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PHTY 800 > Week 3- CR Anatomy/Physiology + Mechanics of Breathing > Flashcards

Week 3- CR Anatomy/Physiology + Mechanics of Breathing Flashcards

1
Q

Main functions of the respiratory system

A

Ventilation + gas exchange

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2
Q

Ventilation

A
  • Movement of gas in/out lungs

- Stops from inhaling foreign particles via mucociliary clearance (MCC) + cough

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3
Q

Gas exchange: functions + to achieve the two functions what does there need to be

A

Diffusion of O2 into the blood + removal of CO2

–> Need air moved via thoracic cage + blood moved via the heart, both to the lungs

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4
Q

The functions of the respiratory system in CR physio are defined as:

A

gas movement + secretion

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5
Q

Upper Respiratory Anatomy + Function + what do nose hairs do

A

Nose / Nasal Cavity / Pharynx (throat) / Larynx

Nose hairs filtrate + trap larger particles (i.e. pollen)

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6
Q

What does the nose do

A

Passageway for air / - Warms, humidifies. + filters air

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7
Q

Nasal cavity

A
  • Nasal cavity increases mucosal surface area + turbulence (slows airflow to allow time for air to be filtered/warmed)
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8
Q

Respiratory mucosa

A

Lines the nasal cavity and has ciliated epithelium that contain goblet cells which secrete mucus + trap inhaled particles

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9
Q

Pharynx

A

(Throat) Common passageway for air, food, + liquid

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10
Q

Larynx

A

Voice box

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11
Q

Lower Respiratory Tract (Function)

A

Conducting / gas exchange

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12
Q

Conducting part of LRT (Anatomy)

A

Trachea / L+R main bronchi / Lobar bronchi / Segmental bronchi / Bronchioles / Terminal bronchioles

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13
Q

2 Functions of the conducting part of LRT

A

(1) Conducts air into gaseous exchange part of lungs

(2) Traps smaller particles (i.e. bacteria) moved via the mucociliary escalator to pharynx where they are swallowed

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14
Q

CENTRAL airway lining of conducting part of LRT

A

> 2 mm diameter (i.e. main bronchi)

  • Mucus layer, ciliated epithelium, goblet cells, submucosal glands.
  • Think about function: has to have mucus which is prod. by goblet cells, + ciliated epithelium which are the hairs that assist.
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15
Q

PERIPHERAL airway lining of conducting part of LRT

A

<2mm diameter (i.e. terminal bronchiole)

- No mucus later, less/smaller cilia, clara cells (don’t make mucus)

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16
Q

Gaseous exchange part of LRT (anatomy)

A

Respiratory bronchioles, alveolar ducts, alveolar sacs, alveoli

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17
Q

Function of the gaseous exchange part of LRT

A

Gas exchange between O2 + Co2 occurs via diffusion in alveoli that are ventilated + perfused

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18
Q

Alveolar ventilation (v)

A

4 L/min- amount of gas getting into alveoli

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19
Q

Diffusion

A

Movement of gases (high to low) betw. alveoli, plasma, + red blood cells.

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20
Q

Perfusion (Q)

A

Pulmonary blood flow - cardiac out ~ 5 L/min

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21
Q

Lung anatomy

A

3 R lobes (UL,ML,LL) (horiz./oblique fissure) - 10 segments

2 L lobes (UL, LL) (oblique fissure) - 8 segments

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22
Q

Purpose of pleural cavity

A

Provides lubrication to reduce friction when the lungs inflate + recoil during breathing.
- Contains a small amount of pleural fluid, which allows the 2 layers to glide over each other during inspir./expir.

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23
Q

Resting volume of lung determined by:

A

The outward spring of the rib cage + inward elastic recoil of the lung matrix

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24
Q

Visceral pleura (inner layer)

A

Attaches to the outer surface of lungs + lines the fissures

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25
Q

Parietal pleura (outer layer)

A

Attaches to the chest/thoracic wall + superior surface of the diaphragm
- Highly sensitive to pain due to innervation from the phrenic/intercostal nerves.

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26
Q

Steps of pleural surfaces working

A
  1. Lungs are elastic + want to recoil inwards
  2. The chest wall wants to expand outwards.
  3. B/c the 2 pleural surfaces are pulling in opp. directions, it creates a - pressure in the pleural cavity. (This is what keeps lungs expanded)
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27
Q

Pneumothorax

A

Air in the pleural cavity; - intrapleural pressure (Ppl is disrupted)

  • Lungs collapse inward
    (i. e. stab wound/punctured lung from rib)
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28
Q

True ribs

A

T1-T7; Attach directly to sternum/spine

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29
Q

False/floating ribs

A

False - 8-12 (5)

Floating - 11,12

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30
Q

Thoracic cage moves in these 2 directions:

A

AP (pump handle) - ribs 2-5 raised during inspiration

Lateral (bucket-handle) - ribs 9-10 move in an upwards + outwards direction during inspiration.

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31
Q

Anterior/posterior apex of the lung

A

Ant. - Sits 2.5 cm above the medial 1/3 clavicle

Post. - C7

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32
Q

Anterior/posterior base of the lung

A

Ant. - to rib 6
Lat - to rib 8
Post. - to 10th rib

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33
Q

Inferior border of R lung

A

6th rib in mid-clavicular line –> 8th rib in the mid-axillary line, + 10th rib posteriorly.

34
Q

Medial border of R lung

A

Ant. - 6th rib from sternoclavicular joint

Post. - T1-T10 to side of spinous processes

35
Q

Location of cardiac notch

A

Medial border of L lung, 3-4 cm deviation from 4-6 rib

36
Q

U / M / L Zones

A

U - above 2nd ant. rib
M - betw 2nd/4th ribs
L - below 4th rib

37
Q

Primary muscles of inspiration

A

(1) Diaphragm

external intercostals, parasternal intercostals + scalene

38
Q

Accessory Inspiration Muscles

A

Sternocleidomastoid, UT, Pec major/minor, Serratus anterior, Thoracic extensors

39
Q

Accessory Expiration Muscles

A

Abdominals / Internal Intercostals

40
Q

Diaphragm

A

Inspiration: contracts or during exercise contracts on expiration too
Origin: Lower costal ribs, lumbar vertebra
Insertion: Central tendon
Innervates: C3,4,5

41
Q

Tidal volume (Vt)

A

Volume of gas inspired/expired w/ each breath

42
Q

Vital capacity (VC)

A

Volume of gas expired after a max inspiration to a max expiration (4L)

43
Q

Total Lung Capacity (TLC)

A

Volume of gas in lungs after max inspiration (5L)

44
Q

Functional Residual Capacity (FRC)

A
  • A reserve for gas exchange/minimises work of breathing

- Volume of gas in the lungs @ the end of a normal (passive) expiration (2.5L)

45
Q

What happens when FRC falls below closing volume?

A

Leads to atelectasis which is associated w/ reduced oxygenation, poor CO2 clearance, + an increased work of breathing.

46
Q

Residual volume

A

Volume of gas remaining in the lungs after a max expiration (cannot be exhaled)

47
Q

What happens to an increase in RV?

A

Occurs in obstructive lung disease due to air trapping.

- leads to altered resp. mechanics, increased work of breathing, + poor gas exchange.

48
Q

Total Lung Capacity

A

Volume of gas in the lungs after a max inspiration

49
Q

Atmospheric/barometric pressure

A

Pressure exerted by the gases in the air. (Sum of all the partial pressures of gases in the air)

50
Q

Intra-alveoral pressure (Pa)

A

Pressure w/in the alveoli; falls w/ inspiration + rises w/ expiration
- always eventually equalises w/ atmospheric pressure.

51
Q

Intrapleural pressure (Ppl) + how is this pressure created

A

Pressure w/in the pleural cavity + decreases on inspiration & increases on expiration.
- pressure created by chest wall wanting to expand out, while the lungs want to recoil in.

52
Q

Mechanics of breathing @ rest - FRC

A

(Pb) - Barometric pressure @ mouth = 0
(Pa) - Pressure in lungs (alveolar pressure) = 0
Intrapleural pressure = -
(No airflow ; Pb=Pa)

53
Q

Mechanics of breathing during inspiration

A

Intrapleural pressure becomes even more -, lungs want to recoil in even more when lungs get bigger
(1) Inspiratory muscles contract
(2) Thoracic cage expands
(3) Lungs expand (increase lung volume)
(4) Intrapleural + intraalveolar pressures decrease
(Pa[-2] < Pb [0] = airflow>lungs)

54
Q

Mechanics of breathing end inspiration

A

Pressures are = again, airflow ceases

Pa=Pb

55
Q

Mechanics of breathing during expiration

A

(1) Respiratory muscles relax
(2) Lungs passively recoil (to FRC)
(3) Alveolar pressure rises (becomes +) compared to mouth (barometric) pressure
so gas moves towards the mouth
Pa>Pb

56
Q

Horizontal fissure on R

A

Just above the level of the 4th rib/nipple, ends @ oblique fissure

57
Q

Oblique fissure of R/L

A

T3/T4 travels to base of lung

- Follows lines of medial scap w/ arm abducted @ 90

58
Q

Total (or minute) ventilation (Ve)

A

Vt (tidal volume[500ml]) x RR (resp. rate) = 6 L/min

- Mass movement of gas in/out of lung

59
Q

Alveolar ventilation (Va) + equation

A
  • The amount of fresh gas getting to the alveoli.

Va= (Vt-Vd) x RR ~ 4.2L/min

60
Q

Anatomical Dead Space (Vd)

A

Gas in the conducting airways (from nose to terminal bronchioles); about 150 ml.

61
Q

Low alveolar ventilation =

A

Increase in PaC02 (partial carbon dioxide)
+ decrease in Pa02 (diffusion)
- PaC02 = most important ABG affecting ventilation

62
Q

Intrapleural pressure (Ppl) affects on ventilation

A
  • Occurs betw. 2 pleural layers
  • is usually - : more - as you move up, if + lungs collapse
  • (- Ppl) keeps lungs expanded, becomes more - on inspiration.
  • More - @ apex b/c gravity
63
Q

Apical region affect on pressure

A

Gravity > lung pulls down more > more - Ppl > stretch on alveoli> alveoli more expanded @ FRC

64
Q

Basal region affect on pressure

A

Gravity less pull down> less - Ppl > alveoli less stretch > alveoli less open @ FRC (able to take more air in during FRC b/c alveoli in apex are already expanded)

65
Q

Lung compliance definition

A

Change in volume produced by a change in pressure (C = change in V / change in P)

66
Q

Low compliance

A

Closed alveoli OR well opened alveoli = harder to inflate (ventilate)

67
Q

High compliance

A

Smaller alveoli = easier to inflate

68
Q

Non-dependent lung region (apex)

A

Uppermost lung
Alveoli stretched open @ FRC b/c - Ppl
Less compliant / take in less air, decreased ventilation

69
Q

Dependent lung region (basal)

A

Lower lung
Alveoli less stretched @ FRC, so less - Ppl
More compliant / increased ventilation

70
Q

Mucus - what is it, how much is prod., what does it contain

A

Mechanical, bio, chem, barrier to inhaled material.

  • prod. 100-250 ml/day
  • covers airways, traps particles + bacteria
  • 2 layers- gel/sol(cilia)
  • Contains natural enzymes that destroy bacteria
71
Q

Cilia

A

Moves particles caught in mucus up to pharynx where it is swallowed.
Stimulated by presence of mucus.

72
Q

Things that - affect mucociliary clearance

A

Age, sleep, respiratory disease, meds, smoking

73
Q

Things that + affect mucociliary clearance

A

Exercise, environment, meds

74
Q

Cough

A

Functions to assist the removal of material from the airways
Used if:
- volume of mucus is too large for normal MCC
-MCC damaged
-Exercise can stimulate

75
Q

Alveolar clearance

A
  • No cilia in the alveoli
  • Only small particles will reach the alveoli (i.e. tobacco, smoke)
  • Deposit via sedimentation/diffusion
  • Particles are engulfed by macrophages
  • Takes 1-3 days
76
Q

ECG - P wave

A

Records electrical activity thru upper chambers (atrial depolarisation)

77
Q

ECG - QRS complex

A

Record the movement of electrical impulses thru lower chambers (ventricle depolarisation)

78
Q

ECG - PR

A

Reflects conduction thru the AV node.

atria contracting

79
Q

ECG - ST segment

A

Shows when the ventricle is contracting but no electricity is flowing thru.

80
Q

ECG - T wave

A

Shows lower heart chambers are resting electrically & prepping for next muscle contraction

PHTY 800 (8 decks)

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