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Human Systems > Respiratory System > Flashcards

Respiratory System Flashcards

1
Q

What are the functions of respiratory tract?

A

Conduction of air (warms and humidifies)
Respiration (gas exchange)
Protection against pathogen (mucous)

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2
Q

What is upper respiratory tract?

A

Nose
Paranasal sinuses
Mouth (with tonsils)
Throat/ pharynx
Larynx

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3
Q

External portion of nose

A
  • Nares (Protuberance - buldge)
  • Defines midline of face
  • Comprised of: Skin, muscle, bone, hyaline cartilage
  • Lined by mucous membrane
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4
Q

What is the internal portion of nose?

A
  • Nasal cavity
  • Paranasal sinuses & nasolacrimal duct openings
    -Nasal septum
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5
Q

What is the epithelial type of Respiratory segment?

A

Ciliated pseudostratified columnar epithelium

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6
Q

What is the epithelial type of Olfactory segment?

A

Ciliated pseudostratified columnar epithelium+ olfactory receptor

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7
Q

What are the functions of Nose?

A
  • Conducts - humidifies - Filters air
  • Olfactory function - Smell
  • Paranasal sinuses - Vocal resonance & speech modification
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8
Q

What are the functions of paranasal sinuses?

A

Lightening weight of the head
Supporting immune defence
Humidifying inspired air
Increasing resonance of voice

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9
Q

What are paranasal sinuses?

A

Air filled spaces - within bones of skull and face
- 4 pairs
Frontal - Sphenoid - Ethmoid - Maxillary

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10
Q

Clinical note related to paranasal sinuses

A

Oro-antral fistula (Mouth-sinus)
Fistula - abnormal communication between 2 epithelial lines organs that do not normally connect

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11
Q

Larynx

A

Ranges from C3-C6
Functions: Acts as a sphincter & Voice-box

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12
Q

How many cartilage in the larynx?

A

The laryngeal skeleton has nine cartilages:
-Unpaired cartilages: thyroid cartilage, cricoid cartilage, epiglottis
-Paired cartilages: arytenoid cartilage, corniculate cartilage, and cuneiform cartilage.

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13
Q

What is the only cartilage that encircle the the trachea completely?

A

Cricoid cartilage

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14
Q

What is Cricothyroidotomy?

A

Used to create an emergency airway in situations where intubation is not possible or has failed. Involves making a small incision in the cricothyroid membrane.

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15
Q

What are the process of Cricothyroidotomy?

A
  • Identify the cricothyroid membrane
  • Clean the area with antiseptic solution
  • Make a small horizontal incision in the cricothyroid membrane
  • Insert a cricothyroidotomy tube or other airway device through the incision
  • Inflate the cuff of the airway device to secure it in place
  • Connect the airway device to a bag-valve mask or other ventilation device to provide oxygen to the patient.
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16
Q

When Cricothyroidotomy may be used?

A

In emergency situations where a patient is unable to breathe due to upper airway obstruction, trauma to the neck or face.

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17
Q

What is trachealis?

A

Smooth muscle posterior of trachea

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18
Q

What is Tracheostomy?

A

Long term mechanical ventilation intervention

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19
Q

What are the differences between R & L bronchus?

A

Right = more vertically pronounced, greater diameter, shorter

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20
Q

Which bronchi is more likely to get obstructed?

A

Right bronchus

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21
Q

What is the function of type 1 and 2 alveoli?

A

Type 1= Responsible for gas exchange with the blood
Type 2= Produce and secrete surfactant, which helps to reduce surface tension in the lungs and prevent collapse

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22
Q

What are the 3 compartments of the thorax?

A
  • Right pleural cavity
  • Left pleural cavity
  • Mediastinum
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23
Q

what is the skeletal elements of the sternum?

A

Manubrium - Body - Xiphoid process

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24
Q

Mention the classification of the ribs?

A

True ribs → 1-7
False ribs → 8-10
Floating ribs → 11-12

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25
Q

What is intercostal space?

A

space between the ribs

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26
Q

What is Costochondral joint ?

A

Joint between the costal cartilage and the ribs.

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27
Q

Mediastinum

A

Superior mediastinum: T1 - Sternal angle (2nd rib)
Inferior mediastinum:
- Anterior - Fat & Thymus
- Middle - Heart
- Posterior - Aorta & Oesophagus

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28
Q

What are the Great Vessels of the Thorax?

A
  • Venae cavae
  • Aorta
  • Pulmonary trunk + branches
  • Pulmonary veins
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29
Q

What is Diaphragm ?

A

A musculotendinous structure → Made of skeletal muscle
Muscle ‘dome-shaped’ on each side but is higher on the right than the left, due to the position of the liver beneath

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30
Q

What innervates the diaphragm?

A

Phrenic nerve (Branch of C3,4,5), Sensory & Motor function

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31
Q

What happens to the diaphragm on inspiration & expiration?

A

Inspiration → Muscle flattens (Increasing thoracic capacity)

Expiration → Diaphragm returns to normal shape ( dome shape)

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32
Q

What are the two meanings of respiration?

A
  • Tissue respiration: Aerobic metabolism in cells
  • Breathing: Gas exchange and associated processes
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33
Q

What is respiration mechanics?

A

Study of mechanical properties of the lung & chest wall (Process of air entering and leaving the lung)

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34
Q

Explain the interaction that happen between reparatory, cardiovascular and muscle system

A
  • Muscle → Heart/Blood → Lungs
  • Peripheral circulation
    Between heart and muscle/cells
  • Pulmonary circulation
    Between heart and lungs
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35
Q

What is the partial pressure of O2 at rest?

A

100+-2 mmHg

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36
Q

What is the partial pressure of CO2 at rest?

A

40+- 2 mmHg

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37
Q

What is the gas exchange rate at rest (Both O2 & CO2)?

A

O2 → 250ml O2/Min
CO2 → 200ml CO2/Min

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38
Q

What is the function of the upper airway?

A

Humidify, Warm and Filter (Via ciliated pseudostratified columnar epithelium and mucus membrane)

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39
Q

What is the Ventilation & Cardiac output rates at rest?

A

Ventilation: 6-7L/min → 12-15 breaths of ~500ml
CO: 5L/min → 70bpm, 70ml/beat

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40
Q

What is the maximum Ventilation & Cardiac output rates?

A

Ventilation:160L/min → 40 breaths of 4L
CO: 25L/min → 200bpm, 125ml/beat

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41
Q

What happens in the Quiet breathing?

A

Inspiration - Active
Expiration - Passive (Elastic recoil)

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42
Q

What happens in Strenuous breathing?

A

Inspiration - Active → greater contraction of Diaphragm (Up to 10cm)
Inspiratory accessory muscles active e.g. Sternocleidomastoid, alae nasi, genioglossus

Expiration - Active → Abdominal muscles & Internal intercostal muscles

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43
Q

Why in the beginning of inspiration the PA=0?

A

The alveolar pressure is 0 because there is no flow

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44
Q

When the flow of air stops?

A

When atmospheric = PA( alveolar pressure)
Then the glottis close.

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45
Q

What is a factor in development of respiratory failure.

A

Respiratory muscle fatigue\ that happens in higher intensity breathing so, the gas flow is turbulent. It uses more muscles then the accessory muscles can fatigue easily to limit exercise.

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46
Q

What is FRC?

A

Functional residual capacity (FRC): is the volume of air in the lung at the end of expiration during quiet breathing.

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47
Q

What is elastic recoil?

A

Forces of lung act to decrease lung volume

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48
Q

Wat happens to the forces and muscles at FRC?

A

-Elastic & outward recoil forces are opposite and equal.
-Muscles are relaxed

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49
Q

What happenes when chest wall muscles are weak (neuromuscular disease)

A

FRC decreases (lung elastic recoil greater).

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50
Q

How we can measure the lung volume?

A

by vitalograph/ spirogram

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51
Q

How gases move in alveoli and in capillaries?

A

Gases move down concentration gradients by diffusion. (Concentration gradients= pressure gradients)

52
Q

What is the partial pressure of oxygen in the mouth in mmHg?

A

159 mmHg

53
Q

What is the partial pressure of oxygen of tracheal air in mmHg?

A

150 mmHg

54
Q

The differences between conducting airways and respiratory unit?

A
  • Conducting airways - Do not carry out respiration
    Trachea → Bronchi
  • Respiratory airways - Gas exchange (A.K.A Respiratory unit)
55
Q

What is respiratory unit?

A

Respiratory bronchioles, alveolar duct, alveoli

56
Q

How many alveolar sacs in an adult?

A

300-400 million

57
Q

What are the differences between alveoli type 1 and 2 ?

A

Type 1 = 97% of S/A → primary site of gas exchange

Type 2 (septal cells) = 3% of S/A → Produce surfactant (reduced surface tension)

58
Q

What are Alveoli features that aid its function (gas exchange)?

A
  • Large S/A → 100m2
  • Thin walls (Good diffusion characteristics)
59
Q

What are the two separate blood supplies of the lungs?

A
  • Pulmonary circulation: brings deoxygenated blood from heart to lung and oxygenated blood from lung to heart and then rest of body.
  • Bronchial circulation - Delivers oxygenated blood to lung parenchyma
60
Q

What is the total blood V in pulmonary circulation?

A

500 ml (10% total)

61
Q

Which one has more pressure gradient O2, CO2?

A

O2

62
Q

Mention anatomical and physiological properties that facilitate gas diffusion in respiratory and circulatory system.

A

1) Large surface area for gas exchange.
2) Large partial pressure gradients.
3) Gases with advantageous diffusion properties.
4) Specialised mechanisms for transporting O2 and CO2 between lungs and tissues.

63
Q

How O2 carried in blood?

A

Dissolved
Bound to haemoglobin (Hb)

64
Q

Explain the O2 dissolved mechanism

A

Dissolved O2 is measured clinically in an arterial blood sample PaO
- Dissolved - (Small percentage)
- At 100mmHg (PaO2) → 0.3ml O2/100ml blood
- Inadequate for metabolic function

65
Q

How much is the arterial blood (PaO2)?

A

100 mmHg

66
Q

Explain a second O2 transport system haemoglobin (Hb)

A
  • 4 haem groups + 4 polypeptide chains (2 Alpha + 2 Beta)
  • Haem groups contain ferrous iron(Fe+++) = site of O2 binding
67
Q

What is a major transport molecules?

A

Haemoglobin (Hb)

68
Q

What is Oxyhaemoglobin Dissociation Curve?

A

Curve indicates affinity for O2 at various partial pressures

  • 100 - 60 mmHg O2 → Affinity unaffected
  • 40 - 0 mmHg O2 → Steep drop off (Affinity reduced) O2 is released here
69
Q

How many O2 atoms can each Hb bind to?

A

4 O2 atoms

70
Q

How can O2 saturation measure?

A

Pulse oximeters: Measures ratio of absorption of red and infrared light by oxyHb and deoxyHb.

71
Q

What is SaO2?

A

O2 saturation: the amount of O2 bound to Hb relative to maximal amount that can bind.

72
Q

What 100% saturation means?

A

That all heme groups of Hb molecules fully saturated with O2.

73
Q

What is respiratory exchange ratio?

A

Ratio of expired CO2 to O2 uptake: 80:100 molecules of CO2:O2

74
Q

How CO2 carried in the blood?

A

7% dissolved.
23% bound to haemoglobin (Hb).
70% converted to bicarbonate.

75
Q

What happens to CO2 in systemic capillaries?

A
  • At systemic capillaries = ⬆️ CO2 (Homeostatic balance shifts right ➡️)
    • More Carbonic acid produced
76
Q

What happens to CO2 in pulmonary capillaries?

A
  • At pulmonary capillaries = ⬇️CO2 (Homeostatic balance shifts left ⬅️)
    • More CO2 reformed to be expelled
77
Q

How acidity can be regulated?

A

-By using ventilation to adjust the PCO2
-By using the kidneys to regulate the bicarbonate concentration.

78
Q

Examples of obstructive lung disease

A

Emphysema, asthma

79
Q

Examples of restrictive lung disease

A

pulmonary fibrosis, neuromuscular diseases

80
Q

From where does brain receives neural signals?

A

From:
-Chemoreceptors - Feedback on blood partial pressures & pH
- Mechanoreceptors - Feedback on lung, chest wall & Airways

81
Q

To where does brain send neural signals?

A

To effector muscles:
- Respiratory muscles - Rhythmic breathing movement
- Upper airway muscles - Laryngeal, pharyngeal, tongue
- Reflex arc - cough, sneeze

82
Q

What is Chemoreceptors?

A

Sensory receptors that detect chemical changes in the surrounding environment.

83
Q

A decreased in O2?

A

Hypoxia

84
Q

An increase in CO2?

A

Hypercapnia

85
Q

What is Mechanoreceptors?

A

Sensory receptors that detect changes in pressure, movement and touch.

86
Q

What is Peripheral chemoreceptors?

A
  • Regions of aortic arch
  • Carotid sinuses
  • Signals sent via CN9 & CN10 → NTS (Nucleus Tractus Solitrarius) in brainstem
87
Q

What do peripheral chemoreceptors respond to?

A

Respond to Hypoxia- decreased in PO2
-Reductions above 60 mmHg O2 → Little effect on ventilation
-<60 mmHg O2 → Progressive hyperventilation
Little role in moment-moment breathing

88
Q

Explain the workflow of p- chemoreceptors?

A

⬇️ in arterial PO2
P-Chemoreceptors stimulated
Neural signals sent (carotid and aortic) to NTS
Ventilation increases = restoring PO2 levels

89
Q

What are Central chemoreceptors?

A

Clusters of neurones in brainstem

90
Q

When central chemoreceptors get activated?

A

Activated upon hypercapnia detection or pH decrease (⬆️ Bicarbonate)

91
Q

What do central chemoreceptors respond to?

A

Respond to Hypercapnia - Increased arterial PCO2
Similar workflow → Ventilation increase
Small changes have large effects on ventilation - major role in moment to moment breathing control

92
Q

Examples of Mechanoreceptors

A

Receptor location - Airway smooth muscles
Stimulus - Inflation/distension of airway
Reflex - Termination of inspiration

Receptor location - Airway epithelium
Stimulus - Rapid lung inflation, deflation or oedema
Reflex - Sigh or shortened expiration

93
Q

From where do NTS receive information?

A

From mechanoreceptors and peripheral chemoreceptors

94
Q

Why respiratory neurones send neural signals to respiratory muscles?

A

To produce rhythmic breathing.

95
Q

What are the higher centres that modified inputs?

A

Volitional & Emotional - modulation

96
Q

What is ventilation?

A

Process by which air moves in and out of lung

97
Q

What is Perfusion (Q) ?

A

Process by which deoxygenated blood passes through the lungs to become oxygenated

98
Q

What is the V/Q ratio?

A

Can be defined for a single alveolus, group of alveoli or entire lung E.g.:

  • Single alveolus → Alveolar ventilation / Capillary flow
  • Lung → Alveolar ventilation / Cardiac output
99
Q

Why might ventilation not be distributed uniformly?

A

Gravity - pulls lung down, away from chest wall

Compliance - High compliancy means ease of lung and chest expansion

Resistance - Narrowing or blockage, reducing airflow

100
Q

What are the effects of gravity on ventilation?

A
  • Gravity pulls lungs down and away from chest wall
  • Ppl pressure more negative at apex (Top) of lung
  • PL pressure greater at apex
  • Increased alveolar volume at apex
101
Q

What is Compliance?

A

How much effort is required to stretch the lungs and chest wall.

102
Q

What high compliance means?

A

lungs and chest wall expand easily. Greater ability to stretch and recoil.

103
Q

What can cause a decrease in compliance?

A
  • Scarring of lung tissue - Tuberculosis
  • Lung filled with fluid - Oedema
  • Surfactant deficiency 💧
  • Elastic fibre destruction - Emphysema
104
Q

What is resistance?

A

Any narrowing or obstruction of the airway that may reduce airflow.

105
Q

What can cause an increase in resistance?

A
  • Asthma
  • COPD - Chronic obstructive pulmonary disease
106
Q

What are 2 types of dead space?

A
  • Anatomical dead space
  • Physiological dead space
107
Q

What is Anatomical dead space?

A

Volume of gas during each breath that fills conducting airways

108
Q

What is Physiological dead space?

A

Total volume of gas in each breath that does not participate in gas exchange

109
Q

What are the two separate blood supplies to the lung?

A

Pulmonary circulation: brings deoxygenated blood from heart to lung and oxygenated blood from lung to heart.

Bronchial circulation: brings oxygenated blood to lung parenchyma.

110
Q

What circulation has low pressure and low resistance?

A

Pulmonary circulation

111
Q

State the V/Q for a healthy lung?

A

0.8-1.2
Can vary greatly

112
Q

What is Perfect V/Q model?

A

Perfect V/Q model = 1

(Maximum efficiency achieved - PO2 and PCO2 balanced)

113
Q

List 4 types of blood gas abnormalities?

A
114
Q

Detail what an anatomical shunt is (Respiratory) and what arises from this process?

A

Mixed venous blood ‘shunted’ into arterial blood

In lung - Pulmonary artery → Pulmonary vein

115
Q

What is a ‘right to left’ shunt’?

A

Blood being shunted is deoxygenated

116
Q

Where do most anatomical shunts occur?

A

In the heart: blood from right atrium or ventricle crosses septum into left chambers (An example of a right to left shunt)

117
Q

What can an anatomical shunt result in (Respiratory)?

A

Varying degrees of hypoxemia

118
Q

What is Physiological Shunt?

A

when non-ventilated alveolus is mixed venous blood.

119
Q

What is Atelectasis ?

A

Obstruction of ventilation due to:
Mucosal plugs
Foreign bodies
Oedema
Tumour

120
Q

What is V/Q Mismatching?

A

Most frequent cause of arterial hypoxemia in patients w/respiratory disorders
Varying V/Q ratios across alveoli → Varying capillary gas contents

121
Q

What is COPD?

A

Chronic obstructive pulmonary disease
Airflow is obstructed
COPD encompasses emphysema and chronic bronchitis
Linked to long term smoking

122
Q

What are 4 symptoms of COPD?

A

Chronic cough
Chest tightness
Shortness of breath
Increased mucous production

123
Q

What is emphysema?

A

Structures in alveoli over inflated
Lungs loose elasticity and cannot fully expand/contract
Exhalation tend to be difficult

124
Q

What is chronic bronchitis?

A

Inflammation of bronchi causing mucous production and excessive swelling
Shortness of breath with mild exertion experienced
Chest infections prevalent

125
Q

What is pulmonary fibrosis?

A

Interstitial lung disease
Scarring and thickening of tissue
Decreased elasticity and gas exchange

126
Q

How much is Health FEV1/FVC ratio?

A

= 70% (70% of lung volume expired in 1 second)

Human Systems (5 decks)

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