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Phys 3 > Exam 3 Pulmonary Physiology > Flashcards

Exam 3 Pulmonary Physiology Flashcards

1
Q

What are the inspiratory muscles?

A

Diaphragm, external intercostals, SCM,anterior serratus, scalenes and levator costarum

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2
Q

What are the expiratory muscles?

A

Abdominals, internal intercostals, post inferior. Serratus, transverse thoracis, Pyramidal

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3
Q

What is the only muscle during inspiration doesn’t lift the rib cage?

A

Diaphragm, which drops the floor of the thoracic cage

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4
Q

Which muscle of expiration is involved in low back pain?

A

Transverse abdominis

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5
Q

During what conditions is expiration passive and associated with recoil of the lungs?

A

Resting conditions

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6
Q

What is pleural pressure?

A

Negative pressure between parietal and visceral pleura which keeps lung inflated against chest wall

Various between -5 to -7.5 cmH20

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7
Q

What are the two different kinds of alveolar pressure?

A

Sub Atmospheric and supra-atmospheric

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8
Q

Which alveolar pressure is associated with inspiration

A

Subatmospheric

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9
Q

What alveolar pressure is associated with expiration

A

Supra-atmospheric

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10
Q

What is transpulmonary pressure?

A

The difference between alveolar P and pleural P

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11
Q

What measures the recoil tendency of the lung and peaks at the end of inspiration_____________.

A

Transpulmonary pressure

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12
Q

True or False

At the onset of inspiration the pleural pressure changes at a faster rate than lung volume?

A

True

Known as “hysteresis” phenomenon

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13
Q

Which lung is easier to inflate a saline or air filled one?

A

Saline because surface tension is gone

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14
Q

What overrides the natural recoil tendency of the lung?

A

Expansion of the thoracic cage resulting in an increase of lung volume

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15
Q

What is Eupnea

A

Normal breathing 12-17 B/min 500-600 ml

Arterial CO2= 40mmHg

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16
Q

What is Hyperpnea

A

Increase in pulmonary ventilating matching metabolic demand

Arterial CO2= 40mmHg

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17
Q

What is happening during hyperventilation

A

Increase in pulmonary ventilation greater than metabolic demand

Arterial CO2 decreases to less than 40mmHg

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18
Q

What occurs during hypoventilation

A

Pulmonary ventilation lower than metabolic demand

Increase in Arterial CO2 greater than 40 mmHg

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19
Q

What is Tachypnea

A

Increase in the frequency of respiratory rate

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20
Q

What is apnea?

A

Absence of breathing

Ex. Sleep apnea

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21
Q

What is Dyspnea

A

Difficult or labored breathing

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22
Q

What is Orthopnea

A

Dyspnea when recumbent, relieved when upright

Ex. Congestive heart failure, asthma, lung failure

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23
Q

True or False

Lungs have a natural tendency to collapse

A

True

Surface tension forces 2/3

Elastic Fibers 1/3

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24
Q

What keeps lungs against the chest wall

A

By negative pleural pressure “suction”

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25
Q

True or False

If the pleural P= atmospheric P the lung will collapse?

A

True

Examples

Puncture of parietal pleural

Erosion of visceral pleura

If a major airway is blocked the air trapped distal to the block will be absorbed by the blood and that segment of the lung will collapse

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26
Q

What is Pleural fluid?

A

Thin layer of mucous fluid

Provides lubrication

Transudate ( interstitial fluid + protein)

Total amount is only a few ml’s

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27
Q

What happens to excess of pleural fluid?

A

Is removed by lymphatics

  • mediastinum
  • superior surface of diaphragm
  • lateral surfaces of parietal pleural
  • helps create negative pleural pressure
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28
Q

What is a pleural effusion?

A

Collection of large amounts of free fluid in pleural space.

Edema of pleural cavity

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29
Q

What are the causes of pleural effusion?

A

Blockage of lymphatic drainage

Cardiac failure- increased capillary filtration P

Reduced plasma colloid osmotic pressure

Infection/inflammation of pleural surfaces which breaks down capillary membranes

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30
Q

What is surfactant?

A

Reduces surface tension forces by forming a mono molecular layer between aqueous fluid lining the alveoli and air, preventing a water-air interface

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31
Q

Surfactant is produced by ________________. It consists of _________________________.

A

Type II alveolar epithelial cells. Dipalmitoyl lecithin, surfactant apoproteins, Ca++ ions

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32
Q

What is the Law of Laplace?

A

P=2T/r

Without surfactant smaller alveolar have increased collapse P and tend to empty into larger alveoli

AKA big would get bigger and small would get smaller

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33
Q

Role of surfactant??

A

As alveolar size decreases the surfactant is concentrated which decreases surface tension forces, of setting the decrease in radius of a smaller cell

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34
Q

What is interdependence?

A

Size of one alveoli determined in part by surrounding alveoli

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35
Q

What is tidal volume

A

Amount of air moved in or out each breath

500ml

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36
Q

What is inspiratory reserve volume?

A

Maximum volume one can inspire above normal inspiration

3000ml

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37
Q

What is expiratory reserve volume

A

Maximum volume one can expire below normal expiration

1100ml

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38
Q

This is the volume of air left in the lungs after maximum expiratory effort

A

residual volume

1200ml

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39
Q

This is the volume of air left in the lungs after a normal expiration, balance point of lung recoil and chest wall forces

A

Functional residual capacity (RV+ERV)

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40
Q

Maximum volume one can inspire during an inspiration effort

A

Inspiratory capacity (TV+IRV)

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41
Q

max volume one can exchange in a respiratory cycle

A

Vital capacity (IRV+TV+ERV)

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42
Q

The air in the lungs at full inflation is called _________________

A

Total lung capacity (IRV+TV+ERV+RV)

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43
Q

What lung volumes cant be determined by basic Spirometry?

A

RV, FRC, TLC

Must use helium dilution method for these

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44
Q

How do you find RV?

A

RV=FRC-ERV

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45
Q

How do you find TLC?

A

TLC=RV+VC

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46
Q

How many generations of branching is there in the lungs?

A

20

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47
Q

How many generations of branching are there in the bronchi?

A

First 11 generations of branching

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48
Q

How many generations of branching are in the bronchioles

A

Next 5 generations after bronchi

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49
Q

How many generations of branching are in respiratory bronchioles

A

Last 4 generations of branching

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50
Q

Where can gas exchange cannot occur?

A

Dead space

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51
Q

SNS beta receptors cause __________

A

Dilation due mainly to indirect effect via circulating epinephrine

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52
Q

Parasympathetic muscarinic receptors cause______________

A

Constriction

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53
Q

NANC nerve (non adrenergic, non cholinergic) due what?

A

Inhibitory release VIP and NO= bronchodialtion

Stimulatory= bronchoconstriction, mucous secretion, vascular hyperpermeability, cough, vasodilation, “neurogenic inflammation”

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54
Q

What are the two types of adapting receptors of afferent nerves?

A

Slow adapting receptors and rapidly adapting receptors

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55
Q

What are slow adapting receptors?

A

Associated with smooth muscle of proximal airways

Stretch receptors- involved in reflex control of breathing and cough reflex

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56
Q

What are rapidly adapting receptors?

A

Sensitive to mechanical +, protons, low Cl solutions, histamine, cigarette smoke, ozone, serotonin, PGF2

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57
Q

what are C fibers

A

They are high density fibers that contain neuropeptides ex. Substance P, neurokinin A, calcitonin gene related peptide

Selectively + by capsaicin

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58
Q

What happens when histamine binds to H1 receptors?

A

Constriction

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59
Q

What happens when histamine binds to H2 receptors

A

Dilation

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60
Q

Slow reactive substance of anaphylaxisis causes?

A

Constriction- allergic response to pollen

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61
Q

What do prostaglandins E series do?

A

Dilation

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62
Q

Prostaglandins F series do?

A

Constriction

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63
Q

Environmental pollution results in _______________. Which is mediated by ___________ and ________________.

A

Constriction

Parasympathetic reflex and local constrictor response

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64
Q

What is the normal level of HCO3?

Metabolic acidosis levels?

Metabolic alkalosis levels?

A

24 mEq/L

Acidosis HCO324 will decrease ventilation

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65
Q

What regulations HCO3 levels?

66
Q

What is the normal level of CO2?

Respiratory acidosis?

Respiratory alkalosis?

A

40mmHg

Acidosis CO2>40 + ventilation

Alkalosis CO2

67
Q

What regulates CO2?

68
Q

All pulmonary arteries have ____________

A

Larger lumen
More compliant
Operate under a lower pressure
Can accommodate 2/3 of SV from RV

69
Q

What is the total amount of Pulmonic blood volume?

A

450 ml (9% of total blood volume)

70
Q

True or False

Shifts in volume can occur from pulmonic to systemic or vice versa

71
Q

What can cause an increase of pulmonary volume of 100%?

A

Mitral stenosis

72
Q

True or False

Shifts have a greater effect on pulmonary circulation?

73
Q

Venous drainage is into the azygous (1/2) or pulmonary veins (1/2) (short circuit)

True or false

74
Q

True or False

The lung is the only organ to receive blood flow in excess of cardiac output because it receives both total pulmonic flow and some systemic flow simultaneously

75
Q

What is the Total blood flow to the lungs?

A

Right ventricular output + bronchial artery flow

76
Q

Which lung does most of the lymphatic tissue drain into?

A

The right lung

77
Q

What helps create the “respiratory membrane”?

A

Pulmonary lymphatics, helps maintain negative interstitial pressure which pulls alveolar epithelium against capillary edothelium

78
Q

What is the range of pulmonary artery pressure?

A

8-25

Mean 15mmhg

79
Q

What is the mean P of pulmonary capillaries

80
Q

What is the P of major pulmonary veins and left atrium?

A

Mean P 2 mmHg

81
Q

True or False

If low alveolar O2 is present it causes release of a local vasoconstrictor which automatically redistributes blood to better ventilated areas

82
Q

SNS will cause mild __________________, mediated by __________________.

A

vasoconstriction, alpha receptors.

However once 30Hz is reached vasodilation is observed as beta receptors are unmasked

83
Q

Parasympathetic Increase will cause __________

A

Mild vasodilation

84
Q

What is a major constrictor on pulmonary vascular smooth muscle is _______________

A

Low alveolar 02

85
Q

Under resting conditions blood is fully oxygenated by the time it has passed _______ of pulmonary capillaries.

86
Q

What is the limiting factor of oxygenation of pulmonary capillaries in exercise

87
Q

What are the effects of hydrostatic P on regional pulmonary blood flow?

A

Zone 1- no flow, alveolar P> capillary P

Zone 2- intermittent flow, during systole= capillary P> alveolar P. During diastole= alveolar P> capillary P

Zone 3- continuous flow, capillary P> alveolar P towards base of lung

88
Q

What cause the entire lung to enter the 3rd zone of pulmonary blood flow

A

Exercise!!!! Capillary P>alveolar P

89
Q

Pulmonary Capillary dynamics results in______

A

Net forces favoring filtration by 1mmHg. The excess fluid removed by lymphatics

90
Q

At a constant T and V of a given quantity of gas is 1/x to the P it exerts

A

Boyle’ Law

91
Q

V of gas at the same T and P contain the same # of molecules

A

Avogadro’s Law

92
Q

At a constant P and V of a gas is x to its absolute T

A

Charles Law

93
Q

The rate of diffusion of a gas is 1/x to the square root of its molecular weight?

A

Grahams Law

94
Q

The quantity of gas that can dissolve in a fluid is = to the partial P of the gas X the solubility coefficient

A

Henry’s Law

95
Q

The P exerted by a mixture of gases is = Energy of the individual (partial) P exerted by each gas

A

Daltons Law of Parital Pressures

96
Q

At body temperature the vapor P of H2O is _________

97
Q

What are the alveoli averages for CO2 and O2?

A

CO2= 40 mmHG

O2= 104 mmHg

98
Q

The respiratory unit contains ___________ alveoli and consists of what two layers?

A

300 million

Alveolar epithelium, capillary endothelium

99
Q

What diffuses at least 20x more readily than oxygen?

A

Carbon Dioxide

100
Q

During expiration what happens to the air?

A

O2 falls from 159 to 104 mmHg
CO2 rises from 0 to 40 mmHg

1st 100 ml of air is from dead space
Last 250 ml of expired air is alveolar air the rest is a mix

101
Q

How many breaths does it take to have a complete turnover of alveolar air?

A

6-7 breaths

Slow turnover prevents large changes in gas concentration in alveoli from breath to breath

102
Q

True of False

Normally alveolar ventilation is matched to pulmonary capillary perfusion at a rate of 4L/min of air to 5L/min of blood

A

True

This means the V/P ratio is 4/5

103
Q

If the ventilation-Perfusion ratio decreases then it is due to a problem resulting in __________

A

Decreased ventilation

104
Q

IF the ventilation -Perfusion ratio increases it is a result from

A

Decreased perfusion of the lungs

105
Q

A physiologic shunt blood is __________

A

Blood that is not oxygenated as it passes the lung due to the decreased V/P ratio

106
Q

A increased V/P ratio due to a decreased perfusion of the lungs from the RV results in _____________

A

Alveolar PO2 increases to 149 mmHg
Alveolar PCO2 will decrease toward ) mmHg

RESULTS IN AN INCREASE IN PHYSIOLOGIC DEAD SPACE

107
Q

When fatty acid utilization for E increases the percentage of metabolic water generated from O2 increases up to _________

108
Q

If only CHO is used for energy no metabolic water is generated from all the all the O2 is converted to _____

109
Q

As PO2 decreases hemoglobin ____________

A

Releases more oxygen

110
Q

A shift to the right of a sigmoid curve indicates ____________

A

Dissociation of Oxygen from hemoglobin

111
Q

Carbon dioxide is carried most commonly in what form in the body at about 70%

A

bicarbonate

112
Q

What percentage of CO2 is bound to hemoglobin?

113
Q

Dissolved CO2 in the blood is what percent

114
Q

Carbon monoxide is ______ higher affinity than oxygen in hemoglobin?

115
Q

Pco= .4mmHg will saturate 97% of hemoglobin which can decrease carry capacity by ________?

116
Q

What concentration can CO be lethal?

A

.1% aka Pco= .6mmHg

117
Q

Is CO produced by the body?

True or False

118
Q

What are the functions of physiologic CO?

A

Signaling molecule in nervous system

Vasodilator

important role in immune,respiratory, GI, kidney and liver systems

119
Q

What sets the basic drive of ventilation?

A

Dorsal respiratory group

120
Q

Where is the dorsal respiratory group located?

A

Primarily in nucleus tracts solitarius in medulla terminate CN IX and X.

Excites muscles of inspiration

121
Q

What does the Pneumotaxic center do?

A

Located in the N. Parabrachialis of upper pons and inhibits the duration of inspiration by turning off DRG

122
Q

Where is the ventral respiratory group of neurons located?

A

Bilaterally in ventral aspect of medulla

123
Q

What do ventral respiratory group of neurons do?

A

Can increase both inspiratory and expiratory respiratory muscles during increased ventilators drive

124
Q

What does the Apneustic center do?

A

Functions to prevent inhibition of DRG under some circumstances

125
Q

What is the Herring Breuer inflation reflex/

A

Stretch receptors located in the wall of airways inhibit DRG when tidal volumes exceed 1500 ml

126
Q

What are irritant receptors?

A

Inhibit and increase sneezing and coughing and possible airway constriction

127
Q

What are J receptors?

A

Located in alveoli next to pulmonary caps

Increase when pulmonary caps are engorged or pulmonary edema

create feeling of dyspnea

128
Q

True or False

Carbon dioxide and hydrogen ions can cross BBB

A

False, only Carbon dioxide can cross BBB

129
Q

When CO2 concentrations increase in CSF they __________ ventilation

130
Q

What are Peripheral chemoreceptors found and what are they responsive too?

A

Aortic and carotid bodies, respond to hypoxia

131
Q

What happens to respiratory centers when brain edema occurs and how to treat it?

A

Respiratory centers are depressed, and treatment is mannitol

132
Q

What is the most prevalent cause of respiratory depression?

A

Narcotics

Ex. Sodium pentobarbital and morphine

133
Q

How much stored O2 is in the body for aerobic metabolism?

A

2L

.5L in lungs

.25L in body fluids

1L in combined with hemoglobin

.3 in muscle myoglobin

134
Q

Heavy exercise how quickly is the stored O2 used up in?

A

2 mins

The O2 debt can reach 11.5 L

135
Q

What is Alactacid oxygen debt?

A

Is about 3.5L is replenished within the first couple minutes of post exercise

136
Q

What is Lactic acid oxygen debt?

A

8L total is changed over the first 40 minutes of poster exercise and helps remove lactic acid

137
Q

How much pressure does it take to have first breath as a baby?

A

40-60 cm H2O of negative pleural P

138
Q

During birth what closes?

A

Foramen ovale

Ductus arteriosis

Ductus venosus

139
Q

True or False

At 63,000 ft the barometric P is 47 mmHg and blood “boils”

140
Q

During acute mountain sickness what is the difference between cerebral edema and pulmonary edema?

A

Both end up in hypoxia.

Pulmonary edema= local vasoconstriction

Cerebral edema= local vasodilation

141
Q

An increase in ph is inhibitory to ventilation and opposes the increase effects of hypoxia on peripheral chemoreceptors
True or False

142
Q

Chronic mountain sickness can result in _________ if person is not removed to a lower altitude

143
Q

Acclimatization results in

A

Increase in RBC
Increase in diffusion capacity of lungs
Increase of tissue vascularity
Increase of ability of tissue to use O2

Increased synthesis of 2,3 DPG shifts curve to the right

144
Q

What altitude do you have to be at for natural acclimatization to occur?

145
Q

What is hyperbarism?

A

When the lungs are exposed to extremely high alveolar gas pressures which can be lethal

146
Q

Effect of N high partial pressures are?

A

120ft- joviality, carefree
150-200 drowsiness
200-250 weakness
250- unable to function lose consciousness

Similar to alcohol intoxication

147
Q

What are the effects of high partial pressure?

A

Oxygen toxicity, siezures and coma within 30-60 mins

This occurs above 2 atmospheres

148
Q

What is decompression sickness aka Bends?

A

Nitrogen bubbles out of fluids after sudden decompression

Symptoms- pain in joints, dizziness, “the chokes”

149
Q

True or False the lung ranks second behind the liver in metabolism?

150
Q

When Angiotensin I is passed through the lung is is converted to ________

A

Angiotensin II

151
Q

True or False

Prostaglandins inactivated in one pass through pulmonary circulation?

152
Q

How much air does the average adult inhale?

153
Q

What do long hairs in the nose do?

A

Filters out larger particles

154
Q

What does mucous coating in the nose do?

A

Traps particles bigger than 10 microns, moisten air 650 ml H20/day

155
Q

What do nasal turbinates do?

A

Highly vascularized, act as radiators to warm air

156
Q

Stats about coughing?

A

Afferents utilize primarily CN X

2.5L of air rapidly inspired

Lung pressure rises to 100mmHg

157
Q

How is sneeze reflex used?

A

Irritation sends signal over CN V to the medulla

158
Q

What does the mucociliary elevator do?

A

Clears smaller airways

Moves the mucous to the pharynx which beat 1000x/min

159
Q

What are alveolar marcrophages called/do?

A

Dust cells

Capable of phagocytosis intraluminal particles

Principal phagocytes cells in the distal air spaces

160
Q

What is the complement system?

A

Small proteins found in the blood to synthesize in the liver

Part of the innate immune system

161
Q

What are the three antibodies in the lung?

A

IgG- lower respiratory tract

IgA- dominate in upper respiratory tract

IgE- predominantly a mucosal antibody

162
Q

What is the humoral immune system?

A

Antibodies, accessory processes, made up of various lipoproteins and glycoproteins

Phys 3 (1 decks)

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