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A&P Summer > Pulmonology > Flashcards

Pulmonology Flashcards

1
Q

Describe the upper respiratory system anatomy

A

Above the larynx; nose, nasal cavity, paranasal sinuses, pharynx.

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2
Q

Describe the upper respiratory system functions.

A

Filter, warm, and humidify incoming air; protecting the more delicate surfaces of the lower respiratory system; also cool and dehumidify outgoing air.

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3
Q

Describe the lower respiratory system anatomy.

A

Below the larynx; includes the larynx, trachea, bronchi, bronchioles, and alveoli

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4
Q

The conducting portion of the respiratory tract:

A

From nasal cavity to terminal bronchioles.

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5
Q

The respiratory portion of the respiratory tract:

A

Smallest most delicate respiratory bronchioles and alveoli. Air-filled pockets with in the lungs. Where all gas exchange takes place.

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6
Q

The respiratory defense system components include:

A

Mucous cells and mucous glands that provides sticky mucous that bathes exposed area; Cilia that sweep trapped degrees/microorganisms toward the pharynx (mucous escalator) and it is swallowed.

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7
Q

Particles 1-5 micrometers are trapped in mucous and can be engulfed by what?

A

Macrophages

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8
Q

The pharynx:

A

Are shared by digestive and respiratory systems; extends from the internal nares to entrances to larynx and esophagus; divided into the nasopharynx, the oropharynx, and the laryngeal pharynx.

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9
Q

Nasopharynx

A

Superior portion of the pharynx; contains pharyngeal tonsils and openings to left and right auditory tubes.

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10
Q

Oropharynx

A

Middle portion of pharynx; communicates with oral cavity.

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11
Q

Laryngopharynx

A

Inferior portion of pharynx; extends from hyoid bone to entrance of the larynx and esophagus.

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12
Q

Larynx

A

A cartilaginous Structure that surrounds the glottis

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13
Q

Cartilages of the larynx

A

Three large, unpaired cartilages including the thyroid and cricoid cartilages and the epiglottis

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14
Q

Thyroid cartilage

A

Aka: Adam’s apple; hyaline cartilage; forms anterior walls of larynx

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15
Q

Cricoid cartilage

A

Hyaline cartilage; forms posterior portion of larynx

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16
Q

Epiglottis

A

Composed of elastic cartilage; ligaments attach to cartilage and hyoid bone

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17
Q

The thyroid and cricoid cartilages support and protect what?

A

The glottis and the entrance to trachea

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18
Q

Describe the larynx during swallowing

A

The larynx is elevated and the epiglottis folds over glottis

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19
Q

Describe the trachea.

A

A tough and flexible tube. Diameter is 1 inch and length is 4.5 inches. Extends from the cricoid cartilage into mediastinum where it branches into right and left pulmonary bronchi.

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20
Q

Submucosa resides where and contains what?

A

Resides beneath mucosa of trachea and contains mucous glands.

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21
Q

Describe the tracheal cartilages:

A

15 to 20; C-shaped; discontinuous where trachea contacts esophagus allowing for distortion.

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22
Q

The right and left primary bronchi are separated by an internal ridge called:

A

The carina.

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23
Q

How is the right primary bronchus different from the left?

A

It is larger in diameter, it descends at a steeper angle, and inhaled objects are usually stuck here.

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24
Q

Where does each primary bronchus travel to? Hint: groove.

A

The hilum along the medial surface of lungs

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25
Q

The inferior portion of each lung rests on the superior surface of diaphragm. Where does the apex extend?

A

Superior to the first rib.

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26
Q

Describe the shape and lobes and fissures of the right lung.

A

The right lung is wider and displaced upwards by liver. Contains a superior, middle, and inferior lobe; separated by horizontal and oblique fissures.

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27
Q

Describe the shape and lobes and fissures of the left lung.

A

The left lung is longer and displaced leftward by the heart forming the cardiac notch. Superior and inferior lobes, separated by an oblique fissure.

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28
Q

A primary bronchus branches to form secondary bronchi (lobar bronchi) that go to each lobe; one secondary bronchus goes to each lobe (right lung has 3, left lung has 2); secondary bronchi then form what?

A

Tertiary bronchi, aka: segmental bronchi. Each supplies air to a single bronchopulmonary segment.

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29
Q

Bronchopulmonary segments in right vs. left lung:

A

Right lung has 10and left lung has 8 or 9

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30
Q

The walls of the primary, secondary, and tertiary bronchi vary how?

A

Each contains less cartilage and more smooth muscle; increased smooth muscle tension affects airway constriction and resistance.

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31
Q

Describe the route of air passing from the trachea to the alveoli.

A

Trachea to left primary bronchus to secondary bronchus to tertiary bronchus to smaller bronchus to bronchiole to terminal bronchiole to respiratory bronchiole to alveoli in a pulmonary lobule.

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32
Q

Alveolar epithelium consists of what type of epithelium? What also does it consist of?

A

Simple squamous epithelium. Consists of thin, delicate pneumocytes type I and pneumocytes type II (septal cells) that produce surfactant. Alveolar macrophages, aka: dust cells, patrol epithelium.

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33
Q

What is surfactant and what does it do?

A

It is a oily secretion; it contains phosolipids and proteins; it coats alveolar surfaces and forms superficial coating over thin layer of water; it reduces surface tension.

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34
Q

The respiratory membrane is significant why?

A

It is the thin membrane of alveoli where gas exchange takes place.

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35
Q

Inflammation of lobules, aka:

A

Pneumonia. Causes fluid to leak into alveoli and respiratory bronchioles swell and constrict.

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36
Q

O2 and Co2 are lipid _______?

A

Lipid soluble, thus diffusing across respiratory membrane.

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37
Q

Blood pressure in pulmonary circuit is low, at _____ mmHg and vessels are blocked by blood clots, fat, or air bubbles, causing pulmonary embolism.

A

30 mmHg.

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38
Q

The right and left plural cavities are separated by what? Each is lined with what?

A

The mediastinum. A serous membrane , aka: the pleura.

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39
Q

The two layers of the pleura include:

A

The parietal: covers inner surface of thoracic wall and extends over diaphragm and mediastinum.

The visceral: outer surface of lungs

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40
Q

Pleural fluid location and function:

A

Lubricate space between two layers;slippery coating which reduces friction

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41
Q

Three processes of external respiration:

A
  1. Pulmonary ventilation (breathing)
  2. Gas diffusion: across respiratory membrane sand capillaries
  3. Transport of O2 and CO2: between alveolar capillaries and between capillary beds in other tissues
42
Q

Boyle’s law defines the relationship between gas pressure and volume:

A

P=1/V

In a contained gas, external pressure forces molecules closer together. Movement of gas molecules exerts pressure on container.

Decreased volume, pressure rises VS. increased volume, pressure falls

43
Q

A respiratory cycle consists of:

A

An inspiration and and expiration.

44
Q

Cyclical changes in intrapleural pressure operate what?

A

The respiratory pump, which aids in venous return to the heart.

45
Q

Respiratory pump, inhalation:

A

Inhalation causes pressure reduction in plural vanity causing air to be pulled into lungs and blood pulled into inferior vena cava and RA from smaller veins of abdominal cavity.

46
Q

Respiratory pump, exhalation:

A

As you exhale, thoracic cavity decreases in size and interpressure rises, forcing air out of lungs and pushing venous blood into RA.

47
Q

Tidal volume:

A

Amount of air moved in and out of lungs in a single respiratory cycle.

48
Q

Mechanics of breathing, inhalation vs. exhalation.

A

Inhalation: always active.

Exhalation: active or passive.

49
Q

Diaphragm contraction draws air into lungs, accounting for ____% of normal air movement.

A

75%

50
Q

External intercostal muscles assist inhalation with contraction. Account for ___% of normal air movement.

A

25%

51
Q

Accessory muscles that assist in elevating ribs:

A

1) sternocleidomastoid
2) serrates anterior
3) pectoralis minor
4) scalene muscles

52
Q

Tidal volume numbers (mL/breath, L/min, volume @ destination)

A

About 500 mL per breath.
6 L of air per minute.
1st 350 mL goes to the conduction zone and enters alveolar space.
Last 150 mL never gets to alveolar area.

53
Q

An anatomical dead space

A

Volume of air remaining in conducting passages

54
Q

Residual volume

A

Amount of air left in lungs after maximal exhalation (~1100mL)

55
Q

Vital capacity

A

Maximum amount of air you can move in and out of lungs in single cycle.

ERV+IRV+Tidal volume (Expiratory reserve volume + inspirations reserve volume + tidal volume)

~3400 to 4800 mL

56
Q

Four calculated respiratory capacities

A

1) inspirations capacity
2) functional residual capacity (FRC)
3) Vital capacity
4) total lung capacity

57
Q

Inspiratory capacity

A

Tidal volume + inspiratory reserve volume

58
Q

Functional residual capacity (FRC)

A

Expiratory reserve volume + residual volume

59
Q

Total lung capacity

A

Vital capacity + residual volume

60
Q

Composition of air (N2, O2, H20, CO2)

A

N2: 78.6%
O2: 20.9%
H20: 0.5%
C02: .04%

61
Q

Atmospheric pressure (combined effects of collision involving each type of molecule; ie., 78.6% of collisions involve nitrogen)

A

760 mmHg

62
Q

Dalton’s Law

A

Each gas contributes to the total pressure, or, all partial pressures add up to 760 mmHg

63
Q

Henry’s Law

A

When gas under pressure comes in contact with liquid, gas is forced to dissolve in liquid until equilibrium is reached.

At a given temp, amount of a gas in solution is proportional to partial pressure off that gas.

64
Q

The actual amount of a gas in solution (at given partial pressure and temp) depends on:

A

The solubility of that gas in that particular liquid.

65
Q

Solubility in Body Fluids (CO2 and 02)

A

CO2 is very soluble.

O2 is less soluble.

N2 has very low solubility.

66
Q

Normal partial pressures in pulmonary vein plasma (CO2, O2, N2):

A

PCO2: 40 mmHg
PO2: 100 mmHg
PN2: 573 mmHg

67
Q

If partial pressure go oxygen in alveoli decrease, the rate of diffusion in the blood will _____?

A

Drop

68
Q

100 mL of plasma can only absorb ____? mL of O2

A

.3mL

69
Q

Each 100 mL of blood leaving alveolar capillaries carries ___? mL of O2.

A

20 mL of O2 (only .3 mL is in solution and the rest bound to hemoglobin)

70
Q

Hemoglobin consists of 4 globular protein subunits (2 alpha and 2 beta), each unit contains heme (iron) and each hemoglobin can transport __ oxygen molecules.

A

4 oxygen molecules.

71
Q

Each RBC has about 280 million hemoglobin molecules, and each RBC can carry more than _____ molecules of oxygen

A

One billion

72
Q

4 key factors affecting hemoglobin:

A

1) PO2 of blood
2) Blood pH
3) Temp
4) Metabolic activity within RBCs

73
Q

Describe the Oxygen-hemoglobin saturation curve:

A

It is a graph relating the saturation of hemoglobin to partial pressure of O2.

Is a curve rather than a straight line (O2 changes shape each time a molecule of O2 is bound)

Each O2 bound makes next 02 binding easier

74
Q

Carbon monoxide binds strongly to what?

A

Hemoglobin, taking the place of O2.

75
Q

Considering the O2-Hemoglobin Saturation Curve (standardized for normal blood with pH 7.4 and @37 degrees C):

When pH drops or temp rises:

A

More O2 is released and curve shifts to the right.

76
Q

Considering the O2-Hemoglobin Saturation Curve (standardized for normal blood with pH 7.4 and @37 degrees C):

When pH rises or temp drops:

A

Less O2 is released and curve shifts to left.

77
Q

The Bohr Effect

A

The effect of pH on hemoglobin-saturation curve, caused by CO2

78
Q

Describe the transformation of C02 after it diffuses into RBC.

A

An enzyme, called carbonic anhydrase, catalyzes reaction with H20, produces carbonic acid (H2CO3).

H2CO3 dissociates into hydrogen ion (H+) and bicarbonate ion (HCO3-).

H+ diffuses out of RBC, lowering pH

79
Q

CO2 is generated as a by-product of _______ metabolism (cellular respiration).

A

Aerobic metabolism

80
Q

C02 in bloodstream may be (three options):

A

1) converted to carbonic acid (70%), then dissociating into H+ and HCO3- (H+ removed by buffers like Hb and HCO3- moves out of RBC in exchange for Cl-)
2) bound to protein of hemoglobin (23%)
3) remains dissolved in plasma (7%)

81
Q

If low plasma O2 levels are there for a long time (for those at high altitude), RBCs generate what?

A

2, 3 bisphosphoglycerate (2,3 BPG), which reduces Hgb affinity for O2, promoting the releasing of the remaining 02 molecules bound to Hgb.

82
Q

When oxygen demand rises, _____ and ______ increase under neural control (both have voluntary and involuntary elements).

A

Cardiac output and respiratory rates

83
Q

Respiratory Centers in CNS found @:

A

Three pairs of nuclei in the reticular formation of the medulla oblongata and pons.

84
Q

The respiratory rhythmicity centers of the medulla oblongata set the pace of respiration and can be divided into two groups:

A

1) Dorsal respiratory group (DRG)

2) Ventral respiratory group (VRG)

85
Q

Dorsal Respiratory Group (DRG)

A

Inspiratory center; functions in quiet and forced breathing

86
Q

Ventral Respiratory Group (VRG)

A

Inspiratory and Expiratory center; functions ONLY in forced breathing

87
Q

Quiet breathing:

A

Brief activity in the DRG (stimulates inspiratory muscles); DRG neurons become inactive (allowing passive exhalation).

88
Q

Forced Breathing

A

Increased activity in DRG (stimulates VRG which activates accessory inspiratory muscles).

After inhalation, Expiratory center neurons stimulate active exhalation.

89
Q

The apneustic and pneumotaxic centers of pons (nosy neighbors):

A

Paired nuclei that adjust output of respiratory rhythmicity centers, regulating respiratory rate and depth of respiration in response to sensory stimuli

90
Q

Apneustic Center

A

Provides continuous stimulation to its DRG center

91
Q

Pneumotaxic Centers

A

Inhibit the apneustic centers; promote passive or active exhalation

92
Q

SIDS (sudden infant death syndrome):

A

Disrupts normal respiratory reflex pattern; may result in connection problems between pacemaker complex and respiratory centers

93
Q

Five Sensory Modifiers of Respiratory Center Activities:

A

1) Chemoreceptors
2) Baroreceptors
3) Stretch receptors
4) irritating physical or chemical stimuli
5) Other sensations

94
Q

Chemoreceptors

A

Sensitive to PCO2, P02, or pH of blood or cerebrospinal fluid.

95
Q

Baroreceptors:

A

In aortic or carotid sinuses are sensitive to changes in BP.

96
Q

Stretch Receptors:

A

Responds to changes in lung volume.

97
Q

Irritating physical or chemical stimuli:

A

In nasal cavity, larynx, or bronchial tree.

98
Q

Other sensations:

A

Including pain, changes in body temp, abnormal visceral sensations.

99
Q

Hearing-Breuer Reflexes (two baroreceptor reflexes involved in forced breathing):

A

1) Inflation reflex: prevents overexpansion of lungs; stretch receptors in bronchial smooth muscle
2) Deflation reflex: inhibits expiratory centers; stimulates inspiratory centers during lung deflation

100
Q

Alveolar collapse due to O2 replacing N2

A

Absorption atelectasis

A&P Summer (4 decks)

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