Respiratory

Question 1

What 3 anatomical structures make up the Upper Respiratory Tract (URT)?

Answer 1

1. Nose & nasal cavity
2. Pharynx
3. Larynx

Question 2

What 3 (4) anatomical structures make up the Lower Respiratory Tract (LRT)?

Answer 2

1. Trachea
2. Bronchi
3. Bronchioles
4. Alveoli

Question 3

What 4 anatomical structures make up the Pharynx?

Answer 3

1. Epiglottis
2. Nasopharynx
3. Oropharynx
4. Laryngopharynx

Question 4

What is the function of the Elastic Fibres? [As a structural component of the airway]

Answer 4

Allows expansion and return to resting state.

Question 5

What is the function of the smooth muscle? [As a structural component of the airway]

Answer 5

Contracts causing bronchoconstriction.

Question 6

What is the function of Mucus? [As a structural component of the airway]

Answer 6

Mucus traps foreign particles.

Question 7

What is the function of the Cilia? [As a structural component of the airway]

Answer 7

Cilia move the mucus towards the pharynx.

Question 8

What 2 major respiratory muscles are in the thoracic cavity?

Answer 8

1. Diaphragm

2. Intercostal muscles

Question 9

What are 2 describing features of Alveoli?

Answer 9

1. Site of gas exchange

2. Surrounded by pulmonary capillaries

Question 10

What 2 things may reduce gas exchange?

Answer 10

1. If respiratory membrane is thickened with fluid e.g. pulmonary oedema.
2. If respiratory membrane surface area is reduced e.g. emphysema.

Question 11

What 3 things does ventilation depend on?

Answer 11

1. Respiratory muscles
2. Elastic recoil of lungs [normal expiration is passive]
3. Airway resistance [bronchoconstriction]

Question 12

What are 5 respiratory defenses and what is their goal?

Answer 12

1. Tonsils
2. Normal respiratory flora
3. Cough
4. Mucocilliary escalator
5. Alveolar macrophages

Goal: Keep bronchi and alveoli sterile

Question 13

Explain Ventilation

Answer 13

Air moving in and out of the lungs

Question 14

Explain Perfusion

Answer 14

Blood in pulmonary capillaries

Question 15

What can lack of homeostasis with reduced ventilation cause/lead to?

Answer 15

1. Obstruction of airways in COPD
2. Hypoxaemia
3. Hypercapnia
4. Pulmonary Embolism

Question 16

What does low PaO2 cause in reduced ventilation?

Answer 16

Constriction of pulmonary arterioles

Question 17

What does high PaO2 cause in reduced ventilation?

Answer 17

Dilation of bronchioles.

Question 18

What does low PaO2 cause in reduced perfusion?

Answer 18

Constriction of bronchioles

Question 19

What does high PaO2 cause in reduced perfusion

Answer 19

Dilation of pulmonary arterioles

Question 20

What occurs to the sympathetic nervous system during respiratory innervation?

Answer 20

1. Releases adrenaline and noradrenaline
2. Binds to Beta 2 adrenergic receptors on bronchi / bronchioles
3. Causes bronchodilation
4. Increases ventilation

Question 21

What occurs to the parasympathetic nervous system during respiratory innervation?

Answer 21

1. Releases acetylcholine
2. Binds to cholinergic receptors on bronchi / bronchioles
3. Causes bronchoconstriction
4. Decreases ventilation

Question 22

Where are the central and peripheral chemoreceptors for respiratory control?

Answer 22

1. Central chemoreceptors in the medulla

2. Peripheral chemoreceptors in the carotid arteries and aortic arch

Question 23

What is the respiratory function process during an increase in carbon dioxide levels in the blood?

Answer 23

1. Rising levels of CO2, decrease in pH
2. Detected by chemoreceptors
3. Respiratory control centre integrates information
4. Action potentials to respiratory muscles (mainly diaphragm)
5. Increased ventilation
6. Homeostasis of blood CO2 and pH restored.

Question 24

What occurs to the pH and breathing during hypoventilation?

Answer 24

1. CO2 decreases in blood, causing hypocapnia

2. pH increases causing respiratory alkalosis

Question 25

Explain acid-base imbalance for respiratory acidosis

Answer 25

1. PaCO2 >45mmHg 2. pH <7.35 3. Occurs with hypercapnia or low pH 4. Due to hypoventilation (impairment of lung function)

Question 26

Explain acid-base imbalance for respiratory alkalosis

Answer 26

1. PaCO2 <35mmhg 2. pH >7.45 3. Occurs with hypocapnia or high pH 4. Due to hyperventilation

Question 27

What is the equation for pulmonary function tests?

Answer 27

(FEV1/FVC)x100=80% FEV1 = forced expiratory volume FVC = forced vital capacity Health lungs can exhale 80% (or more) of FVC in 1 second

Question 28

What are 3 main respiratory obstructive diseases?

Answer 28

1. Asthma 2. Chronic Bronchitis 3. Emphysema *2 + 3 are both part of COPD

Question 29

Explain Obstructive Disease Pathophysiology

Answer 29

Reduced ventilation due to airway obstruction. Contribution to hypoxaemia and hypercapnia. Decreased FEV1 (forced expiratory volume). Dyspnoea, wheezing, increased work of breathing.

Question 30

What are some causes of Asthma?

Answer 30

1. Allergens/irritants e.g. pollens, pollution, cigarette smoke. 2. Recurrent respiratory infections 3. Exercise 4. Cold 5. Stress 6. Drugs e.g. aspirin

Question 31

Explain the pathophysiology of Asthma

Answer 31

Increased airway resistance due to: bronchoconstriction, increased thick mucus secretion, inflammation of bronchial walls (causes oedema). Reduced expiratory flow rates due to air being trapped in lungs (increased residual volume).

Question 32

What 3 things in the airway are remodeled in chronic asthma?

Answer 32

Persistent asthma attacks lead to airway remodeling (anatomical changes of bronchial walls). 1. Excess smooth muscle growth 2. Epithelial injury [loss of bronchial lining] 3. Mucus gland hypertrophy

Question 33

What are 7 clinical features of Asthma?

Answer 33

1. Cough 2. Wheezing 3. Dyspnoea / tachypnoea 4. Nasal flaring and use of accessory muscles 5. Hyper-inflated chest 6. Tachycardia

Question 34

How is asthma managed and prevented?

Answer 34

Management = bronchodilators, oxygen and adrenaline Prevention = avoid allergens, anti-inflammatory (corticosteroids)

Question 35

What are the 2 diseases included in COPD?

Answer 35

1. Emphysema 2. Chronic bronchitis Most individuals have a combination of both.

Question 36

How is COPD characterized?

Answer 36

Progressive, irreversible damage and mainly affects older adults

Question 37

Explain emphysema pathophysiology.

Answer 37

1. Emphysema is characterized by = damaged alveolar walls and the break down of elastic fibres (elastin). 2. Leads to = permanent enlargement of air spaces in lungs, loss of elastic tension/recoil of alveoli, airways collapse during expiration. 3. Causes of air trapping & lung hyperinflation = lungs can expand, but deflate poorly, increased residual volume *Irreversible, progressive damage

Question 38

What are 5 clinical features of emphysema?

Answer 38

1. Dyspnoea 2. Barrel chest (air is trapped in alveoli) 3. Fatigue (forced expiration, use of accessory muscles) 4. "Pink Puffers" (not cyanotic - oxygenation adequate) 5. Use of accessory muscles to breathe.

Question 39

Explain chronic bronchitis pathophysiology.

Answer 39

Chronic bronchitis involves chronic inflammation of the bronchi, producing excess mucus. Chronic productive for at least 3 months or 2yrs consecutively. Excess mucus accumulates and blocks airways. Impairment of cilliary function.

Question 40

What are 3 clinical features of chronic bronchitis?

Answer 40

1. Chronic cough (due to sputum production) 2. Cyanosis (blue skin) 3. Fluid retention

Question 41

What is the management for COPD?

Answer 41

1. Stop smoking 2. Avoid respiratory tract infections 3. Manage malnutrition 4. Regular physical activity 5. Breathing re-training 6. Bronchodilators 7. Inhaled corticosteroids 8. Oxygen therapy