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Pathophys > Lung Function > Flashcards

Lung Function Flashcards

1
Q

the epithelial lining of the bronchi contain

A

single celled exocrine glands = goblet and cilliated cells

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2
Q

primary gas exchange site

A

Alveoli

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3
Q

the Pores of Kohn permit

A

collateral ventilation = permit air to pass thru the septa from alveolus to alveolus

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4
Q

Type I alveolar cells

A

provide structure and support

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5
Q

Type II alveolar cells

A

produce surfactant

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6
Q

how does surfactant prevent lung collapse

A

reduces surface tension so that alveoli can expand

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7
Q

why is surfactant important

A

reduces surface tension
controls lung inflammation
bacteriostatic

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8
Q

alveolar macrophages

A

clear surfactant
ingest foreign material
move thru lymphatic system

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9
Q

the acinus contains

A

alveolar ducts

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10
Q

what are the processes of gas exchange in the body

A

ventilation
diffusion
perfusion

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11
Q

what process of gas exchange is driven by the CV system

A

perfusion

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12
Q

the upper airways are lined with

A

cilliated mucosa

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13
Q

cilliated mucosa

A

warms and humidifies air

removes foreign particles

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14
Q

the larynx

A

connects upper and lower airways

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15
Q

the conducting airways are made up of

A

the nasopharynx and the oropharynx

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16
Q

where do most airway obstructions happen

A

the right bronchi because it is anatomically larger and more vertical than the left bronchi

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17
Q

pulmonary circulation functions

A

facilitates gas exchange
delivers nutrients to lung tissues
acts as a blood reservoir for the Lft Ventricle
serves as filtering system for circulation

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18
Q

Pressure of the Pulmonary Circulation

A

18 mmHg

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19
Q

Pressure of Systemic Circulation

A

90 mmHg

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20
Q

only ________of the pulmonary vessels are filled with blood at any given time

A

1/3

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21
Q

pulmonary artery enters the lung at

A

the hilum

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22
Q

respiratory membrane (alveolocapillary membrane) is made up of these structures

A

epithelial basement membrane of the alveolar cell and the capillary basement membrane of the capillary endothelium

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23
Q

3 types of alveolar cells

A

TYPE I = squamous alveolar cell
TYPE II = surfactant secreting cell
TYPE III = alveolar macrophage

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24
Q

Path of Deoxygenated Blood thru heart

A

Systemic capillaries Blood loses O2 and gains CO2 => SVC, IVC, Coronary Sinus => Right Atrium => Tricuspid Valve =>Right Ventricle => Pulmonary Valve => Pulmonary Trunk and Pulmonary Arteries => Pulmonary Capillaries blood loses CO2 and gains O2

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25
Q

Path of Oxygenated Blood thru heart

A

Pulmonary Capillaries blood loses CO2 and gains O2 => Pulmonary Veins => Left Atrium => Bicuspid valve => Left Ventricle => Aortic valve => Aorta and sytemic arteries

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26
Q

Pulmonary Vein leaves at _______ and enter heart at_____

A

hila, left atrium

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27
Q

T/F Bronchial Circulation participates in Gas Exchange

A

True - it is part of systemic circulation and accounts for 1% of CO

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28
Q

Bronchial Arteries supply

A

trachea, bronchi and branches, esophagus, visceral pleura, vaso vasorum of thoracic aorta, pulmonary arteries and nerves, pulmonary veins, thoracic lymph nodes

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29
Q

T/F All bronchial capillaries drain into their own system

A

F; some go into Pulmonary veins and some contribute to normal R to L shunt

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30
Q

where does lymph fluid and alveolar macrophages enter the pulmonary lymph?

A

migrate from alveoli to the terminal bronchioles, impt process in immune defense and keeping lungs free of fluid

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31
Q

what’s the most important cause of PA constriction?

A

low Alveolar partial pressure (PaO2)

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32
Q

pulmonary circulation is innervated by

A

the medulla and pons of the autonomic nervous system

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33
Q

humoral factors are

A

endocrine and immune messengers transported by the blood

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34
Q

contraction and relaxation of the pulmonary artery is controlled primarily by

A

humoral factors

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35
Q

hypoxia leads to

A

ATP production decrease, causing damage to mitochondria releasing intracellular Ca causing a cascade of enzymes that results in cell damage

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36
Q

alveolar and venous hypoxia causes

A

pulmonary artery constriction, reduction of the PA caliber

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37
Q

PA vasoconstriction can affect

A

one segment of the lung or the entire lung

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38
Q

Pulmonary Hypertension is ____________occurs when___________ occurs through out the vasculature of the lung

A

elevated pulmonary artery pressure, vasoconstriction

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39
Q

pulmonary vasoconstriction reflex occurs as a response to ___________so that _____________can match__________

A

hypoxia, ventilation, perfusion

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40
Q

pulmonary artery HTN can lead to

A

right heart failure

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41
Q

pulmonary system

A
  1. ventilates alveoli
  2. diffuses gases into/out of blood
  3. perfuses the lungs so that the organs and the tissues of the body receive oxygnated blood
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42
Q

central chemoreceptors monitor

A

CSF by sensing pH, PaCO2, and PaO2

43
Q

alveolar ventilation is not good if

A

PaCO2 increases

44
Q

if CO2 increase pH_________________

A

increases

45
Q

increase ventilation causes PaCO2 to

A

decrease

46
Q

peripheral chemoreceptors are located in the

A

aortic bodies, aortic arch, and carotid bodies at bifurcation of carotids

47
Q

3 types of lung sensory receptors

A

Irritant receptors, Stretch Receptors, and Pulmonary C-Fiber Recptors

48
Q

stretch receptors are located at

A

smooth muscles of airways

49
Q

irritant receptors are found at

A

epithelium of conducting airways

50
Q

Hering-Breuer Expiratory Reflex

A

active in newborns or in adults on respirators and assist in ventilation, sensitive to high increase in Tidal Volumes and decrease ventilation rate and volume to protect against excess lung inflation

51
Q

Pulmonary C-fiber receptors are also known as __________ and are located near _____________

A

J-receptors/Juxtapulmonary capillary receptors, capillaries in the alveolar septa

52
Q

when stimulated stretch receptors

A

decrease ventilatory rate and volume

53
Q

when stimulated irritant receptors

A

initiate cough reflex by causing bronchoconstriction and increase ventilation rate

54
Q

J-receptors are sensitive to ___________pulmonary capillary pressure which when stimulated _________

A

increase- rapid, shallow breathing, laryngeal constriction on expiration, and mucus secretion, hypotension and bradycardia

55
Q

T/F the adequacy of alveolar ventilation can be observed

A

F must be measured via arterial gas

56
Q

CO2 is a product of ______________

A

cellular metabolism

57
Q

T/F Ventilation and Respiration are the same

A

F Ventilation is the mechanical movement of air in and out of the lungs while Respiration is the exchange of O2 for CO2

58
Q

medullary rythmicity area

A

in the brainstem its composed of interconnected bilateral groups of neuron = DRG & VRG

59
Q

efferent fibers

A

carrying impulse from the CNS to the organs

60
Q

afferent fibers

A

receive sensory information from the PNS and carry info to the brain (CNS)

61
Q

VRG - Ventral Respiratory Group

A

is a cluster of efferent fibers sending impulses to the diaphragm and inspiratory intercostal muscles - responsible for the basic autorythmicity or respiration

62
Q

DRG - Dorsal Respiratory Group

A

receives afferent impulses from peripheral chemoreceptors - alters breathing patterns to restore normal blood gases

63
Q

pneumotaxic & apneustic centers

A

do not generate 1 respiratory rythm but modify inspiratory rate and depth

64
Q

breathing can also be modified by

A

cortex, limbic system, hypothalamus, pattern of breathing due to emotion and disease

65
Q

normal PaO2

A

80-100 mmHg

66
Q

peripheral chemoreceptors monitor

A

pH (1),PaCO2,PaO2

67
Q

peripheral chemoreceptors are primarily stimulated by

A

O2 levels in arterial blood

68
Q

Receptors that are sensitive to noxious areosols

A

Irritant Receptors

69
Q

Receptors located in the smooth muscle airways

A

Stretch Receptors

70
Q

Receptors stimulated by increases in Volume

A

C-Fiber Receptors

71
Q

Receptors sensitive to alterations in pulmonary capillary pressure

A

J-Receptors

72
Q

diaphragm is innervated by

A

Phrenic Nerve (C3, C4, C5)

73
Q

diaphragm contraction causes the muscle to flatten and

A

increase intrathoracic volume, and decrease intrathoracic pressure pulling air inwards

74
Q

accessory muscles of inspiration

A

SCM and scalenes

75
Q

accessory muscles of exhalation

A

none, usually passive

76
Q

Law of Laplace

A

w/in a sphere surface tension makes expansion of the sphere difficult, because all force vectors point inward. the smaller the sphere the greater the pressure to inflate

77
Q

Surfactant __________the Law of Laplace by

A

reverses, as the radius of the alveoli decreases because the surfactant concentration increase repellling the water molecules from ea other and reversely as the radius of the alveoli increases the surface tension increases due to decreasing surfactant molecules

78
Q

function of surfactant

A

keeps alveoli open, free of fluid and pathogen

79
Q

surfactant SP-B and SP-C

A

hydrophobic molecules seperating fluid molecules thereby decreasing surface tension

80
Q

surfactant SP-A and SP-D

A

anti pathogenic

81
Q

compliance

A

measure of lung and chest wall to swell as a result of pressure from inside

82
Q

compliance is determined by

A

alveolar surface tension/elastic recoil of lung

83
Q

lo compliance means ________work of inspiration or ______lungs

A

increased, stiff lungs

84
Q

hi compliance means__________work of expiration or _______to inspire and lungs that________

A

increased, easy, have lost recoil

85
Q

bronchoconstriction results in _________caused by__________

A

increased airway resistance, PS receptors in bronchial smooth muscles stimulated by irritants, or inflammatory mediators

86
Q

bronchodilation results in ________caused by ______

A

decreased airway resistance, beta adrenergic receptor stimulation

87
Q

airway resistance can also be increased by

A

edema of bronchial mucosa, airway obstruction

88
Q

examples of airway obstruction

A

mucus, tumors, foreign bodies

89
Q

more muscular effort required when

A

decreased lung compliance, chest wall compliance, airway obstruction

90
Q

effective gas exchange requires

A

ventilation and perfusion to be equal

91
Q

T/F Effective lung perfusion is body position dependent

A

T/ base of lung perfused better than apexes

92
Q

Zone 1 (apex)

A

alveolar pressure exceeds pulmonary arterial and venous pressures

93
Q

Zone 2 (above L Atrium)

A

alveolar pressure is greater than venous pressure but not greater than arterial pressure

94
Q

Zone 3 (base of lung)

A

arterial and venous pressures are greater than alveolar pressure and blood flow is not affected by alveolar pressure

95
Q

an ABG measure how much __________where a PulseOx measures ____________

A

how much PaO2, % Hgb bound to O2

96
Q

in the lungs shifts to the right in the dissociation curve of Hgb corresponds to

A

the ease with which oxyhemoglobin dissociates and O2 moves from the capillaries into the cells of tissues

97
Q

in the lungs shifts to the left in the dissociation curve of Hgb corresponds to

A

when PaO2 increases and HgB has a higher want for O2 than the tissues promoting association in the lungs and inhibits dissociation into the tissues

98
Q

things that increase Hgb affinity to O2

A

hi pH, low lactic acid, hypothermic, lo DPG SHIFT to THE LEFT

99
Q

things that decrease Hgb affinity for O2

A

decreased pH, hi PaCO2, hi lactic acid, increased temperature, hi DPG SHIFT To THE RIGHT

100
Q

how is CO2 carried in blood

A

dissolved in plasma, H2CO3, carbamino compounds

101
Q

the most important factor controlling the rate and depth of breathing is

A

the effect of CO2 on the central chemoreceptors

102
Q

an increase in PCO2 in the blood leads to an increase in

A

H ions in the CSF/blood decreasing pH

103
Q

what changes will occur if a person hyperventilates

A

during hyperventilation, CO2 is exhaled lowering PCO2

Pathophys (3 decks)

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