Unit 3 - Respiratory Flashcards

1
Q

upper respiratory

A

nose
nasal cavity.
nasal sinuses
pharynx
larynx
trachea

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2
Q

lower respiratory

A

bronchi
bronchioles
lungs

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3
Q

functions

A
  • supply oxygen + remove CO2.
  • phonation (voice)
  • body temp control
  • acid-base balance
  • olfactory sense
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4
Q

respiration levels

A
  1. external: physically breathing in and out
  2. internal: exchange b/w blood and cells
  3. cellular: ATP production
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5
Q

external structures

A
  1. nose
    - nares supported by nasal cartilage
    - opened by muscles that let air enter
    - dilated = sign that animal is having trouble getting enough oxygen
  • lined with hair to filter
  • skin around nostril continuous with muzzle, covered w/ hair and sebaceous/sweat glands
  • more rigid in rooting animals
  • functions: warm, humidity, filter air before lungs
  • highly vascular, bleeds a lot.
  • sneezing + coughing = debris irritate sensitive mucosa -> expels
  1. nasal cavity
    - hard + soft palates separate it from moth
    - turbinates (AKA conchae) = bony scrolls lined w/mucous membranes . protect from noxious gasses/trap particles
    ~nasal meatus = pathways b/w turbinates~
    - ventral nasal meatus: dorsal to hard palate. route for stomach tube -> nasopharynx. very vascular (bleeding risk)
    - blood vessels below m. membranes warm air
    - nasolacrimal ducts drain excess tears into nasal cavity
    - median nasal septum -> R/L halves
  2. paranasal sinuses
    - maxillary, frontal, sphenoid, and palatine sinuses
    - bilateral symmetry
    - m membrane lines + air-filled
    - reduce skull weight
    - infection prone (in dentistry + dehorning cattle)
  3. pharynx
    - passageway connecting oral cavity -> oropharynx (food) / nasal cavity -> nasopharynx (air)
    - openings into pharynx = mouth, 2 caudal nares, 2 eustachian (auditory) tubes, esophagus, larynx
    - inspired air -> nasal cavity -> caudal nares -> pharynx -> larynx
    - food in mouth -> pharynx -> into esophagus through contraction of pharyngeal muscles as larynx is closed by epiglottis
    - pharynx + larynx work together to make air/food go down the right tube
    - 3 divisions:

a: nasopharynx (part respiratory channel)
- soft palate = floor
- auditory tubes open here connecting to middle ear
- equalize pressure on both sides of ear drum
b: oropharynx (part of GIT)
c: laryngopharynx (respiratory AND GIT passage)

swallowing is series of actions:
- stop breathing
- glottis covers larynx opening
- material -> rear of pharynx
- esophagus opens
- material moves dorsal -> esophagus
- swallow -> larynx opens back up -> breathing resumes
* malfunction of this under anesthesia = aspiration -> pneumonia

  1. larynx (AKA voice box).
    - mucosa lined, cartilage tube joining pharynx + trachea
    - hyoid apparatus supports
    * cats prone to laryngospasm
    - directs air to trachea
    - prevents aspiration of food/water
    - houses vocal organs
  • segments of cartilage (# varies by species) connected + surrounded by muscles
    a. epiglottis
    b. arytenoid cartilages (2) - attach vocal cords which then run down to floor of thyroid cartilage
  • forms boundaries of glottis (larynx opening)
    c. thyroid cartilage (AKA adams apple) - moves w/hyoid, attaches muscles used for swallowing + phonation
    d. cricoid cartilage - connects thyroid cartilage -> trachea, maintains larynx shape so air passes

epiglottis:
- leaf shaped, rostral position, projects forward from ventral larynx
- tip tucked up to dorsal soft palate during breathing
- pulled back to cover larynx (glottis) when swallowing so food doesn’t enter

larynx 3 functions:
1. voice production:
- phonation by relaxing (low pitch/open glottis) + tightening (high pitch/closed glottis) cords as air passes -> they vibrate
2. prevent aspiration
- trapdoor effect of epiglottis + muscle contraction pulling larynx forward -> folding epiglottis back over its opening
- backed up by vocal cords (can meet in midline to close glottis)
3. airflow to/from lungs
- adjusting size of glottis w/vocal folds + closing glottis w/epiglottis

  1. trachea
    - short wide tube from larynx -> thorax
    - C shaped hyaline (opening of C = dorsal), allows trachea to change size + prevents it from collapsing on inspiration
    - lined w/pseudostratified ciliated mucousa (like nasal passages) that trap foreign bodies -> move them cranial to pharynx where they are swallowed
    - increased dust = increased mucous production. irritates trachea lining -> cough to expell
    - divides into 2 bronchi at tracheal bifurcation (AKA carnia) at heart level
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6
Q

lower respiratory tract

A

starts at bronchi, ends at alveoli
- all structures part of lungs

  1. bronchial tree = gradually gets smaller
    - bronchi -> bronchioles -> alveolar ducts -> alveolar sacs (bunch of grapes)
    - smooth muscles relaxes for bronchodilation (during increased oxygen) and tightens for bronchoconstriction (when rested)
    - bronchoconstriction also when irritants in lungs -> difficulty breathing
    * eg. felina asthma (allergic bronchitis), heaves in horses (fungal spore allergy)
  2. alveoli, forming alveolar sac:
    - tiny, thin-walled sacs surrounded by capillary network
    - site for gas exchange
    - contain surfactant: reduces stickiness (surface tension) of walls to help expand during breathing + prevent collapse of lungs
    * important with premature babies (surfactant often not properly formed, contributes to their death)
  3. lungs
    - exchange O for CO2 in blood
    - cone shaped: base at diaphragm, apex at thoracic inlet
    - lateral side of each lung connects to thoracic wall (except at cardiac notch -> contact w/heart)
  • L cranial + caudal lobes
    (L cranial partially subdivided, some may refer to a ‘L middle lobe’)
  • R cranial, middle, caudal, accessory lobes
  • Horse: L and R lobes + accessory
  • hilus: small medial area where air, blood, lymph, nerve cells enter/leave
  • only ‘fastened in place’ area of lung
  • lungs completely fill thoracic cavity from first breath. never collapse regardless of exhale until death
  • necropsy to see if stillborn: cut lung piece -> place it in water (floats -> born alive, sinks -> born dead)
  • pulmonary circulation: lung blood supply
  • blood vessels smaller as they branch down alveoli -> capillaries (network around each alveolus)
  • only 1 blood cell passes through at a time (CO2 diffuses from blood cell into alveolus + O from alveolus into blood)

lung boundaries:
1. dorsal: thoracic vertebrae
2. lateral: ribs
3. ventral: sternum
4. caudal: diaphragm
5. cranial: thoracic inlet (1st ribs, 1st thoracic vertebrae, cranial sternum)

  1. thorax
    - contains lungs, heart, large vessels, nerves, trachea, esophagus, lymph vessels/nodes
    - diaphragm: primary muscle for respiration (thin sheet of skeletal muscle)
    - pleura (thin membrane) covers structures in thorax (visceral) + lines inside of cavity (parietal). space b/w with serous fluid to prevent friction when breathing
    - mediastinum: junction of ^ near thoracic midline. in between the two lungs and contains heart + other structures, but not lungs themselves
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7
Q

respiration

A

air drawn into lungs -> O transferred from alveoli into blood -> CO2 from blood into lungs -> CO2 breathed out

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8
Q

negative intrathoracic pressure

A
  • partial vacuum in thorax keeping lungs against wall
  • whenever thorax expands -> lung volume also expands -> air can enter
  • lungs are passive, thorax and diaphragm are active
  • can hear release if thoracic cavity punctured during surgery
  • if air leaks into space b/w lung + wall, pressure is compromised (pneumothorax) -> body can’t expand lungs -> collapse + death
  • also problem if fluid accumulates in thorax
  • bonus: pressure also helps pull blood into atria
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9
Q

inspiration

A

AKA inhalation
- powered by diaphragm + external intercostal muscles.
- diaphragm normally dome shaped -> contracts + flattens when breathe in

  • external intercostals b/w ribs -> pull ribs up and forward to expand cavity
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10
Q

expiration

A

AKA exhalation
- diaphragm relaxes (gravity + elasticity of lung tissue and wall help this happen)
- less effort than inspiration, nearly passive

forced expiration: powered by internal intercostal + ab muscles
- internal intercostal deep to externals -> pull back and rotate ribs to decrease thorax volume
- ab muscles contract -> push abdominal organs against diaphragm -> dome shape restored + thorax volume decreased

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11
Q

breathing types

A

dyspnea: difficult
apnea: absence
hyperpnea: increase rate and/or depth
polypnea/tachypnea: shallow rapid breath

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12
Q

species resp rates

A

cat: 20-30
dog: 10-30
cow: 18-28
horse: 8-16

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13
Q

auscultation

A
  • little noise if normal, noisy if issue

stridor: high pitch, from upper airway obstruction
stertor: low pitch, flaccid tissue vibrating in airway (like snoring)

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14
Q

respiratory volumes

A

tidal: volume of air exchanged in one breath

minute volume: volume of air exchanged in one minute
- tidal X # breaths/min

residual: volume leftover after exhale
- never completely empty

vital capacity: max air that can be expired

total capacity: residual + vital

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15
Q

alveolar gas exchange

A

room air: 20% O, 0.03% CO2

  • blood entering lungs HIGH in CO2, LOW in O
  • capillary walls use concentration gradient -> CO2 out of blood/into alveoli -> O in alveoli into blood
  • concentration gradient maintained by constant flow of CO2 in capillaries + constant breathing refreshing alveoli
  • exchange rate affected by distance gas needs to cover (eg. edema in lung impacts amount of O absorbed)
  • if part of lung collapses/airway obstructed -> O in alveoli decrease -> local hypoxic vasoconstriction occurs (decreases blood circulating through part of lung that aren’t getting good gas exchange)
  • general hypoxia (high altitude): overall vasoconstriction of lungs
  • increased vascular resistance -> pulmonary hypertension -> heart pumps harder against resistance -> right heart failure
  • high mountain disease in cattle
  • hemoglobin becomes saturated with O during this process (even some still leftover in the CO2 blood coming back to lungs)
  • things that decrease hgb-O bind: increased temp, increased CO2, reduced pH
  • helps Hgb + O dissociate where needed in tissues

partial pressures of gases:
- sum of individual gases pressure = total pressure
ie. each gas accounts for ‘partial’ pressure
- another way of looking at concentration of substances
- substances move DOWN concentration gradient -> partial pressure of O higher in air than blood = O into blood

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16
Q

breath control

A
  • muscles involved = voluntary
  • overall process = involuntary, by respiratory center in brainstem (medulla)
  • ^ subconscious, but can be overridden by conscious control

medullary rhythmicity area: sets rate
- automatic rhythmic signal for inspiration
- expiration is the passive result of this effort ending
- expiratory area only activated if forced

-> signal travels down phrenic nerve -> diaphragm AND intercostal nerves -> costal muscles

2 systems to control:
1. mechanical
- sets limits on inspiration/expiration
- uses ‘stretch receptor’ in lung
- receptor -> respiratory center -> muscles signalled

  1. chemical
    - chemoreceptors monitor CO2, O, pH for balance
    - in brain, carotid artery, aorta
    - rising CO2 stimulates breathing more than decrease O because CO2 + pH linked
    - CO2 high = pH down -> acidic blood -> increase resp rate to ‘blow off’ excess CO2 -> normal pH
    * artificial ventilation if too high during surgery -> risk of blowing off too much CO2 -> animal compensates by holding breath (apnea) -> CO2 rise -> breathing stimulated again

oxygen sensors:
- mild hypoxia: signal to increase
- severe hypoxia: neurons too depressed to signal -> respiratory failure
* in clinic, mechanical receptors in skin cause deeper resp when signalled. newborns can be vigorously rubbed to stimulate this reflex/can also use needle to stimulate philtrum (b/w nose + lips)

17
Q

terminology

A

cough: irritation in trachea/bronchi
- pressure against closed glottis -> sudden release

sneeze: irritation in nasal passages

yawn: slow deep breath stimulated by decrease in O levels in blood (or boredom/fatigue/anxiety)

sigh: deep breath stimulated by decrease in O in blood

hiccup: diaphragm spasm -> sudden glottis closure

panting: heat dissipation. increased resp rate + decreased tidal volume

physiological dead space: part of resp system where there’s no gas exchange
* important during anesthesia. long endotracheal tube = increased dead space = reduced gas exchange
- if the tube is too long exhaled air won’t clear it -> rebreathing same air
- careful w/small animals

dive reflex: helps aquatic mammals stay under long time. when air starts to get into air passages -> heart rate changes -> breathing stops -> blood shunted from less essential tissues

emphysema: alveolar membranes destroyed -> larger lung chambers -> decreased surface area for gas exchange

atelectasis: alveoli collapse (often from obstruction or lack of surfactant)

haemoptysis: coughing up blood

18
Q

pathlogy

A

sinusitis:
- inflammed paranasal sinuses
- can obstruct drainage -> need trephination

tonsilitis:
- common in dogs (esp. toys and brachysephalics)
- can be secondary to mouth, pharynx, or nasal infections

dorsal soft palate displacement:
- vigorous exercise makes soft palate rise and epiglottis fall below -> nasopharynx diameter reduced

larynx related:
- de-barking: suturing/severing vocal cords
- laryngospasm: when area rubbed while incubating
- laryngeal edema: from irritants, trauma to endotracheal intubations, excessive panting in brachys/obese dogs
- laryngeal hemiplegia: in horses (afflicted known as ‘roarers’), paralysis of laryngeal nerve through genetics or injury -> vocal fold constructs airway and vibrates
- laryngeal hemiplasia: vocal cords obstruct lumen and cause roaring when air passes out
* laryngeal-tieback or laryngeal ventriculectomy
- laryngeal paralysis: same thing as hemiplegia but in dogs

upper respiratory tract infections (URI)
- nuisance usually, not threatening
- coughs can be productive
ex. kennel cough

heaves - recurrent airway obstruction (RAO)
- chronic allergy of horse
- laboured breath, cough, low stamina
- common in stable, not pasture
- onset 9-12 years
- secondary to narrowing of airways

heaves - chronic obstructive pulmonary disease (COPD)
- progressive, changes to lung irreversible

penumothorax
- free air in chest -> lung collapses
- hole in chest wall/punctured lung

pulmonary edema:
- fluid in airways/alveoli
- circulatory associations: L ventricle failure, anaphylactic shock, severe allergies
- may be auscultated

pneumonia:
- lung inflammation
- usually when viral/bacterial infection
- penumonitis: non-infectious version
- more serious than bronchitis
- mucus + fluids can accumulate -> plug lung -> decrease gas exchange
* aspiration pneumonia: anesthetized animal not intubated or extubated too early

diaphragmatic hernia:
- trauma result/congenital
- may not show symptoms depending on severity
- abdominal contents enter chest
- abdomen open -> life-threatening
- small tear from negative thorax pressure can cause abdominal viscera to pass through