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I've got hypertension > Lecture 13 > Flashcards

Lecture 13 Flashcards

1
Q

Define respiration

A

this is the exchange of O2 and CO2 between the tissues and the environment

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2
Q

What are three processes that respiration involves and what do these mean?

A
  • external: exchange of O2 and CO2 between the atmosphere and blood flowing through the lungs
  • transport of gases by the blood
  • internal: gas exchange between capillaries and tissues (cellular respiration)
  • overall regulation of respiratory function
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3
Q

What are the 5 steps of respiration?

A
  • ventilation
  • gas exchange
  • gas transport
  • gas exchange
  • cellular respiration
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4
Q

Define ventilation

A

the process of moving air into and out of the lungs (supply O2 and to remove CO2 from the alveoli)

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5
Q

Ventilation occurs through what process?

A

bulk flow

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6
Q

Define gas exchange

A

Exchange of O2 and CO2 across alveolar membrane (air to blood) ie. into the body

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7
Q

Gas exchange occurs through which process? What does this depend on?

A

diffusion

this depends on the pressure gradient to get stuff across

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8
Q

Define gas transport

A

this is the delivery of O2 from the lungs to the tissues and transport CO2 produced by metabolism to the lungs

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9
Q

Gas transport occurs through which process?

A

bulk flow

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10
Q

Define cellular respiraton

A

when cells use O2 to produce CO2

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11
Q

Cellular respiration occurs through which process?

A

metabolism

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12
Q

What are 8 functions of the respiratory system?

  1. provide ______
  2. eliminate _______
  3. _______, ______ and _________ the air we breathe
  4. _________
  5. sense of _______
  6. regulate the ______ of the ________, in association with the _________
  7. defend against ___________
  8. temperature _________
A
  1. provide O2
  2. eliminate CO2
  3. filters, warms and humidifies the air we breathe
  4. communication
  5. sense of smell
  6. regulate the pH of the blood, in association with the kidneys
  7. defend against microbes
  8. temperature regulation
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13
Q

What are 6 things that make up the upper respiratory tract?

A
  1. nasal cavity
  2. pharynx consisting of:
  3. nasopharynx
  4. oropharynx
  5. laryngopharynx
  6. larynx
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14
Q

What are 7 things in the lower respiratory tract?

A
  1. trachea
  2. primary bronchi
  3. primary bronchioles
  4. secondary bronchioles
  5. tertiary (respiratory) bronchioles
  6. alveolar duct
  7. alveoli
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15
Q

What do we lose as we go from the bronchi to the bronchioles?

A

cartilage

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16
Q

The trachea is surrounded by what? Why is this?

A

cartilaginous rings to hold it open

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17
Q

What are the functional units for the respiratory system?

A

the alveolar sacs

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18
Q

What are the alveolar sacs surrounded by?

A

numerous capillaries

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19
Q

Describe the muscles required for quiet inspiration

A

The diaphragm contracts, moving it downwards. This gives enough space for the lungs to expand and inspiration is initiated.

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20
Q

Describe the muscles needed for inspiration during exercise

A

The diaphragm contracts but it is not enough to get enough O2 into the lungs. The external intercostals contract which increases the chest wall anteroposterior diameter to give more room for the lungs to expand. If this is still not enough, the sternomastoid (muscle of the neck) contracts to expand the ribs. There is also the pectorals minor

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21
Q

Expiration is a ________ process at _______

A

passive

rest

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22
Q

Describe the muscles required for expiration

A

The diaphragm stops contracting and it domes back and the internal intercostals help to pull down and reduce the anteroposterior diameter of this chest, aiding in expiration

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23
Q

Describe the muscles needed for expiration and inspiration during restful breathing

A

Inspiration caused by diaphragm contraction
Expiration caused by lung elastic recoil pulling
thorax and relaxed diaphragm inwards. No muscle contraction, therefore “passive”

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24
Q

Describe the muscles needed for expiration and inspiration during deeper breathing

A

Inspiration – diaphragm and external intercostal muscle contraction
Expiration – lung elastic recoil and internal intercostal muscle contraction

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25
Q

Describe the muscles needed for expiration and inspiration during forceful breathes

A

Inspiration – as above plus contraction of sternocleidomastoid and pectoralis minor muscles
Expiration – as above plus abdominal muscle contraction (external oblique abdominal rectus muscle)

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26
Q

Describe the nervous innervation of the lungs

A

There is the phrenic nerves which innervates the diaphragm which tells it to contract or relax during restful breathing.
The intercostal nerves supply the intercostal muscles which helps in additional inspiration or expiration.
Sympathetic and parasympathetic nerves play a role in respiration so damage at the level of the medulla means that you can’t control respiration.

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27
Q

The two lungs are covered in what?

A

pleura

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28
Q

The pleurae form what?

A

an envelope between the lungs and the chest wall

29
Q

What are the two layers of the pleura called and where are these located?

A
  • parietal pleura: the outer layer which lines inside of the chest wall and diaphragm
  • visceral pleura: directly on the lung which lines the outside of the lungs
30
Q

What is in between the two pleural layers?

A

the pleural cavity with pleural fluid

31
Q

The visceral pleura is stuck to the _______ and the parietal pleura is stuck to the _______ ________ but this layer is very _____ so as the chest cavity _________, the lung also _________ along with it.

A 
lungs
chest cavity
thin
moves
moves
32
Q

What is the pleural cavity?

A

This is a slit-like potential space filled with pleural fluid

33
Q

Do the players of pleura normally separate?

A

no, the pleural cavity isn’t really there

34
Q

The fluid layer between the pleura is so minimal, that it creates what?

A

negative pressure

35
Q

What is the abbreviation for atmospheric pressure or barometric pressure?

A

P(atm)

P(b)

36
Q

What is the abbreviation for alveolar pressure?

A

P(alv)

P(A)

37
Q

What is the abbreviation for intra-pleural pressure?

A

P(ip)

P(pl)

38
Q

What is the abbreviation for transpulmonary pressure or lung pressure?

A

P(tp)

P(L)

39
Q

What is the abbreviation for elastic recoil pressure?

A

P(el)

40
Q

What is the abbreviation for resistance?

A

R

41
Q

What is the alveolar pressure/intrapulmonary pressure?

A

pressure inside the lung

42
Q

What is the intrapleural pressue?

A

The pressure between the two layers of pleura (in the cavity)

43
Q

What is the transpulmonary pressure?

A

The difference between the pressure inside (alveolar pressure/intrapulmonary pressure) and outside the lung (pleural pressure)

44
Q

Define ventilation

A

the exchange of air between the atmosphere and alveoli

45
Q

Air moves by _____ from the region of ______ pressure to _______ pressure

A

bulk
high
low

46
Q

What is the equation for bulk flow (F)? What do these symbols mean?
What does this mean for the air flow into or out of the lungs?

A

F = ΔP/R
where ΔP = pressure difference between two points
R = resistance

F=(Palv-Patm)/R

47
Q

All pressures in the respiratory system are given relative to atmospheric pressure which is given as what?

A

760mmHg

48
Q

When there is no air flow, what assumption can we make about alveolar pressure and atmospheric pressure?

A

they are equal

49
Q

We need a pressure gradient to generate air flow. This means we need to create a pressure difference between the ______ and the _______. How can we do this?

A

lungs
atmosphere

by changing the lung volumes

50
Q

What is Boyle’s law?

A

At constant temperature, the volume of a gas varies inversely with absolute pressure.

51
Q

What happens to the lung volume and pressure during inspiration?

A

During inspiration – volume of lung (container) is increased – decreased pressure

52
Q

What happens to the lung volume and pressure during expiration?

A

During expiration – volume of lung (container) is decreased – increased pressure

53
Q

What are the two determinants of lung dimension?

A

Difference in the pressure between the inside and outside of the lung (transpulmonary pressure (Ptp or PL ))
Stretchability of the lungs (compliance) – how much the lungs expand for a given change in Ptp

54
Q

What is the equation for transpulmonary pressure and what do these components mean?

A

Ptp = Palv-Pip
where Pressure inside the lung - pressure inside the alveoli (Palv)
Pressure outside the lung - pressure of the intrapleural fluid surrounding the lung (Pip)

55
Q

Transpulmonary pressure resists the what?

A

elastic recoiling of the lung

56
Q

We want a _________ transpulmonary pressure to _________ the volume of the lung

A

positive

increase

57
Q

In fibrosis, the lung becomes _______ so it is going to be difficult for the lung to ________

A

stiff

expand

58
Q

In emphysema, the alveolar structures become distorted so the lung becomes _________ so it expands but it is going to be difficult to __________ because it loses its _________

A

flaccid
collapse
elasticity

59
Q

What is the pressure across the chest wall?

What is the equation?

A

Pcw =Pip – Patm

Difference between pleural pressure and the atmospheric pressure

60
Q

During quiet breathing Pip is __________, hence Pcw is __________

A

negative

negative

61
Q

The transpulmonary pressure is always

A

positive

62
Q

The intrapleural pressure is always

A

negative

63
Q

Why is the intrapleural pressure always negative?

A

The lung always tries to collapse (when there is no airflow in between breaths) but the chest wall always tries to pull open. As these are trying to go the opposite way, the pleural cavity with the fluid doesn’t allow the lungs to collapse or the chest to expand. This means the pressure becomes negative.

64
Q

For Ptp to be positive Pip should be __________

A

negative

65
Q

To keep the lungs open Ptp should be __________- – which opposes elastic recoil

A

positive

66
Q

If the parietal pleura or visceral pleura is damaged, what can happen?

A

The balance is gone so it changes the pressure in the pleural cavity so now the pleural pressure becomes the same as the atmospheric pressure. This means it becomes positive. If the pleural pressure becomes positive, the transpulmonary pressure won’t be positive and so the lungs will collapse

67
Q

How can the parietal pleura be damaged?

A

knife wound

68
Q

How can the visceral pleura be damaged?

A

you give more O2 to the patient, we increase the positive pressure which can damage the visceral pleura

69
Q

Which ONE of the following is the key for achieving stable balance between the breaths?
A. Transpulmonary pressure should always be positive
B. Intrapleural pressure should become positive at the
end of inspiration
C. Intrapleural pressure should become positive at the
end of expiration
D. Alveoli should expand in size to its maximum during
inspiration
E. Chest wall should maintain its elastic recoiling in-
between the breath

A

A. Transpulmonary pressure should always be positive

I've got hypertension (47 decks)

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