What is the primary function of the respiratory system? Absorption of O2 and excretion of CO2 What is the secondary function of the respiratory system? Filters both inhaled contaminants and small clots or chemicals from blood What is internal respiration? Gas exchange between tissues and systemic capillary blood "into lungs" What is external respiration? gas exchange between lungs and atmosphere What are the stages in the development of respiartory therapy? Embryonic period - conception - week 6 Psuedoglandular period - week 7-16 Canalicular period - week 17-26 Saccular and alveolar period - week 27 - roughly 25 years of age When does respiratory development begin in the embryonic period? On or about the 22nd day after fertilization What happens in respiratory development at the 5th week of development? Tracheal bud continues to develop and bifurcates (divide into to parts) into Left and Right primary bronchial buds What happens during the 6th week of respiratory development? Gestation, lungs and airway development has the appearnce of a glandular structure hence the name, Pseudoglandular stage What happens at week 10 of respiratory development? Growth and branching of the tracheobronchial (TB) tree and pulmonary vasculatre continue with formation of terminal and respiratory bronchioles What 2 bronchioles develop during the 10th week and what do they do? Terminal Bronchiole - conducts airways that do not participate in gas exchange with blood Respiratory Bronchiole - are capable of gas exchange What appears during 16-17 week of development of the respiratory? Acini appear, they are the basic gas exchanging unit of the lung What happens at week 20-24 of respiratory development? Fourth Phase, terminal saccular stage Type 1 and 2 pneumocytes begin to appear (epitheial cells that cover the gas exchange surface) What happens at week 32 until 601 years of age in respiratory development? Mature alveoli occur Alveolar period What happens to alveoli when child is around 10 years old? Type 1 and 2 pneumocytes covering the pulmonary capillaries that have formed just below the basement membrane What is surfactant? It keeps lungs open giving child ability to breathe Reduces surface tension of fluid in the lungs and helps alveoli more stable Made from Type 2 pneumocytes What does surfactant consist of? Phospholipids, some protein and a trace of carbohydrates Type 2 pneumocytes What is the umbilical cord consits of? 1 umbilical vein 2 arteries What is the purpose of fetal lung fluid? Keeps the lung inflated and is constantly being produced What expels fetal lung fluid during birth? 1/3 of the fetal lung fluid is expelled through the mouth by Thoracic compression and the rest is absorbed byt he lymphatic system Do maternal and fetal blood ever touch? What exchanges does it permit? They come in close contact but remain sepearted by an emryonic membrane Exchange of O2, CO2, water, ions, various metabolic molecules and hormones What are the 3 important bypass pathways in fetal circulation? Ductus Venosus Ductus Arteriousus Foramen Ovale 2/3 of blood flow go through what and bypass the livers circulation and flows to the inferior vena cava? Ductus Venosus Approx 50% of this blood is shunted from the Right atrium into the Left atrium through? Foramen Ovale The Ductus arteriosus stays open because? Decreased O2 (hypoxia) Prostaglandins from the mother 90% of blood flow entering pulmonary artery takes the path of least resistance by shunting through the? Ductus Arteriosus, only 10% actually flows through the lungs. During postnatal lung development, infants breathe through their? Nose The ______ is much rounder and the ________ is much larger relative to the size of the oral cavity. Jaw Tongue Greater relative weight in the head can cause what in infants? acute flexion of the cervical spine The larynx is located where in an infant? Lies higher in the neck than in later years, with the glottis located between C3 and C4 It is also more funnel shaped that that of an adult What is the narrowest region of the upper airway? Cricoid cartilage What makes newborns and infants more susceptible to Upper Respiratory infections? Bigger head narrower cricoid cartilage (funnel shaped) Bigger tongue If the chest was split in half, what would the left or right be called? Left or Right Hemithorax If hemithorax was split in half what would that be called? Midclavicular How long is a normal newborn trachea? 5-6 cm and is shorter and narrower What do phrenic fibers do? Form to carry motor signals to diaphragm and intercostal muscles The phrenic nerve is connected to what on the spine? C3, C4 and C5 of spine What are the primary muscles of respiration? Diaphragm and intercostal muscles What do parasympathetics do? Mucous gland to cause mucous production What do sympathetics do? Blood vessels to cause vasoconstriction What is the 10th carnial nerve that carries motor and sensory signals of the parasympathetic system? Vagus nerve During chest wall development an infants thoracic wall...? Is more compliant and their muscles are less developed then those of an adult and provide little structure and support What is more box-like and ribs being horizontally elevated? Infants thoracic cage By age 10, ______ has the configuration of an adult. Ossification of ribs and sternum is complete by the age of 25 and with msucle stiffens the chest wall Ribs and sternum What is the chest wall made up of? skin fat skeletal muscles and bony muscles form over portion of the wall What is the function of chest wall? Cone shaped cavity contains vital organs To protect organs Ability to change shapes, facilitates breathing What is the parietal pleura lined with? Lining of the chest wall inner layer is lined with serious membrane What covers the lungs? Visceral pleura What is seperated by thin fluid layer? Pleural space Why is pleural space needed? To decrease friction/lubricate between parietal and visceral pleura How many pairs of ribs do we have? which ones are true? which ones are false? true ribs = first 7, connect directly to sternum false ribs = 8-10 floating ribs = 11 and 12 What muscles do we use for respiration? Active during resting breathing, 75% of the work is performed by diaphragm other 25% is by intercostal muscles What accessory muscles do we use for inspiration? scalene and sternocleidomastoids Scalene muscles lifts what while inspiration? Upper chest area and clavicle What muscles are used during expiration? abdominal muscles and ribs being pulled down by internal intercostal muscles What is the costophrenic angle or diaphragmatic angle? Where the parietal and pleura departs chest wall to diaphragm How many lobes are in the lungs? 2 in the left 3 in the right What are the lobes in the lungs seperated by and what are they called? Seperated by fissures Oblique fissures are in the bottom of the lobes Transverse or horizontal fissure in the top right lobe The pulmonary venous circulation delivers what TO which atrium? Oxygenated blood blood tTO the left atrium Pulmonary arterial circulation delivers what FROM which ventricle? Deoxygenated blood FROM right ventricle What is the reason for higher resistance in systemic circulation vs pulmonary respiration? Increased pressure = increased resistance Systemic circulation needs higher pressure because it travels a much longer distance How many places can the lungs get O2 from its own tissues? Alveoli/inspired gas Bronchial circulation from Left ventricle (oxygenated blood) What is the function of the lungs? Lung elasticity results from alveolar surface tension and elastic connective tissue What does the Hering-Breuer reflex do? Negative feedback Stretch receptors function to limit further stretch Probably inactive during further breathing Dust and foreign body in lungs are expelled through what? or how? Irritant reflexes Cough, sneeze, bronchospasms, hyperpnea, closing of glottis, vasovagal reaction (bradycardia), irritant reflexes What are some components of the Upper Respiratory Tract? URT Nasal cavities or nares Sinuses Oral cavity Pharynx Larynx What is the nasal cavity for? Humidifies air Filters air Warms air Gas exchange What are your four sets of sinues? Frontal Ethmoid Sphenoid Maxillary What is another name for the adam's apple? Thyroid cartilage What is the space between vocal cord? Glottis What is the function of sinuses? Reduce weight of head Strengthen skull Modify the voide during phonation What is the ideal breathing position for unconscious PT for intubation? "Sniff position" Neck extended back pulling jaw down What gland secretes along the airway? Bronchial gland What are the functions of mucus? Protects from irritants Protects from toxic particles Lubricates Prevents fluid/water loss What is the only purpose of conducting airwaysin the LRT? Convey gas from URT to area of gas exchange (lung parenchyma) What is the wave like or movement of cilia called? Mucocilliary escalator What mainstream bifurcates at carina? Bronchi the Right bronchus is at what angle or degree? why is it easier for foerign aspirate to get into? 20-30 degree angle What is the degree or angle of left bronchus? 45-55 degrees How many segments do the lungs have? 10 segments each What is the measure of anatomic deadspace? ~2 ml/kg of lean body weight, typically 150ml What are the 3 layers of the airway wall? mucosa submucosa adventitia What are the 2 functions of respiratory bronchioles? Conduct gas deeper in respiratory zone Participate in gas exchange What is the airway on terminal bronchi called? Conductivity airway = its for movement not respiration Terminal bronchi to alveoli is called? Acinus = functional of the lung What can impair cilliary movement? Smoke Drying of mucus Atropine The process of gas exchange is called? Diffusion (high pressure to low pressure) What part of the heart gives blood supply to lungs? Bronchial circulation and pulmonary circulation If the costrophrenic angle can not be seen in a chest x-ray, what does that mean? Pleural effusion = fluid in the pleural space