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respiratory > Resp Quiz > Flashcards

Resp Quiz Flashcards

1
Q

Rhinitis needs one or more of the following to qualify as such…

A
  1. Sneezing
  2. Rhinorrhea
  3. Nasal congestion
  4. Nasal itching
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2
Q

Commonly associated symptoms with rhinitis

A
  • Fatigue
  • Headache
  • Cognitive impairment
  • Sleep disturbance
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3
Q

What are the functions of the lungs?

A
  • Gas exchange
  • Metabolism
  • Regulation of blood pH
  • Defense against microbes
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4
Q

Oxygen consumed at rest

A

250 mL/min

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5
Q

Carbon dioxide produced at rest

A

200 mL/min

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6
Q

Ventilation at rest

A

7,000 mL/min

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7
Q

Cardiac output at rest

A

5,000 mL/min

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8
Q

Two stages of respiration

A
  1. Gas exchange

2. Cell respiration

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9
Q

3 processes of respiration

A
  1. Ventilation
  2. Diffusion
  3. Perfusion
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10
Q

What is ventilation?

A

Air intake and output

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11
Q

What is diffusion?

A

Gas exchange

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12
Q

What is perfusion?

A

Movement of gas within the blood

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13
Q

What is the conduction zone of the airways?

A

Trachea»bronchi»bronchioles»terminal bronchioles

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14
Q

What is the respiratory zone of the airways?

A

Respiratory bronchioles»alveolar ducts»alveolar sacs

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15
Q

Where do you lose cartilage down the respiratory tract?

A

Bronchioles

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16
Q

Type II epithelial cells

A

Release surfactant

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17
Q

Type I epithelial cells

A

Structure

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18
Q

What is the function of the cartilage in the upper respiratory tract?

A

Prevent collapse of smooth muscle in trachea and bronchus

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19
Q

Why is a thin blood-gas interface very important?

A

Diffusion

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20
Q

Why is a large blood-gas interface very important?

A

A larger surface area allows for more diffusion

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21
Q

Fick’s law of diffusion

A

Vgas = A/T * D * (P1-P2)

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22
Q

Diffusion constant for any given gas is dependent on…

A
  1. Solubility of the gas in the membrane

2. Inverse of the square root of the molecular weight

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23
Q

Body’s supply of oxygen depends on…

A
  1. Concentration of gases in ambient air

2. Partial pressure

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24
Q

Pb (barometric pressure) @ sea level

A

760 mmHg

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25
Q

Po2 @ sea level

A

159 mmHg

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26
Q

Pco2 @ sea level

A

0.3 mmHg

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27
Q

Pn2 @ sea level

A

600 mmHg

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28
Q

Dalton’s law

A

Pb = Po2 + Pco2 + Pn2

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29
Q

What happens to the trachea air in relation to partial pressures?

A

Partial pressure of nitrogen goes down

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30
Q

What happens to the alveoli in terms of partial pressures?

A

Carbon dioxide partial pressure goes up

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31
Q

Partial pressure of H2O @ 37 C

A

47 mmHg

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32
Q

Henry’s Law

A

Mass of a gas that dissolves in a fluid at a given temperature varies in direct proportion to pressure of the gas over the liquid

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33
Q

Two factors that govern the rate of diffusion into a fluid…

A
  1. Pressure gradient between gas above the fluid and gas dissolved in the fluid
  2. solubility of gas in the fluid
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34
Q

Joints of the thorax

A
  1. Costovertebral
  2. Costotransverse
  3. Sternocostal
  4. Costochondral
  5. Sternoclavicular
  6. Manubriosternal
  7. Xiphisternal
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35
Q

Regions of parietal pleura

A
  1. Cervical
  2. Costal
  3. Diaphragmatic
  4. Mediastinal
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36
Q

What innervates the visceral pleura and what does this mean?

A

Viscerosensory innervation; leaves lungs relatively insensitive to painful stimuli (dull, non-localized pain)

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37
Q

What innervates parietal pleura and what does this mean?

A

Somatosensory nerves, making the parietal pleura sensitive to pain (sharp and well-localized pain)

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38
Q

What nerve innervates the pericardium, mediastinal parietal pleura, and diaphragmatic parietal pleura?

A

Phrenic n.

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39
Q

What dermatomes do pain inputs from phrenic n. refer to?

A

C3-5

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40
Q

What primary muscles are involved during quiet and forceful inspiration and what are their innervations?

A
  • Diaphragm (phrenic n.)

- External intercostals (intercostal nn.)

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41
Q

What secondary muscles are involved during forceful inspiration and what are their innervations?

A
  • Scalene mm. (cervical spinal nn.)
  • Sternocleidomastoid (CN XI - accessory n.)
  • Internal intercostals (intercostal nn.)
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42
Q

Where does the diaphragm go when it contracts during inspiration?

A

Down

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43
Q

Where does the diaphragm go when it relaxes during exhalation?

A

Up

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44
Q

Which ribs move along the A-P axis?

A

2-6

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45
Q

Which ribs move along the transverse axis?

A

7-10

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46
Q

What is expiration mostly due to?

A

Elastic recoil of the lungs

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47
Q

Relaxation of the inspiratory muscles ________ the volume of the thoracic cavity

A

Decreases

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48
Q

What are the muscles involved during forced expiration?

A
  • Abdominal muscles (rectus abdominus, external and internal obliques, transversus abdominus) - increases intra-abdominal pressure, forcing organs up and thereby forcing the diaphragm up
  • internal intercostals
  • innermost intercostals
  • transversus thoracis
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49
Q

What innervates the muscles involved during forced expiration?

A

Intercostal nn. T7-11

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50
Q

What accessory muscles are involved during expiration and what are their functions?

A
  • Scalenes - elevate 1/2 ribs
  • Pec minor and major - elevate ribcage if arms abducted and scapula fixed
  • Serratus anterior - elevates lateral ribcage if scapula fixed
  • Trapezius, levator scapulae, rhomboids - stabilize the scapula so the other muscles can work on the ribcage
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51
Q

What diseases are associated with abnormal hypertrophy of accessory muscles of expiration?

A

COPD, emphysema

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52
Q

Boyle’s Law

A

If temp is constant, pressure and volume are inversely related

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53
Q

What is the basis for atelectasis?

A

If the alveoli collapse, the lung cavity cannot maintain the negative pressure required for normal conditions so air leaves the lung and enters the space between the viscera and the parietal pleura compressing the lung causing it to collapse

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54
Q

What is the sequence of inspiration?

A
  1. Inspiratory muscles contract
  2. Thoracic cavity expands
  3. Pleural pressure becomes more negative
  4. Transpulmonary pressure increases
  5. Lungs inflate
  6. Alveolar pressure becomes subatmospheric
  7. Air flows into the lungs until alveolar pressure equals atmospheric pressure (@ max volume here)
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55
Q

Two major determinants of lung compliance

A
  1. Elasticity of lung tissues due to collagen and elastin

2. Surface tension

56
Q

How are compliance and elastic recoil related?

A

Inversely

57
Q

Compliance can be related to volume and pressure how?

A

Compliance = change in volume / change in pressure

58
Q

How does emphysema alter lung compliance?

A
  • Increased lung volume
  • Easy to inflate
  • Less elastic recoil
59
Q

How does fibrosis or alveolar edema alter lung compliance?

A
  • Decreased lung volume
  • Hard to inflate
  • More elastic recoil
60
Q

Which area of the lung generally has high compliance?

A

Base of the lung

61
Q

Which area of the lung has higher compliance @ residual volume?

A

Apex of the lung

62
Q

Where does surface tension act?

A

ONLY at the gas-liquid interface

63
Q

Law of Laplace

A

P = 2T / r

-At higher radii, the alveoli will have lower pressure

64
Q

Surfactant

A

Lipoprotein mix of phospholipids, proteins, and calcium produced by Type II alveolar epithelial cells

65
Q

What does surfactant do?

A

Disrupts and lowers surface tension

66
Q

Where is surfactant’s greatest effect and why?

A

Its effect is greater in smaller alveoli because the molecules start to stack in layers; thereby reducing surface tension below that of larger alveoli

67
Q

How does surfactant stabilize the alveoli?

A

It reduces the pressure in smaller alveoli by acting to lower surface tension, thereby lowering pressure

68
Q

How does surfactant affect lung compliance?

A

Increases

69
Q

Why is respiratory distress a concern for premature babies?

A
  • Normally surfactant isn’t made until the last 2 months in utero
  • When premature babies are born, the type II cells aren’t mature enough to produce surfactant
  • Without surfactant, the alveoli collapse and have to be re-inflated every time the baby inspires which is a huge energy drain
  • They’re usually put on ventilators to help them breathe
70
Q

What could be a reasonable explanation for decreased lung compliance?

A
  • Decreased functional pulmonary surfactant
  • Fibrosis of the lungs
  • Surgical removal of one lobe
  • Pulmonary vascular congestion
71
Q

What do the choanae do?

A

Connet nasal cavities to the nasopharynx

72
Q

Where does the auditory tube drain?

A

Naspharynx

73
Q

Where does the sphenoid sinus drain?

A

Sphenoethmoidal recess

74
Q

Where do the posterior ethmoid air cells drain?

A

Superior meatus

75
Q

Where do the anterior and middle ethmoid air cells drain?

A

Ethmoid bulla»middle meatus

76
Q

Where do frontal and maxillary sinus drain?

A

Semilunar hiatus»middle meatus

77
Q

Where does the nasolacrimal duct drain?

A

Inferior meatus

78
Q

What is the blood flow through the nose from internal carotid a.?

A

Opthalmic a.»anterior and posterior ethmoidal aa.»anterior and posterior septum or nasal wall, respectively

79
Q

What is the blood flow through the nose from external carotid a.?

A
  • Maxillary a.»sphenopalatine»posterior septum or nasal wall
  • Maxillary a.»descending palatine»greater palatine»incisive&raquo_space;anterior septum or nasal wall
  • branches from facial a.»anterior septum or nasal wall
80
Q

What do vibrissae do?

A

Trap large particles in the nasal vestibule

81
Q

What do conchae do?

A

Create turbulence

82
Q

What does the mucous coating in the respiratory epithelium do?

A

Catch smaller particles

83
Q

What does the lamina propria between respiratory epithelium and bone contain?

A

Arteries, distended veins (swell bodies), and mucoserous glands

84
Q

What do ciliated cells in respiratory epithelium do?

A

Move mucous

85
Q

What do goblet cells in respiratory epithelium do?

A

Create mucin

86
Q

What are basal cells?

A

Stem cell population

87
Q

What are brush cells?

A

Sensory cells

88
Q

What are small granule cells?

A

Endocrine cells

89
Q

What do olfactory ducts and glands in olfactory epithelium do?

A

Release serous fluid

90
Q

What type of epithelium is in the respiratory and olfactory epithelium?

A

Ciliated pseudostratified columnar epithelium

91
Q

Where does the pharynx attach to the skull?

A

Medial pterygoid plate and pharyngeal tubercle

92
Q

What ligament connect the styloid process on the skull to the hyoid bone?

A

Stylohyoid ligament

93
Q

What ligaments connect the cricoid to the thyroid cartilage?

A

Cricothyroid ligaments

94
Q

Function of superior, middle, and inferior pharyngeal constrictors

A

Constrict pharynx to move bolus of food inferiorly

95
Q

Function of stylopharyngeus and salpingopharyngeus

A

Elevate and shorten pharynx

96
Q

Function of muscles of soft palate and uvula, and levator and tensor veli palatini muscles

A

Separate the nasopharynx and oropharynx

97
Q

Function of palatopharyngeus

A

Depress palate and elevate pharynx

98
Q

Function of palatoglossus

A

Depress palate

99
Q

CN IX and X send axons to the pharynx as the __________ __________.

A

Pharyngeal plexus

100
Q

Motor innervation of pharynx

A

CN X (Vagus n.) is motor to all except stylopharyngeus (CN IX - glossopharyngeal n.)

101
Q

Sensory innervation of pharynx

A
  • CN IX is sensory to part of nasopharynx, posterior tongue, and oropharynx
  • CN X is sensory to the spiglottic region, laryngopharynx, larynx, trachea, and esophagus
102
Q

Function and innervation of cricothyroid muscle

A

Tense vocal fold to raise pitch; external branch of superior laryngeal n. (branch of vagus)

103
Q

Function and innervation of thyroarytenoid muscle

A

Relax vocal fold to lower pitch; inferior laryngeal n. (branch of vagus)

104
Q

Function and innervation of vocalis muscle

A

Relax vocal fold to lower pitch; inferior laryngeal n.

105
Q

Function and innervation of lateral cricoarytenoid muscle

A

Adduct vocal fold to lower volume; inferior laryngeal n.

106
Q

Function and innervation of arytenoids (oblique and transverse)

A

Adduct vocal fold to lower volume; inferior laryngeal n.

107
Q

Function and innervation of posterior cricoarytenoid muscle

A

Abduct vocal fold to raise volume; inferior laryngeal n.

108
Q

Deinnervation of what muscle results in hoarseness?

A

Posterior cricoarytenoid muscle

109
Q

Muscles that close the laryngeal opening

A
  • Aryepiglottic muscles - elevate larynx towards epiglottis; innervated by inferior laryngeal
  • Oblique arytenoids - elevate larynx towards epiglottis; innervated by inferior laryngeal
  • Suprahyoid muscles - elevate hyoid and larynx to close laryngeal opening
110
Q

False (vestibular) fold

A

Mucosal fold that does not move toward midline

111
Q

True vocal fold

A

Mucosal fold over the vocal ligament that adducts and abducts from midline

112
Q

Ventricle

A

Space between false and true vocal folds

113
Q

Rima glottidis

A

Space between left and right vocal folds

114
Q

What types of areas can respiratory epithelium be found in?

A

Parts of the airway that do not regularly experience friction or impact

115
Q

Where can stratified squamous epithelium be found?

A

Lines areas that experience friction

116
Q

What does the epiglottis separate?

A

Oral cavity and laryngopharynx

117
Q

What type of epithelium do false folds have?

A

Respiratory epithelium (do not make contact)

118
Q

What type of epithelium do true vocal folds have?

A

Stratified squamous epithelium over DCT and skeletal muscle (make actual contact)

119
Q

Asthma

A

Excessive constriction of bronchiolar smooth muscle, causing difficult air expiration, mucus accumulation

120
Q

Cystic fibrosis

A

Mutation in ion pump (CFTR) results in deficiency of Cl- ions, and therefore water, to reach the airway; airway and ducts in other organs become blocked by this thickened mucous

121
Q

Obstructive lung diseases

A

Affect the parenchyma (airways involved in gas exchange)

  • COPD
  • Asthma
  • Emphysema
  • Bronchitis
  • Cystic fibrosis
122
Q

Interstitial diseases (restrictive)

A

Affect the space between parenchymal cells, the interstitium (space between 2 adjacent alveoli’s basal laminae)

  • asbestosis
  • idiopathic pulmonary fibrosis
  • sarcoidosis
  • connective tissue related ILD
123
Q

Emphysema

A
  • type of COPD
  • smoking leading cause
  • damage to alveolar walls results in reduced surface area and reduced gas exchange
124
Q

What nerves innervate cervical and costal pleurae?

A

Intercostal nn.

125
Q

Pneumothorax

A

Air in pleural space

126
Q

Pleural effusion

A

Fluid in pleural space

127
Q

Hemothorax

A

Blood in pleural space

128
Q

Hydrothorax

A

Excess serous fluid

129
Q

Chylothorax

A

Lymph from adbomen in pleural space

130
Q

Pyothorax

A

Pus in pleural space

131
Q

What can cause fluid to leak from lymphatics into the pleural space?

A

Heart failure, pulmonary emboli, tumors, infections

132
Q

Where are lymphatics found in visceral pleura?

A

Deep to mesothelium among DICT

133
Q

Inferior borders of lungs

A

Anterior - 6th costal cartilage
Lateral - 8th rib
Posterior - 10th rib

134
Q

Where is the line of pleural reflection?

A 
Anterior = 8th costal cartilage
Lateral = 10th rib
Posterior = 12th rib
135
Q

Where should a thoarcocentesis be performed?

A

Lateral = 8th-10th rib

136
Q

What is the relationship between flow and pressure gradient, radius, and length of tube?

A

Increase pressure gradient, increase radius, and decreased length all increase flow

137
Q

Why is the airway resistance not highest in the smallest regions of the airways?

A

Turbulence greatly increases airway resistance so larger radii have higher resistance because their turbulence is very high

respiratory (9 decks)

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