oblongata and pons
Efferent to diaphragm (phrenic nerve), abdominal muscles/muscles of respiration, larynx

44
Q

What are the three phases to a cough?

A

Inspiratory
Compression phase
Expiratory

45
Q

What happens during the compression phase?

A

Laynx closes, muscles (abdominal, diaphragm, intercostal) contract, intrathoracic pressure rises

46
Q

What does the nature of a cough depend on?

A

Where the stimulus occurs

47
Q

Where are receptors found which cause a sneeze?

A

Nasal mucosa- mechanical and chemical stimuli

48
Q

What is the afferent nerve for sneezing?

A

Trigeminal (V)

49
Q

Where is the sneezing centre?

A

Medulla oblongata

50
Q

What are the effects of a sneeze being stimulated?

A

Eye closing, inspiration, closure of glottis, increased intrathroacic pressure, expiration

51
Q

What effects do sneezes and coughs have on the renal system?

A

Both involve closure of the external urethral sphincter and contraction of pelvis muscles

52
Q

What is the nasopulmonary reflex, what is it mediated by?

A

Not 100%
Stimulation of nasal cavity causes bronchoconstriction
By trigeminal and vagal nerves

53
Q

What can increased respiratory demand occur?

A

Exercise, reduces inspired oxygen tension, disease states

54
Q

What is minute ventilation?

A

RR x TV

55
Q

What is alveolar dead space?

A

A ventilated alveolar that is not perfused

56
Q

How does hyperventilation lead to hypoxaemia?

A

Hyperventilation leads to hypercapnia because CO2 is more soluble than oxygen, lowering ventilation

57
Q

How can hyperventilation lead to respiratory alkalosis?

A

Excessive loss of CO2 leads to alkalosis due to H+ being removed indirectly

58
Q

How does increases respiratory rate and tidal volume increase O2 offloading?

A

Increased workload and metabolic demand on respiratory muscles, increases CO2 and H+ production, this facilitates O2 offload by increasing Hb affinity

59
Q

What does mouth breathing a common feature of and why?

A

Dyspnoea

Increased ventilation demand causes demand for low resistance to air flow

60
Q

How can pressure of breathing and compliance be improved by posture?

A

Sternal recumbancy with elbows abducted

61
Q

What is respiratory failure?

A

The end result of uncontrolled respiratory disease, there are two types

62
Q

What is type 1 respiratory failure?

A

Hypoxia with normal or hypocapnia

63
Q

What is type 2 respiratory failure?

A

Hypoxia with hypercapnia

64
Q

What causes type 2 respiratory failure?

A

Usually obstruction
BAB normal but inadequate ventilation
O2 supplementation can worsen hypercapnia by reducing respiratory drive

65
Q

What causes type 1 respiratory failure?

A

Usually disease in lung parenchyma
Alveolar ventilation increased to try and manage hypoxia induced by disease of the gas-exchange portion
Leads to blowing off which can still be exchanged across the compromised BAB
Responds to O2

Year 2 NSF (16 decks)

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