What does the term "respiration" refer to?
-Pulmonary Ventilation
-External Respiration
-Internal Respiration
What are the 4 functions of the respiratory system discussed in class?
1. Provide oxygen to blood and remove carbon dioxide
2. Enable sound production
3. Increase Intra-abdominal pressure
4. Protective and Reflexive Non-breathing air movements (coughing and sneezing)
Which structures are part of the conducting division?
From the nose/mouth to terminal bronchioles
Which are part of the respiratory division?
Respiratory bronchioles to alveoli
Nasal Septum's components?
perpendicular plate of ethmoid bone, vomer bone, and septal cartilage
what are nasal vibrissae?
hairs in the nasal vestibule. they trap debris
nasal conchae
superior and middle are ethmoid bone, inferior conchae is its own bone.
what structures drain into the nasal cavity?
paranasal sinuses (frontal, ethmoidal, sphenoidal, and maxillary)
What are the three functions of the nasal cavity we discussed in class?
1. warm, cleanse, and moisten air
2. smell
3. resonating chamber for speech
What are the functions of the mucous membrane?
The moist ET traps debris/particles. It has enzymes to kill bacteria. It also humidifies and warms air.
Where is the pharynx? What does it do?
IT connects the nasal cavity to the larynx, and connects the oral cavity to the esophagus. It conveys air to the larynx.
What are the three parts of the pharynx, and where are they located?
1. nasopharynx- superior to soft palate
2. oropharynx- posterior to OC, inferior to soft palate
3. laryngopharynx- esophagus or larynx- ends at C6
In what part of the pharynx are the:
a. pharyngeal tonsils
b. lingual tonsils
c. orifice of auditory tube
d. palitine tonsils
e. uvula
a. nasopharynx
b. oropharynx
c. nasopharynx
d. lateral walls of oropharynx
e. oropharynx
what is the larynx? where can you find it? what are the functions of the larynx?
Voice box. It is the passageway between laryngopharynx to trachea. It prevents food from entering lower respiratory system. It permits air flow.
What are the three unpaired cartilages of the larynx? Which one is the :
a. largest
b. laryngeal prominence
c. anterior attachment site for vocal cords
d. closes glottis
e. most inferior
f. most superior
thyroid, epiglottis, cricoid.
a. thyroid
b. thyroid
c. thyroid
d. epiglottis.
e. cricoid
f. epiglottis
the paired cartilage?
arytenoid cartilage. attaches vocal cords posteriorly. sits ontop of cricoid cartilage
what are the vocal cords? vestibular folds? vocal foldS?
They are bands of CT from thyroid cartilage to arytenoid cartilage. Vestibular folds are supportive tissue, and are the "false vocal cords". Vocal folds are used in sound production and are the "true vocal cords"
How is sound produced by true vocal cords? How is it modified?
Air travels through glottis, and vibrates true vocal cords. They can be tightened or loosened by arytenoid cartilage twisting. It is modified using tongue, lips and palate.
What is the trachea
Windpipe. It is a rigid tube from neck to mediastinum. It is formed by C-shaped rings of cartilage. Lined with mucosa
Branching pattern of bronchial tree?
From largest to smallest:
Primary bronchus- one for each lung
Secondary bronchus- one for each LOBE
tertiary bronchus- one for each bronchiopulmonary segment
If you inhale a foreign object, which bronchus will it end up in?
right, because it's bigger and more vertical.
How are bronchioles different from bronchi?
They have little to no cartilage, and more smooth muscles (important in dilation)
Where does gas exchange take place in lungs?
alveolar sacs
Where are lungs located? what are the surfaces?
Lungs lie against rib cage, superior to clavicle to diaphragm.
mediastinal surface, inferior surface, apex, and costal surface
how does L differ from R lung?
a. size
b. number of lobes
c. number of fissures
d. number of segments
e. presence of cardiac notch
a. L is smaller
b. L has 2 R has 3
c. L has 1 R has 2
d. L has 8 or 9, R has 10
e. L has notch. (medial side)
Pulmonary Ventilaton
movement of air in and out of lungs. has 2 phases:
1. inspiration
2. expiration
how does pulmonary respiration work? what happens to size of thorax during each phase?
air goes down the pressure gradient.
During inspiration: thorax size increases
Expiration: size decreases
what muscles are involved in pulmonary respiration?
diaphragm( contracts on inspiration) and external intercostals.
Expiration does not require muscle contraction
What is dead space?
only 2/3 of air gets to the alveoli, the air in the rest of the lungs is the dead space (150 mL)
Tidal volume
volume in and out in one cycle
inspiratory reserve volume
amount you can inspire beyond tidal volume
expiratory reserve volume
amount you can expel beyond tidal volume
residual volume
air still in lungs
vital capacity
VC= TV + ERV + IRV
total lung capacity
Residual plus VC
What causes the movement of respieratory gases in/out of the capillaries/ alveoli/ cells?
diffusion (down chemical gradient)
What is internal respiration? What is the direction of movement of oxygen?
Between blood and tissues. Oxygen goes to the tissues, Co2 to the blood
external respiration
between blood and alveoli
O2 to the blood, Co2 to the lungs
what happens to most of the CO2 that enters the blood? Where does the rest end up?
7% goes in blood plasma
23% binds to Hb in RBC
70% turns into H2CO3 in RBC
what is the formula for bicarbonate ion formation during internal respiration? what happens to it once it is formed?
CO2 + H20 ---> H2CO3--->H+ + HCO3-
ionization occurs
What happens to the H+ formed during the conversion of CO2 to bicarbonate ions?
it binds to available Hb in RBC.
The pH doesnt get lower, because low cell pH enhances O2 release from Hb, which allows the uptake of H+ by Hb (H+ lowers pH)
how is co2 released from blood during external respiration?
Co2 in plasma diffuses
unbinding from Hb---> diffusion
as oxygen binds, H+ unbinds from Hb reforming bicarbonate, reversing the equation, which leads to more diffusion.
What are three mechanisms used by the body for the removal of H+ from body fluids?
1. buffer systems
2. exhalation of CO2
3. excretion of H+ (urination)
hwo does the carbonic acid-bicarbonate buffer system maintain stable blood pH?
low pH is HIGH H+ concentration
H2CO3-----> H+ + HCO3- (reversible)
what happens to blood pH during slow, shallow breathing?
not exhaling CO2, which will increase the H + and HCO3- concentration. will lower pH
what happens during fast, deep breathing?
more Co2 flushed out, lowers H+, raises pH
Where are the respiratory control centers of the brain?
2 in medulla - sets rhythm
1 in pons- alters the rhythm
what is the inflation reflex? what receptors are involved?
Stretch receptors in the lungs respond to protect lungs from overinflating. VIA VAGUS.
where can you find peripheral chemoreceptors? central chemoreceptors? what are they sensitive to?
peripheral are in the aortic arch and carotid sinus
central are in the medulla.
sensitive to chemical changes (CO2 and O2 and H+)
What is the most powerful effect on respiratory activity?
CO2 levels
Which higher brain center mediates changes due to emotion and body temp changes?
hypothalamus
which higher brain center is used for voluntary respiratory control?
cerebral cortex
What other receptors influence respiration
irritant (VAGUS)
in lungs- constrict bronchioles
in trachea- cough
in nasal cavity- sneeze
why will the heart continue beating even if all nerve connections are severed
it has intrinsic control
sequence of excitation of heart
SA node --> AV node --> AV Bundle --> Branches---> Purkinjie Fibers
where is electrical impulse delayed? why?
in AV node (.1 s) this is to allow atria to contract before ventricles
why is it important that the wave of ventricular depolarization runs up superiorly from apex?
so blood pumps up...
where is the autonomic control center for the heart?
medulla
what are the effects of sympathetic and parasympathetic innervation on heart rate?
Sympathetic increases HR, Parasympathetic decreases HR
parasympathetic has dominant influence over heart during rest
what other extrinsic factrs influence heart rate?
hormones, ionic imbalance, age, sex, regular exercise
What is systole and diastole
systole- chamber of heart contracting
diastole- chamber of heart relaxing and filling with blood
the cardiac cycle
sequence of events in one heart beat.
about .8 s
(.3 S, .5 D)
what are the heart sounds?
S1- Av valves closing (left then right)
S2- Semilunar valves closing (left then right)
actually 4 sounds
heart sounds can be used to recognize an enlarged heart, because you can trace where heart is via the oblique heart sounds.
What is cardiac output? How is it related to HR and SV?
CO is the amount of blood pumped out of the LV in one minute. the faster the HR, more CO. higher SV, higher CO
CO= SV * HR
what is SV?
stroke volme. Volume of blood pumped out of LV in each beat.
EDV? ESV?
SV= EDV + ESV
EDV is the amount of blood in ventricle after diastole
ESV is the amount of blood in ventricle after systole
why does resting heart rate decline as a result of CV conditioning?
when stroke volume increases, HR will decrease
The three layers of a blood vessel
Tunica externa-collagen
tunica media- SM fibers and elastic fibers
tunica interna- ET
Veins vs. Arteries?
a. thickness of wall
b. size of lumen
c. muscularity
d. cross-sectional shape
e. BP
a. arteries are thicker
b. veins have larger lumen
c. arteries are more muscular
d. arteries are rounded in X section
veins are collapsed
e. BP in A are higher
what are the two types of arteries? how do they differ?
Elastic and muscular.
Elastic- 1.5 cm
muscular- 6.0 mm
muscular- few elastic cells
E has larger lumen
What are arterioles?
Very small arteries. 1 or 2 cell layers thick. Regulate blood flow into capillaries (autoregulation)
What is artherosclerosis? atheroma? thrombosis?
Atherosclerosis is the hardening of an artery. atheroma is plaque buildup. thrombosis is a clot.
what are capillaries?
they are the narrowest BV's. they are one cell thick, have no tunica media or tunica externa. Gas exchange takes place here.
What is a capillary bed
system of capillaries
thouroughfare channel
capillaries direct route from artery to vein
true capillary
gas exchange happens here
what muscles of capillary bed determines amount of blood flowing through it?
precapillary sphincters
Venous vessels ? 2
venules - smaller, union of capillaries
veins- 3 layers present
blood pressure is low in veins. what mechanism provides most of the force necessary to return blood to heart?
skeletal muscle pumps w/ venous valves. contracting muscles squeeze blood up veins, and valves prevent backflow.
Stretched out veins and unfunctionable- varicose veins
what are hemorrhoids?
varicose vain in rectum
what is blood pressure?
it is the force of blood against the walls of arteries. it decreases with distance from heart.
Blood Flow
F =(delta P)/resistance
what is the pressure gradient between two points?
difference in pressure, higher the difference the greater the blood flow.
what is resistance?
what must be overcome to push blood through the system
what are factors that influence resistance?
Blood viscosity
BV length (longer is more resistance)
BV diameter- most important
peripheral resistance ?
arteries on periphery determine blood flow...bv away from heart have greatest effect on resistance
what is pulse pressure?
SP-DP. smaller further away from the heart
what accounts for the drop in pulse pressure in arteries further away from heart?
elastic arteries are close to heart, and bounce back during diastole like a pump. down the line, they are less elastic.
what is MAP?
mean arterial pressure.
DP+ PP/3
what are the three main influences on MAP?
Cardiac output- higher CO- higher BP
Blood Volume- more fluid, more pressure
Peripheral resistance- more resistance, higher BP
what is the cardiovascular center?
area of medulla oblongotta controls CV activity
are vasomotors parasympathetic, sympathetic, or both?
SYMPATHETIC ONLY
what do vasomotor fibers control?
alters the diameter of the BV it innervates. (tunica media of vessel)
cause vasoconstriction except to cardiac muscle and skeletal muscle
3 major types of input to cardiovascular center
chemical
pressure
higher brain centers (medulla)
what higher brain structure mediates the cardiovascular response to exercise and changes in body temp?
brain stem
what hormones are released by adrenal medulla?
epinephrine and norepinephrine. they increase heart rate. and vasoconstrict, except in cardiac and skeletal muscles
atrial naturietic peptide
target: arterioles and kidney
vasoconstriction and inhibition of ADH and aldosterone
lowers BP
angiotensin II
plasma protein
target: arterioles
vasoconstriction and release of ADH
raises BP
Aldosterone
target: kidneys
increase water and Nacl retention. Raises blood volume which raises blood pressure
ADH
target: kidneys
increases water retention
raises BP
what is autoregulation?
dilation/constriction of bv's leading totissues, based on need.
what is the effect of nitric oxide
? histamine?
NO- dilation
histamine-dilation
what is myogenic response?
a response of vascular smooth muscle cells to stretch.
when bp increases and bv distend, vasoconstriction will occur.
stretch-activated ion channel.
what are the physical boundaries of the oral cavity>
front- labia
sides- cheeks (buccinator)
top- palate
bottom- floor of mouth
back- muscular folds( palatoglossal and palatopharyngeal arches)
what three actions take place in oral cavity
ingestion, taste, digestion
bolus formation
4 types of teeth
incisors, canines, premolars, molars
adults 2:1:2:2 per quadrant
kids 2:1:2
alveolus
tooth socket
gingiva
gums over alveolar bone
crown
above gingiva
root
below gingiva
enamel
highly mineralized bone
cementum
covers root(like bone)
periodontal ligament
connects root to alveolar bone
dentin
body of tooth
pulp chamber
chamber of tooth for nerves and BV
root canal
pathway for nerves and BV to get to pulp chamber
what part of the tongue is in the oral cavity? and what part is in the oropharynx?
the oral cavity houses the anterior 2/3 of the tongue
the oropharynx holds the posterior 1/3 of the tongue
the sulcus terminalis separates the two regions
what are the functions of the tongue?
speech, move food, voluntary swallowing, taste
what are papillae?
bumps on tongue
what are the 3 major salivary glands/ducts?
sublingual-mini ducts under tongue
submandibular- subm duct, drains into mandibular body
parotid- largest, by ear parotid duct to 2nd molar
purpose of pharynx/esophagus with respect to digestive system
pharynx- convey bolus to esophagus
esophagus- convey bolus stomach
what parts of pharynx that food goes through?
oropharynx and laryngopharynx
three muscles that make up pharynx walls?>
"constrictor" superior, middle, inferior. they squeeze food down. they are skeletal muscles (voluntary)
how does food get pushed down esophagus?
peristalsis
what is gastroesophageal sphincteR?
s.m. junction between stomach and esophagus. opens when food is present on esophageal side.
GERD?
gastroesophageal reflux disorder
dysfunctional sphincter, reguritates stomach acid into esophagus.
Hiatal hernia, eating/drinking to excess, running, obesity, pregnancy
functions of the stomach
1.temporary storage of bolus
2. digestion
3. formation of chyme
4. move chyme to S.I.
what side of body is the stomach on
upper left quadrant
gastric rugae
mucosa of the stomach is folded when empty. stomach can then be further stretched
what sphincter does chyme pass through to get to small intestine?
pyloric sphincter
what is the major digestive enzyme of gastric juice?
pepsin- digestion of proteins. activated by HCl
what hormone is released when food arrives at stomach?
gastrin- stimulates further production of gastric juice
functions of small intestine?
1.receive chyme from stomach
2. major site of digestion
3. site of nutrient absorption
4. transport waste to large intestine.
folds, villi, microvilli
they increase surface area of the mucosa. villi contain ET cells which have microvilli on them.
three regions of the small intestine
duodenum- no mesentery
jejunem- 2.5 m, suspended by mesentery
ileum- 3.5 m, suspended by mesentery
how does the pH of the SI compare to stomach
pH is higher- mucosa secretes alkaline substance
most absorption takes place in
jejunem- it is highly folded compared to the other two regions
the duodenum
receives secretions from the pancreas, liver, and gall bladder. the name of the duct they all come from hepatopancreatic ampulla. formed by common bile duct and main pancreatic duct.
valve between SI and LI
ileocecal
why is it called the large intestine?
it has a larger lumen
where in the abdomen does the LI start
lower right quadrant. ends at the anus
what does the LI do?
resorption of water and electrolytes
why does one produce more intestinal gas as a result of eating more indigestible carbohydrates
bacteria in the LI will eat the leftover carbs, their waste is intestinal gas
pathway through LI
cecum
ascending colon
transverse colon
descending colon
sigmoid colon
rectum
what is the name for that part of the rectum located inferior to the pelvic diaphragm?
anal canal
how many lobes does the liver have?
4. left, right, caudate and quadrate
what is the portal region of the liver
everything passes through it
portal vein, hepatic artery, nerves, bv, hepatic ducts
functions of liver
1.synthesis and storage of vitamins
2. synthesis and storage of glycogen
3. synthesis of plasma proteins
4. synthesis of cholesterol
5. destruct old damaged rbcs
6. detox center
7. maintain normal nutrient levels
8. produce bile
two major functions of pancreas
endocrine- insulin and glucagon
exocrine- pancreatic juice to p. duct
enzymes found in pancreatic juice?
pancreatic amylase- carb digestion
pancreatic lipase- lipid digestion
proteinases- protein digestion
secretin
inhibits stomach, stimulates buffer secretion in pancreas
cck
cholecystokinin
inhibits stomach, stimulates digestive enzyme secretion of pancreas, stimulates contraction of gall bladder
GIP
gastroihibitory peptide
inhibits stomach, stimulates insulin production
3 divisions of the gut
foregut, midgut, hindgut- based on embryonic development (placement of vitelline duct)
foregut
celiac artery
liver, gall bladder, pancreas
Sympathetic- celiac ganglia
parasympathetic- vagus
midgut
superior mesenteric artery
last 1/3 of duodenum to the left colic flexure
sympathetic- sup. mes ganglion
parasympathetic- vagus
hindgut
inf. mesenteric artery
left colic flexure to rectum
sympathetic- inferior mesenteric ganglion
parasympathetic- pelvic splanchnic nerve
mesentery
bilayer of peritoneum
falciform ligament
divides liver int o two lobes (mesentery)
two major carbohydrates
starch and glycogen
what organs are retroperitoneal
kidneys, pancreas, ascending and descending colon
emulsification
big droplets into little droplets
lipid digestion
duodenum- already fat globules b/c of hydprophobic nature, bile emulsifies lipids then pancreatic lipase breaks them down
lacteals
transfer big things to veins (lymph system) lipid fragments attach to transport proteins
four layers of gi tract
mucosa
submucosa
muscularis externa (two layers):inner(circular) and outer(longitudinal)
serosa (visceral peritoneum)