The Respiratory System Flashcards

1
Q

Is the control of breathing under conscious control, unconscious control or both?

A

Both.

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2
Q

What separates the 2 lungs?

A

The mediastinum.

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3
Q

Describe the normal, living appearance of the lungs.

A

In the healthy living person the lungs are light, soft and spongy.

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4
Q

Describe the location of the lungs.

A

The lungs are located within the thorax and extend from their apex, just above the first rib superiorly, level with T1, to the diaphragm inferiorly, level with T12 at their most inferior point in the posterior thorax on inspiration.

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5
Q

The lungs attach to the heart and trachea by the structures that comprise the what?

A

Roots of the lungs.

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6
Q

What is the root of the lung formed by?

A

By the bronchus, nerves, lymphatic vessels and the pulmonary vessels entering and emerging from the lung at its hilum.

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7
Q

At the hilum the visceral pleura reflects to become the what?

A

The parietal pleura.

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8
Q

What fissures divide the lungs into lobes?

A

The horizontal and oblique fissures.

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9
Q

How many lobes do the right and left lungs have?

A

The right lung has three lobes and the left lung has two lobes.

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10
Q

How does the size and the weight of the 2 lungs differ?

A

The right lung is larger and heavier than the left lung but it is shorter and wider because the right dome of the diaphragm is higher.

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11
Q

Describe the margin of each lung.

A

The anterior margin of the right lung is relatively straight whereas the margin of the left lung has a deep cardiac notch.

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12
Q

The cardiac notch indents the what?

A

The anteroinferior aspect of the superior lobe of the left lung.

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13
Q

Name the 3 surfaces of the lungs.

A

The costal, mediastinal and diaphragmatic surfaces.

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14
Q

Name the 3 borders of the lungs.

A

The anterior, inferior, and posterior borders.

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15
Q

Each lung has an apex extending into the root of the neck, above which rib?

A

The first rib.

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16
Q

Each lung is enclosed by a serous pleural sac consisting of two membranes called the what?

A

The pleurae.

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17
Q

Describe the visceral pleura.

A

The visceral pleura covers the lungs and is adherent to all its surfaces, including the horizontal and oblique fissures; it cannot be separated from the lungs.

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18
Q

Describe the parietal pleura.

A

The parietal pleura lines the pulmonary cavities, it is adherent to the thoracic wall, the mediastinum and the diaphragm.

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19
Q

Name and describe the 4 parts of the parietal pleura.

A

Costal pleura - covers the internal surfaces of the thoracic wall

Mediastinal pleura - covers the lateral aspects of the mediastinum

Diaphragmatic pleura - covers the superior aspect of the diaphragm on each side of the mediastinum

Cervical pleura - extends through the superior thoracic aperture forming domed pleura over the apex of the lung

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20
Q

What is the pleural cavity?

A

The pleural cavity is the potential space between the layers of pleura.

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21
Q

What fills the pleural cavity and what is its function?

A

It is filled with serous pleural fluid which lubricates the pleural surfaces and allows the layers of the pleura to slide smoothly over each other during respiration. The fluid also provides the surface tension that keeps the surface of the lung in contact with the thoracic wall.

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22
Q

The respiratory system can be divided into what?

A

The upper and lower respiratory system.

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23
Q

Where is the upper respiratory system located?

A

The upper respiratory system extends from the nose to the top of the trachea, including the larynx.

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24
Q

What is the function of the upper respiratory system and what does it do to the air before it reaches the lungs?

A

The upper respiratory tract conditions inspired air to match the environment in the lungs.

Before reaching the lungs air is:

  • Warmed to body temperature
  • Humidified
  • Filtered for particulates (>10μm)
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25
Q

What does the lower respiratory system consist of?

A
  • Trachea
  • Bronchi
  • Bronchioles
  • Alveoli
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26
Q

What is the function of the lower respiratory system?

A
  • Gas exchange
  • Conducting inspired air to the tissues involved in gas exchange
  • Further removal of particulates
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27
Q

Which region of the brain contains the respiratory centre that controls the rhythm of breathing?

A

The respiratory centre is located in the lower part of the brainstem, in the medulla oblongata.

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28
Q

Name the neurons that are active during breathing in and out and when they’re active.

A

Inspiratory neurones - During inspiration

Expiratory neurones - During expiration

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29
Q

The automatic rhythm of breathing can be modified by the afferent information. Afferent information comes from where?

A
  • Chemoreceptors
  • The brain
  • Receptors in the lungs
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30
Q

Which nerves innervate the diaphragm?

A

Right and left phrenic nerves.

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31
Q

What type of muscle is involved in ventilation?

A

Skeletal Muscle.

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32
Q

Describe the surface anatomy of the diaphragm.

A

At rest the highest point of the diaphragm is level with T9, inferiorly it is attached to the body wall at T12.

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33
Q

Which nerves innervate the intercostal muscles?

A

The intercostal nerves.

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34
Q

What muscles are active during gentle inspiration?

A

During quiet breathing the diaphragm provides most of the inspiratory force, however the external intercostal muscles may be used.

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35
Q

What two planes do the ribs move in during respiration?

A

Forwards and backwards (anteroposterior) and laterally.

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36
Q

What muscles are active during forced inspiration?

A

During forced inspiration the action of the diaphragm and the external intercostals is increased and the accessory muscles also contribute.

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37
Q

What creates the force required for expiration?

A

During quiet breathing expiration is entirely passive and relies on the elastic recoil of the lung tissue and the weight of the ribcage.
During forced breathing expiration becomes an active process and involves the internal intercostals and abdominal muscles.

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38
Q

Describe the diaphragm.

A

The diaphragm is a thin, musculotendinous, dome-shaped sheet of muscle that separates the thorax from the abdomen.

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39
Q

Which ribs is the diaphragm attached to?

A

Lower ribs.

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40
Q

Where is the origin of the phrenic nerves?

A

The phrenic nerves have their origins at the third to fifth cervical segments (C3-C5) of the spinal cord.

41
Q

Where does the blood supply of the diaphragm originate and where does it drain to?

A

Blood supply of the diaphragm originates from the intercostal arteries and drains to the inferior vena cava.

42
Q

Contraction of the diaphragm flattens it. This increases the volume of the thorax and aids inspiration. The concurrent reduction in abdominal volume is possible due to what?

A

The malleable nature of many of the abdominal organs.

43
Q

How is the transverse diameter of the thorax increased?

A

The rib margins are lifted and moved out.

44
Q

How far inferiorly does the apex of the diaphragm move during quiet breathing?

A

1-2cm.

45
Q

How far inferiorly does the apex of the diaphragm move during deep breathing?

A

Up to 10 cm.

46
Q

Where are the intercostal muscles located?

A

Between the ribs.

47
Q

Where are the external intercostal muscles located?

A

Superficial to the internal intercostals.

48
Q

How many sets of intercostal muscles are there?

A

11 sets of each.

49
Q

Which vessels supply the intercostal muscles and which vessels drain the blood from them?

A

Blood supply comes from the intercostal arteries and drains to the intercostal veins.

50
Q

Describe the location of the external intercostal muscles.

A

The external intercostal muscles extend from the tubercles of the superior ribs of the intercostal space dorsally, to the cartilages of the ribs ventrally on the inferior rib.

51
Q

Where do the external intercostal muscles end?

A

They end ventrally in thin membranes, the Anterior (external) Intercostal Membranes which continue forward to the sternum.

52
Q

Describe what the external intercostal muscles do to the ribs during inspiration?

A

They pull the ribs upwards and forwards causing an increase in both the lateral and anteroposterior diameters.

53
Q

Describe the location of the internal intercostal muscles.

A

The internal intercostal muscles begin ventrally, at the sternum in the interspaces between the cartilages of the true ribs (ribs 1-7) and at the ventral extremities of the cartilages of the false ribs (8-12).

54
Q

The internal intercostal muscles extend downward as far as the angles of the ribs, where they continue to the vertebral column as thin membranes called the what?

A

Posterior (internal) Intercostal Membranes.

55
Q

What separates the internal intercostal muscles from the innermost intercostal muscles?

A

The bundle of intercostal blood vessel and nerves.

56
Q

Describe what the internal intercostal muscles do to the ribs during active respiration?

A

They pull the ribs down and inward.

57
Q

The fibres of the innermost intercostal muscles pass in the same direction as the what?

A

The internal intercostals.

58
Q

The innermost intercostal muscles pass from rib to rib deep to the what?

A

The internal intercostals.

59
Q

Which intercostal muscles are incomplete and variable?

A

The innermost intercostals.

60
Q

What is the anteroposterior motion of the ribcage often compared to?

A

A pump handle action where the ribs are the handle of the pump.

61
Q

What is the lateral motion of the ribcage often compared to?

A

A bucket handle where the ribs are a handle pivoting at the spine and sternum.

62
Q

What do the accessory muscles include?

A

The accessory muscles include the sternocleidomastoids and the scalenes.

63
Q

Each lung is composed of two treelike structures, the ____1____ tree and the ___2___ tree, embedded in lung tissue.

A
  1. Vascular

2. Airway

64
Q

What is the vascular tree composed of?

A

The arteries, veins and capillaries which conduct poorly oxygenated blood to the lungs and returns highly oxygenated blood to the heart.

65
Q

What is the airway tree composed of?

A

Air-filled branching tubes originating from the trachea, which conduct ‘new’ atmospheric air to the gas exchange surfaces and return ‘used’ air to the environment.

66
Q

Which of the conducting airways is the widest and has the smallest total cross-sectional area of them all?

A

The trachea.

67
Q

Which of the airways contributes most to resistance in the lungs?

A

The trachea.

68
Q

To prevent collapse on inspiration the trachea is surrounded and supported by rings of ______ _____ which can be easily felt at the base of the neck.

A

Hyaline cartilage.

69
Q

Which airways enter the lungs?

A

The primary bronchi.

70
Q

The trachea bifurcates into what?

A

2 primary bronchi.

71
Q

The primary bronchi form the trunks of each of the lungs and go on to further divide (up to __1__ times) into smaller and smaller bronchi. These conducting tubes are also supported by ____ __2__ ____.

A
  1. 11

2. Rings of cartilage

72
Q

Which airways form the conducting system of the lower respiratory system?

A

The first 17 generations of airways, from the trachea through the next 16 successive airway branches.

73
Q

When do bronchi become bronchioles?

A

At about the 12th division of the bronchi.

74
Q

Describe bronchioles.

A

Small collapsible passageways with smooth muscle walls.

75
Q

When do the bronchioles become the respiratory bronchioles?

A

Up to the 11th division of the bronchioles.

76
Q

What are the respiratory bronchioles? Where do they terminate?

A

Respiratory bronchioles are the transition between the conducting airways and the gas exchanging tissues of the lung. These terminate at the alveolar ducts which lead to the alveoli.

77
Q

Which structures make up the respiratory zone of the lungs?

A

The structures from the respiratory bronchioles to the alveoli.

78
Q

What are alveoli?

A

Alveoli are the primary site of gas exchange. They are small outpockets which greatly increase the surface area for gas exchange.

79
Q

What is a lung lobule?

A

A lung lobule is a cluster of alveoli supplied by a single respiratory bronchiole, surrounded by the connective tissue of the lung.

80
Q

Describe the structure of alveoli.

A

Alveoli have extremely thin walls (only one cell thick) with basement membranes fused to the endothelium of the capillaries that surround them.

81
Q

Describe the apical surface of alveoli and what is special about it.

A

The apical surface is covered in a surfactant into which gases dissolve to aid their diffusion.

82
Q

The architecture of the nasal cavity and sinuses is designed with a _____ _____ _____ to warm and moisten inhaled air.

A

Large surface area.

83
Q

What are the nasal cavities lined with? Describe it.

A

Pseudostratified columnar epithelium.
The columnar cells have numerous cilia on their surface and the epithelium also contains mucous secreting goblet cells.
This type of epithelium is present throughout the upper respiratory system and is known as respiratory type epithelium.

84
Q

How far does respiratory type epithelium extend through the airways?

A

Respiratory type epithelum extends as far as far as the bronchioles but progressively becomes thinner, columnar cells become cuboidal and the epithelium become simple not pseudostratified.

85
Q

What are the bronchioles?

A

The bronchioles are distal airways located between the cartilage-walled bronchi and the point where ciliated epithelium ceases.

86
Q

The walls of the trachea and large bronchi are supported by rings of ______ 1 ______ and have incomplete smooth muscle support.
As the airways become smaller ______ 1 ______ are replaced with ______ 2 ______ (in the intrapulmonary bronchi) and eventually ______ 3 _______ becomes the major component of support.

A
  1. Hyaline cartilage
  2. Cartilage plates
  3. Smooth muscle
87
Q

The distal respiratory tract is the site of ______ ______.

A

Gaseous exchange.

88
Q

What is the most proximal part of the respiratory tract and what are they lined with?

A

The most proximal components are the respiratory bronchioles which are lined with cuboidal ciliated epithelium.

89
Q

What are alveolar ducts and what are they lined with?

A

The alveolar ducts are passageways formed mostly from the openings to alveoli. The ducts are lined with flattened epithelium.

90
Q

Describe type I pneumocytes.

A

Type I pneumocytes are very thin cells which allow gaseous diffusion.
They are flattened cells with flattened nuclei and are joined together by tight junctions.
They have few organelles and provide a very thin covering over the basement membrane; the thinness of which contributes to the efficiency of gaseous exchange.

91
Q

The alveoli consist of Type I and II _________ that lie on the basement membrane and also of alveolar macrophages.

A

Pneumocytes.

92
Q

Describe type II pneumocytes.

A

Type II pneumocytes secrete surfactant.

These cells are rounded in shape and contain numerous mitochondria.

93
Q

What does the alveolar wall contain considerable amounts of?

A

Elastin.

94
Q

What is the function of elastin in the distal respiratory tract?

A

Elastin allows the lungs to stretch to accommodate inspired air. It recoils to its original shape, allowing air to be expelled.
Specifically in the distal airways it acts as a support, attaching airways with no cartilage firmly to the connective tissue of the lung.

95
Q

Type I or type II pneumocytes? They represent about 40% of the number of alveolar cells but 90% of the surface area lining the alveoli.

A

Type I.

96
Q

Type I or type II pneumocytes? They represent 60% of the number of alveolar cells but only 5-10% of the surface area lining the alveoli.

A

Type II.

97
Q

Some type II pneumocytes act as precursor stem cells for what?

A

Type I pneumocytes.

98
Q

What does surfactant do?

A

Surfactant acts as a detergent, reducing alveolar surface tension, preventing collapse of the alveoli during expiration and facilitating inspirational expansion.

99
Q

Describe the actions of alveolar macrophages.

A

Alveolar macrophages ‘patrol’ the alveolar air spaces and the interalveolar septa (the walls of the alveoli) and can pass freely between the two.
Alveolar macrophages phagocytose inhaled particles, including pathogens.
After phagocytosis they either pass into the lymphatic system or ascend the mucociliary elevator to the trachea where they are expelled by coughing.