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Respiratory KC > Physiology > Flashcards

Physiology Flashcards

1
Q

Where are central chemoreceptors located?

A

near the surface of the medulla

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2
Q

the proportion of the FVC expired in first second

A

FEV1/FVC ratio

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3
Q

The Bohr Effect causes a left shift in the oxygen-dissociation curve - true or false?

A

false it causes a right shift as it becomes easier for O2 to dissociate even at higher PO2s

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4
Q

Chronic adaptations to hypoxia (5)

A
  1. increase in RBC production
  2. Increase 2,3BPG produced within RBC - increases O2 offloading
  3. Increase no, of capillaries
  4. Increase no, of mitochondria - use O2 more efficiently
  5. Kidneys conserve acid - decrease arterial pH
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5
Q

At the lungs, O2 binding Hb ______ the ability of Hb to bind CO2 and H+

A

Weakens

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6
Q

Main muscle of inspiration at rest

A

Diaphragm

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7
Q

difference between myoglobin and haemoglobin?

A

haemoglobin has 4 haem groups, myoglobin has one

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8
Q

What can increased pulmonary compliance be a result of?

A

elastic recoil loss

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9
Q

Which effect does the Bohr Effect pair up with?

A

Haldane effect

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10
Q

Why is alveolar ventilation more important?

A

it represents the new air available for gas exchange with blood.

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11
Q

The graph for oxygen dissociation curve is….

A

sigmoidal

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12
Q

Average intra-pleural pressure during inspiration

A

754mmHg

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13
Q

What is the primary determinant of oxygen saturation of haemoglobin with O2?

A

PO2

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14
Q

Where can rhythm of breathing be modified?

A

The Pons

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15
Q

PAO2 = PiO2 - [PaCO2/0.8]

A

partial pressure of O2 in alveoli

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16
Q

If there is a decrease in blood pressure, the is a(n) _______ in ventilation

A

increase

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17
Q

Hypoxia at high altitudes is caused by…

A

a decreased partial pressure of inspired oxygen (PiO2)

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18
Q

Sectioning where causes ventilation to cease?

A

below the medulla

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19
Q

Surfactant is a mixture of proteins and carbohydrates - true or false?

A

False Surfactant is a mixture of proteins and lipids

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20
Q

Pneumothorax abolishes the ___________ and causes the lung to ______

A

transmural gradient, collapse

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21
Q

Compliance

A

A measure of effort that has to go into stretching or distending the lungs

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22
Q

Patients with Heart Failure will get SOB before….

A

pulmonary oedema occurs

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23
Q

Afferent discharge from irritated airwasy stimulates what reaction from the medulla…(4)

A
  1. short intake of breath
  2. closure of larynx
  3. contraction of abdominal muscles
  4. opening of larynx and expulsion of air at high speed
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24
Q

If the partial pressure in a gas phase is increased, the concentration of the gas in the liquid phase would decrease proportionally - true or false?

A

false According to Henry’s Law it would increase proportionally

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25
Q

PiO2

A

partial pressure of inspired air

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26
Q

Amount of O2 dissolved in the blood at rest?

A

3ml/L

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27
Q

What types of pneumothorax can occur?

A

traumatic (wound to chest wall) spontaneous (lung side)

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28
Q

Sympathetic stimulation causes ________ and ________ resistance

A

bronchodilation and decreased

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29
Q

H+ dissociates from CO3- to join

A

Hb –> HbH

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30
Q

The ventral respiratory group neurons…

a. are activated during normal breathing
b. are activated during hyperventilation
c. are activated during apnoea

A

b. are activated during hyperventilation

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31
Q

Residual volume ________ when the elastic recoil of the lungs is lost as it becomes difficult to get the air out i.e. in ________

A

increases, emphysema

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32
Q

What are the accessory muscles of inspiration?

A

sternocleidomastoid scalenus

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33
Q

Rhythm for inspiration followed by expiration is generated by the _______

A

medulla oblongata

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34
Q

What does the Haldane effect work in tandem with?

A

The Bohr Effect

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35
Q

Ventilation

A

the rate at which gas is passing through the lungs

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36
Q

Increased _________ ___ as a result of increased ventilation causes pulmonary _______ which increases blood flow to match a larger airflow

A

alveolar O2, vasodilation

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37
Q

Cells that produce pulmonary surfactant

A

Type II alveoli

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38
Q

Forces keeping the alveoli open

A

Transmural pressure gradient Pulmonary surfactant Alveolar interdependence

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39
Q

Why are diseases airways not able to cope with dynamic airway compression?

A

the driving pressure is lost over the obstructed segment. This causes a fall in airway pressure downstream resulting in airway compression by the rising pleural pressure.

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40
Q

Why is alveolar ventilation less than pulmonary ventilation?

A

because of the anatomical dead space

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41
Q

How can respiratory distress syndrome of the New Born be prevented?

A

if prematurity is anticipated - provide mother with steroids to try and mature baby’s lungs

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42
Q

The hypoxic drive of respiration is completely through central chemoreceptors - true or false?

A

false

it is entirely through peripheral chemoreceptors

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43
Q

when are pulmonary stretch receptors likely to be activated?

A

during active inspiration where tidal volumes are >1L

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44
Q

A local tissue increase in O2 will cause systemic arterioles to ….

A

constrict - this avoids too much oxygen being offloaded where it is no longer needed

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45
Q

O2 consumption of our cells at rest

A

250ml/min

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46
Q

How does binding of one O2 molecule affect haemoglobin?

A

increases its affinity for oxygen in a co-operative manner

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47
Q

Which particular blood protein forms a carbamino compound?

A

globulin

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48
Q

Oxygen content of arterial blood can be calculated as…

A

CaO2 = 1.34 x Hb x SaO2

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49
Q

Conditions where the Bohr Effect might come into play?

A
  1. increased PCO2
  2. increased H+
  3. increased temperature
  4. increased 2,3-biphosphoglycerate
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50
Q

Why does HbF have a higher affinity for O2 than HbA?

A

to allow foetus to hijack O2 from mother

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51
Q

What is Respiratory Distress Syndrome of the New Born?

A

where newborn lungs are unable to produce the pulmonary surfactant to reduce the alveolar surface tension and thus have to make strenuous inspiratory efforts

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52
Q

What might a large difference between alveolar and arterial O2 partial pressure indicate?

A

issues with gas exchange or a right to left cardiac shunt

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53
Q

Normal CI

A

2.4-.42L/min/m2

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54
Q

What allows the lungs to relax and recoil?

A

elastic connective tissue alveolar surface tension

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55
Q

What adaptations do the lungs have to promote gas exchange?

A

large surface area promoted further by extensive alveoli and bronchial trees Extensive pulmonary capillary network

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56
Q

Average intra-alveolar pressure at rest

A

760mmHg

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57
Q

Joint receptors in exercise cause…

A

an increase in ventilation

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58
Q

H+ drive of respiration is driven by the _______ chemoreceptors

A

peripheral

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59
Q

Factors affecting rate of gas exchange (4)

A
  • partial pressure gradient of O2 and CO2 - Diffusion coefficient for O2 and CO2 - Surface area of alveolar membrane - Thickness of alveolar membrane
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60
Q

Pre-Botzinger complex

A

a network of neurons which controls rhythms

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61
Q

What is internal respiration?

A

the intracellular mechanisms that consume oxygen and produces CO2

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62
Q

apneusis

A

inspiration prolonged with brief expiration

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63
Q

Residual Volume

A

minimum volumes of air remaining in the lungs even after a maximal expiration 1200ml

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64
Q

Dorsal respiratory group neurons excites which muscles?

A

Inspiratory muscles

Diaphragm

External Intercostals

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65
Q

Sectioning above the medulla

a. retains fairly normal ventilation
b. causes ventilation ceases
c. causes an abnormal breathing pattern

A

a - it retains fairly normal ventilation

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66
Q

the rate at which blood is passing through the lungs

A

Perfusion

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67
Q

Neurons from the apneustic centre excite…

A

the inspiratory area of the medulla and prolong inspiration

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68
Q

What is ventilation?

A

the mechanical process of moving air between the atmosphere and alveolar sacs

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69
Q

What is the Haldane Effect?

A

where reduced Hb can bind more CO2 than HbO2 removing the O2 from Hb increases its ability to bind CO2 and CO2 generated H+

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70
Q

pulmonary compliance is reduced by factors such as…(5)

A

pulmonary fibrosis pulmonary oedema lung collapse pneumonia absence of surfactant

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71
Q

Parasympathetic stimulation causes bronchodilation and and decreased resistance - true or false?

A

false PS stimulation causes bronchoconstriction and increased resistance

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72
Q

Stimulation of peripheral chemoreceptors by H+ causes (2)

A
  1. hyperventilation
  2. increased elimination of CO2
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73
Q

The less compliant the lungs are, the more work is required to produce a degree of inflation - true or false

A

true

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74
Q

Forces promoting alveolar collapse

A

Elasticity of stretched pulmonary connective tissue Alveolar surface tension

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75
Q

A measure of effort that has to go into stretching or distending the lungs

A

Compliance

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76
Q

What is the primary determinant of airway resistance?

A

the radius of the conducting airway

77
Q

Accumulation of CO2 in the alveoli as a result of increased perfusion _______ airway resistance leading to ______ airflow

A

decreases, increased

78
Q

Definition of alveolar ventilation

A

the volume of air exchanged between the alveoli and atmosphere per minute

79
Q

Dynamic airway compression causes no problems in normal people. The _______ airway resistance causes an increase in airway pressure _______. This helps open the ______ by increasing the driving pressure between the ______ and _____.

A

increased, upstream, airways, alveolus, airway

80
Q

Atmospheric pKa?

A

21kPa

81
Q

What is the average distance of interstitial space between the capillaries and alveolus?

A

0.5µm

82
Q

Inspiratory Reserve Volume

A

Volume of air that can be breathed in if required during active breathing 3000ml

83
Q

At a normal PaCO2 of around 40mmHg, PAO2 =

A

100mmHg

84
Q

Haemoglobin can for a _____ combination with I2 where each Hb molecule contains __ haem groups each of which can bind ____ molecule

A

reversible, four, one

85
Q

Functional Residual Capacity

A

Volume of the air in the lungs at the end of normal passive expiration 2200ml FRC = ERV + RV

86
Q

PaCO2

A

partial pressure of arterial CO2

87
Q

FEV1/FVC ratio

A

the proportion of the FVC expired in first second

88
Q

Average intra-pleural pressure at rest

A

756mmHg

89
Q

The Pre-Botzinger complex, a group of neurons that display _______ activity near the upper end of the _______ respiratory centre

A

pacemaker, medullary

90
Q

where reduced Hb can bind more CO2 than HbO2 removing the O2 from Hb increases its ability to bind CO2 and CO2 generated H+

A

Haldane Effect

91
Q

Normally the work of breathing is ____% of total energy expenditure

A

3

92
Q

Factors that may increase ventilation during exercise (5)

A
  1. Reflexes from body movement (joint receptors)
  2. Adrenaline release
  3. Impulses from cerebral cortex
  4. Increase in body temperature
  5. accumulation of CO2 and H+ generated by muscles
93
Q

During inspiration, which neurons are excited?

A

dorsal respiratory group neurons

94
Q

tissues pKa?

A

5kPa

95
Q

Surfactant acts to intersperse the water molecules lining the alveoli - true or false?

A

true

96
Q

Partial pressure of inspired O2 depends on total pressure and proportion of CO2 in the gas mixture - true or false?

A

false proportion of O2 - around 21% in atmosphere

97
Q

Three pressures important for ventilation

A

Atmospheric Intra-alveolar Intra-pleural

98
Q

The presence of myoglobin in the blood is of no concern - true or false?

A

false it indicates muscle damage

99
Q

Why is the Bohr Effect useful?

A

allows oxygen offloading without the need for a drop in PO2

100
Q

The transfer of gases between the body and atmosphere depends upon….

A

ventilation perfusion

101
Q

How do we work out the partial pressure of O2 in the atmosphere?

A

21% of 760mmHg = 160mmHg which is breathed in

102
Q

Average intra-alveolar pressure during expiration

A

761mmHg

103
Q

What are the muscles of active expiration?

A

internal intercostals abdominal muscles

104
Q

FEV1/FVC ratio is less than 75% in obstructive lung diseases - true or false

A

true

105
Q

Why is negative intrapleural pressure so important for linking the lungs and thorax?

A

the sub-atmospheric intrapleural pressure creates a transmural gradient forcing the lungs to expand outwards.

106
Q

What is chloride shift?

A

the switching of Cl and CO3- so that the bicarbonate is moved to the blood

107
Q

What are the major muscles of inspiration?

A

external intercostal muscles diaphragm

108
Q

Why is CSF less able to buffer H+?

A

because there are less proteins

109
Q

Where is myoglobin present?

A

skeletal and cardiac muscles

110
Q

What is external respiration?

A

sequence of events that leads to exchange of O2 and CO2 between the external environment and the cells of the body

111
Q

The pneumotaxic centre is stimulated when…

a. ventral respiratory neurons fire
b. ventral respiratory neurons stop firing
c. dorsal respiratory neurons fire

A

c. the pneumotaxic centre is stimualted when dorsal respiratory neurons fire.

112
Q

The ventral respiratory group neurons stimulate…

A

the internal intercostals and abdominals leading to forceful expiration

113
Q

What cannot pass through to the CSF via the blood brain barrier?

a. CO2
b. H
c. HCO3

A

H and HCO3

The CO2 diffuses easily and can generate H ions in the CSF as it is not so well buffered

114
Q

What body systems are involved in external respiration? (4)

A
  1. Respiratory
  2. Cardiovascular
  3. Haematology
  4. Nervous System
115
Q

CO2 has a smaller partial pressure gradient, how is this offset so that CO2 still moves freely between the blood and alveoli?

A

it is 20x more soluble in membranes as it has a higher diffusion coefficient

116
Q

The peripheral chemoreceptors are…

A

aortic and carotid bodies

117
Q

the amount of a given gas dissolved in a given type and volume of liquid at a constant temperature is proportional to the partial pressure of the gas in equilibrium with the liquid

A

Henrys Law

118
Q

Inspiratory Capacity

A

The total volume of air that can be inspired 3500ml

119
Q

Average intra-alveolar pressure during inspiration

A

759mmHg

120
Q

Tidal Volume

A

Volume of air inspired and expired during normal passive breathing 500ml

121
Q

As gas volume increases, the pressure increases - True or False?

A

False

As gas volume increases, the pressure decreases allowing the air to move into the lungs as the intra-alveolar pressure decreases below that of the atmosphere

122
Q

How does foetal Hb differ from adult haemoglobin in structure?

A

has two gamma subunits instead

123
Q

What are the 4 stages of External Respiration?

A
  1. Ventilation
  2. Gas Exchange between Alveoli and blood Gas
  3. Transport in the blood
  4. Gas Exchange in the tissues
124
Q

Normal O2 concentration in arterial blood at rest

A

200ml/L

125
Q

Other non-respiratory functions of the resp. system (7)

A
  • water loss and heat elimination - enhanced venous return - normal acid-base balance maintenance - speech, singing, vocalisations - defence against inhaled foreign matter - modification and removal of materials passing through - nose as an organ of smell
126
Q

Dynamic Airway Compression Pressure applied to the _______ helps to push air out of the lungs, whereas pressure applied to the ______ is not desirable as it tends to compress it. The rising pleural pressure during _____ expiration compresses the _______ and _______ which is known as dynamic airway compression

A

alveolus, airway, active, alveolus, airway

127
Q

The flat upper portion of the oxygen dissociation curve is important as it means a _______ fall in O2 will not affect oxygen _____ onto _______

A

moderate, loading, haemoglobin

128
Q

Active expiration during hyperventilation causes the dorsal neurons to…

A

excite the ventral respiratory group neurons

129
Q

What does Ficks Law of Diffusion tell us in respect to the movement of gases?

A

a large surface area and thin membrane is important for gas exchange

130
Q

The aortic and carotid bodies sense the _____ of ______ and _____ and the concentration of ___ in the blood

A

tension, oxygen, carbon dioxide, H

131
Q

Which particular gas is very regulated in respiration?

A

CO2

132
Q

What is the cause of alveolar dead space?

A

when the ventilated alveoli are not adequately perfused with blood

133
Q

What are carbamino compounds?

A

when CO2 combines with a terminal amine group in blood proteins

134
Q

Total Lung Capacity

A

maximum volume of air that the lungs can hold TLC = VC + RV 5700ml approx.

135
Q

Innervation of diaphragm

A

Phrenic nerve; C3,4,5

136
Q

Oxygen delivery to the tissues can be impaired by… (3)

A

respiratory disease Anemia Heart Failure

137
Q

What is a pneumothorax?

A

air in the pleural space

138
Q

Muscles of active inspiration

A

external intercostals - contraction lifts ribs and moves out sternum

139
Q

Pulmonary ventilation (L) =

A

tidal volume x resp. rate

140
Q

The steeper lower part of the oxygen dissociation curve is important as it allows _______ ______ to get a lot of oxygen for a _____ drop in PO2

A

peripheral tissues, small

141
Q

the rate at which gas is passing through the lungs

A

Ventilation

142
Q

What is physiological dead space?

A

alveolar dead space + anatomical dead space

143
Q

According to La Place’s law…

A

smaller alveoli with a smaller radius have a higher tendency to collapse as there is a greater inwardly directed collapsing pressure

144
Q

How much oxygen is carried by 1g of Hb when fully saturated?

A

1.34ml

145
Q

What are the differences between HbF and HbA?

A

HbF has higher affinity for O2 and interacts less with 2,3-biphosphoglycerate

146
Q

During inspiration the ______ and ______ expand as a result of contraction of _________ muscles

A

thorax, lungs, inspiratory

147
Q

Work of breathing is increased by…(4)

A

decrease in pulmonary compliance airway resistance increase elastic recoil is decreased a need for increased ventilation

148
Q

H+ drive of respiration is important in…

A

acid base balance

149
Q

In healthy people, alveolar dead space is of great importance - true or false?

A

false alveolar dead space should be minimal in a healthy individual

150
Q

What is the most important force for linking the lungs and the thorax?

A

negative intrapleural pressure

151
Q

What allows the conversion of CO2 to bicarbonate to remain favourable?

A

chloride shift

152
Q

Boyle’s Law

A

At any constant temperature, the pressure exerted by a gas varies inversely with the volume of the gas

153
Q

Daltons Law of Partial Pressures

A

The total pressure exerted by a gaseous mixture = the sum of the partial pressures of each individual component in gas mixture

154
Q

alveolar pKa?

A

13.3kPa

155
Q

Influence the respiratory centres (6)

A

Higher brain centres

Stretch receptors in the bronchi/bronchioles

Juxtapulmonary receptors

Joint receptors

Baroceptors

Central and Peripheral Chemoreceptors

156
Q

Percentage of CO2 carried as carbamino compounds in the blood?

A

30%

157
Q

In systemic arterioles, a decrease in O2 will cause vasodilation to…

A

promote offloading of oxygen to the tissues

158
Q

DO2I =

A

CaO2 x CI oxygen delivery index where CI is just CO accounting for body surface area

159
Q

Anatomical dead space

A

where some inspired air remains in the airways and is not available for gas exchange

160
Q

The majority of CO2 is carried in solution in the blood - true or false?

A

false the majority is carried in bicarbonate

161
Q

What two forces hold the thoracic wall and lungs in close opposition?

A
  1. Intrapleural fluid cohesiveness
  2. Negative intrapleural pressure
162
Q

Decreased pulmonary compliance may cause a _______ pattern of lung volumes in spirometry

A

restrictive

163
Q

Why does it not matter how much haemoglobin there is, if partial pressure is normal?

A

it will become saturated

164
Q

Definition of pulmonary ventilation

A

the volume of air breathed in and out per minute

165
Q

To increase pulmonary ventilation, both the depth (_____ _____) and rate of breathing increase. Because of dead space, it is more advantageous to increase the _______.

A

tidal volume, depth

166
Q

What is the difference in oxygen dissociation in myoglobin?

A

hyperbolic curve as only dissociates at very low PO2

167
Q

Surfactant _______ the surface tension of smaller alveoli preventing them from ________

A

lowers, collapsing into larger alveoli

168
Q

Enzyme that converts CO2 and H2O to carbonic acid

A

carbonic anhydrase

169
Q

How is the Oxygen dissociation curve affected in HbF?

A

shifted to the left

170
Q

What is the body’s normal response to acute hypoxia?

A

hyperventilation and increased CO

171
Q

Stimulation the _______ _____ terminates inspiration

A

Pneumotaxic centre

172
Q

Gases move across cell membranes by….

A

pressure gradients

173
Q

Percentage of O2 bound to haemoglobin?

A

98.5%

174
Q

Alveolar ventilation (L) =

A

(tidal volume - dead space) x resp. rate

175
Q

Increased pulmonary compliance occurs in…

A

emphysema

176
Q

Expiratory Reserve Volume

A

Extra volume of air that can be expired during forced expiration 1000ml

177
Q

What higher centres in the brain influence respiratory centres?

A

cerebral cortex, limbic system, hypothalamus

178
Q

what is PAO2 at sea level approx?

A

100mmHg

179
Q

What is a peak flow meter?

A

a device which the patient gives a sharp fast blow after maximal inspiration gives an estimate of airway function best of 3

180
Q

The cough reflex is activated by…

A

irritation of the airways or tight airways in asthma

181
Q

Perfusion

A

the rate at which blood is passing through the lungs

182
Q

If an alveolus starts to collapse, the surrounding alveoli are ______ and then ______ exerting expanding forces on the collapsing alveolus to ______ it

A

stretched, recoil, open

183
Q

Vital Capacity

A

maximum volume of air that can be moved out during a single breath following a maximal inspiration 4500ml VC = IRV + TV + ERV

184
Q

Where does the reaction that converts CO2 to bicarbonate occur?

A

in the red blood cells

185
Q

Hering-Breur Reflex

A

Stretch receptors in the walls of the bronchi/bronchioles that reflex guards against hyperinflation

186
Q

Henrys Law

A

the amount of a given gas dissolved in a given type and volume of liquid at a constant temperature is proportional to the partial pressure of the gas in equilibrium with the liquid

187
Q

In which situations is the hypoxic drive of respiration important?

A
  1. in patients with chronic CO2 retention
  2. at high altitudes
188
Q

FEV1/FVC ratio is less than 75% in restrictive lung diseases - true or false?

A

false as both the FVC and FEV1 both fall, the ratio of remains at a normal level

Respiratory KC (20 decks)

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