RET1485 The Respiratory System (Chp1)

What are the 3 main functions of the nose?

Filter out particles, warm inspired air, and saturate air with H20 vapor

How does the nose filter out particles?

Air hits the turbinates, hits the back of the nasopharynx, and the nasal hairs trap particles

The septum can what?

commonly deviate side to side causing trouble inserting suction cath

Turbinates do what?

Filter and humidify inspired air

Paranasal sinuses help with what?

production of sound

What drains into area between turbinates?

paranasal sinuses

Hard and soft palate do what?

separate oral and nasal cavity

What structure controls the flow of food and if potentially removed causes food to go into nasopharynx

Uvula

What structures are located to the side of the oral cavity? (children can have chronic infections because of these)

Tonsils

What's at the back of the tongue?

the gag reflex

What does the gag reflex do?

Induces vomiting

The pharynx starts and ends where?

From nasal cavities to where the trachea and esophagus start

Located behind nasal cavaties

NASOpharynx

Oropharynx from where to where?

Uvula to epiglottis

Part of pharynx from epiglottis to larynx

laryngopharynx

Larynx does what?

protects lower airways

the vocal chords are located where?

the larynx

What is the epiglottis?

A flat flap of cartilage that diverts food away from the trachea by opening and closing during swallowing

Epiglottis located where?

Base of tongue

What sits before true vocal chords and helps close off airway when generating pressure to cough?

false chords

What ligament can swell after intubation?

True chords

What is the opening between the vocal folds?

glottis

Function of the thyroid cartilage

Protection; Attachment site for vocal cords.

Adams apple is really what?

Thyroid cartilage

What is the only complete ring of cartilage in the larynx and trachea?

Cricoid cartilage

What is the narrowest part of the infant airway?

cricoid cartilage

What ligament is cut through for emergency opening of airway?

Cricothyroid ligament

Function of hyoid bone

Provides support to larynx

function of arytenoid cartilage

anchors and makes vocal cords open and close

Below the larynx starts what?

the lower respiratory tract

Where do the conducting airways begin?

The trachea

blood gas exchange occurs in what airway zone

respiratory zone

What is the shape of the cartilage around the trachea and why is it this shape?

C-shaped rings // they are c-shaped because the esophagus is directly behind the trachea if the cartilage went all around it'd be hard for food to get down the esophagus

At what anatomical point does the trachea end?

the carina

The carina is where what happens?

where the trachea divides into the left and right main stem bronchi

If you intubate a patient and only hear breath sounds out of one lung which lung would you probably hear and why?

You would only hear the right lung sounds // this is because the angle at which the right main bronchus separates from the carina is less than the left thus causing a more direct path from the trachea to the right side

Which mainstem bronchus contains 3 lobes (name them)

The right mainstem bronchus (right superior, middle, and inferior lobes)

the left mainstem bronchus contains how many lobes?

2 (left superior and inferior lobe)

Which lung fissure is seen in both the left and right lung?

The oblique

The right lung has how many fissures and name them

2 fissures // oblique and horizontal fissure

The oblique fissure in the right lung separates what lobes?

the right middle and right inferior lobes

The right superior lobe and right middle lobe are separated by what fissure?

The horizontal fissure

Name of fissure (only fissure) in the left lung and what does it separate?

Oblique fissure // separates left superior lobe and left inferior lobe

What are the 5 divisions of the bronchi in order?

1. mainstem bronchi, 2. lobar bronchi, 3. segmental bronchi, 4. subsegmental bronchi, 5. small bronchi

true or false: all 5 divisions of bronchi are in the respiratory zone of airway

False // they are all in the conducting airway

true or false: bronchi have complete rings of cartilage around them

True

true or false: bronchioles have cartilage

False

How much more cross sectional area do the bronchioles have compared to the trachea and how?

20x more cross sectional area because there are a lot of them, this helps decrease airway resistance

Where does the conducting airway end?

At the terminal bronchioles

What is another name for the respiratory zone?

Acinus

What makes up the acinus?

respiratory bronchioles, alveolar ducts, alveoli

Where is the primary site for gas exchange?

alveoli

true or false: the alveolar ducts have 10 attached alveoli

false, they have 16 alveoli attached

What surrounds the alveolar membrane?

an extensive capillary network

What are Type 1 cells and what do they do

Epithelial cells that form the alveolar membrane where gas exchange occurs

What do type 2 cells do?

produce surfactant

Surfactant does what?

Fluid that prevents alveoli from collapsing by decreasing surface tension in alveoli

What are the pores of kohn and what do they do

openings that connect one alveoli to another to help with cross ventilation

job of alveolar macrophages

to devour bacteria and other foreign material invading the alveoli

What system are the alveolar macrophages apart of

immune system

What can make it harder for oxygen to reach alveoli and how?

Fluid, through trauma and infections

What are the interstitial spaces?

Connective tissue between alveolar and capillary epithelium

What does heart failure do to the interstitial spaces?

fluid accumulation

What type of epithelium is in the mucosa of the respiratory tract?

pseudo-stratified ciliated columnar epithelium

What is pseudostratified ciliated columnar epithelium? (break down the name)

fake layer, ciliated, tall epithelium

How much mucus does a healthy person produce a day?

100ml

What does mucus do for the respiratory system?

traps foreign particles like dust and bacteria

true or false: mast cells produce mucus

false, goblet cells produce mucus

Cillia do what for the respiratory system?

constantly move mucus

What do mast cells contain and do?

They contain histamine, this histamine alerts the immune system to start working in the area

What is the role of the submucosal gland?

it is the major source of mucus secretion for the airway

Where does the parietal pleura attach?

inner surface of chest wall

What covers the lungs?

visceral pleura

Where does fluid also accumulate during heart failure?

the pleural "space"

What is fluid accumulation in the pleural space called

pleural effusion

What makes up the acinus? (in order)

respiratory bronchioles, alveolar ducts, and the alveoli

The sternum has how many parts name them

3, manubrium, body of sternum, and xiphoid process

The manubrium is what?

A major anatomical point where the angle of louis is and where the 2nd rib attaches

How many pairs of thoracic vertebrae?

12

What type of movement do the ribs have during inspiration and exhalation?

Movement up and down like a bucket handle, ribs go out for inspiration and in during expiration

7th and 8th ribs mark what?

where lungs end and where diaphragm is

What is the diaphragm

dome shaped flat muscle that is active during quiet breathing and exercise

true or false: left side of diaphragm sits higher then right side

false, the right side sits higher because of the liver

What sits on top of the left side of the diaphragm

heart

What type of pressure helps during exhalation and why

intra-abdominal pressure, when the diaphragm contracts it lays on and compresses the abd organs, once the diaphragm relaxes the abdominal organs help push air out because they are returning to their normal shape

Name all of the accessory muscles that help with inhalation

scalene muscles, sternomastoid muscles, and the pectoralis major

When are the accessory muscles used for respiration

During exercise, heavy breathing, or with patients that have chronic obstructive lung disease (COPD)

What happens to the diaphragm when a patient has COPD

The diaphragm stays in a flattened position because air becomes trapped constantly pushing the diaphragm down, this makes the next breath harder for the patient because they cannot generate negative pressure because the diaphragm is already flat

true or false: inhalation is usually passive

false, exhalation is passive

When does exhalation become active and how

exercise and COPD , the abdominal muscles will help push air out of lungs

What is generated inside the lungs when the diaphragm contracts and the ribs move outwards?

negative pressure

Negative pressure causes what

Causes air to move into the lungs due to the increased volume in the lungs and the low pressure caused by the diaphragm contracting and ribs moving outwards

Which nerve innervates the diaphragm?

phrenic nerve

Where does the phrenic nerve branch off

c3, c4, and c5

3, 4 , and 5 keep what alive?

the diaphragm alive

What drains fluid from the interstitial spaces (part of immune system)

lymphatic vessels

What is air accumulation in the pleural space called?

pneumothorax

You have encountered blood in the pleural space what is that called?

a hemathorax

Sinuses are named after what?

The bone they are near

How many sinuses do you have and name all of them

4, frontal sinus, ethmoid sinus, sphenoid sinus, and maxillary sinus