Psl 301 Lec 22

Front 1

1) What is dyskinesia?

2) What is ROHHAD?

s6

Back 1

1) Cillia don't have Dynein, so won't be able to move and get lung muccus buildup and infection

2) Rapid onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation.

-> Problem in hypothalamus development; which is important in breathing control.

Front 2

1) Describe the anatomy of the respiratory system and mention the parts. (review)

video

Back 2

1) Moves air through nose, pharynx, larynx, trachea and bronchi to alveoli, where gas exhchange occurs.

-> Nares are openning to nose. Nasal cavity lined with cilia, mucus membranes, blood capillaries. Air filtered with cillia, moistened by mucus membranes, warmed by blood.

-> Air into pharynx or throat. Goes onto larynx. Epiglottis, closes off larynx when swallowing to prevent food from entering.

-> Larynx has vocal folds. Trachea connects larynx to bronchial tree. Cartilage rings of bronchia prevent from collapsing.

-> Lungs have alveoli and cappilaries. Breathing with expansion and contraction of lungs. Bronchi carrying air divide into bronchioles. At end of each are the alveolar sacs, which are surrounded by capillaries and have single layer alveolar cells, where gas exchange occurs. Oxygenated air goes from nose to pharynx, larynx, trachea, bronchus and alveoli. Diffusion takes O2 from alveoli to capillaries. CO2 moves from capillaries to alveoli and exhaled (respiration)

Front 3

1) What are the 5 components of the respiratory system?

2) What are the 2 types of respiration?

s9

Back 3

1) Airways, thorax, lungs, alveoli, respiratory muscles

2) -> cellular respiration: intercellular reaction of oxygen with organic molecules to produce CO2, water and energy (ATP)

-> external respiration (ventilation/breathing): Interchange of gases between environment and the body's cells

Front 4

1) What are the functions of the respiratory system?

s12

Back 4

1) -> Gas exchange between air and cell

-> Regulation of pH

-> Defence from inhaled pathogens/foreign particles

-> Vocalization

Front 5

1) What are the components of the upper respiratory tract? lower?

s14

Back 5

1) -> upper: tongue, nasal cavity, pharynx, vocal cords, Esophagus, Larynx

-> lower: Trachea, Right and left lung, Right and left bronchus, diaphragm

Front 6

1) What are the muscles of the inspiratory class?

s15

Back 6

1) Expand the chest and create negative pressure to bring O2 inside. main muscle here is the diaphragm muscle, attached to lower ribs. When diaphragm contract, increases volume in thorax and brings air in.

-> sternocleidomastoids: Lifts the rib cage

-> scalenes: also lifts rib cage

-> external intercostal: Can increase size and distance between ribs

-> genioglossus muscle of tongue: , contracts for each inspiration. If don't have it might have sleep apnea

Front 7

1) What are the muscles of the expiratory muscle, what do they do?

s15

Back 7

-> Expiratory is a passive act, don't actively do it. Rib cage goes back to original size and pushes air outside the lung. In some conditions (voluntary expiration or environmental challenges) , can use accessory muscles to exhale, e.g. abdominal muscles and intercostal muscles; force ribs inward and decrease abdominal volume

Front 8

1) How is the diaphragm controlled and how does it work?

2) How are the inspiratory accessory muscles controlled and how do they work?

s16, 17

Back 8

1) Controlled by the phrenic nerve from spinal segments C3, C4, C5.

Inserted in the lower ribs, moves downwards when contracted.

2) Innervated by intercostal nerves, inserted in upper ribs, lift ribs and expand thorax

Front 9

1) What happens in Congenital diaphragmatic hernias (CDH)?

Describe symptoms, causes, treatments

s21

Back 9

1) congenital (birth defect) hole in the diaphragm of new born. Organs can protrude in the hole.

-> Severe breathing difficulty just after birth because of ineffective movement of diaphragm and crowding of lung tissue, causing collapse

-> Cause: improper joining of structures during fetal development.

-> Surgery can be done to place abdominal organs in proper position and repair opening in diaphragm.

Front 10

1) What structures are at the lung enclosure?

2) What are the functions of the pleural cavity (pleural fluid and sacs)

s25

Back 10

1) The heart in between the lungs, the pleural membranes; pleural sacs of the pleural cavity that are attached to the lungs and the rib cage, that enclose the lungs

2) -> Create moist, slippery surface facilitating movements, lubrication

-> Hold the lungs tight against the thoracic wall for suction and adherence.

Front 11

1) What are the main components of the airways?

2) Describe the feature of the different components

s30

Back 11

1) Larynx, trachea, mouth, nasal cavity, pharynx, bronchiole, alveoli

2) Trachea have rings around it, make it hard. Pressure and flow inside flow is strong, so hardness prevents this.

Trachea separate into 2 main bronchi (left primary and right primary). Divide into bronchioles, that are net very hard as there is less pressure as they are smaller. Then there are alveoli. The more the branches, more exchange surface

Front 12

1) What are the main function of the airways?

s30

Back 12

1) Passage for air from mouth/nose to alveoli

-> Warm air to 37 degrees

-> Humidify air to 100% (can't be dry)

-> Filter particles (through nose and respiratory cilia)

-> Vocalization

Front 13

1) How does an endotracheal tube insertion in mechanically ventilated patients work?

What is the challenge and how fixed?

s31

Back 13

1) Tube in trachea, upper airways are bypassed.

But air is cold and dry. The lower airways lose heat and water, and secretions would thicken. Secretion (mucus) may accumulate and block airways.

Solution is to heat tubes and 100% humidity in inspired gases

Front 14

1) What are the segments and functions of the conducting airways.

s33

Back 14

1) First part has cartilage (type of connective tissue), maintains shape.

-> 1st bifurcation: right and left main bronchi

-> 2nd to 4th bifurcation: lobar bronchi

Bronchial muscles:

-> 5th to 11th bifurcation: segmental bronchi

-> 12th to 16th bifurcation: terminal bronchioles

Front 15

1) Describe the action of the cilia

s34

Back 15

1) They cover the airways. Produce fluid that moves mucus (mucus from goblet cells) out of bronchioles and eliminate particles e.g. bacteria, using the mucus.

Front 16

1) What is CF, what are the symptoms and the causes

s37

Back 16

1) Genetic disease causes thick, sticky mucus to build up in the lungs and digestive tract

-> Delayed growth in newborns, failure to gain weight, salty tasking skin, coughing and increased mucus in lungs, nasal congestion, pneumonia

-> Defective chloride ion transport (CFTR; cystic fibrosis transmembrane byregulator) in epithelial cells. Usually get chloride out the cell, which secretes water and get thin mucus; but in CF, this not working

Front 17

1) Where is the main site of gas exchange? describe it

s38,39

Back 17

1) Done at alveoli. 300 million alveoli * 300 um diameter. total SA 100m2.

They build up to the alveoli sac. Have muscles that allow contraction of alveoli, also have capillary beds that trap the alveoli to optimize gas exchange.

Elastic fibres help in contracting alveoli.

Vein and arteries bring blood to the region.

Front 18

1) What are the 3 types of alveolar cells.

s40

Back 18

1) -> Type I: Most important, for gas exchange, passive diffusion

-> Type II: Synthesize and secrete surfactant.

-> Alveolar macrophage: Remove foreign particles.

Front 19

1) Describe surface tension and how does it work in alveoli

s43

Back 19

1) Molecules of water attracted by H bonds. At surface, molecules attracted only sideways and downwards. Forces liquid to adopt minimal surface possible. Creates stretched membrane effect.

If this takes place in alveoli, surface tension would collapse molecule. So alveoli needs surfactant, which has polar head on one side and no polarity on the other. This compensates for surface tension.

Front 20

1) What is infant respiratory distress syndrome (IRDS)?

s45

Back 20

1) Also called neonatal respiratory distress syndrome. In premature infants caused by developmental insufficiency of surfactant production and structural immaturity of the lungs. Surfactant deficient lung has collapsed air spaces alternating with hyper-expanded areas.

-> Symptoms: Bluish colour of skin and mucus membranes, grunting and nasal flaring, apnea, rapid breathing, shallow breathing

-> Causes: genetic problem with associated proteins. Leading cause of death in preterm deaths

-> Treatments: Oxygen given with small continuous position airway pressure. Artificial or natural surfactants, given through endotracheal tube