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(SALMA) Physiology > RS > Flashcards

RS Flashcards

1
Q

what is the function of the upper resp tract

A

filters
humidifies
warms air

and voice production

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2
Q

what are the 2 functions of voice production

A
  • voice production

- reduces weight of skull

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3
Q

what does the frontal sinus drain into

A

middle meatus

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4
Q

what does the ethmoid sinus drain into

A

superior and middle meatus

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5
Q

what do the sphenoid n maxillary sinus drain into

A

sphenoethmoidal sinus

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6
Q

what is the nasopharynx innervated by

A

maxillary branch of CNV

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7
Q

what is the oropharynx innervated by

A

CN IX

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8
Q

what is the laryngopharynx innervated by

A

CN X

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9
Q

what are the single cartilages of the larynx

A

epiglottis
thyroid
cricoid

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10
Q

what are the paired cartilages of the larynx

A

cuneiform
corniculate
arytenoid

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11
Q

what does the carotid sheath contain

A

common carotid artery
interna jugular vein
vagus nerve

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12
Q

what are the 2 lobes of the thumbs connected by

A

isthmus

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13
Q

what is the arterial supply of the thyroid

A

superior and inferior thyroid arteries

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14
Q

what 3 things happen at t4/5

A
  1. sternocostal angle
  2. trachea bifurcation
  3. division btwn sup n inf mediastinum
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15
Q

what is the blood supply of the pharyngeal constrictor muscles

A

ext carotids

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16
Q

what does the hilum of the lung contain

A 
bronchus
1 pul artery
2 pul veins
bronchial arteries
plexus of nerves n lymphatics
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17
Q

where is the caval opening

A

t8

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18
Q

what runs through the caval opening

A

IVC

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19
Q

where is the oesophageal hiatus

A

t10

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20
Q

what runs through the oesophageal hiatus

A

oesophagus

vagus nerve

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21
Q

what runs through the aortic hiatus

A

aorta
thoracic duct
azygous vein

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22
Q

where is the aortic hiatus

A

t12

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23
Q

how many lobes does left lung have

A

2 - sup n inf

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24
Q

how many lobes does the right lung have

A

3 - sup, mid n inf

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25
Q

what are the fissures of the left lung

A

oblique

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26
Q

what are the fissures of right lung

A

oblique n horizontal fissure

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27
Q

what does the visceral pleura cover

A

lung

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28
Q

what does parietal pleura cover

A

int thoracic cavity

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29
Q

what is in the potential space btwn 2 layers of viscera

A

serous fluid - lubricité n produces surface tension so lungs can expand

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30
Q

what is the parietal pleura innervated by

A

phrenic n intercostal nerves

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31
Q

what is the pump handle mechanism

A

elevation of rib causes anterior part to move forward as well as up

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32
Q

what is the bucket hand mechanism

A

middle part of rib move out as well as up during inspiration

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33
Q

what are the normal muscles involved in passive exp/insp

A

external intercostals

diaphragm for inspiration

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34
Q

which extra muscles are involved in active breathing

A

internal intercostals
SCM
pec major

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35
Q

what is the innervation of the diaphragm

A

c3, 4, 5

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36
Q

what is the innervation of intercostals

A

T1-11

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37
Q

describe inspiration (4)

A
  1. diaphragm and ext intercostals contract - thoracic expansion
  2. pressure of pleural fluid becomes sub-atmospheric
  3. transpulmonary pressure increases (pressure difference btwn inside n outside lung) –> lungs expand
  4. alveolar pressure becomes sub-atmospheric –> air flows into alveoli
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38
Q

describe expiration (5)

A
  1. diaphragm n ext intercostals stop contracting
  2. chest wall recoils inwards
  3. pleural fluid pressure increases –> trans pulmonary pressure decreases
  4. lungs return to pre-inspiration volume –> alveolar air compressed
  5. alveolar pressure > atmospheric pressure –> air flows out of the lung
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39
Q

what is the loop for resp control

A 
sensor (peripheral/central chemoreceptors)
-
controller (medulla/pons)
-
effector (diaphragm/intercostals)
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40
Q

what are the 2 parts to the medullary resp centre

A

inspiratory group - inspiration

expiratory group - sends inhibitory impulse to apneustic centre

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41
Q

what are the inspiratory and expiratory group a part of

A

medullary resp centre

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42
Q

what does the inspiratory group of medullary resp centre do

A

inspiration

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43
Q

what does the expiratory group of medullary resp centre do

A

sends inhibitory impulse to apneustic centre

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44
Q

what does the pontine resp centre do

A

helps inspiration - expiration transition

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45
Q

what are the 2 parts to the pontine resp centre

A

apneustic centre - fine tunes inspiratory groups output

pneumotaxic centre - inhibits inspiratory neurone for expiration

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46
Q

what does the apneustic centre of pontine resp centre d

A

fine tunes inspiratory groups output

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47
Q

what does the pneumotaxic centre of the pontine resp centre do

A

inhibits inspiratory neurone for expiation

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48
Q

where are central chemoreceptors found

A

medulla

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49
Q

what do central chemoreceptors respond to

A

hydrogen ion conc in csf

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50
Q

where are peripheral chemoreceptors found

A

aortic arch

carotid sinus

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51
Q

what do peripheral chemoreceptors respond to

A

H+ conc (90%)

arterial oxygen conc (10%)

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52
Q

what are the 3 types of stretch receptors

A

slow adapting stretch receptors (SASR)
fast adapting stretch receptors (FASR)
c fibres j receptors

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53
Q

where are SASR found

A

smooth muscle

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54
Q

discuss SASR (4)

A
  • found in smooth muscle
  • activated by lung distension
  • high SASR activity inhibits insp - begin exp
  • adaptive receptors over chronic inflation
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55
Q

discuss FASR (3)

A
  • found btwn airway cells
  • activated by irritants
  • brief sharp bursts of activity –> bronchodilation
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56
Q

where are SASR found

A

smooth muscle

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57
Q

where are FASR found

A

btwn airway cells

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58
Q

which receptors are activated by irritants

A

FASR

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59
Q

which receptors are activated by lung distension

A

SASR

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60
Q

what are c fibres j receptors (2)

A

type of stretch receptor

  • activates by an increase in interstitial fluid
  • causes hyperventilation and bronchoconstriction
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61
Q

which receptors are activated by increase in interstitial fluid

A

c fibres j receptors

62
Q

which receptors cause bronchoconstricton and bronchodilation

A

bronchoconstriction - c fibres j receptors

bronchodilation - FASR

63
Q

what is alveolar recruitment

A

during high oxygen requirement (exercise) alveoli that were shut off from air supply are recruited - increases gas exchange

64
Q

what is the oxygen dissociationn curve shape

A

non linear

sigmoid

65
Q

what does a left shift in the sigmoid curve mean

A

higher affinity
less dissocation
increased CO conc

66
Q

what does a right shift in the sigmoid curve mean

A

lower affinity
more dissocation
increased H ion conc
increased temp

67
Q

what are the 7 layers of gas exchange

A
  1. surfactant
  2. type 1 pneumocystis (alveolar membrane - squamous epithelium)
  3. interstitial fluid
  4. capillary endothelium
  5. blood plasma
  6. RBC membrane
  7. RBC cytoplasm
68
Q

what is ventilation

A

rate of air flow to lungs

69
Q

what is perfusion

A

rate of blood flow to alveoli

70
Q

what is V/Q mismatch

A

when rates of ventilation and perfusion are not equal

71
Q

list 3 causes of V/Q mismatch

A

shunting (blood doesn’t get to capillaries)
bronchial artery occlusion
pulmonary oedema

72
Q

what is the equation for Boyle’s law

A

V1 x P1 = V2 X P2

73
Q

what is Boyle’s law

A

vol and pressure are inversely proportional

74
Q

what is the equation for Dalton’s law

A

P1 + P2 + P3 = P(1+2+3)

75
Q

what is dalton’s law

A

total pressure = sum of gas partial pressure

76
Q

what is the equation for Henry’s law

A

PAO2 = PaO2

77
Q

what is henry’s law

A

amount of oxygen dissolved in blood is proportional to partial pressure of oxygen in alveoli

78
Q

what is the alveolar gas equation

A
  • PAO2 = PiO2 - PaCO2/RQ
79
Q

what is Laplace’s law (2)

A

air will travel from smaller alveoli to bigger alveoli - larger radius = lower pressure

surfactant abolishes surface tension - all alveoli are same size, homogeneous aeration of lungs

80
Q

what is acid base balance

A

H2O + CO2 H2CO3 H+ + HCO3-

81
Q

what is the dissocation equation catalysed by

A

carbonic anhydrase

82
Q

what is the Henderson hasselbach equation

A

pH = 6.1 + log([HCO3-]/[PaCO2x0.03])

83
Q

what is resp acidosis

A

incr PaCO2
decr pH

hypoventilation

84
Q

what is resp alkalosis

A

decr PaCO2
incr pH

hyperventilation

85
Q

what is met alkalosis

A

incr HCO3-
not enough H+
incr pH

vomiting

86
Q

what is met acidosis

A

decr HCO3-
decr pH

renal failure

87
Q

what is hypoxia

A

not enough oxygen

88
Q

what is hypercapnia

A

too much carbon dioxide

89
Q

what is t1 resp failure

A

hypoxia (PaO2 < 8kPa)

can’t get enough oxygen into blood

90
Q

what is t2 resp failure

A

hypoxia (PaO2 < 8kPa)

hypercapnia (PaCO2 > 6kPa)

91
Q

list some causes of t1 resp failure

A 
high altitude
v/q mismatch
pulmonary embolism
hypoventilation
pneumonia
92
Q

list some causes of t2 resp failure

A

can’t get rid of CO2 - COPD, asthma

93
Q

define tidal volume (TV)

A

vol of air inspired n expired in normal breathing (500ml)

94
Q

define vital capacity (VC)

A

max vol of air that can be expired (3000-5000ml)

95
Q

define total lung capacity (TLC)

A

total vol of air in lungs (6000ml)

96
Q

define residual volume (RV)

A

volume of air remaining in lungs after forced expiration

97
Q

define functional residual capacity (FRC)

A

vol of air remaining in lungs after tidal expiration

98
Q

define inspiratory capacity (IC)

A

vol of air that can be inspired after tidal expiration

99
Q

define inspiratory reserve volume (IRV)

A

vol of air that can be inspired after tidal inspiration

100
Q

what is FEV1

A

FEV in 1 second

101
Q

what is FEV6

A

FEV in 6 seconds (basically FVC)

102
Q

what is the peak expiratory flow (PEF) on a flow/volume graph

A

highest point on graph

103
Q

what is obstructive lung disease

A

patients cannot expire air quickly completely - airways are too constricted

104
Q

what is restrictive lung disease

A

patients cannot inspire enough air - lungs do not expand fully

105
Q

what is the diff btwn obstructive and restrictive lung disease

A

obstructive - constricted airways, cannot expire

restrictive - lungs don’t expand fully, can’t inspire

106
Q

what is the FEV1/FVC ratio in obstructive lung disease

A

<0.7

bc reduced FEV1 - can’t exhale 70% of air in 1 second

107
Q

what are examples of obstructive lung diseases

A

COPD
asthma
bronchitis

108
Q

what is the FEV1/FVC ratio in restrictive lung disease

A

> 0.8

bc reduced FVC - air can get out fine

109
Q

what is an example of restrictive lung disease

A

pulmonary fibrosis

110
Q

how does blood travel in pulmonary vessels

A

at low pressure bc p BV have thin, poorly muscularised walls

111
Q

what is the effect of oxygen in systemic circulation and thus pulmonary

A

systemic - vasoconstrictor
pulmonary - vasodilator

reverse in hypoxia

112
Q

what is the Gell and Coombs classification for hypersensitivity

A

t1-4

igE
igM
IgG
T cells

113
Q

what happens type 1 in g and c hypersensitivity classification

A

involves IgE
- fast allergic response
eg hayfever

114
Q

what happens in t2 g and c hypersensitivity classification

A

involves IgM
- immune system thinks cells are foreign
eg blood transfusion

115
Q

what happens in t3 g and c hypersensitivity classification

A

involves IgG
- complex deposits and causes inflammation
eg lupus

116
Q

what happens in t4 g and c hypersensitivity classification

A

involves t cells
- part of learned immune response
eg contact dermatitis

117
Q

what happens in a t1 IgE reaction (3)

A
  1. IgE binds to mast cells n basophils
  2. cells degranulate - release histamine n prostaglandins
  3. local response - vasodilation leads to inflammation
118
Q

does the SNS cause bronchodilation or constriction

A

bronchodilation

119
Q

what neurotransmitter is involved in brochodilation

A

Ad

120
Q

does the PNS cause bronchodilation or constriction

A

bronchoconstriction

121
Q

which nerve involves PNS and bronchoconstriction

A

vagus nerve

122
Q

which neurotransmitter is involved in bronchoconstriction

A

ACh

123
Q

what are the 2 cholinergic receptors

A

nicotinic and muscarinic

124
Q

what are the muscarinic receptors n what do they cause

A

m3

bronchoconstriction

125
Q

what are the 2 adrenergic receptors

A

alpha n beta

126
Q

what are the beta receptors n what do they cause

A

beta 2

bronchodilation

127
Q

what happens during the sympathetic response

A
  • Ad released from adrenal glands
  • binds to beta 2 receptors
  • bronchodilation
128
Q

what happens during parasympathetic response

A
  • ACh released
  • binds to m3 receptors
  • bronchoconstriction
129
Q

what do beta 2 agonists do

A

stimulate bronchodilation

130
Q

what do m3 antagonists do

A

inhibits bronchoconstriction

131
Q

what is innate immunity

A

non specific and generic response to pathogens

132
Q

what is the muco-ciliary escalator

A
  • mucous is elastic n viscous (secreted by goblet cells in resp epithelium)
  • upper mucus n lower surfactant layer
  • resp epithelium cilia beat in upwards direction - moves mucus from lower resp tract to pharynx
133
Q

what is mucous secreted by

A

goblet cells in resp epithelium

134
Q

which direction does cilia beat in

A

upwards

135
Q

describe the coughing mechanism (4)

A
  1. afferent impulse from vagus n glossopharyngeal to medulla
  2. epiglottis n vocal cords shut, abdominal n intercostals contract
  3. intrathoracic pressure increases –> epiglottis n vocal cords suddenly open
  4. large pressure diff causes rapid expulsion of air through trachea
136
Q

what are the 3 types of cells in alveolar epithelium

A

type 1 pneumocytes
type 2 pneumocytes
alveolar macrophages

137
Q

name 3 features of t1 pneumocytes

A
  • simple squamous
  • 90% SA (form walls)
  • thin blood gas barrier
138
Q

name 2 features of t2 pneumocytes

A
  • secrete surfactant

- less SA but 60% of cells

139
Q

what are alveolar macrophages

A

resident macrophages of lung

phagocytose foreign material

140
Q

what are the 2 main occurrences in inflammation

A
  1. alveolar macrophage responds to damaged tissue, releases cytokines - mast cells release histamine
  2. neutrophils n basophils migrate to damaged cite - involved in phagocytosis of foreign materials and sticks to endothelial walls
141
Q

where are B cells produced

A

bone marrow

142
Q

where do B cells mature

A

lymph nodes n spleen

143
Q

where are T cells produced

A

bone marrow

144
Q

where do T cells get released from

A

thymus

145
Q

what does a B cell differentiate into to release specific antibodies

A

plasma cell

146
Q

what do t helper cells do

A
  1. cd4 receptors recognise antigen presenting cells

2. cytokines are released which stim B cells and cytotoxic t cells

147
Q

what do cytotoxic T cells do

A
  1. cd8 receptors recognise foreign pathogen
  2. cause perforin release
  3. thus cell lysis
148
Q

why do memory cells remain after infection elimination

A

to allow fast response to future infection

149
Q

what is an antibody

A

unique receptor (IgG) that binds to foreign pathogen n can agglutinate or active T killer cell for destruction

150
Q

describe immunisation

A
  • uses dead or attenuated pathogen
  • memory cells remain –> protection from actual infection
  • herd immunity –> if enough ppl get vaccinated, nobody will get disease
151
Q

what is dead space

A

vol of air inhaled that does not take part in the gas exchange

152
Q

why is there dead space (2)

A
  1. remains in conducting airways

2. reaches alveoli that are not/poorly perfused

(SALMA) Physiology (12 decks)

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