Respiratory Flashcards
(290 cards)
1
Q
What branch of medicine deals with diseases of the ears, nose, and throat (ENT)?
A
Otorhinolaryngology
2
Q
What branch of medicine deals with diseases of the lungs?
A
Pulmonology
3
Q
Excessive CO2 in the body leads to what?
A
Acidosis
4
Q
What are some additional functions above and beyond O2 CO2 exchange the Respiratory system is involved in?
A
- Blood pH Regulation
- Contains Receptors for sense of smell
- Filters Inspired Air
- Helps Produce Sounds
- Rids body of heat and water through exhalation
5
Q
What is the Respiratory macro anatomy?
A
Nose Pharynx (throat) Larynx (Voice box) Trachea (windpipe) Bronchi Lungs
6
Q
What is the structural anatomy of the Upper Respiratory System?
A
Nose
Nasal Cavity
Pharynx
Associated Structures
7
Q
What is the structural anatomy of the Lower Respiratory System?
A
Larynx
Trachea
Bronchi
Lungs
8
Q
What is the Conducting Zone of the Functional Anatomy?
A
Where these Occur:
- Filtration
- Warming
- Moistening of air
9
Q
What are the respiratory anatomy parts that make up the Conducting Zone?
A
Nose Nasal Cavity Pharynx Larynx Trachea Bronchi Bronchioles Terminal Bronchioles
10
Q
What is the Respiratory Zone of the Functional Anatomy?
A
Tubes and Tissues within the lungs where gas exchange occurs
11
Q
What are the respiratory anatomy parts that make up the Respiratory Zone?
A
Respiratory Bronchioles
Alveolar Ducts
Alveolar Sacs
Alveoli
12
Q
What forms the bony framework of the Nasal Anatomy?
A
Nasal Bone
Maxillae Bone
13
Q
What forms the Cartilaginous Framework of the Nasal Anatomy?
A
Septal Nasal Cartilage
Lateral Nasal Cartilage
Alar Cartilage
14
Q
The Cartilaginous Framework makes up what portion of the nose?
A
External Nose Flexible
15
Q
What is the name of the openings of the nose seen on the face?
A
External Nares
16
Q
What is the large space in the anterior skull that lies inferior to nasal bone and superior to maxilla?
A
Nasal Cavity (Internal Aspect of Nasal Anatomy)
17
Q
The Nasal Cavity communicates with what Posteriorly and Anteriorly?
A
Posteriorly: Pharynx
Anteriorly: External Nose
18
Q
What is the name of the two openings the Nasal Cavity communicates through to the Pharynx?
A
Internal Nares (Choanae)
19
Q
What drains into the Nasal Cavity?
A
Paranasal Sinuses
Nasolacrimal Ducts
20
Q
What are the names of the Paranasal Sinuses?
A
Maxillary
Frontal
Sphenoidal
Ethmoidal
21
Q
What makes up the Roof of the nasal Cavity?
A
Ethmoid Bone
22
Q
What makes up the floor of the nasal cavity?
A
Palatine Bones
Palatine processes of Maxillae
23
Q
What makes up the Lateral walls of the nasal cavity?
A
Ethmoid Bone Maxillae Bone Lacrimal Bone Palatine Bone Inferior Nasal Conchae Bones
24
Q
What is the Anterior portion of the nasal cavity inside the nostrils surrounded by cartilage?
A
Nasal Vestibule
25
What is the vertical partition in the nasal cavity, made up mostly of hyaline cartilage?
Nasal Septum
26
The Nasal Septum is formed from what parts of the Nasal Anatomy?
- Perpendicular plate of the ethmoid bone
- Septal (quadrangular) cartilage
- Vomer Bone
27
What clinical correlation is indicated from a septum that does not run along midline of nasal cavity?
Deviated Nasal Septum
28
A Deviated Nasal Septum usually occurs at what junction?
Vomer Bone and Septal Cartilage
29
What does air first enter into when breathing through the nose?
Nasal Vestibules
30
In the Nasal Passageway air pass over these structures that arise from the lateral walls toward the septum?
Turbinates (Nasal Conchae Bones)
31
What are the names of the turbinates in each nostril?
Inferior
Middle
Superior
32
What is the space in between the turbinates Called?
Meatuses (groove-like passageways)
33
What lines the conchae which help catch water droplets on exhalation?
Mucous Membranes
34
What is contained in the mucous membranes?
Goblet Cells
| Cilia
35
What do the turbinates help do to the air as it passes them?
Larger Surface Area
- Warm air
- Moisten air (Mucous)
- Filter air (Cilia)
36
What is the funnel shaped tube that begins at the internal nares and extends to the level of the cricoid cartilage?
Pharynx
37
The wall of the pharynx is what type of muscle?
Skeletal Muscle
- Inner Layer: Longitudinal
- Outer Layer: Circular
38
What does relaxation and contraction of the muscle of the pharynx cause?
Relaxation: Patent
Contraction: Assists in deglutition
39
What are some of the functions of the pharynx?
- Passageway for air and food
- Helps resonate speech/sound
- House tonsils
40
What are the three anatomical regions of the Pharynx?
Nasopharynx
Oropharynx
Layngopharynx/
Hypopharynx
41
What are the five openings found in the Nasopharynx?
Two Internal Nares
Two Eustachian Tube
Opening into Oropharynx
42
What tonsils are contained in the Nasopharynx?
Adenoids (Pharyngeal Tonsils)
43
This is the intermediate portion of the pharynx, extends from soft palate inferiorly to the level of hyoid bone and only has one opening, the fauces (mouth)?
Oropharynx
44
What tonsils are found in the Oropharynx?
Palatine
| Lingual (Singluar)
45
This portion of the pharynx begins at the level of hyoid bone, Inferior end opens into esophagus posteriorly or larynx anteriorly, and has respiratory and digestive functions?
Layngopharynx/Hypopharynx
46
Inflammation of any portion of the pharynx (usually oropharynx), with symptoms of sore throat, erythema, enlarged tonsils, clinically indicates what?
Pharyngitis
47
What are some causes of Pharyngitis?
-Bacterial (Strep,
N. Gocoonrhea/Chlamydia)
-Viral
-Allergic
48
This is cellular debris deposited on tissue, usually white, byproduct of bacterial activity in the region?
Exudate
49
Caused by capillary bleeding under the skin, mucous membrane, etc... (Strep, CMV, Mono)?
Petechiae
50
What are the individual parts that make up the Larynx?
```
Epiglottis
Supraglottis
Vocal Cord
Glottis
Subglottis
```
51
What lies midline in the neck, anterior to 4th-6th cervical vertebrae and esophagus, beginning at inferior hypopharynx and includes space superior to trachea?
Larynx
52
what are the functions of the Larynx?
- Open: Breathing
- Partially Open: Phonation/Speaking
- Closed: Deglutition
53
How many pieces of Cartilage make up the Larynx?
9
54
Name the singular pieces that are part of the Larynx?
Thyroid
Epiglottis
Cricoid
55
Name the Paired pieces of cartilage (for moving vocal cords)?
Arytenoid
Corniculate
Cuneiform
56
Name all nine pieces that make up the cartilage pieces of the Larynx?
```
Thyroid
Epiglottis
Cricoid
Arytenoid (Pair, vocal)
Corniculate (Pair, vocal)
Cuneiform (Pair, vocal)
```
57
Which cartilage piece gives the larynx a triangular shape (Adam's Apple)?
Thyroid Cartilage
58
What gives the "point" shape of the Adam's Apple?
Laryngeal Prominence
59
What cartilaginous piece attaches to posterior aspect of thyroid cartilage by thyroepiglottic ligament and base connects to posterior surface of thyroid cartilage?
Epiglottis
60
This cartilaginous piece of the Laryngeal anatomy is leaf-shaped, elastic cartilage that hovers and closes over the glottis?
Epiglottis
61
What Cartilaginous piece of the Larynx is a ring of hyaline cartilage that forms the inferior wall and is the only "true" ring (Circumferential)?
Cricoid Cartilage
62
The Thyroid cartilage is connected to this structure via the cricothyroid ligament and inferior thyroid cartilage horns?
Cricoid Cartilage
63
What are the two sets of arteries that supply the lungs with blood?
Pulmonary Arteries
| Bronchial Arteries
64
What are the only arteries in the body to carry deoxygenated blood and come from the right ventricle?
Pulmonary Arteries
65
What arteries branch off from the aorta and deliver oxygenated blood to the lungs that perfuses into the muscular walls of the bronchi and bronchioles?
Bronchial Arteries
66
What vessel returns oxygenated blood to the left atrium? 2 vessels from each lung
Pulmonary veins
67
Pulmonary blood vessels constrict during what times?
Hypoxia (only blood vessels to do this)
68
What are the three basic steps of respiration?
- Pulmonary Ventilation (breathing)
- External Respiration
- Internal Respiration
69
Which step of respiration involves the inhalation and exhalation of air and exchange of air between atmosphere and alveoli?
Pulmonary Ventilation (Breathing)
70
Which step of respiration involves the exchange of gases between alveoli and blood in pulmonary capillaries, blood gains O2 and loses CO2?
External Respiration
71
Which step of respiration involves the exchange of gases between systemic capillaries and tissue cells?
Internal Respiration
72
What is occurring at the cellular level of internal respiration?
-Blood loses O2 and gains CO2
73
What is the metabolic reaction that consumes O2 and gives off CO2 within the cells?
Cellular Respiration
74
What influences the rate of airflow and effort needed for breathing?
- Alveolar Surface tension (Surfactant)
- Compliance of lungs (fibrosis)
- Airway resistance (asthma)
75
What is the Pressure between two layers of pleural cavity called?
Intrapleural (Intrathoracic) Pressure
76
What is the pressure inside the lungs called?
Alveolar (Intrapulmonic) Pressure
77
Prior to the start of inhalation pressure in the lungs is equal to what?
atmospheric pressure (760mmHg or 1atm)
78
Boyles Law states?
Pressure of a gas in a closed container is inversely proportional to the volume of the container
79
What are the main muscles of inhalation used to expand the lungs thus decreasing the pressure within the thoracic cavity allowing for air to move into the lungs?
Diaphragm
| External Intercostals
80
What is the most important muscle of inhalation?
Diaphragm
81
The Diaphragm is innervated by what/which nerves?
Phrenic Nerves (C3/C4/C5)
82
During normal inhalation the diaphragm descends approximately how far?
1cm
83
This diaphragmatic contraction during normal inhalation produces a pressure difference of how many mmHg and causes how many mL's of air to be inhaled?
- Decreases pressure 1-3mmHG
| - Inhale 500mL
84
During strenuous breathing the diaphragm may descend up to how much?
10cm
85
This diaphragmatic contraction during strenuous breathing produces a pressure difference of how many mmHg and causes how many mL's of air to be inhaled?
- Decrease pressure 100mmHg
| - Inhale 2-3L
86
The contraction of the diaphragm is responsible for what percentage of air that enters the lungs during normal breathing?
75%
87
What are three other factors that contribute to the rate of airflow and ease of pulmonary ventilation?
- Surface tension of alveolar fluid
- Compliance of the lungs
- Airway Resistance
88
What is surface tension?
Air-water interface due to polar water molecules being strongly attracted to each other rather than to gases
89
What role does Surface tension play within the lungs?
- Causes alveoli to assume smallest diameter (around gas inside)
- Must be overcome to expand the lungs (inhalation)
- Accounts for 2/3 of elastic recoil during exhalation
90
What apparatus is used to measure volume of air exchanged during breathing and the respiratory rate?
Spirometer/Respirometer
91
The record of measurements from a spirometer is called?
Spirogram
92
How is Inhalation and Exhalation recorded on a spirogram?
- Inhalation: Upward Deflection
| - Exhalation: Downward Deflection
93
What is the equation for the Alveolar Vent Rate?
Alveolar Vent Rate= 70% (resp zone) X breaths/min
94
The Alveolar Vent Rate represents what?
Volume that actually reaches respiratory zone in one minute
95
What is Inspiratory Reserve Volume?
Additional Air Inhaled by taking a very deep breath.
96
What is Inspiratory capacity?
Tidal Volume + Inspiratory Reserve Volume
97
What is Functional Residual Capacity?
Residual Volume + Expiratory Reserve Volume
98
What is Vital Capacity?
Inspiratory Reserve Volume + Tidal Volume + Expiratory Reserve Volume
99
What is Total Lung Capacity?
Vital Capacity + Residual Volume
100
What is the Vital Capacity for male and females?
Male: 4800mL
Female: 3100mL
101
What is the Total Lung Capacity for male and female?
Male: 6000mL
Female: 4200mL
102
What is Dalton's Gas Law (Dalton's Law of partial Pressures)?
A mixture of non-reacting gases, the total pressure exerted is equal to the sum of the partial pressures of the individual gases
103
What is Dalton's Gas Law (Dalton's Law of partial Pressures)?
A mixture of non-reacting gases, the total pressure exerted is equal to the sum of the partial pressures of the individual gases
104
What is PaO2 a measurement of?
Partial pressure of dissolved (free) oxygen in arterial blood (the only oxygen that exerts pressure)
105
What type of blood draw is a PaO2 obtained from?
Arterial Blood Draw
106
What does SaO2 measure?
Measurement of Oxygen that is bound to hemoglobin (saturation) in arterial blood
107
What does SpO2 Measure?
Measurement of the oxygen that is bound to hemoglobin peripherally
108
What does a Pulse oximeter use to provide measurements?
Colorimetric Measurements
109
What gas has a much higher affinity for hemoglobin than oxygen?
Carbon Monoxide (CO)
110
More oxygen detached from the hemoglobin results in what?
Increase dissolved O2---> Increases PaO2
111
More CO attached to hemoglobin results in what?
Decrease attached O2---> Decrease SaO2
112
How many mL's of oxygen is used each minute by the body at rest?
200mL
113
During exercise oxygen use increase by how many times?
15-20 times (3,000-4,000mL/min)
114
Under normal conditions, each 100mL of deoxygenated blood contains what amount of CO2?
53mL
115
What are the three forms CO2 is transported as within the body?
- Dissolved CO2
- Carbamino Compounds
- Bicarbonate Ion
116
Which form of CO2 transport is makes up the smallest percentage (7%) and is exhaled from the lungs?
Dissolved CO2
117
What form of CO2 transport accounts for about 23%, combines w/ amino acids and proteins (hemoglobin most prevalent protein), which most is bound to hemoglobin (Carbaminohemoglobin)?
Carbamino Compounds
118
This form of CO2 transports account for the majority 70%?
Bicarbonate Ions
119
Elite endurance athletes may see how large of an increase in Oxygen use per minute?
30 times
| 6,000mL/min
120
By age 70 respiratory Vital Capacity can decrease by what percentage?
35%
121
What else decreases as the body ages regarding the respiratory system?
- Blood O2
- Alveolar macrophage
- Ciliary Action of Epithelium
122
What Pulmonary disorders become more prevalent as people age?
Pneumonia
Bronchitis
Emphysema
etc....
123
What influence does the Limbic system have on the respiratory system?
Sends impulses to inspiratory area when stimulated
124
How does Temperature influence the respiratory system?
- Temp increases causes increase respiration
| - Temp Decrease causes Decrease respiration
125
A sudden shock of cold may bring on what?
Temporary Apnea (Take your breath away)
126
What effects can pain have on the Respiratory system?
- Sudden, Sever: Apnea
- Prolonged Somatic: Increases Respiration
- Visceral Pain: Slow Respiration Rate
127
What type of influences does stretching the anal sphincter have on the respiratory system?
Increases respiratory rate
| -Can be used to stimulate breathing
128
A cessation of breathing followed by a Cough or Sneeze may be caused by?
Irritation of airways (Physical or Chemical Irritation)
129
The Carotid and/or Aortic Baroreceptors detect a drop in blood pressure what influence will this have on the Respiratory system?
Increases the Respiration Rate
130
The Carotid and/or Aortic Baroreceptors detect a sudden rise in BP what influence will this have on the Respiratory system?
Decreases the Respiration Rate
131
The voluntary ability to hold your breath is limited by what and due to what?
Inspiratory Center becoming strongly stimulated due to increasing CO2 and H+
132
What chemicals provide stimuli to the Chemoreceptors?
O2
H+
CO2
133
Where are the Chemoreceptors located?
- Central: In/Near Medulla Oblongata
| - Peripheral: In Aortic and Carotid Bodies
134
The Central Chemoreceptors respond to changes in what Chemicals?
H+ and CO2
135
The Peripheral Chemoreceptors respond to changes in what chemicals?
H+, CO2, and O2
136
These receptors can cause a change in heart rate and depth of breathing before changes in Po2, Pco2, H+ in anticipation of changes in chemical composition?
Proprioceptors
137
What is the name of the Respiratory Center area whose function is to control basic rhythm of respiration?
Medullary Rhythmicity
138
What Respiratory areas helps control transition between inhalation and exhalation?
Pneumotaxic Area in the Pons
| Apneustic Area in the Pons
139
What is a major function of the Pneumotaxic Area?
Inhibit inspiratory area before lungs become too full.
| Shorten duration of inhalation as needed
140
What is a major effect of the Apneustic Area?
Prolong inhalation or provide deep inhalation
141
What area of Respiration will override the Apneuistic Area when it is active (stimulated)?
Pneumotaxic Area in the Pons
142
What is an Oxygen-Hemoglobin Dissociation Curve?
Graphical representation depicting the relationship between the % saturation of hemoglobin and Po2 (Partial Pressure of O2)
143
What effect of hemoglobin O2 affinity is seen when Po2 increases and decreases?
Increase: O2 affinity to Hemoglobin increases
Decrease: O2 affinity to Hemoglobin decreases
144
What are four factors that affect the affinity of O2?
Acidity (pH)
PCO2
Temperature
2,3-bisphosphoglycerate (BPG)
145
A decrease in pH (more acidic) has what affect on O2 Affinity?
Decreases O2 Affinity, O2 dissociates from hemoglobin more readily
146
What kind of shift will be seen on the Oxygen-Hemoglobin Dissociation Curve with decreased pH (More acidic)?
Right Shit
147
A Right shift due to lower pH on the Oxygen-Hemoglobin Dissociation Curve indicates what regarding Po2?
At Higher Po2, saturation of hemoglobin is less than if the pH were normal
148
An increase in pH (more alkaline) has what affect on O2 affinity?
Increases O2 affinity, O2 dissociates from hemoglobin less readily (More difficult for dissociation)
149
What kind of shift will be seen on the Oxygen-Hemoglobin Dissociation Curve with an increase of pH (More Alkaline)?
Left Shift
150
A Left shift due to higher pH on the Oxygen-Hemoglobin Dissociation Curve indicates what regarding Po2?
At Higher Po2, saturation of hemoglobin is higher than if the pH were normal
151
What affect does an increase of PCO2 have on O2 Affinity?
Increase CO2: pH decreases (more acidic)--> Decreased O2 Affinity (Right Shift)
(Same Curve as pH since CO2 affects pH)
152
What affect does an decrease of PCO2 have on O2 Affinity?
Decrease CO2: pH increases (more Alkaline)--> Increased O2 Affinity (Left Shift)
(Same Curve as pH since CO2 affects pH)
153
What affect does Temperature have on O2 Affinity?
-Inverse relationship
Increase Temp: Decrease O2 Affinity
Decrease Temp: Increase O2 Affinity
(Similar curve to CO2 and pH but wider spread)
154
At rest a healthy adult averages how many breathes a minute and moves how much air with each inhalation and exhalation?
12 breaths a minute
| 500mL
155
What is Tidal Volume (Vt)?
Volume of one breath - normal 500mL
156
What is Minute Volume (MV)?
Total volume of air inhaled and exhaled each minute
157
How is minute volume calculated?
Respiratory Rate x Tidal Volume
158
How much air in a typical adult reaches the respiratory zone? Where is the rest of the air sitting?
- 70% of tidal volume (350ml) reach respiratory zone
| - 30% (150mL) remains in conducting zone
159
The 30% (150mL) of tidal volume sitting in the conducting zone is in an area called what because no gas exchange can occur here?
Anatomic Dead Space
160
What is Expiratory Reserve Volume?
Amount of air over the tidal volume that is exhaled, usually by forcefully exhaling using accessory muscles
161
What is Residual Volume?
Air that cannot be exhaled (alveoli would collapse) and air in non-collapsible airways.
162
What volume cannot be determined by spirometry?
Residual Volume
163
What factors influence Alveolar Air?
- Composition of inspired air
- Alveolar Ventilation
- Concentration of Dissolved gases in mixed venous blood
164
What is the composition of Atmospheric air?
79% Nitrogen
21% Oxygen
<1% other gases
165
What is occurring as air is inspired into the respiratory tract?
- Warms to body temp
- Humidified (saturated with water)
- Composition of alveolar air changes in respiratory zone and gas exchange occurs
166
Partial Pressures of gases determine the movement of O2 and CO2 between what?
Atmosphere and Lungs
Lungs and Blood
Blood and Tissue Cells
167
What effect does higher partial pressure have on gas movement?
The higher partial pressure (or gradient) the faster the gas moves from higher to lower pressure space
168
What is Henry's Law?
The quantity of gas that will dissolve in a liquid is proportional to the partial pressure of the gas and it's solubility
169
How does Henry's Law apply to the human body and body fluids?
Gas in body fluids ability to stay in solution is greater when it's partial pressure is higher and when it's solubility in water is higher
170
What gas is dissolved at higher concentrations in blood plasma?
CO2 (Solubility is 24times greater than O2)
171
What is occurring during External Respiration during Pulmonary Gas Exchange?
- Diffusion of O2 from air in alveoli into blood in pulmonary capillaries
- Diffusion of CO2 from pulmonary capillaries into alveoli and then exhaled
- Deoxygenated blood to Oxygenated blood
172
During External Respiration diffusion continues until pressures are equal, What are the pressures for O2 in the Alveolar air and Capillary blood?
Alveolar air - PO2 = 105mmHg
Capillary blood - PO2 = 40mmHg
-O2 will move from high (Alveolar) pressure to lower (Capillary) pressure
173
During External Respiration pressures for CO2 in the Alveolar air and Capillary Blood are what?
Capillary blood - PCO2 = 45mmHg
Alveolar air - PCO2 = 40mmHg
-CO2 will move from blood to alveolar air
174
What is Systemic gas exchange during internal respiration?
-Diffusion of O2 from blood in capillaries to the tissue cells
-Diffusion of CO2 from tissue cells to blood capillaries
(Oxygenated blood in capillaries diffuses O2 into tissue and becomes Deoxygenated by picking up CO2 from tissue cells)
175
Internal Respiration: O2 moves from Systemic capillary to tissues cells, what are the pressures in the systemic capillaries and Tissue Cells of O2?
Systemic Capillaries - PO2 = 100mmHg
| Tissue Cells - PO2 = 40mmHg
176
Internal Respiration: CO2 moves from Tissue cells to Systemic Capillaries, what are the pressures in the Tissue Cells and Capillaries?
Tissue Cells - PCO2 = 45mmHg
| Systemic Capillaries - PCO2 = 40mmHg
177
What role does surface area play in the ability of gas exchange?
Larger surface area = faster and easier gas exchange
178
How does Emphysema impact gas exchange?
Causes decrease in surface area reducing rate of gas exchange
179
How does diffusion distance affect gas exchange?
Increase of fluid in the lungs increase diffusion time.
180
Approx. how much inhaled O2 dissolves into blood plasma and how much is bound to Hemoglobin?
1. 5% dissolved into blood plasma (can diffuse)
| 98. 5% bound to hemoglobin (cannot diffuse)
181
What is the most important factor that determines how much O2 is bound to hemoglobin?
Partial Pressure of O2
182
Higher PO2 means what regarding O2 bound to hemoglobin?
Higher PO2 = More O2 Bound to Hemoglobin
183
These are triangular pieces of mostly hyaline cartilage located at the posterior, superior border of the cricoid cartilage and for synovial joint w/ cricoid cartilage allowing for mobility of the vocal cords?
Arytenoid Cartilage (gives rise to true vocal cords)
184
The Arytenoid Cartilage and the synovial joints w/ cricoid cartilage play what role in sound?
Influence change in vocal cords position and tension to produce sound
185
What cartilage of the Larynx has a horn shape, very small, and sits atop the arytenoid cartilage?
Corniculate Cartilage
186
The Corniculate Cartilage gives rise to what?
Vestibular/Ventricular ligaments (FALSE VOCAL CORDS)
187
What Cartilage of the larynx is non-articulating, sits anterolateral and superior to corniculate cartilage, moves w/both corniculate and arytenoid cartilages, supporting movement of both vocal folds?
Cuneiform Cartilage
188
The lining of the larynx (larynx Histology) inferior to the vocal cords consists of what type of tissue?
Pseudostratified Ciliated Columnar Epithelium
189
The Pseudostratified Ciliated Columnar Epithelium of the larynx inferior to the vocal cords also contains what cells? What do the cells provide/produce?
- Ciliated Columnar Cells: Move particles up to pharynx
- Goblet Cells: Produce mucus to help trap dust
- Basal Cells: Provides structure and Strength
190
What are the Two pairs of folds found in the Larynx that are structures of sound production?
Vestibular/Ventricular Folds
| Vocal Folds
191
Which fold is considered the False vocal Cords?
Vestibular/Ventricular Folds
192
Which fold is the inferior pair of the two folds in the larynx for sound production?
Vocal Folds
193
The True vocal cords are which pair of structural folds in the larynx?
Vocal Folds
194
Which pair of folds is the superior pair in the Larynx?
Vestibular/Ventricular Folds
195
These folds close together to help hold the breath against pressure in the thoracic cavity?
Vestibular/Ventricular folds
196
What is the principal structure of normal voice production?
Vocal (Inferior, true) Folds
197
The elastic ligaments for the true vocal cords are stretched between which rigid cartilage segments?
Thyroid Cartilage
| Arytenoid Cartilage
198
When the rima glottidis is narrowed due to the contracting of the laryngeal muscles what is occurring regarding the vocal cords?
Vocal Cords are Adducted
199
Air passing over the cords produces what?
Sound/ Phonation (speaking) by vibrating the cords
200
What occurs with the produced sound with greater air pressure?
Louder sound is produced
201
A tight vocal cord produces what pitch sound?
| A relaxed vocal cord produces what pitch sound?
Tight: Higher Pitch
Relaxed: Lower Pitch
202
What is occurring during Whispering?
- Closing of all but posterior portion of rima glottidis
| - Cords don't vibrate
203
How is intelligible speech formed?
Changing the shape of oral cavity as we enunciate (resonance quality changes)
204
What structures help with voice production by acting as resonating chambers?
Pharynx, mouth, nasal cavity, and paranasal sinuses
205
What sounds are made by constricting/relaxing muscles in the wall of the pharynx?
Vowel Sounds
206
Consonant sounds are made by movement of what?
The mouth
207
What helps in enunciation of both vowels and consonants?
Muscles of the face, lips, and tongue
208
What is the typical difference between male and female vocal cords and what provides the difference?
Male: Thicker, longer--> Slower vibration, lower pitch
Female: Thinner, shorter--> faster vibration, higher pitch
-Androgen influence on males
209
What is the name of the tubular passageway for air that lies anterior to esophagus and is apporx. 5 inches long and 1 inch in diameter?
Trachea
210
The trachea typically extends from where to where?
Larynx to superior border of T5
211
At the level of T5 what typically occurs to the trachea?
Divides into right and left primary bronchi
212
Name the layers of the Trachea from exterior to lumen?
1. Adventitia
2. Hyaline Cartilage
3. Submucosa
4. Mucosa
213
The Hyaline Cartilage rings characteristics?
- 16-20 horizontal rings stacked, "C-shape", incomplete
- Opening posterior, facing esophagus
- Semi-rigid, prevents collapse
214
The posterior opening of the tracheal rings characteristics.
- Fibromuscular membrane
- Trachealis Muscle: inside membrane, smooth transverse muscle
- Elastic connective tissue allows diameter change
215
The submucosa consist of what type of tissue and contains what?
Areolar connective tissue
| Seromucous glands and ducts
216
Mucosa layer of the trachea consists of what tissue?
Pseudostratified ciliated columnar epithelium (dust protector)
217
Give the Bronchial Tree Flow Chart for Right and Left Lungs?
```
Primary Bronchus: 1 R and 1 L
Secondary (Lobar) Bronchi: 3 R and 2 L
Tertiary (Segmental) Bronchi: 10 R and 10 L
Lobular bronchioles
Terminal Bronchioles
Respiratory bronchioles
Alveolar Ducts
Alveolar Sacs
Alveolus
```
218
State the histology of the Bronchi (1,2,3 degrees)?
- Hyaline Cartilage: incomplete ring
- Pseudostratified ciliated columnar epithelium (dust protector)
- Goblet secretory cells
- Serous/mucous glands
219
The bronchioles to terminal bronchioles have what type of epithelium and secretory cells?
- Simple Column Ciliated
| - Goblet & Exocrine (Clara/Club)
220
Describe what is occurring to the cartilage as the bronchi transition down to the bronchioles?
Bronchi: Rings turn into plates
Bronchi (Tertiary, terminal, respiratory): smaller plate
Bronchioles: Complete smooth muscle, no cartilage
221
What represents the end of the conducting zone of the respiratory system?
Terminal Bronchioles
222
What function do the Bronchioles have?
Exocrine Function: Contain Clara(club) cells
- Columnar, non-ciliated cells interspersed
- Protect against toxins and carcinogens
- Produce/secrete: surfactant (liquid/mucous)
- Stem Cells (reserve cells): give rise to cells in epithelium
223
Describe what is occurring in the bronchioles when there is sympathetic stimulation, such as in exercise?
- Release of epi and norepi from adrenal medulla
- Cause relaxation of smooth muscles in bronchioles
- Allows more O2 to alveoli, improved ventilation
- More O2 to muscle tissue
224
Describe what is occurring in the bronchioles when there is parasympathetic stimulation, such as at rest?
- Release of Ach from Postganglionic fibers
- Cause contraction of smooth muscles
- Reduces ventilation
225
What is a chronic respiratory disease, characterized by episodic bronchoconstriction and mucous secretion, resulting in increased airway resistance and dyspnea?
Asthma
226
What separates the two pleural cavities that contain the lungs?
Mediastinum
| -Heart, Aorta, Thymus Gland, Chest Portion of Trachea, Esophagus, Lymph nodes, Nerves
227
What encloses and protects each lung?
Pleural Membrane: double layered serous membrane
- Parietal Pleura: Superficial thoracic cavity wall lining
- Visceral Pleura: Deep layer covers lungs
228
What is the Pleural Cavity?
Space between Parietal Pleura and Visceral Pleura
- Smooth movement between layers
- Contains 8-10 mL of fluid
229
Describe the Pleural fluid and what it provides?
2-10cc in cavity space
- 100cc per/hr made parietal layer and drained at visceral layer and lymphatics
- Provides surface tension (Layers "Adhere" and slide)
230
What term describes increased fluid in the pleural cavity?
Pleural Effusion
231
What term describes decreased fluid in the pleural cavity?
Pleurisy
232
What may inflammation of either or both layers of the pleura cause?
Reduced surface tension
| -Pain with breathing, chest wall pain
233
Air trapped in the pleural cavity may cause what? This allows what to occur to the lung? What must be done?
Pneumothorax
- Loss of surface tension: Lung deflates
- Remove air to inflate lung
234
What is collapse of a part/whole lung called?
Atelectasis
235
Name some causes of Atelectasis?
Air, Blood, Pus, Obstruction
- Reduced breathing depth (Elderly, fractures)
- Typically in distal portions
236
Name the number of lobes and segments for each for the right and left lungs?
```
Right: 3 Lobes
Superior Lobe: 3 Segments
Middle Lobe: 2 Segments
Inferior Lobe: 5 Segments
Left: 2 Lobes
Superior Lobe: 5 Segments
Inferior Lobe: 5 Segments
```
237
What is the medial projection of the inferior aspect of the superior left lobe called?
Lungula (Helps Protects the heart)
238
Where is the only place the lung is able to be palpated?
Supraclavicular Space: the apex of the lung
239
Which lung is thicker and broader but shorter?
Right lung due to Liver
240
Which lung is thinner and slightly smaller?
Left lung due to cardiac notch (10%)
241
What is the anterior portion of the lungs that lie against the ribs?
Costal
242
The Oblique (Major) Fissure separates what in the left lung?
Superior and Inferior Lobes
243
The Oblique (Major) Fissure separates what in the right lung?
-Inferior and Middle Lobes, small portion of lateral aspect of superior and inferior lobes
244
The Horizontal (minor) fissure separates what in the right lung?
Superior and middle lobe
245
What is a Bronchopulmonary segment? How many per lung?
Segment of lung tissue supplied by one tertiary bronchus
| -10 ea Lung
246
The Segments are broken down into compartments called what?
Lobules
247
What is contained in each lobule and describe the tissue?
- Lymphatic Vessel
- Arteriole
- Venule
- Branch of terminal Bronchiole
- Wrapped in elastic connective tissue
248
The terminal Bronchioles in the Lobules of the Bronchopulmonary segments further divided into what?
Respiratory Bronchioles (multiple)
249
What is significant of the respiratory bronchioles?
Alveoli begin budding
- Gas exchange begins
- Respiratory Zone starts at Respiratory bronchioles
250
How many levels of branching occur from Trachea to Alveolar Ducts?
25
251
What portion of the lung anatomy makes up the microscopic airways?
```
Terminal Bronchioles
Respiratory Bronchioles
Alveolar Ducts
Alveolar Sacs
Alveoli
```
252
Describe an Alveolar sac and give another name it may be called.
Two or more alveoli sharing same alveolar duct (grapes)
| -ACINUS
253
What is a cup-shaped out-pouching from alveolar duct?
Alveoli
254
Alveolar Fluid is a complex mixture of what?
Phospholipids and Lipoproteins that contains surfactant
255
What releases surfactant?
Clara/club cells in terminal bronchioles
256
What is the function/role of surfactant?
-Lowers surface tension of alveolar fluid
-Reduces tendency of alveoli to collapse (patency)
(Reduces inward pressure pulling alveoli walls together)
-Allows alveoli to open w/less air pressure (increases compliance)
257
Where is high surface tension important?
Pleural Cavity: keep the parietal and visceral layers together (keep lungs inflated)
258
Where is low surface tension important?
Alveoli to keep layers apart
259
Where does diffusion take place of O2 and CO2?
Alveolar and Capillary Walls
260
The respiratory membrane (Alveolar and Capillary Walls) are how thick?
0.5 micrometers thick (1/16th of an RBC)
| Allows for rapid diffusion
261
What is the estimated amount of alveoli the lungs contain and what is the approx. surface area?
300 million
| 750ft^2
262
Describe what occurs when the External Intercostal Muscles contract.
- Elevate the ribs
- Increase anteroposterior and lateral diameters of chest cavity
- Account for 25% of inspired air
263
What is the approx. pleural pressure just before inhalation?
756mmHg
264
The Parietal and visceral pleurae adhere tightly because of what?
Subatmostpheric pressure
| Surface tension
265
What are the accessory muscles of inhalation and what do they move?
Sternocleidomastoids: Elevate Sternum
Scalenes: Elevate first two ribs
Pectoralis Minors: Elevate 3-5 ribs
266
When are accessory muscles used?
Deep, forceful inhalation
267
What makes inhalation an active process?
Muscular Contraction
268
What makes normal exhalation a passive process?
Does not include muscular contraction
269
Elastic Recoil occurs from what two inwardly directed forces?
Recoil of elastic fibers during inhalation
| Inward pull of surface tension of the film of alveolar fluid
270
When does exhalation begin?
Relaxation of inspiratory muscles
271
At the beginning of exhalation the alveolar (intrapulmonic) pressure increases to what?
762mmHg
272
State the Law of Laplace.
Pressure inside a spherical (curved) surface is inversely proportional to its radius
273
What is the formula expressing the Law of Laplace
```
P = 2T/r
P=Pressure
T=Tension
r=radius
(explains why smaller alveoli have higher pressure)
```
274
What syndrome is found in premature newborns born before their lungs have capability of producing surfactant, alveoli collapse easier, reduces breathing capability?
Respiratory Distress Syndrome (RDS)
| Typically enough surfactant production by 35 weeks
275
What is caused by anything that causes alveoli to collapse (Ventilated, constrictive pressure, Pneumonia, Neuromuscular disease), or is a partial or complete collapse of the lung?
Atelectasis
276
What does Compliance of the lungs refer to?
Measure of how much effort is required to stretch the lungs and chest wall
277
What is high compliance?
Lungs and chest wall expand easily
278
What is low compliance?
Lungs and chest wall resist expansion
279
What determines compliance? Why do lungs normally have high compliance?
Elasticity and Surface Tension
| -Elastic fibers in lung tissue and surfactant in surface tension
280
Name some causes that will decrease compliance of the lungs?
- Scarred lung tissue (tuberculosis)
- Fluid filled lung tissue (Pulmonary edema)
- Surfactant deficiency
- Impediment of lung expansion (paralysis of intercostal)
- Destruction of elastic fibers (emphysema)
281
Airway resistance is especially found in the walls of what portion of the airway?
Bronchioles
282
What decreases and increases airway resistance?
Decrease:
-Lung expansion- bronchiole walls expand
Increase:
-Lung recoil- bronchiole walls shrink
283
What else plays a role in bronchodilation and decreasing airway resistance?
Sympathetic ANS stimulation of smooth muscle in walls
284
What is Eupnea?
Normal pattern of quiet breathing
| can consist of shallow, deep, or combined breathing
285
What is Costal Breathing?
- Pattern of shallow (chest) breathing
| - Upward and outward movement of chest due to contraction of external intercostal muscles
286
Describe Diaphragmatic Breathing?
Pattern of deep breathing
| -Outward movement of abdomen due to constriction and descent of diaphragm
287
What occurs in the blood by increasing the pressure of O2 above that of the atmosphere, such as in a hyperbaric chamber?
Increases the amount of O2 dissolved in blood
288
What can a Hyperbaric Chamber be used to treat?
```
Anaerobic Bacterial Infections
Certain heart Disorders
Carbon Monoxide Poisoning
Gas Embolisms
Cerebral Edema
Smoke Inhalation, Asphyxia
```
289
If labs were drawn on a patient with CO poisoning what values may be seen?
- Normal or elevated PaO2
- SaO2 Decrease
- SpO2: false normal reading due to colormetric (red)
290
What lab should be drawn and what is the treatment for CO Poisoning?
Serum Carboxyhemoglobin Level
| 100% O2
