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Physiotherapy > The Cardiac and Respiratory Systems > Flashcards

The Cardiac and Respiratory Systems Flashcards

1
Q

Pulmonary circulation

A

through the lungs to oxygenate blood

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2
Q

Peripheral circulation

A
  • via arteries to deliver oxygen & other nutrients to the tissues
  • collect waste metabolites via veins
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3
Q

What 3 structures are present in vessel walls?

A
  • tunica externa (adventitia)
  • tunica media
  • tunica intima (interna)
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4
Q

Tunica externa (or adventitia)

A

outermost layer made up of loose connective tissue

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5
Q

Tunica media

A

middle layer made up of smooth muscle, collagen, some elastic tissue

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6
Q

Tunica intima (interna)

A

smooth inner layer of simple squamous endothelium to be a selectively permeable barrier that usually repels blood cells and platelets

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7
Q

Cardiac cycle

A

one completed cycle of contraction & relaxation of all 4 chambers of the heart

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8
Q

What are the events of the cardiac cycle?

A
  1. Ventricular filling
  2. Heart contraction
  3. Ejection of blood from ventricle into the circulation
  4. Heart relaxation
  5. …the cycle continues…
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9
Q

Systole

A

contraction

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10
Q

Dystole

A

relaxation

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11
Q

Atrioventricular valves

A
  • prevent backflow of blood from ventricles into the atria
  • close and open passively
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12
Q

Aortic & Pulmonary artery valves

A

semi-lunar valves snap shut at end of systole to prevent backflow of blood

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13
Q

Upper respiratory tract includes what?

A
  • nose (mouth)
  • pharynx (nasopharynx, oropharynx, laryngopharynx)
  • larynx
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14
Q

Lower respiratory tract includes what?

A
  • trachea
  • bronchi (primary - main; secondary - lobar; tertiary - segmental)
  • bronchioles (conducting and respiratory zones)
  • alveoli
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15
Q

Describe the role of the nasal conchae in the respiratory system.

A

increase turbulence through the nasal cavity (slows airflow to allow for warming, humidification and filtering)

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16
Q

Why is the sneeze reflex easily triggered?

A

there’s a large number of sensory nerve endings in the nose

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17
Q

What is the purpose of the epiglottis?

A

protects the larynx from food by closing over it during swallowing

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18
Q

What does the larynx contain which relates to an effective cough?

A

contains vocal chords (glottic)

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19
Q

Is the trachea situated posteriorly or anteriorly to the oesophagus?

A

anteriorly

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20
Q

Why is there cartilage in the trachea?

A

to prevent tracheal collapse during pressure changes
- C-shaped rings supporting the anterior and lateral aspects, not posteriorly to allow oesophagus to expand anteriorly as food is swallowed

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21
Q

Parietal pleura

A

lines the inner surface of the thoracic wall and superior surface of the diagram

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22
Q

Visceral pleura

A

covers the outer surface of the lungs and lines the fissures

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23
Q

Pleural membrane

A

double-layered serous sacs that cover the lungs

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24
Q

Pleural cavity

A

space between the 2 layers (contains pleural fluid)

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25
Q

Pleural fluid

A
  • acts as a lubricant allowing layers to glide over each other during inspiration and expiration
  • increases surface tension ‘locks’ 2 pleural layers together
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26
Q

What 2 muscles are used for inspiration?

A
  • diaphragm
  • external intercostals
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27
Q

What are 2 accessory muscles of inspiration?

A
  • sternocleidomastoid
  • scalenes (x3)
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28
Q

What 3 muscles are used for forces expiration?

A
  • internal intercostals
  • rectus abdominis
  • internal and external obliques
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29
Q

Atelectasis

A

collapse of alveoli and segment of lung tissue

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30
Q

Describe how relaxed inspiration takes place.

A
  • controlled by impulses from the respiratory centre in the brainstem
  • nerve stimulation causes contraction of the diaphragm and outer intercostals (expands thoracic cage and lungs)
  • expansion creates lower pressure (relative to outside the body)
  • air rushes in
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31
Q

Describe how the abdominal muscles cause forced expiration.

A

abdominal muscles contract, causing the abdominal contents to push up against the diaphragm - reducing the vertical diameter of the thorax

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32
Q

Where does the ciliated epithelium line?

A
  • nasopharynx
  • pharynx
  • trachea
  • bronchi
  • bronchioles
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33
Q

What are the (3) sub-divisions of the pharynx?

A
  • Nasopharynx
  • Oropharynx
  • Laryngopharynx
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34
Q

What does the larynx contain?

A

vocal cords

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35
Q

What is the glottic (vocal cord) function essential for?

A

an effective cough

36
Q

Where does the trachea birfucate?

A

the carina (into the R&L main (primary) bronchi)

37
Q

What angle does the right main bronchus branch off at?

A

20-30°

38
Q

What angle does the left main bronchus branch off at?

A

45-55°

39
Q

Describe the secondary/lobar bronchi.

A
  • Main bronchus divides into secondary bronchi
  • Right = 3 and Left = 2
  • Supply each lobe of the lungs
40
Q

Describe the tertiary/segmental bronchi.

A
  • Secondary bronchi divide into tertiary bronchi
  • Right = 10 and Left = 9
  • Supply each segment of the lung
  • Segments are subdivisions of the lobes of the lung
41
Q

What impact does the secretion of surfactant by cells in the alveoli have?

A

prevent surface tension effects

42
Q

What is collateral ventilation?

A

Alveoli can be ventilated by channels which bypass the normal route of airways
- Channels of Martin
- Canals of Lambert
- Pores of Kohn

43
Q

Channels of Martin.

A

bronchiole-bronchiole

44
Q

Canals of Lambert.

A

bronchiole-alveolar

45
Q

Pores of Kohn.

A
  • Alveolar-alveolar
  • Adult alveolus has ~5-20 pores
  • Not present in infants under 1 year
46
Q

What are the (3) components of the mucociliary transport system (defence)?

A
  • Cilia
  • Aqueous (sol) layer
  • Viscous (gel) layer
47
Q

What is the role of cilia in the mucociliary transport system (defence)?

A
  • Tips of cilia hook into the gel layer to sweep it towards laryngopharynx
  • Cilia beat in a coordinated fashion at 20 cycles per second, which can propel mucus at a rate of 2cm/min
48
Q

What is the role of aqueous (sol) layer in the mucociliary transport system (defence)?

A
  • Serous fluid which bathes the cilia
  • Ciliary movement is impaired with increased and decreased levels of fluid
49
Q

What is the role of the viscous (gel) layer in the mucociliary transport system (defence)?

A
  • Made of mucous secreted from goblet cells
  • Goblet cells produce 10-100ml mucus per day
  • Foreign particles, cellular debris and microbes become trapped
50
Q

What lobes are the lungs divided into?

A

Right lung = 3:
- Upper / superior
- Middle
- Lower / inferior

Left lung = 2:
- Upper / superior
- Lower / inferior
(Smaller due to position of heart)

51
Q

What are the lobes of the lungs divided by?

A

fissures
- Right = oblique + horizontal
- Left = oblique

52
Q

What is the parietal pleura?

A

Lines the inner surface of the thoracic wall and superior surface of the diaphragm

53
Q

What is the visceral pleura?

A

Covers the outer surface of the lungs and lines the fissures

54
Q

What is the purpose of the pleural fluid?

A
  • Acts as a lubricant allowing the layers to glide over each other during inspiration and expiration
  • Increases surface tension ‘locks’ 2 pleural layers together
55
Q

True Ribs.

A
  • Pairs 1-7
  • Articulate with vertebra and directly with sternum (via costal cartilage)
56
Q

False Ribs.

A
  • Pairs 8-10
  • Articulate with vertebra and indirectly with sternum (via costal cartilage of ribs 6 and 7)
57
Q

How many pairs of ribs are there?

A

12

58
Q

What are the (3) elements of the sternum?

A
  • Manubrium
  • Body
  • Xiphoid process
59
Q

What bones articulate at the sternocostal joints?

A

Joints between ribs 1-7 (true ribs) & sternum

60
Q

What type of joint is it between the manubrium and 1st rib?

A

fibrocartilaginous joint

61
Q

Which ribs are surrounded by thin capsules?

A

Ribs 2-7

62
Q

What muscles produce inspiration?

A
  • Diaphragm
  • External intercostals
63
Q

What are the accessory muscles of inspiration?

A
  • Sternocleidomastoid
  • Scalenes
  • Pec minor + pec major
64
Q

What muscles produce forced expiration?

A
  • Internal intercostals
  • Rectus abdominis
  • Transversus abdominis
  • Internal + external obliques
65
Q

What are the origins of the diaphragm?

A

Costal part: lower margin of costal arch (inner surface ribs 7-12)

Lumbar part:
- Medial: L1-L3 vertebral bodies and intervertebral discs (2nd and 3rd), anterior longitudinal ligament
- Lateral: arcuate ligaments (median, medial and lateral)

Sternal part: posterior surface of xiphoid process

66
Q

Where is the insertion of the diaphragm?

A

Central tendon

67
Q

What is the innervation of the diaphragm?

A

Phrenic nerve (C3, C4, C5)

68
Q

Is expiration an active or passive process?

A

mostly passive, but can be active too

69
Q

Is inspiration an active or passive process?

A

active (requiring energy)

70
Q

Breathing/respiration

A

a collective term for inspiration and expiration

71
Q

What are (8) abnormal breathing patterns?

A
  • Bradypnoea
  • Hyperventilation/Tachypnoea
  • Dyspnoea
  • Apnoea
  • Agonal breathing
  • Orthopnoea
  • Kussmaul respiration
  • Cheyne-Stokes breathing
72
Q

Accessory muscles of inspiration can assist what (2) things?

A
  • Deep inspiration
  • During episodes of respiratory distress
73
Q

What can the use of accessory muscle of inspiration suggest?

A

a sign of respiratory distress

74
Q

How does forced expiration occur?

A
  • Contraction of the abdominal muscles: causes the abdominal contents to push up against the diaphragm (reduces the vertical diameter of the thorax)
  • Contraction of the internal intercostals: depress the ribs and decrease space in the thorax
75
Q

What is the pump handle biomechanics of breathing?

A
  • Primarily involves upper ribs and sternum
  • Increases the anterior-posterior dimension of the chest
76
Q

What is the bucket handle biomechanics of breathing?

A
  • Primarily involves the lower ribs
  • Increases the transverse diameter of the chest
77
Q

What are the interchondrial joints?

A
  • Ribs 7-10 involved
  • Synovial joints
  • Occur between the costal cartilages of adjacent ribs
78
Q

Floating ribs.

A
  • Pairs 11-12
  • Articulate with vertebra, no attachment anteriorly to sternum
79
Q

Which ribs are typical?

A

2-9

80
Q

Which ribs are atypical?

A

1, 10, 11 + 12

81
Q

Where does ciliated epithelium line?

A
  • Nasopharynx
  • Pharynx
  • Trachea
  • Bronchi
  • Bronchioles
82
Q

What does ciliated epithelium contain?

A
  • Goblet cells (secrete mucus)
    Cilia (microscopic hair like structures capable of rhythmic motion 1 of the 3 components of the MTS)
83
Q

Why is the 10th rib atypical?

A

head of rib has 1 facet for articulation with 1 vertebral body (T10)

84
Q

Why are the 11th & 12th ribs atypical?

A
  • No anterior attachment to sternum
  • Only articulate with 1 vertebral body (rib 11 = T11, rib 12 = T12)
  • No tubercles
  • Shorter than the other ribs
85
Q

What ribs are involved in interchondrial joints?

A

ribs 7-10

86
Q

What is the purpose of interchondrial joints?

A

provide anchorage to the sternum

Physiotherapy (44 decks)

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