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AP2 > Respiratory System > Flashcards

Respiratory System Flashcards

1
Q

What system works with the respiratory system? What is their function?

A

The respiratory and the circulatory systems function together to supply the body with O2 and dispose of CO2

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2
Q

What is the function of the nose?

A

a. Provides an airway for respiration
b. Filters, moistens and warms the inspired air
c. Serves as a resonating chamber for speech
d. Houses olfactory receptors

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3
Q

Describe the nose

A

a. External
i. root, bridge, dorsum nasi, apex, nares, and philtrum
b. Internal:
i. Nasal cavity:
ii. Divided by a nasal septum
iii. Roof: ethmoid and sphenoid bones
iv. Floor: hard and soft palates

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4
Q

What are paranasal sinuses?

A

Cavities in bones to lighten the skull and to warm and moisten the air

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5
Q

Describe the pharynx

A

a. Muscular tube that connects to the nasal cavity and mouth superiorly
c. Larynx and esophagus inferiorly
d. Divided into 3 anatomic regions

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6
Q

Name the 3 anatomic regions of the pharynx

A

a. Nasopharynx
b. Oropharynx
c. laryngopharynx

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7
Q

Describe the nasopharynx

A

a. Pharyngeal tonsil (adenoids) on posterior wall

b. Eustachian (pharyngotympanic) tubes open into the lateral walls

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8
Q

Describe the oropharynx

A

a. Passageway for food and air from the level of the soft palate to the epiglottis
b. Palatine tonsils here
c. Lingual tonsil on the back of the tongue

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9
Q

Describe the laryngopharynx

A

Ends in an bifurcation – one path leads to the larynx, the other down the esophagus

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10
Q

Describe the larynx

A

a. Continuous with the trachea below it
b. Functions
i. Provides an airway
ii. Production of speech sounds

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11
Q

What are some of the cartilages of the larynx?

A

a. Cartilages of the larynx are all hyaline cartilage except for the epiglottis
b. Thyroid cartilage with laryngeal prominence (Adam’s apple)
c. Cricoid cartilage
d. Epiglottis: elastic cartilage; covers the larynx during swallowing

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12
Q

Describe the vocal ligaments (true vocal cords)

A

a. Opening between them is the glottis

b. Folds bang into each other and vibrate to produce sound as air rushes up from the lungs

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13
Q

Describe the vestibular folds (false vocal cords)

A

a. Superior to the true vocal cords
b. No part in sound production
c. Help to close the glottis during swallowing

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14
Q

Vocal folds may act as what? Why?

A

a. Vocal folds may act as a sphincter to prevent air passage
b. Example: Valsalva’s maneuver (“bear down,” noise made during heavy lifting)
i. Glottis closes to prevent exhalation
ii. Abdominal muscles contract
iii. Intra-abdominal pressure rises
iv. Helps to empty the rectum or stabilizes the trunk during heavy lifting

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15
Q
  1. Describe voice production
A

a. Speech: intermittent release of expired air while opening and closing the glottis
b. Pitch is determined by the length and tension of the vocal cords
c. Loudness depends upon the force of air
d. Nose, mouth, and sinuses amplify and enhance sound quality
e. Sound is “shaped” into language by muscles of the pharynx, tongue, soft palate, and lips

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16
Q

Describe the “windpipe”

A

a. Trachea= windpipe
b. from the larynx to the carina
c. Carina
d. Last tracheal cartilage
e. Point where trachea branches into two bronchi, which go to the lungs

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17
Q

How many bronchi air passage branches are there?

A

Air passages undergo 23 orders of branching

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18
Q

What is the name of the bronchi air passage pattern?

A

Branching pattern called the bronchial (respiratory) tree

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19
Q

Describe the conducting zone structures

A

a. Trachea splits into R and L primary bronchi
b. Each primary bronchus enters one lung where each branches into secondary (lobar) bronchi
c. Each lobar bronchus supplies one of the five lobes of the lungs (three right, two left)
d. Each lobar bronchus branches into numerous (tertiary) bronchi
e. Bronchioles are much smaller bronchi
f. Terminal bronchioles are the smallest

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20
Q

Describe respiratory zone (end of the line)

A

a. Respiratory bronchioles, alveolar ducts, alveolar sacs (clusters of alveoli)
b. ~300 million alveoli account for most of the lungs’ volume and are the main site for gas exchange (perfusion)

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21
Q
  1. Describe Alveoli (“Cavities”)
A

a. Very thin (~0.5 μm) air-blood barrier

b. Alveolar pores connect adjacent alveoli, allowing air pressure throughout the lung to be equalized

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22
Q

What keeps alveoli surfaces sterile?

A

Alveolar macrophages keep surfaces sterile

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23
Q

Describe the cell types of the alveolar walls

A

a. Alveolar walls:
b. Type I cells - single layer of squamous epithelium for diffusion
c. Type II cells - cuboidal cells that secrete surfactant (decreases surface tension)

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24
Q

Describe lungs

A

a. Apex: superior tip
b. Base: surface that rests on the diaphragm
c. Cardiac notch of left lung: concavity that accommodates the heart
d. Left lung is smaller, separated into two lobes by an oblique fissure
e. Right lung has three lobes separated by oblique and horizontal fissures
f. Lobules are the smallest subdivisions; served by bronchioles and their branches (not important)

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25
Q

Describe pleurae

A

a. Thin, double-layered serosa
b. Parietal pleura lines the thoracic wall
c. Visceral pleura is bound to external lung surface
d. Pleural fluid fills the thin pleural cavity between the serosae, providing lubrication

26
Q

Describe mechanics of breathing

A

a. Pulmonary ventilation consists of two phases
i. Inspiration: gases flow into the lungs
ii. Expiration: gases exit the lungs
b. The average number of respirations at rest is ~14/min (tidal breathing) (eupnea or good/happy breathing)
c. Inhalation is caused by the increase in the size of the thoracic cage.
d. Size is proportional to volume.
e. As the volume increases the pressure in the thoracic cavity decreases.

27
Q

Describe pressure relationship in the thoracic cavity

A

a. Atmospheric pressure (Patm)
i. 760 mm Hg at sea level
b. Intrapulmonary pressure (Ppul)
i. Pressure in the alveoli
ii. Fluctuates with breathing (758-759 during inspiration, 761-762 during expiration)
iii. Always eventually equalizes with Patm

28
Q

Describe intrapleural pressure

A

a. Intrapleural pressure (Pip):
i. Pressure in the pleural cavity
ii. If Pip = Ppul the lungs collapse

29
Q

Name of lung collapse and what may cause it

A

a. Atelectasis (lung collapse) is due to:
i. Obstructed bronchioles leading to collapse of alveoli
ii. Pneumothorax - wound that admits air into pleural cavity

30
Q

Describe inspiration

A

a. An active process
b. Inspiratory muscles contract (external intercostals and diaphragm)
c. Thoracic volume increases
d. Lungs are stretched and intrapulmonary volume increases – Ppul drops to ~758 mm Hg
e. Air flows into the lungs from the atmosphere, down its pressure gradient, until Ppul = Patm

31
Q

Describe expiration

A

a. Quiet expiration is normally a passive process
i. Inspiratory muscles relax
ii. Thoracic cavity volume decreases
iii. Elastic lungs recoil and intrapulmonary volume decreases
iv. Ppul rises to ~761 mm Hg
v. Air flows out of the lungs down its pressure gradient until Ppul = 760
b. Forced expiration is an active process: it uses abdominal and internal intercostal muscles

32
Q

What are physical factors influencing pulmonary ventilation?

A

a. Inspiratory muscles consume energy to overcome two main factors that slow air passage:
i. Airway resistance
ii. Alveolar surface tension (surfactant from type 2 cells)
b. Usually insignificant because of large airway diameters of trachea and primary and secondary bronchi

33
Q

Describe airway resistance

A

a. Resistance is usually insignificant because of large airway diameters of trachea and primary and secondary bronchi
b. Resistance disappears at the terminal bronchioles where diffusion drives gas movement (unless you have asthma)
c. Severe constriction or obstruction of bronchioles can make breathing movements become more strenuous and prevent vital ventilation
i. Acute asthma attacks can stop ventilation
d. Epinephrine dilates bronchioles and reduces air resistance

34
Q

Describe alveolar surface tension

A

a. Surface tension - attracts water molecules to one another at a gas-liquid interface
b. Surfactant – A detergent-like lipid and protein complex produced by alveoli
c. Reduces surface tension, discouraging alveolar collapse
d. Insufficient quantity in premature infants causes infant respiratory distress syndrome (RDS)(Drs. Use surfactant spray)

35
Q

What is the respiratory volume for normal in normal out?

A

Tidal volume (TV) = [normal in normal out]

36
Q

What is the respiratory volume for max in?

A

Inspiratory reserve volume (IRV) = [MAX in]

37
Q

What is the respiratory volume for mad out?

A

Expiratory reserve volume (ERV) = [MAX out]

38
Q

What is the respiratory volume for Heimlich air (air you can’t breathe out)?

A

Residual volume (RV) = [Heimlich air]

39
Q

What is the respiratory capacity for max possible inhalation?

A

a. Inspiratory capacity (IC) = [MAX poss inhaled]

b. TV + IRV

40
Q

What is the respiratory capacity for volume of air in lungs after tidal exhalation?

A

a. Functional residual capacity (FRC) = volume of air in lungs after tidal exhalation
b. ERV + RV

41
Q

What is the respiratory capacity for deepest in, deepest out?

A

a. Vital capacity (VC) = [deepest in, deepest out]

b. TV + IRV + ERV

42
Q

What is the respiratory capacity for max amount of air in lungs after deepest inhalation?

A

a. Total lung capacity (TLC) = max amt of air in lungs after deepest inhalation = RV + VC

43
Q

Describe the pulmonary function test

A

Spirometer: instrument used to measure respiratory volumes and capacities – correct interpretations can distinguish between obstructive and restrictive disorders

44
Q

Describe dead space

A

a. Some inspired air never contributes to gas exchange
b. Anatomical dead space – air-filled ducts (larynx, trachea, bronchi, bronchioles)
c. Alveolar dead space – alveoli that are non-functional

45
Q

Describe nonrespiratory air movements (NRAM)

A

a. Most result from reflex action
b. Cough – deep breath, close glottis, force air up and out explosively
c. Sneeze – like cough but pushed thru nasal cav.
d. Crying / Laughing – deep breath released in series of short expirations
i. Crying- close throat
ii. Laughing- open throat
e. Hiccupping – diaphragm spasms
f. Yawning – ventilates alveoli; O2 more blood

46
Q

Describe ventilation-perfusion coupling

A

a. Ventilation: amount of gas reaching the alveoli
b. Perfusion: blood flow reaching the alveoli
c. Ventilation and perfusion must be matched (coupled) for efficient gas exchange across capillary walls

47
Q

Describe O2 transport

A

a. Molecular O2 is carried in the blood
b. 2% dissolved in plasma
c. 98% loosely bound to each Fe of hemoglobin (Hb) in RBCs

48
Q

Define O2 and Hemoblobin (loaded and unloaded)

A

a. Oxyhemoglobin: hemoglobin and O2 bound together

b. Deoxyhemoglobin: hemoglobin that has released O2

49
Q

Describe O2 and Hemoglobin loading and unloading

A

a. Loading and unloading of O2 is facilitated by change in shape of Hb
b. As O2 binds, Hb affinity for O2 increases
c. As O2 is released, Hb affinity for O2 decreases
d. Fully (100%) saturated if all four heme groups carry O2
e. Hb has higher affinity for CO (carbonmonoxide) than either O2 or CO2, wont let it go (cant transport O2 or CO2)

50
Q

Describe the Bohr effect

A

a. As cells metabolize glucose
b. CO2 and H+ levels increase in concentration
c. CO2 + H2O —-> H2CO3 —-> H + + HCO3–
d. Declining pH weakens the Hb-O2 bond
e. (Bohr effect - higher acidity leads to more oxygen released from Hb)

51
Q

Describe hypoxia and its causes

A

a. Inadequate O2 delivery to tissues
b. Due to a variety of causes:
i. Too few RBCs
ii. Abnormal or too little Hb
iii. Blocked circulation
iv. Pulmonary disease
v. Carbon monoxide (CO)

52
Q

Describe CO2 transport

A

a. CO2 is transported in the blood in three forms
b. 10% dissolved in plasma
c. 20% bound to Hb (carbaminohemoglobin)
d. 70% transported as bicarbonate ions (HCO3–) in plasma
e. CO2 + H2O —-> H2CO3 —-> H + + HCO3–

53
Q

Describe chloride shift

A

a. In systemic capillaries
b. HCO3– quickly diffuses out of RBCs into the plasma
c. The chloride shift occurs: outrush of HCO3– from the RBCs is balanced as Cl– moves in from the plasma
d. One negative out puts another one in

54
Q

Describe the influence of CO2 on blood pH

A

a. Changes in respiratory rate can also alter blood pH
i. Hypoventilation - slow shallow breathing allows CO2 to accumulate in the blood, causing pH to drop – respiratory acidosis
ii. Hyperventilation will produce opposite effects for the same chemical reasons

55
Q

Describe control of respiration

A

a. Not well understood . . .
b. Involves neurons in the of the medulla and pons
c. Most widely accepted hypothesis is that two sets of neuronal networks in the medulla sets the rhythm – there is debate . . .

56
Q

Describe medullary respiratory centers

A

a. Ventral respiratory group (VRG)
i. Rhythm-generating and integrative center
ii. Respiratory neurons excite and inhibit the inspiratory neurons to allow tidal breathing
iii. Sets eupnea (12–15 breaths/minute)
b. Dorsal respiratory group (DRG)
i. Integrates input from chemoreceptors – modifies rhythms generated by VRG

57
Q

Describe poutine respiratory centers

A

a. Influence and modify activity of the VRG

b. Allows smooth transition between inspiration and expiration (and vice versa)

58
Q

Describe respiratory apnea

A

Apnea: period of breathing cessation that occurs when Pco2 is abnormally low

59
Q

Give a summary of chemical factors

A

a. Rising CO2 (= falling pH) levels are the most powerful respiratory stimulant
b. Normally blood O2 levels affect breathing only indirectly by influencing chemoreceptor sensitivity to CO2
c. When arterial O2 falls to a very low level, it becomes the major stimulus for respiration

60
Q

Define and describe acclimatization to high altitude

A

a. Acclimatization: respiratory and hematopoietic adjustments to altitude
b. Chemoreceptors become more responsive to CO2 when O2 declines
c. Ventilation increases and stabilizes in a few days to 2–3 L/min higher than at sea level

AP2 (11 decks)

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