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Flashcards in Resp Session 1 Deck (102):
1

What is inspiratory reserve volume?

Additional volume that can be breathe in over that at rest

2

What is expiratory reserve volume?

Additional volume that can be breathed out at rest

3

What is partial pressure?

The fraction of total air pressure exerted by each gas

4

What is the partial pressure of gas proportional to?

Volume of the gas in the mixture

5

What is the partial pressure of oxygen in air at atmospheric pressure?

21.1 kPa

6

What does Boyle's law state?

Pressure of a gas is inversely proportional to its volume of the temperature and amount of gas remain constant

7

Why does air become less dense as altitude increases?

Fewer molecules pressing down therefore molecules are more widely dispersed

8

What does Charles's law state?

Is volume and amount of gas present is constant pressure is proportional to absolute temperature

9

What is saturated vapour pressure?

Pressure exerted by water molecules as they enter and leave the gas phase as in gas exchange at mucosal surfaces

10

What does saturated vapour pressure exclusively depend on?

Pressure

11

What is saturated vapour pressure at 37 degrees Celsius?

6.28 kPa

12

Why is air saturated with water vapour as it passes the URT?

To reduce the risk of damage to the LRT?

13

What causes The Bends?

Swimming up to the water surface too quickly so partial pressure changes are not gradual resulting in gas exchange which is not quick enough --> nitrogen bubbles

14

Describe the movement of gas molecules with relation to a liquid for example in gas exchange at a mucosal surface.

Gas molecules move in and out until an eqm of tension exerted by the gas in the liquid = partial pressure of gas in air

15

What can we assume about the gas tension of oxygen in arterial plasma?

It is equal to the partial pressure of oxygen in air assuming exchange time is sufficient

16

How is the amount of a gas dissolved in a liquid calculated?

Solubility x tension

17

What does using the tension of a gas dissolved in a liquid take into account when calculating how much gas is presentation?

any reaction that takes place so calculates the total content of reacted and dissolved gas

18

What components of oxygen transport need to be considered when considering the amount of oxygen dissolved in blood?

Fraction dissolved in plasma + fraction reacted with Hb

19

Why does the pulmonary circulation form basically no tissue fluid?

Low resistance
Low pressure
Receives whole cardiac output
Ventilation/perfusion ratio

20

Lost the airways in the lungs from largest to smallest.

Trachea --> bronchi --> bronchioles --> terminal bronchioles --> respiratory bronchioles --> alveolar ducts --> alveolar sacs

21

In which airways does gas exchange take place?

Respiratory bronchioles
Alveolar ducts
Alveolar sacs

22

Describe the blood supply to the airway tree.

Similar structure with bronchial arteries supplying bronchi themselves

23

What is tidal volume?

Volume breathed in and out with each breath during quiet respiration at rest

24

What are conducting airways?

Larger airways where gas exchange does not take place

25

Which airways are the last of the conducting airways?

Terminal bronchioles

26

Where do mucous membranes line in the respiratory tract?

Conducting portion

27

Are the number of mucus secreting cells in the mucus membranes constant throughout the respiratory system?

No

28

Where do serous membranes line the respiratory tract?

Pleural sacs which envelope each lung

29

Why does the lung appear 'shiny' on examination?

Covered by moist visceral pleura

30

What are Clara cells?

Domed cells without cilia that secrete lipoprotein surfactant and CC16 (Clara cell protein 16)

31

What does raised CC16 in serum indicate?

Leakage across air-blood barrier

32

What is the function of the lipoprotein surfactant secreted by Clara cells?

Prevents bronchiole collapse

33

What epithelium lines from the nasal cavity to the largest bronchioles?

Pseudostratified columnar with cilia and goblet cells

34

What epithelium lines the bronchioles to respiratory bronchioles?

Simple columnar with cilia and Clara cells

35

What epithelium lines respiratory bronchioles to alveolar ducts?

Simple cuboidal with Clara cells and a few sparse cilia

36

What type of cells are found in the alveoli?

Type I and II pneumocytes

37

What pushes odorons away from the olfactory regions of the respiratory tract?

Bauman's glands

38

Describe the epithelium in the olfactory regions of the respiratory tract.

Thick pseudostratified columnar (particularly tall)with microvilli and no goblet cells
LP blends with submucosa

39

Where are the olfactory regions of the respiratory tract found?

Posterior and superior region of each nasal fossa

40

What maintains patency of non-olfactory regions in the nasal cavities?

Surrounding cartilage and bone

41

What is the function of venous sinuses in the non-olfactory regions of the nasal cavities?

Swell every 20-30 mins to alternate airflow and prevent over drying

42

What is the effect of arterial blood flow on inspired air in the nasal cavity?

Warms inspired air

43

What are olfactory cells?

Bipolar neurones where one dendrite extends to the surface to form swelling from which non-motile cilia extend parallel with surface to detect scents

44

What forms an olfactory nerve?

Axons of bipolar neurones joining

45

What is located in the ventricle of the larynx which contributes to resonance of voice?

Ventricular folds

46

What epithelium lines the true vocal cord?

Stratified squamous

47

What forms the true vocal cord?

Vocal ligament and vocalis muscle combined by a large bundle of elastic fibres front and back

48

What is the action of the vocal cords in coughing to prevent entry of a foreign object into the lungs?

Cords close to build up pressure

49

What lines the ventricular folds of the larynx?

Pseudostratified epithelium with mucus glands and lymph nodules

50

Why are foreign objects more likely to lodge in the right lung?

Right bronchus is more vertical so provides easier passage

51

What is found in the submucosa of the trachea?

Seromucous glands

52

What type of cartilage if sound in the trachea?

Hyaline

53

What allows variable trachea lumen diameter?

Trachealis muscle

54

What is the trachealis muscle contained in?

Fibroelastic membrane

55

Describe the cilia found in the trachea.

~250 per cell beating at 12Hz

56

What is the structure of the tracheal wall?

Pseudostratified ciliated columnar epithelium
Lamina propria
Submucosa with seromucous glands
C-shaped cartilage rings

57

What is the lamina propria of the trachea rich in?

Elastin fibres
Immune cells

58

What does the epithelium and submucosa of the trachea secrete?

Mucins
Water
Serum proteins
Lysozymes
Anti proteases
Lymphocytes contribute IgA

59

How does the histology of the bronchioles compare to the primary bronchi?

Largely the same except cartilage decreases in size and turns from ring-shape to more irregular islands

60

What do bronchioles rely to keep them open as they decrease in diameter?

Elastic properties of surrounding alveoli

61

How does the lining epithelium of bronchioles change as their diameter decreases in size?

Pseudostratified --> simple columnar ciliated --> cuboidal
Goblet cells give way to Clara cells

62

What causes collapse of bronchioles in expiration of asthma pts which exacerbates the bronchoconstriction already present?

Lack of cartilage and surrounding alveoli not being able to maintain a patent airway

63

How does the number of alveolar openings vary from terminal bronchioles down to alveolar sacs?

Progressively increases

64

What can alveoli open into?

Repository bronchiole
Alveolar duct
Alveolar sac
Another alveolus via an alveolar pore

65

When do new alveoli stop developing?

When you reach 8 y.o.

66

What are found in type II pneumocytes?

Lamellar bodies

67

What is the function of type II pneumocytes?

Cuboidal cells to secrete surfactant to decrease surface tension and prevent alveoli collapse

68

What line the alveolar surface to decrease the likelihood of infection?

Macrophages which reach through into alveolar lumen

69

What is the advantage of having a capillary basket around each alveolus?

Short diffusion distance
Slow blood flow but RBCs spend

70

What is the pathogenesis of emphysema?

Smoking or alpha-1-antitrypsin deficiency --> destruction of alveolar walls --> permanent enlargement of air spaces --> bronchioles collapse on exhalation whilst air is still in the lungs

71

What is the hallmark function of emphysema and what is its action?

Pursed lip breathing to create back-pressure to prevent bronchiole collapse

72

What is the pathogenesis of pneumonia?

Bacterial infection --> inflammation of lung --> lung consolidation due to filling of alveolar spaces with fluid and inflammatory cells --> prevention of gas exchange

73

What are the borders of the three parts of the pharynx?

Nasopharynx: above lower border of soft palette
Oropharynx: lover border of soft palette --> tip of epiglottis
Laryngopharynx: below tip of epiglottis

74

Why does URT lead to middle ear infections, especially in children?

Nasopharynx connects to eustaschian tube

75

What can viral URTIs lead to?

Sinusitis
Middle ear infection

76

What can cause laryngeal obstruction leading to respiratory difficulty?

Oedema in anaphylaxis or severe infection --> vocal cord swelling
Tumour
Aspiration of foreign body

77

What can cause pharyngeal obstruction causing respiratory difficulty?

Tongue in unconscious pts or sleep apnoea where pharyngeal muscle tone decreases during sleep and floppy muscles obstruct the airway

78

What is the glottis?

2x vocal cords and aperture between them (rima glottidis)

79

What controls movement of vocal cords?

Intrinsic muscle of the larynx

80

What supplies all intrinsic laryngeal muscles except one?

Recurrent laryngeal nerve

81

What is the course of the RLN?

Arises form vagus nerve, curves around subclavian artery on R or arch of aorta on L and moves back up to larynx

82

Why does hoarseness of voice >3 weeks indicate investigation of RLN?

Suggests possible damage in the thorax due to lung tumour or aortic aneurysm

83

What is the function of the vocal cords with reference to the trachea?

Act as a valve to guard the entrance to the trachea

84

How does the position of the vocal cords change in different situations?

Open during respiration
Closed during swallowing
Partially closed during speech
Initially closed them rapidly open in coughing

85

What defines speech in admiration to partial opening of vocal cords?

Pharynx, tongue and lips

86

How are the false vocal cords found?

Red tissue located adjacent to the pearly true white vocal cords

87

Why are mechanisms to prevent aspiration of food particle important?

Air and food have common passage through the oropharynx and laryngopharynx

88

What are the features of the external nose?

Root (radix)
Bridge (dorsum)
Wing (alar)
Nostril
Septum
Tip

89

What are the functions of the nose in respiration?

Filters air using hairs in nostrils and mucus
Humidifies air using watery nasal secretions
Warms air using BV just below epithelium
Turbinates air and slows its flow

90

What does the mucus in the nose contain?

Ig and other antibacterial components

91

How does the nose act as the organ of smell?

Olfactory mucosa at roof of nasal cavity is specially adapted

92

Where do local secretions received by the nose arise?

Sinuses and the nasolacrimal duct

93

What are the bony processes in the nasal cavity called?

3x Concha/turbinate - superior, middle and inferior

94

What are the spaces between the bony processes in the nasal cavity called?

3x meatus - superior, middle and inferior

95

Where does the nasal cavity extend from and to?

From nostrils --> posterior nares

96

What forms the medial wall of each nasal cavity?

Nasal septum = cartilage and 2 bones

97

What are the four paranasal sinuses?

Frontal
Ethmoid
Maxillary
Sphenoid

98

How are the paranasal sinuses names?

By the bones they are located in

99

What lines the paranasal sinuses?

Pseudostratified columnar epithelium with cilia and goblet cells

100

What are the respiratory functions of the paranasal sinuses?

Humidify and warm inspired air

101

Which sinus is only visible on lateral view?

Sphenoid

102

Why does the frontal bone which forms the roof of the nasal cavity have perforations?

For olfactory nerves