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Physio > Chapter 16 - Respiratory System > Flashcards

Chapter 16 - Respiratory System Flashcards

1
Q

what is internal respiration

A

using O2 for oxidative phosphorylation inside mitochondria, releasing CO2 as waste

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2
Q

what is external respiration

A

pulmonary ventilation (moving air in/out of lungs), gas exchange between lungs and blood, transportation in blood, and gas exchange between blood and body tissues

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3
Q

what are the upper airways

A

air passages of the head and neck: nasal cavities, oral cavity, and pharynx

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4
Q

what is the respiratory tract

A

this term is used in the textbook and describes all airways from pharynx to lungs (lower respiratory tract): larynx, trachea, bronchi, and alveoli

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5
Q

what is the conducting zone

A

passages for air. passages in the conducting zone (with exception of bronchioles) have cartilage in their walls. remain open. trachea, bronchi and bronchioles have smooth muscles in their walls

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6
Q

what is the larynx

A

the voice box. consists of epiglottis - protects airways during swallowing, and glottis - opening between vocal folds. the walls are made of cartilage

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7
Q

describe trachea

A

the windpipe. 2.5 cm diameter, 10 cm long, wall contains 15-20 C shaped bands of cartilage, stays open

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8
Q

describe bronchi in conducting zone

A

primary (or main) bronchi right and left. secondary (or lobar) bronchi: 3 on right side to 3 lobes of right lung and 2 on left side to 2 lobes of left lung. in all there are 20-23 orders of branching in bronchial tree. terminal bronchioles are the smallest bronchioles and the end of conducting zone

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9
Q

what is the function of conducting zone

A

air passageway that conditions incoming air by humidifying, warming up, and removing dust and particles from air

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10
Q

describe mucosa of conducting zone

A

goblet cells and mucus glands secrete mucus that help to condition air. ciliated cells have cilia that move particles trapped in mucus toward mouth (mucus escalator)

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11
Q

what is the function of the respiratory zone

A

exchange of gases between air and blood. the mechanism of this action is diffusion

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12
Q

what are the structures of the respiratory zone

A

respiratory bronchioles (have alveoli in their walls). alveolar ducts, and alveolar sacs

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13
Q

what is epithelium like in respiratory zone

A

very thin

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14
Q

what is the arrangement of respiratory membrane

A

back to back arrangement: epithelial cell layer of alveoli along with endothelial cell layer of capillaries

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15
Q

describe alveoli

A

sites of gas exchange, 300 million alveoli in lungs (size of tennis court). rich blood supply because capillaries form dense network over alveoli. alveoli are connected through pores

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16
Q

name 3 cells of the alveoli

A

type 1 alveolar cells that form wall of alveoli (single layer of thin epithelial cells), type 2 alveolar cells secrete surfactant and alveolar macrophages

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17
Q

name bones of the thoracic cavity

A

sternum, thoracic vertebrae, and ribs

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18
Q

describe muscles of thoracic cavity

A

internal and external intercostal muscles in spaces between the ribs, and the diaphragm separates the thoracic and abdominal cavities

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19
Q

what is the pleura

A

the membrane lining of lungs and chest wall: a pleural sac surrounds each lung, intrapleural space is filled with intrapleural fluid (volume is 15 mL)

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20
Q

what is intrapleural space

A

a potential space between the visceral and parietal pleurae, that contains 15 mL of fluid

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21
Q

what is visceral pleura

A

part of the pleura that covers the surface of the lung

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22
Q

what is parietal pleura

A

part of pleura that attaches to rib cage, diaphragm, and pericardium

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23
Q

describe arrangement of visceral and parietal pleura

A

they are in contact with each other held together by surface tension of pleural fluid

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24
Q

what causes air to move in and out of lungs

A

bulk flow determines where air goes, so a pressure gradient drives the flow. air moves from high to low pressure. during inspiration the pressure in lungs is lower than atmospheric pressure, during expiration pressure in lungs is greater than atmospheric pressure

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25
Q

what is Patm, Palv, and Pip

A

atmospheric pressure, intra-alveolar pressure (pressure of air in alveoli), and intrapleural pressure (pressure inside pleural sac)

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26
Q

how do you calculate transpulmonary pressure and what is it

A

Palv-Pip = transpulmonary pressure. it is the distending pressure across the lung wall

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27
Q

what is atmospheric pressure

A

760mm Hg at sea level. other lung pressures are given relative to atmospheric pressure (set Patm = 0 mm Hg)

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28
Q

describe Palv

A

pressure of air in alveoli, given relative to atmospheric pressure, varies with phase of respiration. during inspiration it is negative (less than atmospheric), during expiration it is positive (more than atmospheric)

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29
Q

what drives ventilation

A

the difference between Palv and Patm

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30
Q

describe Pip

A

the pressure inside pleural sac is always negative under normal conditions and always less than Palv. it varies with phase of respiration but at rest it is -4 mm Hg.

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31
Q

what gives Pip its value

A

it is negative due to elasticity in lungs and chest wall. lungs have elastic recoil - tendency to collapse, chest also has elastic recoil - tendency to expand. between the lungs and chest wall is the sealed off intrapleural space. opposing forces pull on intrapleural space and so the pressure inside is less than atmospheric pressure. intrapleural fluid keeps visceral and parietal pleura in close contact and allows frictionless sliding against each other during breathing

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32
Q

what does an increase in transpulmonary pressure cause

A

lungs (alveoli) to expand, increasing the volume. increase in lung volume decreases lung pressure Palv below atmospheric pressure and air flows in down pressure gradient

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33
Q

describe a pneumothorax

A

the entry of air into intrapleural space. without negative intrapleural pressure, elastic recoil is unopposed and causes lung to collapse. to restore negative pressure and open the lung, the intrapleural space is sealed and air is sucked out of it

34
Q

describe equation for air flow

A

Patm - Palv / R (R is resistance to air flow and is related to airway radius and mucus)

35
Q

what is boyle’s law

A

pressure of gas is inversely proportional to its volume

36
Q

do changes in alveolar pressure or atmospheric pressure affect the gradient for air flow

A

changes in alveolar pressure affect the gradient, atmospheric pressure is constant during breathing cycle

37
Q

what is Palv at rest (between breathings)

A

0 (equal to atmospheric pressure) since there is no pressure gradient, no air flow in or out of lungs

38
Q

what happens to Palv as lungs expand

A

alveolar volume increases so Palv decreases driving air into lungs

39
Q

what happens to Palv as lungs recoil

A

alveolar volume decreases and so Palv increases pressure gradient drives air out of lungs

40
Q

describe mechanisms of breathing in quiet respiration

A

contraction of inspiratory muscles increases volume of thoracic cavity while relaxation of inspiratory muscles decrease volume of thoracic cavity

41
Q

describe diagphram and intercostals during quit respiration inspiration

A

diaphragm moves down, increasing superior-inferior dimension of thoracic cavity while intercostals move the ribs up and outward increasing lateral dimension of thoracic cavity

42
Q

describe muscles involved in forceful inspiration

A

additional neck and shoulder muscle contract to increase force expanding the rib cage: sternocleidomastoid and scalenes pulls on the sternum and ribs as well as pectoralis major and minor pull on sternum and ribs

43
Q

describe muscles involved in forceful expiration

A

muscles of abdominal wall increase intra-abdominal pressure and force the diaphragm up

44
Q

compare external and internal intercostals

A

external intercostals are inspiratory muscles while internal intercostals muscles are expiratory muscles

45
Q

describe inspiration sequence of events

A

neural stimulation of inspiratory muscles, diaphragm contraction causes it to flatten and move downward. contraction of external intercostals makes ribs pivot upward and outward, expanding the chest wall. collectively, thoracic cavity volume increases. outward pull on pleura decreases intrapleural pressure, which results in an increase in transpulmonary pressure. alveoli expand, decreasing alveolar pressure, and air flows into alveoli by bulk flow

46
Q

what is lung compliance

A

the ease with which lungs can be stretched. the equation is: deltaV / delta(Palv-Pip)

47
Q

what does a larger lung compliance mean

A

smaller change in trans-pulmonary pressure is needed to bring in a given volume of air, making it easier to inspire.

48
Q

do lungs have a small or large compliance

A

they have a relatively large compliance

49
Q

name two factors affecting lung compliance

A

elasticity and surface tension in alveoli

50
Q

what does more elasticity mean for compliance

A

the more elastic the less compliant

51
Q

describe surface tension in alveoli

A

surface tension: force alveoli to collapse or resist expansion. surface tension arises due to forces of attraction between water molecules at the air-water interface. thin layer of fluid lines alveolar surface and generates surface tension, greater tension leads to less compliance

52
Q

how to alveoli overcome surface tension

A

surfactant secreted from type 2 cells is a detergent-like substance. it reduces forces of attraction between water molecules on surface of alveoli. this decreases surface tension therefore increasing lung compliance making it easier to inspire

53
Q

what is LaPlace’s law equation

A

P = 2T / r

54
Q

describe airway resistance

A

as in vascular resistance alveolar resistance is inversely proportional to 4th power of radius. as airways get smaller in diameter they increase in number keeping overall resistance low normally not impeding airflow. pressure difference of around 1 mm Hg is enough for normal breathing. asthma and chronic pulmonary diseases happen due to an increase in airway resistance

55
Q

name passive forces affecting airway resistance

A

changes in transpulmonary pressure during respiratory cycle: inspiration - transpulmonary pressure increases causing smaller airways to expand. tractive forces: inspiration - as tissues move away from airways, they pull the airways open

56
Q

name 2 non passive factors affecting airway resistance

A

contractile activity of smooth muscle and mucus secretion

57
Q

describe role of bronchiolar smooth muscle in airway resistance

A

bronchoconstriction is where smooth muscle contracts reducing radius while bronchodilation is where smooth muscle relaxes leading to an increase in radius. these states are under the control of both extrinsic and intrinsic controls

58
Q

describe sympathetic control of bronchiole radius

A

relaxation of smooth muscle and thus bronchodilation

59
Q

describe parasympathetic control of bronchiole radius

A

contraction of smooth muscle leading to bronchoconstriction

60
Q

describe hormonal control of bronchiole radius

A

epinephrine leads to relaxation of smooth muscle and thus bronchodilation

61
Q

describe intrinsic control of bronchiole radius

A

histamine leads to bronchoconstriction, this is released during asthma and allergies. it also increases mucus secretion. CO2 leads to bronchodilation

62
Q

name two pathological states that lead to increased airway resistance

A

asthma (which is caused by spastic contractions of bronchiolar smooth muscle), and chronic obstructive pulmonary diseases (COPD)

63
Q

what is spirometry

A

a method of measuring volumes of air and rate of air flow, used as an assessment of lung function.

64
Q

describe tidal volume

A

Vt is a single quiet (unforced) breath with normal volume of 500 mL

65
Q

describe inspiratory reserve volume

A

IRV is after breathing in, the volume you can still inspire. normal volume is 3000 mL

66
Q

describe expiratory reserve volume

A

after breathing out, volume you can still expire. normal volume is 1000 mL

67
Q

describe residual volume

A

volume left inside lungs after ERV (cannot be measure by spirometry, measured by helium dilution method). but normal volume is 1200 mL

68
Q

what is the equation for total lung capacity

A

TLC = Vt + ERV + IRV + RV = 5700 mL (normal)

69
Q

what is forced vital capacity test

A

FVC is a maxiumum-volume inhalation followed by forced exhalation as fast as possible. a low FVC indicates restrictive pulmonary disease

70
Q

what is forced expiratory volume

A

FEV1 is the volume that can be exhaled as fast as possible in the 1st second

71
Q

what is Ratio FEV1/FVC

A

the percentage of FVC that can be exhaled within 1 second. 80% is normal and less than that indicates obstructive pulmonary disease

72
Q

what is an obstructive pulmonary disease

A

associated with increased airway resistance. causes limitation in airflow. major obstructive pulmonary diseases are COPD diseases like chronic bronchities (long-standing inflammation of bronchioles/bronchi) and emphysema (destruction of alveolar walls, producing smaller numbers of larger alveoli). and then non COPD diseases like asthma (inflammation coupled with spasms of smooth muscle of bronchioles)

73
Q

what is a restrictive pulmonary disease

A

any lung disorder that reduces FRC, VC or TLC. making lungs more difficult to expand. decreased compliance, increased stiffness in lung tissues - fibrosis (scarring), lack of surfactant. problems with pleura and chest wall. problems with nerves innervating muscles of chest wall. resistance to airflow is usually normal with these types of disorders

74
Q

what is minute ventilation

A

total volume of air entering and leaving the respiratory system each minute. or minute ventilation = TV x respiration rate

75
Q

what is a normal respiration rate

A

12 breaths/min

76
Q

what is normal minute ventilation

A

500ml x 12 breaths/min = 6000 mL/min. not all of that air is available for gas exchange in alveoli. the reason is anatomical dead space

77
Q

what is anatomical dead space

A

air that fills conducting zone does not participate in gas exchange. so conducting space is anatomical dead space. the volume of dead space is approximately 150 mL

78
Q

what is alveolar ventilation

A

(tidal volume - dead space) x respiratory rate. this is more important for evaluating efficiency of ventilation that minute ventilation

79
Q

what is normal alveolar ventilation value

A

(500ml/breath-150ml/breath) x 12 breaths / min = 4200 mL/min

80
Q

which is more effective at increasing alveolar ventilation: increased depth of breathing or increased rate of breathing

A

increased depth leads to high alveolar ventilation

Physio (7 decks)

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