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PY1103 - Intro to Cardiorespiratory Physiotherapy > Week 1 (parts 1 and 2) > Flashcards

Week 1 (parts 1 and 2) Flashcards

(84 cards)

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1
Q
A
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2
Q

What makes up the upper respiratory tract

A

Nose (mouth), Pharynx and Larynx

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3
Q

What makes up the lower respiratory tract

A

Trachea, Bronchi, Bronchioles, Alveoli

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4
Q

what 3 parts is the pharynx split into

A

nasopharynx (air), oropharynx (air+ food), Laryngopharynx (air+ food, site of bijurication)

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5
Q

larynx functions/ facts

A

larynx is protected form food by Epiglottis that closes over the larynx during swallowing, contains vocal cords (essential for effective cough)

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6
Q

What 3 parts are the Bronchi split into

A

Primary (main), Secondary (lobar), Tertiary (segmental)

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7
Q

what 2 zones are the bronchioles split up into

A

Conducting zone, Respiratory zone

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8
Q

where does the trachea descend from and to

A

from larynx into the thorax (situated anteriorly to the oesophagus)

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9
Q

what are the different parts of bronchi

A

Right and Left primary bronchi, Secondary (lobar) bronchi, Tertiary (segmental) bronchi

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10
Q

what is the structure of the left and right main bronchi

A

R - branches off at 20-30 degrees, wider and shorter than L
L - branches off at 45-55 degrees

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11
Q

what is the structure and function of the secondary and tertiary bronchi

A

secondary - main bronchi divides into secondary bronchi, Right = 3 and L = 2, supply each lobe of the lung
Tertiary - Secondary bronchi divide into tertiary bronchi, Right = 10 L = 9, supply each segment of the lung

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12
Q

where does gaseous exchange occur

A

Alveoli of lungs

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13
Q

what are the branches of the lungs

A

Trachea - Primary Bronchus - Bronchial Tree, Terminal Bronchi - Bronchioles - terminal bronchioles - respiratory bronchioles

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14
Q

what are the lobes of the right lung (3)

A

upper/superior, middle, lower/inferior

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15
Q

what are the lobes of the left lung (2)

A

upper/ superior, lower/inferior
(smaller due to position of heart)

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16
Q

what are the right and left lung lobes divided by

A

fissures: (right - oblique and horizontal) (left - oblique)

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17
Q

what covers the lungs

A

pleural membrane (pleura)

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18
Q

what is the outer layer of the pleura called

A

parietal pleura - lines inner surface of the thoracic wall and superior surface of the diaphragm

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19
Q

what is the inner pleura layer called

A

visceral pleura - covers the outer surface of the lungs and lines the fissures

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20
Q

what is the space between the outer and inner pleura layers called

A

pleural cavity - contains pleural fluid

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21
Q

functions of pleural fluid

A

acts as a lubricant allowing the layers to glide over each other during inspiration and expiration, increases surface tension/ locks 2 pleural layers together

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22
Q

what makes up the thoracic cage

A

ribs, sternum, thoracic vertebra

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23
Q

how many pairs of ribs are there

A

12 pairs in total: pairs 1-7 (true ribs) articulate with vertebra and sternum,
pairs 8-10 (False ribs) articulate with vertebra and indirectly with sternum, pairs 11-12 (floating ribs) articulate with vertebra no attachment anteriorly to sternum

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24
Q

which ribs are typical and atypical

A

typical = 2-9
atypical = 1,10,11,12

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25
what are the three elements of the sternum
manubrium, body, Xiphoid process
26
what is the structure of typical ribs
posterior end = head +tubercle anterior end = continuous costal cartilage which articulates with sternum
27
rib 1 structure
flat in the horizontal plane, broad superior and inferior surfaces, articulates with the body of T1only bony landmarks: scalene tubercle, grooves, costal cartilage
28
alveoli structure
channels of martin (bronchiole-bronchiole) Canals of Lambert (bronchiole-alveolar) Pores of Kohn (alveolar-alveolar)
29
3 different sternocostal joints
- joints between rins 1-7 (true ribs) and sternum - Rib 1 and the manubrium (fibrocartilaginous joint) - ribs 2-7 synovial, surrounded by thin capsules
30
interchondrial joints
ribs 7-10, synovial joints, occur between costal cartilages of adjacent ribs, provide anchorage to the sternum
31
muscles active during inspiration
diaphragm external intercostals Accessory muscles: Sternocleidomastoid Scalenes Pec minor and major
32
Muscles active dring forced expiration
- internal intercostal - rectus abdominis - Transversus abdominis - internal and external obliques
33
origins of the diaphragm
costal part: lower margin of costal arch (inner surface ribs 7-12) Lumbar part: medial - L1-L3 vertebral bodies and intervertebral discs (2nd and 3rd), anterior longitudinal ligament Lateral - arcuate ligaments (median, medial and lateral) Sternal part: Posterior surface of xiphoid process
34
what is the insertion point of the diaphragm
central tendon
35
what is the innervation of the diaphragm
phrenic nerve (C3,C4,C5)
36
relaxed inspiration process
1. Controlled by autonomic nerve impulses from the respiratory centre in the brainstem 2. Nerve stimulation causes contraction of the diaphragm and the external intercostals this expands the thoracic cage and lungs 3. Expansion creates a lower pressure relative to the outside of the body 4. Although only a small difference (gradient) the low resistance properties of the airway ensures efficiency 5. Air rushes in
37
Biomechanics of breathing
Pump handle: - Primarily involves upper ribs and sternum - Increases the anterior-posterior dimension of the chest Bucket Handle: - Primarily involves the lower ribs - Increases the transverse diameter of the chest
38
how pump and bucket handle works
During inhalation, both pump handle and bucket handle movements occur simultaneously, allowing for maximum expansion of the chest cavity and intake of air.  The relative contribution of each movement can vary depending on breathing patterns and individual anatomy. 
39
during forced inspiration what do the accessory muscles do
assist deep inspiration and assist during episodes of respiratory distress also help to elevate the rib cage
40
is relaxed expiration a passive or active process
passive - relaxing of the diaphragm and external intercostal muscles, allows for elastic recoil of lung tissue
41
examples of forced expiration
cough, sneeze, physical exertion
42
what happens during forced expiration
contraction of the abdominal muscles causes the abdominal contents to push up against the diaphragm - reduces the vertical diameter of the thorax contraction of the internal intercostal depress the ribs and decrease space in the thorax
43
what is bradypnoea
An abnormally slow respiratory rate (below 12 breaths per min)
44
what is hyperventilation/ tachypnoea
shortness of breath/ shallow breathing
45
what is apnoea
e.g sleep apnea, repeated lapses in breathing due to a partially or completely blocked airway
46
what is agonal breathing
Abnormal pattern of breathing characterised by laboured, gasping breaths that occur because of insufficient oxygen
47
what is orthopnoea
shortness of breath when lying down
48
what is kussmaul respiration
abnormal breathing at a rapid and deep rate (signals respiratory distress)
49
what is cheyne-stokes breathing
compensatory reflex that allows the body to quickly restore oxygen levels
50
WEEK 1
Module introduction
51
PULMONARY A AND P (PP 2)
52
what part of the brain controls breathing
respiratory control centers in the brainstem
53
what are the 4 respiratory control centers in the brainstem
Inspiratory centre (medulla) Expiratory centre (medulla) Pneumotaxic centre (pons) Apneuristic centre (pons)
54
where do medullary resp centres provide output to
respiratory and muscles and pontine centres Occurs automatically without any concious effort
55
what are the factors controlling breathing
cerebral cortex can exert voluntary control over breathing as well as centres involved in emotion and pain Peripheral chemoreceptors in vascular system and central chemoreceptors in brain detect changes to oxygen and carbon dioxide levels stretch receptors in lungs and activity receptors in muscles and joints
56
characteristics of the airways
large surface area to enable efficient gaseous exchange Tissues have intrinsic elastic properties to make the processes of breathing energy efficient Rich blood supply for gaseous exchange Fluid lubrication ensure rapid diffusion and counteract physical forces such as surface tension
57
what are the main gases in the body
oxygen (required for sustainable energy production) and carbon dioxide (can become toxic to cells at high levels)
58
what is bulk flow
movement of air from the atmosphere to alveoli (occurs due to pressure difference during inspiration in alveoli where alveoli pressure is less than the atmospheres)
59
What is diffusion of gas
movement of molecules from alveoli - blood - cell - blood - alveoli (occurs due to a high to low pressure gradient)
60
what does partial pressure mean
the concentration of each gas in the body
61
what are partial pressures measured in
kilopascals (kPa) or millimetres of mercury (mmHg)
62
what is the symbol for partial pressure of oxygen/ carbon dioxide in the air
PO2/PCO2
63
what is the symbol for the partial pressure of oxygen dissolved in plasma of arterial blood
PaO2
64
what is the symbol of partial pressure of carbon dioxide dissolved in plasma of venous blood
PvCO2
65
what are the factors affecting gas solubility (3)
Partial pressure of gas - the greater the partial pressure the faster it will dissolve into the liquid phase Partial pressure of gas in liquid phase - If the partial pressure of a gas in the liquid phase becomes higher than its partial pressure in the gas phase, some of the dissolved gas will re-enter the gas phase Solubility of a gas - E.g. CO2 is 20x more soluble in water than O2, so more will be dissolved at a lower partial pressure
66
where does gaseous exchange in the lungs occur
respiratory membrane (the alveolar airspace and the blood capillaries)
67
what three factors affect Gaseous exchange in the lungs
- gas partial pressure and gas solubility - matching of alveolar ventilation with pulmonary blood perfusion structural characteristics of the respiratory membrane
68
what is Ventilation (V)
volume of air entering the alveoli
69
What is Perfusion (Q)
volume of blood flowing through the lungs
70
what is V/Q mismatch
inadequacy of V or Q will significantly impact the oxygenation of the blood and the removal of CO2
71
in a healthy adult where in the lung is ventilation most optimal
lower 1/3 of the lung AKA dependent lung region
72
what do the upper (non-dependent) lung regions do
they have a greater initial volume e.g the alveoli are already expanded with little capacity for volume change
73
in a healthy self-ventilating adult lung where is perfusion most optimal
lower 1/3 of the lung AKA dependent lung region
74
what is perfusion influenced by
gravity, interaction of alveolar arterial and tissue pressure
75
why is the respiratory membrane able to enhance gaseous exchange
large surface area due to large number of lung alveoli Very thin membrane so small depth for diffusion (1-2000ths of a millimetre)
76
what are the 2 ways oxygen is transported in the body
bound to haemoglobin in RBCs (98.5%) Dissolved in plasma (1.5%)
77
what is haemoglobin composed of
4 polypeptide chains each bound to a haem group
78
what is the process of oxygen transport
1. Hb molecule can combine with 4 molecules of O2 forms oxyhaemoglobin (no O2 = deoxyhaemoglobin 2. Oxygen binds with the haem molecules 3. once the first molecule is attached the molecule changes its shape and increases O2 binding capacity 4. Affinity of Hb for O2 changes according to the O2 saturation
79
how much O2 is reversible bound or released is determined by
- Partial pressure of oxygen in blood (PO2) - Temperature - Blood pH - The partial press of CO2 (PCO2) and therefore concentration of H+ ions - blood concentration of BPG produced by RBC
80
how much carbon dioxide do respiring cells produce a minute
200ml
81
what are the 3 ways blood carries CO2 to the lungs
1. dissolved as CO2 in blood plasma (7-10%) 2. Chemically bound to Hb in RBCs as carbaminohaemoglobin (20%) 3. Bicarbonate ions in plasma (roughly 70%)
82
Haemoglobin (20%)
- rapid reversible reaction - CO2 binds to globin portion of molecule forming carbaminohaemoglobin - O2 binds with the haem portion = no competition but deoxyhaemoglobin combines more readily with CO2 - CO2 rapidly disassociates from Hb in the lungs when PCO2 in alveoli is lower than in the blood - CO2 is loaded in the tissues where PCO2 is higher than in the blood
83
Bicarbonate ions (roughly 70%)
- series of chemical reactions in plasma or RBCs (majority in RBCs) - CO2 rapidly diffuses into RBCs where it combines with water to form carbonic acid - This reaction is 1000x faster in RBCs due to the action of an enzyme called carbonic anhydrase - Carbonic acid produced is highly unstable and quickly disassociates into hydrogen ions and bicarbonate ions - When hydrogen ions are released, they in turn bind to haemoglobin and facilitate the release of oxygen
84
respiration chemical reaction
CO2 + H20 <---->H2CO3 <---> H+ +HCO3-

PY1103 - Intro to Cardiorespiratory Physiotherapy (11 decks)

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