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141 Cards in this Set
- Front
- Back
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What germ layer forms the epithelial lining of the respiratory tract? |
Endoderm |
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What is the sulcus laryngotrachealis? |
A groove in the ventral lower pharynx that will develop into the lungs |
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What is the next step in lung development aft er the sulcus laryngotrachealis forms? |
The true lung promordium buds from the lower portion |
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What happens after the true lung promordium forms? |
It divides into two main bronchi, and the endodermal branches into the lobes |
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What cell is the precursor of ciliated epithelium and secretory cells in the pulmonary system? |
Cubic epithelium |
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What sinus drains into the nasal cavity? |
Maxillary |
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Which meatus contains openings of maxillary and ethmoidal sinuses? |
Middle meatus |
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What makes up the lateral walls of the nose? |
The conchae |
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Which concha is a separate bone and contains erectile tissue? |
The inferior concha |
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What are the four sinuses? |
1. Sphenoid 2. Frontal 3. Maxillary 4. Ethmoid |
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Wht arteries supply the nose? |
Anterior and posterior ethmoidal from the opthalamic artery
Sphenopalatine and greater palatine from the maxillary artery |
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What is the hayfever ganglion? |
The Pterygopalatine ganglion mandibular division of CN V |
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Describe the location of the larynx by bony landmarks |
It lies between the levels of the C3 - C6 vertebrae |
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The thyroid cartilage attaches to which cartilage? |
Cricoid |
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What is the working cartilage of the larynx? |
Arytenoid |
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Wht cartilage sitd atop the arytenoid cartilage? |
Corniculate cartilage |
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What is the space between the vocal cords called? |
Rima glottidis, or glottis |
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What is the overall source of the nerves to the larynx? |
CN X (vagus) |
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What is in the posterior mediastinum? |
Esophagus Descending aorta Azygous veins Thoracic duct Smypathetic trunk |
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What is in the superior mediastinum? |
Aortic arch Brachiocephalic veins Phrenic nerve Vagus nerve |
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Foreign objects are more likely to get caught in which lung? |
The right lung, because the right pulmonary bronchus is wider, shorter and more vertical ly oriented than the left |
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What are the subdivisions of the bronchial tree? |
Trachea -> principle bronchus -? lobar bronchus -> segmental bronchus -> terminal bronchiole -> respiratory bronchiole -> alveolar duct -> alveolar sac -> alveolus |
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What adheres lung to thoracic cage, diaphragm and pericardium? |
Parietal pleura |
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What is the thin layer over the lung called? |
Visceral pleura |
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What is it called when you get a loss of vacuum between the visceral and parietal pleura? |
Pneumothorax |
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What carries blood from aorta to lung tissue? |
Bronchial artery |
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What carries blood from lung tissue to azygous veins? |
Bronchial vein |
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What carries deoxygenated blood from right ventricle to alveoli? |
Pulmonary artery |
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What carries oxygenated blood from alveoli to left atrium? |
Pulmonary vein |
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What is the location of passage of bronchi, blood vessels and nerves? |
The hilum of the lung |
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Which lung has a horizontal fissure? |
the right |
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The cardiac notch is found in which lung? |
the left |
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What is the projection of the upper lobe of the left lung called? |
The lingula |
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What nerve innervates the lumgs? |
CN X (Vagus) |
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T/F: the pulmonary plexus is filled with autonomic nerve fibers that innervate the lungs? |
T. The pulmonary plexus is comprised of sympathetic and parasympathetic fiberst hat control the lungs |
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What constricts bronchioles? |
Parasympathetics |
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What dilates bronchioles? |
Sympathetics |
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What is in the anterior mediastinum? |
The thymus gland |
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What is in the middle mediastinum? |
The heart & pericardium |
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Quiet inspiration uses what to inhale? |
The diaphragm |
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Active inspiration uses what to inhale? |
Scalenes, external intercostals, SCM |
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Active expiration uses what to exhale? |
Rectus abdominus and internal intercostals |
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The elastic ability of the lungs to recoil on expiration is based on what two factors? |
1. Elastin 2. Surface tension |
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What describes a tissue's ability to distend, i.e. the ability of the lngs to expand? |
Compliance |
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What describes a tissue's ability to recoil? |
Elasticity |
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What do we have to overcome in order to inhale? |
Surface tension |
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What substance allows the body to overcome surface tension? |
Surfactant |
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When is the lung most likely to collapse? |
End exhilatory volumes |
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In describing the work of breathing, is rate work elastic or non-elastic? |
Non-elastic |
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In describing the work of breathing, is depth work elastic or non-elastic? |
Elastic |
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What describes work required to overcome air friction in the respiratory passages? |
Non-elastic work |
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The elastic work of the lungs has to overcome what two factors? |
1. The elastic nature of tissue 2. Surface tension |
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What happens with decreased compliance? |
It is harder to inflate the lungs |
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Histamine, leukotrienes and prostaglandins have what effect on lung airway passages? |
Bronchoconstriction |
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Sympathetic stimulation with release of Epi stimulates beta 2 receptors on bronchiole smooth muscle to do what? |
To relax, causing bronchodilation |
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The rate at which new air reaches the respiratory areas is known as what? |
Alveolar ventilation |
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The amont of air expired after quiet expiration is known as what? |
Tidal volume |
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Maximum inspiration followed by the measurement of the volume of air expired during maximum expiration is known as what? |
Forced vital capacity |
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A volume of air that fills the conducting passageways is known as what? |
Anatomical dead space |
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A volume of air in respiratory areas for which no gas exchange takes place is known as what? |
Physiological dead space |
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The amount of air expired after one second is measured as what? |
Forced expiratory volume at one second (FEV1) |
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Under what conditions do we get vasoconstriction? |
Stress Inhaled irritants
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The volume of air remaining in lungs after a forced expiration is known as what? |
Residual volume |
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What nerve innervates the diaphragm? |
Phrenic N |
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What respiratory center will spontaneously depolarize and allow for smooth breathing by sending signals to the phrenic nerve? |
The dorsal respiratory group |
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What sends out inhibitory signals to the dorsal respiratory group, slowing down depolarization levels and helping set final respiratory rate and pattern? |
The pneumotaxic centers |
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What sends signals to the accessory muscle groups, eading to forced or active breathing? |
Ventral respiratory groups |
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Where are the peripheral chemorecptors located? |
Aortic arch and carotids |
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To what are peripheral chemoreceptors sensitive? |
O2 levels |
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With decreased O2 levels, where does the peripheral chemoreceptor send its signal to increase the rate of breating? |
The dorsal respiratory group |
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Where are the central chemoreceptors located? |
IN the brain |
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To what are central chemoreceptors sensitive? |
CO2 levels |
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What will increased CO2 levels do? |
They will cause the body to increase rate and depth of breathing |
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What is the major control factor of breathing? |
CO2 levels |
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What factors affect diffusion across the respiratory membrane? |
1. Membrane thickness -> decreased diffusion 2. Partial Pressure differences 3. Surface area -- less SA + less diffusion |
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A concept that allows us to understand respiratory exchange when there is an imbalance between alveolar ventilation and alveolar blood flow is know as what? |
Ventilation/ perfusion ratio, which should be kept at 1, to match ventilation rate with blood flow |
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A situation where there id blod that is not being oxygenated (extra blood) due to decreased alveolar ventilation is known as what? (decreases the ratio) |
Physiological shunt |
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What disorders set up the physiological shunt? |
Lung dz, e.g. emphysema |
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A situation in which there is extra air but not enough blood to oxygenate is known as what? (increases the ratio) |
Physiological dead space |
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What disorders will contribute to physiological dead space? Which side of the ratio will they affect? |
Hyperventilation - increases alveolar ventilation
Pulmonary Embolism -- decreases blood flow |
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What three things affect the oxygen=hemoglobin dissociation curve? |
1. CO2 binding -> O2 dissociates from Hgb 2. H+ ions -> O2 dissociates from Hgb 3. Temperature -> O2 dissociates from Hgb |
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What are three ways CO2 is carried in the body? |
1. Dissolved in plasma (7%) 2. Inside RBC, bound to Hgb (23%) 3. In plasma as bicarbonate ion (70%) |
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How is respiration involved in acid-base balance? |
Via creation of bicarbonate, which acts as a buffer in the blood: CO2 + H2O -> H2Co3 -> H+ + HCO3- |
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In order to release CO2, what must lung tissue do? |
release it from bicarbonate |
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CO2 is bound with a H ion to form what? |
carbonic acid |
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What enzyme converts carbonic acid into water and CO2? |
Carbonic anhydrase |
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What is the structure of surfactant? |
It is a lipoprotein |
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Respiratory mucus is composed of what? |
95% H2O, which is mostly bound with a gel containing mucins, digestive enzymes, IgA, lysozmes, electrolytes, and metabolic waste |
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What role do mucins play in respiratory mucus? |
They protect and lubricate the tissue |
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What bacteria causes pneumonia in immunocompromised patients? |
Klebsiella pneumoniae |
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What causes whooping cough? |
Bordatella pertussis |
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What organism causes tuberculosis? |
Mycobacterium tuberculosis |
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What is the skin test for TB called? |
Mantoux skin test = PPV (purified protein derivative) = tuberculin test |
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What is the vaccine against TB called? |
BCG; Bacillus Calmette-Guerin |
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How is TB transmitted? |
By respiratory droplet |
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What kind of immune response does the body have to TB? |
Cell-mediated response; no antibodies are involved |
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What is TB infection that has spread to the blood called? |
Miliary TB |
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What organism causes many cases of walking pneumonia? |
Mycoplasma pneumoniae |
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What fungus can cause Status Asthmaticus? |
Aspergillus |
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What viral pathogen with over 41 antigenic types commonly causes pharyngitis and conjunctivitis? |
Adenovirus |
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What are the three main vectors for Adenovirus? |
1. Respiratory droplets 2. Fecal-oral routes 3. Direct fomite innoculation |
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What is allergic rhinitis? |
Type I immune reaction mediated by IgE, typicallg causing nasal discharge |
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What is epiglottitis? |
Life-threatening inflammation ot eh epiglottis, caused by H. influenzae |
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What are the Sx of epiglottitis? |
HIgh fever Drooling Inspiratory stridor Toxic appearance |
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What is the most common malignant tumor of the larynx? |
SCC |
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What condition is associated with vocal abuse and heavy cigarette smoking? |
Singer's nodule, a form of vocal cord polyps |
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What type of atelectasis is caused by a mass in the pleural cavity? |
Compression atelectasis, which causes compression of alveoli |
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What type of atelectasis results from Cystic Fibrosis or Adult Respiratory Distress Syndrome (ARDS)? |
Patchy atelectasis |
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How are chronic COPD diseases characterized? |
Physical or functional airflow obstruction |
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What are the four types of obstructive lung diseases? |
1. Emphysema 2. Chronic bronchitis 3. Bronchiectasis 4, Asthma |
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What is emphysema? |
A dz resulting from enlarged alveolar spaces and increased residual volume of the ling |
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What is the term associated with patients with emphysema? |
Pink Puffers; have to work to expel air from lungs |
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What is the clinical definition of chronic bronchitis? |
A productive cough occurring for at least three consecutive months over the course of two consecutive years |
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What is the term associated with patients with chronic bronchitis? |
Blue bloaters; cyanotic due to blockes airways and systemic edema |
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What is bronchiectasis? |
Permanent, abnormal bronchial dilation caused by chronic infection and resulting in abundant, purulent sputum and bronchial obstruction |
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What is extrinsic asthma? |
Childhood asthma that develops as a hypersensitivity reaction to allergens, involving IgE bound to mast cells |
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What is the problem in restrictive lung dz? |
Decreased lung volumes and decreased compliance from conditions affecting the interalveolar septa and connective tissue |
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What are some types of restrictive lung dz? |
Pneumoconiosis Sarcoidosis ARDS Hypersensitivity pneumonitis Goodpasture's Syndrome |
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What is ARDS? |
Respiratory failure from simultaneous pulmonary insults, including bacterial or viral pneumonia, sepsis, chest trauma, or fat embolism |
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Goodpasture's Syndrome is what type of Hypersensitivity reaction? |
Type II |
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What are the signs and symptoms of pulmonary thromboembolism? |
1. Dyspnea with tachypnea 2. Pulmonary HTN with right ventricular failure 3. Hyperventilation 4. Arterial hypoxemia 5. Pulmonary infarction |
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What is the #1 cause of immediate death? |
Death form pneumonia |
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What would you expect to find with bacterial pneumonia? |
Consolidation Chills and fever Productive cough Blood-tinged, rusty sputum Hypoxia SOB Pleuritic pain |
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What two other terms are used for primary atypical pneumonia? |
Walking pneumonia Interstitial pneumonia |
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10 - 15% of lung abscesses are associated with what condition? |
Bronchogenic cancer |
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What are common causes of viral pneumonia? |
Adenoviruses Influenza Rubeola Varicella Respiratory Syncytial virus (RSV)
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How does viral pneumonia present in the lungs? |
Patchy, unilateral or bilateral lobar involvement without consolidation, pleuritis, or pleural effusion |
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Where is histoplasmosis typically found? |
Mississipi and Ohio River valleys, where it is spread by wind, birds and bats |
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What does histoplasmosis mimic? |
TB |
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What is another name for coccidiodomycosis? |
San Joaquin Valley Fever |
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Where is coccidiodomycosis typically found? |
Southern CA, SW USA, Northern Mexico, parts of South America -- spread by wind, birds and bats |
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Patients with HIV infection may develop which type of pneumonia? |
Pneumocystis carinii pneumonia (PCP) = Pneumocystis jiroveci pneumonia (PJP) |
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What is the initial infection in TB called? |
Primary TB |
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What is found in primary TB? |
A Ghon focus, which is a single granuloma with caseous necrosis in the center and located near the pleura of one lung |
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How is primary TB detected? |
Positive reaction to a TB test |
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What occurs in secondary TB? |
10% of patients with primary TB develop granulomas that erode into the bronchi and bronchioles. TB may then be spread to others via aerosolized bronchial secretions |
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What is the most common cause of death from cancer worldwide and in the US? |
Malignant carcinoma of the lung |
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What causes 85% of all lung cancers? |
Cigarette smoking |
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What types of malignant neoplasms affect the lung? |
SCC Large and small cell carcinoma Adenocarcinoma Bronchial carcinoid |
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What types of lung tumors respond to chemotherapy? |
Small cell carcinoma only |
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What complications may occur with pneumothorax? |
Negative loss of pressure of the lung mady cause the mediastinum to shift and compress the other lung, creating a life-threatening situation |
