Chapter 22: The Respiratory System

Which form of CO2 transport accounts for the greatest amount of CO2 transported in blood? - Dissolved in plasma - As carbon monoxide in plasma - As bicarbonate ions in plasma - Chemically bound to hemoglobin

- As bicarbonate ions in plasma

________, or lung collapse, is a homeostatic imbalance that occurs when a bronchiole becomes plugged. - Hypoxia - Pneumothorax - Atelectasis - Pleurisy

- Atelectasis

Which respiratory structure has the smallest diameter? - Trachea - Bronchi - Bronchiole - Pharynx - Larynx

- Bronchiole

Which of the following is not involved in respiration? - External ventilation - External respiration - Internal respiration - Pulmonary ventilation

- External ventilation

Which of the following is NOT a function of the conducting zone? - Cleansing of air - Warming of air - Gas exchange - Mucous secretion - Transport of air

- Gas exchange

Which form of hypoxia occurs when body cells are unable to use O2 even though adequate amounts are delivered? (This type of hypoxia is usually the consequence of metabolic poisons, such as cyanide.) - Anemic hypoxia - Hypoxemic hypoxia - Ischemic (stagnant) hypoxia - Histotoxic hypoxia

- Histotoxic hypoxia

Which of the following terms describes the increase in depth and force of breathing that occurs during vigorous exercise? - Hyperpnea - Hypercapnia - Hyperventilation - Anoxia - Hypoxia

- Hyperpnea

Which of the following is NOT a direct function of the respiratory system? - Inspiration - External respiration - Internal respiration - Contraction of the diaphragm - Expiration

- Internal respiration

Which of the following statements best describes the mechanism of normal breathing patterns? - It is set by two sets of pacemakers that excite each other. - It is set by a single pacemaker that stimulates inspiration. - It is set by a single pacemaker that stimulates expiration. - It is set by two sets of pacemakers that inhibit each other.

- It is set by two sets of pacemakers that inhibit each other.

Which of the following is not a function of the trachealis muscle? - It allows the esophagus to expand anteriorly when food is swallowed. - It helps expel mucus during coughing. - It decreases the diameter during expiration to expel air with a greater force. - It prevents the trachea from collapsing and keeps it patent despite the pressure changes that take place during breathing.

- It prevents the trachea from collapsing and keeps it patent despite the pressure changes that take place during breathing.

Which of the following statements about voice production is incorrect? - Loudness of voice depends on the size of the vocal cords. - Themore tense the vocal cords, the higher the pitch. - The glottis is wide when deep tones are produced. - The larynx enlarges in males during puberty.

- Loudness of voice depends on the size of the vocal cords.

Which of the following controls the respiratory rate? - Alveolar sacs - Spinal cord - Pons - Medulla - Cerebral cortex

- Medulla

_____ secreted by endothelium of blood vessel is a well known vasodilator. - HCO3 - CO2 - NO - CO

- NO

Which of the following lists the regions of the pharynx, from superior to inferior? - Nasopharynx; Laryngopharynx; Oropharynx - Oropharynx; Laryngopharynx; Nasopharynx - Laryngopharynx; Oropharynx; Nasopharynx - Nasopharynx; Oropharynx; Laryngopharynx

- Nasopharynx; Oropharynx; Laryngopharynx

Which of the following gases has no effect in the blood until hyperbaric conditions occur (as in SCUBA diving when one stays down too long at great depths), then a condition called ""rapture of the deep"" occurs, producing a narcotic-like effect as this gas interacts with other blood chemicals? - Nitrogen - Carbon dioxide - Oxygen - Carbon monoxide - Helium

- Nitrogen

This tissue lines the trachea. - Simple squamous epithelium - Stratified squamous epithelium - Areolar connective tissue - Hyaline cartilage - Pseudostratified columnar epithelium

- Pseudostratified columnar epithelium

____________ is the inflammation of the nasal mucosa accompanied by excessive mucus production, nasal congestion, and postnasal drip. - Laryngitis - The common cold - Sinusitis - Rhinitis

- Rhinitis

Which of the following occurs during infant respiratory distress syndrome (IRDS)? - The pleurae produce an excessive amount of fluid, putting pressure on the baby's lungs, hindering breathing. - The baby is unable to keep his or her alveoli inflated between breaths. - The baby's cilia are damaged or destroyed, and only coughing can prevent mucus from accumulating in the lungs. - Histamine and other inflammatory chemicals cause the baby's bronchioles to constrict.

- The baby is unable to keep his or her alveoli inflated between breaths.

______________ pressure keeps the air spaces in the lung opened. - Intrapulmonary - Intrapleural - Atmospheric - Transpulmonary

- Transpulmonary

Which of the following are the hairs within the nasal cavity that filter coarse particles, such as pollen and dust, from inspired air? - Microvilli - Cilia - Vibrissae - Alveoli

- Vibrissae

Which respiratory measurement is normally the greatest? - Expiratory reserve volume - Tidal volume - Vital capacity - Inspiratory capacity - Residual volume

- Vital capacity

In the alveoli, the partial pressure of oxygen is - about 104 mmHg. - the same as PO2 for venous blood. - equal with that in the tissues. - lower than the PO2 of venous blood. - much higher than the PO2 for arterial blood.

- about 104 mmHg.

The _______ are the site of gas exchange within the lungs. - bronchi - hila - alveoli - respiratory bronchioles

- alveoli

An example of an enzyme located in the lung capillary membrane that acts on material in the blood is - angiotensin converting enzyme. - prostoglandins. - renin - interferon.

- angiotensin converting enzyme.

Airway resistance is insignificant in relationship to gas flow because - the blood flow is very high in comparison to the viscosity of air. - the gas flow stops in the medium-sized bronchioles and diffusion takes over; therefore, airway resistance is no longer an issue. - in the respiratory system the airway resistance is not related to the diameter of the conducting tubes. - as the airways get smaller they branch more which results in a huge total cross-sectional area.

- as the airways get smaller they branch more which results in a huge total cross-sectional area.

About 20% of carbon dioxide is transported in the blood as - hydrogen ions. - bicarbonate ions. - dissolved gas in the plasma. - oxyhemoglobin. - carbaminohemoglobin.

- carbaminohemoglobin.

Most of the carbon dioxide transported by the blood is - carried by white blood cells. - dissolved in plasma. - converted to bicarbonate ions and transported in plasma. - bound to hemoglobin. - bound to the same protein as carbon dioxide.

- converted to bicarbonate ions and transported in plasma.

The ____________ cartilage is connected to the vocal cords. - corniculate - cricoid - cuneiform - thyroid

- corniculate

"Lung volume reduction" surgery could be used to treat - tuberculosis. - pneumothorax. - emphysema. - asthma.

- emphysema.

The _________________ is covered by a mucosa containing taste buds, and keeps food out of the lower respiratory passages. - epiglottis - vestibular folds - glottis - uvula

- epiglottis

The elastic cartilage that shields the opening to the larynx during swallowing is the - epiglottis. - cuneiform cartilage. - corniculate cartilage. - cricoid cartilage. - thyroid cartilage.

- epiglottis.

Which of the following non-respiratory movements is caused by irritation of the diaphragm? - coughing - hiccups - laughing - crying

- hiccups

The increase in ventilation in response to metabolic needs is called ___________. - hyperpnea - hypocapnia - Hering-Breuer reflex - hyperventilation

- hyperpnea

Which of the following conditions would not decrease the total respiratory compliance? - thorax deformities - paralysis of the intercostal muscles - increase in lung compliance - calcification of the coastal cartilages

- increase in lung compliance

All of the following would diminish lung compliance except - an increase in alveolar surface tension. - chronic inflammation. - increase in the production of surfactant. - tuberculosis.

- increase in the production of surfactant.

All of the following would be caused by breathing excessively high concentrations of oxygen for a long period of time except - coma. - oxygen toxicity. - production of huge amounts of free radicals. - increased mental function.

- increased mental function.

The philtrum of the nose is the part that is located - inferior to the apex. - between the eyebrows. - superior to the alae. - on the anterior margin.

- inferior to the apex.

Which of the following functions is not performed by the respiratory system? - internal respiration - pulmonary ventilation - breathing - external respiration

- internal respiration

The transpulmonary pressure is the difference between the ____________ and the __________ pressure. - intrapulmonary; intrapleural - atmospheric; intrapulmonary - intrapleural; alveolar - atmospheric; intrapleural

- intrapulmonary; intrapleural

The dorsal respiratory group - is located dorsally at the root of cranial nerve IX. - ends at the pons-medullary junction. - extends from the brain stem. - is a rhythm generating center.

- is located dorsally at the root of cranial nerve IX.

The smallest subdivision of the lung that is visible to the naked eye is the - alveolus. - lobule. - bronchiole. - lobe.

- lobule.

Which of the following would not be found in a "blue bloater"? - right-sided heart failure - pulmonary hypertension - cyanosis - loss of weight

- loss of weight

Involuntary hyperventilation during an anxiety attack may cause the person to become faint due to - decreasing O2 levels in the blood causing cells to NOT have enough ATP. - increased temperature due to increased intercostals muscle activity. - effects of increased O2 levels in the blood and consequent constriction of cerebral blood vessels. - Increasing CO2 levels due to increase in cellular respiration, reducing brain perfusion and causing ischemia - lowering CO2 levels in the blood and consequent constriction of cerebral blood vessels.

- lowering CO2 levels in the blood and consequent constriction of cerebral blood vessels.

Hemoglobin has a tendency to release oxygen where - pH is more acidic. - partial pressures of carbon dioxide are lower. - pH is more alkaline. - temperature is lower. - partial pressures of oxygen are higher.

- pH is more acidic.

The tubular tonsils arch over the opening to the - nasopharynx. - layryngopharynx - pharyngotympanic tubes. - oropharynx.

- pharyngotympanic tubes.

The movement of air into and out of the lungs is called - internal respiration. - cellular respiration. - external respiration. - oxidative phosphorylation. - pulmonary ventilation.

- pulmonary ventilation.

Which of the following conditions would not cause atelectasis? - after pneumonia - smoking - a chest wound that perforates the pleura and allows air into the pleural cavity - plugging of bronchioli

- smoking

Which of the following would not directly decrease the alveolar surface involved in gas exchange? - smoking - tumors of the lung - inflammatory products - emphysema

- smoking

The pontine respiratory group is responsible for all of the following functions except - regulating and modifying the activity of the medullary neurons. - smoothing out the transition from inspiration to expiration. - causing apneustic breathing if it is damaged. - stimulating the contraction of the diaphragm.

- stimulating the contraction of the diaphragm.

The ___________ is the elastic connective tissue found within the lungs. - stroma - pulmonary plexus - parietal pleura - visceral pleura

- stroma

Air moves into the lungs because - the thorax is muscular. - contraction of the diaphragm decreases the volume of the pleural cavity. - the gas pressure in the lungs becomes less than outside pressure as the diaphragm contracts. - the internal intercostals muscles decrease the thoracic cavity volume. - the volume of the lungs decreases with inspiration.

- the gas pressure in the lungs becomes less than outside pressure as the diaphragm contracts.

Alveolar ventilation rate is - the utilization of oxygen by alveolar cells to support metabolism. - movement of dissolved gases from the blood to the alveoli. - less than pulmonary ventilation due to dead space. - the movement of dissolved gases from the alveoli to the blood. - the movement of air into and out of the alveoli during a particular time.

- the movement of air into and out of the alveoli during a particular time.

Which of the following non-respiratory movements would ventilate all of the alveoli? - crying - yawning - hiccups - sneezing

- yawning

expiration

-During quiet breathing, expiration achieved by elasticity of lung and thoracic cage -as volume of thoracic cavity decreases intrapulmonary pressure increases and air is expelled -After inspiration, phrenic nerves continue to stimulate diaphragm to produce a braking action to elastic recoil. Phrenic nerve help to stimulate diaphragm

respiration system processes

-respiration supplies body with oxygen and disposes of carbon dioxide 4 processes 1. Pulmonary ventilation movement of air into and out of lungs gases continually changed 2. External respiration gas exchange between blood and lungs Circulatory system 3. Transport of respiratory gases oxygen uptake and carbon dioxide dump transport of gases between lungs and cells 4. Internal respiration (tissue) gas exchange between systemic blood cells Need both respiratory and circulatory system without one the cell dies

The three factors that affect how easy air passage and the amount of energy required for ventilation

1. Airway resistance a certain amount of flow of air based on the 2. Alveolar surface tension 3. Lung compliance

Three components that create the respiratory membrane

1. Alveolar epithelium , 2. fused basement membranes of alveolar epithelium and capillary endothelium 3. Capillary endothelium

pulmonary circulation ( lungs are perfused by two circulations

1.pulmonary circulation (deoxygenated) Pulmonary arteries deliver systemic venous blood from heart to lungs for oxygenation Branch profusely to feed into pulmonary capillaries network Pulmonary veins: carry oxygenated blood from respiratory zone back to the heart. Low pressure high volume system Lung capillary endothelium contain many enzymes that act in different substances in blood Example angiotensin-converting enzymes activates blood pressure hormone Angiotensin covering enzymes (ACE) enters into the lungs using ACE Angiotensin 1 cleaves to angiotensin 2. Increase blood pressure and blood volume activated and gets the release of aldosterone

Air inhaled in

760mmHg diaphragm contracts move down Air exhaled Exhalation diaphragm relaxes moves up 762 in thoracic cage 762

Respriatory defense system

A quart if mucus containing lysosomes is secreted to trap particles and kill bacteria Defensins natural antibiotic are secreted to kill microbes Nasal cavity exposure to unpleasant stimuli infection increases production of mucus. Ex cold Nasal mucosa richly supplied w/nerve endings irritating particles trigger sneeze to blow irritants out 100 mph Nasal cavity cilia sweep mucus with movement of mucus to pharynx trapped debris toward pharynx to be swallowed mucocillary esculator

nasopharynx

Air passages posterior to nasal cavity Lining contains pseudostratified columnar epithelium Soft palate and uvula close nasopharynx during swallowing Pharyngeal tonsils adenoids located on posterior wall Pharyngotympanic tubes (auditory tubes) drain and equalize pressure in middle ear and open into lateral wall

Braching

Air ways undergo 23 orders of branching Branching referred to as bronchial tree Tips for bronchial tree Conducting zone structures give rise to respiratory zone structures

breathing mechanic

Atmospheric pressure drives respiration 1 atmospheric pressure 760mmHg Pressure gradients difference between atmospheric and intrapulmonary pressure also called intra-alveolar pressure Flow of air in and out of lung require a pressure difference between air pressure within. Lungs and outside. As we inhale we flatten the diaphragm it opens up increase in volume cause a decrease in pressure cause air to flow in Intraplureal is more negative than intrapulmonary pressure-4mm Hg 756 before you breathe

Why is the right lung have three lines and left side has 2

Because the apex of the heart is on the left side. Right is bigger and can exchange More gas

How do we breathe

Boyles law if you decrease the volume of gas the pressure will rise; if you increase the volume of gas its pressure will fall Air flow will flow from higher pressure to lower diffusion Pressure= pressure of gas V= volume of gas Temperature must be constant P1xV1 = P 2 V2

respritory membrane

Composed of simple squamous blood air barrier that consists of alveolar and capillary walls along with their fused basement membrane very thin allows gas exchange across membrane by simple diffusion Alveolar walls consist of single layers of squamous epithelium (type 1 alveolar cell) 2. Scattered cuboidal type 2 alveolar cells secrete surfactant antimicrobial proteins help keep alveolar open Also alveoli macrophages

Superior middle and inferior meatuses

Create turbulence why? To bump into mucus and gives time air time to warm up

Nose is the only external portion of respiratory system

Function of nose Provides an airway for respiration Moisten and warms entering air Filters and cleans inspired air Serves as resonating chamber for speech House olfactory receptors Divides into two regions external nose and nasal cavity

Lungs

Help get rid of waste

larynx anatomy

Hyoid bone only bone , membrane attaching to it. Is connect via ligaments thyroid cartilage main component Function in the production of sound you have vocal fold two set outer vestibular fold on the top inner vocal fold . Glottis covers vocal fold air moves across true vocal fold that vibrates creates sound Vocal folds in closed position closed glottis Glottis is the opening between vocal folds Folds vibrate to produce sound as air rushes up from lungs Vestibular folds (false vocal cords) Superior to vocal folds no part in sound help close glottis during swallowing

Clinically swollen adenoids

Infected adenoids can block air passages in nasopharynx making it necessary to breathe through the mouth As a result air is not properly moistened warmed or filtrated before reaching the lungs When adenoids are chronically enlarged both speech and sleep may be disrupted

Mechanics is breathing Pulmonary ventilation consists of two phases

Inspiration gases flow into lungs Expiration gases exit lungs

inspiration

Intrapleural pressure needs to be more negative As the volume of thoracic cavity increase pleura clings to parietal pleura Intrapulmonary pressure Lungs expand with visceral pleura Transpulmonary pressure Inteapleural minus intrapulmonary pressure not all pressure change in the pleural cavity is transferred to the lungs Inflation aided by warming of inhaled air think tires on bike expanding in warmer weather

Hilum found on mediastinal surface, it is the site for entry/ exit of blood vessels, bronchi, lymphatic vessels, and nerves

Left lung is separated into superior and inferior lobes by oblique fissure Smaller than right because of the position of the Heart Cardiac notch con cavity for heart to fit into Right lung separated into superior, middle, and inferior lobes Superior and middle lobes separated by horizontal fissures Middle and inferior lobes separated by oblique fissure

Gross Anatomy of the Lungs

Lungs occupy all of the thoracic cavity except for mediastinum Root: site of vascular and bronchial attachment to mediastinum Costal surface anterior, lateral, and posterior surface Apex: superior tip, deep to clavicle Base: inferior surface that rests on diaphragm Only one locate where bronchi enter the pulmonary artery pulmonary vein enter hilum region

Trachea walls composed of

Mucosa ciliated pseudostratified epithelium with goblet cells Submucosa Connective tissue with seromucous glands supported by 16-20 c shaped cartilage rings that prevent collapse of trachea Adventia Outermost layer made of connective tissue Trachealis Consist of smooth muscle fibers that connect posterior parts of cartilage rings Contract during coughing to expel mucus Carina Last tracheal cartilage that expands and found at point where trachea branches into 2 main bronchi Mucosa of carina highly sensitive Violent coughing will trigger if foreign object makes contact with it

Mucus

Mucus humidifies air inhaled Air in Swirls around picks up heat and evaporates water from nasal mucus Protects delicate respiratory surfaces from begin effected Air out Warmer airs warm nasal mucus and water condenses back into the mucus Breathing through your nose hell prevent water loss When cold cilia becomes sluggish and mucus drips out nose water condenses at lower temperatures Capillaries and thin walled vein warm incoming air dilated when it's cold = epistaxis )nosebleeds

If a child inhaled toe nail clippers where would they end up. Which mainstream bronchus is this item lodged in. Where would you expect it to go?

On the right side because it's wider and shorter . Right primary bronchi

Pharynx funnel-shaped muscular tube that runs from base of skull to vertebrae c6 connects nasal cavity and mouth to larynx and esophagus composed of skeletal muscle

Oropharynx Laryngopharynx Nasopharynx

pleural effusion: fluid accumulation in pleural cavity

Other fluids that may accumulate in pleural cavity Blood leaked from damaged blood vessels Blood filtrate watery fluid that Izzy's from lungs capillaries when left side heart failure occurs

The bronchi and subdivision

Other significant features of alveoli surrounded by fine elastic fibers and pulmonary capillaries Alveolar pores connect adjacent alveoli Equalize air pressure throughout lung Provide alternative route invade of blockage Alveolar macrophages keep alveolar surface sterile 2million dead macrophages/hour carried by cilia to throat and swallowed. Key for fight pathogens

oropharynx

Passageway for food and air from level of soft palate to epiglottis Lining consist of stratified squamous epithelium -lsthmus of faucets opening to oral cavity -palatine tonsils located in lateral walls of fauces Lingual tonsil located on posterior surface of tongue

atelctasis

Plugged bronchioles which cause collapse of alveoli or pneumothorax air in pleural cavity Can occur from either wound in parietal pleura or rupture of visceral pleura; treated by removing air with chest tubes When pleurae heal lung reinflates

bronchial tree ( the conducting zone)

Right & left primary main stem bronchi formed by division of trachea right side is wider, shorter and move more vertical than left Secondary bronchi 3 on right and 2 on left each goes to one lobe of lung Tertiary bronchi divides into 4th 5. Up to 23 Bronchioles no cartilage under 1mm have smooth muscle Terminal bronchioles smallest Respiratory son presence of thin walled air sacs alveoli Respiratory bronchioles arise from terminal bronchioles end in alveolar sac/ alveoli covering like grapes on a bunch

hemothroax

Ruptured blood vessel lead to problems inflating the lungs

pneumothorax

Rupturing either the parietal or visceral pleura can cause pneumothorax. Air in the pleural cavity causes intrapleural pressure to become equal to intrapulmonary pressure as a result the lungs collapse

Why smoker get smokers cough?

Smoking inhibits and ultimately destroys cilia Without cilia coughing is the only way to prevent mucus from accumulating in lungs When people stop smoking ciliary functions usually recovers within a few weeks Morning smokers cough will subside once ciliary function is restored

Pleura

Thin doubled layer serial membrane that divides thoracic cavity into two pleural compartments and mediastinum Parietal pleura Membrane on thoracic wall superior face of diaphragm around heart and between lungs Visceral pleura Membrane on external lung surface Pleural fluid fills slitlike pleural cavity between two pleurae Provides lubrication and surface tension that assists in expansion and recoil of lung

Larynx

Voice box Attach to hyoid bone inferiorly connects with trachea 3 function 1. Provides open airway 2. Switching mechanism for food and air 3. Produce sound Epiglottis is composed of elastic cartilage During swallowing the epiglottis tips downward to cover the larynx and protect the airways

Tidal Volume (TV)

amount of air inhaled or exhaled with each breath under resting conditions about 500 ml for most people

Trachea (windpipe)

extends from the larynx to the 2 bronchi 10 -12cm cartilage rings keep the airways open Trachealis muscle controlled by ANS sympathetic nerves system can increase diameter

pleurisy

inflammation of the pleura that often result from pneumonia Inflamed pleurae become rough resulting in friction and stabbing pain with each breath Pleurae May produce excessive amounts of fluid which may exert pressure on lungs hindering breathing

Laryngitis

inflammation of the vocal folds that causes the vocal folds to swell interfering with vibrations Result in changes to vocal tone causing hoarseness in severe cases speaking is limited to a whisper Laryngitis is most often. Causes by viral infection but may also be due to overuse of voice very dry air bacterial infections tumors

lower respiratory system

larynx, trachea, bronchi, lungs Broken into two zones Respiratory zone site of gas exchange Consists of microscopic structures such as respiratory bronchioles alveolar ducts and alveoli Conducting zone conduits the transport gas to and from gas exchange Includes all other respiratory structures Cleanse warms and humidifies air

Larygopharynx

passageway for food and air Posture to upright Extends to larynx where it is continuous with esophagus Lined with stratified squamous epithelium

Intrapulmonary pressure

pressure in the alveoli, (also called intra-alveolar pressure -Fluctuates with breathing always eventually equalizes with P atm

type 2 pneumocytes

produce surfactant decrease surface tension due to water. Key for premature infants created before birth premature infants lack pneumocyte

Four processes of respiration

pulmonary ventilation, movement of air into and out of lungs (breathing) consists of inspiration and expiration inspiration moves air into the lungs from the atmosphere Expiration moves air out of the lungs into atmosphere 2. External respiration exchanges of oxygen and carbon dioxide from the lungs and blood (occur at the lungs) oxygen diffuse from lungs to the blood Carbon dioxide diffuse from blood to lungs 3. Transport of oxygen to carbon dioxide in blood The cardiovascular system transport gases using blood as the transporting 4. Internal respiration exchanges of oxygen to carbon dioxide between systemic blood vessels

Major functions of the respiratory system

supply the body with oxygen and dispose of carbon dioxide for cellular respiration and dispose of Carbon dioxide a waste product of cellular respiration respiratory are circulatory system are closed coupled also functions in olfaction and speech

Major organs of the respiratory system

upper: nose and nasal cavity, paranasal sinuses, pharynx lower: larynx, trachea, bronchi and branches, lungs and alveoli