-
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.
-
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
|
|
