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Pharyngeal tonsils(adenoids)- located on the posterior wall of the nasopharynx
Palatine tonsils- Located in the posterior portion of the oral cavity
Small cavities in the skull bones, they reduce the weight of the facial bones and add resonance to the voice.
As it enters the nasal passage it is warmed and moistened by the highly vascular mucosa & foreign material is filtered out by the mucous secretions and hairs before the air enters the delicate lung tissue.
Describe the purpose of: Surfactant
has a detergent action that reduces surface tension of the alveolar fluid(the tendency for fluid to reduce its surface area by forming droplets), facilitating inspiration and preventing total collapse of the alveoli during expiration.
Describe the purpose of: The respiratory membrane
a combined alveolar and capillary wall, a very thin membrane, through which gas exchange takes place.
forms the inferior boundary
Describe the purpose of:The bronical artery
Explain why frequent forced expirations are fatiguing.
Passive respiration does not require any cellular enery. Forced expirations are fatiguing because it requires additional energy & muscular activity, and also would not leave suficant amount of oxygen in the system leading to less energy because the body needs oxygen to operate.
Depression of the central nervous system activity(drugs)- leads to slow, shallow breathing
Activity of the hypothalamus- perhaps in response to emotions
Stretch receptors in the lungs or Hering-Breuer reflex- prevents excessive lung expansion
Voluntary control- as required with singing( limited by the levels of carbon dioxide in the blood)
The gas easily diffuses into the cerebrospinal fluid, lowering pH & stimulating the respiratory center, resulting in an increased rate and depth of respirations (hyperventilation)
State the normal serum pH and describe how compensation for decreased serum pH due to a respiratory impairment is achieved.
Normal pH- 7.35 to 7.45A marked decrease inoxygen is necessary before the chemorecptors respond to hypoxemia. This control mechanizm can be important when individuals have chronic lung disease.
Describe how acidosis affects the central nervous system and give two physiologic signs of this condition.
Acidosis depresses the central nervous system, physiologic signs are: headache, lethargy, weakness, & confusion develop, leading eventually to coma and death.
Oxygen diffuses from alveolar air, an area of high concentration of oxygen, to the blood in the pulmonary capillary, which has a low concentration of oxygen, until the concentration becomes equal.
Name the blood vessels bringing blood into the pulmonary circulation, and describe the blood in these vessels.
Pulmonaries arteries- bring venous blood (dark-blue red deoxygenated) to the right side of the heart to be oxygenated
Pulmonary capillaries- in which diffusion of gas exchange occur (where blood become oxygenated)
Pulmonary Veins- which return the oxygenated blood( bright red) to the left side of the heart, which then pumps it out into the systemic circulation
Describe the effect of a thickened respiratory membrane on blood levels of oxygen and carbondioxide. Which gas is affected more?
Fluid accumulates in the alveoli or interstital tissue, diffusion, particularily of oxygen is impaired.
Extra fluid may also impede blood flow through the pulmonary capillaries & increase surface tension in the alveoli, restricting expansion of the lungs. Carbon dioxide levels are increased.
Death by drowning can occur in either of two ways, by the airways filling with water(more common), or reflex laryngospasm (strong muscle contraction of the larynx closing it). Explain how each mechanism causes death.
Death by Drowning is death from asphyxia(severely deficient supply of oxygen to the body) due to suffocation caused by water entering the lungs and preventing the absorption of oxygen leading to cerebral hypoxia.
Relex laryngospasm or Dry drowning:occurs when a person's lungs become unable to extract oxygen from the air
· Stridor- a high pitch crowing noise, usually indicates upper airway obstruction.
Supraglottic inflammation and swelling of epiglottis obstructs airway, onset is rapid.
Signs- High fever, drooling, dysphagia, appears ill, rapid respirations and pulse, Tripod postion.
These drugs may interfere with attachment of the virus to the host cell, with the shedding of the protein coat, with action of enzymes such as reverse transcriptase required for synthesis of DNA & RNA or with protein synthesis.
Describe and explain the significance of a tubercle and cavitation in the progress of TB infection.
The significance of a tubercle is that it distroys the alveoli of the lungs, creating granular, necrosis tissue that does not function. Cavitation is the formation of large open areas in the lungs & erosion into the bronchi & blood vessels. With cavitation spread of organisms to other parts of the lungs is promoted due to open areas & erosion.
Describe how cystic fibrosis affects the lungs and sweat glands.
Lungs- muscus obstructs airflow in the bronchioles and small bronchi, causing air trapping or atelectasis with permanent damage to the bronchial walls.
Sweat glands- Producing sweat that is very high in sodium chloride content, this could lead to excessive loss of electrolytes during hot weather or strenuous activity.
The incidence of lung cancer are about 215,000 case per year in USA & Canada. Women are more likely to develop lung cancer then men. Higher incidence in black males than white males. Almost 90% is related to smoking.
Which structures in the lungs contain a higher percentage of smooth muscle?
The bronchioles & the Bronchi
Explain how obstruction develops in an asthmatic patient following exposure to an inhaled allergens.
- results with air trapping and hyperventilation of the lungs. Air passes distal to the obstruction and aveoli, but is only partially expired, this often causes the bronchial wall to collapse creating further barrier to expiratory airflow.Residual volume increases, it becomes more difficult to inspire fresh air or to cough effectively to remove mucus. This causes the oxygen level in the body to fall and the carbon dioxide levels to rise.
Results when mucus plugs completely block the flow of air in the already narrowed passage. The affect of this is collapse or closure of alveoli resulting in reduced or absent gas exchange. Oxygen levels reduced significantly.
Explain the timing and development of respiratory alkalosis, respiratory acidosis, and metabolic acidosis during as asthma attack.
Respiratory alkalosis- develops initially, because of hyperventilation
Respiratory Acidosis- develops in time due to air trapping, and marked fatigue causes decreased respiratory effort with weaker cough.
Metabolic Acidosis- developsafter respiratory acidosis due to hypoxia(increased lactic acid) and from metabolic acid accumulating from increased metabolic activity and dehydration.
Obstruction of the alveolus, destruction of the alveolar walls & cappillaries & inflammation impairs ventilation and diffusion of O2. This causes air trapping & increased residual volume in the lungs which makes it hard for the person to expire air. Also fibrosis & thickening of the bronical walls intfer with normal expiatory airflow.
Respiratory failure may result because of severe hypoxia or hypercapnia. High blood pressure within the blood vessels of the lungs, can put a strain on the right side of the heart. When the right side of the heart fails or is unable to work against the abnormally high pressures within the lungs, this is called cor pulmonale.
Describe and explain the preferred postion for patients with COPD(e.g., one who is having a dental treatment). Should the patient be relatively supine, upright, or otherwise postioned?
Typical preferred postion for a patient with COPD is a sitting postion, leaning forward(tripod postion), to facilitate breathing.
Explain why bronchiectasis tends to be progressive.
Bronchiectasis is most often secondary to an infectious process, that results in the abnormal and permanent distortion of one or more of the conducting bronchi or airways. Since the affects are permanent this tends to be a progressive disease, with each flare up worsening the condition.
· Inflammation in the lungs, increasing capillary permeability
· Plasma protein levels are low, decreasing plasma osmotic pressure.
· Pulmonary hypertension develops
Explain which is more likely to occur with acute pulmonary edema- Hypoxemia, hypercapnia, or both equally.
Hypoxemia is more likely to occur with pulmonary edema because excessive amounts of fluid in the interstitial areas and alveoli interfere with the diffusion of oxygen, causing severe hypoxemia.
A pulmonary embolus is a blood clot or mass of other material that can block an artery, pulmonary vein, or other areas of the heart causing right sided heart failure & decreased cardiac output (shock).
Explain why a large pleural effusion may have more serious consequences than an obstruction in a major bronchus.
Large pleural effusion can cause limited expansion of the lung, impairing breathing, a tracheal deviation indicates this shift. Also venous return in the inferior vena cava and cardiac filling may be imparied because large effusions increase pressure in the mediastinum. This can cause further problems, even death if not treated.
Explain the signs of atelectasis.
Small areas are asymptomatic.
Large areas- cause dyspnea, increased heart rate & respiratory rates, & chest pain. Chest expansion may appear abnormal or asymmetric.
occurs when air can enter the pleural cavity through an opening directly from the internal airways. There ia no opening in the chest wall.
occurs when a tear on the surface of the lung allows air to escaoe from inside the lung through a bronchus and the visceral pleural into the pleural cavity. As the lung tissue collapses, it seals off the leak.
related to premature birth, occur most commonly in male children, cesarean delivery can be a factor as well as infants born to mothers with diabetes.
Using an example, explain how respiratory failure may develop and explain why this is life threatening.
Chronic conditions such as emphysema may lead to respiratory failure if the degenerative tissue changes progress to the point at which ventilation and gas exchange are minimal. Since the lunga are the only way for us to get oxygen in our body this is life threatening, without adequate oxygen in our body, our cells begin to die and the body itself may expire.
can cause depression of the central nervous system that can result in decreased rate of breathing, decreased heart rate, and loss of consciousness possibly leading to coma or death.
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