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89 Cards in this Set
- Front
- Back
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What is the Primary Function of the Respiratory System?
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absorbtion of O2 and excretion of CO2
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What is Internal Respiration?
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Gas exchange between the tissue cells and the systemic capillary blood
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What is External Respiration?
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absorption of O2 and excretion of CO2
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What are the secondary functions of the respiratory system?
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Filters both inhaled contaminants
Filters small clots or chemicals from blood Humidification of inspired gases Smell and Speech |
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Lungs (shape and sides)
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Shape: Cone-shaped, sponge-like
Sides: Apex, Base(concave, rest on diaphragm, and the right is higher than the left to accommodate the liver), Costal, Medial (concave to allow space for heart and blood vessels) |
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Which lung is larger?
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Left is larger than the right
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The Lung elasticity results from which three things?
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alveolar surface tension
elastic tissue connective tissue |
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How many lobes does each lung have? and what divides them?
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Left: Two lobes(upper, lower) separated by the oblique fissure
Right: Three lobes(upper, middle, lower) separated by the transverse and oblique fissures |
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Hilum
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Center of the mediastinal border where the main stem bronchi, blood vessels, lymph vessels, and various nerves enter and exist the lungs
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How many segments are in each lung?
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Left: 8
Right: 10 |
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Visceral Pleura
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lining that covers the lung
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Parietal Pleura
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Lining that lines the thoracic cavity
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Potential Space, What makes it negative?
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space between the visceral and parietal pleura
acts as lubricant decreasing lung friction Ribs tend to pull outward and lungs tend to collapse |
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Costophrenic Angle
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formed where the parietal pleura departs chest wall to diaphragm
angle at the costal side and base of the lung. When fluid builds up it makes the angle obtuse and indicates pt is developing a disease or pneumonia |
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What are the Thoracic landmarks
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Anterior: Right/Left Midclavicular, Midsternal
Lateral: Anterior Axillary, Midaxillary, Posterior Axillary Posterior: Right/Left Scapular, Midspinal |
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Chest Wall contains what vital organs and what is its function?
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Contains: heart, lungs, esophagus, trachea, mainstem bronchi
Function: Protect organs, facilitates breathing |
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How many vertebrae are in the cervical, thoracic, and lumbar regions?
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Cervical: 7
Thoracic: 12 Lumbar: 5 |
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How many ribs are there?
Which are true ribs, false ribs, and floating ribs? |
12 pairs of ribs
1-7 are true ribs 8-10 are false ribs(bc they connect to cartilage) 11-12 floating ribs (no anterior attachment) |
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Rib Movement: Rib 1
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raise slightly, pulls sternum up increasing AP diameter
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Rib Movement: Ribs 2-7
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Move in two directions:
Pump Handle: Increases AP diameter Bucket Handle: Increases Lateral space |
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Rib Movement: Ribs 8-10
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similar to rib movement of 2-7 however slight reduction of AP diameter while increasing lateral space
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Pump Action
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Increases AP diameter
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Bucket Handle
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Increases Lateral Space
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Diaphragm: Basics
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Dome shaped muscle(2 hemidiaphragms)
does 75% of the work during breathing Active during resting breathing Relaxation results in exhalation(passive) |
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Diaphragm: Excursion, Hyperinflation, Prolonged Contraction
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Excursion: Normal 1-2cm; max during inspiration may be 10cm
Hyperinflation: Flattens dome shape, Contraction decreases AP diameter and increases work of breathing, seen in severe asthma and COPD pt's Prolonged Contraction: aids in compression of abdomen for vomiting, coughing, defecation, parturition |
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Intercostal Muscles
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External and Internal
Between all ribs Accessory muscle for inspiration Prevent intercostal spaces from bulging during ventilation |
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Scalenus Muscles
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Accessory muscle of Inspiration
Function: to flex neck Elevates ribs one and two |
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Sternocleidomastoid Muscle
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Accessory muscle of Inspiration
Raises upper ribs |
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Pectoralis Major/Minor
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Accessory muscle of Inspiration
Lifts upper chest wall |
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Trapezius Muscle
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Accessory muscle of Inspiration
Elevates thoracic cage normally rotates scapula, raise shoulders, and abduct and flex arms |
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Accessory Muscles of Inspiration
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Internal/External Intercostals
Scalenus Muscles Sternocleidomastoid Muscle Pectoralis Major/Minor Trapezius Muscle |
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Exhalation
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passive at rest- uses lungs elastic properties, no energy expended, during resting exhalation only muscles used are abdominal
During exercise- muscle contractions increases in speed. ribs pulled down and together by intercostal muscles. considered to be forced |
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Accessory Muscles of Exhalation
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Intercostal Muscles
Abdominal Muscles: Rectus abdominus, Transverse abdominus, Internal Obliqie, External Oblique, |
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Abdominal Muscles
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Causes forced expiration
Pull down on thorax OR stabilizes thorax so other muscles can pull down thorax OR constricting/compressing the diaphragm |
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Upper airway is composed of:
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Nasal cavities and Sinuses
Oral Cavity Pharynx Larynx |
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Functions and Boundaries of the Upper airways
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Functions: Heating/cooling inspired gases
Filtering inspired gases Humidification of inspired gases Olfaction Phonation Conduction of gases for ventilation Boundaries: From the Nose to the Vocal Chords |
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Nasal Cavity
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Consists of Nasal, Maxilla Bones and 5 cartilages
Contains 3 seperate functional regions: Vestibular Region, Olfactory Region, Respiratory Region |
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Nasal Cavity: Vestibular Region
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contains gross hairs that act as a filter
Stratified squamous lining |
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Nasal Cavity: Olfactory Region
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Contains Olfacctory(smell) cells
Cell lining transitions |
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Nasal Cavity: Respiratory Region
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Contains Turbinates Conchae(Three shelf-like bones(superior,middle,inferrior) projecting from lateral walls
Function: increase surface area for filtering, warming, and humidifying inhaled gases Turbulent flow to aid filtering Lined with pseudostratified ciliated columnar epithelium |
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Sinuses (basics, function, sets)
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Hollow spaces in facial bones
Function: Reduce weight of head, strengthen skull, modify voice (main organ influencing speech) Four sets: Frontal, Ethmoid, Sphenoid, maxillary |
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Oral Cavity
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Forms common passage for air,food and fluids
Posterior portion of tongue contain nerve endings that trigger gag reflex to help protect airway |
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Pharynx
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Oral and nasal cavities open up into pharynx
Three sections: Nasopharynx, Oropharynx, and Laryngopharynx |
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Nasopharynx
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Posterior portion of nasal cavity to the soft palate
adenoid lie right where many particles impact Eustachian tubes link to middle ear |
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Oropharynx
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From soft palate to base of tongue
Contain Palatine tonsils(removed in tonsillectomy) |
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Laryngopharynx
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Base of tongue to esophageal entrance
location where the respiratory and digestive tracts divide |
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Larynx
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Contains 9 Cartilages: Thyroid(adams apple), Cricoid (falls just below thyroid), Epiglottis(attaches to thyroid cartilage, w/ thyroid-closes laryngeal opening during swallowing)
Key landmark for intubation |
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Patent Upper Airway
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affected by postions of oral cavity, pharynx, larynx
Head titlting forward can cause partial or total occlusion Extend head into "sniff position" to open airway and facilitate artificial airway insertion |
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Lower Respiratory Tract
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Everything Distal to Larynx
Made up of Conducting(zones 1-19) and Respiratory(zones 20-28) airways 28 Generations Function: Move air in and out, external expiration(gas exchange) |
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Lower Airway: Conducting Zone
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First 19 generations
Purpose is to convey gas from URT to the area of gas exchange (Lung parenchyma) and heat, humidify, and filter gases |
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Lower Airway: Respiratory Zone
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Generations 20-28
Microscopic airways distal to conducting zone Participate in gas exchange with the blood |
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Trachea and Bronchi
Generation:0 |
Extends from cricoid cartilage to the point of bifrucation(splitting)
Anterior to the esophagus Lined with pseudostratified ciliated columnar epithelium(Respiratory epithelium) and contains goblet cells |
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Trachea and Bronchi
Generation: 1 |
Where the right and left mainstem bronchi bifurcate(split) at carina
Not symmetrical when splitting Right bronchus branches at a 25degree angle (lesser angle means most foreign aspiration goes to the right lower lobe, also if intubation is inserted too far it will go into the right lobe) Left bronchus branches at 40-60degree angle Respiratory epithelium |
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Trachea and Bronchi
Generation 2 |
aka Lobar Branch
One for each lobe of lung (3-right/2-left) Respiratory epithelium |
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Trachea and Bronchi
Generation 3 |
18 total segmental bronchi: 10 right, 8 left
Cartilage rings become less regular in size and shape Respiratory epithelium |
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Trachea and Bronchi
Generations 4-9 |
Subsegmental Bronchi
Become progressively smaller 1-4mm Cartilage becomes irregular pieces Respiratory epithelium but # of goblet cells and submucosal glands decrease significantly Connective tissues surrounding airways decreases and disappears |
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Bronchioles
Generations 10-15 |
Anything below generation 9 becomes bronchioles
about 1mm in diameter Cartilage and Connective tissue is now gone Airway patency is now dependent on smooth, elastic, and fibrous tissues(pressure in thoracic cavity affects airway patency now) Respiratory epithelium(cells bein to shorten) |
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Bronchospasms
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Caused when the smooth muscle of the bronchioles contracts, closing airway
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Bronchioles
Generations 16-19 |
Final airways of conducting system
0.5mm diameter Epithelium becomes cuboidal and loses cilia Clara cells appear Canals of Lambert appear |
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Clara Cells
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Produce mucous and surfactant
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Canals of Lambert
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Connecting tubes to terminal bronchioles
provides equalization of the pressue and volume Uses collateral ventilation |
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Bronchioles
Generation 20-23 |
First level of gas exchange with capillary(small amounts of exchange)
Occasional aveoli on walls Small cuboidal lines airways/aveoli is lined with simple squamous 1-2 cells thick for easier gas exchange |
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Alveolar Ducts and Sacs
Generation 24-27 |
Alveolar Ducts
Airway walls made up of alveoli Simple Squamous lining Contain about 50% of all alveoli at this level |
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Alveolar Ducts and Sacs
Generation 28 |
Alveolar Sacs
Last generation arising from alveolar ducts Grape-like clusters of alveoli |
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Pores of Kohn
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Connections between alveoli which allow for collateral ventilation
increase in number with size and age |
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Primary Lobule Concept
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Consists of all respiratory bronchioles, alveolar ducts, and aveolar sacs that arise from a single terminal bronchiole
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Individual Alveoli
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Contain capillaries in their walls to allow for gas exchange
about 300 million on average 70 sq meters of surface area (tennis court) |
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Shunt
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Blood flow in the alveolus with no ventilation
ex: Pneumonia |
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Dead Space
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Aveolus filled with gas but no blood flow
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Type I Pneumocytes
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very flat, cover about 95% of alveolar surface
facilitates gas exchange form tight joins which limits movement of materials into alveolar space Function: Gas exchange |
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Type II Pneumocytes
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Cuboidal
Function: Manufacture and Store Surfactant -Reduces surface tension and alveolar tendency to collapse -Increases compliance and decreases work of breathing Not mature in infants so typically this is a problem for infants breathing |
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Functions of the circulation to the lungs
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Gas exchange at the alveolar-capillary membrane(primary function) - Pick up oxygen and drop off CO2
Aveolar-capillary membrane controls fluid exchange in lung Production, processing, and clearance of a variety of chemicals and blood clots |
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What major blood vessels enter the lungs through the hilum?
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Pulmonary Arteries
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Pulmonary Circulation: Three layers of walls
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Tunica Intima- Endothelium and small amount of connective tissue(Inner layer)
Tunica Media- Elastic tissue in larger and smooth muscle in smaller (middle layer) Tunica Adventitia- Connective tissue and small vessels(outer layer) Provide a rigid vessel to help handle high pressure and high flows |
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Arterioles
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Arteries become arterioles
Provide nutrition to the respiratory zone of the lung known as resistance vessels |
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Capillaries
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Elastic and smooth muscles disappear
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Venules
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Tiny veins that extend from the capillaries
-Empty into the veins that carry blood back to the heart |
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Veins
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Have 3 similar layers to their walls
Thinner walls than arteries Smaller veins have only 2 layers(no tunic adventitia) No valves in the pulmonary veins, unlike systemic veins Capable of collecting and holding large amounts of blood Have a more direct route to the heart |
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Pulmonary Circulation vs Systemic Circulatied
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Pulmonary is thinner walled than systemic
-makes it susceptibe to mechanical factors like gravity, thoracic pressures which effect blood flow Less response to sympathetic stimulation than systemic resistance vessels(arterioles) affected by decreased aveolar O2, hypoxemia, and acidemia -causes vasoconstriction leading to resistance to blood flow Pulmonary: LOW pressure LOW resistance Systemic: HIGH pressure, HIGH resistance |
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Bronchial Circulation
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Bronchial arteries supply blood to the larger lung structures
Bronchial veins drain via various routes -some drain to pulmonary veins, contributing to anatomic shunt -when pulmonary circulation is compromised, bronchial flow increases and vice versa |
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Lymphatic Vessels
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Located beneath visceral pleura
Function: to remove excess fluid and protein molecules Follow bronchial airways and Pulmonary circulation Smooth muscle serve to move fluid along |
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Lymph Nodes
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Collection of lymph tissues along the lymph stream
produce lymphocytes and monocytes Filter debris and bacteria out of the blood stream |
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Nervous Control of Lungs: Somatic Nerves
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Innervate chest wall and respiratory muscles(phrenic and intercostal nerves)
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Nervous Control of the Lungs: Autonomic Nerves
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Sympathetic and parasympathetic nerves
Innervate: Airway smooth muscles and glands Pulmonary arteriole smooth muscle -Result in balanced control of Bronchodialation/Bronchoconstriction, Vasodialation/Vasocontriction, Glandular secretion |
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Sympathetic Nerves
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relaxes smooth muscle of airway
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Parasympathetic Nerves
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Constricts airway smooth muscle
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Hering-Breuer Reflex
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Inflation reflex
Stretch receptors located in airway smooth muscle function to limit further stretch. Stimulation may cause: Increased respiratory rate Bronchodilation Tachycardia Vasocontriction |
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Deflation Reflex
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Lung collapse stimulates an increased force and frequency of inspiratory duct
mediated by the vagus nerve, Receptors involved are unknown |
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Irritant Receptors
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found in epithelium of trachea, larynx, nose, pharynx, and splitting of larger bronchi
Stimulation caused by: inspired irritants(histamines, ammonia, perfumes) Anaphylaxis Pneumothorax Pulmonary Congestion Can result in: Cough, sneeze, bronchospasm, hyperpnea |
