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HAN 202 > Chapter 22: Respiratory System > Flashcards

Chapter 22: Respiratory System Flashcards

1
Q

Larynx (voicebox)

A
  • vocal folds macy act as a sphincter to prevent air passage
  • example: Valsalva’s Maneuver
  • glottis closes to prevent exhalation
  • abdominal muscles contract
  • intra-abdominal pressure rises
  • helps to empty the rectum or stabilizes the trunk during heavy lifting
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2
Q

trachea

A
  • windpipe: from the larynx to primary bronchioles
  • wall composed of 3 layers:
    1. mucosa
    2. submucosa
    3. adventitia: outermost layer

*tracheostomy

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3
Q

Conducting zone structures

A

Trachea-> right and left main (primary) bronchi

  • main bronchus enters the hilum of one lung
  • each main bronchus branches into lobar (secondary) bronchi (three right, 2 left)
  • each lobar bronchus supplies one lobe
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4
Q

Conducting zone structures

A

Trachea-> right and left main (primary) bronchi

  • main bronchus enters the hilum of one lung
  • each main bronchus branches into lobar (secondary) bronchi (three right, 2 left)
  • each lobar bronchus supplies one lobe

** Lobar (secondary) branchus-> segmental (tertiary) bronchus-> bronchioles-> terminal bronchioles are the smallest

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5
Q

respiratory zone

A

respiratory bronchioles, alveolar ducts, alveolar sacs (clusters of alveoli)

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6
Q

alveoli features

A
  1. surrounded by fine elastic fibers
  2. open alveolar pores-equalizes air pressure throughout the lung
  3. house alveolar macrophages-keep surfaces sterile
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7
Q

smoking

A
  • tobacco
  • nicotine: stimulates increased HR
  • carbon monoxide: blocks oxygen transport in HB
  • Tar: cancer causing
  • > smoking paralyzes cilia
  • > without cilia inhaled particles cling to wall or enter lung
  • cilia helps move mucus
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8
Q

lungs

A

2 lungs

  • left has 2 lobes
  • right has 3 lobes
  • > Apex-> superior tip just under clavicle
  • > Base: concave inferior portion above diaphragm
  • > hilum: vessels
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9
Q

Occasionally food or liquids will “go down the wrong pipe,” initiating a cough reflex. Which structural barrier has been breached if this happens?

A

epiglottis

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10
Q

The respiratory membrane is composed of ________.

A

the alveolar membrane, the capillary wall, and their fused basement membrane

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11
Q

Men tend to have deeper voices than women because their vocal cords …

A

are longer and thicker

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12
Q

Blood supply

A
  • > pulmonary circulation (low pressure, high volume):
  • pulmonary AA- blood from heart to be oxygenated

*pulmonary vv: freshly oxygenated blood

  • > Bronchial circulation:
  • oxygenated blood to lung tissue
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13
Q

Pleurae

A
  • > thin, double-layered serosa
  • parietal pleura: thoracic wall
  • visceral pleura: on lung tissue
  • pleural space: pleural fluid for lubrication
  • > allows friction free movement during breathing
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14
Q

pressure relationships in the thoracic cavity

A
  • Atmospheric pressure:
  • pressure exerted by the air surrounding body
  • 760 mm Hg at sea level
  • > respiratory pressures:
  • negative respiratory pressure is less than Patm :(
  • positive respiratory pressure is greater than Patm
  • zero respiratory pressure= Patm
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15
Q

intrapulmonary pressure

A

Intrapulmonary (intra-alveolar) pressure (Ppul)

  • Pressure in the alveoli
  • Always eventually equalizes with Patm

Intrapleural pressure (Pip):

  • Pressure in the pleural cavity
  • Always a negative pressure (
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16
Q

pressure relationships

A
  • if Pip (intrapleural pressure)= Ppul (intrapulmonary pressure) the lung collapse
  • > (Ppul-Pip)= transpulmonary pressure
  • keeps the airways open
  • the greater the transpulmonary pressure, the larger the lungs
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17
Q

pulmonary ventilation

A
  • inspiration and expiration
  • mechanical processes that depend on volume changes in the thoracic cavity
  • volume changes -> pressure changes

*pressure changes -> gases flow to equalize pressure

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18
Q

Boyle’s law

A
  • the relationship between the pressure and volume of a gas

- pressure (p) varies inversely with volume… P1V1=P2V2

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19
Q

Inspiration

A

an active process:
-inspiratory muscles contract

  • thoracic volume increases
  • lungs are stretched and intrapulmonary volume increases
  • intrapulmonary pressure drops (to -1 mm Hg)
  • air flows into the lungs, down its pressure gradient, until Ppul (intrapulmonary pressure)=Patm
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20
Q

sequence of events: Inspiration

A
  1. Inspiratory muscles
    contract (diaphragm
    descends; rib cage rises).
  2. thoracic cavity volume increases
  3. lungs are stretched; intrapulmonary volume increases
  4. intrapulmonary pressure drops (to -1 mm Hg)
5. Air (gases) flows into 
lungs down its pressure 
gradient until intrapulmonary 
pressure is 0 (equal to 
atmospheric pressure).
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21
Q

expiration

A

Quiet expiration is normally a passive process:

  • Inspiratory muscles relax
  • Thoracic cavity volume decreases
  • Elastic lungs recoil and intrapulmonary volume decreases
  • Ppul rises (to +1 mm Hg)
  • Air flows out of the lungs down its pressure gradient until Ppul = 0

Note: forced expiration is an active process: it uses abdominal and internal intercostal muscles

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22
Q

sequence of events: expiration

A
  1. Inspiratory muscles
    relax (diaphragm rises; rib
    cage descends due to
    recoil of costal cartilages).
  2. thoracic cavity volume decreases
  3. elastic lungs recoil passively; intrapulmonary volume decreases
  4. intrapulmonary pressure rises (to +1 mm Hg)
  5. Air (gases) flows out of
    lungs down its pressure
    gradient until intra-
    pulmonary pressure is 0.
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23
Q

physical factors influencing pulmonary ventiliation

A

-inspiratory muscles work to overcome 3 factors that hinder air passage and pulmonary ventilation

  1. airway resistance
  2. alveolar surface tension
  3. lung compliance
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24
Q
  1. airway resistance
A
  • Friction = resistance to gas flow
  • The relationship between flow (F), pressure (P), and resistance (R) is:F = (P2-P1)/ R
  • > delta P is the pressure gradient between the atmosphere and the alveoli (2 mm Hg or less during normal quiet breathing)
  • > Gas flow changes inversely with resistance (straw)
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25
Q

Airway resistance

A

Resistance is usually insignificant because of:
-Large airway diameters in the first part of the conducting zone

  • Progressive branching of airways as they get smaller, increasing the total cross-sectional area
  • Resistance disappears at the terminal bronchioles where diffusion drives gas movement
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26
Q

Airway resistance

A

-As airway resistance rises breathing become more strenuous

  • Severely constricting or obstruction of bronchioles
  • Can occur during acute asthma attacks and stop ventilation

-Epinephrine (SNS) dilates bronchioles and reduces air resistance

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27
Q
  1. alveoli surface area
A
  • film over alveoli contains surfactant which reduces cohesiveness of water and prevents collapse of alveoli
  • respiratory distress syndrome (RSD)
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28
Q
  1. lung compliance
A

-change in lung volume that occurs with a given change in transpulmonary pressure

  • normally high due to:
  • distensibility of the lung tissue
  • alveolar surface tension
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29
Q

lung compliance

A

diminished by:

  • nonelastic scar tissue (fibrosis)
  • reduced production of surfactant
  • decreased flexibility of the thoracic cage balloon
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30
Q

Why is the trachea reinforced with cartilage & why are these cartilaginous rings incomplete posteriorly?

A

cartilage prevents collapse during pressure changes w/ breathing. incomplete rings allows food bolus down the esophagus

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31
Q

Under what conditions does air tend to flow into the lungs? (thoracic volume & pressure)

A

increase thoracic volume and decrease in pressure

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32
Q

The pressure in the alveoli is known as __________.

A

intrapulmonary pressure

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33
Q

If transpulmonary pressure were to suddenly decrease to 0, predict the response by the lungs

A

The lungs would immediately collapse.

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34
Q

Surfactant helps to prevent the alveoli from collapsing by …

A

Interfering with the cohesiveness of water molecules, thereby reducing the surface tension of alveolar fluid

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35
Q

Air moves into the lungs during inspiration due to the force of

A

atmospheric pressure

36
Q

What effect does increased airway resistance have on air flow?

A

reduces air flow

37
Q

What would happen if an opening were made into the chest cavity, as with a puncture wound?

A

destroys the partial vacuum in the pleural space and the lung would collapse

38
Q

respiratory volumes

A

Used to assess a person’s respiratory status:

  • > Tidal volume(TV): air exchange between normal breathing
  • > Inspiratory reserve volume (IRV): amount of air that can be forcefully inhaled
  • > expiratory reserve volume (ERV): amount of air that can be forcefully exhaled
  • > residual volume (RV): amount of air remaining in the lungs after a forceful exhale
39
Q

Respiratory Capacities

A
  • inspiratory capacity (IC): tidal volume and inspiratory reserve
  • functional residual capacity (FRC): expiratory reserve and residual volume
  • vital capacity (VC): volume of exchangeable air
  • everything but residual volume

-total lung capacity (TLC)

40
Q

Dead Space

A
  • some inspired air never contributes to gas exchange
  • anatomical dead space: conducting zones
  • alveolar dead space: alveoli that are collapsed or obstructed
41
Q

pulmonary function tests

A

can determine obstructive lung disease from restrictive lung disease

42
Q

Non-respiratory air movements

A
  • most result from reflex action

- examples: cough, sneeze, crying, laughing, hiccups, and yawns

43
Q

Gas exchanges between blood, lungs, and tissues

A
  • external respiration
  • internal respiration
  • to understand the above processes, first consider
  • physical properties of gases
  • composition of alveolar gas
44
Q

external respiration

A

-exchange of O2 and CO2 across the respiratory membrane

  • influenced by:
    1. partial pressure gradients and gas solubilities
  1. ventilation-perfusion coupling
  2. structural characteristics of the respiratory membrane
45
Q

partial pressures

A
  • pressure exerted by a gas
  • directly proportional to the percentage of that gas in the mixture
  • at higher altitudes, partial pressures decline in direct proportion to decrease in atm pressure
46
Q
  1. partial pressure gradients and gas solubilities
A
  • Partial pressure gradient for O2 in the lungs is steep
  • venous blood PO2= 40 mmHg
  • alveolar PO2= 104 mmHg
  • O2 partial pressures reach equilibrium of 104 mm Hg in .25 sec, about 1/3 the time a red blood cell is in a pulmonary capillary
47
Q

partial pressure gradients and gas solubilities

A
  • partial pressure gradient for CO2 in the lungs is less steep:
  • venous blood PCO2= 45 mmHg
  • alveolar PCO2= 40 mm Hg
48
Q
  1. ventilation-perfusion coupling
A
  • Ventilation: amount of gas reaching the alveoli
  • perfusion: blood flow reaching the alveoli
  • ventilation and perfusion must be matched (coupled) for efficient gas exchange
49
Q

ventilation-perfusion coupling

A
  • > Changes in Po2 in the alveoli cause changes in the diameters of the arterioles.
  • Where alveolar O2 is high, arterioles dilate
  • Where alveolar O2 is low, arterioles constrict (moves blood to other areas)
  • > CHANGES IN PCO2 IN THE ALVEOLI CAUSE CHANGES IN THE DIAMETERS OF THE BRONCHIOLES
  • WHERE ALVEOLAR CO2 IS HIGH, BRONCHIOLES DILATE

*WHERE ALVEOLAR CO2 IS LOW, BRONCHIOLES CONSTRICT

50
Q
  1. thickness and surface area of the respiratory membrane
A
  • > respiratory membranes: large surface area
  • > edema/fluid causes increased thickening of membrane (CHF)
  • > reduction in surface area with emphysema (destruction of alveoli)
51
Q

internal respiration

A
  • > Capillary gas exchange in body tissues
  • > Partial pressures and diffusion gradients are reversed compared to external respiration
  • Po2 in tissue is always lower than in systemic arterial blood
  • Po2 of venous blood is 40 mm Hg and Pco2 is 45 mm Hg
52
Q

Respiratory transport- O2

A
  • > Molecular O2 is carried in the blood
  • 1.5% dissolved in plasma (poorly soluble in water)
  • 98.5% loosely bound to each Fe of hemoglobin (Hb) in RBCs
  • 4 O2 per Hb
53
Q

Even the most forceful exhalation leaves air in the lungs; this is called the _______ and is needed to _______.

A

residual volume; keep alveoli patent

54
Q

If there is an increase in alveolar CO2, the body will adjust by:

A

dilating the bronchioles in the lungs

55
Q

An increase in temperature or CO2 will cause

A
  • a shift in the curve to the right
  • an increase in O2 unloading

*(bohr effect)

56
Q

O2 and hemoglobin

A
  • rate of loading and unloading of O2 is regulated by
  • Po2
  • Temp
  • Blood pH
  • Pco2

-oxygen-hemoglobin disassociation curve

57
Q

other factors influencing hemoglobin saturation

A

-increases in temp, H+ and Pco2, enhance O2 unloading

  • occur in systemic capillaries
  • shift the O2-hemoglobin dissociation curve to the right (Bohr effect)

-decreases in these factors shift the curve to the left

58
Q

factors that increase release of O2 by hemoglobin

A
  • as cells metabolize glucose:
  • PCO2 and H+ increase in blood
  • declining pH (acidic) enhances O2 unloading (Bohr effect- shift to right)
  • heat production increases
  • increasing temp causes HB to unload more O2 to working muscles
59
Q

CO2 transport

A

CO2 is transported in the blood in 3 forms

  1. Plasma (7 to 10%)
  2. Bound to globin of hemoglobin 20%
  3. bicarbonate ions (HCO3-) 70% in plasma
60
Q

Haldane effect

A
  • the amount of CO2 transported is affected by the Po2
  • at tissues: the lower the Po2 and O2 saturation the more CO2 the blood can carry
  • at lungs: uptake of O2 facilitates release of CO2
61
Q

influence of CO2 on blood pH

A
  • > CARBONIC ACID-BICARBONATE BUFFER SYSTEM:
  • CO2 + H20-> H2CO3-> H+ HCO3
  • > IF H+ CONCENTRATION IN BLOOD RISES, EXCESS H+ IS REMOVED BY COMBINING WITH HCO3–
  • > IF H+ CONCENTRATION BEGINS TO DROP, H2CO3 DISSOCIATES, RELEASING H+
62
Q

influence of C02 on blood pH

A
  • changes in RR or depth can change blood pH
  • short shallow breaths- increases CO2, lowers pH
  • deep breaths-> reduce CO2
  • can use this to adjust blood pH during:
  • increased lactic acid during exercise

-FATTY ACID METABOLISM (KETONE BODIES) IN UNCONTROLLED DM

63
Q

voice production

A
  • speech: intermittent release of expired air while opening and closing the glottis
  • pitch: determined by the length and tension of the vocal cords. faster virbation-higher pitch, boys in puberty
  • loudness: depends on the force of air
  • sounds: is shaped into language by muscles of the pharynx, tongue, soft palate, and lips
64
Q

larynx

A

vocal ligaments (true vocal cords)

-vestibular folds (false vocal cords)

65
Q

larynx (voice box)

A

9 CARTILAGES OF THE LARYNX

  • THYROID CARTILAGE (ADAM’S APPLE)
  • RING-SHAPED CRICOID CARTILAGE
  • 3 PAIRED CARTILAGES

EPIGLOTTIS: ELASTIC CARTILAGE; COVERS THE LARYNGEAL INLET DURING SWALLOWING

66
Q

larynx (voice box)

A

attaches to the hyoid bone and opens into the laryngopharynx

functions:

  1. provides a patent airway
  2. routes air and food into proper channels
  3. voice production
67
Q

pharynx (throat)

A
  1. NASOPHARYNX – AIR PASSAGE, UVULA PREVENTS FOOD FROM ENTERING CAVITY, EUSTASCIAN TUBE
  2. OROPHARYNX – PSEUDOSTRATIFED COLUMNAR PROTECTS AGAINST FRICTION AND CHEMICAL TRAUMA
  3. LARYNGOPHARYNX – LIES POSTERIOR TO EPIGLOTTIS
68
Q

nasal cavity

A

VESTIBULE: NASAL CAVITY SUPERIOR TO THE NOSTRILS
*Superior, middle and inferior nasal conchae

-> OLFACTORY MUCOSA (SMELL RECEPTORS)

  • > RESPIRATORY MUCOSA
  • GOBLET CELLS (CONTAIN LYSOZYME AND DEFENSINS)
  • CILIA – MOVES CONTAMINATED MUCUS
  • WARMS INSPIRED AIR

***filter, heat, and moisten air

69
Q

the nose

A

functions:
-PROVIDES AN AIRWAY FOR RESPIRATION

  • MOISTENS AND WARMS THE ENTERING AIR
  • FILTERS AND CLEANS INSPIRED AIR
  • SERVES AS A RESONATING CHAMBER FOR SPEECH
  • HOUSES OLFACTORY RECEPTORS (HUMANS – 5 MILLION SCENT RECEPTORS, BLOODHOUND HAS 300 MILLION)
70
Q

respiration

A

Respiratory system:
PULMONARY VENTILATION: *MOVEMENT OF AIR INTO AND OUT OF THE LUNGS

EXTERNAL RESPIRATION:
*O2 AND CO2 EXCHANGE BETWEEN THE LUNGS AND THE BLOOD

Circulatory System:
TRANSPORT: O2 AND CO2 IN THE BLOOD

INTERNAL RESPIRATION: O2 AND CO2 EXCHANGE BETWEEN SYSTEMIC BLOOD VESSELS AND TISSUES

71
Q

Influence of CO2 on blood pH

A
  • changes in RR or depth can change blood pH
  • short shallow breaths- increased CO2 lowers pH
  • deep breaths- reduce CO2
  • can use this to adjust blood pH during:
  • increased lactic acid during exercise
  • fatty acid metabolism (ketone bodies) in uncontrolled DM
72
Q

Even the most forceful exhalation leaves air in the lungs; this is called the _______ and is needed to _______.

A

residual volume; keep alveoli patent

73
Q

If there is an increase in alveolar CO2, the body will adjust by:

A

A greater partial pressure of carbon dioxide in the alveoli causes the bronchioles to increase their diameter as will a decreased level of oxygen in the blood supply, allowing carbon dioxide to be exhaled from the body at a greater rate.

74
Q

an increase in temperature or CO2 will cause

A

a shift in the curve to the right

-an increase in O2 unloading

75
Q

factors that shift the oxygen dissociation curve

A 
to the left:
inc. pH
inc. PCO2
dec. temp
dec DPG
dec. HbF
dec COHb

-to the right
dec. pH
inc PCO2
inc. temp
inc. DPG

76
Q

control of respiration

A
  • > pontine respiration center:
  • influence and modify activity of the VRG
  • smooth out transition between inspiration and expiration and vice versa
  • > Medullary respiration centers:
  • DRG- (DORSAL)- integrates input from baroreceptors (peripheral stretch) and chemoreceptors

*VRG- (VENTRAL)- sets RR at 12-15 BPM. inspiratory neurons excite. expiratory neurons inhibit.

77
Q

Pontine respiratory centers

A

interact with the medullary respiratory centers to smooth the respiratory pattern

  • Ventral respiratory group (VRG) contains rhythm generators whose output drives respiration
  • dorsal respiratory group (DRG) integrates peripheral sensory input and modifies the rhythms generated by the VRG
78
Q

chemical factors

A

influence of PCO2:
-if PCO2 levels rise (hypercapnia), CO2 accumulates in the brain

  • elevated H+ stimulates the central chemoreceptors of the brain stem
  • chemoreceptors synapse with the respiratory regulatory centers, increasing the depth and rate of breathing
79
Q

slide 88

A

flow chart of what happens when increase in CO2

80
Q

depth and rate of breathing

A

hyperventilation: increased depth and rate of breathing that exceeds the bodys need to remove CO2

  • causes CO2 levels to decline (hypocapnia)
  • may cause cerebral vasoconstriction and cerebral ischemia
81
Q

chemical factors

A

influence of PO2:
*peripheral chemoreceptors in the aortic and carotid bodies are O2 sensors

*substantial drops in arterial PO2 (to 60 mm Hg) must occur in order to stimulate increased ventilation

82
Q

summary of chemical factors

A
  • rising CO2 levels are the most powerful respiratory stimulant
  • normally blood PO2 affects breathing only indirectly by influencing peripheral chemoreceptor sensitivity to changes in PCO2
83
Q

INFLUENCE OF HIGHER BRAIN CENTERS

A
  • HYPOTHALAMIC CONTROLS ACT THROUGH THE LIMBIC SYSTEM TO MODIFY RATE AND DEPTH OF RESPIRATION
  • EXAMPLE: BREATH HOLDING THAT OCCURS IN ANGER OR GASPING WITH PAIN

-A RISE IN BODY TEMPERATURE ACTS TO INCREASE RESPIRATORY RATE (REVERSE OCCURS – JUMP IN COLD WATER)

  • CORTICAL CONTROLS CAN BYPASS MEDULLARY CONTROLS
  • EXAMPLE: VOLUNTARY BREATH HOLDING
84
Q

inflation reflex

A

Hering-Breuer reflex:
-stretch receptors in the pleurae and airways are stimulated by lung inflation

  • these receptors send message to respiratory center (vagus nn) to end inhalation
  • protective response
85
Q

homeostatic imbalances of respiratory system

A

COPD:

  • chronic bronchitis
  • emphysema

RESTRICTIVE LUNG DISEASE:

  • als/ md
  • scoliosis
  • obesity
  • sarcoidosis

HAN 202 (13 decks)

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