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Anatomy And Physiology 2 > Chapter 22: Respiratory system > Flashcards

Chapter 22: Respiratory system Flashcards

0
Q

Respiration:

A

◼️supplying body with O2 for cellular respiration; dispose of CO2, a waste product of cellular respiration
◼️it’s four processes involve both respiratory and circulatory systems
◼️also functions in olfaction and speech

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1
Q

Respiratory major function:

A

Respiration

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2
Q

How many processes does the respiratory system have?

A

Four

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3
Q

What are the four processes of respiration?

A

◼️pulmonary ventilation(breathing)
◼️external respiration
◼️transport
◼️internal respiration

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4
Q

Which two of the four processes is in the respiratory system?

A

◼️pulmonary ventilation (breathing )

◼️external respiration

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5
Q

Which two of the four respiratory processes are in the circulatory system?

A

◼️transport

◼️internal respiration

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6
Q

What is pulmonary ventilation?

A

Movement of air into and out of lungs

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7
Q

What is External respiration?

A

O2 and CO2 exchange between lungs and blood

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8
Q

What is the transport process?

A

O2 and CO2 in blood

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9
Q

What is the internal respiration process?

A

O2 and CO2 exchange between systemic blood vessels and tissues

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10
Q

Major organs of respiration system?

A 
◼️nose, nasal cavity , para nasal sinuses 
◼️pharynx 
◼️larynx 
◼️trachea 
◼️bronchi and their branches 
◼️lungs and alveoli
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11
Q

Respiratory zone:

A

◼️site of gas exchange

◼️microscopic structures : respiratory bronchioles , alveolar ducts, and alveoli

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12
Q

Conducting zone:

A

◼️conduits to gas exchange sites

◼️includes all other respiratory structures: cleanses, warms, humidifies air

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13
Q

The ____ and other respiratory muscles promote ventilation ?

A

Diaphragm

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14
Q

The nose functions :

A 
◼️provides an airway for respiration. 
◼️moistens and warm entering air 
◼️filters cleans inspired air 
◼️serves as resonating chamber for speech 
◼️houses olfactory receptors
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15
Q

What are the two regions of the nose?

A

◼️external nose

◼️nasal cavity

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16
Q

What is the external nose?

A

◼️root, bridge, dorsum nasi, and apex
▪️philtrum - shallow vertical groove inferior to apex
▪️nostrils(nares) - bounded laterally by alae

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17
Q

Nasal cavity:

A

◼️within and posterior to external nose
▪️divided by midline nasal septum
▪️posterior nasal apertures (choanae) open into nasoparynx
▪️roof-ethmoid and sphenoid bones
▪️floor-hard (bone) ad soft palates (muscle)

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18
Q

Nasal vestibule:

A

Nasal cavity superior to nostrils

▪️vibrissae(hairs) filter coarse particles from inspires air

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19
Q

The rest of the nasal cavity is lined with two mucous membranes:

A

◼️olfactory mucosa

◼️respiratory mucosa

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20
Q

What does the olfactory mucosa contain?

A

Olfactory epithelium

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21
Q

What does the respiratory mucosa contain?

A

◼️pseudostratified ciliated columnar epithelium
◼️mucous and serous secretions contain lysozyme and defensins
◼️cilia move contaminated mucus posteriorly to the throat
◼️inspired air warmed by plexuses of capillaries and veins
◼️sensory nerve endings trigger sneezing

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22
Q

Nasal conchae:

A

Superior, middle, and inferior
◼️protrude edible from lateral walls
◼️increase mucosal area
◼️enhance air turbulence

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23
Q

Nasal meatus:

A

Groove inferior to each concha

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24
Q

During inhalation, conchae and nasal mucosa do what?

A

◼️filter
◼️heat
◼️moisten air

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25
Q

During exhalation , conchae and nasal mucosa do what?

A

Reclaim heat and moisture

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26
Q

Where are the paranasal sinuses located?

A

◼️frontal
◼️sphenoid
◼️ethmoid
◼️maxillary

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27
Q

What do the paranasal sinuses do?

A

◼️lighten skull
◼️secrete mucus
◼️help warm & moisten air

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28
Q

Rhinitis:

A

◼️inflammation of nasal mucosa
◼️nasal mucosa continuous with mucosa of respiratory tract ➡️ spreads from nose➡️ throat ➡️ chest
◼️spreads to tear ducts and paranasal sinuses causing
▪️blocked sinus passageways ➡️air absorbed ➡️vacuum ➡️sinus headache

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29
Q

Pharynx:

A

◼️muscular tube from base of skull to C6
▪️connects nasal cavity and mouth to larynx and esophagus
▪️composed of skeletal muscles

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30
Q

Three regions of pharynx ?

A

◼️nasopharynx
◼️oropharynx
◼️laryngopharynx

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31
Q

What is the nasopharynx?

A

Air passageway posterior to nasal cavity

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32
Q

Nasoparynx lining?

A

Pseudostratified columnar epithelium

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33
Q

What closes the nasoparynx during swallowing ?

A

Soft palate and uvula

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34
Q

Which tonsils are on posterior wall of nasopharynx?

A

Pharyngeal tonsil

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35
Q

Where is the pharyngotympanic located?

A

In the nasopharynx open into lateral walls

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36
Q

What is the pharyngotympanic ?

A

Tubes drain and equalize pressure in middle ear

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37
Q

What is the oropharynx?

A

Passageway of food and air from level of soft palate to epiglottis

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38
Q

What three structures are in the oropharynx?

A

◼️isthmus of Fauces
◼️palatine tonsils
◼️lingual tonsils

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39
Q

What type of lining does the oropharynx have?

A

Stratified squamous epithelium

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40
Q

Isthmus of Fauces:

A

Opening to oral cavity

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41
Q

Palatine tonsils :

A

In lateral walls of Fauces

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42
Q

Lingual tonsils:

A

On posterior surface of tongue

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43
Q

Laryngopharynx:

A

Passageway for food and air

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44
Q

Where is the laryngopharynx located?

A

Posterior to upright epiglottis

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45
Q

The laryngopharynx extends to what?

A

To larynx where continuous with esophagus

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46
Q

What type of tissue lines the laryngopharynx ?

A

Stratified squamous epithelium

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47
Q

Larynx:

A

Attaches to hyoid bone, opens into laryngopharynx , continuous with trachea

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48
Q

Functions of larynx?

A

◼️provides patent airway
◼️routes air and food into proper chambers
◼️voice production
▪️houses vocal folds

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49
Q

What are the nine cartilages f the larynx ?

A

All are hyaline cartilage except epiglottis:
▪️thyroid cartilage with laryngeal prominence(Adam’s apple)
▪️ring-shaped cricoid cartilage
▪️paired arytenoid, cuneiform, and corniculate cartilage
▪️epiglottis-ELASTIC CARTILAGE ; covers laryngeal inlet during swallowing ; covered in taste bud containing mucosa
▪️
▪️
▪️
▪️

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50
Q

Vocal ligaments in larynx are located where?

A

Deep to laryngeal mucosa

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51
Q

What do vocal ligaments do?

A

◼️attach arytenoid cartilages to thyroid cartilages
◼️contain elastic fibers
◼️form core of vocal folds (true vocal cords)
▪️glottis- opening between vocal folds
▪️folds vibrate to produce sound as air rushes up from lungs

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52
Q

What are vestibular folds( false vocal cords)?

A

◼️superior to vocal folds
◼️no part on sound production
◼️help to close glottis during swallowing

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53
Q

Epithelium of larynx:

A

◼️superior portion : stratified squamous epithelium

◼️inferior to vocal folds: pseudostratified ciliated columnar epithelium

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54
Q

Voice production:

A

◼️speech-intermittent release of expired air while opening and closing glottis

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55
Q

How is voice production pitch determined?

A

By length and tension of vocal cords

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56
Q

What does voice production loudness depend on?

A

Upon force of air

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57
Q

What chambers amplify and enhance sound quality?

A

◼️pharynx
◼️oral
◼️nasal
◼️sinus cavities

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58
Q

Sound is shaped into language by what?

A 
Muscles of 
▪️pharynx 
▪️tongue 
▪️soft palate 
▪️lips
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59
Q

The larynx may act as ___ to prevent air passage?

A

Sphincter

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60
Q

Valsalva’s maneuver:

A

◼️glottis closes to prevent exhalation
◼️abdominal muscles contract
◼️intra-abdominal pressure rises
◼️helps to empty rectum or stabilizes trunk during heavy lifting

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61
Q

What is the trachea?

A

Windpipe- from larynx into mediastinum

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62
Q

What three layers compose the trachea?

A

◼️mucosa
◼️sub mucosa
◼️adventitia

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63
Q

Mucosa of trachea:

A

Ciliated pseudostratified epithelium with goblet cells

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64
Q

Submucosa of trachea:

A

Connective tissue with seromucous glands

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65
Q

Adventitia of trachea:

A

Outermost layer made of connective tissue ; encases C-shaped rings of hyaline cartilage

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66
Q

Trachealis:

A

◼️connects posterior parts of cartilage rings

◼️contracts during coughing to expel mucus

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67
Q

Carina:

A

◼️spar of cartilage on last, expanded tracheal cartilage

◼️point where trachea branches into two main bronchi

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68
Q

Bronchi and subdivisions:

A

◼️air passages undergo 23 orders of branching ➡️ bronchial (respiratory ) tree
◼️from tips of bronchial tree ➡️ conducting zone structures ➡️ respiratory zone structures

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69
Q

Conducting zone structures :

A

◼️trachea ➡️ right and left main(primary ) bronchi
◼️each main bronchus enters Hilum of one lung
-right main bronchus wider, shorter, more vertical than left
◼️each main bronchus branches into lobar (secondary) bronchi (three on right, two on left)
-each lobar bronchus supplies one lobe

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70
Q

Each lobar bronchus branches into what?

A

Segmental (tertiary ) bronchi
- segmental bronchi divide repeatedly
◼️branches become smaller and smaller :
-bronchioles = less than 1mm in diameter
-terminal bronchioles = smallest -less than 0.5 diameter

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71
Q

In conducting zone, from bronchi through bronchioles, structural changes occur :

A

◼️cartilage rings become irregular plates; in bronchioles elastic fibers replace cartilage
◼️epithelium chambers from pseudostratified columnar to cuboidal ; cilia and goblet cells become sparse
◼️relative punt of smooth muscle increases ➡️ allows constriction

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72
Q

Respiratory zone:

A

Begins as terminal bronchioles ➡️ respiratory bronchioles ➡️ alveolar ducts ➡️ alveolar ducts

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73
Q

Alveolar sacs contain what?

A

Clusters of alveoli
▪️~300 million alveoli make up most of lung volume
▪️sites of gas exchange

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74
Q

Respiratory membrane:

A

◼️alveolar and capillary walls and their fused basement membranes:
-~0.5 um thick; gas exchange across membrane by simple diffusion
◼️alveolar walls (single layer of squamous epithelium –type I alveolar cells )
◼️scattered cuboidal type II alveolar cells secrete cuboidal surfactant and anti microbial proteins

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75
Q

Alveoli is surrounded by what?

A

Fine elastic fibers and pulmonary capillaries

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76
Q

Alveolar pores:

A

Connect to adjacent alveoli.

▪️they equalize air pressure throughout lung

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77
Q

Alveolar macrophages:

A

Keep alveolar surfaces sterile

▪️2 million dead macrophages/hour carried by cilia➡️throat➡️swallowed

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78
Q

Lungs occupy the what?

A

Thoracic cavity except mediastinum

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79
Q

The roots of the lungs is:

A

The site of vascular and bronchial attachment to mediastinum

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80
Q

The lungs costal surface is:

A

Anterior, lateral, and posterior surfaces

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81
Q

Lungs are composed primarily of what?

A

Primarily of alveoli

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82
Q

The lungs balance :

A

Stroma- elastic connective tissue ➡️elasticity

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83
Q

The apex of the lungs :

A

Superior tip, deep to clavicle

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84
Q

The base of the lungs:

A

Inferior surface ; rests on diaphragm

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85
Q

The Hilum of the lungs:

A

On mediastinal surface; site for entry/exit of blood vessels, and nerves

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86
Q

The left lung is smaller than the right. True or false?

A

True

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87
Q

Cardiac notch:

A

Con cavity for heart

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88
Q

The right lung:

A

Superior , middle, inferior lobes separated by oblique and horizontal fissures

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89
Q

Bronchopulmonary segments:

A

(10 right , 8-10 left) separated by connective tissue septa

▪️ if diseased can be individually removed

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90
Q

Lobules:

A

Smallest subdivisions visible to naked eye; served by bronchioles and their branches

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91
Q

Pulmonary circulation:

A

(Low pressure, high volume)

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92
Q

Pulmonary arteries:

A

Deliver systemic venous blood to lungs for oxygenation

▪️branch profusely, feed into pulmonary capillary networks

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93
Q

Pulmonary veins :

A

Carry oxygenated blood from respiratory zones to heart

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94
Q

The lung capillary epithelium contains ____ to act on substances in blood?

A

Enzymes

Ex: angiotensin-converting enzyme- activates blood pressure hormone

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95
Q

What do Bronchial arteries do?

A

Provide oxygenated blood to lung tissue

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96
Q

Bronchial arteries:

A

▪️arise from aorta and enter lungs at Hilum
▪️part of systemic circulation (high pressure, low volume)
▪️supply all lung tissue except alveoli
▪️bronchial veins anastomose with pulmonary veins (pulmonary veins carry most venous blood back to heart)

97
Q

What is pleurae?

A

Thin, double layered serosa; divides thoracic cavity into two pleural compartments and mediastinum

98
Q

Parietal pleurae:

A

On thoracic wall, superior face of diaphragm, around heart, between lungs

99
Q

Visceral pleurae:

A

On external surface of lungs

100
Q

Pleural fluid:

A

Fills slit like pleural cavity

-Provides lubrication and surface tension ➡️assists in expansion and recoil

101
Q

Pulmonary ventilation consists of two phases:

A

◼️inspiration -gases flow into lungs

◼️expiration- gases exit lungs

102
Q

Atmospheric pressure:

A

◼️pressure exerted by air surrounding body

◼️760 mm Hg at sea level = 1 atmosphere

103
Q

Respiratory pressures described relative to P ATM:

A

◼️negative respiratory pressure- less than P ATM
◼️positive respiratory pressure -greater than P ATM
◼️zero respiratory pressure = P ATM

104
Q

Intrapulmonary pressure(intra-alveolar) P pul:

A

◼️pressure in alveoli
◼️fluctuations with breathing
◼️always eventually equalizes with P ATM

105
Q

Intrapleural pressure(Pip):

A 
◼️pressure in pleural cavity 
◼️fluctuates with breathing 
◼️always NEGATIVE pressure 
◼️fluid level must be minimal 
      ▪️pumped out by lymphatics 
       ▪️if accumulates ➡️ positive Pip             pressure ➡️ lung collapse
106
Q

Negative Pip caused by opposing forces:

A

◼️two inward forces promote lung collapse
▪️elastic recoil of lungs decreases lung size
▪️surface tension of alveolar fluid reduces alveolar size

◼️one outward force tends to enlarge lungs
▪️elasticity of chest wall pulls thorax outward

107
Q

Pressure relationships:

A

◼if Pip = Ppul or Patm ➡️➡️lung collapse

108
Q

Ppul - Pip = transpulmonary pressure :

A

◼️keeps airways open

◼️greater trans pulmonary pressure ➡️larger lungs

109
Q

Atelectasis(lung collapse):

A

◼️plugged bronchioles = collapse of alveoli
◼️pneumothorax : air in pleural cavity
▪️from either wound in pariet or rupture of visceral pleura
▪️treated by removing air with chest tubes; pleurae heal ➡️lung reinflates

110
Q

Pulmonary ventilation :

A

◼️inspiration and expiration
◼️mechanical processes that depend on volume changes in thoracic cavity :
▪️volume changes➡️pressure changes
▪️pressure changes ➡️gases flow to equalize pressure

111
Q

Boyle’s Law :

A

◼️relationship between pressure and volume of a gas
▪️gases fill container; if container size reduced ➡️increased pressure
◼️pressure (P) varies inversely with volume (V) :
P1V1= P2V2

112
Q

Inspiration:

A

◼️active processes:
▪️inspiration muscles (diaphragm and external intercostals) contract
▪️thoracic volume increases ➡️intra pulmonary pressure drops (to -1mm Hg)
▪️lungs stretched and intra pulmonary volume increases
▪️air flows into lungs, down its pressure gradient until Ppul= Patm

113
Q

Forced inspiration:

A

Vigorous excerise, COPD➡️ ACCESSORY MUSCLES (scalene a, sternoccleidomastoid, pectorals minor)➡️ further increase in thoracic cage size

114
Q

Quiet expiration normally passive process:

A

◼Inspiratory muscles relax
◼️thoracic cavity volume decreases
◼️elastic lungs recoils and intra pulmonary volume decreases ➡️pressure increases (Ppul rises to +1 mmHg) ➡️
◼️air flows out of lungs down its pressure gradient until Ppul= 0

115
Q

Forced expiration- active process uses abdominal (oblique and transverse) and internal intercostal muscles. True or false ?

A

True

116
Q

Three physical factors influencing pulmonary ventilation:

A

◼️airway resistance
◼️alveolar surface tension
◼️lung compliance

117
Q

Airway resistance:

A

◼️friction- major non elastic source of resistance to gas flow; occurs in airways
◼️relationship between flow (F) pressure (P ) and resistance (R) is:
F=

118
Q

Airway resistance is usually insignificant :

A

◼️large airway diameters in first part of conducting zone
◼️progressive branching of airways as get smaller, increasing greatest in medium-sized bronchi
◼️resistance disappears at terminal bronchioles where diffusion drives gas movement

119
Q

As airway resistance rises, breathing movements become more what?

A

Strenuous

120
Q

Severe constriction or obstruction of bronchioles:

A

◼️can prevent life sustaining ventilation

◼️can occur during acute asthma attacks; stops ventilation

121
Q

Epinephrine dilates bronchioles , reduces what ?

A

Air resistance

122
Q

Surface tension:

A

◼️attracts liquid molecules to one another at gas-liquid interface
◼️resisted any force that tends to increase surface area of liquid
◼️water-high tension; coats alveolar walls➡️ reduces them to smallest size

123
Q

Lung compliance :

A

◼️measure of change in lung volume that occurs with given change in trans pulmonary pressure
◼️higher lung compliance ➡️easier to expand lungs
◼️normally high due to :
-distensibility of lung tissue
-surfactant , which decreases alveolar surface tension

124
Q

Lung compliance is diminished by:

A

◼️non elastic scar tissue replacing lung tissue (fibrosis)
◼️reduced production of surfactant
◼️decreased flexibility of thoracic cage

125
Q

Total respiratory compliance is also influenced by compliance of the thoracic wall which is decrease by:

A

◼️deformities of thorax
◼️ossification of costal cartilage
◼️paralysis of intercostal muscles

126
Q

Used to assess respiratory status:

A

◼️tidal volume (TV)
◼️Inspiratory reserve volume(IRV)
◼️exploratory reserve volume(ERV)
◼️residual volume (RV)

127
Q

Respiratory capacities:

A

◼️Inspiratory capacity (IC)
◼️functional residual capacity (FRC)
◼️vital capacity (VC)
◼️total lung capacity (TLC)

128
Q

Anatomical dead space:

A

◼️no contribution to gas exchange

◼️air remaining in passageways ; ~150 ml

129
Q

Alveolar dead space:

A

Non functional alveoli Due to collapse or obstruction

130
Q

Total dead space:

A

Sum of anatomical and alveolar dead space

131
Q

Spirometer:

A

Instrument for measuring respiratory volumes and capacities.
Spirometer can distinguish between :
▪️obstructive pulmonary disease
▪️restrictive disorders

132
Q

Obstructive pulmonary disease:

A

Increased airway resistance (ex: bronchitis )

◼️TLC ,FRC ,RV may increase

133
Q

Restrictive disorders:

A

Reduced TLC due to disease or fibrosis

◼️VC, TLC ,RV decline

134
Q

To measure RATE of gas movement :

A

◼️forced vital capacity (FVC)

◼️forced exploratory volume (FEV)

135
Q

Forced vital capacity:

A

Gas forcibly expelled after taking deep breath

136
Q

Forced exploratory volume :

A

Amount of gas expelled during one specific time intervals or FVC

137
Q

Minute ventilation:

A

Total amount if gas flow into or out of respiratory tract in one minute:
▪️normal at rest = ~6 L/min
▪️normal with excerise = up to 200L/min
▪️only rough estimate of respiratory efficiency

138
Q

Alveolar ventilation:

A

◼️good indicator of effective ventilation
◼️alveolar ventilation rate (AVR) - flow of gases into and out of alveoli during a particular time
◼️dead space normally constant
◼️rapid, shallow breathing decreases AVR

139
Q

Non respiratory air movements:

A

◼️May modify normal respiratory rhythm
◼️most result from reflex action; some voluntary
◼️examples include: cough, sneeze, crying, laughing, hiccups, and yawns

140
Q

Gas exchange between blood, lungs, and tissues : external respiration:

A

Diffusion of gases in lungs

141
Q

Gas exchange between blood, lungs, and tissues : internal respiration:

A

Diffusion of gases at body tissues

142
Q

Gas exchange between blood, lungs, and tissues : external/internal respiration both involve ?

A

◼️physical properties if gases

◼️composition of alveolar gas

143
Q

Dalton’s Law of Partial Pressures :

A

◼️total pressure exerted by mixture of gases = sum of pressure extorted by each gas
◼️partial pressure:
▪️pressure exerted by each gas mixture
▪️directly proportion to its percentage in mixture

144
Q

Henry’s Law:

A

◼️gas mixtures in contact with liquid:
▪️each gas dissolves in proportion to its partial pressure
▪️at equilibrium , partial pressures in two phases will be equal
▪️amount of each gas that will dissolve depends on:
-solubility -CO2 20 times more soluble in water than O2 ; little N2 dissolves in water
-temperature- as temperature rises, solubility decreases
-

145
Q

Alveoli contain more CO2 and water vapor than atmospheric air:

A

◼️gas exchange in lungs
◼humidification of air
◼️mixing of alveolar gas with each breath

146
Q

External respiration:

A

◼️exchange of of O2 and CO2 across respiratory membrane
◼️influenced by :
▪️thickness and surface area of respiratory membrane
▪️partial pressure gradients and gas solubilities
▪️ventilation-perfusion coupling

147
Q

Thickness of respiratory membranes :

A

◼️0.5 to 1 u m thick

◼️large total surface area (40 minutes that of skin) for gas exchange

148
Q

Respiratory membranes thicken if lungs become waterlogged and edematous➡️

A

Gas exchange inadequate

149
Q

Reduced surface area in emphysema (walls of adjacent alveoli break down) , rumors, inflammation, mucus. True or false?

A

True

150
Q

Steel partial pressure gradient for O2 in lungs :

A

◼️venous blood Po2 = 40 mm Hg
◼️alveolar Po2 = 104 mmHg
▪️drives oxygen flow to blood
▪️equilibrium reached across respiratory membrane in ~ .25 seconds, about 1/3 time a red bold cell in pulmonary capillary ➡️adequate oxygenation even if blood flow increases 3X

151
Q

Parties pressure gradient for CO2 in lungs less steep:

A

◼️venous blood Pco2 = 45 mm Hg
◼️alveolar Pco2 = 40 mmHg

◼️though gradient not as steep, CO2 diffuse in equal amounts with oxygen :
▪️CO2 20 times more soluble in plasma than oxygen

152
Q

Perfusion is :

A

Blood flow reaching alveoli

153
Q

Ventilation is:

A

Amount of GAS reaching alveoli

154
Q

Ventilation and perfusion matched (coupled) for efficient gas exchange :

A

◼️never balanced for all alveoli due to:
▪️regional variations due to effect of gravity on blood and air flow
▪️some alveolar ducts plugged with mucus

155
Q

Perfusion:

A

Changes in Po2 in alveoli cause changes in diameters of Arterioles :
▪️where alveolar O2 is high, Arterioles dilate
▪️where alveolar O2 is low, Arterioles constrict
▪️directs most blood where alveolar oxygen high

156
Q

Changes in Pco2 in alveoli cause changes in diameters of bronchioles :

A

◼️where alveolar CO2 is high, bronchioles dilate
◼️where alveolar CO2 is low, bronchioles constrict
◼️allows elimination of CO2 more rapidly

157
Q

Internal respiration:

A

◼️capillary gas exchange in body tissues
◼️partial pressures and diffusion gradients reversed compared to external respiration :
▪️tissue Po2 always lower than in systemic arterial blood➡️oxygen from blood tissues
▪️CO2 ➡️from tissues to blood
▪️venous blood Po2 40 mmHg and Pco2 45 mmHg
▪️

158
Q

Transports of respiratory gases by blood:

A

◼️oxygen transport

◼️Carson dioxide transport

159
Q

O2 (oxygen) transport:

A

◼️molecular O2 carried on blood:
▪️1.5 % dissolved in plasma
▪️98.5% loosely bound to each Fe of myoglobin (Hb) in RBCs
4 O2 per Hb

160
Q

Oxyhemoglobin :(HbO2)

A

Hemoglobin-O2 combination

161
Q

Reduced hemoglobin (deoxyhemoglobin) (HHb)-

A

Hemoglobin that has released O2

162
Q

Loading and unloading of O2 facilitated by change in shape of Hb:

A

◼️As O2 binds, Hb affinity for O2 increases
◼️as O2 is released, Hb affinity for O2 decreases
◼️fully saturated: 100% if all four heme groups carry O2
◼️partially saturated when one to three hemes carry O2

163
Q

Rate of loading and unloading of O2 regulated to ensure adequate oxygen delivery to cells:

A 
◼️Po2
◼️temperature
◼️blood pH 
◼️Pco2
◼️concentration- of BPG- produced by RBCs during glycolysis ; levels rise when oxygen levels chronically low
164
Q

Influence of Po2 on hemoglobin saturation:

A

◼️oxygen-hemoglobin dissociation curve
◼️hemoglobin saturation plotted against Po2 not linear; S-shaped curve
▪️binding and release of O2 influenced by Po2

165
Q

Influence of Po2 on hemoglobin saturation : In arterial blood:

A

◼️Po2 = 100 mmHg
◼️contains 20 ml oxygen per 100 ml blood (20 vol%)
◼️Hb is 98% saturated
◼️further increases in Po2 (ex: breathing deeaply) produce minimal increase in O2 binding

166
Q

Influence of Po2 on hemoglobin saturation : in venous blood:

A

◼️Po2 = 40mmHg
◼️contains 15 vol % oxygen
◼️Hb is 85% saturated
◼️venous reserve : oxygen remaining in venous blood

167
Q

Other factors influencing hemoglobin saturation :

A

◼️increases in temperature , H+ , Pco2, and BPG:
▪️modify structure of hemoglobin ; decrease its affinity for O2
▪️occur in systemic capillaries
▪️enhance O2 unloading from blood
▪️shift O2- hemoglobin dissociation curve to right

◼️decreases in these factors shift curve to left :
▪️decreases oxygen unloading from blood

168
Q

Factors that increase release of O2 by hemoglobin:

A

◼️as cells metabolize glucose and use O2:

▪️Pco2 and H+ increase in capillary blood ➡️
▪️declining blood pH and increasing Pco2 ➡️
-Bohr effect: Hb-O2 bond weakens➡️oxygen unloading where needed most
▪️heat production increases ➡️directly and indirectly decreases Hb affinity for O2➡️increased oxygen unloading to active tissues

169
Q

Hypoxia :

A

Inadequate O2 delivery to tissues ➡️cyanosis

170
Q

Anemic hypoxia :

A

Too few RBC ; abnormal or too little Hb

171
Q

Ischemic hypoxia :

A

Impaired / blocked circulation

172
Q

Histotoxic hypoxia:

A

Cells unable to use O2 , as in metabolic poisons

173
Q

Hypoxemic hypoxia :

A

Abnormal ventilation ; pulmonary disease

174
Q

Carbon monoxide poisoning :

A

Especially from fire; 200X greater affinity for Hb than oxygen

175
Q

CO2 transport:

A

◼️CO2 transported in blood in three forms:
▪️7 to 10% dissolved in plasma
▪️20% bound to glob in of hemoglobin
▪️70% transported as bicarbonate ions (HCO3-) in plasma

176
Q

Transport and exchange of CO2:

A

◼️CO2 combines with water to form carbonic acid (H2CO23) which quickly dissociates
◼️occurs primarily in RBCs where carbonic anhydrase reversibly and rapidly catalyzes reaction

177
Q

Transport and exchange of CO2 : in systemic capillaries:

A

◼️HCO3- Quickly diffuses from RBCs Into plasma :

▪️chloride shift occurs : outrush of HCO3- from RBCs balanced as Cl- moves into RBCs from plasma

178
Q

Transport and exchange of CO2 : on pulmonary capillaries:

A

◼️HCO3- moves into RBCs (while Cl- moves out) ; binds with H+ to form H2CO3
◼️H2CO3 split by carbonic anhydrase into CO2 and water
◼️CO2 diffuses into alveoli

179
Q

Haldane effect: amount of CO2 transported affected by Po2:

A

▪️reduced hemoglobin (less oxygen saturation ) forms carbonaminohemoglobin and buffers H+ more easily ➡️
▪️lowers Po2 and hemoglobin saturation with O2; more CO2 carried in blood
◼️encourages CO2 exchange in tissues and lungs

180
Q

Haldane effect : at tissues as more CO2 enters blood :

A

◼️more oxygen dissociates from hemoglobin (Bohr effect)

◼️as Hbo2 releases O2, it more readily forms binds with CO2 to form carbaminohemoglobin

181
Q

Carbonic acid-bicarbonate buffer system:

A

Resists change a in blood pH
▪️if H+ in blood rises, excess H+ is removed by combining with HCO3- ➡️H2CO3
▪️if H+ concentration begins to drop, H2CO3 dissociates , releasing H+
▪️HCO3- is alkaline reserve of carbonic acid-bicarbonate buffer system

182
Q

Influence of CO2 on blood pH:

Changes in respiratory rate and depth affect blood pH:

A

◼️slow, shallow breathing➡️increased CO2 in blood➡️ drop in pH
◼️rapid, deep breathing ➡️decreased CO2 in blood➡️ rise in pH

◼️changes in ventilation can adjust pH when disturbed by metabolic factors

183
Q

Control of respiration:

A

◼️involves higher brain centers, chemoreceptors , and other reflexes
◼️neural controls

184
Q

What are the neural controls of respiration?

A

◼️neurons in reticular formation of medulla and pons
◼️clustered neurons in medulla important :
▪️ventral respiratory group
▪️dorsal respiratory group

185
Q

Ventral respiratory group (VRG) :

Rhythm:

A

Generating and integrative center.

-sets eupnea (12-15 breaths/ min) —normal respiratory rate and rhythm

186
Q

Ventral respiratory group (VRG) :

Inspiratory neurons excite Inspiratory muscles via ___ and ___?

A 
Via phrenic (diaphragm)
And 
Intercostal nerves (external intercostals)
187
Q

Ventral respiratory group (VRG) :

Exploratory neurons inhibit ___?

A

Inspiratory neurons

188
Q

Dorsal respiratory group (DRG):

A

◼️near root of cranial nerve IX

◼️integrates input from peripheral stretch and chemoreceptors ; sends information ➡️ VRG

189
Q

Pontine respiratory centers:

A

◼️influence and modify activity of VRG
◼️smooth out transition between inspiration and expiration and vice versa
◼️transmit impulses to VRG➡️modify and fine-tune breathing rhythms during vocalization, sleep, exercise

190
Q

Generation of the respiratory system:

A

◼️not well understood
◼️one hypophysis :
▪️pacemaker neurons with intrinsic rhythmicity
◼️most widely accepted hypothesis
▪️reciprocal inhibition of two sets of interconnected pacemaker neurons in medulla that generates rhythm

191
Q

Factors influencing breathing rate and depth:

A

◼️depth determined by how actively respiratory center stimulates respiratory muscles
◼️rate determined by how long Inspiratory center active
◼️both modified in response to changing body demands:
▪️most important are changing levels of CO2 , O2, and H+
▪️sensed by central and peripher chemoreceptors

192
Q

Chemical factors : influence of Pco2 ( most potent; most closely controlled) :

A

◼️of blood Pco2 levels rise (hypercapnia) CO2 accumulates in brain➡️
◼️CO2 in brain hydrated ➡️carbonic acid➡️dissociates, releasing H+➡️ pH drops
◼️H+ stimulates central chemoreceptors of brain stem
◼️chemoreceptors synapse with respiratory regulatory centers➡️increased depth and rate of breathing ➡️lower blood Pco2➡️ pH rises

193
Q

Hyperventilation:

A

◼️increased depth and rate of breathing that exceeds body’s need to remove Co2
▪️➡️decreased blood CO2 levels (hypocapnia)
▪️➡️cerebral vasoconstriction and cerebral ischemia
➡️dizziness , fainting

194
Q

Apnea:

A

Breathing cessation; may be due to abnormally low Pco2

195
Q

Chemical factors: influence of Po2:

A

◼️peripheral chemoreceptors in aortic and carotid bodies– arterial O2 level sensors
▪️when excited, cause respiratory center to increase ventilation
◼️declining Po2, normally slight effect on ventilation :
▪️huge O2 reservoir bound to Hb
▪️requires substantial drop in arterial Po2 (to 60 mm Hg) to stimulate increased ventilation

196
Q

Chemical factors: influence of arterial pH:

A

◼️can modify respiratory rate and rhythm even if CO2 and O2 levels normal
◼️mediated by peripheral chemoreceptors
◼️decreased pH may reflect
▪️CO2 retention; accumulation of lactic acid; excess ketone bodies
◼️respiratory system controls attempt to raise pH by increasing respiratory rate and depth

197
Q

Summary of chemical factors:

A

◼️rising CO2 levels most powerful respiratory stimulant
◼️normally blood Po2 affects breathing by indirectly by influencing peripheral chemoreceptors sensitivity to changes in Pco2

198
Q

When arterial Po2 falls below 60mm Hg, it becomes major stimulus for ___?

A

Respiration (via peripheral chemoreceptors )

199
Q

Changes in arterial pH resulting from Co2 retention or metabolic factors act indirectly through __?

A

Peripheral chemoreceptors

200
Q

Hypothalamic controls:

A

◼️act through limbic system to modify rate and depth of respiration (ex:breath holding that occurs in anger or gasping with pain)
◼️rise in body temperature increases respiratory rate

201
Q

Cortical controls:

A

Direct signals from cerebral motor cortex that bypass medullary controls
(Ex: voluntary breath holding. Brain stem reinstates breathing when blood CO2 critical)

202
Q

Pulmonary irritant reflexes:

A

◼️receptors on bronchioles respond to irritants :
▪️communicate with respiratory centers via Vagal nerve afferents
◼️promote reflective constriction of air passages
◼️same irritant ➡️cough in trachea or bronchi ; sneeze in nasal cavity

203
Q

Hering-Breuer Reflex (inflation reflex):

A

◼️stretch receptors in pleurae and airways stimulated by lung inflation
▪️inhibitory signals to medullary respiration centers end inhalation and allow expiration
▪️acts as protective response more than normal regulatory mechanism

204
Q

Respiratory adjustments geared to both __ and __?

A

Intensity
And
Duration if exercise

205
Q

Hyperpnea:

A

◼️increased ventilation (10 to 20 fold) in response to metabolic needs

206
Q

What 3 factors remain constant during exercise?

A

◼️Pco2
◼️Po2
◼️pH

207
Q

3 neural factors cause increase in ventilation as exercise begins:

A

◼️psychological stimuli: anticipation of exercise
◼️simultaneous cortical motor activation of skeletal muscles and respiratory centers
◼️excitatory impulses to respiratory centers from proprioceptora in moving muscles , tendons, joints

208
Q

Respiratory adjustments: exercise:

A

◼️ventilation declines suddenly as exercise ends because the three neural factors shut off
◼️gradual decline to baseline because of decline in CO2 flow after exercise ends
◼️exercise ➡️anaerobic respiration➡️lactic acid
▪️not from poor respiratory function; from insufficient cardiac output or skeletal muscle inability to increase oxygen uptake

209
Q

High altitude :

A

◼️quick travel to altitudes above 2400 meters (8000 feet) may ➡️symptoms of acute mountain sickness (AMS)
▪️atmospheric pressure and Po2 levels lower
▪️headaches, shortness of breath, dizziness , nausea
▪️in severe cases, lethal cerebral and pulmonary edema

210
Q

Acclimatization:

A

◼️respiratory and hematopoietic adjustments to long-term move to high altitude
▪️chemoreceptors become more responsive to Pco2 when Po2 declines
▪️substantial decline in Po2 directly stimulates peripheral chemoreceptors
▪️result – minute ventilation increases and stabilizes in few days to 2-3 L/min higher than at sea level

211
Q

Acclimatization to high altitude is always __ than normal Hb saturation levels?

A

Lower than normal.

-less O2 available

212
Q

Decline in blood O2 stimulates ___ to accelerate production of EPO?

A

Kidneys

213
Q

RBC numbers ___ to provide long-term compensation?

A

Increase slowly

214
Q

Chronic obstructive pulmonary disease:

A

◼️exemplified by chronic bronchitis and emphysema
◼️irreversible decrease on ability to force air out of lungs
◼️other common features:
▪️history of smoking in 80% of patients
▪️dyspnea: labored breathing “air hunger”
▪️coughing and frequent pulmonary infections
▪️most develop respiratory failure (hypo ventilation) accompanied by respiratory acidosis, hypoxemia

215
Q

Emphysema:

A

◼️permanent enlargement of alveoli; destruction of alveolar walls ; decreased lung elasticity ➡️
▪️accessory muscles necessary for breathing
-exhaustion from energy usage
▪️hyperinflation➡️flattened diaphragm ➡️reduced ventilation efficiency
▪️damaged pulmonary capillaries➡️enlarged right ventricle

216
Q

Chronic bronchitis:

A

◼️inhaled irritants➡️chronic excessive mucus ➡️
◼️inflamed and fibrosis lower respiratory passageways➡️
◼️obstructed airways➡️
◼️impaired lung ventilation and gas exchange ➡️
◼️frequent pulmonary infections

217
Q

COPD symptoms:

A

◼️strength of innate respiratory drive ➡️different symptoms in patients
▪️”pink” buffers -thin bear normal blood gases
▪️”blue” buffers - stocky , hypoxic

218
Q

COPD treatment :

A 
Treated with :
▪️bronchodilators
▪️corticosteroids
▪️oxygen
▪️sometimes surgery
219
Q

Asthma -reversible COPD:

A

◼️characterized by coughing, dyspnea, wheezing, and chest tightness
◼️active inflammation of airways precedes bronchospasms
◼️airway inflammation is immune response caused by release of interleukins, production of IgE , and recruitment of inflammatory cells
◼️airways thickened with inflammatory exudate magnify effect of bronchspasms

220
Q

Tuberculosis(TB):

A

◼️infectious disease caused by bacterium Mycobacterium tuberculosis
◼️symptoms: fever, night sweats, weight loss, racking cough , coughing up blood
◼️treatment -12 month course of antibiotics
▪️are antibiotic resistant strains

221
Q

Lung cancer:

A 
◼️leading cause of cancer deaths in North America 
◼️90% of all cases result of smoking 
◼️three most common types:
▪️adenocarcinoma
▪️squamous cell carcinoma 
▪️small cell carcinoma
222
Q

Adenocarcinoma:

A

(40% of cases)

Originates in peripheral lung areas -bronchi glands, alveolar cells

223
Q

Squamous cell carcinoma:

A

(20-40% of cases)

In bronchial epithelium

224
Q

Small Cell carcinoma:

A

(20% of cases)

Contains lymphocyte-like cells that originate in primary bronchi and subsequently meta size

225
Q

___ scan better than chest X ray?

A

Helical CT scan

226
Q

Of no metastasis __?

A

Then surgery to remove diseased lung tissue

227
Q

If metastasis__?

A

Radiation and chemotherapy

228
Q

New therapies for lung cancer:

A

◼️antibodies target growth factors required by Timor ; or deliver toxic agents to tumor
◼️cancer vaccines to stimulate immune system
◼️gene therapy to replace defective genes

229
Q

Which structures develop first?

A

Upper respiratory structures

230
Q

Olfactory placodes:

A

Invaginate into olfactory pits (> nasal cavities ) by fourth week

231
Q

Laryngotracheal bud:

A

Present by 5th week

232
Q

Mucosae of bronchi and lung alveoli present by what week?

A

8th week

233
Q

By what week can a premature baby breathe on its own?

A

28th

234
Q

How does gas exchange take place in fetus?

A

Via placenta

235
Q

Cystic fibrosis:

A

◼️most common lethal genetic disease in North America
◼️abnormal viscous mucus clogs passageways ➡️bacterial infections
▪️affects lungs , pancreatic ducts, reproductive ducts
◼️cause abnormal gene for Cl- membrane channel

236
Q

Treatment for cystic fibrosis :

A

◼️mucus - dissolving drugs ; manipulation to loosen mucus ; antibiotics
◼️research into:
▪️introducing normal genes
▪️prodding different protein➡️ Cl- channel
▪️feeding patients abnormal protein from ER to ➡️Cl- channels
▪️inhaling hypertonic saline to thin mucus

237
Q

At birth , respiratory centers activated __ and __ ?

A

◼️alveoli inflate

◼️lungs begin to function

238
Q

Respiratory rate highest in __?

A

Newborns and slows until adulthood

239
Q

Lungs continue to mature and more alveoli formed until ___?

A

Young adulthood

240
Q

Respiratory efficiency decreases in __ ?

A

Old age

Anatomy And Physiology 2 (7 decks)

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