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Physiology and Pathology Exam 1 > Test 2 Respiratory/Pulmonary > Flashcards

Test 2 Respiratory/Pulmonary Flashcards

1
Q

What is a cause of morbidity and mortality in premature infants?

A

immaturity of the respiratory tract

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2
Q

What begins after week 20?

A

Surfactant(a detergent) production: fluid that lines the alveoli- purpose to lower surface tension and pressure and make you able to contract lungs)

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3
Q

At what weeks of gestation are sufficient alveoli present to permit survival?

A

25th to 28th week

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4
Q

About how many alveoli does one have at birth? 3-7 years old? and final adulthood?

A

birth-20-50million
3-7 years ~ 300million
adult ~ 700million

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5
Q

Lack of stiff structural support for airways makes infants more susceptible to what?

A

atelectasis(lung collapse) and obstruction

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6
Q

Why are infant airways much more resistant to air flow than adults?

A

infant airways are smaller

ex: imagine breathing through a coffee straw and a mcdonalds straw

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7
Q

Are neonates predominantly mouth-breathers or nose-breathers?

A

nose-breathers

Therefore obstruction of the nose or nasopharynx increases upper airway resistance and increases work of breathing

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8
Q

Who is more likely to suffer from pneumonia, newborn or adults and why?

A

newborn bc of lack of alveoli

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9
Q

What is a sign of increased respiratory resistance more so in infants?

A

Nose flaring

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10
Q

What are things that can dramatically reduce airflow?

A

mucus, edema, or airway constriction

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11
Q

Most respiratory disorders in infants result in what?

A

reduced lung compliance (ability to stretch and recoil) or increased airway resistance

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12
Q

There are six signs of reduced compliance or increased resistance. What are they?

A

Increased respiratory rate (tachypnea)
Grunting (audible noise during expiration)
Nasal flaring
Retractions (skin being sucked in around ribs during inspiration)
Stridor (sound caused by increased turbulence of air moving through the trachea and large airways)
Wheezing (sound caused by increased turbulence of air moving through the smaller airways)

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13
Q

Infants have more ____ cells that cause them to create more mucous that can obstruct their airways.

A

goblet cells

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14
Q

What are the two major airways made up of?

A

Upper airway:
Nasopharynx
Oropharynx
Laryngopharynx

Lower airway:
Larynx
Trachea
Bronchi 
Acinus
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15
Q

The nasal cavity has 6 functions. Summarize.

A

CONDUCTS gases to and from lungs
FILTERS,WARMS,HUMIDIES air
TURBINATES are convoluted and vascular
(Efficient heat exchanger.
Water (mucous) evaporates from surface to humidify air)
Rigid (bone/cartilage) to PREVENTS COLLAPSE
VIBRISSAE(large hairs) trap foreign particles
MUCOSAL EPITHELIAL CILIA sweep mucous into nasopharynx, which is then swallowed or expectorated

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16
Q

What are the four paranasal sinuses?

A

Maxillary(cheeks get infection with sinus infection), frontal(not everyone has them), ethymoid, sphenoid(last two more posterior)

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17
Q

What do the paranasal sinuses contribute to?

A

speech resonance, heat and water vapor exchange (warming and humidifying air)
ex: when someone has a cold their voice changes

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18
Q

What removes bacteria and debris in the sinuses?

A

mucociliary action

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19
Q

What allows pressure equalization of the middle ear?

A

eustachian tube

ex: like when you’re on a plane

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20
Q

At what time do the eustachian tubes open?

A

open during swallowing

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21
Q

The eustachian tubes are in different positions in children than adults. At what position does it sit? What risk increases with this position?

A

Horizontal position and shorter length in children. This causes more ear infections bc fluids can’t drain as easily

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22
Q

What do your conducting airways(what are responsible for moving air) consist of?

A

oral and nasal pharynx and larynx is what takes up air
trachea, segmental bronchi and bronchioles (nonrespiratory)
branches of bronchioles and alveolar ducts(respiratory)

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23
Q

Kartagenrous syndrome is what?

A

No functional cilia which means sterile(no cilia in fallopian tubes), sinus infections, etc. Cant beat mucous away

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24
Q

What are the conducting airways made of?

A

Ciliated columnar mucosal epithelial cells

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25
Q

Cilia above the esophagus are beating ____ and below(like in the lungs) are beating mucous ____. why?

A

down. up. want to swallow the mucous

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26
Q

What is a primary defense mechanism of the airways?

A

Mucociliary transport: Moves inhaled particles and mucous to the esophagus for swallowing or coughing

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27
Q

Ciliary function is impaired by what?

A 
Smoking
Ethanol 
Hypo or hyperthermia
Cold or hot air, low humidity
Anesthetics, corticosteroids, noxious gases
Viral infection (common cold)
Excessive mucous production
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28
Q

What do goblet cells produce?

A

Produce mucous (100 mL/day)

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29
Q

what is sIgA?

A

antibody secreted on mucousal surfaces that organisms can bind to and prevent infection

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30
Q

List the functions of the larynx.

A

Sound production
Valve to control air movement out of the lungs, including to expel foreign substances, e.g. coughing
Prevent foreign substances from entering the trachea and lungs

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31
Q

a horseshoe shaped bone from which the larynx is suspended

A

hyoid bone

32
Q

What are the three cartilages of the larynx?

A

THYROID: a V-shaped cartilage containing the vocal folds (attach anteriorly, one you can feel)
CRICOID: a ring shaped cartilage connected to the trachea, supports the arytenoid cartilages posteriorly(isthmus of thyroid gland runs here)
ARTHENOID: vocal folds connect on posterior side

33
Q

these vibrate when air passes over them, forming sound (longer folds create lower sounds, tighter folds create higher sounds)

A

vocal folds

34
Q

Vocal folds must remain ____ so when air passes over them and they vibrate.

A

tight

35
Q

Longer vocal folds means higher or lower pitch? Tighter folds create which?

A

lower the pitch ;

higher sounds

36
Q

Where does the trachea divide into the right and left mainstream bronchi?

A

carina

37
Q

How many lobes does the right lung have?

A

3

38
Q

How many lobes does the left lung have?

A

2

39
Q

Describes the largest unit of the lung to the smallest.

A

Lobular bronchi  segmental bronchi (forming bronchopulmonary segments)  bronchopulmonary segments  terminal bronchioles (smallest units)

40
Q

Where do alveoli form on?

A

respiratory bronchioles

41
Q

alveoli = ____

A

gas exchange

42
Q

adults have how many alveoli per lung?

A

about 300 million total

43
Q

what occurs on the surface of alveoli?

A

O2 and CO2 exchange

44
Q

What are the 3 types of alveolar cells?

A

Type I: squamous epithelial cells (“pneumocytes”)-Majority of cells, form gas exchange surface
Type II: produce surfactant-
Phospholipid-containing liquid that lowers surface tension (eases opening) and facilitates gas exchange
Type III: alveolar macrophages (“dust” cells)-
Phagocytize particles / microbes that reach alveoli

45
Q

What are the 3 types of alveolar cells?

A

Type I: squamous epithelial cells (“pneumocytes”)-Majority of cells, form gas exchange surface(surfactant covering these cells)
Type II: produce surfactant-
Phospholipid-containing liquid that lowers surface tension (eases opening) and facilitates gas exchange
Type III: alveolar macrophages (“dust” cells)-
Phagocytize particles / microbes that reach alveoli(can cause black lung-found in coal miners. our bodies don’t have enzymes that can phagocytize coal

46
Q

What are the visceral pleura and parietal pleura?

A

visceral plura- Thin, continuous membranes covering the lungs
parietal plura-Thin, continuous membranes covering the thoracic cavity
the sacs that surrounds the lungs

47
Q

What are the membranes separated by?

A

small amount of serous fluid to lubricate (around 15 ml)

48
Q

Intrapleural space at maintained at _____ which keeps it expanded (i.e., a vacuum, which keeps lungs pressed against thorax wall)

A

negative pressure

PS. if negative pressure would be disrupted could cause a collapsed lung

49
Q

What makes up the autonomic nervous system?

A

parasympathetic and sympathetic

50
Q

What nerve stimulates the parasympathetic nervous system?

A

Vagus nerve

51
Q

what does the vagus nerve(cranial nerve 10) stimulate?

A

constriction of bronchial smooth muscle (bronchoconstriction)– this is rest and digest so don’t need as much air flow

52
Q

what causes the relaxation of bronchial smooth muscle?

A

Sympathetic innervation (T1-T4) and epinephrine / norepinephrine (adrenal gland medulla)

53
Q

What is the sympathetic nervous system mediated by?

A

beta-2 adrenergic receptors

54
Q

what is the defense against excessive secretions or foreign/irritating substances?

A

cough reflex

55
Q

if the cough reflex decreases what risk increases?

A

risk of aspiration

May be caused by cough suppressant medicines, brainstem injury, age

56
Q

what is a cough initiated by?

A

tracheobronchial cough receptors in carina (bifurcation of right and left mainstem bronchi) and coordinated in brainstem (medulla oblongata)

57
Q

how is a cough produced?

A

when vocal folds and epiglottis close tightly against air trapped in lungs
Expiratory muscles (intercostal and abdominal) contract and increase pressure against closed vocal folds and epiglottis
Vocal folds and epiglottis suddenly open
High pressure air escapes, ejecting debris, mucus

58
Q

What arises from the thoracic aorta (oxygenated arterial blood)?

A

bronchial artery system

59
Q

What supplies oxygenated blood to bronchi and supporting lung structures?

A

bronchial artery system

60
Q

What arises from the pulmonary artery and divides into right and left pulmonary arteries?

A

Pulmonary artery system

61
Q

What delivers unoxygenated blood from the right ventricle?

A

pulmonary artery

62
Q

The pulmonary artery system is a huge capillary network for what?

A

gas exchange

*Fewer capillaries in elderly and infants (therefore less efficient gas exchange)

63
Q

The pulmonary artery system is a ____ pressure arterial system.

A

low

64
Q

Blood flow may _____ to adjust for gas exchange needs

A

be increased or reduced

65
Q

Oxygenated blood exits through ______

A

pulmonary vein into left atrium

66
Q

What are the 2 mechanisms that increase capillary perfusion?

A
  1. Recruiting (opening) previously closed capillaries
    –Normally only 25% of pulmonary capillaries are perfused
  2. Increasing arteriolar
    blood flow
67
Q 
Pulmonary arterioles 
  \_\_\_\_\_\_ in response 
 to alveolar hypoxia 
 (insufficient O2 or 
 excess CO2), re-routing 
 blood flow to alveoli 
 that are well-ventilated
A

constrict

68
Q

What are the 3 factors that regulate fluid balance across lung tissue?

A
  1. Hydrostatic pressure (blood pressure vs tissue pressure)
  2. Colloid osmotic (oncotic) pressure (related to protein concentration on either side of a membrane)
  3. Capillary permeability (leakiness between endothelial cells lining capillaries)
69
Q

What is the process of ventilation?

A

Ventilation is the process of moving air into and out of the lungs

70
Q

What is the purpose of ventilation?

A

Purpose is to allow O2 absorption from inspired air and removal of CO2 to expired air

71
Q

What are 3 things that influence ventilation?

A
  1. Age (e.g., reduced with older age)
  2. Body size and shape (e.g., reduced with obesity)
  3. Body position (e.g., reduced with supine position)
72
Q

What are 4 lung volumes? What are 4 lung capacities?

A
  1. Tidal
  2. Inspiratory Reserve
  3. Expiratory Reserve
  4. Residual Volume
  5. Vital Capacity
  6. Inspiratory Capacity
  7. Functional Residual
  8. Total Lung Capacity
73
Q

The volume of air breathed in and out without conscious effort in a “normal” breath (~500 cc)

A

tidal volume (TV)

74
Q

The volume of air above TV that can be inhaled with maximum effort after a normal inspiration (~3 L)

A

Inspiratory reserve volume (IRV)

75
Q

The volume of air above TV that can be forcibly exhaled with maximal effort after normal exhalation (~1.2 L)

A

Expiratory reserve volume (ERV)

76
Q

The volume of air left in the lungs after a maximum exhalation (~1.2 L)

A

Residual volume (RV)

77
Q

The total volume of air that can be exhaled after a maximum inhalation (VC = TV + IRV + ERV, ~4.7 L)

A

Vital Capacity (VC)

Physiology and Pathology Exam 1 (4 decks)

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