Chapter 22 - The Respiratory System Flashcards

1
Q

The major function of the respiratory system is ___.

A

respiration

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2
Q

The respiratory system plays what part in cellular respiration?

A
  1. supplies body with oxygen -for-

2. disposes of carbon dioxide as a waste product -of-

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3
Q

The four processes of respiration involve both ___ and ___ systems.

A

respiratory; circulatory

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4
Q

The respiratory system also functions in:

A

olfaction and speech

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5
Q

The processes of respiration are:

A
  1. pulmonary ventilation
  2. external respiration
  3. transport
  4. internal respiration
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6
Q

The processes of respiration are divided into two systems:

A
  1. respiratory system

2. circulatory system

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7
Q

The processes of respiration in the respiratory system are:

A

pulmonary ventilation and external respiration

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8
Q

The processes of respiration in the circulatory system are:

A

transport and internal respiration

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9
Q

Pulmonary ventilation is:

A

(breathing)-movement of air into and out of lungs

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10
Q

External respiration is:

A

O2 and CO2 exchange between lungs and blood

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11
Q

Transport in respiration is:

A

O2 and CO2 in blood

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12
Q

Internal respiration is:

A

O2 and CO2 exchange between systemic blood vessels and tissues

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13
Q

The major organs of the respiratory system are:

A
  • nose, nasal cavity, and paranasal sinuses
  • pharynx
  • larynx
  • trachea
  • bronchi and their branches
  • lungs and alveoli
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14
Q

The functional anatomy of the respiratory system are divided into two zones, which are:

A
  1. respiratory zone

2. conducting zone

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15
Q

The respiratory zone is the site of:

A

gas exchange

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16
Q

The microscopic structures of the respiratory zone are:

A
  • respiratory bronchioles
  • alveolar ducts
  • alveoli
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17
Q

The conducting zone acts as:

A

a conduit to gas exchange sites

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18
Q

The conducting zone includes ___ structures.

A

all other respiratory

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19
Q

The function of the conducting zone is:

A

cleansing, warming, and humidifying air

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20
Q

____ and ___ promote ventilation.

A

Diaphragm; other respiratory muscles

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21
Q

The nose’s functions are:

A
  1. providing an airway for respiration
  2. moistening and warming entering air
  3. filtering and cleaning inspired air
  4. serving as a resonating chamber for speech
  5. housing olfactory receptors
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22
Q

The two regions of the nose are:

A

external nose and nasal cavity

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23
Q

External nose structures:

A
  • root
  • bridge
  • dorsum nasi
  • apex
  • philtrum
  • nares (nostrils)
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24
Q

shallow vertical groove inferior to nose apex

A

philtrum

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25
Q

nares are bounded laterally by:

A

alae

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26
Q

The nasal cavity is located:

A

within and posterior to external nose

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27
Q

structures of the nasal cavity

A
  1. nasal septum
  2. posterior nasal apertures (chonchae)
  3. roof-ethmoid and sphenoid bones
  4. on floor-hard (bone) and soft palates (muscle)
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28
Q

the nasal cavity is divided midline by

A

the nasal septum

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29
Q

these open into the nasal pharynx

A

posterior nasal apertures (chonchae)

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30
Q

nasal cavity structures (continued)

A
  • nasal vestibule
  • nasal conchae
  • nasal meatus
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31
Q

part of the nasal cavity superior to the nostrils

A

nasal vestibule

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32
Q

the nasal vestibule contains:

A

vibrissae (hairs)

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33
Q

function of vibrissae

A

to filter coarse particles from inspired air

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34
Q

The rest of the nasal cavity is lined with mucous membranes, which are:

A
  1. olfactory mucosa

2. respiratory mucosa

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35
Q

Olfactory mucosa contains _____.

A

olfactory epithelium

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36
Q

cell structure of respiratory mucosa

A

pseudostratified ciliated columnar epithelium

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37
Q

mucous and serous secretions of respiratory mucosa contain:

A

lysozyme and defensins

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38
Q

function of the cilia of respiratory mucosa

A

move contaminated mucus posteriorly to throat

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39
Q

inspired air is warmed by ____ of respiratory mucosa

A

plexuses of capillaries and veins

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40
Q

____ trigger sneezing in respiratory mucosa

A

sensory nerve endings

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41
Q

Nasal conchae protrudes ____ from ____.

A

medially; lateral walls

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42
Q

functions of nasal conchae

A
  • increase mucosal area

- enhance air turbulence

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43
Q

groove inferior to each nasal concha

A

nasal meatus

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44
Q

During inhalation, nasal conchae and nasal mucosa do what?

A

filter, heat, and moisten air

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45
Q

During exhalation, nasal conchae and nasal mucosa do what?

A

reclaim heat and moisture

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46
Q

the paranasal sinuses are located

A

in frontal, sphenoid, ethmoid, and maxillary bones

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47
Q

functions of the paranasal sinuses

A
  1. lighten skull
  2. secrete mucus
  3. help to warm and moisten air
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48
Q

Homeostatic imbalance of nasal mucosa leads to

A

rhinitis

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49
Q

inflammation of nasal mucosa

A

rhinitis

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50
Q

in rhinitis, nasal mucosa is continuous with mucosa of the respiratory tract, which leads to

A

spreading from the nose to the throat to the chest

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51
Q

in rhinitis, nasal mucosa also spreads to

A

tear ducts and paranasal sinuses

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52
Q

when nasal mucosa spreads to tear ducts and paranasal sinuses in rhinitis, what happens?

A

blocked sinus passageways

  • -> air absorbed
  • -> vacuum
  • -> sinus headache
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53
Q

muscular tube from base of skull to C6

A

pharynx

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54
Q

the pharynx connects

A

nasal cavity and mouth to larynx and esophagus

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55
Q

the pharynx is composed of

A

skeletal muscle

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56
Q

The three regions of the pharynx are:

A
  1. nasopharynx
  2. oropharynx
  3. laryngopharynx
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57
Q

air passageway posterior to nasal cavity

A

nasopharynx

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58
Q

the lining of the nasopharynx is:

A

pseudostratified columnar epithelium

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59
Q

___ and ___ close nasopharynx during swallowing.

A

soft palate; uvula

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60
Q

The nasopharynx extends from ____, to ____, to ____.

A

pharyngeal tonsil; pharyngotympanic tube; uvula

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61
Q

located on the posterior wall of the nasopharynx

A

pharyngeal tonsil

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62
Q

pharyngeal tonsil is also called

A

adenoids

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63
Q

function of pharyngotympanic tubes

A

drain and equalise pressure in middle ear

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64
Q

pharyngotympanic tubes open into ___ walls

A

lateral

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65
Q

pharyngotympanic tubes are also called

A

auditory

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66
Q

passageway for food and air

A

oropharynx

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67
Q

food and air passageway of the oropharynx extends from the level of ___ to ____.

A

soft palate; epiglottis

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68
Q

the oropharynx has a lining of

A

stratified squamous epithelium

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69
Q

opening to oral cavity is called

A

isthmus of fauces

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70
Q

these are located in lateral walls of fauces

A

palatine tonsils

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71
Q

located on the posterior surface of the tongue

A

lingual tonsil

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72
Q

the ___ is also a passageway for food and air

A

laryngopharynx

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73
Q

the laryngopharynx is posterior to

A

upright epiglottis

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74
Q

the laryngopharynx extends to ____, where it is continuous with ___.

A

larynx; esophagus

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75
Q

the laryngopharynx is lined with

A

stratified squamous epithelium

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76
Q

The larynx attaches to

A

hyoid bone

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77
Q

The larynx opens into

A

laryngopharynx

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78
Q

The larynx is continuous with

A

trachea

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79
Q

Functions of the larynx are:

A
  • provides patent airway
  • routes air and food into proper channels
  • voice production (houses vocal cords)
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80
Q

The larynx is all ___ cartilage except for the epiglottis.

A

hyaline

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81
Q

The different cartilages of the larynx are:

A
  1. thyroid cartilage
  2. cricoid cartilage
  3. paired arytenoid
  4. paired cuneiform
  5. paired corniculate
  6. elastic cartilage (epiglottis)
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82
Q

The thyroid cartilage of the larynx has

A

laryngeal prominence (Adam’s apple)

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83
Q

the elastic cartilage of the epiglottis covers

A

laryngeal inlet during swallowing

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84
Q

the epiglottis is covered in

A

taste bud-containing mucosa

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85
Q

located deep to laryngeal mucosa

A

vocal ligaments

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86
Q

Vocal ligaments attach ___ to ____.

A

arytenoid cartilages; thyroid cartilage

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87
Q

vocal ligaments contain ___ fibres.

A

elastic

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88
Q

vocal ligaments form the core of:

A

vocal folds (true vocal cords)

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89
Q

opening between vocal folds

A

glottis

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90
Q

vocal folds produce sound by

A

vibration as air rushes up from lungs

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91
Q

Vestibular folds are ___ vocal cords.

A

false

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92
Q

Vestibular folds are located

A

superior to vocal folds

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93
Q

Do vestibular folds play a part in sound production?

A

no

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94
Q

Vestibular folds help to close what?

A

glottis during swallowing

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95
Q

The epithelium of the superior portion of the larynx is

A

stratified squamous epithelium

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96
Q

The epithelium inferior to vocal folds of the larynx is

A

pseudostratified ciliated columnar epithelium

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97
Q

How is speech produced?

A

by intermittent release of expired air while opening and closing glottis

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98
Q

Voice pitch is determined by

A

length and tension of vocal cords

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99
Q

Loudness of voice is determined by

A

force of air upon vocal cords

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100
Q

Chambers of ___ amplify and enhance sound quality.

A
  • pharynx
  • oral
  • nasal
  • sinus
    cavities
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101
Q

Sound is “shaped” into language by muscles of:

A
  1. pharynx
  2. tongue
  3. soft palate
  4. lips
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102
Q

vocal folds of larynx may act to prevent air passage as

A

sphincter

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103
Q

an example of acting as sphincter

A

Valsalva’s manoeuvre

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104
Q

Process of Valsalva’s manoevre

A
  • glottis closes to prevent exhalation
  • -> abdominal muscles contract
  • -> intra-abdominal pressure rises
  • -> helps to empty rectum or stabilises trunk during heavy lifting
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105
Q

the trachea is also known as

A

windpipe

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106
Q

the trachea extends from

A

larynx into mediastinum

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107
Q

The treacheal wall is composed of three layers:

A
  1. mucosa
  2. submucosa
  3. adventitia
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108
Q

structure of mucosa in trachea

A

ciliated pseudostratified epithelium with goblet cells

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109
Q

structure of submucosa in trachea

A

connective tissue with seromucous glands

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110
Q

structure of adventitia in trachea

A
  • outermost layer is made of connective tissue

- encases C-shaped rings of hyaline cartilage

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111
Q

the trachealis muscle connects

A

posterior parts of cartilage rings

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112
Q

trachealis muscle contracts when?

A

during coughing to expel mucus

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113
Q

spar of cartilage on last, expanded tracheal cartilage

A

carina

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114
Q

the carina is the point where the trachea branches into

A

two main bronchi

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115
Q

Air passages undergo how many orders of branching? What is this known as?

A

23; bronchial (respiratory) tree

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116
Q

Process of air passage from bronchial tree

A
  • tips of bronchial tree
  • ->conducting zone structures
  • ->respiratory zone structures
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117
Q

The trachea branches into

A

right and left main (primary) bronchi

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118
Q

Each main bronchus enters ___ of one lung.

A

hilum

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119
Q

Right main bronchus is more ___ than left.

A
  • wider
  • shorter
  • more vertical
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120
Q

Each main bronchus branches into

A

lobar (secondary) bronchi

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121
Q

There are ___ lobar bronchi on right, ___ on left.

A

three; two

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122
Q

Each lobar bronchus supplies

A

one lobe

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123
Q

Each lobar bronchus branches into

A

segmental (tertiary) bronchi

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124
Q

Segmental bronchi divide

A

repeatedly

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125
Q

Bronchi branches become smaller and smaller into

A
  1. bronchioles

2. terminal bronchioles

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126
Q

size of bronchioles

A

less than 1 mm in diameter

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127
Q

size of terminal bronchioles

A

smallest–less than 0.5 mm in diameter

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128
Q

The conducting zone structures are

A

from bronchi through bronchioles

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129
Q

Structural changes occur from bronchi through bronchioles. Cartilage rings become:

A

irregular plates

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130
Q

in bronchioles ___ replace cartilage

A

elastic fibres

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131
Q

The epithelium from bronchi through bronchioles changes from ___ to ___.

A

pseudostratified columnar; cuboidal

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132
Q

From bronchi through bronchioles, ___ and ___ become sparse.

A

cilia; goblet cells

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133
Q

From bronchi through bronchioles, the relative amount of ___ increases. This allows for ____.

A

smooth muscles; constriction

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134
Q

The respiratory zone begins as

A

terminal bronchioles

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135
Q

Branches of the respiratory zone

A
  • begins as terminal bronchioles
  • ->respiratory bronchioles
  • ->alveolar ducts
  • ->alveolar sacs
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136
Q

Alveolar sacs contain clusters of ___.

A

alveoli

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137
Q

Most of the lung volume is made up of

A

~300 million alveoli

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138
Q

Alveoli are sites of

A

gas exchange

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139
Q

The respiratory membrane is composed of

A
  • alveolar and capillary walls and their fused basement membranes
  • type i alveolar cells
  • type ii alveolar cells
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140
Q

the fused basement membrane of alveolar and capillary walls is approximately ____ thick

A

0.5 micrometres

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141
Q

the fused basement membrane of alveolar and capillary walls allows for

A

gas exchange across membrane by simple diffusion

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142
Q

cell type of type i alveolar cells/alveolar walls

A

single layer of squamous epithelium

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143
Q

cell type of type ii alveolar cells

A

scattered cuboidal

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144
Q

type ii alveolar cells secrete

A

surfactant and antimicrobial proteins

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145
Q

alveoli are surrounded by ___ and ____

A

fine elastic fibres; pulmonary capillaries

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146
Q

____ connect adjacent alveoli

A

alveolar pores

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147
Q

alveolar pores allow for

A

equalising air pressure throughout lung

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148
Q

____ keep alveolar surfaces sterile

A

alveolar macrophages

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149
Q

dead macrophages are carried by ___ to ___ to ___

A

cilia; throat; being swallowed

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150
Q

rate of dead macrophage carriage by cilia

A

2 million/hour

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151
Q

The lungs occupy all of the thoracic cavity except

A

mediastinum

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152
Q

The root of the lung is

A

site of vascular and bronchial attachment to mediastinum

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153
Q

costal surface of lung is divided into

A

anterior, lateral, and posterior surfaces

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154
Q

the lungs are composed mainly of

A

alveoli

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155
Q

lung balance is maintained by

A

stroma–elastic connective tissue (allows for elasticity)

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156
Q

the apex of the lung is located

A

superior tip; deep to clavicle

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157
Q

the base of the lung is located

A

inferior surface; rests on diaphragm

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158
Q

the hilum of the lung is located

A

on mediastinal surface

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159
Q

the hilum of the lung is site for

A

entry/exit of blood vessels, bronchi, lymphatic vessels, and nerves

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160
Q

the ___ lung is smaller than the ___

A

left; right

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161
Q

concavity of lung for heart

A

cardiac notch

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162
Q

the left lung is separated into lobes by

A

oblique fissure

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163
Q

lobes of the left lung

A
  • superior

- inferior

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164
Q

the right lung is separated into lobes by

A

oblique and horizontal fissures

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165
Q

lobes of the right lung

A
  1. superior
  2. middle
  3. inferior
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166
Q

the lungs contain

A
  • bronchopulmonary segments

- lobules

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167
Q

amount of bronchopulmonary segments in right lung

A

10

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168
Q

amount of bronchopulmonary segments in left lung

A

8-10

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169
Q

bronchopulmonary segments in lungs are separated by

A

connective tissue septa

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170
Q

if bronchopulmonary segments are diseased

A

they can be individually removed

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171
Q

smallest subdivisions in the lungs visible to the naked eye

A

lobules

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172
Q

lobules are served by

A

bronchioles and their branches

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173
Q

circulation with low pressure and high volume

A

pulmonary

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174
Q

_____ deliver systemic venous blood to lungs for oxygenation

A

pulmonary arteries

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175
Q

pulmonary arteries branch profusely and feed into

A

pulmonary capillary networks

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176
Q

___ carry oxygenated blood from respiratory zones to the heart

A

pulmonary veins

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177
Q

Lung capillary endothelium contains

A

enzymes that act on substances in blood

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178
Q

Example of enzyme lung capillary endothelium contains

A

angiotensin-converting enzyme–activates blood pressure hormone

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179
Q

____ provide oxygenated blood to lung tissue

A

bronchial arteries

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180
Q

bronchial arteries arise from ___ and enter lungs at ___.

A

aorta; hilum

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181
Q

bronchial arteries are part of ___ circulation

A

systemic (high pressure, low volume)

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182
Q

bronchial arteries supply all lung tissue except

A

alveoli

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183
Q

bronchial veins anastomose with

A

pulmonary veins

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184
Q

Pulmonary veins carry

A

most venous blood back to heart

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185
Q

thin, double-layered serosa

A

pleurae

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186
Q

pleurae divides this into

A

thoracic cavity; two pleural compartments and mediastinum

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187
Q

the pleural compartments of the thoracic cavity are

A
  1. parietal

2. visceral

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188
Q

location of parietal pleura

A
  • on thoracic wall
  • superior face of diaphragm
  • around heart
  • between lungs
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189
Q

location of visercal pleura

A

on external lung surface

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190
Q

___ fills pleural cavity

A

pleural fluid

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191
Q

pleural fluid in pleural cavity allows for

A
  • lubrication and surface tension

- assists in expansion and recoil

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192
Q

pulmonary ventilation consists of two phases

A
  1. inspiration

2. expiration

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193
Q

pressure exerted by air surrounding body

A

atmospheric pressure (Patm)

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194
Q

1 atm is equal to

A

760 mm Hg at sea level

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195
Q

____ are described relative to Patm

A

respiratory pressures

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196
Q

pressure less than Patm

A

negative respiratory pressure

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197
Q

pressure greater than Patm

A

positive respiratory pressure

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198
Q

pressure equal to Patm

A

zero respiratory pressure

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199
Q

pressure in alveoli

A

intrapulmonary (intra-alveolar) pressure (Ppul)

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200
Q

Intrapulmonary pressure fluctuates with

A

breathing

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201
Q

Intrapulmonary pressure always eventually

A

equalises with Patm

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202
Q

pressure in pleural cavity

A

intrapleural pressure (Pip)

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203
Q

intrapleural pressure fluctuates with

A

breathing

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204
Q

Intrapleural pressure is always

A

a negative pressure (< Patm and < Ppul)

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205
Q

Fluid level of intrapleural pressure must be

A

minimal

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206
Q

Fluid is pumped out of the pleural cavity by

A

lymphatics

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207
Q

If fluid accumulates in pleural cavity, what happens to intrapleural pressure?

A

it becomes positive, and lung collapses

208
Q

Negative intrapleural pressure is caused by

A

opposing forces

209
Q

Two inward forces of intrapleural pressure promote

A

lung collapse

210
Q

inward forces of intrapleural pressure that promote lung collapse are

A
  • elastic recoil of lungs decreases lung size

- surface tension of alveolar fluid reduces alveolar size

211
Q

one outward force of intrapleural pressure tends to enlarge lungs, which is

A

elasticity of chest wall pulls thorax outward

212
Q

lungs collapse if

A

Pip is equal to Ppul or Patm

213
Q

transpulmonary pressure equation

A

Ppul - Pip

214
Q

what does transpulmonary pressure do

A

keeps airways open

215
Q

greater transpulmonary pressure leads to

A

larger lungs

216
Q

lung collapse due to plugged bronchioles

A

atelectasis

217
Q

when bronchioles are plugged in atelectasis, what happens?

A

alveoli collapse by using up what is left of oxygen

218
Q

air in pleural cavity is called

A

pneumothorax

219
Q

Pneumothorax is “caught” by

A

-wound in parietal pleura
or
-rupture of visceral pleura

220
Q

Pneumothorax is treated by

A

removing air with chest tubes; pleurae heal, lung reinflates

221
Q

Pulmonary ventilation is regulated by

A

inspiration and expiration

222
Q

Pulmonary ventilation is made up of mechanical processes that depend on

A

volume changes in thoracic cavity

223
Q

Volume changes of thoracic cavity lead to

A

pressure changes

224
Q

Pressure changes of thoracic cavity lead to

A

gases flowing to equalise pressure

225
Q

relationship between pressure and volume of a gas

A

Boyle’s Law

226
Q

when gases fill container, if container size is reduced, it leads to

A

increased pressure

227
Q

pressure varies ___ with volume

A

inversely

228
Q

formula for Boyle’s Law

A

P1V1 = P2V2

229
Q

inspiration is ___ process

A

active

230
Q

during inspiration, inspiratory muscles

A

contract

231
Q

inspiratory muscles of inspiration are

A

diaphragm and external intercostals

232
Q

after inspiratory muscles contract during inspiration, what happens?

A

thoracic volume increases –> intrapulmonary pressure drops (to -1 mm Hg)

233
Q

during inspiration, lungs are ____ and intrapulmonary volume ___

A

stretched; increases

234
Q

during inspiration, air flows into lungs, down its pressure gradient, until

A

Ppul = Patm

235
Q

forced inspiration is characteristic of

A

vigorous exercise, COPD

236
Q

process of forced inspiration

A
  • accessory muscles (scalenes, sternocleidomastoid, pectoralis minor)
  • ->further increase in thoracic cage size
237
Q

quiet expiration is normally a ___ process

A

passive

238
Q

during expiration, inspiratory muscles

A

relax

239
Q

during expiration, thoracic cavity volume

A

decreases

240
Q

during expiration, elastic lungs ____ and intrapulmonary volume ___

A

recoil; decreases

241
Q

when elastic lungs recoil and intrapulmonary volume decreases in expiration, what happens?

A

pressure increases (Ppul rises to +1 mm Hg)

242
Q

after pressure increases during expiration, what happens?

A

air flows out of lungs down its pressure gradient until Ppul = 0

243
Q

forced expiration is a ___ process

A

active

244
Q

forced expiration uses ___ and ___ muscles

A

abdominal (oblique and transverse); internal intercostal muscles

245
Q

Three factors hinder air passage and pulmonary ventilation and require energy to overcome:

A
  1. airway resistance
  2. alveolar surface tension
  3. lung compliance
246
Q

a major nonelastic source of resistance to gas flow; occurs in airways

A

friction

247
Q

Relationship between flow (F), pressure (P), and resistance (R) is:

A

F = delta P/ R

248
Q

pressure gradient between atmosphere and alveoli

A

delta P

249
Q

delta P is usually ____ during normal quiet breathing

A

2 mm Hg or less

250
Q

gas flow changes inversely with

A

resistance

251
Q

resistance in airway is usually significant or insignificant?

A

insignificant

252
Q

airway resistance is usually insignificant because ___ are in first part of conducting zone

A

large airway diameters

253
Q

airway resistance is usually insignificant because of this in airways as they branch

A

they get smaller, increasing total cross-sectional area

254
Q

resistance is greatest in

A

medium-sized bronchi

255
Q

Resistance disappears at

A

terminal bronchioles

256
Q

why does resistance disappear at terminal bronchioles

A

diffusion drives gas movement

257
Q

as airway resistance rises, breathing movements become

A

more strenuous

258
Q

severe constriction or obstruction of bronchioles can

A
  • prevent life-sustaining ventilation

- occur during acute asthma attacks; stops ventilation

259
Q

what does epinephrine do to bronchioles and how does this affect air resistance?

A

it dilates bronchioles and reduces air resistance

260
Q

surface tension of alveoli attracts

A

liquid molecules to one another at gas-liquid interface

261
Q

surface tension of alveoli resists any force that tends to

A

increase surface area of liquid

262
Q

is the surface tension of alveoli liquid-high or gas-high?

A

liquid (water-high)

263
Q

water-high surface tension of alveoli coats ___ to do what?

A

alveolar walls; reduce them to smallest size

264
Q

detergent-like lipid and protein complex

A

surfactant

265
Q

surfactant is produced by

A

type II alveolar cells

266
Q

surfactant reduces

A

surface tension of alveolar fluid

267
Q

surfactant discourages

A

alveolar collapse

268
Q

insufficient quantity of surfactant in premature infants causes

A

infant respiratory distress syndrome

269
Q

what happens in infant respiratory distress syndrome?

A

alveoli collapse after each breath

270
Q

the measure of change in lung volume that occurs with given change in transpulmonary pressure

A

lung compliance

271
Q

higher lung compliance –>

A

easier to expand lungs

272
Q

lung compliance is normally high due to

A
  • distensibility of lung tissue

- alveolar surface tension

273
Q

lung compliance is diminished by

A
  • nonelastic scar tissue replacing lung tissue (fibrosis)
  • reduced production of surfactant
  • decreased flexibility of thoracic cage
274
Q

homeostatic imbalances that reduce compliance are

A
  • deformities of thorax
  • ossification of costal cartilage
  • paralysis of intercostal muscles
275
Q

respiratory volumes used to assess respiratory status are

A
  1. tidal volume (TV)
  2. inspiratory reserve volume (IRV)
  3. expiratory reserve volume (ERV)
  4. residual volume (RV)
276
Q

respiratory capacities are combinations of

A

respiratory volumes

277
Q

the different respiratory capacities

A
  • inspiratory capacity (IC)
  • functional residual capacity (FRC)
  • vital capacity (VC)
  • total lung capacity (TLC)
278
Q

anatomical dead space’s contribution to gas exchange

A

none

279
Q

anatomical dead space is the air

A

remaining in passageways; ~150 ml

280
Q

non-functional alveoli due to collapse or obstruction

A

alveolar dead space

281
Q

sum of anatomical and alveolar dead space

A

total dead space

282
Q

instrument for measuring respiratory volumes and capacities

A

spirometer

283
Q

spirometry can distinguish between

A
  1. obstructive pulmonary disease

2. restrictive disorders

284
Q

increased airway resistance can lead to

A

obstructive pulmonary disease (e.g. bronchitis)

285
Q

reduced total lung capacity due to disease or fibrosis can lead to

A

restrictive disorders

286
Q

in obstructive pulmonary disease what may change?

A

TLC, FRC, and RV may increase

287
Q

in restrictive disorders, what changes?

A

VC, TLC, FRC, and RV decline

288
Q

To measure rate of gas movement, find

A
  • forced vital capacity (FVC)

- forced expiratory volume (FEV)

289
Q

the gas forcibly expelled after taking a deep breath

A

forced vital capacity (FVC)

290
Q

amount of gas expelled during specific time intervals of forced vital capacity

A

forced expiratory volume (FEV)

291
Q

total amount of gas flow into or out of respiratory tract in one minute

A

minute ventilation

292
Q

normal minute ventilation at rest is

A

~6 L/min

293
Q

normal minute ventilation with exercise is

A

up to 200 L/min

294
Q

minute ventilation is ___ estimate of respiratory efficiency

A

only rough

295
Q

minute ventilation is a good indicatory of

A

effective ventilation

296
Q

flow of gases into and out of alveoli during a particular time

A

alveolar ventilation rate (AVR)

297
Q

formula for AVR

A

AVR = frequency x (TV - dead space)

ml/min) (breaths/min) (ml/breath

298
Q

dead space is normally

A

constant

299
Q

rapid, shallow breathing ___ AVR

A

decreases

300
Q

nonrespiratory air movements may modify

A

normal respiratory rhythm

301
Q

most nonrespiratory air movements result from

A

reflex action; some can be voluntary

302
Q

examples of reflex action nonrespiratory air movements

A

cough, sneeze, crying, laughing, hiccups, and yawns

303
Q

diffusion of gases in lungs

A

external respiration

304
Q

diffusion of gases at body tissues

A

internal respiration

305
Q

both internal and external respiration involve

A
  • physical properties of gases

- composition of alveolar gas

306
Q

Dalton’s Law of partial pressures states that

A

total pressure exerted by mixture of gases = sum of pressures exerted by each gas

307
Q

pressure exerted by each gas in mixture; directly proportional to its percentage in mixture

A

partial pressure

308
Q

by Henry’s Law, when gas mixtures are in contact with liquid, each gas dissolves in proportion to

A

its partial pressure

309
Q

by Henry’s Law, at equilibrium, partial pressures in two phases will be

A

equal

310
Q

by Henry’s Law, the amount of each gas that will dissolve depends on

A
  • solubility (CO2 is 20 times more soluble in water than O2; little N2 dissolves in water)
  • temperature (as temp rises, solubility decreases)
311
Q

Alveoli contain more ____ and ____ than ____.

A

CO2; water vapor, atmospheric air

312
Q

gas exchanges in

A

lungs

313
Q

alveoli allow for ___ of air

A

humidification

314
Q

there is a mixing of ___ with each breath

A

alveolar gas

315
Q

There is an exchange of ___ across respiratory membrane in external respiration.

A

O2 and CO2

316
Q

External respiration/exchange of O2 and CO2 across respiratory membrance is influenced by

A
  • thickness and surface area of respiratory membrane
  • partial pressure gradients and gas solubilities
  • ventilation-perfusion coupling
317
Q

respiratory membranes are approximately ____ thick

A

0.5 to 1 micrometre

318
Q

total surface area of respiratory membranes is

A

large (40 times that of skin); allows for gas exchange

319
Q

respiratory membrane thickens if

A

lungs become waterlogged and edematous; gas exchange becomes inadequate

320
Q

reduced surface area of respiratory membrane is present in

A
  • emphysema
  • tumours
  • inflammation
  • mucus
321
Q

partial pressure gradient for O2 in lungs is

A

steep

322
Q

Venous blood PO2 =

A

40 mm Hg

323
Q

Alveolar PO2 =

A

104 mm Hg

324
Q

steep partial pressure gradient for O2 in lungs drives oxygen flow to

A

the blood

325
Q

Equilibrium between partial pressure of alveoli and venous blood is reached across respiratory membrane in what amount of time? What does this allow for?

A

~0.25 sec (about 1/3 time for RBC in pulmonary capillary); adequate oxygenation even if blood flow increases 3x

326
Q

partial pressure gradient for CO2 in lungs is

A

less steep than O2

327
Q

venous blood PCO2 =

A

45 mm Hg

328
Q

alveolar PCO2 =

A

40 mm Hg

329
Q

the gradient for PCO2 is not as steep as PO2, but

A

CO2 diffuses in equal amounts with O2

330
Q

solubility of CO2 in plasma compared to O2

A

20x more soluble

331
Q

blood flow reaching alveoli

A

perfusion

332
Q

amount of gas reaching alveoli

A

ventilation

333
Q

ventilation and perfusion are matched (coupled) for

A

efficient gas exchange

334
Q

ventilation and perfusion are never balanced for all alveoli due to

A
  • regional variations (due to effect of gravity on blood and air flow)
  • some alveolar ducts are plugged with mucus
335
Q

in perfusion, changes in PO2 in alveoli cause changes in

A

diameters of arterioles

336
Q

Where alveolar O2 is high,

A

arterioles dilate

337
Q

Where alveolar O2 is low,

A

arterioles constrict

338
Q

changes in PO2 in alveoli direct most blood where

A

alveolar oxygen is high

339
Q

Changes in PCO2 in alveoli cause changes in

A

diameters of bronchioles

340
Q

Where alveolar CO2 is high

A

bronchioles dilate

341
Q

where alveolar CO2 is low

A

bronchioles contract

342
Q

changes in PCO2 in alveoli allow for

A

elimination of CO2 more rapidly

343
Q

Capillary gas exchanges in

A

body tissues (internal respiration)

344
Q

___ and ___ are reversed in internal respiration compared to external respiration

A

partial pressures; diffusion gradients

345
Q

In internal respiration, tissue PO2 is always ____ than systemic arterial blood

A

lower

346
Q

In internal respiration low PO2 moves

A

oxygen from blood to tissues

347
Q

In internal respiration CO2 goes from

A

tissues to blood

348
Q

In internal respiration, venous blood PO2 is ____ and PCO2 is ____

A

40 mm Hg; 45 mm Hg

349
Q

Molecular O2 is carried in

A

the blood

350
Q

proportion of where O2 is in blood transport

A
  • 1.5% dissolved in plasma

- 98.5% loosely bound to each Fe and Hb in RBCs

351
Q

hemoglobin-O2 combination

A

oxyhemoglobin (HbO2)

352
Q

hemoglobin that has released O2

A

reduced hemoglobin (deoxyhemoglobin) (HHb)

353
Q

O2 and hemoglobin in blood reversible reaction

A

HHb + O2 HbO2 + H+

354
Q

Loading and unloading of O2 is facilitated by

A

shape of Hb

355
Q

As O2 binds to Hb, Hb affinity for O2

A

increases

356
Q

As O2 is released from Hb, Hb affinity for O2

A

decreases

357
Q

all four heme groups carry O2

A

fully saturated

358
Q

one to three hemes carry O2

A

partially saturated

359
Q

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

A
  • PO2
  • Temperature
  • blood pH
  • PCO2
  • Concentration of BPG
360
Q

produced by RBCs during glycolysis; levels rise when oxygen levels chronically lowest

A

BPG

361
Q

Shape of hemoglobin saturation plotted against PO2 in a graph

A

S-shaped curve

362
Q

Binding and release of O2 is influenced by

A

PO2

363
Q

In arterial blood, PO2 =

A

100 mm Hg

364
Q

In arterial blood, contains ____ oxygen per 100 ml blood

A

20 ml (20 vol %)

365
Q

In arterial blood, HB is ___% saturated.

A

98

366
Q

Further increases in PO2 (e.g. breathing deeply) produce

A

minimal increases in O2 binding

367
Q

In venous blood, PO2 =

A

40 mm Hg

368
Q

Venous blood contains ____% oxygen.

A

15 vol

369
Q

In venous blood, Hb is ___% saturated.

A

75

370
Q

Oxygen remaining in venous blood

A

venous reserve

371
Q

Other factors influencing Hb saturation are

A
  • increase in temperature
  • H+
  • PCO2
  • BPG
372
Q

Factors that influence Hb saturation modify structure of Hb and

A

decrease its affinity for O2

373
Q

Hb saturation factors occur in

A

systemic capillaries

374
Q

Hb saturation factors enhance

A

O2 unloading from blood

375
Q

Hb saturation factors shift dissociation curve to

A

the right

376
Q

Decrease in Hb saturation factors shift dissociation curve to

A

the left

377
Q

Decrease in Hb saturation factors decreases

A

oxygen unloading from blood

378
Q

As cells metabolise glucose and use O2, PCO2 and H+

A

increase in capillary blood

379
Q

Declining blood pH and increasing PCO2 lead to

A

Bohr effect

380
Q

with the Bohr effect, what happens?

A

Hb-O2 bond weakens –> oxygen unloading where needed most

381
Q

Head production increases, then

A

directly and indirectly decreases Hb affinity for O2 –> increased oxygen unloading to active tissues

382
Q

inadequate O2 delivery to tissues; this can lead to ___

A

hypoxia; cyanosis

383
Q

too few RBCs; abnormal or too little Hb

A

anemic hypoxia

384
Q

impaired/blocked circulation

A

ischemic hypoxia

385
Q

cells unable to use O2, as in metabolic poisons

A

histotoxic hypoxia

386
Q

abnormal ventilation; pulmonary disease

A

hypoxemic hypoxia

387
Q

this results as a homeostatic imbalance and has a 200X greater affinity for Hb than oxygen

A

carbon monoxide poisoning

388
Q

The three ways CO2 is transported in blood

A
  • 7-10% dissolved in plasma
  • 20% bound to globin of Hb
  • 70% transported as bicarbonate ions in plasma
389
Q

CO2 combines with water to form ___, which quickly dissociates

A

carbonic acid (H2CO3)

390
Q

CO2 combination with water occurs primarily in RBCs, where _____ reversibly and rapidly catalyses reaction

A

carbonic anhydrase

391
Q

in systemic capillaries, HCO3-

A

quickly diffuses from RBCs into plasma

392
Q

When HCO3- diffuses from RBCs into plasma, ____ occurs

A

chloride shift

393
Q

Outrush of HCO3- from RBCs is

A

balanced as Cl- moves into RBCs from plasma

394
Q

In pulmonary capillaries, HCO3-

A

moves into RBCs (while Cl- moves out); binds with H+ to form H2CO3

395
Q

In pulmonary capillaries, H2CO3 is split by

A

carbonic anhydrase into CO2 and water

396
Q

In pulmonary capillaries, CO2 diffuses

A

into alveoli

397
Q

Amount of CO2 transported is affected by PO2. This is called

A

Haldane Effect

398
Q

Reduced Hb (less oxygen saturation) forms ___ and buffers ___ more easily.

A

carbaminohemoglobin; H+

399
Q

lower PO2 and hemoglobin saturation with ___; more ___ carried in blood

A

O2; CO2

400
Q

Haldane Effect encourages exchange in

A

tissues and lungs

401
Q

At tissues, as more CO2 enters blood

A
  • more oxygen dissociates from Hb (Bohr effect)

- as HbO2 releases O2, it more readily forms bonds with CO2 to form carbaminohemoglobin

402
Q

resists changes in blood pH

A

carbonic acid-bicarbonate buffer system

403
Q

If H+ concentration in blood rises,

A

excess H+ is removed by combining with HCO3- –> H2CO3

404
Q

If H+ concentration begins to drop,

A

H2CO3 dissociates, releasing H+

405
Q

HCO3- is ___ of carbonic acid-bicarbonate buffer system

A

alkaline reserve

406
Q

changes in respiratory rate and depth affect

A

blood pH

407
Q

slow, shallow breathing –>

A

increased CO2 in blood –> drop in pH

408
Q

rapid, deep breathing –>

A

decreased CO2 in blood –> rise in pH

409
Q

changes in ventilation can adjust ___ when disturbed by ____

A

pH; metabolic factors

410
Q

respiration involves

A
  • higher brain centres
  • chemoreceptors
  • other reflexes
411
Q

Neural controls of respiration are

A

neurons in reticular formation of medulla and pons

412
Q

Clustered neurons in the medulla that are important for respiration are

A
  1. ventral respiratory group

2. dorsal respiratory group

413
Q

ventral respiratory group does what?

A

rhythm-generating and integrative centre

414
Q

VRG sets ____

A

eupnea (12-15 breaths/min)

415
Q

Eupnea is

A

normal respiratory rate and rhythm

416
Q

Inspiratory neurons of VRG excite inspiratory muscles via ___ and ____

A

phrenic (diaphragm); intercostal nerves (external intercostals)

417
Q

Expiratory neurons inhibit

A

inspiratory neurons

418
Q

Dorsal respiratory group is located

A

near root of cranial nerve IX

419
Q

DRG integrates input from

A

peripheral stretch and chemoreceptors; sends information to VRG

420
Q

influence and modify activity of VRG

A

pontine respiratory centres

421
Q

these smooth out the transition between inspiration and expiration and vice versa

A

pontine respiratory centres

422
Q

Pontine respiratory centres transmit impulses to

A

VRG –> modify and fine-tune breathing rhythms during vocalisation, sleep, exercise

423
Q

respiratory rhythm is hypothetically generated by

A

pacemaker neurons with intrinsic rhythmicity

424
Q

Most widely accepted hypothesis for generation of respiratory rhythm is

A

reciprocal inhibition of two sets of interconnected pacemaker neurons in medulla generate rhythms

425
Q

breathing depth is determined by

A

how actively respiratory centre stimulates respiratory muscles

426
Q

breathing rate is determined by

A

how long inspiratory centre is active

427
Q

both breathing rate and depth are modified in response to

A
  • changing levels of CO2, O2, and H+

- sensed by central and peripheral chemoreceptors

428
Q

chemical factors of ___ is most potent and most closely controlled

A

PCO2

429
Q

If blood PCO2 levels rise, CO2

A

accumulates in brain

430
Q

when PCO2 levels rise, this is called

A

hypercapnia

431
Q

when CO2 accumulates in brain,

A

CO2 in brain is hydrated

  • ->carbonic acid
  • ->dissociates, releasing H+
  • ->pH drops
432
Q

H+ stimulates

A

central chemoreceptors in brain stem

433
Q

Chemoreceptors synapse with

A

respiratory regulatory centres

434
Q

When chemoreceptors synapse with respiratory regulatory centres, what happens?

A
  • increased rate and depth of breathing
  • ->lower blood PCO2
  • ->pH rises
435
Q

increased depth and rate of breathing that exceeds body’s need to remove CO2

A

hyperventilation

436
Q

hyperventilation leads to

A

decreased blood CO2 levels

  • -> cerebral vasoconstriction and cerebral ischemia
  • ->dizziness, fainting
437
Q

decreased blood CO2 levels is known as

A

hypocapnia

438
Q

breathing cessation from abnormally low PCO2

A

apnea

439
Q

chemical factors influence of PO2 are

A

-peripheral chemoreceptors in aortic and carotid bodies–arterial O2 level sensors

440
Q

declining PO2 normally has ____ effect on ventilation

A

slight

441
Q

When excited, peripheral chemoreceptors cause

A

respiratory centres to increase ventilation

442
Q

Why does declining PO2 normally have only a slight effect on ventilation?

A
  • huge O2 reservoir bound to Hb

- requires substantial drop in arterial PO2 (to 60 mm Hg) to stimulate increased ventilation

443
Q

arterial pH can modify

A

respiratory rate and rhythm even if CO2 and O2 levels are normal

444
Q

arterial pH is mediated by

A

peripheral chemoreceptors

445
Q

decreased arterial pH may reflect

A

CO2 retention; accumulation of lactic acid; excess ketone bodies

446
Q

respiratory system controls attempt to raise pH by

A

increasing respiratory rate and depth

447
Q

The most powerful respiratory stimulant is

A

Rising CO2 levels

448
Q

Normally blood PO2 affects breathing only indirectly by

A

Influencing peripheral chemoreceptor sensitivity to changes in PCO2

449
Q

When arterial PO2 falls below 60 mm Hg, it becomes

A

Major stimulus for respiration (via peripheral chemoreceptors)

450
Q

Changes in arterial pH resulting from ___ act indirectly through peripheral chemoreceptors

A

CO2 retention or metabolic factors

451
Q

Hypothalamic controls act through ___ to modify

A

Limbic system; rate and depth of respiration

452
Q

Example of hypothalamic control of respiration

A

Breath holding that occurs in anger or gasping with pain

453
Q

Rise in body temperature increases

A

Respiratory rate

454
Q

Direct signals from cerebral motor cortex that bypass medullary controls

A

Cortical controls

455
Q

Example of cortical controls

A

Voluntary breath holding

456
Q

When breath is voluntarily held, the brain stem

A

Reinstates breathing when blood CO2 is critical

457
Q

Receptors in bronchioles respond to

A

irritants

458
Q

When bronchiole receptors respond to irritants, they communicate with ____ via ____

A

Respiratory centers; Vagal nerve afferents

459
Q

Pulmonary irritant reflexes promote reflexive constriction of

A

air passages

460
Q

Repeated irritant leads to

A

Cough in trachea or bronchi; sneeze in nasal cavity

461
Q

Three 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 centers to respiratory centers from proprioceptors in moving muscles, tendons, joints
462
Q

Ventilation declines suddenly as exercise ends because

A

The three neural factors shut off

463
Q

After exercise there is a gradual decline to baseline because of

A

Decline in CO2 flow after exercise ends

464
Q

Exercise –> anaerobic respiration –> lactic acid

Not from ____, but from

A

poor respiratory function; insufficient cardiac output or skeletal muscle inability to increase oxygen uptake

465
Q

Respiratory and hematopoietic adjustments to long-term move to high altitude

A

Acclimitisation

466
Q

Chemoreceptors become more responsive to PCO2 when

A

PO2 declines

467
Q

Substantial decline in PO2 directly stimulates

A

Peripheral chemoreceptors

468
Q

Result of acclimatisation

A

Minute ventilation increases and stabilises in a few days to 2-3 L/min higher than at sea level

469
Q

At high altitude, Hb saturation and O2 levels are

A

Lower than normal; less O2 available

470
Q

Decline in blood O2 stimulates kidneys to

A

Accelerate production of EPO

471
Q

During acclimatisation RBC numbers increase slowly to provide

A

Long-term compensation

472
Q

This is exemplified by chronic bronchitis and emphysema

A

Chronic obstructive pulmonary disease (COPD)

473
Q

In COPD, there is an irreversible decrease in ability to

A

Force air out of lungs

474
Q

Labored breathing

A

Dyspnea (characteristic of COPD)

475
Q

Most people with COPD develop

A
  • respiratory failure (hypoventilation)
  • respiratory acidosis
  • hypoxemia
476
Q

Permanent enlargement of alveoli

  • destruction of alveolar walls
  • decreased lung elasticity
A

Emphysema

477
Q

Decreased lung elasticity in emphysema requires

A

Accessory muscles necessary for breathing

478
Q

When accessory muscles are required for respiration in emphysema, what happens?

A

Exhaustion from energy usage

479
Q

Hyperinflation in emphysema leads to

A

Flattened diaphragm

–>reduced ventilation efficiency

480
Q

Damaged pulmonary capillaries in emphysema leads to

A

Enlarged right ventricle

481
Q

Inhaled irritants in chronic bronchitis leads to

A

Chronic excessive mucus

->inflamed and fibrosed lower respiratory passageways

482
Q

Inflamed and fibrosed lower respiratory passageways in chronic bronchitis leads to

A

Obstructed airways

  • ->impaired lung ventilation and gas exchange
  • ->frequent pulmonary infections
483
Q

Strength of innate respiratory drive in COPD leads to

A

Different symptoms in patients

484
Q

The different COPD symptoms in patients are

A
  • pink puffers

- blue bloaters

485
Q

Characteristics of pink puffers

A

Thin; near-normal blood gases

486
Q

Characteristics of blue bloaters

A

Stocky, hypoxic

487
Q

COPD symptoms are treated with

A
  • bronchodilators
  • corticosteroids
  • oxygen
  • sometimes surgery
488
Q

Reversible COPD is known as

A

Asthma

489
Q

Characterised by coughing, dyspnea, wheezing, and chest tightness

A

Asthma

490
Q

In asthma, active inflammation of airways precedes

A

Bronchospasms

491
Q

Airway inflammation in asthma is immune response caused by release of

A
  • interleukins
  • production of IgE
  • recruitment of inflammatory cells
492
Q

In asthma, airways thickened with inflammatory exudate magnify

A

Effect of bronchospasms

493
Q

Symptoms of this disease are fever, night sweats, weight loss, racking cough, coughing up blood

A

Tuberculosis

494
Q

Treatment of tuberculosis is

A

12-month course of antibiotics

-however, there are antibiotic resistant strains

495
Q
  • leading cause of cancer deaths in North America

- 90% of all cases result of smoking

A

Lung cancer

496
Q

Three most common types of lung cancer are

A
  • adenocarcinoma
  • squamous cell carcinoma
  • small cell carcinoma
497
Q

Adenocarcinoma is ___% of lung cancer cases

A

~40%

498
Q

Squamous cell carcinoma is ___% of cases in lung cancer

A

20-40%

499
Q

Small cell carcinoma is ___% of cases in lung cancer

A

~20%

500
Q

This type of lung cancer originates in peripheral lung areas - bronchial glands, alveolar cells

A

Adenocarcinoma

501
Q

This type of lung cancer is located in bronchial epithelium

A

Squamous cell carcinoma

502
Q

This type of lung cancer contains lymphocyte-like cells that originate in primary bronchi and subsequently metastasise

A

Small cell carcinoma

503
Q

Key to survival of lung cancer

A

Early detection

504
Q

Best scan for lung cancer

A

Helial CT scan better than chest x-ray

505
Q

Lung cancer

  • developing breath test of gold nanoparticles
  • if no metastasis –> ___
  • if metastasis –> ___
A
  • surgery to remove diseased lung tissue

- radiation and chemotherapy

506
Q

By ____ premature baby can breathe on its own

A

28 weeks

507
Q

During fetal life, lungs are filled with fluid and blood

A

Bypasses lungs

508
Q

In fetal development, gas exchange takes place via

A

Placenta

509
Q

Lungs don’t fully inflate until how long after birth?

A

2 weeks

510
Q

Respiratory rate in newborns is

A

Highest; slows until adulthood

511
Q

During development, lungs continue to mature and more alveoli are formed until

A

young adulthood

512
Q

Most common lethal genetic disease in North America

A

Cystic fibrosis

513
Q

In cystic fibrosis, abnormal, viscous mucus clogs passageways which leads to

A

Bacterial infections

-affects lungs, pancreatic ducts, reproductive ducts

514
Q

The cause for cystic fibrosis is

A

Abnormal gene for Cl- membrane channel

515
Q

Treatments for cystic fibrosis

A

Mucus-dissolving drugs; manipulation to loosen mucus; antibiotics