Chapter 40: Respiratory & Oxygentation Cliff Notes Flashcards
The ______ and _______ systems supply the oxygen demands of the body. _______ is oxygenated through the mechanisms of ventilation, perfusion, and transport of respiratory gases. ______ and _______ regulators control the rate and depth of respiration in response to changing tissue oxygen demands. The cardiovascular system provides the _____ mechanisms to distribute oxygen to cells and tissues of the body.
Cardiac and Respiratory
Blood
Neural and chemical
Transport
Respiration is the exchange of oxygen and carbon dioxide during _______. The airways of the lung transfer oxygen from the atmosphere to the alveoli, where the oxygen is __________ for carbon dioxide. Through the _____________, oxygen transfers to the blood, and carbon dioxide transfers from the blood to the alveoli. There are three steps in the process of oxygenation. What are the three steps?
Cellular Metabolism
Exchanged
Alveolar Capillary Membrane
Ventilation, Perfusion, and Diffusion
The respiratory muscles, pleural space, lungs, and alveoli are essential for ventilation, perfusion, and exchange of respiratory gases. Gases move into and out of the lungs through ________ changes. __________ pressure is negative, or less than atmospheric pressure, which is _______mm/Hg at sea level. For air to flow into the lungs, intrapleural pressure becomes more negative, setting up a __________ between the atmosphere and the alveoli. The diaphragm and external intercostal muscles contract to create ________ pleural pressure and increase the size of the thorax for inspiration. _______ of the diaphragm and __________ of the internal intercostal muscles allow air to escape from the lungs.
Pressure Intrapleural 760 mm/Hg Pressure Gradient Negative Relaxation Contraction
This requires coordination of the muscular and elastic properties of the lung and thorax. The major inspiratory muscle of respiration is the diaphragm. It is innervated by the phrenic nerve, which exits the spinal cord at the fourth cervical vertebra. What is this defined as?
Ventilation
This is the effort required to expand and contract the lungs. In the healthy individual breathing is quiet and accomplished with minimal effort. The amount of energy expended on breathing depends on the rate and depth of breathing, the ease in which the lungs can be expanded (compliance), and airway resistance. What is this defined as?
Work of breathing (WOB)
This muscle used during respiration can increase lung volume during inspiration. Patients with COPD, especially emphysema, frequently use these muscles to increase lung volume. Prolonged use of these muscles does not promote effective ventilation and causes fatigue. What is this defined as?
During assessment observe for elevation of the patient’s ______ during inspiration, which can indicate ventilatory fatigue, air hunger, or decreased lung expansion.
Accessory muscles
Clavicles
This is the ability of the lungs to distend or expand in response to increased intraalveolar pressure. What is this defined as?
This decreases in diseases such as _________, interstitial and pleural __________, and congenital or traumatic structural abnormalities such as __________ or fractured ribs.
Compliance
Pulmonary Edema
Fibrosis
Kyphosis
This is the increase in pressure that occurs as the diameter of the airways decreases from mouth/nose to alveoli. Any further decrease in airway diameter by bronchoconstriction can increase this. What is this defined as?
Airway Resistance
Decreased lung ________, increased airway resistance, and the increased use of accessory muscles increases the WOB, resulting in increased __________. Therefore the body increases its ___________ and the need for more oxygen. The need for elimination of __________ also increases. This sequence is a vicious cycle for a patient with ____________, causing further deterioration of respiratory status and the ability to oxygenate adequately.
Compliance Energy Expenditure Metabolic Rate Carbon Dioxide Impaired Ventilation
__________ is the amount of air exhaled after normal inspiration.
Tidal Volume
Diseases causing airway obstruction such as asthma and tracheal edema ___________ airway resistance.
When airway resistance increases, the amount of oxygen delivered to the alveoli ____________.
Increase
Decreases
The primary function of this is to move blood to and from the alveolar capillary membrane for gas exchange. This begins at the pulmonary artery, which receives poorly oxygenated mixed venous blood from the right ventricle. Blood flow through this system depends on the pumping ability of the right ventricle. The flow continues from the pulmonary artery through the pulmonary arterioles to the pulmonary capillaries, where blood comes in contact with the alveolar capillary membrane and the exchange of respiratory gases occurs. The oxygen-rich blood then circulates through the pulmonary venules and pulmonary veins, returning to the left atrium. What is this defined as?
Pulmonary Circulation
___________ of respiratory gases occurs at the alveolar capillary membrane. The thickness of the membrane affects the rate of diffusion. Increased thickness of the membrane ________ diffusion because gases take longer to transfer across the membrane. Patients with ______, ________, and ________ have a thickened membrane, resulting in slow diffusion, slow exchange of respiratory gases, and decreased delivery of oxygen to tissues. What is this process defined as?
Diffusion Slows Pulmonary edema Pulmonary infiltrates Pulmonary effusion Respiratory Gas Exchange
The ____________ system consists of the lungs and cardiovascular system. Delivery depends on the amount of oxygen entering the lungs also known as _________, blood flow to the lungs and tissues also known as ________, rate of _______, and oxygen-carrying ________.
Oxygen Transport Ventilation Perfusion Diffusion Capacity
This is a product of cellular metabolism, this product diffuses into red blood cells and is rapidly hydrated into carbonic acid (H2CO3). The carbonic acid then dissociates into hydrogen (H) and bicarbonate (HCO3−) ions. Hemoglobin buffers the hydrogen ion, and the (HCO3−) diffuses into the plasma. Reduced hemoglobin (deoxyhemoglobin) combines with this product, and the venous blood transports the majority of this product back to the lungs to be exhaled. What is this process defined as?
Carbon Dioxide Transport
This is necessary to ensure sufficient oxygen intake and carbon dioxide elimination to meet the demands of the body (e.g., during exercise, infection, or pregnancy). What is this defined as?
________ and ________ regulators control the process of respiration.
Regulation of Respiration
Neural and Chemical
Chronic diseases (e.g., ________), acute diseases (e.g., ________), and surgical processes (e.g.,______) often alter the amount of alveolar capillary membrane surface area.
Emphysema
Pneumothorax
Lobectomy
The amount of dissolved oxygen in the plasma,
The amount of hemoglobin,
The tendency of hemoglobin to bind with oxygen. These three things influence what?
The capacity of the blood to carry oxygen.
Rationale: Hemoglobin, which is a carrier for oxygen and carbon dioxide, transports most oxygen (approximately 97%).
