Respiratory A&P

Question 1

what is included in respiration?

Answer 1

1. ventilation
2. gas exchange between blood and alveoli
3. gas delivery to the tissues
4. gas exchange between blood and tissues
5. oxygen utilization by tissues
6. return of gases from tissues to lungs
7. exhalation

Question 2

distinguish between internal and external respiration

Answer 2

1. Internal → oxygen utilization and gas exchange in tissues
2. External → ventilation and gas exchange in lungs

Question 3

describe the movement of the diaphragm with breathing

Answer 3

flattens with inhalation

domes with exhalating

Question 4

what may limit diaphragm displacement?

Answer 4

1. obesity
2. pregnancy
3. size of GI organs
4. ascites

Question 5

how does the supine position impact the diaphragm?

Answer 5

there are no effects of gravity so the level of the diaphragm rises and there is greater excursion

lung volumes are lower b/c of elevated position of the abdominal organs

Question 6

how does the upright position impact the diaphragm?

Answer 6

it is pulled down due to gravity and there is reduced excursion but lung volumes are increased

Question 7

how does the sidelying position impact the diaphragm?

Answer 7

1. the hemidiaphragms are unequal in their positions here
   
   1. uppermost side drops to a lower position and has less excursion than in sitting
   2. lowermost side (dependent) rises higher in the thorax and has greater excursion than in sitting position

Question 8

why would a pneumonia pt want to be positioned sidelying with their “bad” lung higher?

Answer 8

this will allow the “good” lung on the lower side to have greater excursion

Question 9

how does the external intercostal impact respiration?

Answer 9

1. it is a muscle of inspiration
   
   1. contraction of this muscle pulls the lower rib up and out toward the upper rib
   2. this elevates the ribs and expands the chest

Question 10

how does the internal intercoastal impact respiration?

Answer 10

1. it is a muscle of expiration
   
   1. contraction of this muscle pulls the ribs downward

Question 11

briefly describe inspiration

Answer 11

1. an active process at rest and during exercise
   
   1. involves contraction of diaphragm and external intercostals
   2. accessory respiratory muscles are involved in pulmonary pathologies

Question 12

briefly describe expriation

Answer 12

1. at rest, is a passive process and achieved through the elastic recoil of the lung
   
   1. relaxed breathing → ribs drop, diaphragm relaxes and domes
   2. elastic recoil → rebound of the lungs after having been stretched by inhalation

Question 13

describe forced expiration

Answer 13

1. involves the abdominals and internal intercostal muscles
2. contraction of the intercostals pull the ribs downward reducing the volume of the thoracic cavity and compressing the lungs
3. contraction of the abdominal muscles force the viscera upwards against the diaphragm also compressing the abdominal cavity and hence the thoracic cavity

Question 14

list the muscles of inspiration

Answer 14

1. external intercostals
2. SCM
3. Scalenes
4. Upper Trapezius
5. Pec Major and Minor
6. Serratus Anterior and Rhomboids
7. Latissimus dorsi
8. Serratus posterior superior
9. thoracic erector spinae muscles

Question 15

where is the apex of the lungs?

Answer 15

in the root of the neck

highest point being approximately 1 inch above the middle third of each clavicle

Question 16

describe the lobes, fissures, and segments of the R Lung

Answer 16

1. 3 lobes
   
   1. RUL → has 3 segments
   2. RML → has 2 segments
   3. RLL → has 4 segments
2. 2 fissures
   
   1. oblique (major) fissure → separates the RLL from the RML and RUL
   2. horizontal (minor) fissure → separates the RML from the RUL

Question 17

Describe the lobes, fissures, and segments of the L Lung

Answer 17

1. 2 Lobes separated by an oblique fissure
   
   1. LUL → has 4 segments
      
      1. anterior
      2. apico-posterior
      3. superior linguar
      4. inferior linguar
   2. LLL → has 4 segments
      
      1. apical
      2. anterior
      3. posterior
      4. lateral

Question 18

what makes up the respiratory zone within the lungs?

Answer 18

1. respiratory bronchioles
2. alveolar ducts
3. alveoli

Question 19

T/F: Inspiration is always a passive process

Answer 19

FALSE
active process

Question 20

an increase in the volume of the thoracic cavity and the lungs leads to a __________ in intrapulmonary pressure

Answer 20

reduction

(reduces pressure in the lung/alveoli)

Question 21

what is minute ventilation?

Answer 21

1. the total volume of air that is inhaled or exhaled in one minute
2. Assessment of effective ventilation
3. expressed in L/min and is calculated by multiplying the ventilatory rate and tidal volume

Question 22

what is a primary determinant of lung compliance?

Answer 22

1. Elasticity → ability to return to initial size after being stretched

Question 23

what disease impacts lung elasticity?

Answer 23

1. emphysema degrades elastin which results in an increased compliance and a very easily inflated lung that now has a reduced capacity to recoil
2. edema → decreased compliance

Question 24

what does low/high compliance indicate?

Answer 24

1. low → indicates a stiffer lung (can be thought of as a thicker balloon)
2. high → indicates a more pliable lung (a thinner balloon)

Question 25

how is compliance lowered in the lungs?

Answer 25

reduced or lowered by factors that produce a resistance to distension such as infiltration of connective tissue into the lung parenchyma (pulmonary fibrosis)

Question 26

how does surface tension impact lung compliance?

Answer 26

helps favor the recoil of the lungs inward and therefore helps determine compliance

Question 27

what is surfactant?

Answer 27

a compound that reduces surface tension (w/o it recoil goes up and compliance goes down)

Question 28

what is the role of surface tension in the lungs?

Answer 28

1. it is created by fluid secreted onto the lining of the alveoli 2. resists lung expansion/distension 3. acts to collapse the alveolus and raise the pressure of the alveolar air

Question 29

T/F: pulmonary ventilation and perfusion are equally distributed

Answer 29

FALSE pulmonary ventilation → 2.5x greater at the base than at the apex pulmonary perfusion → 6x greater at base than apex (due to gravity)

Question 30

what is the purpose of a ventilation perfusion scan

Answer 30

1. a test that measures air and blood flow in lungs 2. most often is used to help diagnose or rule out a pulmonary embolism 3. involves radioactive albumin injected into the blood (perfusion) and addition of a radionuclide such xenon and technetium into the air breathed in

Question 31

what is Dalton's Law?

Answer 31

the total pressure of a gas mixture is equal to the sum of the pressure of each in it

Question 32

how does increased CO2 within the blood impact pH?

Answer 32

reduces pH and makes blood more acidic results in hypoventilation and reduced exhalation volumes

Question 33

how does decreased CO2 within in the blood impact pH and respiration?

Answer 33

increased blood pH → more alkalotic hyperventilation, reduced exhalation volumes