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Respiratory (LECTURE NOTES) > Anatomy and Physiology of the lungs > Flashcards

Anatomy and Physiology of the lungs Flashcards

1
Q

What is the main function of the respiratory system

A

To bring air from the atmosphere and blood from the circulation into close proximity across the alveolar capillary membrane in order to facilitate the exchange of oxygen and carbon monoxide

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2
Q

Describe the structure of the trachea

A

Cartilaginous horseshoe shaped rings in the anterior and lateral walls and a flaccid posterior wall

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3
Q

What happens to the posterior wall of the trachea during coughing

A

It bulges forward

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4
Q

Where does the trachea divide into the right and left main bronchi

A

At the level of the sternal angle

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5
Q

What main bronchus is longer?

A

The left

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6
Q

If an inhaled foreign object was to get stuck, where is it most likely to get stuck

A

The right lung because the right main bronchus is more directly in line with the trachea

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7
Q

What do the main bronchi divide into?

A

Lobar bronchi

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8
Q

What do lobar bronchi divide into?

A

Segmental bronchi

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9
Q

What structure separates bronchi from bronchioles

A

The presence of cartilage in the bronchi

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10
Q

What are the bronchioles which are immediately proximal to the alveoli known as

A

Terminal bronchioles

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11
Q

Describe the epithelial lining of the bronchi

A

Ciliated and includes goblet cells

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12
Q

Describe what the mucociliary escalator is

A

The cilia beating in an organised fashion to move material trapped in the mucus layer upwards and out of the lung

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13
Q

Why is the mucociliary escalator so important?

A

It is an important part of the lung’s defences

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14
Q

What happens to the acinar mucu-secreting glands in the submucosa in chronic bronchitis

A

They show signs of hypertrophy

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15
Q

Name the two types of alveolar cells

A

Type 1 pneumocytes

Type 2 pneumocytes

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16
Q

What is the role of type 1 pneumocytes

A

They have flattened processes that extend to cover most of the internal surface of the alveoli

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17
Q

What is the role of type 2 pneumocytes

A

They contain lamellated structures that are concerned with the production of surfactant

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18
Q

Describe the blood supply to the lungs

A

Dual supply

1 from the pulmonary circulation and 1 from the systemic circulation

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19
Q

Where do the pulmonary venules drain?

A

Laterally to the periphery of lung lobules and then pass centrally in the interlobular and intersegmental septa and then they join to form the 4 pulmonary veins.

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20
Q

Where do some small bronchial arteries arise from?

A

The descending aorta

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21
Q

What might happen to the bronchial arteries in chronic pulmonary inflammation

A

They may undergo hypertrophy

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22
Q

Where does haemoptysis arise from in diseases such as bronchiectasis or aspergilloma

A

Bronchial arteries

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23
Q

What are the 2 steps of bringing oxygen into the body and removing carbon dioxide

A

1 - moving air in and out of the lungs (between outside world and alveoli)
2 - gas exchange (between airspace of alveoli and the blood)

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24
Q

Where is the function of the lungs coordinated

A

By a centre in the brain stem

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25
Q

What are the main 2 forces involved in breathing

A

Inherent elastic property of the lungs and the resistance to airflow thought the bronchi (airway resistance)

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26
Q

What is the principal muscle of inspiration

A

Diaphragm

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27
Q

Describe the location of the diaphragm

A

Domed position, high in the thorax

28
Q

What happens to the ribs on inspiration

A

They move upwards and outwards

29
Q

What happens to the abdominal cavity during inspiration

A

It is pushed inferiorly by the diaphragm

30
Q

The inability to inflate the lungs is an example of what?

A

Restrictive ventilatory defect

31
Q

What muscles elevate the upper ribs and sternum

A

The scalene muscles

32
Q

What other muscles are involved in breathing

A

Sternocleidomastoids

Intercostal muscles

33
Q

What are another group of muscles involved during coughing

A

Abdominal muscles

34
Q

What counteracts the lungs tendency to contract

A

The semi-rigid chest wall

35
Q

The opposing forces from the lung and the chest wall generate what type of pressure and where?

A

Negative pressure within the pleural space

36
Q

What is the importance of the l=negative pressure

A

It maintains the lung in its stretched state

37
Q

Define lung compliance

A

The change in lung volume brought about by a unit change in transpulmonary (intrapleural) pressure

38
Q

What two things to the muscles of respiration have to overcome

A

1- the elastic properties of the lung and the chest wall

2 - the frictional forces opposing flow up and down the airways

39
Q

Describe the relationship between the resistance to flow in a tube and the radius of the tube

A

Resistance is inversely proportional to the radius^4

40
Q

Where is the greater part of total airway reisitance situated in a healthy individual

A

The large airways - layrnx, trachea, main bronchi

41
Q

What type of pressure is generated in the alveolar space during expiration

A

A positive pressure

42
Q

What happens to the maximum flow rate in COPD

A

It is reduced

43
Q

What happens to the lung elastic recoil as the lung volume decreases

A

It diminishes and therefore provides less support for the airway

44
Q

What is the maximum flow rate achievable dependent upon

A

The lung volume

45
Q

What is FEV1?

A

The forced expiratory volume in 1 second

46
Q

What must be in intimate contact for gas exchange to take place?

A

Air and blood

47
Q

Where does the majority of air inhaled go to and why?

A

The bases of the lungs

They are essentially sitting on the diaphragm and are not as stretched as the upper parts of the lung

48
Q

What is the driving pressure of the pulmonary circulation at rest?

A

15mmHg

49
Q

What will happen to the PCO2 if the alveolar ventilation increases?

A

It will fall

50
Q

What is PCO2 a sensitive index of ?

A

Alveolar ventilation

51
Q

If alveolar ventilation were reduced, what would happen to the PO2?

A

It would also be reduced

52
Q

What is the PO2 of moist atmospheric air?

A

20kPa

53
Q

What is the dissociation curve?

A

the quantity of gas carried by blood when exposed to different partial pressures of the gas

54
Q

Why does PO2 level off on the dissociation curve?

A

The haemoglobin is fully saturated

55
Q

Describe the content of O2 and CO2 in areas of low V/Q

A

Rise in arterial CO2 and a fall in arterial O2

56
Q

What allows us to distinguish a low oxygen level due to under ventilation from a level cause by intrinsic lung disease when looking at arterial blood gas results?

A

The alveolar gas equation

57
Q

What happens in pure underventilation

A

An increase in PCO2 and a proportionate fall in PO2.

58
Q

What does an increase in PCO2 and a proportionate fall in PO2 signify

A

Type 2 respiratory failure

59
Q

A disturbance of VQ matching leads to a fall in what?

A

A fall in PO2 and no change in pCO2

60
Q

What does a fall in PO2 and no change in pCO2 signify?

A

Type 1 respiratory failure

61
Q

What is the principal driver of ventilation

A

CO2 (due to pH)

62
Q

What is PCO2 maintained at in health

A

5.3kPa (40mmHg)

63
Q

What happens if the PCO2 is increased above 5.3kPa

A

Hyperventilation

64
Q

What happens if the PCO2 is decreased below 5.3kPa

A

Hypoventilation

65
Q

What SpO2 is aimed for in patients with COPD

A

88-92%

66
Q

When does hypoxia act as a stimulant

A

When the PO2 is less than about 8kPa

Respiratory (LECTURE NOTES) (19 decks)

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