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630: Medical Physiology > Breathing > Flashcards

Breathing Flashcards

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USMLE® Step 1 flashcards
1
Q

What is breathing controlled by?

A

centers in the brainstem

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2
Q

What are the 4 components that control breathing

A

1) chemoreceptors for O2 and CO2
2) mechanoreceptors in the lungs and joints
3) control centers for breathing in the brainstem
4) respiratory muscles

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3
Q

Breathing is an involuntary process that is controlled by the _____ and _____ of the brainstem.

A

medulla

pons

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4
Q

What are the 3 brain stem centers that control the frequency of normal, involuntary breathing?

A
  • medullary respiratory center
  • apneustic center
  • pneumotaxic center
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5
Q

What are the 2 groups of neurons that compose the medullary respiratory center?

A
  • inspiratory center

- expiratory center

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6
Q

Afferent (sensory) information reaches the medullary inspiratory center via what 3 things?

A
  • central chemoreceptors
  • peripheral chemoreceptors
  • mechanoreceptors (in the lungs, muscles, and joints)
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7
Q

Efferent (motor) information is sent from the medullary inspiratory center to which nerve?

A

To the phrenic nerve, which innervates the diaphragm

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8
Q

What is apneusis?

A

An abnormal breathing pattern with prolonged inspiratory gasps, followed by brief expiratory movement

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9
Q

Stimulation of the apneustic center _____ the inspiratory center in the medulla. What does this result in?

A

excites

Results in prolonging the period of APs in the phrenic nerve, and thereby prolonging the contraction of the diaphragm

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10
Q

The pneumotaxic center turns inspiration ___.

A

off

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11
Q

What structures are the most important for the minute-to-minute control of breathing?

A

the central chemoreceptors in the brainstem

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12
Q

Increases in arterial PCO2 produces _____ in PCO2 in the brain and the CSF, which _____ pH of the CSF. Central chemoreceptors detect this decrease in pH and signal the inspiratory center to _____ the breathing rate

A

increases

decreases

increase

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13
Q

Other than chemoreceptors, what other types of receptors are involved in the control of breathing?

A
  • Lung stretch receptors
  • Joint and muscle receptors
  • Irritant receptors
  • J receptors
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14
Q

Lung stretch receptors instruct the inspiratory center to _____ the breathing rate.

A

decrease

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15
Q

Joint and muscle receptors instruct the inspiratory center to _____ the breathing rate.

A

increase

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16
Q

Irritant receptors instruct the inspiratory center to _____ the breathing rate.

A

increase

17
Q

J receptors instruct the inspiratory center to _____ the breathing rate.

A

increase

18
Q

What 6 things increase in response to exercise?

A
  • O2 consumption
  • CO2 production
  • ventilation
  • CO
  • pulmonary blood flow
  • venous PCO2
19
Q

What 2 things decrease in response to exercise?

A
  • pH (sometimes)

- physiologic dead space

20
Q

What 3 things are unaffected in response to exercise?

A
  • Arterial PO2
  • Arterial PCO2
  • pH (sometimes)
21
Q

What happens to V/Q in response to exercise?

A

It increases in the lungs

22
Q

In response to exercise the O2-hemoglobin dissociation curve shifts to the ____. Which means P50 _____ and the affinity for O2 _____.

A

right

increases

decreases

23
Q

What 4 things increase in response to high altitude?

A
  • ventilation rate
  • pH
  • pulmonary resistance
  • pulmonary artery pressure
24
Q

What 2 things decrease in response to high altitude?

A
  • alveolar PO2

- arterial PO2

25
Q

In response to high altitude the O2-hemoglobin dissociation curve shifts to the ____. Which means P50 _____ and the affinity for O2 _____.

A

right

increases

decreases

26
Q

Define hypoxemia

A

a decrease in arterial PO2

27
Q

What are 5 examples in which arterial PO2 decreases, which causes hypoxemia?

A
  • high altitude
  • hypoventilation
  • diffusion defect (fibrosis)
  • V/Q defect
  • right-to-left shunt
28
Q

What is a useful tool for comparing causes of hypoxemia?

A

the A-a gradient

29
Q

What is the A-a gradient?

A

the difference between the PO2 of alveolar gas and the PO2 of systemic arterial blood

A-a gradient = PAO2 - PaO2

30
Q

In some cases of hypoxemia, the A-a gradient is _____. What does this signify?

A

increased, signifying a defect in O2 equilibrium

31
Q

Define hypoxia

A

a decrease in O2 delivery to, or utilization by, the tissues

32
Q

What are the 5 causes of hypoxia?

A
  • decreased cardiac output
  • hypoxemia
  • anemia
  • carbon monoxide poisoning
  • cyanide poisoning

630: Medical Physiology (24 decks)

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