respiratory exam 3

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1

Pulmonary ventilation

breathing

movement of air into and out of the lungs

2

External respiration

O2 and CO2 exchange between the lungs and the blood

3

Transport

O2 and CO2 in the blood

4

Internal respiration

O2 and CO2 exchange between systemic blood vessels and tissues

5

structures within the repiratory zone

Microscopic structures: respiratory bronchioles, alveolar ducts and alveoli

6

structures within the conducting zone

includes all other respiratory structures not in the repiratory zone

7

Major organs

nose, nasal cavity, paranasal sinuses
pharynx, larynx, trachea, bronchi and their branches, lungs and alveoli

8

respiratory muscles

diaphragm and other muscles that promote ventilation

9

functions of the nose

airway for respiration
moistens and warms the air
filters and cleans air
resonating chamber for speech
houses olfactory receptors

10

vestibule

nasal cavity superior to the nostrils

11

olfactory mucosa

lines the superior nasal cavity
contains smell receptors

12

respiratory mucosa

Pseudostratified ciliated columnar epithelium

13

Mucous and serous secretions of the respiratory mucosa contain:

lysozyme and defensins

14

Cilia of respiratory mucosa do what:

move contaminated mucus posteriorly to throat

15

plexuses of capillaries and veins of the respiratory mucosa do what:

warm inspired air

16

sensory nerve endings of the respiratory mucosa do what:

trigger sneezing

17

3 parts of the nasal cavity

superior, middle, and inferior nasal conchae

18

nasal conchae protrude from?

lateral walls

19

nasal conchae increase __________ and enhance ___ ___________:

mucosal area

air turbulence

20

During inhalation, the conchae and nasal mucosa:

filter, heat, and moisten air

21

During exhalation, the conchae and nasal mucosa:

reclaim heat and moisture

22

Pharynx

muscular tube that connects to the nasal cavity and mouth superiorly and to the larynx and esophagus inferiorly

23

Pharynx lies

from the base of the skull to the level of the 6th cervical vertebra

24

nasopharynx

air passageway posterior to the nasal cavity

25

lining of the nasopharynx consists of what type of cells?

pseudostratified columnar epithelium

26

Oropharynx

passageway for food and air from the level of the soft palate to the epiglottis

27

lining of the oropharynx consists of what type of cells?

stratified squamous epithelium

28

Laryngopharynx

passageway for food and air

29

location of laryngopharynx

posterior to the upright epiglottis and
extends to the larynx, where it is also continuous with the esophagus

30

Larynx

attaches to hyoid bone and opens into the laryngopharynx

is continuous with the trachea

31

functions of the larynx

patent airway
routes air and food into proper channels
voice production

32

cartilages of the larynx

hyaline cartilage except for the epilottis

thyroid cartilage with laryngeal prominence (Adam's apple)

Ring-shaped cricoid cartilage

33

Epiglottis

elastic cartilage

covers the laryngeal inlet during swallowing

34

speech

intermittent release of expired air while opening and closing the glottis

35

pitch of speech is determined by

length and tension of vocal cords

36

loudness of speech depends on

the force of air

37

what structures amplify and enhance sound quality

pharynx, oral, nasal, and sinus cavities

38

muscles of the pharynx, tongue, softpalate, and lips

"shape" sound into language

39

trachea

windpipe: from the larynx into the mediastinum

40

3 layers of wall of trachea

mucosa, submucosa, and adventitia

41

mucosa of trachea is composed of

ciliated pseudostratified epithelium with goblet cells

42

submucosa of trachea is composed of

connective tissue with seromucous glands

43

adventitia of trachea is composed of

connective tissue that encases the C-shaped rings of hyaline cartilage

44

trachealis muscle

connects posterior parts of the cartilage rings

contracts during coughing to expel mucous

45

carina

last tracheal cartilage

point where trachea branches into two bronchi

46

there are _____ orders of branching to the _____ __________ . It's called the _______ _____________.

23,air passages

bronchial/respiratory tree

47

Conducting zone structures include

trachea, main bronchi, lobar (secondary) bronchi, segmental (tertiary) bronchi, bronchioles, terminal bronchioles

48

trachea branches into

right and left main (primary) bronchi

49

each main bronchus enters:

the hilum of one lung

50

describe the right main bronchus

wider, shorter, and more vertical than the left

51

each main bronchus branches into:

lobar secondary) bronchi (3 right, 2 left)

52

each lobar bronchus supplies:

one lobe

53

each lobar bronchus branches into:

segmental (tertiary) bronchi (divide repeatedly)

54

bronchioles are less than:

1 mm in diameter

55

terminal bronchioles are the __________

smallest--less than .5 mm diameter

56

respiratory zone structures

bronchioles, alviolar ducts, alveolar sacs (clusters of alveoli)

57

describe alveoli

approximately 300 million that account for most of the lungs' volume

main site for gas exchange

58

respiratory membrane

is approx. .5 mm thick air-blood barrier

includes alveolar and capillary walls and their fused basement membranes

59

alveolar walls are composed of what type of cell?

single layer of squamous epithelium (type I cells)

60

scattered type II cuboidal cells of the respiratory membrane secrete:

surfactant and antimicrobial proteins

61

alveoli contain________ __________ that:

open pores

connect adjacent alveoli

allow air pressure throughout the lung to be equalized

62

Alveoli house:

alveolar macrophages that keep alveolar surfaces sterile

63

parts of the lung:

apex (superior tip)
base (inferior surface that rests on the diaphragm
hilum (on mediastinal surface)
cardiac notch of left lung (accommodates heart)

64

hilum

site for attachment of blood vessels, brinchi, lymphatic vessels, and nerves

65

left lung is __________ and separated into ______ lobes by and _____________

smaller
2
oblique fissure

66

right lunge has ___ lobes separated by _____________________________.

3
oblique and horizontal fissures

67

how many bronchopulmonary segments are there?

10 right

8-9 left

68

lobules are the _____________ _______________
and served by _____________ and ____________

smallest subdivisions
bronchioles and their branches

69

describe pumonary circulation

low pressure
high volume

70

pulmonary arteries deliver ___________ ______________ blood

systemic venous blood

71

pulmonary arteries feed into:

pulmonary capillary networks

72

pulmonary veins carry _____________ from ________ to ______________

oxygenated blood

respiratory zones to the heart

73

pleurae

thin, double-layered serosa

74

where is parietal pleura located?

on the thoracic wall and superior face of diaphragm

75

visceral pleura is on _______________

external lung surface

76

pleural fluid fills the ________________________ and provides ____________________

slitlike pleural cavity

lubrication and surface tension

77

pulmonary ventilation consists of ________

2phases
inspiration
expiration

78

atmospheric pressure

pressure exerted by the air surrounding the body
760 mm hg at sea level

79

respiratory pressures are described relative to ______________

atmospheric pressure

80

negative respiratory pressure is

less than atmospheric pressure

81

positive respiratory pressure is

greater than atmospheric pressure

82

zero respiratory pressure equals

atmospheric pressure

83

intrapulmonary (intra-alveolar) pressure

pressure in the alveoli

fluctuates with breathing

always eventually equalizes with atmospheric pressure

84

intrapleural pressure

pressure in the pleural cavity

fluctuates with breathing

always a negative pressure (less that atmospheric pressure and less than intrapulmonary pressure

85

If intrapleural pressure and intrapulmonary pressure are equal:

lungs collapse

86

intrapulmonary pressure minus intrapleural pressure equals:

transpumonary pressure

87

transpulmonary pressure

keeps the airways open

the greater the transpulmonary pressure, the larger the lungs

88

Atelectasis

lung collape caused by:

plugged bronchioles and collapse of alveoli

wound that admits air into pleural cavity (pneumothorax)

89

pulmonary ventilation

inspiration and expiration

90

mechanical processes that depend on volume changes in the thoracic cavity

volume changes causing pressure changes

pressure changes cause gas flow to equalize pressure

91

inspiration

active process where insiratory muscles contract, thoracic volume increases

lungs are stretched and intrapulmonary volume increases

intrapulmonary pressure drops to -1 mm Hg

air flows into the lungs, down its pressure gradient, until intrapulmonary pressure equals atmospheric pressure

92

quiet expiration

normally passive process where the inspiratory muscles relax, thoracic cavity volume decreases, elastic lungs recoil and intrapulmonary volume decreases

intrapulmonary pressure rises to +1mm Hg and air flows out of the lungs down its pressure gradient until intrapulmonary pressure = 0

93

forced expiration

is an active process that uses abdominal and internal intercostal muscles

94

inspiratory muscles consume energy to overcome what 3 physical factors that influence pulmonary ventilation

airway resistance

alveolar surface tension

lung compliance

95

airway resistance

friction is the major nonelastic source of resistance to gas flow

96

airway resistance is usually insignificant because of:

large airway diameters in the first part of the conducting zone

progressive branching of airwas as they get smaller, increasing the total cross-sectional area

97

resistance disappears at the

terminal bronchioles where diffusion drives gas movement

98

as airway resistance rises....

breathing movements become more strenuous severely constricting or obstructing of bronchioles

99

severely constricting or obstruction of bronchioles can

prevent life-sustaining ventilation and/or occur during acute asthma attacks and stop ventilation

100

epinephrine

dilates bronchioles and reduces air resistance

101

alvolar surface tension

attracts liquid molecules to one another at a gas-liquid interface

resists any force that tends to increase the surface area of the liquid

102

surfactant

detergent-like lipid and protein complex produced by type II alvolar cells

reduces surface tension of alveolar fluid and discourages alveolar collapse

insufficient quantity in premature infants causes infant respiratory distress syndrom

103

Dalton's Law of Partial Pressures

total pressure exerted by a mixture of gases is the sum of the pressures exerted by each gas

partial pressure of each gas is directly proportional to its percentage in the mixture

104

composition of alveolar gas

alveoli contain more CO2 and water vapor than atmospheric air due to:

gas exchanges in lungs
humidification of air
mixing of alveolar gas that occurs with each breath

105

external respiration

exchange of O2 and CO2 across respiratory membrane

106

external respiration is inluenced by:

partial pressure gradients and gas solubilities

ventilation-perfusion coupling

structural characteristics of the respiratory membrane

107

partial pressure gradient for _______________ in lungs is steep across __________ ____________

oxygen

respiratory membrane

108

PO2 of deoxygenated blood in pulmonary arteries is

40 mm Hg

109

alveolar PO2 is ________ and as result O2 diffuses rapidly from the ____________ to the ________________

104 mm Hg

aveoli

pulmonary capillary blood

110

equilibrium partial pressure gradient is

PO2 of 104 mm Hg on both sides of the respiratory membrane

111

respiratory membrane is _________________ thick and its surface area is ___________

.5- 1um thick

40 times larger than one's skin

112

respiratory membranes thicken if

lungs become waterlogged and edematous and gas exchange becomes inadequate

113

reduction in surface area with emphysema occurs when

walls of adjacent alvieli

114

internal respiration

capillary gas exchange in body tissues

partial pressures and diffusion gradients are reversed compared to external respiration

- PO2 in tissue always lower than in systemic arterial blood

-PO2 of venous blood is 40 mm Hg and PCO2 is 45 mm Hg

115

O2 transport

molecular O2 carried in blood-- 1.5 dissolved in plasma

- 98.5% loosely bound to each Fe of hemoglobin (Hb) in RBCs

- 4 O2 per Hb

116

O2 and hemoglobin

oxyhemoglobin (HbO2)

117

reduced hemoglobin (HHb)

hemoglobin that has released O2

118

Loading and unloading of O2 is

facilitated by change in shape of Hb

-as O2 binds, Hb affinity for O2 increases

-as O2 is released, Hb affinity for O2 decreases

119

saturation of hemoglobin

fully saturated if all 4 heme groups carry O2

partially saturated when 1 to 3 hemes carry O2

120

Hypoxia

homeostatic imbalance

inadequate O2 delivery to tissues

Due to: too few RBCs, abnormal or too little Hb, blocked circulation, metabolic poisons, pulmonary disease

121

CO2 transport forms

7-10% dissolved in plasma

20% bound to globin of hemoglobin (carbaminohemoglobin)

70% transported as bicarbonate ions (HCO3-) in plasma

122

In systemic capillaries HCO3- quickly

diffuses from RBCs into the plasma

the chloride shift occurs: outrush of HCO3- from the RBCs is balanced as Cl- moves in ffrom the plasma

123

In pulmonary capillaries HCO3- moves

into the RBCs and binds with H+ to form H2CO3

H2CO3 is split by carbonic anhydrase into CO2 and water

Co2 diffuses into alveoli

124

control of respiration

involves neurons in the reticular formation of the medulla and pons

125

hypothalamic controls act through the

limbic system to modify rate and depth of respiration

ex: breath holding that occurs in anger or gasping with pain

126

Rise in body temp

acts to increase respiratory rate

127

Cortical controls are

direct signals from the cerebral motor cortex that bypass medullary controls

ex: voluntary breath holding

128

receptors in bronchioles

respond to irritants

promote reflexive constriction of air passages

129

receptors in the large airways

mediate cough and sneeze reflexes

130

Hering-Breuer Reflex

inflation reflex in which stretch receptors in the pleurae and airways are stimulated by lung inflation

inhibitory signals to medullary respiratory centers end inhalation and allow expiration to occur

acts more as protective response than normal regulatory mechanism

131

Chronic obstructive pulmonary disease (COPD)

exemplified by chronic bronchitis and emphysema

irreversible decrease in ability to force air out of lungs

other features: history of smoking (80%), dyspnea (labored breathing), cough and freq. pulmonary infections, most develop respiratory failure (hypoventilation) with respiratory acidosis

132

asthma

coughing, dyspnea, wheezing and chest tightness

active inflammation of airways precedes bronchospasms, immune response caused by release of interlukins, production of IgE and recruitment of inflammatory cells

airways thickened with inflammatory exudate magnify effect of bronchospasms

133

tuberculosis

caused by mycobacterium tuberculosis

fever, night sweats, weight loss, racking cough, spitting up blood

12 month course of antibiotics

134

lung cancer

leading cause of concer deaths in north america

90% of all cases are result of smoking

135

3 types of lung cancer

squamous cell carcinoma (20-40%) in bronchial epithelium

adenocarcinoma (approx. 40%) originates in peripheral lung areas

small cell carcinoma (approx. 20%) contains lymphocyte like cells that originate in primary bronchi and metastasize

136

olfactory placodes invaginate into

olfactory pits by 4th week

137

laryngotracheal buds present by

5th week

138

mucosae of bronchi and lung alveoli present by

8th week

139

baby born prematurely can breathe on its own by

28th week

140

during fetal life

lungs filled with fluid and blood bypasses lungs

gas exchange takes place via placenta

141

at birth respiratory centers

are activated, alveoli inflate, and lungs begin to function

142

respiratory rate is highest

in newborns and slows until adulthood

143

lungs continue to mature and more alveoli

formed until young adulthood