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Pathophysiology Test 3 > Oxygenation > Flashcards

Oxygenation Flashcards

0
Q

Goblet Cells

A
  1. Mucus-secreting and ciliated cells.

2. Produces a mucus blanket that protects the airway epithelium

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1
Q

Functions of Surfactant

A
  1. Facilitates O2 exchange
  2. Produces nutrients for the alveoli
  3. Commits air exchange between alveoli and alveolar ducts by reducing surface tension
  4. Facilitates alveolar expansion during inspiration
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2
Q

Type 1 Alveolar Epithelial Cells

A
  1. Provide structure
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3
Q

Type 2 alveolar Epithelial Cells

A
  1. Produce Surfactant
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4
Q

Surfactant

A
  1. Lipoprotein that coats the inner surface of the alveolus and lowers alveolar surface tension at end-expiration
    - Prevents lung collapse
  2. Produced by type 2 alveolar cells
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5
Q

Vagus Nerve

A
  1. The lung receives parasympathetic innervation by the vagus nerve
  2. Also innervates the heart
    - Rest & Digest
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6
Q

Vagus Nerve

-Medication that lifts effects of Vagus Nerve

A
  1. Atropine is given to reverse effects of Vagus Nerve
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7
Q

Vagus Nerve

-Total Heart Transplant Considerations

A
  1. Because the innervation from the vagus nerve has been severed, atropine will no longer work on the heart
  2. Give the pt Epinephrine instead
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8
Q

Perfusion

A
  1. Movement of blood into and out of the capillary beds of the lungs to the body organs and tissues
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9
Q

Ventilation

A
  1. Movement of air into and out of the lungs

- breathing

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10
Q

Pulmonary System Activities

A
  1. Ventilation & Diffusion
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11
Q

Cardiovascular System Activity

A
  1. Perfusion
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12
Q

Mediastinum

A
  1. Space between the lungs, which contains the heart, great vessels, and esophagus
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13
Q

Upper Airway

-Consists of

A
  1. Nasopharynx
  2. Oropharynx
    - Lined w/ ciliated mucosa that warms and humidifies inspired air and removes foreign particles
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14
Q

Alveoli

A
  1. Primary gas-exchange units of the lung where oxygen enters the blood and carbon dioxide is removed
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15
Q

Pulmonary Circulation

-Function

A
  1. Facilitates gas exchange
  2. Delivers nutrients to lung tissues
  3. Acts as reservoir for the left ventricle
  4. Filtering system that removes clots, air, and other debris
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16
Q

Pulmonary Circulation Vs. Systemic Circulation

A
  1. Pulmonary arteries are exposed to about one fifth the pressure of the systemic circulation
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17
Q

Alveolocapillary Membrane

A
  1. Gas exchange occurs across the alveolocapillary membrane

2. Any disorder than thickens the membrane impairs gas exchange

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18
Q

Pulmonary Veins

A
  1. Take oxygenated blood back to the left atrium of the heart
  2. Pulmonary veins do not have valves
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19
Q

Bronchial Circulation

A
  1. Part of the systemic circulation
  2. Supplies nutrients to the conducting airways, large pulmonary vessels, and membranes that surround the lungs
  3. DOES NOT participate in gas exchange
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20
Q

Functions of the Pulmonary System

A
  1. Ventilates the Alveoli
  2. Diffuses gases into and out of the blood
  3. Perfuses the lungs so that organs and tissues of teh body receive oxygen rich blood
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21
Q

Neurochemical Control of Ventilation

-Dorsal Respiratory Group (DRG)

A
  1. Responsible for setting the basic automatic rhythm of respirations
  2. Receives afferent input from
    - Peripheral chemoreceptors in the carotid and aortic bodies
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22
Q

Neurochemical Control of Ventilation

-Ventral Respiratory Group (VRG)

A
  1. Contains both inspiratory and expiratory neurons and is almost inactive during normal, quiet respiration
  2. the VRG becomes active when increased ventilatory effort is required
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23
Q

Neurochemical Control of Ventilation

-Pneumotaxic Center & Apneustic Center

A
  1. Situated in the pons
  2. Do not generate primary rhythm
  3. Act as modifiers of the rhythm established by the medullary centers
24
Q

Lung Receptors

-Irritant Receptors

A
  1. (C-fibers) are found in the epithelium of all conducting airways
  2. Sensitive to noxious aerosols (vapors), gases, and particulate matter (inhaled dusts)
  3. Initiate cough reflex
25
Q

Lung Receptors
-Irritant Receptors
(What happens when they are stimulated)

A
  1. Cause bronchoconstriction and increased ventilatory rate
26
Q

Lung Receptors

-Stretch Receptors

A
  1. Located in the smooth muscle of the airways

2. Sensitive to increases in the size and volume of the lungs

27
Q

Lung Receptors

-J Receptors (Juxtapulmonary capillary receptors

A
  1. Located near the capillaries in the alveolar septa

2. Sensitive to increased pulmonary capillary pressure

28
Q

Lung Receptors

-J-receptors action when stimulated

A
  1. Initiate rapid, shallow breathing, hypotension, and bradycardia
29
Q

Sympathetic Action in the Lungs

A
  1. Sympathetic receptors cause the smooth muscle in the lungs to relax
30
Q

Parasympathetic Action in the Lungs

A
  1. Parasympathetic receptors cause smooth muscle to contract
31
Q

Central Chemoreceptors

A
  1. Indirectly monitor arterial blood by sensing changes in the pH of cerebrospinal fluid.
  2. Located near the respiratory center
  3. Sensitive to H+ ion concentration in the CSF
32
Q

Peripheral Chemoreceptors

A
  1. As PaO2 and pH drop, peripheral chemoreceptors in the carotid bodies send signals to increase ventilation
33
Q

Major Muscles of Inspiration

A
  1. The diaphragm & external intercostal muscles
34
Q

Accessory Muscles of Inspiration

A
  1. Sternocleidomastoid

2. Scalene Muscles

35
Q

Major Muscles for Expiration

A
  1. There are NO major muscles of expiration because normal, relaxed expiration is passive and requires no muscular effort.
36
Q

Accessory Muscle of Expiration

A
  1. Abdominal muscles
  2. Internal intercostal muscles
    - Assist expiration when minute volume is high, during coughing, or when airway obstruction is present
37
Q

Role Of Surfactant in Alveolar Ventilation

A
  1. Alveolar ventilation, or distention is made possible by surfactant, which lowers surface tension by coating the air-liquid interface in the alveoli.
  2. The decrease in surface tension caused by surfactant keeps the alveoli free from fluid
38
Q

Lack of Surfactant Causes What?

A
  1. Alveolar surface tension increases, causing:
    - Alveolar collapse
    - Decreased lung expansion
    - Increased work of breathing
    - Severe gas-exchange abnormalities
39
Q

Elastic Recoil

A
  1. Tendency of the lungs to return to the resting state after inspiration
  2. Normal elastic recoil permits passive expiration
40
Q

What Happens During Inspiration

A
  1. Diaphragm and intercostal muscles contract

2. Air flows into the lungs and the chest wall expands

41
Q

Compliance

A
  1. Measure of lung and chest wall distensibility and is defined as:
    - Volume change per unit of pressure change
  2. Opposite of elasticity
42
Q

Increased Compliance

-Indicates what?

A
  1. Indicates that the lungs or chest wall is abnormally easy to inflate and has lost some elastic recoil
43
Q

Decreased Compliance

-Indicates

A
  1. Indicates that the lungs or chest wall is abnormally stiff or difficult to inflate
44
Q

Compliance Increases with?

A
  1. Normal aging

2. Disorders such as emphysema

45
Q

Compliance Decreases with?

A
  1. Individuals with acute respiratory syndrome
  2. Pneumonia
  3. Pulmonary edema
  4. FIbrosis
46
Q

Barometric Pressure

A
  1. Also known as atmospheric pressure
  2. Pressure exerted by gas molecules in air at specific altitudes
  3. At sea level, barometric pressure is 760 mmHg
47
Q

Partial Pressure

A
  1. The portion of the total pressure exerted by an individual gas
48
Q

Gas Consistency of Air at sea level

A
  1. Oxygen = 21%
  2. Nitrogen = 78%
  3. other gases
49
Q

Lung Zones

-Zone I

A
  1. Alveolar pressure exceeds pulmonary arterial and venous pressures
  2. Capillary bed collapses & normal blood flow stops
  3. Zone I is a very small part of lung at Apex
50
Q

Lung Zones

-Zone II

A
  1. Alveolar pressure is greater than venous pressure but not arterial pressure
  2. Blood flows through Zone II but is slowed by alveolar pressure
  3. Zone II is normally above the level of the left atrium
51
Q

Lung Zones

-Zone III

A
  1. Both arterial and venous pressures are greater than alveolar pressure
  2. Blood flow is not affected by alveolar pressure
  3. Zone III is located in the base of the lung
52
Q

V/Q Ratio in Apices of Lungs

A
  1. Ventilation exceeds perfusion in the apices of the lung
53
Q

V/Q Ratio in Bases of the Lungs

A
  1. Perfusion exceeds ventilation in the bases
54
Q

Shift To the Right

A
  1. HgB’s decreased affinity for O2 or an increase in the ease with which oxyhemoglobin dissociates and oxygen moves into the cell
  2. Oxygen Unloading
55
Q

Shift to the Left

A
  1. A shift to the left depicts Hbg’s increased affinity for oxygen
  2. Promotes association in the lungs and inhibits dissociation in the tissues
  3. Oxygen Loading
56
Q

Shift to the Right

-Causes

A
  1. Oxygen Unloading
  2. Caused by:
    - Acidosis
    - Hypercapnia
    - Increased Temperature
57
Q

Shift to the Left

-Causes

A
  1. Oxygen Loading
  2. Caused by:
    - Alkalosis
    - Hypocapnia
    - Decreased Temperature
58
Q

Chronic Alveolar Hypoxia

-Leads to…

A
  1. Chronic alveolar hypoxia can result in permanent pulmonary artery hypertension, eventually leading to Right Sided Heart Failure (Cor Pulmonale)

Pathophysiology Test 3 (8 decks)

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