Test #6: Respiratory & Urinary Systems Flashcards
How many functions of the nose?
5 functions
What are the 5 functions of the nose?
- Provides an airway; 2. Warms and moistens air; 3. Filters air; 4. Olfactory sense; and 5. Resonating chamber for speech
How many external parts to the nose?
2 parts
What are the 2 external parts to the nose?
- Nasal bones; and 2. Hyaline cartilage
How many internal parts to the nose?
4 parts
What are the 4 internal parts to the nose?
- Nasal septum; 2. Olfactory and respiratory mucosa; 3. Conchae; and 4. Paranasal sinuses
Nose: Nasal Septum
Made up of the vomer bone and perpendicular plate of the ethmoid bone
Nose: Olfactory Mucosa
Lines the roof of the nasal cavity where the sense of smell is located. Chemoreceptors (nerve endings which respond to chemicals in solution) send an action potential to the brain.
Nose: Respiratory Mucosa
Lines the walls and floor of the nasal cavity. All mucosa have nerve endings which responds to debris triggering a sneeze.
Nose: Conchae
Superior and middle are bone markings on the ethmoid cranial bone. Inferior are facial bones. They warm, moisten and filter air.
Nose: Paranasal sinuses
Open cavities within bone which lightens weight of the skull and act as resonating chambers. They warm, moisten and filter air.
How many paranasal sinuses?
4 paranasal sinuses
What are the 4 paranasal sinuses?
- Frontal; 2. Sphenoid; 3. Ethmoid; and 4. Maxillary
Pharynx
aka “The Throat”
5-inch long skeletal muscle tube.
How many functions of the pharynx?
3 functions
What are the 3 functions of the pharynx?
- Common pathway for air and food; 2. Equalizes pressure (auditory tubes); and 3. Houses tonsils
How many parts of the pharynx?
3 parts
What are the 3 parts of the pharynx?
- Nasopharynx; 2. Oropharynx; and 3. Laryngopharynx
Pharynx: Nasopharynx
Connects the nasal cavity to the oropharynx
How many parts of the nasopharynx?
3 parts
What are the 3 parts of the nasopharynx?
- Tonsils; 2. Auditory Tubes; and 3. Cilia
Nasopharynx: Tonsils
Tonsils present are the pharyngeal (adenoids) and tubal.
Nasopharynx: Auditory Tubes
Equalize pressure between nasopharynx and inner ear.
Nasopharynx: Cilia
The mucous membrane is ciliated to move the mucous blanket down toward the mouth and stomach (to swallow and cough it out).
Pharynx: Oropharynx
Posterior to oral cavity; connects the nasopharynx to the laryngopharynx.
Oropharynx: Tonsils
Tonsils present are the palatine and lingual.
Pharynx: Laryngopharynx
Connects the oropharynx to the esophagus and larynx.
Larynx
aka “The Voicebox”
About 2 inches in length and made up of 9 pieces of cartilage.
How many functions of the larynx?
4 functions
What are the 4 functions of the larynx?
- Airway; 2. Switching mechanism; 3. Speech; and 4. Cilia
Larynx: Airway
It provides and open airway.
Larynx: Switching mechanism
the epiglottis routes food down the esophagus and away from the lungs. The epiglottis will trigger a cough reflex if food enters the larynx.
Larynx: Speech
The vocal chords are located here and the larynx is attached to the hyoid bone.
Larynx: Cilia
Moves the mucous blanket up towards esophagus and mouth.
How many parts to the larynx?
4 parts
What are the 4 parts to the larynx?
- Thyroid Cartilage; 2. Epiglottis; 3. Glottis; and 4. Vocal chords
Larynx: Thyroid Cartilage
aka “The Adam’s Apple”
1 of 9 pieces of cartilage that make up the larynx. Male’s is larger due to testosterone.
Larynx: Glottis
Opening of the larynx
Larynx: Vocal Chords
Made up of skeletal muscle and elastic ligaments stretched across the opening of the larynx and vibrate as air passes by them.
An increase of volume is caused by an increase of air.
Male vocal chords are thicker and less taught which lowers pitch and tone due to testosterone.
Trachea
aka “the Wind Pipe”
An open airway tube held open by hyaline cartilage rings. They are C-shaped and the posterior is smooth muscle to allow the esophagus to expand when swallowing food. It branches to the left and right to serve the lungs.
Lungs
Fill the thoracic cavity from the clavicles down to the diaphragm. The right lung has 3 lobes or segments and the left lung has 2 to make room for the heart.
Pleural Membranes
Pleura is a double layer serous membrane which houses and protects the lungs.
What are the 2 layers of the pleural membrane?
- Parietal pleura; and 2. Visceral pleura
Parietal Pleura
Outer layer just deep to the ribs and on top of the diaphragm.
Visceral Pleura
Inner layer, covers the lungs themselves.
Pleural Cavity and Fluid
Thin space between the the parietal and visceral layers filled with serous fluid to reduce friction when the lungs expand and recoil.
The bronchial tree is made up of how many zones?
2 zones
What are the 2 zones of the bronchial tree?
- Conducting zone; and 2. Respiratory zone
How many parts of the conducting zone?
5 parts
What are the 5 parts of the conducting zone?
- Primary bronchi; 2. Secondary bronchi; 3. Tertiary bronchi; 4. Bronchioles; and 5. Terminal bronchioles
Bronchial Tree: Conducting Zone*
It “conducts” or delivers air to/from the lungs.
Trachea branches to enter the lungs at the level of T7 > primary bronchi > secondary bronchi > tertiary bronchi > branches up to 23 times > at 1 mm they are called bronchioles > at .5 mm they are called terminal bronchioles
How many parts of the respiratory zone?
3 parts
What are the 3 parts of the respiratory zone?
- Respiratory bronchioles; 2. Alveolar ducts; and 3. Alveoli
Bronchial Tree: Respiratory Zone*
It does gaseous exchange (O2 & CO2)
Terminal bronchioles > respiratory bronchioles > alveolar ducts > alveoli (about 300 million functional units)
How many characteristic changes along the bronchial tree pathway?
7 characteristic changes
What are the 7 characteristic changes along the bronchial tree pathway?*
1-3. Cilia, cartilage rings and mucous production decreases
4-7. Elastic tissue, smooth muscle, macrophages, and lymphoid nodules increases
What helps alveolus to recoil?
Surface tension of water molecules inside alveolus.
What prevents alveolus from collapsing completely during recoil?
Surfactant - a fat protein/molecule reduces the surface tension of the water molecules inside alveolus.
How many phases of respiration?
4 phases
What are the 4 phases of respiration?
- Pulmonary ventilation; 2. External respiration; 3. Transportation of respiratory gases; and 4. Internal respiration
Pulmonary Ventilation
The process of breathing (inhalation and exhalation).
External respiration
The diffusion of O2 and CO2 between the alveoli and blood capillaries
Transportation of respiratory gases
O2 and CO2 are carried in our blood. O2 binds to hemoglobin in red blood cells and CO2 dissolved in plasma (and a small amount in hemoglobin) creates a buffer to regulate blood pH (7.35-7.45).
Internal respiration
Diffusion of O2 and CO2 between blood capillaries and the cells of the body.
How many techniques to consider when working with a client dealing with respiratory issues?
4 techniques
What are the 4 techniques to consider when working with a client dealing with respiratory issues?
- Tapotement; 2. Aromatherapy; 3. Positioning on the table; and 4. Massage for the muscles of respiration
Tapotement
An effective method for breaking up congestion within the lungs (cupping).
Aromatherapy
Use of menthol and eucalyptus may help to open respiratory passageways.
Positioning on the table
For ease of breathing, consider sidelying, prone, supine, and seated positions as well as using pillows to aid clients with respiratory congestion.
What muscles could be massaged for respiration?
- Diaphragm; 2. External and Internal Intercostals; 3. SCM; 4. Scalenes; 5. Pec Minor; 6. Abs; (7-8. Lats and QL).
How many phases for pulmonary ventilation?
2 phases
What are the 2 phases for pulmonary ventilation?
- Inspiration (inhalation); and 2. Expiration (exhalation)
Inspiration
The process of taking air in.
How many types of inspiration?
2 types
What are the 2 types of inspiration?
- Diaphragmatic; and 2. Costal
Diaphragmatic Inspiration
Deep abdominal breaths
Costal Inspiration
Shallow breaths
Expiration
Releasing air
Inhalation Muscles*
Diaphragm and external intercostals contract
Exhalation Muscles*
Diaphragm and external intercostals relax
No contraction! Exhalation is a passive process.
Forced Inhalation Muscles*
Diaphragm, external intercostals, SCM, scalenes, and pec minor contract.
Forced Exhalation Muscles*
Diaphragm, external intercostals, SCM, scalenes, and pec minor relax.
Abs and internal intercostals (and sometimes lats and QL) contract.
How many pressure relationships for respiration?
3 relationships
What are the 3 pressure relationships for respiration?
- Atmospheric; 2. Intrapulmonary; and 3. Intrapleural
Atmospheric pressure
The amount of pressure exerted on our body by the air around us.
What is the atmospheric pressure at sea level?
760 mmHg
Intrapulmonary pressure
The pressure inside the lungs will rise and fall but will always strive for equilibrium with atmospheric pressure.
Intrapleural pressure
The pressure inside the pleural membranes will rise and fall but is always less than intrapulmonary.
Boyle’s Law
With temperature remaining constant, the pressure of a gas varies inversely with its volume.
Increase volume = decrease of pressure
Decrease volume = increase of pressure
Respiratory process as defined by Boyle’s Law and pressure relationships
Pressure gradients from high to low, created by skeletal muscle contraction and relaxation which increases or decreases the volume of the lungs
Vocab: Hypoxia
A low level of oxygen in the tissue.
Vocab: Eupnea
A normal respiration rate
Vocab: Apnea
A cessation of breathing
What are some factors that affect respiration?
- Inflexibility of the muscles of respiration
- Emotional states
- Anything which affects the respiratory passageways by either creating a resistance of airflow or a decrease in the expansion/recoil ability of the lungs. e.g. Inflammation, adhesions, scar tissue, etc.
Kidney: Size
4-5 inches in length; 1-2 inches thick = roughly the size of a bar of soap
Kidney: Shape
Kidney bean shaped
Kidney: Location
Between T12-L3 with right kidney slightly lower than the left kidney due to crowding of the liver
How many functions of the kidneys?
4 functions
What are the 4 functions of the kidneys?
- Blood volume and composition; 2. Regulation of pH; 3. Regulation of blood pressure; and 4. Stimulate red blood cell production
Kidneys: Blood volume and composition
If changes need to be made, the brain will signal the kidneys to retain or release water.
Kidneys: Regulation of pH
Can hold onto or excrete hydrogen ions which act as buffers in blood.
Kidneys: Regulation of blood pressure
If too high, they make more urine to remove water; if too low, they make less urine or they produce the hormone renin which causes vasoconstriction.
Kidneys: Stimulate red blood cell production
If oxygen is too low (hypoxia), they produce a hormone which causes an increase in red blood cell production from bone marrow.
How many parts to the external anatomy of the kidney?
4 parts
What are the 4 parts to the external anatomy of the kidney?
- Renal hilus; 2. Renal capsule; 3. Adipose capsule; and 4. Renal fascia
Kidneys: Renal hilus
Concave area on medial side serves as the entry/exit point for blood vessels, nerves, lymphatics and the ureter.
Kidneys: Renal capsule
A transparent, dense layer of connective tissue on the outside of the kidney. It protects the kidney from bacteria.
Kidneys: Adipose capsule
A layer of fat lying superficial to the renal capsule. It protects and insulates the kidney.
Kidneys: Renal fascia
A layer of connective tissue superficial to the adipose capsule that anchors and further protects the kidneys.
How many regions to the internal anatomy of the kidney?
3 distinct regions
What are the 3 distinct regions to the internal anatomy of the kidney?
- Cortex; 2. Medulla; and 3. Pelvis
Kidneys: Renal cortex
Outermost region of the internal anatomy which contains the bulk of the nephron.
Kidneys: Renal medulla/pyramids
Lies deep to the renal cortex which contains collecting tubes.
Renal medulla: Minor Calyx
A smooth muscle tube which collects urine from the collecting tubes in the renal medulla.
Renal medulla: Major Calyx
A smooth muscle tube which collects urine from the minor calyx.
Kidneys: Renal pelvis
A funnel-shaped smooth muscle tube which collects urine from the major calyx and drains into the ureter.
Vocab: Peristalsis
Slow, rhythmic contractions of smooth muscle to move urine along.
Kidneys: Blood supply
Kidneys receive 25% of cardiac output every minute.
Kidneys: Nephron
The functional unit of the kidneys. About 1 million per kidney. It filters blood and makes the necessary adjustments.
How many regions of the nephron?
2 regions
What are the 2 regions of the nephron?
- Glomerulus; and 2. Renal tubule
Nephron: Glomerulus
A collection of blood capillaries which filter blood by hydrostatic pressure and the forces of blood pressure.
Nephron: Renal tubule
1.25 inches in length. It makes all the necessary adjustments by keeping the good stuff and ridding the bad stuff.
How many parts to the renal tubule?
4 parts
What are the 4 parts to the renal tubule?
- Glomerulus capsule; 2. Proximal convoluted tubule; 3. Loop of Henle; 4. Distal convoluted tubule; and 5. Collecting tubes
Renal tubule: Glomerulus tubule
A cup shaped region which surrounds the glomerulus.
Renal tubule: Proximal convoluted tubule
The proximal region of the tubule involved in urine formation
Renal tubule: Loop of Henle
A “hairpin” loop in the tubule.
Renal tubule: Distal convoluted tubule
The distal region of the tubule involved in urine formation.
Renal tubule: Collecting tubes
Slender tubes which receive Urine from the nephron and then drain into the calyces and then the renal pelvis.
How much blood is filtered through the kidneys?
47 gallons of blood per day
How much urine is excreted by the kidneys?
1-2 liters per day
How many phases of urine production?
3 phases
What are the 3 phases of urine production?*
- Glomerular filtration; 2. Tubular reabsorption; and 3. Tubular secretion
Glomerular Filtration*
Blood is brought to the glomerulus and filtered by the forces of hydrostatic and blood pressures. Most passes through the glomerulus except blood cells and large proteins.
Tubular Reabsorption*
All the “good stuff” is put back into the blood stream.
Good stuff = 99% of water, electrolytes, glucose and anything else still useful to the body.
Tubular Secretion*
Any waste product remaining in the blood gets put back into the nephron. Hydrogen ions are also secreted back into the tubule to adjust blood pH.
Urine
Water and waste product
Ureters (2)
Slender tubes lined with epithelial tissue and a layer of smooth muscle. They perform peristalsis to deliver urine from the collecting tubes to the urinary bladder.
Urinary bladder
A collapsible storage tank for urine. Can hold up to about 1,000 ml of urine. Peristalsis occurs every 200-300 ml. Located behind the pubic symphysis. Just anterior to the uterus in females.
Urethra
A tube which delivers urine from the bladder to the outside.
What is the scientific name for urination?
Micturition
What are some things we should not see in our urine?
Red blood cells (bleeding), glucose (diabetes), white blood cells (infection), proteins (faulty nephrons), etc.
Water Balance
The average adult has about 40 liters of water making up 50-60% of our body weight:
Fat - 20%
Muscle - 65%
How many compartments does water exist within out bodies?
2 compartments
What are the 2 compartments does water exist within out bodies?
- Intracellular - 2/3 inside cells; and 2. Extracellular - 1/3 outside cells
Osmosis
The passive diffusion of water between the intracellular and extracellular compartments.
Water always follows salts and proteins.
Electrolytes
A molecule which easily dissolves in water and carries an electrical charge. Salts, acids and bases can call be electrolytes, but it’s usually salts which govern the electrolyte balance of the body.
e.g. Sodium (Na), Potassium (K) and Calcium (Ca)
NaCl = table salt / sodium chloride
in water = Na+ and Cl-
Massage and the Urinary System
- Be cautious of deep work over the kidneys at the upper lumbar region (between T12 and L3).
- A client receiving dialysis treatments for kidney failure is contraindicated for circulatory massage but may benefit from energy work.