* A&p Review Questions

Front 1

What is the most common upper respiratory tract infection? What other 3 can follow?

Back 1

Strep throat: causes by streptococcus pyogenes.

Includes:

Sinitus: infection of the cranial sinuses (frontal, ethmoid, maxillary)

Tonsillitis: inflamed and enlarged tonsils.

Laryngitis: inflammation of the larynx. Inability to talk in audible voice.

Front 2

Types of lower respiratory infections

Back 2

Bronchitis: bacterial infection of the primary and secondary bronchi.

Pneumonia: viral or bacterial infection of the lungs. Bronchi and alveoli fill with thick fluid.

Front 3

What is tuberculosis?

Back 3

Caused by the tubercle bacillus bacterium. Lung tissue develops tubercles around the invading pathogens.

Front 4

Restrictive pulmonary disorders

Back 4

Vital capacity is reduced, lungs have lost their elasticity.

- pulmonary fibrosis: fibrous connective tissue buildup on lungs. Can be caused by silica, coal dust, asbestos, clay, cement, flour or fiberglass.

Front 5

Obstructive pulmonary disorders

Back 5

Air does not flow freely on the airways, maximal inhalation or exhalation time is greatly increased.

COPD: develops slowly, over a long period of time, recurrent, chronic bronchitis, smoking.

Front 6

Emphysema

Back 6

Incurable disorder, alveoli are distended, alveolar walls have been damaged and the surface area available for gas exchange has been reduced.

Front 7

Asthma

Back 7

Acute obstructive disorder, disease of the bronchi and bronchioles. Not curable but treatable.

Front 8

Lung cancer

Back 8

Thickening and calussing of cells lining in primary bronchi, cells with atypical nuclea appear in the callused lining, cells break loose and penetrate other tissues (metastasis)

Front 9

What is oxygen toxicity and hyperbaric oxygen

Back 9

Oxygen toxicity: pure O2 breathed at 2.5atm or higher.

Hyperbaric oxygen: formerly used to treat premature infants, causes retinal damage and was discontinued.

Front 10

Tracheostomy

Back 10

Temporary opening in the trachea inferior to the larynx and insert a tube to allow airflow. Prevents asphyxiation, inhaled air bypasses nasal cavity and is not humidified, promotes infection.

Front 11

Pneumothorax

Back 11

Thoracic wall is punctured, inspiration sucks air through the wound into the pleural cavity, potential space becomes air filled cavity, loss of negative intrapleual pressure allows lungs to recoil and collapse.

Front 12

Variations in respiratory rhythm (10)

Back 12

Eupnea: relaxed quiet breathing.

Apnea: temporary cessation of breathing.

Respiratory arrest: permanent cessation of breathing.

Dyspnea: labored, gasping breathing, shortness of breath.

Hyperpnea: increased rate and depth of breathing in response to exercise, pain or other conditions.

Hyperventilation: increased pulmonary ventilation in excess of metabolic demand.

Hypoventilation: reduced pulmonary ventilation.

Kussmaul respiration: deep, rapid breathing often induced by acidosis.

Othopnea: dyspnea that occurs when person is lying down.

Tachypnea: accelerated respiration

Front 13

What is the major function of the respiratory system?

Back 13

Respiration, olfaction and speech.

Front 14

4 systems of respiration (respiratory and circulating systems)

Back 14

1. Pulmonary ventilation: breathing. Respiratory system.

2. External respiration: exchange of O2 and CO2 between lungs and blood. Respiratory system.

3. Transport: of O2 and CO2 in blood. Circulating system.

4. Internal respiration: exchange of O2 and CO2 between systemic blood vessels and tissues. Circulating system.

Front 15

Conducting division and respiratory division

Back 15

Conducting division: passages that serve only for airflow, no gas exchange, nostrils through major bronchioles. Includes upper respiratory tract: organs of the thorax (larynx then trachea through lungs).

Respiratory division: consists of alveoli and othe organs exchange regions.

Front 16

Organs of the upper respiratory system

Back 16

- nose and nasal cavity

- paranasal sinuses

- pharynx

Front 17

Organs of the lower respiratory system

Back 17

- larynx

- trachea

- bronchi and branches (bronchial tree)

- lungs and alveoli

- pleura

Front 18

Features of the nose (external nose and nasal cavity)

Back 18

External nose: only external feature of the respiratory system. Formed by nasal and frontal bones superiorly, from bridge and root. Maxillary bones laterally and plates of hyaline cartilage inferiorly. Include root, bridge and apex, includes nostrils (nares)

Nasal cavity: divided by nasal septum (vomer and ethmoid bones).

Posterior nasal apparatuses: choanae. Opening where nasal cavity turns into nasopharynx.

Roof: formed by ethmoid and sphenoid bones.

Floor: forms by hard palate (bone) and soft palate (muscle).

Nasal vestibule: nasal cavity superior to nostrils, line with vibrissae (hairs).

* respiratory epithelium lines rest of nasal cavity except for vestibule. Also lined with mucous membranes.

Front 19

Mucosa of the nose (2)

Back 19

Olfactory mucosa: contains olfactory epithelium.

Respiratory mucosa: pseuodostratified cilliated columnar epithelium that contain goblet cells. Contain lysozyme and defensins.

Front 20

Nasal conchae and nasal meatus

Back 20

Nasal conchae: mucosa covered projections. Superior, middle and inferior.

Nasal meatus: grooves inferior to conchae.

Front 21

Paranasal sinuses

Back 21

Airfileld cavities in cranial bones surrounding nasal cavity, form ring around nasal cavities, located in frontal, sphenoid, ethmoid and maxillary bones.

Front 22

What is the pharynx and its 3 subdivisions?

Back 22

Pharynx: muscular tube from base of skull to C6. Composed of skeletal muscle, passageway connecting nasal cavity to larynx and oral cavity to esophagus.

- nasopharynx: air passageway posterior to nasal cavity, lining contains pseudostratified columnar epithelium. Soft palate and uvula close nasopharynx during swallowing.

Includes: pharyngeal tonsils: adenoids, and pharyngotympanic tubes: auditory tubes drain and equalize pressure in middle ear.

- oropharynx: passageway for air and food from level of soft palate to epiglottis. Lining consists of stratified squamous epithelium. Includes: isthmus of fauces: opening to oral cavity, Palatine tonsils: in lateral walls of fauces, and lingual tonsils: on posterior surface of tongue.

Laryngopharynx: passageway for air and food, posterior to upright epiglottis, extends to larynx where it is continuous with esophagus. Lined with stratified squamous epithelium.

Front 23

Functions of the upper respiratory system organs

Back 23

Nose: external nose and nasal cavity, produce mucous, filters/warms/moistens/cleans incoming air, resonance chamber for speech, houses olfactory receptors.

Paranasal sinuses: form ring around nasal cavities, lighten skull, also may warm/moisten/filter incoming air.

Pharynx: passageway for air and food, facilitates exposure of immune system to inhaled antigens (in tonsils)

Front 24

Pharyngitis

Back 24

Infected, swollen adenoids, can block air passage on nasopharynx.

Front 25

Which organ is known as the voice box?

Back 25

Larynx: opens into laryngopharynx and is continuous with the trachea! Connects pharynx to trachea, opening between vocal folds (glottis) can be closed by epiglottis or vocal folds. Form core of vocal cords- true vocal cords= inferior. False vocal folds= superior vestibular folds, which help close glottis during swallowing. Folds produce sound as air rushes up from lungs. Vocal folds may as as sphincters to prevent air passage. Ex. Valsalvas maneuver: glottis closes to prevent air exhalation, abdominal muscles contact.

Framework consists of 9 hyaline cartilages except for epiglottis

Front 26

Name 3 cartilages in larynx

Back 26

Thyroid cartilage: Adam's apple, large shield shaped that contains laryngeal prominence.

Cricoid cartilage: ring shaped, paired arytenoid, cuneiform, corniculate cartilages.

Epiglottis: consist of elastic cartilage (not hyaline), coners laryngeal inlet during swallowing, covered in taste bud containing mucosa.

Front 27

Laryngitis

Back 27

Inflammation of the vocal folds that causes them the swell, interfering with vibrations.

Front 28

Which organ is known as the windpipe?

Back 28

Trachea: flexible tube running from larynx into mediastinum and dividing it into 2 main bronchi. Contains incomplete C shaped rings (pseudostratified columnar epithelium) Wall composed of 3 layers:

Mucosa: ciliated pseudostratified epithelium with goblet cells.

Submucosa: connective tissue with seromucous glands supported by 16-20 C shaped rings that prevent collapse of trachea.

Adventitia: outermost layer made of connective tissue.

Trachealis: consist of smooth muscle fibers that connect posterior parts of cartilage rings, contract during coughing to expel mucous.

Carina: last tracheal cartilage that is expanded and found at point where trachea branches into 2 main bronchi. Mucosa of carina is highly sensitive, violent coughing triggered.

Front 29

Heimlich maneuver

Back 29

Air in victims lungs is used to pop out or expel an obstructing peice of food.

Front 30

Bronchi and branches (bronchial tree)

Back 30

Airway passages undergo 23 orders of branching referred to as bronchial tree. R. and L. Main bronchi which subdivide within the lungs to form lobar and segmental bronchi and bronchioles.

Front 31

Alveoli

Back 31

Microscopic structures at termini of bronchial tree. Special alveolar cells produce surfactant. 150 million alveoli in each lung, providing about 70m2 of surface area for gas exchange.

Front 32

Cells of alveolus (3)

Back 32

Squamous type I alveolar cells: thin, broad cells that allow for rapid gas diffusion between alveolus and bloodstream. Cover 95% of alveolus surface area.

Great type II alveolar cells: round to cuboidal cells that cover remaining 5% of alveolar surface area. Repair alveolar epithelium when squamous type I cells are damaged. Secrete pulmonary surfactant.

Alveolar macrophages: dust cells, most numerous of all lung cells, keep alveolar surface sterile by keeping alveoli free from debris by phagocytizing dust particles. 100 million dust cells perish each day. 2 million dead macrophages/hour carried to the throat and swallowed.

Front 33

Respiratory membrane

Back 33

Blood air barrier that consists of alveolar and capillary walls along with their fused basement membranes. No energy required! Very thin, allows gas exchange across membrane by simple diffusion.

Alveolar walls: single layer of squamous epithelium (type I alveolar cells) and scattered cuboidal type II alveolar cells.

Front 34

Alveolar pores

Back 34

Connect adjacent alveoli, equalize air pressure, provide alternate routes.

Front 35

Lungs

Back 35

Composed primarily of alveoli and respiratory passages, occupy all of the thoracic cavity except for mediastinum.

Front 36

What allows lungs to recoil during expiration?

Back 36

Stroma: elastic connective tissue, double layered serosa, divides thoracic cavity into 2 plural components and mediastinum.

Front 37

2 plural components in the lungs

Back 37

Parietal pleura: on thoracic wall, superior face of diaphram, around heart, between lungs, lines thoracic cavity.

Visceral pleura: covers external lung surfaces.

Front 38

Pleura

Back 38

Serous membranes. Contain pleural fluid: fills slit like pleural cavity. Provides lubrication and surface tension. Assists in expansion and recoil.

Front 39

Pleurisy

Back 39

Inflammation of pleurae, often results from pneumonia, resulting in friction and stabbing pain with each breath.

Front 40

Other fluids that may accumulate in pleural cavity

Back 40

Blood: leaked from damaged blood vessels.

Blood filtrate: watery fluid that oozes from lung capillaries when left sided heart failure occurs.

Pleural effusion: fluid accumulation in pleural cavity.

Front 41

Lung anatomy

Back 41

Root: site of vascular and bronchial attachment to mediastinum.

Costal surface: anterior, lateral and posterior surfaces.

Apex: superior tip, deep to clavicle.

Base: inferior surface that rests of diaphram.

Hilum: found on mediastinal surface, site for entry and exit of blood vessels, bronchi, lymphatic vessels and nerves.

Left lung: separated into superior and inferior lobes by oblique fissure, includes cardiac notch: concavity for lungs to fit into.

Right lung: separated into superior, middle and inferior lobes by horizontal and oblique fissure.

Bronchopulmonary segments: each lobe further divided which can be individually removed.

Lobules: smallest subdivisions visible to naked eye, served by bronchioles and their branches.

Front 42

Functions of lower respiratory system organs

Back 42

Larynx: voicebox, provides patent airway passageway, routes air and food into proper channels preventing it from entering lower respiratory tract. Voice production, house vocal folds.

Trachea: air passageway, cleans/warms/moistens incoming air.

Bronchial tree: air passageways connecting trachea with alveoli, cleans/warms/moistens incoming air.

Alveoli: main sites for gas exchange, surfactant, reduces surface tension and prevents lung collapse.

Lungs: house respiratory passages smaller than main bronchi.

Pleurae: produce lubricating fluid and compartmentalize lungs.

Front 43

Rhinitis

Back 43

Inflammation of nasal mucosa, continuous with mucosa of respiratory tract, so infections spread from nose to throat to chest. Can also spread to tear ducts and paranasal sinuses causing blockage of sinus passageways.

Front 44

2 zones of the lower respiratory system

Back 44

Conducting zone: conduits that transport gas to and from gas exchange sites. Includes all other respiratory structures. Cleans/warms/humidifies air.

Conducting zone structures: trachea: divides to form L and R main (primary) bronchi, each main bronchus then branches into lobar (secondary) bronchi. Each lobar bronchus branches into segmental (tertiary) bronchi. Branches become smaller and smaller (bronchioles) >1mm and the smaller terminal bronchioles >0.5mm. Final branches of the conducting division.

Changes occur: support structures change, epithelium type changes to cuboidal, amount of smooth muscle increases, have no mucous glands or goblet cells. Conducting zone structures give rise to:

Respiratory zone: microscopic structures, begins where terminal bronchioles fees into respiratory bronchioles, which lead to alveolar ducts and finally into alveolar sacs (saccules) which contain clusters or alveoli, site or actual gas exchange.

Front 45

What are the 2 circulations that lung are perfused by?

Back 45

Pulmonary circulation: in which pulmonary arteries deliver systemic venous blood from heart to lungs for oxygenation and pulmonary veins that carry oxygenated blood from respiratory zones back to the heart. Low pressure, high volume system. Ex. Angiotensin converting enzymes activated blood pressure hormones.

Bronchial circulation: in which bronchial arteries provide oxygenated blood to lung tissue, arose from aorta and enter lungs at hilum. Part of systemic circulation so are high pressure, low volume system. Supply all lung tissue except alveoli, and bronchial veins that anastomose with pulmonary veins (which carry most of venous blood back to heart).

Front 46

Innervation of the lungs are inverted by what 2 things?

Back 46

Parasympathetic fibers which cause bronchoconstriction and sympathetic fibers which cause bronchodilation.

As well as visceral sensory fibers. Nerves enter through pulmonary plexus on lung root (run along bronchial trees and blood vessels).