AP Respiratory

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tiffanydawnn
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74159
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AP Respiratory
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2011-03-21 23:27:26
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AP Respiratory
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AP Respiratory
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  1. respiratory system
    • made of all organs that move air in and out of the lungs
    • grouped by structure and function
    • structures: URT and LRT
    • functions: conducting and gas exchange
  2. upper respiratory tract
    nose and throat (pharynx)
  3. lower respiratory tract
    larynx, trachea, bronchial tree, lungs
  4. conducting division
    all tubes that move air in and out of lungs
  5. gas exchange division
    • aka respiratory division
    • terminal branch of duct system where O2 and CO2 move between air sacs and blood
  6. nose
    • 2 divisions: internal and external
    • 3 functions: modify sound for speech, smell via olfactory receptors, incoming air filtration, warming, moistening
  7. external nose
    • nasal bone and hyline cartilage covered with skin
    • lined with hair
    • 2 external openings (nostrils)
  8. internal nose
    • 2 nares: internal opening that contact throat
    • 4 paranasal sinuses: cavities in bone that make it lighter
    • openings for lacrimal ducts
    • lateral walls: ethmoid, maxilla, inferior nasal concha
    • floor: palatine bone
    • septum: divides nose in 2
    • posterior septum: vomer bone
    • anterior septum: hyline cartilage
  9. pharynx
    • funnel shaped passage
    • begins at base of skull
    • ends at C6
  10. nasopharynx
    • above soft palate
    • passageway for air
    • pseudostratified ciliated columnar ET
    • 2 openings into nose and 2 openings into Eustachian tube
  11. Eustachian tube
    connects nasopharynx to middle ear
  12. oropharynx
    • behind mouth between soft palate and hyoid
    • stratified squamous non-keritinized ET
    • passageway for food and air
  13. laryngopharynx
    • between hyoid and larynx
    • stratified squamous non-keritinized ET
  14. larynx
    • voice box
    • connects pharynx to trachea
    • located at C6
    • phonation: voice production
    • helps keep airway open
    • channels food and air into proper tubes
    • 6 cartilages: thyroid cartilage, epiglottis, cricoid, arytenoid, corniculate, cuneiform
  15. thyroid cartilage
    • Adam's apple
    • front part of larynx
  16. epiglottis
    flexible spoon like structure that covers trachea when food is swallowed
  17. cricoid
    • ring of cartilage that forms inferior larynx
    • landmark for trachs
    • used to intubate
  18. arytenoid
    paired cartilage that attaches to vocal cords to help them move
  19. corniculate
    paired cartilage that attaches to arytenoid to indirectly move vocal cords
  20. cuneiform
    help support vocal cords and epiglottis
  21. glottis
    space inside larynx
  22. vocal cords
    • 2 string like structures that run through glottis
    • speech is produced as air crosses cords
    • tight cords: high sounds
    • loose cords: low sounds
  23. trachea
    • windpipe
    • 4" long
    • kept open by C-shaped rings of hyline cartilage
    • lined with pseudostratified ciliated columnar ET w goblet cells
  24. carina
    inferior trachea before split into bronchial tree
  25. bronchial tree
    • primary bronchus: one per lung
    • secondary bronchus: one per lobe (3 R, 2L)
    • tertiary bronchus: one per segment (10 per lung)
    • all kept open by cartilage
  26. bronchioles
    • hundreds
    • first place in tree where cartilage disappears - could collapse
  27. respiratory bronchioles
    • thousands
    • tissue changes to simple squamous ET
    • gas exchange first begins
  28. alveoli
    • microscopic grape-like structures that form terminal branch of duct system
    • simple squamous ET
    • major site of gas exchange in the.body
    • 3 types of cells: squamous pulmonary ET type 1, alveolar septal cells type 2, alveolar macrophages
  29. squamous pulmonary ET type 1
    • largest cells
    • form alveolar wall
    • site of gas exchange
  30. alveolar septal cells type 2
    produce surfactant
  31. alveolar macrophages
    phagocytes that remove dust and bac from lungs
  32. surfactant
    • gooey liquid that reduces surface tension in the lungs
    • allows alveoli to expand
  33. left lung
    • 2 lobes - superior and inferior
    • separated by oblique fissure
    • smaller than right
    • contains cardiac notch (where heart rests against lung)
  34. right lung
    • 3 lobes - superior, medial, inferior
    • horizontal fissure: separates superior and medial lobes
    • oblique fissure: separates medial and inferior lobes
  35. capula
    top of lung
  36. base
    bottom of lung
  37. mediastinum
    mass of tissue between lungs
  38. hilus
    where bronchial tree enters lungs
  39. pressures
    • 3 pressures control breathing
    • atmospheric pressure
    • intrapulmonic pressure
    • intrapleural pressure
  40. atmospheric pressure
    760 mmHg at sea level
  41. intrapulmonic pressure
    • pressure inside the lungs
    • not breathing:760
    • inhale: 757
    • exhale: 762
  42. intrapleural pressure
    • pressure inside the pleural space
    • must always be less than AP and intrapulmonic
    • approximately 756
  43. atelectasis
    any condition that equalizes pressures and causes collapsed lung
  44. pneumothorax
    air in the pleural cavity
  45. Boyle's law
    • explains how air moves in and out of lungs
    • pressure of a gas in a closed container is inversely proportional to volume of container at constant temp
  46. inhalation
    • active process involving skeletal muscle contraction
    • body needs O2 - phrenic nerve contracts diaphragm down and intercostal nerves contract intercostal muscles up - thoracic cavity enlarges
    • lungs expand - pressure drops - pressure gradient causes air to move in
  47. exhalation
    • passive process involving elastic recoil of lung tissue
    • as lungs recoil, slightly smaller than original size - intrapulmonic pressure greater than AP - air moves out down gradient
  48. compliance
    • how easily the lungs and thoracic wall expand
    • high compliance - easy
    • low compliance - difficult
  49. airway resistance
    friction encountered by air as it moves through tube system
  50. spirometer
    device used to measure volumes and capacities
  51. tidal volume
    • amt of air inhaled / exhaled during quiet breathing while resting
    • 500 ml
  52. minute respiratory volume
    • volume per minute
    • 6000 ml
  53. dead air volume
    • amt of air that remains in tube system and does not participate in gas exchange
    • 150 ml
  54. inspiratory reserve volume
    • max amt of air that one can inhale after normal inspiration
    • 3100 ml
  55. expiratory reserve volume
    • max amt one can exhale after normal expiration
    • 1200 ml
  56. residual volume
    • amt that remains in lungs after ERV
    • 1200 ml
  57. minimal volume
    • amt in lungs after collapse
    • variable
  58. vital capacity
    • max amt exhaled after max inhale
    • = TV + IRV + ERV
    • 4800 ml
  59. inspiratory capacity
    • total amt that can be exhaled
    • = TV + IRV
    • 3600 ml
  60. functional residual capacity
    • amt of air that stays in the lungs after normal exhale
    • = ERV + RV
    • 2400 ml
  61. total lung capacity
    = TV + IRV + ERV + RV
  62. gas exchange
    • by simple diffusion
    • explained by Dalton's Law
  63. Dalton's Law
    • in a mix of gases, each individual gas exists independently
    • each gas has its own pressure
    • sum of all partial pressures = total pressure of mix
    • pO2 = 160 in air (21%)
    • p explains diffusion of O2, CO2 between alveoli/DOB and OB/tissues
    • gases move from greater to lesser p
  64. external respiration
    • diffusion of O2/CO2 across alveolar capillary membrane
    • occurs between alveoli and pulmonary blood capillaries (DOB)
    • converts DOB to OB
    • inhale pO2 = 160
    • alveolar pO2 = 104 / DOB pO2 = 40
    • alveolar pCO2 = 40 / DOB pC02 = 45
  65. external respiration factors
    • AC membrane microthin with huge surface area
    • millions of pulm capillaries with extensive branches (lots of blood)
    • p concentration gradient (easy diffusion)
    • gases travel short distance
  66. TB
    • alveolar walls thick and fibrous
    • filled with bacteria
    • trouble inhaling, exhaling, gas exchange
  67. emphysema
    • alveolar walls erode
    • 99% due to smoking
    • trouble with exhaling, gas exchange
  68. internal respiration
    • exchange of O2/CO2 between systemic blood capillaries and body tissues
    • OB pO2 = 104 / tissue pO2 = 40
    • OB pCO2 = 40 / tissue pCO2 = 45
  69. Henry's Law
    • the ability of gas to dissolve in a solution depends on its p and its solubility coefficient
    • explains O2/CO2 transport
  70. solubility coefficient
    • determines how easily a gas dissolves
    • high SC: dissolves quickly and easily
    • low SC: dissolves slowly with difficulty
    • O2/CO2 have low SC - do not dissolve well in plasma
    • CO2 higher SC than O2
    • O2: diffuse into RBC (attaches to heme)
    • CO2: floats in plasma as HCO3- ions
  71. hyperbaria
    pressure greater than 1 atm (760 mmHg)
  72. hyperbaric chamber
    • contains O2 at a p greater than 160
    • forces more than normal amount of O2 into blood
    • used to treat CO poisoning, gangrene, tetanus (anerobic bac)
  73. scuba diving
    • ex. of Henry's Law
    • constantly breathing under hyperbaric conditions
    • when descending, pressure of all gasses increases
    • nitrogen is dangerous b/c SC is 0 - causes bubbles in the blood
    • divers must surface slowly so bubbles can release in the lungs
    • causes the bends, decompression sickness, nitrogen narcosis
  74. O2 transport
    • 100ml OB contains 20ml O2
    • 1.5% dissolves in plasma
    • 98.5% diffuses into RBC (attaches to heme)
    • forms H-bond with iron
  75. alloesteric cooperativity
    • O2 attaches one at a time
    • each subsequent attachment is easier
  76. fully saturated Hgb
    • all Hgb bound to O2
    • called oxyhemoglobin (HgbO2)
    • occurs in lungs and OB
  77. partially saturated Hgb
    • combination of HgbO2 and Hgb
    • occurs in DOB and tissues
  78. deoxyhemoglobin
    no Hgb bound to O2
  79. hemoglobin disassociation curve
    • % saturation of O2
    • all metabolically active tissues at rest need and use O2 and as a by-product of metabolism, produce CO2, heat, acid, BPG
    • normal is homeostasis
  80. curve shifts right
    • tissue more active, requires more O2
    • more O2 released from Hgb
    • increased CO2, temp, 2-3 BPG, acid
    • Bohr effect
  81. curve shifts left
    • tissue less active, requires less O2
    • less O2 released from Hgb
    • decreased CO2, temp, 2-3 BPG, acid
    • Haldane effect
  82. BPG
    produced as RBC breaks down glucose for energy
  83. CO2 transport
    • major role in acid-base balance
    • 100ml DOB contains 5ml C02
    • carried in blood 3 ways
    • 7% dissolves in plasma (diffuses easily in lungs)
    • 23% enters RBC (carbaminohemoglobin)
    • 70% carried in plasma as HCO3-
  84. carbaminohemoglobin
    • HgbCO2
    • CO2 attached to globin
    • occurs in tissues and DOB
  85. chloride shift
    • HCO3- enters RBC, immediately diffuses back into plasma
    • at same time, Cl- ions move from plasma into RBC
    • exchange of negative ions is critical to maintain electrical balance
  86. carbonic anhydrase
    enzyme that controls initial formation of HCO3- ions
  87. nervous control of resp
    controlled by MO and pons
  88. medullary rhythmicity area
    • in MO
    • controls rhythm of breathing
    • contains origin of phrenic and intercostal nerves
    • 2 sec inhalation, 3 sec exhalation
  89. pneumotaxic
    • in upper pons
    • stops inhalation to prevent lung overinflation
    • coordinates smooth transition between inhale/exhale
  90. apneustic
    • in lower pons
    • coordinates smooth transition between inhale/exhale
    • allows for breath holding
  91. hering-brewer reflex
    large group of stretch receptors that prevent lung overinflation
  92. apnea
    temporary stop in breathing
  93. eupnea
    normal breathing
  94. dyspnea
    difficult and painful breathing
  95. hyperpnea
    rapid breathing
  96. hypoxia
    O2 levels in tissues reduced due to clogged blood vessels or breathing issues
  97. anoxia
    no O2 to tissues due to breathing issues or completely clogged vessels
  98. respiratory acidosis
    • blood pH < 7.35 b/c of hypoventilation
    • slow, shallow breathing
  99. respiratory alkalosis
    • blood pH > 7.45 b/c of hyperventilation
    • rapid breathing

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