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Respiratory System Flashcards

(116 cards)

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1
Q

What portions is the respiratory system divided into?

A

Conducting portion
Respiratory portion

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2
Q

What are the roles of the conducting portion of the respiratory system?

A

Transports air
Conditions air (warms, moistens, filters)

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3
Q

What are the roles of the respiratory portion of the respiratory system?

A

Site of gas exchange
Provides thin, moist and delicate membrane

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4
Q

What are the four paranasal sinuses?
[INSERT PIC]

A

Blue = frontal
Orange = sphenoid
Green = ethmoid
Purple = maxillary

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5
Q

What are the three regions of the pharynx and where are they?

A

Nasopharynx
- from nasal cavity to soft palate
Oropharynx
- soft palate to epiglottis
Laryngopharynx
- epiglottis to oesophagus

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6
Q

What is the margin called at the bottom of the thoracic cavity?

A

Costal margin

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7
Q

What is the mediastinum?

A

The area of the thoracic cavity with the heart in

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8
Q

Describe the structures in which the trachea becomes the terminal bronchiole

A

Trachea
Primary bronchi
Lobar bronchi
Segmental bronchi
Terminal bronchiole

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9
Q

What are these?
[insert pic]

A

Conchae (turbinate bones) with meatii in between (openings)

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10
Q

What happens to the sinuses during sinusitis?

A

They fill with mucus

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11
Q

Do the capillaries around the alveolar sacs receive oxygenated or deoxygenated blood from the heart?

A

Receive deoxygenated blood via the pulmonary arteries

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12
Q

Describe the lobes and fissures of the left lung
[insert pic]

A

It has a superior and inferior lobe with the oblique fissure between

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13
Q

Describe the lobes and fissures of the right lung
[insert pic]

A

It has inferior, superior and middle lobes
The oblique fissure separates the inferior lobes and the horizontal fissure separates the superior and middle lobes

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14
Q

Describe the structures shown below on the medial aspect of the hilum of the left lung
[insert pic]

A

Blue = pulmonary artery
Purple = primary bronchus dividing into secondary bronchus
Red = pulmonary veins
Orange = pulmonary ligament

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15
Q

What is the role of the pulmonary ligament?

A

To anchor the lung in place

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16
Q

Describe the structures shown below on the medial aspect of the hilum of the right lung
[insert pic]

A

Blue = pulmonary artery
Purple = primary bronchus dividing into secondary bronchus
Red = pulmonary veins
Orange = pulmonary ligament

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17
Q

What structures make up the upper respiratory tract?

A

Nasal cavity
Sinuses
Pharynx
Larynx

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18
Q

What structures make up the lower respiratory tract?

A

Trachea
Bronchi
Lungs

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19
Q

What are the functions of the thoracic cage?

A

Protection - for vital organs
Support - areas of attachment for muscles
Respiratory movements - changes in volume

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20
Q

Describe the structure of the sternum

A

Top = manubrium
Middle = sternum body
Bottom = xiphoid process
Sternal angle between manubrium and body

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21
Q

How is the diaphragm innervated?

A

By the phrenic nerve

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22
Q

Describe the structure of the intercostal muscles

A

[insert pic]

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23
Q

What order to the components of the intercostal neurovascular bundle sit in?

A

(From top to bottom)
Vein
Artery
Nerve

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24
Q

Describe the structure of the pleura

A

Lungs are surrounded by the visceral pleura and then parietal pleura

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25
What are the parts of the parietal pleura called?
Superior = cervical Inferior = diaphragmatic Outer = costal Inner = mediastinal
26
What kind of conditions are asthma, COPD and lung cancer?
Obstructive conditions
27
What kind of conditions are pulmonary fibrosis, pneumothorax and thoracic skeleton disorders?
Restrictive conditions
28
When alveolar pressure is less than atmospheric pressure is it inspiration or expiration?
Inspiration
29
When alveolar pressure is greater than atmospheric pressure is it inspiration or expiration?
Expiration
30
What muscles are in use in quiet breathing in comparison to increased effort breathing during inspiration?
Quiet - diaphragm, external intercostal muscles Increased effort - diaphragm, external intercostal muscles, accessory muscles, neck muscles, shoulder girdle muscles
31
What muscles are in use in quiet breathing in comparison to increased effort breathing during expiration?
Quiet - elastic recoil of tissues Increased effort - internal intercostals, abdominal wall muscles
32
How are the intercostal muscles innervated?
By segmental thoracic nerves
33
Why are the pleura important?
They make the lungs expand when the thoracic cage expands When the thoracic cage expands it decreases the pressure on the intrapleural space
34
What conditions do these pictures display? [insert pic]
Pneumothorax or pleural effusion disruption expansion
35
How is the volume of air moving in and out of the lungs measured?
Using a spirometer
36
What is tidal volume?
The volume of air moved in or out of the lungs during normal breathing
37
What are the typical rates of tidal volume?
At rest - 6-7 ml/kg During exercise - 15 ml/kg
38
What is inspiratory reserve volume?
After normal inspiration take as deep a breath as possible
39
What is the typical value of inspiratory reserve volume?
For a 70kg male - 3000ml
40
What is expiratory reserve volume?
After a normal expiration, breath out as deeply as possible
41
What is a typical value for expiratory reserve volume?
For 70kg man - 1500ml
42
What is residual volume?
After maximum expiration there is still a volume of air left in the lungs because they never properly empty (normally around 1000ml)
43
What capacity am I describing? TV + IRV + ERV + RV
Total lung capacity
44
What capacity am I describing? TV + IRV + ERV
Vital capacity
45
What capacity am I describing? ERV + RV
Functional residual capacity
46
What is compliance? (Definition)
The change in lung volume per unit change in intrathoracic pressure
47
Describe what compliance is and how it works
High compliance means the lungs expand easily with little pressure changes Low compliance means the lungs require more of a change in pressure to expand
48
What diseases are associated with reduced compliance?
Circumferential burn Pulmonary fibrosis Kyphoscoliosis
49
What disease is associated with increased compliance?
Emphysema
50
Is compliance equal throughout the lungs?
Due to gravity is it not because there is more pressure on the alveolar sacs at the bottom of the lungs
51
What is closing capacity?
The capacity from when the airways start to close to zero lung volume
52
What is the layer called that lines the alveoli?
Surfactant layer
53
Describe the structure and function of the surfactant layer
Produced by type 2 alveolar cells 90% phospholipid, 10% protein Reduces alveolar surface tension
54
What condition causes a deficiency is surfactant in the alveolar sacs?
Infant respiratory distress syndrome
55
What are the causes of hysteresis?
Reduced compliance of elastic structures Airway calibre
56
Why does airway calibre have such a major effect on flow?
In the equation for flow airway calibre is to the power of 4
57
What is the difference between laminar and turbulent flow?
Laminar flow is energy efficient whereas turbulent is less
58
What is the FEV1?
The forced expiratory volume in 1 second
59
What can you measure with a spirometer?
FVC FEV1
60
What can you measure with a peak flow meter?
The peak expiratory flow rate
61
Describe what is being shown in this graph [insert pic]
In the restrictive defect line, the FEV1 is relatively normal but their FVC is lower because they have a lower total capacity In the obstructive defect line, the FEV1 is significantly lower because the airways are obstructed so less air can escape but the FVC is relatively normal because the total capacity is normal
62
How do you calculate minute ventilation?
breathing frequency x tidal volume
63
What factors can change the amount of breath needed?
Activity Altitude Disease
64
What are the two parts of the brain circled here?
Superiorly - pons Inferiorly - medulla oblongata
65
What is the role of the pons in the brain?
To regulate the medulla
66
What are the VRG and DRG?
respiratory groups in the medulla DRG - inspiration VRG - expiration
67
Which of these factors are cortical and which are hypothalamic when it comes to higher brain influences on the respiratory system? -emotion -voluntary hyperventilation -sensory reflexes -voluntary breath holding
Cortical - voluntary hyperventilation and breath holding Hypothalamic - emotion and sensory reflexes
68
What is hypocapnia?
low CO2
69
Does hypocapnia cause acidosis or alkalosis?
alkalosis
70
What is the role of the the pulmonary stretch receptors?
To prevent over stretching of the lungs during inspiration which would cause damage
71
How do the pulmonary stretch receptors work?
As inspiration progresses the receptors excite the VRG and inhibit the DRG causing expiration
72
What is the role of local anaesthetic when passing endotracheal or nasogastric tubes into patients?
Local anaesthetic prevent the reflexes from cough and irritant receptors in the airways
73
What are the parts of the joints and muscles that stimulate breathing when exercising and in motion?
Muscle spindles Proprioreceptors
74
What is the function of J receptors?
they lie close to the capillaries around the alveolar walls they are activated by pulmonary traumas causing increased ventilation
75
What do central chemoreceptors detect?
Changes in pH due to increased CO2
76
Why can't increased H+ ions be directly detected by the medulla?
Due to the blood-brain barrier (CO2 can cross but H+ can't)
77
What are the carotid and aortic bodies examples of?
Peripheral chemoreceptors
78
On a intercellular level, how does hypoxia stimulate the respiratory centre in the brain?
Hypoxia triggers Ca2+ influx into glomus cells via depolarisation The Ca2+ triggers release of transmitters into the afferent nerve
79
What is the difference between afferent and efferent?
Afferent is towards the brain Efferent is exiting the brain
80
What are these types of - aerosol and DPI?
Inhalers
81
What happens to the airways during an asthma attack?
Wall of airway becomes inflamed and thickened Smooth muscles tighten around the airway
82
Describe how beta-2 agonists cause bronchodilation
Beta-2 agonist binds to the beta-2 receptor on the smooth muscle membrane This activates adenylate cyclase which causes ATP -> cAMP cAMP activates protein kinase A This causes bronchodilation
83
What do muscarinic antagonists do?
They prevent bronchoconstriction
84
What is the difference between formoterol and other LABAs?
Formoterol is a full agonist so achieves complete relaxation Other LABAs only produce 7-% max relaxation
85
Why is formoterol such a good beta-2 agonist compared to salbutamol and salmeterol?
Salbutamol is hydrophilic so can go through the receptor so has a short duration and fast onset Salmeterol is lipophilic so diffuses through the membrane so has a long duration and slow onset Formoterol combines both of these so has a long duration and fast onset
86
87
What is the mechanism of coughing?
- cough receptors or lung irritant receptors - cough centre in medulla - vagal stimulation leading to cough
88
How do we suppress a cough if the stimuli is above the larynx?
Linctuses
89
How do we suppress a cough if the stimuli is below the larynx?
Steam inhalation
90
How do you treat a cough when the stimuli is on the efferent side?
Antitussives E.g. opioids, non opioids, sedatives
91
What does yellow sputum production indicate?
Infection
92
How do expectorants treat a productive cough?
They increase volume of the secretion
93
How do mucolytics treat a productive cough?
They decrease the viscosity
94
What are the factors you have to consider for appropriate treatment of a lung disease?
Inflammation Bronchi constriction Mucus plugs
95
What are non specific ways to reduce bronchial hyperactivity?
Stop smoking Weight reduction Corticosteroids
96
What colour are the ICS inhalers? (inhaled corticosteroids)
Brown
97
What types of corticosteroids are used to treat asthma?
Inhaled corticosteroids (ICS) Oral corticosteroids
98
What is inhaling corticosteroids better than taking oral corticosteroids?
You can use a significantly lower dose during inhalation
99
What are the methods of dilating narrowed bronchi?
Mimicking the dilator neurotransmitter Direct acting bronchodilators Blockade of constrictor transmitter
100
What are the 2 agents that inhibit the leukotriene pathway?
Leukotriene synthesis inhibitors (inhibit 5 lipoxygenase) Leukotriene receptor antagonists
101
When are leukotriene receptor antagonists used?
For allergy induced asthma &Exercise induced asthma Given orally so good for children
102
What colour is the inhaler that acts via beta 2 adrenoceptors?
Blue
103
What type of agents are these? Albuterol (salbutamol) Salmetrol Adrenaline
Sympathomimetic agents
104
How are methylxanthines administered?
Orally or IV
105
Theophylline is a type of methylxanthine. Describe the features and function
It’s given orally 90% metabolised Adjuvant therapy in asthma
106
Aminophylline is a type of methylxanthine. Describe the features and function
Intravenous Used in severe asthma
107
How do anticholinergic agents work?
They act via inhibiting muscarinic receptors
108
What type of agents are ipratropium, tiotropium and oxitropium and what are they used for?
Anticholingeric agents Inhibits effects of vagus nerve stimulation Used in acute sever asthma/COPD
109
What does LAMA stand for?
Long acting muscarinic antagonists
110
What kind of drug is tiotropium?
LAMA
111
How do anti IgE monoclonal antibodies work to reduce the severity of asthma?
Inhibits binding of IgE to mast cells E.g. omalizumab Very expensive £££
112
How do anti IL-5 monoclonal antibodies work o reduce the severity of asthma?
Reduce the production and survival of eosinophils E.g mepolizumab Very expensive £££
113
How is ketotifen used to reduce the severity of asthma and is it effective?
It is a histamine receptor antagonist No proven benefit but some anti asthma effect Side effect of drowsiness
114
What is given to asthma patients if they fail to respond to inhaled bronchodilators?
Magnesium (by IV)
115
In life threatening or near fatal asthma what drug is used as a bronchodilator but doesn’t have a role in routine management?
Ketamine
116
What is the approach for treatment of COPD?
Similar to asthma Antimuscarins are more effective than beta2 agonists Stopping smoking

Body Systems (5 decks)

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