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GM Phys 3 > Exam 3 Pulmonary Physiology > Flashcards

Exam 3 Pulmonary Physiology Flashcards

1
Q

What are the 3 functions of the respiratory neurons in the brain stem

A
  • sets basic drive of ventilation
  • descending neural traffic to spinal cord
  • activation of muscles of respiration
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2
Q

What are 3 things that activate pulmonary physiology

A
  • respiratory neurons in the brain stem
  • ventilation of alveoli coupled with perfusion of pulmonary capillaries
  • exchange of oxygen and CO2
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3
Q

What is the ventilatory cycle

A

The alveolar (avl.) pressure oscillates around atmospheric pressure (atm.)

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4
Q

During inspiration what is the ventilatory cycle look like in regards to Pavl vs. Patm

A

during inspiration

Pavl. < Patm.

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5
Q

During expiration what is the ventilatory cycle look like in regards to Pavl vs. Patm

A

During expiration

Pavl > Patm

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6
Q

At the end of inspiration or expiration what does the ventilatory cycles equation in regards to Pavl vs Patm

A

Pavl = Patm

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7
Q

Where are the respiratory centers located within the brainstem

A
  • dorsal and ventral medullary group

- pneumotaxic and apneustic centers

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8
Q

What do respiratory centers do

A

Affect rate and depth of ventilation

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9
Q

What 3 things that respiratory centers are influenced by

A
  • higher brain centers
  • peripheral mechanoreceptors
  • peripheral and central chemoreceptors
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10
Q

What are the functions of inspiratory muscles of ventilation

A

Increase thoracic cage volumes

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11
Q

What are the inspiratory muscles

A
  • diaphragm, external intercostals, SCM

- Ant and Post sup. Serratus, scaleni, levator costarum

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12
Q

What is the function of expiratory muscles of ventilation

A

Decreased thoracic cage volume

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13
Q

What are the expiratory muscles

A

Abdominals, internal intercostals, post. Inf. Serratus, transverse thoracics, pyramidal

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14
Q

What happens when muscles of inspiration are contracted

A

Increase thoracic cage volume

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15
Q

What happens when muscles of expiration are contracted

A

They pull the rib cage down decreasing thoracic cage volume (forced expiration)

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16
Q

What is pleural pressure

A

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

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17
Q

What is the range of pleural pressure

A

Between -5 and -7.5 cm H2O (inspiration to expiration)

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18
Q

What is alveolar pressure for inspiration and expiration

A
  • sub atmospheric during inspiration

- supra-atmospheric during expiration

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19
Q

What is transpulmonary pressure

A

The difference between alveolar P and pleural P

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20
Q

What does transpulmonary pressure measure

A

The recoil of tendency of the lung

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21
Q

What peaks at the end of inspiration

A

Transpulmonary pressure

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22
Q

What is the equation for compliance of the lung

A

Change in volume divided by chang in pressure

∆V/∆P

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23
Q

What is hysteresis

A

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

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24
Q

What is significant between air filled lung vs. saline filled lung

A

Easier to inflate a saline filled lung than air filled because surface tension forces have been eliminated in the saline filled lung

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25
Q

What reflects back at the hilum to form visceral pleura

A

Parietal pleura attached firmly to the rib cage

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26
Q

Where is visceral pleura attached to

A

Firmly to the lungs

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27
Q

What exists between the 2 pleura

A

A negative pleural pressure which creates a suction such that the visceral pleura will follow the parietal pleura

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28
Q

What does expansion of the thoracic cage produce when increasing lung volume

A

Overrides the natural recoil tendency of the lung

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29
Q

At the end of a normal expiration, ____ are opposite but equal of ____

A

Chest wall forces, lung recoil forces

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30
Q

What happens in terms of volume in the lungs and functional residual capacity when all the respiratory muscles are relaxed

A

Volume in the lungs = FRC

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31
Q

What is the effect of thoracic cage on the lung

A

Reduces compliance by about 1/2 around functional residual capacity (at end of normal expiration)

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32
Q

What is greatly reduced at high or low lung volumes

A

Compliance

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33
Q

What is compliance (elastic) work

A

Accounts for most of the work normally

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34
Q

What is the viscosity of chest wall and lung

A

Tissue resistance work

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35
Q

How much energy is required for ventilation

A

3-5% of total body energy

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36
Q

What are the 4 different works of breathing

A
  • compliance(elastic) work
  • tissue resistance work
  • airway resistance work
  • energy required for ventilation
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37
Q

What is Eupnea

A

Normal breathing (12-17 b/min, 500-600 ml/b)

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38
Q

What is tidal volume

A

amount of air moved in/out each breath (500mL)

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39
Q

What is IRV

A

Inspiratory reserve volume

- max volume one can inspire above normal inspiration (3000mL)

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40
Q

What is ERV

A

Expiratory reserve volume

- max volume one can expire below normal expiration (1100mL)

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41
Q

What is RV

A

Residual volume

- volume of air left in lungs after max expiratory effort (1200mL)

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42
Q

What is FRC

A

Functional residual capacity

  • RV+ ERV
  • volume of air left in lungs after normal expiration
  • balance point of lung recoil and chest wall forces
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43
Q

What is inspiratory capacity

A
  • TV+IRV

- max volume on can inspire during inspiration effort

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44
Q

What is vital capacity

A
  • IRV + TV + ERV

- max volume one can exchange in respiratory cycle

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45
Q

What is total lung capacity

A
  • IRV + TV + ERV + RV

- the air in lungs at full inflation

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46
Q

What is the helium dilution method

A

FRC = ([He]i/[He]f-l)Vi

  • [He]i = initial concentration of helium
  • Hef is final concentration
  • Vi is initial volume of air in jar
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47
Q

What is determined from basic spirometry

A

ERV and VC

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48
Q

What decreases with restrictive lung conditions

A

VC, IRV, IC

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49
Q

What is minute respiratory volume

A

Resting rate x tidal volume

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50
Q

What is the breakdown of airways in the lung

A

Trachea, bronchi, bronchioles, respiratory bronchioles, alveolar ducts, alveolar sacs, alveoli

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51
Q

What is the amount of anatomical dead space

A

150mL

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52
Q

What is physiological dead space

A

Anatomical + non functional alveoli

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53
Q

What is alveolar volume

A

Alveolar volume (2150mL) = FRC (2300mL) - dead space (150mL)

54
Q

What is the turnover of alveoli

A

6-7 breaths

55
Q

What is the equation of rate of alveolar ventilation

A

Va= RR(Vt-Vd)

56
Q

What are NANC nerves

A

Non adrenergic, non cholinergic

  • inhibitory release of VIP and NO = bronchodilation
  • stimulatory = constriction
57
Q

What part of autonomic control contains neuropeptides

A

C fibers = selectively stimulated by capsaicin

58
Q

What histamines and prostaglandins are associated with dilation

A

Prostaglandin E and histamine binding to H2 receptors

59
Q

What histamines and prostaglandins are associated with constriction

A

Prostaglandin F and histamine binding to H1 receptors

60
Q

What will metabolic acidosis or alkalosis do

A
  • Acidosis (HCO3 <24) = stimulate ventilation

- alkalosis (HCO3 >24) will inhibit ventilation

61
Q

What is the normal level of CO2 and how does it affect ventilation

A
  • acidosis (CO2>40) stimulates ventilation

- alkalosis(CO2<40) inhibits ventilaiton

62
Q

What will low alveolar O2 cause

A

Release of local vasoconstrictor that automatically redistributes blood to better ventilated areas

63
Q

What happens with SNS stimulation on pulmonary vascular smooth muscle

A

SNS stimulation= mild vasoconstriction mediated by alpha receptors. No more at 30Hz then vasodilation mediated by Beta receptors takes over

64
Q

What is the major constrictor effect on pulmonary vascular smooth muscle

A

Low alveolar O2

65
Q

From apex to base what happens to capillary pressur

A

Capillary pressure increases

66
Q

What happens in zone one hydrostatic pressure

A
  • no. Flow
  • alveolar P > capillary P
  • normally does not exist
67
Q

What happens in zone 2 of hydrostatic P

A
  • intermittent flow (to apex)
  • systole = capillary P>alveolar P
  • diastole=alveolar P>capillaryP
68
Q

Effect of hydrostatic pressure of zone 3

A
  • continuous flow (toward base)

- capillaryP>alveolarP

69
Q

What happens during exercise for hydrostatic pressure zones

A

Always zone 3

70
Q

What is boyle’s law

A

At constant T, V of gas is inversely proportional to P it exerts

71
Q

What is avogrado’s law

A

V of gas at same T/P contain same # of molecules

72
Q

What is charles law

A

At constant P the V of gas is proportional to absolute T

73
Q

What is the gas law sum

A

PV=nRT

74
Q

What is grahams law

A

Rate of diffusion of gas is inversely proportional to square root of molecular weight

75
Q

What is henry’s law

A

Quantity of gas that can dissolve in fluid is = to partial P of gas x the solubility coefficient

76
Q

What is daltons law of partial pressures

A

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

77
Q

At body temp vapor P of H2O is what

A

47 mmHg

78
Q

What are the alveolar gas concentrations of O2 and CO2

A

O2 = 104 mmHg, CO2= 40mmHg

79
Q

What diffuses at least 20x more readily than oxygen

A

CO2

80
Q

The first 100mL of expired air is from where

A

Dead space

81
Q

The last 250mL of expired air is from where

A

Alveolar air

82
Q

What happens to ventilation if ventilation perfusion ratio decreases or increases

A

Decrease = decrease ventilation, increase = decreased perfusion of lungs

83
Q

A decreased V/P ratio as ventilation goes to 0 results in what?

A

An increase in “physiologic shunt blood” = blood that is not oxygenated as it passes the lung

84
Q

Increased V/P ratio due to what

A

Decreased perfusion of lungs from RV

85
Q

What happens in transport of O2

A
  • 5mL/dl carried from lungs-tissue
  • dissolved = 3%
  • bound to hemoglobin = 97%
86
Q

What happens in transport of CO2

A
  • 4ml/dl carried from tissue - lungs
  • dissolved = 7%
  • bound to hemoglobin = 23%
  • bicarbinate ion = 70%
87
Q

What is the pH of arterial blood

A

7.41

88
Q

What is the blood pH of venous blood

A

7.37, buffered by blood buffers

89
Q

Exercise venous blood pH can drop to what

A

6.9

90
Q

What happens in oxy-hemoglobin dissociation if shifts to the right

A

Increase temp, increase CO2(decrease pH), increase 2,3 DPG

91
Q

What are the physiological roles of CO

A
  • signal for NS
  • vasodilator
  • immunne, resp, GI, kidney, liver
92
Q

The nervous system adjusts the level of ventilation to match what

A

Perfusion of the lungs

93
Q

By matching ventilation with pulmonary blood flow we also match what

A

Ventilation with overall metabolic demand

94
Q

What provides neural control of ventilation

A

Dorsal respiratory group located primarily in nucleus tractus solitarius in medulla

95
Q

Where is the pneumotaxic center located and what does it do

A

Dorsally in n. Parabrachialis of upper pons, inhibits duration of inspiration by turning of DRG ramp signal after inspiration starts

96
Q

Where is the ventral respiratory group of neurons and what does it do

A

Located bilaterally in ventral aspect of medulla can stimulate inspiratory/expiratory muscles during increased ventilatory drive

97
Q

Where is the apneuistic center and what does it doe

A

Lower pons and funx to prevent inhibition of DRG under some circumstances

98
Q

What stimulates sneezing and coughing

A

Irritant receptors among airway epithelium

99
Q

What stimulates when pulmonary caps are engorged or pulmonary edema

A

J receptors

100
Q

What creates a feeling of dyspnea

A

When j receptors stimulated by pulmonary caps engorged/edema

101
Q

What is responsive to hypoxia

A

Peripheral chemoreceptors

102
Q

What are some consequences of hyperventilation

A

Blood flow decreased all around, muscle spasm/tetany, oxyhemoglobin affinity increased, repolarization of heart is impaired

103
Q

What is the effect of edema on the brain

A

Depression/inactivation of respiratory centers tx is use o iv hypertonic solution

104
Q

What is the effect of anesthesia/narcotics on ventilation

A

Most prevalent cause of respiratory depression

  • sodium pentobarbital
  • morphine
105
Q

How much stored O2 dos the body contain

A

About 2 L used for aerobic metabolism mostly combined with hemoglobin

106
Q

What happens to stored O2 in exercise

A

Used within 2 minutes, O2 debt can reach 11.5 L

107
Q

How long is o2 debt in alactacid and lactic acid

A

Alactacid (3.5L) = first couple minutes, lactic acid (8L) over 40 minutes post exercise

108
Q

How much cm H2O of negative plueral P is necessary to open alveoli on first breath

A

40-60 cm H2O

109
Q

What closures happen at birth

A

Foramen ovale, ductus arteriosus, ductus venosus

110
Q

What happens in acute mountain sickness

A

Onset is hours to 2 days,

  • cerebral edem = hypoxia, stimulation of local vasodilation
  • pulmonary edema = hypoxia stimulation of local vasoconstriction
111
Q

What happens in chronic mountain sickness

A

Increase in red cell mass, pulmonary BP, RV enlargement, decreased TPR, congestive Heart failure, person dies if not moved to lower altitude

112
Q

What happens in acclimitization

A

Increase in RBC, diffusion capacity, vascularity, use of O2, synthesis of 2,3DPG (shifts dissociation to the right)

113
Q

What is hyperbarism

A

To keep lungs from collapsing in air must be supplied at high pressures exposing pulmonary capillary blood to extremely high alveolar gas pressures, can be lethal

114
Q

What is the effect of high partial pressures of high PN2

A

Causes narcosis = state of stupor, drowsiness, unconsciousness similar to alcohol intoxication

115
Q

What effect does high partial pressure have from high PO2

A

Oxygen toxicity = seizures, coma, cannot exceed established max depth of given breathing gas to prevent

116
Q

What is the effect of high partial pressure of CO2

A

Usually not a problem as depth does not increase alveolar PCO2, can occur in certain diving gear occurring when alveolar PCO2>80mmHg

117
Q

What is decompression

A

When person breaths air under high pressure the amount of N2 in body fluids increases, N2 not metabolized, potential problem if person submerged at deep level for hours

118
Q

Decompression sickness

A

Aka the “Bends” = nitrogen bubbles out of fluids after sudden decompression

119
Q

Where does the lung rank as an organ of metabolism

A

Second to liver, advantage though because all blood passes through lung

120
Q

What are examples of lung as organ of metabolism

A

Angiotensin, prostaglandins

121
Q

What is the average inhalation amount of air/day

A

10,000L

122
Q

What protects the upper respiratory tracts

A

Nasal passages have vibrassae (long hairs) and nares filtering out larger particles

123
Q

What are nasal turbinates

A

Highly vascularized, act as radiators to warm air

124
Q

What nerve stimulates cough

A

CN X

125
Q

What is associated with sneeze reflex

A

Nasal passages, irritation signals CN V to medulla different than cough because uses uvula

126
Q

What clears the smaller airways

A

Mucociliary elevator moves mucous from bronchioles up to pharynx

127
Q

What are dust cells

A

Alveolar macrophages

128
Q

What is the complement system

A

Small proteins found in blood synthesized in liver for antibodies and phagocytosis

129
Q

What antibodies are associated with the mucosa

A

IgG=lower resp. Tract, IgA=upper resp, IgE = a mucosal antibody

130
Q

How do dust cells work

A

Present pieces of organism to effector cells through interactions involving cytokines promoting more vigorous/widespread response

131
Q

What is the humoral immune system

A

Antibodies, accessory processes using Th2 activation and other stuff

GM Phys 3 (3 decks)

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