resp/urinary anatomy exam

respiration

ventilation of the lungs (breathing) that is accomplished by the respiratory system, which rhythmically takes in air and expels it from the body

respiratory system functions

• gas exchange: O2 and CO2 exchanged between blood and air

• communication: speech, laughing, crying

• olfaction: sense of smell

• acid-base balance: influences pH of body fluids by eliminating CO2

• BP regulation: by synthesis of angiotensin II

• blood and lymph flow: breathing creates pressure gradients

• platelet production: more than half of platelets are made by megakarocytes in lungs

• expulsion of abdominal contents: breath-holding assists in urination, defecation, and childbirth

nose

functions to warm, cleanse, and humidify air; also detect odor

nasal septum

vertical wall that divides nasal cavity

hard palate

forms floor and separates nasal cavity from oral cavity and allows you to breath while you chew food

vibrissae

stiff guard hairs that block insects and debris from entering nose

superior, middles, and inferior nasal conchae

project from lateral walls toward septum, creating a narrow chamber and subsequent air turbulence (ensures most air contacts mucous membranes to clean, warm, and moisten air)

respiratory epithelium

• consists of:

  • ciliated pseudostratified columnar epithelium

  • nested in epithelial cells are goblet cells that produce mucous

  • mucous traps inhaled debris; mobile cilia propel debris-ridden mucous posteriorly toward pharynx where its swallowed or spit out

the pharynx

muscular funnel extending from oral/nasal cavity to the larynx

three pharynx regions

nasopharynx, oropharynx, laryngopharynx

nasopharynx

superior to soft palate receives auditory tubes and contains pharyngeal tonsils

oropharynx

space between soft palate and epiglottis, and contains palatine tonsils

laryngopharynx

epiglottis to cricoid cartilage, where esophagus begins

larynx

• cartillaginous chambers (4cm long)

• responsible for phonation, aka voice box

• guarded by epiglottis

• primary function to keep food/drink out of airway

epiglottis

• at rest stands almost vertically

• during swallowing, extrinsic muscles pull larynx upward

• tongue pushes ______ down to meet larynx

• closes airway and directs food to esophagus behind it

3 large larynx cartilages

• epiglottic cartilage: spoon-shapes supportive palate in epiglottis

• thyroid cartilage: shield like w/ midline laryngeal prominence (adams apple)

• cricoid cartilage: ring-like; connects larynx to trachea

3 small larynx cartilages

• arytenoid cartilage - posterior to thyroid cartilage

• comiculate cartilage: attatched to arytenoid cargilage like a pair of horns

• cuneiform cartilages: sit atop arytenoids and support soft tissue between arytenoids and epiglottis

3 fibrous larynx ligaments

• thyrohyoid ligament: suspends larynx from hyoid

• cricothyroid ligament: susepends cricoid from thyroid cartilage

  • location of incision made in tracheotomy

• cricotracheal ligament: suspends trachea from cricoid cartilage

• collectively caleld the extrinsic laryngeal ligaments! bc they link larynx to other organs

superior vestibular folds

• no role in speech

• close larynx during swallowing

inferior vocal cords

• produce sound when air passes between them

• contains vocal ligaments

• stratified squamous epithelium

• glottis is the opening between the cords

how vocal cords produce sound

• intrinsic laryngeal muscles control the vocal cords by pulling on the corniculate and arytenoid cartilages, causing them to pivot. when they pivot, they cause the vocal cords to adduct and abducts, when air passes through them they vibrate and produce sound

• ADDUCT: high pitch, taunt

• ABDUCT: low pitch, slack

the trachea

• rigid tube, anterior to esophagus

• 16-20 c-shaped rings of hyaline cartilage

hyaline rings of trachea

• act to reinforce trachea and prevent collapse during inhalation

• opening in c rings faces posteriorly toward esophagus

• allow esophagus to expand as food passes by

• trachealis muscle spars opening in rings; contracts or relaxes to adjust airflow

the tracheal wall

• lined by pseudostratified columnar epithelium

  • mucous-secreting goblet cells, ciliated cells, and stem cells

• mucociliary escalator, a mechanism for debris removal

• middle tracheal layer

  • ct beneath tracheal epithelium

  • contains lymphatic nodules, muscous and serous glands, and the tracheal cartilages

costal surface

pressed against ribs

mediastinal surface

faces medially; toward heart

right lung

• 3 lobes

• inferior, middle, superior

• horizontal and oblique fissure

left lung

• 2 lobes

• superior and inferior

• oblique fissure

• cardiac impression

hilium

slit where lung recieves main bronchus, bv, lymphatics and nerves

bronchial tree

branching system of air tubes in each lung

right main bronchi

• gives off three lobar bronchi

• aspirated foreign objects lodge more in _______ than left, because its wider and more vertical

left main bronchi

• gives off to lobar (secondary) bronchi

• in both lungs, lobar bronchi divide into 8-10 segmental (tertiary) bronchi

histology of bronchial tree

• epithelium - ciliated pseudostratified columnar epithelium

• mucous glands and lymphocytes nodules act to intercept pathogens

• elastic ct acts in recoil that expels air during expiration

bronchioles

• continuations of airways that lack cartilage and have ciliated cuboidal epithelium

  • well-developed layer of smooth muscle

  • each one divides in to 50-80 terminal ______

terminal bronchioles

• no muscous glands/goblet cells

• have cilia that move muscous draining into them back by muscociliary escalator

• gives off 2+ respiratory ______

  • these divide into 2-10 alveolar ducts

trachea, main bronchi, secondary bronchi, tertiary bronchi, smaller branches, bronchioles, terminal bronchioles, respiratory bronchioles, alveolar ducts, alveoli

flow of air

squamous type 1

cell that is directly involved in gas exchange

great type 2

repair alveolar epithelium, secrete pulmonary surfactant, preventing collapse with exhalation

alveolar macrophage

dust cells that keep alveoli free from debris by phagocytizing dust particles

visceral pleura

forms lung inner surface

parietal pleura

adheres to mediastinum, inner surface of rib cage, and superior diaphragm

pleural cavity

potential space between plurae

pleura function

• reduction of friction

• creates pressure gradient between atmosphere and lungs

• creates compartment that prevents spread of infection from one organ in mediastinum to other

respiratory muscles

change lung volume and create differences in pressure in relation to the atmosphere

diaphragm

prime mover of respiration accounts for 2/3 of airflow

internal and external intercostal muscles

synergists to diaphragm

ventral respiratory group

primary generator of the respiratory rhythm of 8-12 breaths per minute

dorsal respiratory group

modifies the basic respiratory rhythm after recieving info from chemo and stretch receptors

pontine respiratory group

recieves input from HBCs and sends input to both VRG and DRG, adapting breathing to special circumstances such as sleep, exercise, vocalization and emotional responses

intrapulmonary pressure

that within alveoli

intrapleural pressure

slightly negative pressure that exists between the out parietal and inner visceral pleural layers, within the pleural cavity, filled w/ pleural fluid

equal

at rest, the intrapulmonary pressures are ____, and there is no airflow

steps to inspiration

• when the ribs swing upward and outward during inspiration, the parietal pleura follows them

• the visceral pleura clings to it by the cohesion of water and it follows the parietal pleura

• alveoli within the lungs are stretched

• so, the entire lung expands along the thoracic cage

• as lung increases in volume, its internal pressure drops below ambient atmospheric pressure, and air flows in

• warming of inhaled air also contributes to expansion

two factors that determine airway resistance

diameter of bronchioles, pulmonary compliance

bronchodialation

• increase in diameter

• epinephrine and sympathetic stimulation increase airflow

bronchoconstriction

• decrease in diameter

• histamine, parasympathetic nerves, cold air, and chemical irritants decrease airflow

pulmonary compliance

• ease of which the lungs can expand, reduced in diseases in which the lungs are stiffened by scar tissue

• compliance is limited by the surface tension of the water film inside alveoli, increasing stickiness of alveolar walls too much

  • SOLUTION: pulmonary surfactant. it reduces surface tension and improves compliance

  • take home idea: PULMONARY COMPLIANCE IS PROPORTIONAL TO FLOW

anatomical dead space

the volume of air within the respiratory system's conducting airways (nose, mouth, trachea, bronchioles) that does not participate in gas exchange

spirometry

clinical measurement of pulmonary ventilation

partial pressure

if a contained is filled with more than one gas, each exerts its own pressure. that pressure is this

o2 transport

• 98.5% bound to hemoglobin

• 1.5% dissolved in plasma

• when o2 bound to hemoglobin = oxyhemoglobin

• when 100% saturated - 4 o2 - 1 hgb

• 75% - 3o2 - 1 hgb

co2 transport

• 90% is hydrated to form carbonic acid

• 5% bound to proteins

• 5% dissolved as gas in plasma

kidney functions

• filter blood and excrete toxic metabolic wastes

• reg blood volume, pressure, and osmolarity

• reg electrolytes and acid-base balance

• secrete EPO, which stims the prod of RBC

• help reg ca+ lvls through calcitrol synthesis

• clear hormones from blood

• in starvation, they synthesize glucose from aa

metabolic waste

• waste substances produced by the body

  • major sources:

  • 50% urea

  • uric acid

  • creatine

  • BUN measures lvl of nitrogenous waste in blood

excretion

• separating wastes from body fluids and eliminating them

  • respiratory

  • integumentary

  • digestive

  • urinary

kidney position, size, and shape

• position: posterior abdominal wall T-12 to L3, right lower than left

• size: bar of bath soap

• shape: convex lateral surface; convex medial surface w/ hilium that gets bvs, lymphatics, and ureter

• enclosed in fascia, fat and fibrous capsule

renal columns

extensions of cortex that project inward toward sinus

renal pyramids

6 to 10 conical structures with broad base facing cortex and renal papilla facing sinus

lobe of kidney

one pyramid and its overlying cortex

minor calyx

cup that nestles the papilla of each pyramid; collects its urine

major calyces

formed by convergence of 2 or 3 minor calyces

renal pelvis

formed by convergence of 2 or 3 major calyces

ureter

a tubular continuation of the pelvis that drains urine down to the urinary bladder

renal a, segmental a, interlobar a, arcuate a, interlobular (cortical radiate) a, afferent arterioles, glomerulus, efferent arteriola, pertitubular capillaries, interlobular v, arcuate v, interlobar, renal v

renal blood circulation (RSIAIAGEPIAIR)

vasa recta

in the medulla, the efferent arterioles give rise to this. its the capillary bed supplying the nephron loop

peritubular capillaries

branch off the efferent arterioles supplying the tissue near the glomerulus

nephron

• functional unit of the kidney

  • two principal parts

  • renal corpuscle: filers blood plasma

  • renal tubule: converts filtrate to urine

renal corpuscle

• glomerulus

• glomerular capsule: encloses glomerulus

  • parietal outer layer: ss epithelium

  • visceral inner layer: podocytes

renal tubule

• duct leading away from glomerular capsule

• four regions

  • pct

  • nephron loop ayyyy *descending/ascending limb)

  • dct

glomerular capsule, pct, nephron loop, dct, collecting duct, papillary duct, minor calyx, major calyx, renal pelvis, ureter, urinary bladder, urethra

flow of fluid from the point where the glomerular filtrate is formed in the renal tubule to the point where it leaves body (GPNDCPMMRUUU)

renal plexus

• nerves and ganglia wrapped around each renal artery

  • sympathetic stim —> reduces glom blood flow and urine prod

    • additional role to respond to falling bp by stim kidneys to secrete RENIN

four stages of urine conversion (from blood plasma)

• glomerular filtration

• tubular reabsorption

• tubular secretion

• water conservation

glomerular filtrate

the fluid in the capsular space; like blood plasma except it has no protein

tubular fluid

fluid from the pct through the dct; substances have been removed or added by tubular cells

urine

fluid that enters the collecting duct; undergoes little alteration beyond this point except for changes in water content

glomerular filtration (step 1)

process by which water/solutes in blood plasma pass from glomerular capillaries into capsular space of nephron

podocytes

spider-like blood capillaries that from the visceral layer of the glomerular capsule (has ARMS and FOOT PROCESSES, and FILTRATION SLITS dafuggg??? bro dis a monster)

filtration membrane three barriers

1. fenestrated epithelium of capillary pores

2. basement membrane

3. filtration slits of FOOT PROCESSES (aka monster)

three pressures through gfm

1. blood hydrostatic pressure

2. colloid osmotic pressure

3. capsular hydrostatic pressure

glomerular filtration rate

• amount of filtrate produced

• 99% of filtrate is reabsorbed (wahhhh????)

• gfr too high = dehydration/electrolyte depletion

• too low = wastes are reabsorbed

  • chronic = kidney disease

gfr regulation

1. renal autoregulation

   • myogenic

   • tubuloglomerular

2. sympathetic

3. hormonal

   1. renin

renin-angiotensin-aldosterone mechanism

• drop in bp - baroreceptors alter symp ns

• sympathetic fibers release renin —> results in angiotensin that raises bp

• constriction of art bv stimulates aldosterone release, which increases nacl and h20 retention in nephron

tubular reabsorption and secretion (step 2)

• occurs through pct to dct

• tubular fluid is modified

• OCCURS ALONG ENTIRE RENAL TUBULE

  • renal tubule extracts waste chemicals from blood and secretes them in

pct reabsorption

• this reabsorbs 65% of glomerular filtrate

  • na+, glc, k+, cl-, h2o, urea, uric acid

  • na+ creates steep gradient that drives reabsorption

  • transcellular and paracellular

salinity gradient

• generated by nephron loop

• enables collecting duct to concentrate the urine and conserve water

• needed bc tubular fluid is still dilute in dct

concurrent multiplier

• feedback mechanism

• this is how nephron loop maintains osmotic gradient

• descending loop - h2o only, not nacl

• ascending loop - na, k, cl only, not h2o

h2o conservation in collecting duct

• collecting duct reabsorbs water which concentrates urine x4!! (crazy girl!)

  • tissue fluid osmolarity 4x higher in medullary cd than in cortex

  • medullary portion of cd more permeable to water than solutes

adh role

• acts upon permeability of medullar collecting duct epithelial cells to water by upregulating aquaporins

  • dont drink water —> adh increase

  • drink lots —> adh decrease

normal urine volume

1-2 liters per day

polyuria

• urine output in excess of 2L per day

• body can’t maintain safe, low concentration of water in plasma

  • leads to AZOTEMIA - elevated nitrogenous waste in blood