Test 1 Study Guide Flashcards
Gas exchange between blood, tissues, and
cells of the body
Internal Respiration
What affects the way gases move?
Diffusion
Thickness of membrane
Partial Pressures
Solubility
The ______ bronchioles mark the beginning of the respiratory or gas-exchange zone.
Respiratory
The upper airways consist of:
Nose
Oral cavity
Pharynx
Larynx
The nose’s main purpose
warm, humidify and filter inspired gas
Breathing route of choice for adults at rest
Nose
the space behind the nasal
cavities that extends down behind the tongue to the
larynx.
Pharynx
Parts of the pharynx
Nasopharynx
* Oropharynx
* Laryngopharynx (hypopharynx
Large leaf-like cartilage. Prevents aspiration of food and liquids.
Epiglottis
Covers opening of the larynx
during swallowing.
Epiglottis
Space between epiglottis and
tongue. Important landmark during
endotracheal intubation
Vallecula
Conducting airways consist of (histology)
Mucus blanket
* Epithelium
* Basement membrane
* Lamina propria
- Lines the trachea down to the
respiratory bronchioles. Contain mucus secreting goblet cells.
Pseudostratified Ciliated Columnar
Epithelium
- Known as the mucociliary escalator.
Pseudostratified Ciliated Columnar
Epithelium
Contains 250 cilia beating at 1300
times per minute. Moves sheet of mucus toward the pharynx at 2 cm per minute.
Pseudostratified Ciliated Columnar
Epithelium
2 types of epithelial cells in the Alveolar epithelium
Type I: Gas exchange
surface
Type II: Surfactant
Adjoining basement membranes
of the alveolar epithelium and
capillary endothelium form
extremely thin blood-air barrier
that is highly or lowly permeable to
gases?
Highly
large migratory phagocytes wandering
freely throughout the alveolar airspaces and interstitium.
Alveolar Macrophages
in the acinus engulf foreign material
(organic and inorganic), destroying bacteria and entrapping inorganic particles.
Alveolar Macrophages
Some phagocytized material is _____, and some is simply surrounded and isolated.
Dissolved
Potent ____ and oxidizing agents kill bacteria, viruses, and fungi.
Enzymes
All airways before beginning of alveoli.
Begins at nose and ends at terminal bronchioles.
Conducting airways
Conducts gas to the alveoli.
No gas exchange occurs
Conducting airways
Provide for collateral ventilation between acini or primary lobules.
Channels of Martin, Canals of
Lambert, and Pores of Kohn
Additional ventilation for blocked alveolar units.. May explain why diseases spread so quickly at the lung tissue (parenchymal) level.
Channels of Martin, Canals of
Lambert, and Pores of Kohn
major muscle of
inspiration where the lung bases rest
Diaphragm
The _____ hemidiaphragm is slightly lower
Left
The heart rests on the ___ half of the diaphragm
Left
The liver is crowded into the_____ cavity below the right.
Abdominal
The _____ and _____ pleurae are a continuous membrane forming sealed envelopes surrounding each lung.
visceral and parietal
The _____ pleura, attached to the lungs surface, doubles back on itself at the hilar region to form the parietal pleura
Visceral
Covers the inner chest wall surface
parietal pleura
Fluid in pleural space
Pleural Effusion
Fluid settles into _____ angles,
blunting their outline on CXR.
Costophrenic
surgical removal of
excess pleural fluid via tube insertion
into pleural cavity.
Thoracentesis
The paired ____ nerves supply motor innervation to the hemidiaphragms:
Phrenic
Originate from C3-C5 spinal nerves and cross in front of the scalenus anterior muscles of the neck and enter the chest,
sandwiched between the subclavian arteries and veins.
Phrenic Nerves
Injury from surgery, trauma, or disease
Somatic innervation
May paralyze diaphragm (3-5 keep diaphragm alive) if injured. Breathing is possible if accessory nerves are intact.
Somatic innervation
Accessory muscles of inspiration
Scalene muscles
Sternocleidomastoid muscles
Pectoralis major muscles
External intercostal muscles
______ are the only
Accessory Muscles of Expiration
Abdominals
Abdominal Muscles
Internal intercostal muscles.
Rectus abdominis muscles (most important).
External abdominis oblique.
Internal abdominis oblique.
Transverses abdominis.
The collective action of the _____muscles of expiration causes the intrapleural pressure to increase, the chest to move outward, and gas flow
to increase.
Accessory
At sea level, atmospheric
pressure exerts a force equal to the
weight of a mercury column ____
mm Hg high.
Therefore, standard PB
at sea level is
expressed as height of the mercury
column it supports.
760
The act of inspiring heats air to body temperature (37°C) and saturates it with water vapor (100%
relative humidity [RH]).
Partial pressure of water vapor
Because the PH2O of gas in the lung is constant; under body temperature and humidity conditions,
the PH2O is always _____ mm Hg
47
At sea level the total pressure of all gases in the lung, including water vapor, is ____ mm Hg.
760
Because water vapor accounts for 47 mm Hg of the total, the rest of the atmospheric gases account for the remaining ____ mm Hg.
713
defined as the volume of air either entering or leaving the lung each minute.
Minute ventilation (VE)
Formula for minute ventilation
VE = VT x f
If a persons tidal volume (VT
) is 500 mL and breathing frequency is 12
breaths/min, what is their minute ventilation?
VE = .500 mL x 12 breaths/min
VE = 6000 mL/min or 6.0 L/min
consists of the conducting airways which run from the mouth and
nose down to the terminal bronchioles
Anatomical dead space (VDanat)
Necessary to move gas to and from the alveoli. No gas exchange occurs between blood and across their walls.
Anatomical dead space (VDanat)
- Increases slightly with deep inspiration, and with drugs that increase airway diameter (bronchodilators).
- Increases in diseases which cause hyperinflation
Anatomical dead space (VDanat)
related to lung size; in normal adults, _____ _____ _____ is
approximately 1 mL per pound of ideal bodyweight
Anatomical dead space (VDanat)
Ideal body weight formula for males
- Males = [height (inches) – 60] x 2.3 + 50
Ideal body weight formula for females
Females = [height (inches) – 60] x 2.3 + 45.5
the volume contained in non-perfused alveoli- that is, alveoli with no
blood flow.
Alveolar dead space (VDA)
The presence of ___ is abnormal, and any factor decreasing pulmonary blood flow, increase ____.
Alveolar dead space (VDA)
Signs of alveolar dead space
- Extremely low cardiac output
- Pulmonary embolus
represents a decreased surface area for gas exchange and an increase in total
wasted ventilation
Alveolar dead space (VDA)
- Blood clot in pulmonary arteries or
arterioles. - Reduces or completely blocks pulmonary
blood flow.
Pulmonary embolus
_____ _____ beyond obstruction is
wasted, or dead space, ventilation
Alveolar Ventilation
Normal Ventilatory Formula
- VT = 5 to 8 mL/kg/IBW
Average Ventilatory Measure
Average VT = 500 mL
Adult Ventilatory Rate
12-20 breaths/min
Inspiratory to Expiratory (I:E) ratio
1:3
Normal, spontaneous
breathing
Eupnea
I:E ratio with eupnea
1:3
An abnormal breathing pattern of
progressively deeper breathing,
followed by a gradual decrease in
volume, followed by apnea
Cheyne-Stokes Respiration
Each cycle of Cheyne-Stokes Respiration lasts between ___ to
____ seconds
30 to 120 seconds
The collateral airways of Channels of Martin, Canals of Lambert, and Pores of Kohn provide additional _____ for blocked alveoli pathways
Ventilation
The respiratory bronchioles mark the beginning of what region in the airways?
Gas-exchange zone
Abdominal muscles are the only accessory muscles of ______
Expiration
The scalenus anterior muscles are located where?
The neck (scales are on neck of lizards)
What is the normal ventilatory range for tidal volume?
5-8 mL per Kg of IBW
The pseudostratified ciliated columnar epithelium lines the airways from the ____ down to the respiratory bronchioles
Trachea
Potent enzymes and oxidizing agents that kill bacteria, viruses, and fungi is part of what mechanism?
The Alveolar Clearance Mechanisms
The pseudostratified ciliated columnar epithelium contains mucus secreting cells called ____
Goblet Cells
Anatomical dead space is related to lung size. In normal adults, anatomical dead space is approximately ____ mL per pound of ideal bodyweight
1 mL
An abnormal breathing pattern of progressively deeper breathing, followed by a gradual decrease in volume, followed by apnea
Cheyne-Stokes Respiration
What does pulmonary embolus do? What effect does it have?
Reduces or completely blocks pulmonary blood flow; can stop perfusion to gas exchange surfaces (alveoli)
The accessory abdominal muscles are recruited to assist during times of increased ___ ____
Airway resistance
The mucus blanket, epithelium, blanket membrane and lamina propria are the tissue layers that make up what part of the airways?
The conducting airways
