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physiology lecture > exam 4- respiratory and renal > Flashcards

exam 4- respiratory and renal Flashcards

1
Q

intrapulmonary or alveolar pressure

A

Pa (P sub a)

equals the atmospheric pressure at rest

altered by changes in the lung volume

with lung expansion, Pa falls below atmospheric pressure and air flows in

with lung compression, Pa rises above atmospheric pressure and air flows out

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2
Q

intrapleural pressure

A

Ppl (P sub pl)
sub-atmospheric at rest
determined by lungs and chest wall
always more negative than Pa

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3
Q

transpulmonary pressure

A

Pa-Ppl
pressure difference across lung
determines lung volume

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4
Q

atmospheric pressure

A

Patm
760 mmHg

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5
Q

what determines how compliant a lung is?

A

lung structure
surface tension
higher surface tension resists expansion

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6
Q

respiratory distress syndrome

A

premature babies type 2 alveoli do not develop (no surfactant) causes collapsed alveoli
fluid gets in lungs instead of air

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7
Q

elastic recoil

A

the ability for the lung to bounce back into shape after being inflated
just because it is very compliant does not mean it is necessarily good on elastic recoil

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8
Q

where does gas exchange happen in the lungs

A

respiratory zone

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9
Q

how do gases move between blood and air

A

diffusion due to concentration or partial pressure gradient

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10
Q

partial pressure of H2O in inspired air

A

variable (depends on humidity)

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11
Q

partial pressure of CO2 in inspired air

A

000.3 mmHg

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12
Q

partial pressure of O2 in inspired air

A

159 mmHg

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13
Q

partial pressure of N2 in inspired air

A

601 mmHg

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14
Q

total pressure of inspired air

A

760 mmHg

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15
Q

partial pressure of H2O in alveolar air

A

47 mmHg (humidification)

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16
Q

partial pressure of CO2 in alveolar air

A

40 mmHg (produced)

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17
Q

partial pressure of O2 in alveolar air

A

100 mmHg (used)

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18
Q

partial pressure of N2 in alveolar air

A

568 mmHg (makes room for water)

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19
Q

total pressure in alveolar air

A

760 mmHg

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20
Q

what determines the amount of each gas dissolved in liquid

A

temperature of the fluid
partial pressure of the gas
solubility of the gas

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21
Q

is O2 soluble in plasma

A

no

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22
Q

what do red blood cells have?

A

hemoglobin which increases oxygen concentration in blood (4 binding sites for oxygen on each hemoglobin)

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23
Q

what causes an O2 left shift (more binding affinity)

A

pH rise / H+ drop

pCO2 drop

temperature drop

2,3-DPG drop

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24
Q

what causes an O2 right shift (less binding affinity)

A

pH drop / H+ rise

pCO2 rise

temperature rise

2,3-DPG rise

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25
Q

What does CO2 transport in the blood consist of? (3 things)

A

HCO3 (70%)
dissolved CO2 (10%)
carbaminohemoglobin (20%) this is just CO2 in red blood cells

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26
Q

explain how CO2 is transported in the blood

A

H2O and CO2, through carbonic anhydrase (ca), get made into H2CO3, which turns into H+ and HCO3

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27
Q

what is the gradient of CO2

A

it moves from pulmonary blood into the alveolar air

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28
Q

eupnea

A

normal quiet breathing

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29
Q

hyperpnea

A

increased respiratory rate and/or volume in response to increased metabolism (ex:exercise)

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30
Q

hyperventilation

A

increased respiratory rate and/or volume without increased metabolism (ex: emotional hyperventilation, blowing up a balloon)

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31
Q

hypoventilation

A

decreased alveolar ventilation (ex: shallow breathing, asthma, restrictive lung disease)

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32
Q

tachypnea

A

rapid breathing, usually increased respiratory rate with decreased depth (ex: panting)

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33
Q

dyspnea

A

difficulty breathing (ex: various pathologies or hard exercise)

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34
Q

apnea

A

cessation of breathing (ex: voluntary breath-holding, depression of CNS control centers)

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35
Q

emphysema

A

destructive disease

decreased alveoli -> decreased surface area -> decreased gas exchange

decreased elastic recoil of lung

increased lung compliance

alveolar PO2 normal or low

plasma PO2 low

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36
Q

fibrotic lung disease

A

restrictive disease

thicker alveoli -> increases distance for diffusion -> slows gas exchange

loss of lung compliance

black lung (inhalation of particulate matter)

alveolar PO2 normal or low

plasma PO2 low

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37
Q

asthma

A

obstructive disease

increased airway resistance -> decreased ventilation

bronchioles restricted

alveoli PO2 low

plasma PO2 low

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38
Q

COPD

A

a mix of emphysema (destructive) and chronic bronchitis (obstructive)

treatment: stop smoking, avoid lung irritants, medicines, surgery

walls of alveoli are destroyed, bronchioles clogged with mucus

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39
Q

tidal volume

A

the amount of air going in and out of the lungs with each respiratory cycle (breathe in and out)

40
Q

residual volume

A

the amount of volume in the lungs after you breathe all the way out

41
Q

vital capacity

A

breathe all the way in and all the way out

42
Q

total lung capacity

A

vital capacity plus residual volume

43
Q

what does the forced vital capacity of someone with emphysema look like

A

due to collapsed airways, the FVC is smaller. the gas becomes trapped and cannot be exhaled

44
Q

what do we use FEV1/FVC for

A

used to diagnose obstructive and restrictive lung diseases

it is the proportion of a person’s vital capacity that they can exhale in the first second of forced exhalation to the full FVC

45
Q

restrictive disease FEV1/FVC
(ex: black lung)

A

ratio is similar to normal ratio, but there’s less volume

2.5/2.6 = .96 (restrictive)

4.0/4.5 = .89 (normal)

46
Q

mild obstructive disease FEV1/FVC
(ex: asthma)

A

the resistance to air flow is higher, it’s gonna take this person longer to move the air and exhale

this reduces the ratio

47
Q

severe obstructive disease FEV1/FVC
(ex: COPD)

A

harder to move the air, increases resistance and decreases FVC due to gas trapping (lowest ratio)

48
Q

pulmonary edema

A

excess interstitial fluid increases the diffusion distance, taking longer for the diffusion to happen

congestive heart failure

alveolar PO2 normal

plasma PO2 low

49
Q

pneumonia

A

infection of one or both of the lungs where the alveoli fill with pus and other liquid

50
Q

COVID-19

A

can cause lasting lung damage (fibrosis)

fluid enters alveolus and disrupts normal gas exchange

alveoli can collapse due to fluid and loss of surfactant

51
Q

obstructive sleep apnea

A

decreased PO2 of alveoli -> decreased arterial PO2 and increased arterial PCO2

52
Q

three receptor types for reflexive automatic pathways

A

unmyelinated C fibers
rapidly adapting receptors
pulmonary stretch receptors

53
Q

unmyelinated C fibers

A

respond to bradykinin (a peptide that promotes inflammation) and histamine (injury)

produces rapid/shallow breathing (pain)

54
Q

rapidly adapting receptors

A

located in airway mucosa

respond to inhaled irritants (smoke causes coughing)

stimulates cough

55
Q

pulmonary stretch receptors

A

aka hering-breuer reflex

sense lung volume, expansion reduces inspiration effort

important for normal breathing pattern in infants

prevents over expansion of the lung

56
Q

Rf

A

respiratory frequency (breaths/min)

57
Q

Vt

A

tidal volume (ml)

58
Q

Vd

A

anatomical dead space

59
Q

minute ventilation

A

Rf x Vt

60
Q

alveolar ventilation

A

Rf x (Vt-Vd)

61
Q

central hypoventilation syndrome

A

loss of automatic respiratory pathway

must be awake to voluntarily control breathing

this is rare, but it demonstrates that there are 2 pathways: voluntary and involuntary

62
Q

conscious voluntary breathing path

A

cerebral cortex -> spinal cord (somatic motoneurons to skeletal respiratory muscles) -> chemoreceptors activated -> medulla oblongata

63
Q

what do chemoreceptors do

A

monitor changes in arterial blood PCO2 and pH

64
Q

central chemoreceptors

A

medulla, primarily sense PCO2 via pH of cerebral spinal fluid

65
Q

peripheral chemorecptors

A

carotid and aortic bodies, primarily sensing for PCO2 (this dictates your 12 breaths/min) / H+, will sense PO2 if it drops significantly

66
Q

path to chemoreceptors

A

CO2 starts in arteries, crossed blood brain barrier and gets diffused into cerebrospinal fluid. then CA turns it into HCO3 and H+, which is what activates the chemoreceptors in medulla oblongata

67
Q

ventilation rates

A

normal ventilation PCO2=40
hypoventilation = increase in PCO2
hyperventilation = decreased arterial PCO2

68
Q

what must arterial PO2 do before activation?

A

it must drop significantly (to about 60 mmHg) before activating peripheral chemoreceptors to increase ventilation back up to 100 mmHg

69
Q

cardiac output at rest

A

5 L/min

70
Q

cardiac output during exercise

A

25 L/min

71
Q

percentages of cardiac output by organ during exercise

A

GI = 3-5%
heart = 4-5%
kidney = 2-4%
bone = 0.5-1%
brain = 3-4%
skin = variable
skeletal muscle = 80-85%

72
Q

percentages of cardiac output by organ during rest

A

GI = 20-25%
heart = 4-5%
kidney = 20%
bone = 3-5%
brain = 15%
skin = 4-5%
skeletal muscle = 15-20%

73
Q

what does ventilation do during exercise

A

it continues to increase so that everything else (blood gases) remain constant. however, once the ventilation gets beyond aerobic metabolism, then different systems have to jump in and create ATP and these systems tend to lower arterial pH, which sends a signal to activate chemoreceptors to cause hyperventilation

74
Q

compliance

A

the ability for a lung to stretch

75
Q

which gas has the biggest increase in alveolar partial pressure when compared to that found in warm humid atmospheric air?

A

carbon dioxide

76
Q

lung compliance is likely to be decreased by

A

increased fibrosis

77
Q

what occurs first in active expiration?

A

expiratory muscles contract

78
Q

at rest, what is the normal PCO2 in the pulmonary artery of a healthy person?

A

46 mmHg

79
Q

which value is about the same in both the pulmonary and the systemic circulations?

A

total blood flow per minute

80
Q

which part of the brain is most important in determining the respiratory pattern for a person that is doing spirometric measurements like a forced vital capacity?

A

cerebral cortex

81
Q

expiration of alveolar gas:

A

can follow contraction of the expiratory muscles

82
Q

the volume of air inhaled between the FRC and a maximal inspiration is the:

A

inspiratory capacity

83
Q

emphysema, a pulmonary blood clot, and lung cancer are all likely to:

A

decrease the surface area for gas exchange

84
Q

hemoglobin in systemic arterial blood is usually described as:

A

fully saturated with oxygen

85
Q

the oxygen-hemoglobin dissociation curve:

A

has a plateau portion that facilitates O2 loading in the lungs

86
Q

the oxygen-hemoglobin dissociation curve is shifted rightward by increasing which property in the blood?

A

2,3-DPG

87
Q

70% of CO2 in the blood is transported in what form?

A

HCO3-

88
Q

when a patient secretes large amounts of mucus into the airways, you would expect the mucus to _________ the lumen of the conducting zone, __________ the resistance to airflow, and ________ the volume of dead space

A

narrow
increase
decrease

89
Q

which aspect of blood chemistry elicits the greatest increase in activity of the peripheral chemoreceptors?

A

arterial PO2 less than 60 mmHg

90
Q

when someone visits a region of high altitudes, what is the primary sensed variable that leads to an increase in one’s minute ventilation?

A

systemic arterial PO2

91
Q

what causes the partial lung collapse in a person that has pneumonia?

A

transpulmonary pressure decreases

92
Q

which cell type is most likely to be abnormal in a prematurely born baby?

A

type 2 alveolar

93
Q

which brain region is most important in altering your breathing while watching a basketball game?

A

subcortical regions

94
Q

gas exchange across your lungs may be reduced by:

A

congestive heart failure

95
Q

pulmonary surfactant:

A

increases lung compliance

96
Q

the pressure difference between the pressures in the atmosphere and in the alveoli is equal to:

A

pressure / flow

physiology lecture (4 decks)

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