W4 - Respiratory System Flashcards

1
Q

Importance of the respiratory system

A

Gas exchange

Acid-base balance reg

Vocalisation

Homeostatic reg of body pH

Protection from inhaled pathogens + irritating substances

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2
Q

What are the types of respiration?

A

Pulmonary

Cellular

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3
Q

What comes under pulmonary respiration?

A

Process of ventilation

O2 + CO2 exchange in lungs

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4
Q

What comes under cellular respiration?

A

O2 utilisation

CO2 production

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5
Q

Site of carina

A

Ridge at the base of the trachea

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6
Q

What does the site of carina separate?

A

Openings or right + left bronchi

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7
Q

What leads off from the trachea?

A

Right + left primary bronchus

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8
Q

What leads off the right + left primary bronchus?

A

Secondary (lobar) bronchi

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9
Q

What leads off the secondary (lobar) bronchi?

A

Segmental tertiary bronchi

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10
Q

Where do the bronchioles branch off from?

A

Segmental tertiary bronchi

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11
Q

What are the types of bronchioles?

A

Lobular

Respiratory

Terminal

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12
Q

How many alveoli are there? What coverage??

A

480 million alveoli covering 75 square meters

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13
Q

What are the different zones in respiration?

A

Conducting

Respiratory

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14
Q

Purpose of the conducting zone

A

Moves air to respiratory zone

Humidifies, warms + filters air

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15
Q

What components are found in the conducting zone

A

Trachea

Bronchial tree

Terminal bronchioles

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16
Q

Purpose of the respiratory zones

A

Gas exchange

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17
Q

What components are found in the respiratory zone

A

Respiratory bronchioles

Alveolar ducts

Alveolar sacs

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18
Q

No. of tubes in trachea

A

1

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19
Q

No. of tubes in bronchi

A

2, 4, 8

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20
Q

No. of tubes in bronchioles

A

16

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21
Q

Type II alveolar cell (septal cell)

Major functions

A

Synthesis + secretion of surfactant

Xenobiotic metabolism

Transepithelial movement of H20

Regeneration of alveolar epithelium after lung injury.

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22
Q

What is Xenobiotic metabolism ?

A

Typically:

Lipophilic compounds –> more readily excreted hydrophilic metabolites.

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23
Q

Definition for lipophilic

A

Tend to combine w. or dissolve in lipids or fats

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24
Q

Describe Type I alveolar cells

A

Squamous

Very thin

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25
Q

Function of Type I alveolar cells

A

Involved in GE between alveoli + blood

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26
Q

What are alveolar macrophages?

A

Primary phagocytes of innate immune system

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27
Q

What do Alveolar macrophages do?

A

Clear air spaces of infectious, toxic or allergic particles that have evaded the mechanical defences of the respiratory tract, i.e nasal passages.

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28
Q

What comes under pulmonary ventilation / breathing?

A

Inhalation

Exhalation

(Exchange of air between atmosphere + alveoli)

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29
Q

What comes under external pulmonary respiration?

A

GE between alveoli + blood

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30
Q

What comes under internal cellular respiration

A

Systemic capillaries transport to tissue cells

Supplies cellular respiration

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31
Q

What law is inhalation based on?

A

Boyle’s law

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32
Q

What does Boyle’s law state?

A

Pressure of a gas in a closed container is inversely proportional to the vol of the container at a CONSTANT temp

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33
Q

What happens to the diaphragm, ribs and chest cavity during inhalation/inspiration?

A

D = Contracts, flattens + descends

R = Rise

CC = Elongates + enlarges

== ⬆️ air into lungs as intrapulmonic pressure is below atmospheric pressure

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34
Q

How does inspiration during physical activity differ from resting inspiration?

A

Diaphragm, rib cage + abdominal muscles synchronise to contribute.

Scaleni + external intercostal muscles between ribs contract = ribs rotate + move up + away from body.

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35
Q

What are the 2 factors from which expiration results from?

A

Natural recoil of stretched lung tissue

Relaxation of inspiratory muscles.

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36
Q

How are the thoracic dimensions reduced during strenuous activity?

A

Internal intercostal + abdominal muscles act powerfully on ribs + abdominal cavity

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37
Q

Intrapulmonary and intrapleural pressure relationships

A

Alveolar pressure changes during different phases of the cycle.

Equalizes at 760 mm Hg but doesn’t stay there.

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38
Q

What is Intrapleural pressure

A

Air pressure in pleural cavity between visceral + parietal pleurae

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39
Q

Which is always less than the other?

Intrapulmonary or intra pleural pressures?

A

Intrapleural is always less than intrapulmonary

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40
Q

What is the intrapulmonary pressure during inspiration + expiration?

A

Inspiration = Subatmospheric

Expiration = Greater than atmospheric pressure

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41
Q

What are the effects to COPD?

A

Chronic inflammation of airways

Structural changes + collapse of small airways

Impaired exhalation

Lung hyperinflation

Altered diaphragm

Reduced motion

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42
Q

What 3 components are measured in the diaphragm release technique (DRT)

A

Diaphragm mobility

Respiratory pressures

Chest wall + abdominal kinematics

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43
Q

What does the diaphragm release technique (DRT) improve?

A

Diaphragm mobility

Inspiratory capacity

⬆️ Vital capacity

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44
Q

What has inspiratory muscle training (IMT) been observed to do for people with cervical spinal cord injuries?

A

⬆️ inspiratory muscle strength

Reduce dyspnea

⬆️ diaphragm thickness by 22%

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45
Q

What is dyspnea

A

Inordinate shortness of breath

Sense of breathing incapacity during PA

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46
Q

Tidal volume (TV)

A

Vol of air breathed in or out per breath

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47
Q

Inspiratory reserve volume (IRV)

A

Max inspiration after TV inspiration

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48
Q

Expiratory reserve volume (ERV)

A

Max expiration after TV expired

49
Q

Total lung capacity (TLC)

A

Vol. in lungs after max inspiration

50
Q

Residual lung vol (RLV)

A

Vol in lungs after max expiration

51
Q

Forced Vital Capacity (FVC)

A

Max vol of air expired after Max inspiration

52
Q

How is minute ventilation calculated?

A

TV x breathing freq

53
Q

What % of the tidal volume reaches the respiratory zone?

A

70%

54
Q

What % of the tidal volume reaches the conducting zone?

A

30%

55
Q

What is airway resistance?

A

Amount of resistance to the flow of air through the respiratory tract during inspiration + expiration

56
Q

What does the degree of airway resistance depend on in particular?

A

Diameter of airway

Whether flow is laminar or turbulent

57
Q

Airway resistance represents 80% of the resistance to the flow of air, what causes the other 20% resistance?

A

Friction of pulmonary + thoracic tissues

58
Q

What does P(little ATM) stand for?

A

Atmospheric pressure

59
Q

What does P(little A) stand for?

A

Alveolar pressure

60
Q

What does V stand for?

A

Volumetric airflow

61
Q

Equation for measuring airway resistance

A

R(little AW) = P(little ATM) - P(little A) / V

62
Q

Functional residual capacity (FRC)

A

Vol or air in lungs at end of passive expiration

63
Q

What is the total lung capacity ?

A

~6L

64
Q

How is vital capacity calculated?

A

TV + IRV + ERV

65
Q

How is inspiratory capacity calculated?

A

TV + IRV

66
Q

How is the functional residual capacity calculated? (FRC)

A

ERV + RV

67
Q

How is total lung capacity calculated?

A

TV + ERV + IRV + RV

68
Q

Where is the respiratory centre located?

A

Medulla oblongata + pons in the brainstem

69
Q

What are the 3 major respiratory groups of the respiratory centre?

A

Dorsal respiratory group

Ventral respiratory group

Pontine respiratory group

70
Q

Which of the 3 major respiratory groups of the respiratory centre are found in the medulla?

A

Dorsal respiratory group

Ventral respiratory group

71
Q

Which of the 3 major respiratory groups of the respiratory centre are found in the pons?

A

Pontine respiratory group

72
Q

What are the 2 centres of the pontine respiratory group?

A

Pneumotaxic centre

Apneustic centre

73
Q

In order to regulate the RATE + DEPTH of breathing, where does the respiratory centre receive input from?

A

Chemoreceptors

Mechanoreceptors

Cerebral cortex

Hypothalamus

74
Q

What is the main function of the medulla oblongata?

A

Sends signals to the muscles that initiate inspiration + expiration

75
Q

Pneumotaxic centre/area of the pontine respiratory group.

Where?

A

Superior portion of pons

76
Q

Pneumotaxic centre/area of the pontine respiratory group.

What does it do?

A

Works w/ the medulla rhythmicity area to set the rhythm of breathing.

Has inhibitory impulses.

Prevents lungs from becoming too full w. air.

Limits duration of inspiration.

77
Q

Pneumotaxic centre/area of the pontine respiratory group.

Active or inactive?

A

Active

78
Q

Pneumotaxic centre/area of the pontine respiratory group.

Quicker or slower than the apneustic centre/area?

A

Quicker

79
Q

Apneustic centre/area of the pontine respiratory group.

Where?

A

Inferior portion of pons

80
Q

Apneustic centre/area of the pontine respiratory group.

What does it do?

A

Coordinates transition between inspiration + expiration.

stimulate inspiratory area to prolong inspiration + slow rate of breathing

81
Q

Apneustic centre/area of the pontine respiratory group.

When does it occur?

A

Only when pneumotaxic area is inactive.

82
Q

Which is overridden by which?

Apneustic vs Pneumotaxic

A

Apneustic is overriden by pneumotaxic

83
Q

Apneustic centre/area of the pontine respiratory group.

Active or inactive?

A

Active

84
Q

Apneustic centre/area of the pontine respiratory group.

Quicker or slower than the Pneumotaxic centre/area?

A

Slower

85
Q

Medullary rhythmicity area at REST

What happens during active inspiration?

A

w/in 2 secs:

Diaphragm + external intercostals actively contract

86
Q

Medullary rhythmicity area at REST

What happens during active expiration?

A

W/in 3 secs:

Diaphragm + external intercostals relax

Elastic recoil or chest wall + lungs

87
Q

Medullary rhythmicity area - FORCED BREATHING

What happens as soon as forced inspiratory happens?

A

Expiratory area is activated:

Internal intercostals + abdominal muscles contract

= forced expiration

88
Q

What dictates how we breathe?

A

Voluntary Control

Involuntary Control

89
Q

Where are central chemoreceptors located?

A

Medulla oblongata of brainstem

90
Q

What do central chemoreceptors do?

A

Detect changes in arterial pCO2.

91
Q

What happens once changes in arterial pCO2 are detected by the central chemoreceptors?

A

Send impulses to respiratory centres in brainstem to:

initiate changes in ventilation to restore normal pCO2.

= hyperventilation.

92
Q

What happens to CO2 once it enters the Cerebrospinal fluid (CSF) after diffusing across the blood brain barrier from the arterial blood?

A

Carbonic anhydrase converts it to HCO3- + H+.

H+ = ⬇️ CSF pH

Both elevated pCO2 + red pH stimulate the chemoreceptors.

93
Q

Where are the peripheral chemoreceptors primarily located?

A

Carotid body

…then the aortic body

94
Q

Function of the peripheral carotid chemoreceptors

A

Stimulate breathing in response to hypoxia.

95
Q

What is the carotid sinus nerve?

A

A branch of the glossopharyngeal nerve (a.k.a cranial nerve 9 (CN9))

96
Q

What does the carotid sinus nerve do with the branch of the glossopharyngeal nerve?

A

Provides sensory innervation to the carotid body.

97
Q

What is the sensory nerve fibre in the glossopharyngeal nerve sensitive to?

A

⬇️ in p02

98
Q

What do the aortic body peripheral chemoreceptors do?

A

Measure changes in bp

99
Q

Where do signals from the aortic body chemoreceptors travel down to the medulla?

A

Vagus nerve (CN X)

100
Q

What are the respiratory stretch receptors activated by?

A

Over inflation of the lungs

101
Q

What happens when the respiratory stretch receptors are activated?

A

Inhibitory discharge is sent to the inspiratory area…

Expiration begins + lungs deflate

102
Q

Where can irritant receptors be found?

A

Between airway epithelial cells

103
Q

What are irritant receptors stimulated by?

A

Noxious gases

Cold + inhaled dusts

104
Q

What happens once the irritant receptors have been activated?

A

Send APs down vagus nerve to cause:

Bronchoconstriction + ⬆️ resp rate

105
Q

Where are proprioreceptors located?

A

In NM spindles + Golgi tendon organs

106
Q

What are the 3 basic types of proprioreceptors?

A

Muscle spindles

Golgi tendon organs

Joint receptors (low-threshold mechanoreceptors)

107
Q

What are afferent impulses?

A

Neural impulses travelling from sensory organs/receptors to the CNS

108
Q

What are efferent impulses?

A

Neural impulses travelling from CNS to the organs/glands.

109
Q

In a study inhibiting muscle afferent fb, what did they use to partially block sensory responses?

A

Lumbar intrathecal fentanyl

110
Q

What was measured in the study inhibiting muscle afferent fb

A

Minute ventilation (V little E)

Breathing frq. (f)

Tidal vol

111
Q

What is the most commonly used pulmonary function test?

A

Spirometry test

112
Q

Overview of procedure for spirometry test

A

Patient breathes in to full inspiration

Hold their breath long enough to seal their lips around mouthpiece.

Patient forcibly expires until nothing left to expel.

113
Q

For how long can the forced expiration for the spirometer test last for those who suffer from severe COPD?

A

up to 15 secs

114
Q

How many spirometer readings should be taken?

A

3

Best 2 should be w/in 100ml or 5% of each other

115
Q

What does spirometry measure?

A

Records vol vs time.

116
Q

What after a spirometry test is used to determine where there’s any evidence of restrictive or obstructive lung disease?

A

Ratio of FEV1 to FVC

117
Q

What needs to be corrected for when looking at the individuals measurements of FEV1 and FVC?

FEV1 = Forced expiratory volume in 1 second

A

Sex

Ethnicity

Height

Age

118
Q

How is FEV1 + FVC expressed after a spirometry test?

A

As a % of predicted for matched, healthy ind w/ no lung disease.

119
Q

What happens to FEV1 with obstructive spirometry?

A

Decreases

w/ less than 70% of the total amount in the 1st second.