Chapter 23 Respiratory Flashcards
What are the two zone of the resp. system? What are the general functions and specific parts of those zones?
Respiratory Zone: gas exchange (bronchioles, alveolar ducts, alveoli)
Conducting Zone: What leads air to reach gas exchange sites (nose, nasal cav., phaynx, trachea)
What are the resp. muscles?
Diaphragm and other muscles that promote respiration.
What is the functions of the nose?
airway
moist/warm air
filter
What makes up the vestibule?
Nasal cavity
Vibrissae-filtering coarse hairs
Where do you find olfactory mucosa, what does it contain?
Superior nasal cavity
Smell receptors
What is the purpose of respiratory mucosa, what type of epithelium exists here?
Glands that secrete mucus containing lysozome and defensins to help destroy bacteria.
Psuedostratified Columnar Epithelium
What is inspired air?
What removes contaminated mucus?
What triggers sneezing?
Humidified by water content in nasal cavity, warmed by cap.plexus
Ciliated mucosal cells.
Particles irritating sensitive mucosa.
During exhalation, the nasal mucosa and conchae attempt what?
Reclaim heat/moisture (and minimize loss)
The nasopharynx is lined with? And ________ during swallowing, why?
Pseudostratified columnar epithelium (air only passages contain)
Closes-prevent food upward
The oropharynx opens to the oral cavity via what archway? And is lined with a protective ______ _______ ________.
Fauces
Stratified squamous epithelium (air and food)
What is the common passageway for air and food?
Laryngopharynx
The three functions of the larynx (voice box) are?
An open airway.
Switching mechanism for routing air and food to proper channel.
Voice production.
What are the cartilages of the larynx?
Hyaline Thyroid cart. Cricoid cart. arytenoid cart. Epiglottis-elastic cart.
What are the four processes of respiration? What does each accomplish?
Pulmonary Ventilation-air movement in/out of lungs
External respiration-O2 from lung to blood. CO2 from blood to lung.
Transport of gases-O2 from lung to tissue, bring CO2 from tissue to lung.
Internal respiration-O2 from blood to tissue, CO2 from tissue to blood.
What is the epiglottis?
Elastic cartilage covering laryngeal inlet when swallowing.
Describe the vocal production of each of the following:
Speech
Pitch
Loudness
Speech-intermittent release of expired air while opening and closing the glottis.
Pitch-determined by the length and TENSION of the vocal cords.
Loudness-depends upon the FORCE at which the AIR rushes across the vocal cords.
(Pharynx amps sound quality)
The larynx is closed during coughing, sneezing, and Valsalva’s Maneuver…What is this?
Held air (closed glottis) in low resp. tract, abdominal pressure during ab contraction.
- empties rectum
- trunk splint for heavy loads
What are the three layers that make up the trachea?
(superficial to deep)
Adventitia-hyaline c-rings
Mucosa-goblet cells and ciliated epithelium
Submucosa-connective tissue
Bronchioles consist of _________ epithelium, have a complete layer of ________ muscle, lack _________ support and _________-producing cells.
cuboidal
smooth
cartilage, mucous
Alveoli presence define the ________ zone at the resp. bronchioles. These account for most of the lungs _______.
Respiratory
Volume
The air-blood barrier is composed of:
Alveolar walls are made of type 1 _________ cells, that permit:
What do type II cells secrete?
Alveolar and cap. walls, fused basal laminas.
Epithelial (SS)
simple diffusion gas exchange
surfactant
Alveoli contain open pores that:
What keeps alveolar surfaces sterile?
connect adjacent alveoli
allow equalized air pressure throughout lung
macrophages
What two circulations are the lungs perfused by?
Pulmonary A (Blue): branches along with bronchi into pul. cap. net., deoxygenated blood carried.
Pulmonary V (Red): carry oxygenated blood from resp. zone to heart.
The pulmonary plexus are _______ that enter lungs root and run along blood vessels. What do each cause? Why?
Nerves
Sym. NS: (F or F) dilate bronchioles-relaxing the bronchi allowing larger opening for more O2 inward flow (Epi->B2 recep on lungs->bronchidilate
Parasym NS: (R or D) constrict bronchi-preventing unec. O2 flow inward to clean
What is pleurisy? What happens?
Inflammation of the pleurae (often result of pnuemonia) causes friction (painful), fluid produced and accumulates (pleural effusion).
Breathing (pulmonary ventilation) consists of what two phases?
Inspiration
Expiration
What is respiratory pressure? What does pos and neg resp. press represent?
atmospheric pressure (760 mmHg)
Neg-resp. pres. is less than AP
Pos-resp. pres. is greater than AP
What are intrapulmonary pressure and intrapleural pressure? After pressure fluctuations, how do these relate homeostatically?
IPul:pressure within alveoli-always equals back to AP
IPle:pressure within pleural cavity-always less than IPul and AP.
What is lung collapse caused by? What is transpulmonary pressure?
Equalization of intrapleural and intrapulmonary pressures.
TPul=the diff between IPul and IPle pressures.
What is atelectasis? How does this occur? What is pneumothorax?
lung collapse, bronchiole obstruction.
Air enters pleural cavity by chest wound (air enters from outside) or visceral pleura rupture (air enter from resp. tract)
Presence of air in intrapleural space.
What is a more detailed description of pulmonary ventilation?
Flow of gas dependent on volume. (Vol changes lead to pressure changes, allowing gas flow, equalizing pressure). dec V is inc P=expiration (air out) (above)>760mmHg inc V is dec P=inhalation (air in) (below)
What relationship does Boyles Law represent? Identify the formula and clarify each representation.
Relationship between pressure and volume of gases.
P1V1=P2V2
P=pressure of gas in mmHg
V=Volume of gas in cubic cm or mm
(subscripts rep. initial and resulting conditions)
Describe the 4 phases of inspiration.
1-Diaphragm and intercostal muscles contract, rib cage expands.
2-Lungs are stretched and intrapulmonary volume increases.
3-Intrapulmonary pressure drops below atmospheric pressure (-1mmHg or 759 mmHg)
4-Air flows into the lungs down pressure gradient, until intrapleural pressure = atmospheric pressure.
Describe the 5 phases of Expiration.
1-Inspiratory muscles relax and the rib cage descends due to gravity.
2-Thoracic cavity volume decreases.
3-Elastic lungs recoil passively and intrapulmonary volume decreases.
4-Intrapulmonary pressure rises above atmospheric pressure (+1mmHg or 761 mmHg).
5-Gases flow out of the lungs down the pressure gradient until intrapulmonary pressure is 0.
Gas flow in inversely proportional to resistance with the greatest resistance being in the ________ ________ ________.
medium sized bronchi
If airway resistance rises, breathing becomes more strenuous. Severely constricted/obstructed bronchioles can:
Prevent life-sustaining ventilation
Occurs during acute asthma attacks stopping ventilation.
What is surfactant? What does it do for the alveolus?
A detergent-like complex. reduces surface tension and prevents alveoli collapse. (Keeps alveoli damp w/ air pocket vs. water drops filling alveoli).
What is IRDS, Infant Resp. Distress Syndrome?
Not enough surfactant produced in the lungs of premature babies.
What is lung compliance, and the two determining factors?
The ease with which lungs can be expanded.(Measure of lung volume changes that occur with transpulmonary press. changes)
1-Distensibility (of lung tissue and thoracic cage)
2-Surface Tension (of alveoli)
Name 4 factors that can diminish lung compliance.
Fibrosis (scar tissue)-reduces resilience of lungs
Blockage-mucus/fluid in smaller resp. passages
Reduced surfactant
Decreased flexibility-thoracic cage
Name 3 medical examples of poor lung compliance.
Deformities of the thorax
Ossification of the costal cartilage
Paralysis of intercostal muscles
Define the 4 respiratory volumes.
Tidal volume (TV)-normal breathing
Inspiratory Reserve Vol (IRV)-forced additional inspired air beyond TV
Expiratory Res. Vol (ERV)-forced addition expired air beyond tidal.
Residual Vol (RV)-never removed air
Define the 4 respiratory capacities.
1-Inspiratory Cap (IC)-Total amount that can be inspired after tidal expir. (TV+IRV)
2.Functional Residual Cap (FRC)-at rest, amount of air remaining in lung after tidal exp. (ERV+RV)
3-Vital Capacity (VC)-total amount of exchangeable air (IRV+TV+ERV)
4-Total Lung Capacity (TLC)-sum of all volumes (IRV+TV+ERV+RV)
As a spirometer is the instrument that evaluates resp. function. Spirometry can distinguish between:
Obstructive pulmonary dz-airway resis (inward air block)
Restrictive Disorder-TLC reduced (compliance issue, physical issues such as baby on chest, corset, calcified inter. cart, scar tissue)
The take home message is that obstructive dz’s increase _____,_____,and _____.
And restrictive dz causes…
TLC, FRC, and RV
Reduction in VC, TLC, FRC, and RV.
Define the 3 dead spaces.
Anatomical ds-vol of conducting resp pass (150ml) Alveolar dp (shouldnt have)-collapsed/obstruct alveoli (no gas exch) Total dp-sum of alveolar and anatom ds
What is AVR, Alveolar Ventilation Rate?
Measures the flow of fresh gases into and out of the alveoli during a particular time.
Slow deep breathing increase AVR *good
Rapid shallow breathing decreases AVR *bad
Define Daltons Law.
total pressure exerted by a mixture of gases is the sum of the pressures exerted independently by each gas in the mixture. Exp: 78% Nit=593 mmhg 20% Oxy=152 mmhg 1% CO=8mmhg 1%H20=8mmhg =760 mmHg (Atom Press)
Define Henrys Law. How does it apply to Nitrogen, oxygen, and carbon dioxide? What is used to apply Henrys law?
When a mixture of gases is in contact with a liquid, each gas will dissolve in the liquid in proportion to its partial pressure.
Nit-insoluble in plasma
Oxy-1/20 as soluble as co (not easily dis)
CO-most soluble
*the higher the P of gas, the more likely to stay in liquid…so…O2 needs higher P to dissolve in blood.
What are 3 factors influencing the movement of oxygen and carbon dioxide across the resp. membrane?
1-Partial pressure gradients and gas solubilities
2-Matching of alveolar (airflow) ventilation and pulmonary (blood flow) blood perfusion.
3-Structural characteristics of the resp. membrane
The partial P O2 of venous blood is 40mmhg; the partial P in alveoli is 104mmhg, why?
Steep gradient allows O2 part. P to rapidly reach equilibrium and thus blood can move 3X as quick through pulmonary cap and be oxygenated.
CO has lower part P gradient but diffuses in equal amounts with ____?
O2
What two things must be tightly regulated to have efficient gas exchange?
Ventilation-amount of gas reaching aveoli
Perfusion-blood flow reaching alveoli
Changes is what effect the bronchioles diameter? What makes them dilate/constrict?
Pco2 (CO Part. P)
High alveolar CO(low O2)-Dilate
Low alveolar CO(High O2)-Constrict
Describe the chemical formula for hemoglobin and O2.
Hb binds four O2
Hemo+Oxy=HbO2 (oxyhemoglobin)
Hemo-Oxy=HHb (reduced hemo or deoxyhemo)
(lungs)
HHb + O2 HbO2 + H+
(tissue)
What is sat and part. sat hemo?
sat-all four hemes are O2 bound
part. sat-one to three hemes bound to O2
What factors regulate the rate of hemoglobin binding/releasing?
Releases: Binds:
PO2 \/ /\
PCO2 /\ \/
H+ /\ \/
PH (blood) \/ /\
BPG /\ \/
(ATP non sugar sources)
98% sat arterial blood contains ___ml O2 per ____ml blood (___%). How much is released in caps?
Hemoglobin is almost completely sat at a PO2 of ____mmHg.
Only ___%-___% of bound O2 is unloaded during one systemic circulation.
20 per 100 (20%)
5ml
70mmhg
20-25
As cells metabolize glucose, co2 is released into the blood causing:
Then, these cells release heat as byproduct, rise in temp increases ___ synthesis.
Which ensures _______ _________ near working tissue cells.
increase PO2 and H+ concentration in caps, decline ph (acid) weakening hemo-oxy bond (BOHR effect)
BPG
o2 unloading
What is hypoxia? Explain the following: Anemic Hypoxia Ischemic Hypoxia Histotoxic Hypoxia Hypoxemic Hypoxia
inadequate o2 delivery to tissues
AH-too few RBC’s
IH-flow impaired (chf/emboli thrombi)
HH-cells unable to use O2 (tissue issue, cyanide pois)
HH-reduced arterial P02(abn vent-perf coup, pneum/pul dz, emphaz, asthma attack/breathing low o2, high alt)
What is carbon monoxide poisoning? Why can it be lethal?
CO competes with O2 for binding sites on Hb.
CO binds 200 times easier than O2 to Hb.
Healthy blush appears on victim
In what three forms is CO transported in the blood?
1: Dissolved in blood plasma (7-10%)
2: Hb bound (20% carbaminohemoglobin)
3: **Bicarbonate ion in flow (70% HCO3) **(BULK)
What is the happens in the transport and exchange of CO2 from the tissue to the lungs?
What reversibly catalyzes the conversion of CO and H2O to carbonic acid?
CO+H2OH2CO3H+ + HCO3
(Carbon Dioxide + Water Carbonic Acid Hydrogen Ion + Bicarbonate ion)
Carbonic anhydrase
At the tissues, bicarbonate does what?
diffuses from rbc’s into plasma
At the lungs, HCO3 (bicarbonate), H2CO3 (carbonic acid), and CO does what?
Bicarb-move into rbcs and bind w/ hydrogen ions to form carbonic acid.
carb. acid is split by carb. anhydrase to release co and water.
co diffuses from blood to alveoli.
What is the Haldane effect?
the lower the Po2 and hemo sat w/ O2, the more CO can be carried in the blood.
(/\ O2->release of co2 @lungs)
How are Bohr effect and Haldane effect related?
They are opposite processes.
BE= release of O2 @ tissue (/\co2,/\h+,\/ph)
HE=release of co2 @ lung (/\O2)
If hydrogen ion concentrations begin to rise or drop what occurs?
rise-excess H+ is removed by reacting with HCO3
drop-carbonic acid dissociates, releasing H+
So…
H2CO3 (if too acidic this occurs)H+ + HCO3 (if too basic this occurs)
Resp rate changes can also alter ph? How so?
Slow shallow breathing lowers PH-keeps CO2 inward raising level, which makes increased H+, and therefore acts as an acid.
Rapid deep breathing raises PH-rids CO2, making basic
There are 3 medullary resp. centers. What are those and what is the central job of each?
Dorsal resp. group (DRG)-Monitors the chemical composition in the blood (input from receptors of the lung, aorta, and carotid)
Ventral resp. group (VRG)-Pacesetter, EUPNEA: normal RR
Pontine resp group (PRG)-Works with other medullary centers to make breathing smooth, efficient, and regular.
The depth and rate of breathing reflexes include:
Pulmonary irritant reflexes-irritant promote reflexive constriction of air passages
Inflation reflex-stretch receptor in lung stimulated by lung inflation.
When fully inflated, signals sent to medulla to end inspiration and begin expir.
3 other factors control the depth and rate of breathing and bypass medullary controls. What are these?
Hypothalamic act thru limbic (anger)
Body temp (release heat)
Cortical controls direct sig of cerebral cortex (volunteer breath hold)
Of all the chemicals, which is the most potent and influential of depth and rate?
CO2
Pco2 levels rise resulting in increased depth and rate of breathing is an example of? And leads to?
hypercapnea
Hyperventilation
What is hyperventilation? What can too much cause?
increased depth and rate of breathing flushing CO2 from blood
Hypocapnea-lower CO2 (dizziness)
What is hypoventilation and can cause?
slow/shallow breathing due to abnormally low Pco2 levels
apnea (sleep cessation) - until Pco2 levels rise
Exercise enhanced breathing is not prompted by an increase in ___ or a decrease in ____ or ___.
Pco2
Po2
PH
How are hyperpnea and hyperventilation different?
Hyperpnea is exercised induced. Matches CO2 production.
Hyperventilation flushes co2 and will make changes to gases
What is nitrogen narcosis?
When Nitrogen concentrates in lipid rich tissue (takes extended time period). gives a “high” to scuba divers
What is acute mountain sickness?
high altitude
ha, sob, nausea, dizziness
COPD victims develop resp failure as _________, accompanied by _______, ____ ______ ______, and ________ ________. They also have a hx of?
hypoventilation
hypoxemia
CO retention
resp. acidosis
smoking
dyspnea
coughing/pulmonary infections
What is emphysema?
enlargement of alveoli with destruction of alveolar walls. (resp. zone)
requires energy
collapse bronchioles w/ air trapping in alveoli
increased resistance from damaged pulm caps (making r vent. overwork and enlarge)
Chronic bronchitis is a result of?
inhaled irritants lead to chronic mucus production and fibrosis of the mucosal tissue.
Vent and gas excha impaired
pulm infections
dyspnea moderate compared to emphysema
Compare the pink puffer vs blue bloater.
PP-works hard maintaining vent, loses weight, normal blood gas
BB-Stocky, sufficiently hypoxic, cyanotic
Active inflammation of the airways precedes bronchospams in what dz?
Asthma
Discuss the 3 forms of lung ca.
Squamous Cell carcinoma-arises in bronchial epithelium
Adenocarcinoma-peripheral lung area from bronchial glands/alveolar cells
Small Cell Carcinoma-lymphocyte-like cells that originate in the primary bronchi and subsequently metastasize.
