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Human Anatomy & Physiology 1 > Chapter 22 (Respiratory) > Flashcards

Chapter 22 (Respiratory) Flashcards

1
Q

Asthma

A

Long-term inflammatory condition of the airways of the lungs, chronic
- recurring symptoms
- triggers
- variable and recurring
- reversible airflow obstruction and bronchi spasm (airways are constricting because they respond to something and they constrict)
- mimics copd
- symptoms: dyspnea (shortness of breath), wheezing (air moving through spasming bronchi), coughing, chest tightening
- eosinophil, immunoglobulin E, IgE
- eosinophil against parasitic infection, helminths, worms
- IgE - allergic responses, crosslinking on mast cells and release histamine and heparin, cause inflammation
- not a true allergy
- pulmonary function test - to induce asthma
- ratio decrease FEV1 below 80 when having an asthma attack
1. induce airways to bronchi spasm and undergo obstructive symptoms
2. give methacholine to do ^
3. stimulates cholinergic and acetylcholine receptors
4. cholinergic receptors cause secretions
5. ratio decreases goes into copd scenario
6. treat with albuterol, beta 2 agonist that cause relaxation of the smooth muscle wall in the lungs (bronchial smooth muscle relaxation)
- must be able to induce and treat to determine if asthma cause reversible

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2
Q

COPD (chronic obstructive pulmonary disease)

A
  • test through FEV1/FVC ratio
    2 TYPES
    1. obstructive (chronic bronchitis, emphysema, asthma) if below 80
  1. restrictive (pulmonary fibrosis) normal or increase - get a lot of excess stuff

if below 80 either emphysema or chronic bronchitis, inflammation that narrows airways, often due to smoking

  • chronic bronchitis = change in purulence in the amount and in the frequency of the cough for a certain period of time (at least 3 months, twice a year)
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3
Q

nostril

A

breath in air from nose

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4
Q

turbinates

A

spin to the air so air can have spiraling nature (so air can spiral its way down to respiratory tract)
- needs energy

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5
Q

uvula

A

soft tissue

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6
Q

olfactory (smell)

A

cranial nerve 1

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7
Q

cribriform plate of ethmoid bone

A

allows olfactory fibers to pass through in order for you to smell things

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8
Q

most common symptom of seizures to occur

A

olfactory tend to smell (electrical smell before seizure)

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9
Q

aura

A

warning before seizure
- olfactory

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10
Q

larynx

A

voicebox
- first area where air has contact with respiratory tree
- has glottis, opening for air, can be closed by the epiglottis
- area to find true vocal cords

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11
Q

nose (external nose and nasal cavity)

A

jutting external portion is supported by bone and cartilage. internal nasal cavity is divided by multiple by midline nasal septum and lined with mucosa

produces mucus; filters, warms, and moistens incoming air; resonance chamber for speech

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12
Q

paranasal sinuses

A

mucosa-lined, air-filled cavities in cranial bones surrounding nasal cavity

lighten skull; also may warm, moisten, and filter incoming air

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13
Q

pharynx

A

passageway connecting nasal cavity to larynx and oral cavity to esophagus. three subdivisions: nasopharynx, oropharynx, and laryngopharynx

houses tonsils (lymphoid tissue masses involved in protection against pathogens)

passageway for air and food

facilitates exposure of immune system to inhalted antigens

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14
Q

larynx

A

connects pharynx to trachea. has framework of cartilage and dense connective tissue. opening (glottis) can be closed by epiglottis or vocal folds

houses vocal folds (true vocal cords)

air passageway; prevents food from entering lower respiratory tract

voice production

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15
Q

trachea

A

flexible tube running from larynx and diving inferiorly into two main bronchi. walls contain c-shaped cartilages that are incomplete posteriorly where connected by trachealis

air passageways; cleans, warms, and moistens incoming air

  • windpipe
  • posterior side has trachealis muscle
  • lined by ciliated pseudostratified columnar epithelium with goblet cells
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16
Q

bronchial tree

A

consists of right and left main bronchi, whihc subdivide within the lungs to from lobar and segmental bronchi and bronchioles, bronchiolar walls lack cartilage but contain complete layer of smooth muscle. constriction of this muscle impedes expiration

air passageways connecting trachea with alveoli; cleans, warms, and moistens incoming air

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17
Q

alveoli

A

microscopic chambers at termini of bronchial tree. walls of simple squamous epithelium overlie thin basement membrane. external surfaces are intimately associated with pulmonary capillaries

special alveolar cells produce surfactant (reduces surface tension and prevents lungs from collapsing) (lipid fatty acid)

main sites of gas exchange

reduces surface tension; helps prevent lung collapse

  • true gas exchange and ture lung function
  • lined by simple squamous epithelium
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18
Q

lungs

A

paired composite organs that flank mediastinum thorax. composed primarily of alveoli and respiratory passageways. stroma is elastic connective tissue, allowing lungs to recoil passively during expiration

house respiratory passages smaller than the main bronchi

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19
Q

pleurae

A

serous membranes. parietal pleura lines thoracic cavity; visceral pleura covers external lung surface

produce lubricating fluid and compartmentalize lungs

  • surround the lungs
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20
Q

vestibular folds

A

false vocal cords

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21
Q

intubation

A

putting a air tube through someone’s larynx down through there bronchial tree usually stop around cornea
- so oxygenates lungs both at the same time

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22
Q

cornea

A

bifurcation point between the lungs

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23
Q

acute respiratory distress syndrome (ARDS)

A

issues synthesizing surfactant in lungs
- problems breathing in and expanding lungs because they don’t have surfactant

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24
Q

thyroid cartilage

A

laryngeal prominence (Adam’s Apple)

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25
Q

epiglottitis

A
  • cause: Haemophilus influenzae type B (gram negative bacteria)
  • Hib vaccine
  • thumb print sign on xray
  • on lateral xray of neck thumb print impression on the epiglottis
  • give antibiotics
26
Q

croup

A

barking seal cough
- laryngotracheobronchitis
- inflammation from the larynx to the bronchi
- cause: parainfluenza virus
- steeple sign on xray

27
Q

influenza virus

A
  • causes flu
  • H1N1
  • H = hemagglutinin (entry)
  • N = neuraminidase (exit)
  • hemagglutinin is what the influenza virus uses to enter or infect the cell while neuraminidase is what the influenza virus uses to exit the cell (has to exit the cell in order to infect more cells)
  • vaccine against H and N
  • the act of it licensing cells in order to release itself
  • secondary bacterial pneumonia can happen
  • immune system is so occupied and exhausted by dealing with the virus itself that by the time the virus is clear the bacteria will proliferate and take advantage of the damaged lung
28
Q

tamiflu

A

is only effective in the first 48 hours of flu infection
- antiviral medicine
- inhibit viral entry and exit

29
Q

bronchiolitis

A
  • respiratory syncytial virus (RSV)
  • big deal in babies and children especially newborns
30
Q

whooping cough (bordetella pertussis)

A
  • bacteria
  • Tdap vaccine which has tetanus (muscle infection), diphtheria (which is an esophagus infection), and pertussis
31
Q

Esophagus is posterior to c-shaped rings

A

trachea anterior

32
Q

right lung

A

3 lobes 2 fissures
superior, middle, inferior lobe
- more vertical
- exacerbation from foreign objects, gastric fluids, saliva that contain bacteria pneumonia are at higher risk due to vertical nature
- feeds into the middle lobe
- lobar pneumonia is in middle lobe probably aspiration pneumonia or foreign object
- pulmonary infiltrates into lung to kill infection, helps predict pneumonia

33
Q

left lung

A

2 lobes 1 oblique fissure
superior and inferior lobe
lingula (looks like tongue)
indentation or impression of the heart
- more horizontal

34
Q

trachea stops at cornea, bifurcates into two bronchi

A
35
Q

foreign objects exasperation has coin sign (IN)

A

right bronchi preference
- retrieve foreign objects by bronchoscopy

36
Q

exacerberation pneumonia

A
  • swallow study, when they swallow is it going in right tube
  • repeated injuries can lead to pulmonary abscess, organized collection of bacteria that sealed itself off into a pouch of bacterial growth that the immune system has difficulty dealing with
  • surgery or needle exacerbation
  • clindamycin, antibiotic designed to deal with pulmonary abscess and aerobic bacteria sealed off
37
Q

vocal cord

A
  • control = recurrent laryngeal nerve
  • if damage to nerve, voice is effected
  • most common damage is smoker
  • thyroid surgery is a risk to damage it
38
Q

atelectasis

A
  • lung collapse
  • use spirometry to prevent
  • occur from it you don’t use it you lose it
  • occurs from when you don’t use it from pain after surgery, don’t breathe enough from pain killers opioids
  • not enough breathing
  • pneumonia, cystic fibrosis, copd
39
Q

pneuthorax

A
  • punctured lung
  • ruptured lung and losing negative intrapleural space, losing that negative pressure from the thoracic cavity
  • will have atelectasis
  • no gradient = no air flow
40
Q

flail chest

A
  • paradoxical movement of lungs
  • inhale chest expand exhale depress normally if inhaling chest is expand and there is a segment of broken ribs it will suck inward moving opposite of the chest
  • do opposite of what is expected because frail muscle is no longer tethered to the normal muscle or bone
41
Q
A
41
Q

trachea down to cornea, bronchioles down to terminal and respiratory bronchioles duct and alveoli themselves

A

terminal bronchioles is not last

  • terminal bronchioles, respiratory bronchioles, alveolar duct, alveoli
42
Q
  • pulmonary arteries carry deoxygenated blood from the heart to the lung
  • pulmonary veins carry oxygenated blood from the lung to the heart
  • right heart supply deoxygenated blood through the pulmonary artery to the lung
  • right heart is going to accept oxygenated blood from the pulmonary veins that it will accept in the left heart, to shoot out from the aorta and supply to the rest of body
  • bronchial artery will supply oxygenated blood to the lung
  • bronchial vein will take away deoxygenated blood from the lung back to the heart
  • pulmonary artery comes off right heart and it is giving deoxygenated blood to the lungs for them to oxygenate in alveoli
  • pulmonary veins are collecting oxygenated blood and returning to left heart in order for the left heart to pump it to the aorta for the rest of the body to have
  • pulmonary vessels are for the body, bronchial vessels is lung specific
  • all enter at hilum
    -pulmonary artery most superior, bronchus both deliver deoxygenated blood
  • pulmonary veins are leaving going to the left heart to give oxygenated blood
A

lung is an organ with dual blood supply (two reserves)
- liver detox blood
- kidney produce urine

43
Q

red vessels are pulmonary veins

A
44
Q

intrapleural must be maintained at negative because of inhalation (-4)

A
45
Q

Residual volume (RV)

A

Amount of air remaining in the lungs after a forced expiration
- 1200 ml
- in dead space of lung and will always be there
- it keeps lungs inflated
- always in the lungs
- dead space = parts of the lung not involved in gas exchange

46
Q

Expiratory reserve
volume (ERV)

A

Amount of air that can be forcefully exhaled after a normal tidal volume expiration
- 1200 ml
- exercise

47
Q

Tidal volume (TV)

A

Amount of air inhaled or exhaled with each breath under resting
conditions
- 500 ml under normal what we are inhaling and exhaling

48
Q

Inspiratory reserve
volume (IRV)

A

Amount of air that can be forcefully inhaled after a normal tidal
volume inspiration
- exercise

49
Q

Total lung capacity (TLC)

A

Maximum amount of air contained in lungs after a maximum
inspiratory effort: TLC  TV  IRV ERV RV
- ALL VALUES ADDED TOGETHER

50
Q

Vital capacity (VC)

A

Maximum amount of air that can be expired after a maximum
inspiratory effort: VC  TV  IRV ERV
- Tidal + Inspiration + Expiration
- ability of your lungs to breathe maximally
- basically total capacity without residual

51
Q

Inspiratory capacity (IC)

A

Maximum amount of air that can be inspired after a normal tidal
volume expiration: IC  TV IRV
- Tidal + Inspiration

52
Q

Functional residual
capacity (FRC)

A

Volume of air remaining in the lungs after a normal tidal volume
expiration: FRC  ERV RV
- Expiration + Residual

53
Q

Mismatch of ventilation and perfusion

A
  • ventilation = air going into alveoli
  • perfusion = blood that is coming to the alveoli to be oxygenated
  • if there is a mismatched, the lung is shunt blood away from the mismatched region
  • if there is decrease ventilation in the area of the lung, rise of CO2 there, decrease of oxygen, problem of mismatched happens (less ventilation and too much perfusion)
  • lung will then shunt perfusion away, the amount of perfusion is decreased to match the amount of ventilation that was decreased
  • vice versus
  • first is usually ventilation, second perfusion
  • biggest is decrease ventilation
54
Q

tissue release carbon dioxide and they want to absorb oxygen
- oxygen is released from hemoglobin and it is going to go where it is needed in the tissues, driving by pH gradient
- tissues that require oxygen are more ischemic
- 6 carbon sugar

A

carbon dioxide = acid
if carbon dioxide is there it makes lower pH
- allows tissue to attract
- CO2 dissolves into bicarbonate
- in erythrocyte, CO2 combines with water through the action enzyme carbonate anhydrase which produces bicarbonate
- CO2 and water become carbonic acid, carbonic acid is going to breakdown into bicarbonate, bicarbonate is going to be shunted out into the blood plasma through chlorine channels
- chlorine channels are antiporters, take chlorine in and pump bicarbonate out
- CO2 is in the area of the tissues, it causes localized pH to change more acidic, CO2 is diffusing across the barrier, going to erythrocyte, going to plasma, in plasma it becomes bicarbonate, in erythrocyte carbonate anhydrase makes it carbonic acid, carbonic acid breaks down into bicarbonates, erythrocyte has chlorine channel, it is chlorine antiporter, chlorine enters erythrocyte, bicarbonate pumped out
- blood is kept alkaline by creating bicarbonate here
- at the lung it works reverse, chlorine pushed out and bicarbonate is pushed in, carbonic anhydrase converted back to CO2 and water, CO2 diffused across to the lung and breathed out

55
Q

shifts of hemoglobin

A

shift to the left = increased affinity
shift to the right = decreased affinity

56
Q

pons of brain stems there are respiratory centers, they interact with medulla
- in pons there are chemoreceptors that sense pH of blood, and by that they can sense hoe we handle carbon dioxide
- excess co2 in blood decrease pH of blood and make it more acidic, means not ventilating properly and must hyperventilate to get rid of it

A
57
Q

emphysema

A

2 TYPES
1. centrilobular - lose elastase tissue by smoking
2. panlobular - genetic deficiency of alpha 1 antitrypsin, entire lobule is inflamed and destroyed

  • antitrypsin inhibit elastase from neutrophils, these digest through the lungs, elastase break the lung tissue down and inhibit it with intriense alpha 1 antitrypsin in the lung itself
58
Q

cystic fibrosis

A
  • delta f508 mutation
  • CFTR gene
  • normally CFTR is a chlorine channel that hydrates mucus by releasing chlorine, sodium and water follow the release
  • CFTR is mutated and not functioning
  • nutritionally deficient
  • pancreas is getting killed
59
Q

Pseudomonas pneumonia

A
  • gram negative, highly resistant bacteria, infections
  • because of the mucus that has not been hydrated properly
60
Q

squamous cell carcinoma

A
  • central calcium
  • calcification
  • risk factor for damaged lungs
  • smoking
61
Q

adenocarcinoma

A
  • peripheral
  • smoking is not a risk factor
  • very difficult
  • if want to stage it get CT
  • start with chest x ray then CT

Human Anatomy & Physiology 1 (8 decks)

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