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PT 509 Physiology > Lecture 3 > Flashcards

Lecture 3 Flashcards

1
Q

What are the two types of respiration?

A

External

Cellular

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2
Q

External Respiration

A

Breathing air in and out and transporting it to the circulatory via the heart

1) Ventilation (atm and air sacs)
2) O2/CO2 between alveoli and blood
3) Transport O2/CO2 by blood between lungs/tissues

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3
Q

Cellular Respiration

A

Exchange of O2 and CO2 between the blood in the systemic capillaries and the tissue cells

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4
Q

Respiratory Airways

A 
Terminal bronchiole (smooth m.)
2 branches (pulmonary artery/vein/capillaries)
Alveolar ducts
Alveolar sac
...elastic fibers (expansion/retraction)
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5
Q

Trachea/Larger Bronchi

A

rigid
non-muscular
rings of cartilage

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6
Q

Bronchioles

A

no cartilage
smooth m. walls (ANS innervated)
sensitive to hormones

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7
Q

Alveoli

A

Type I, structural support

Type II, bigger, secretes surfactant, decreases surface tension, prevents collapsing of alveoli

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8
Q

Alveolar macrophage

A

fights infection

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9
Q

Why is pulmonary capillary close to the alveolus?

A

For gas exchange

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10
Q

Lungs are housed in…

A

Thoracic cavity

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11
Q

Lungs consists of…

A

highly branched airways, alveoli, pulmonary blood vessels, large quantities of elastic C.T. (expansion/recoil)

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12
Q

Thorax

A

Outer chest wall

12 pairs of ribs/sternum/thoracic vertebrae (protects)

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13
Q

Diaphragm

A

dome-shaped sheet of skeletal m.

*Only vital for survival

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14
Q

Pleural sac

A 
Separates each lung from thoracic wall
Interpleural fluid
Generates pressure gradient
Parietal (outer)
Visceral (inner)
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15
Q

When does the lung start to develop?

A

4 weeks, epithelial lining

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16
Q

When does the bronchial buds start to develop?

A

28 days

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17
Q

When does the 2nd bronchi start to develop?

A

35 days

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18
Q

When does all the branches formed?

A

42 days

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19
Q

When does the alveoli form (Type 2 cells) start to develop?

A

24 weeks

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20
Q

When does surfactant start to produce?

A

26-28 weeks

important for baby to be born and survive

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21
Q

Respiratory distress syndrome is AKA

A

Hyaline membrane disease
alveoli collapses, damaged type 2 cells, low levels of surfactant
baby becomes hypoxia, pulmonary restrictions, damages structural support for lung cells

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22
Q

When does a baby develop muscles for chest expansion?

A

3-6 months

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23
Q

By age 8 how many new alveoli?

A

300

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24
Q

3 pressures related to ventilation

A

Patm
Pia
Pip

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25
Q

Patm

A

atmospheric pressure
pressure exerted by the weight of the gas in the atm
760mmHg

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26
Q

Pia

A

intra-alveolar
pressure within alveoli
760mmHg

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27
Q

Pip

A

interpleural pressure
pressure in the pleural sac
756mmHg

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28
Q

Muscles involved in inspiration

A

sternocleiodomastoid-
scalenus-
- forceful

external intercostal*
diaphragm*
*major muscles for every inspiration, relax causes passive expiration

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29
Q

Muscles involved in expiration

A

internal intercostal

*only during ACTIVE expiration

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30
Q

Bringing air in…

A

pressure inside (alveoli) has to be less than atmospheric pressure

lower intrapleural pressure, this allows diffusion

Pia

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31
Q

Pushing air out…

A

higher pressure intrapleural pressure

pressure inside (alveoli) has to be greater than the atmospheric pressure

Pia>Patm

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32
Q

Airway resistance

A

bronchoconstriction, decrease radius we will increase resistance

bronchodilation, increase radius we will decrease resistance

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33
Q

Main types of obstructive lung diseases

A

emphysema (more sever)
chronic bronchitis
asthma

34
Q

Emphysema

A

alveolar wall destruction

overinflation

35
Q

Chronic bronchitis

A

Productive cough

Airway inflammation

36
Q

Asthma

A

Reversible obstruction

triggers by allergens, infection

37
Q

Compliance

A

how much effort is required to stretch/distend the lungs

1) Elastic C.T.
2) Alveolar surface tension (low, prevent collapsing)

38
Q

Elastic Recoil

A

how readily the lungs rebound after being stretched

1) Elastic C.T.
2) Alveolar surface tension

39
Q

Surface tension

A

tendency of molecules in the fluid, to draw to the center of the fluid

40
Q

Pulmonary surfactant function:

A

decrease surface tension

contributes to lunch stability

41
Q

Pulmonary surfactant benefits:

A

increases pulmonary compliance

reduces lungs tendency to recoil, when we don’t want it to

42
Q

Tidal volume (TV)***

A

amount of air you can passively expire/inspire

43
Q

Inspiratory reserve volume (IRV)

A

amount of air that’s left in the lungs after forcefully inspire

44
Q

Expiratory reserve volume (ERV)

A

amount of air you can expire forcefully

45
Q

Residual volume***

A

amount of air in your lungs after maximal expiration (1.2L, don’t want this to increase)

46
Q

Average total lung capacity***?

A

6L

47
Q

Total lung capacity

A

total capability of lungs to expire/inspire maximally and residual volume

IRV + ERV + TV + RV

48
Q

Minute ventilation

A

total amount of air moved in/out of respiratory system/min

Respiratory Rate = # breaths taken per min

49
Q

Anatomic dead space

A

part of respiratory system where gas exchange does not take place

50
Q

Alveolar ventilation

A

amount of air that enters the parts of the respiratory system in which gas exchange takes place/min

51
Q

Simple diffusion

A

response to conc gradient

52
Q

Diffusion depends on…

A

partial pressure of gas

53
Q

Partial pressure…

A

total pression x fractional composition gas in mixture

54
Q

Most O2 in the blood is transported bound to…

A

hemoglobin

55
Q

Percentage of O2

A
  1. 5% physically dissolved

98. 5% bound to hemoglobin

56
Q

Percentage of CO2

A

10% physically dissolve
20% bound to hemoglobin
60% as bicarbonate

57
Q

% Saturation, oxygen-hemoglobin dissociation curve

A

full saturated in pulmonary capillaries

58
Q

Direction of O2 and CO2 is…

A

opposite… high to low pressures

blood leaving lungs is high in O2 and low in CO2

59
Q

Pulmonary circulation

A

high O2
low CO2
(in/out of the left heart to body)

60
Q

Systemic circulation

A

low O2
high CO2
(back to the right side of the heart out to lungs)

61
Q

Where is the brain control for respiration?

A

In the brain…

62
Q

What senses the O2/CO2 changes?

A

peripheral chemoreceptors

in the carotid/aortic bodies

63
Q

Decrease PO2 in the arterial blood…

A

stimulates P.C. when

64
Q

Increase PO2 in the arterial blood

A

increase H in ECF
weekly stimulates P.C.
stimulates C.C.

65
Q

Increase H in the arterial blood

A

stimulates P.C. in balance

cannot penetrate BBB (controls what comes in/out)

66
Q

In aging…

A

Everything decreases and is less

VC decrease, increase RV

67
Q

Symptoms of COPD

A 
SOB
fever (important)
unable to speak full sentences
productive cough
audible wheezing
dyspnea
68
Q

Changes in Physiology (COPD)

A

caused by chemical irritant to lungs (smoke, pollution)
inflammation/irritation in bronchioles
breakdown of elastin
genetic risk factor

69
Q

Changes in Physiology

A

(Bronchitis)
bronchial edema
chronic productive cough
bronchospasm

(Emphysema)
destruction of alveolar walls
lung fibrosis
air trapping

70
Q

Leads to overtime…

A

abnormal ventilation(air)-perfusion(blood) ratio
hypoxemia
hypoventilation

71
Q

Changes in large airways of COPD

A 
neutrophils in sputum
mucus hypersecretion
goblet cell hyperplasia
mucus gland hyperplasia
squamous metaplasia of epithelium
no basement membrane thickening
increase macrophages
increase lymphocytes
little increase in airway smooth m. (loses m. tone)
72
Q

Pathogenesis

A

decrease elasticity
air sac walls destroyed
walls thick and inflamed
increase mucus

73
Q

Causes of COPD

A

chemical irritants (#1)
genetics
second hand smoke
chronic exposure at work

74
Q

COPD presented with…

A

bronchitis and emphysema

75
Q

Chronic bronchitis (Blue bloater)

A

overweight and cyanotic
elevated hemoglobin
peripheral edema
rhonchi and wheezing

76
Q

Emphysema (Pink Puffer)

A

older and thin
severe dyspnea
quiet chest
x-ray, hyperinflation with flattened diaphragm

77
Q

Stages of COPD (GOLD)

A

1) mild, 80% normal lung function
2) moderate, 50-80% normal lung function
3) severe, 30-50% normal lung function
4) very severe,

78
Q

Clinical Manifestions

A 
easily fatigued
frequent respiratory infections
use of accessory muscles to breathe
orthopneic
wheezing
purse-lip breathing
chronic cough
dyspnea
prolonged expiratory time
increased sputum (bronchitis)
digital clubbing
thin appearance
Cor Pulmonale
79
Q

Cor Pulmonale

A

right sides heart failure, lungs backed up

80
Q

Treatment Goals for COPD

A 
relieve symptoms
slow progression of disease
improve exercise tolerance
prevent/treat complications
improve overall health
81
Q

Lifestyle changes

A

avoid lung irritants
nutritional supplements
safe physical activity
pulmonary rehab

82
Q

Treatments (less to worse)

A 
self management
bronchodilators
inhaled corticosteroids
pulmonary rehab
oxygen
surgery

PT 509 Physiology (9 decks)

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