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physiology Flashcards

1
Q

what is cellular respiration

A

use O2 and produce CO2

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2
Q

what is external respiration

A

the process of how O2 and CO2 are exchanged around the body

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3
Q

how many steps is there for external respiration

A

4

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4
Q

what is step 1 of external respiration

A

ventilation

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5
Q

what is ventilation

A

air moved in and out of the lungs so it can be exchanged

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6
Q

what is step 2 of external respiration

A

oxygen and CO2 are exchanged between air in the alveoli and blood

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7
Q

what is step 3 of external respiration

A

transport of O2 and CO2 between the lungs and tissues

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8
Q

what is step 4 of external respiration

A

oxygen and CO2 are exchanged between tissue cells and blood

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9
Q

what does the respiratory system include

A
  • airways into lung
  • lungs
  • structures of thorax
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10
Q

what are the respiratory airways

A

tubes that carry air between the atmosphere and the air sacs

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11
Q

how does airways begin

A

nasal passage (nose)

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12
Q

is the oesophagus open or closed during inspiration

A

closed so air doesn’t go into stomach

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13
Q

what is the larynx

A

voice box

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14
Q

where are the vocal folds

A

two bands of elastic tissue that lie across the opening of the larynx h

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15
Q

how does air pass into the larynx

A

through the space between the vocal folds

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16
Q

what is the laryngeal opening

A

glottis

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17
Q

what happens to the glottis during swallowing

A

closed

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18
Q

how is the glottis closed

A

via the laryngeal muscles

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19
Q

what does the trachea branch into

A

the right and left bronchi

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20
Q

what are the smaller branches of the bronchi called

A

bronchioles

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21
Q

what are at the end of the terminal bronchioles

A

alveoli

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22
Q

do small bronchioles have cartilage

A

no they contain smooth muscle

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23
Q

what makes up the alveolar walls

A

type I alveolar cells

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24
Q

what surrounds each alevoli

A

network of pulmonary capillaries

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25
Q

what do type II alveolar cells secrete

A

pulmonary surfactant

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26
Q

what is the only muscle within the lungs

A

smooth muscles

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27
Q

what muscle is the diaphragm

A

skeletal muscle

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28
Q

what separates each lung from the thoracic wall

A

pleural sac

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29
Q

what is the interior of the pleural sac known as

A

pleural cavity

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30
Q

what is pleurisy

A

inflammation of pleural sac

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31
Q

how does air move

A

down a pressure gradient

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32
Q

what are the 3 important pressure in ventilation

A
  • atmospheric
  • intra-alveolar
  • intra-pleural
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33
Q

what is atmospheric pressure

A

pressure exerted by the weight of the air in the atmosphere

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34
Q

value of atmospheric pressure

A

760mmHg

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35
Q

what is intra-alveolar pressure

A

pressure within the alveoli

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36
Q

what is intrapleural pressure

A

pressure within the pleural sac

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37
Q

value of intra-pleural pressure

A

756 mm Hg

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38
Q

is the pleural sac open or closed

A

closed

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39
Q

what two forces hold the lungs and thorax in close apposition

A
  • intrapleural fluid cohesiveness

- transmural pressure gradient

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40
Q

what is intrapleural fluid cohesiveness

A

water molecules resist being pulled apart because they are polar and attracted to one another

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41
Q

what is the transmural pressure gradient

A

as alveolar pressure is larger than pleural pressure the lungs are forced to expand

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42
Q

what is pneumothorax

A

air flowing down its pressure gradient into pleural space

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43
Q

what must alveolar pressure be for inspiration

A

alveolar pressure must be less than atmospheric

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44
Q

Boyle’s law

A

at any constant temperature the pressure exerted by a gas varies inversely with the volume of the gas
= the volume of a gas increases the pressure exerted by the gas decreases

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45
Q

what are the major inspiratory muscles

A
  • diaphragm

- external intercostal muscle

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46
Q

what are the pressures before inspiration

A

intra-alveolar pressure equals atmospheric pressure

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47
Q

what is the major muscle of inspiration

A

diaphragm

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48
Q

what innervates the diaphragm

A

phrenic nerve

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49
Q

what happens to the diaphragm when it contracts

A

descends downwards enlarging the volume of the thoracic cavity

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50
Q

what lies on top of what between external intercostal and internal intercostal

A

external intercostal lie on top of internal intercostal

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51
Q

what direction do the fibres of external intercostal run

A

downward (hands in pockets)

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52
Q

what happens when the external intercostal contract

A

they elevate the ribs and the sternum up and out

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53
Q

what activate the intercostal muscles

A

intercostal nerves

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54
Q

what happens to intra-alveolar pressure when the lungs enlarge

A

it drops (because the same number of air molecules occupy a larger volume)

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55
Q

what happens now intra-alveolar pressure decreases

A

air flows into the lung down the pressure gradient

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56
Q

what value is the intrapleural pressure during inspiration

A

754 mm hg

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57
Q

what are the accessory muscles of inspiration

A
  • sternocleidomastoid

- scalenus

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58
Q

what do the inspiratory muscles do at the end of inspiration

A

relax

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59
Q

what happens to the intra-alveolar pressure when the lungs recoil

A

rises because the greater number of air molecules are contained in a smaller volume

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60
Q

what happens to air when the intra-alveolar pressure increases

A

air moves out down its pressure gradient

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61
Q

what is the phrenic nerve

A

C3,4,5

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62
Q

is expiration active or passive

A

passive

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63
Q

is inspiration active or passive

A

always active

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64
Q

what are the muscles of expiration

A
  • abdominal muscle

- internal intercostal muscle

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65
Q

what is the primary determinant of resistance of airflow

A

radius of the conducting airways

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66
Q

what does parasympathetic stimulation do to bronchial smooth muscle

A

bronchoconstriction

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67
Q

what does sympathetic stimulation do to bronchial smooth muscle

A

bronchodilation

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68
Q

what characterises COPD

A

increased air way resistance

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69
Q

what is encompassed in COPD

A
  • chronic bronchitis
  • emphysema
  • asthma
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70
Q

what is chronic bronchitis

A

inflammatory condition of the lower respiratory airways

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71
Q

what do irritants do to ciliary mucus escalator

A

immobilise

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72
Q

why does pulmonary bacterial infection frequently occur in chronic bronchitis

A

the accumulated mucus serves as an excellent medium for bacterial growth

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73
Q

what is airway obstruction in asthma a result of

A
  • thickening of airway walls
  • plugging of the airways by excessive secretion of thick mucus
  • airway hyperresponsiveness
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74
Q

triggers of asthma

A
  • allergens (dust mites, pollen)
  • irritants
  • infections
  • exercise
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75
Q

characteristics of emphysema

A
  • collapse of smaller airways

- breakdown of alveolar walls

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76
Q

is emphysema reversible

A

no

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77
Q

what causes emphysema

A

excessive release of protein digesting enzymes e.g. trpysin

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78
Q

what protects the lungs from enzymes like trypsin

A

alpha1- antitrypsin

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79
Q

what can happen with over production of alpha1-antitrypsin

A

they start to destroy lung tissue as they get overwhelmed

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80
Q

what is more difficult in COPD expiration or inspiration

A

expiration

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81
Q

do the smaller airways have cartilaginous rings

A

no

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82
Q

why do asthmatics have a wheeze

A

expiration is more difficult than inspiration so air is forced out through the narrowed airways

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83
Q

what in the lungs allows them to be stretched and then return to their normal size

A
  • compliance

- elastic recoil

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84
Q

what is compliance

A

how much effort is required to stretch or distend the lung

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85
Q

what does it mean if compliance is high

A

is stretches far for little increase

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86
Q

what does it mean if compliance is low

A

more effort is taken to stretch the lungs

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87
Q

examples of diseases that cause decreased compliance

A

pulmonary fibrosis

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88
Q

where is pulmonary fibrosis

A

normal lung tissue is replaced with scar forming connective tissue

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89
Q

what is elastic recoil

A

how readily the lungs rebound after being stretched

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90
Q

what does the lungs elastic behaviour depend on

A
  • high elastic connective tissue

- alveolar surface tension

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91
Q

what are elastin fibers

A

fibres that have elastic properties

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92
Q

how are elastin fibres arranged

A

meshwork that amplifies their elastic behaviour

93
Q

what bonds make water attracted to each other

A

hydrogen

94
Q

what is link between surface tension and lung compliance

A

the greater the surface tension the less compliant the lungs

95
Q

what happens to elastic recoil in emphysema

A

elastic recoil is decreased

96
Q

do patients with emphysema have difficulty with inspiration or expiration

A

expiration

97
Q

what cells secrete pulmonary surfactant

A

type II alveolar cell

98
Q

what does pulmonary surfactant do

A

it intersperses between the water molecules in the fluid lining the alveoli and lowers alveolar surface tension

99
Q

what is the law of LaPlace

A

smaller alveoli have higher tendency to collapse

100
Q

what size of cells is surfactant greater on

A

smaller

101
Q

how are alveoli interconnected

A

by connective tissue

102
Q

what happens if an alveolus starts to collapse

A

surrounding alveoli are stretched as their walls are pulled in the direction
= alveoler interdependence

103
Q

why does newborn respiratory distress syndrome

A

developing foetal lungs do not produce surfactant until late in the pregnancy

104
Q

what disease causes airway resistance to increase

A

COPD

105
Q

what disease causes elastic recoil to decrease

A

emphysema

106
Q

what causes a need for increased ventilation

A

exercise

107
Q

tidal volume

A

volume of air entering or leaving the lungs during a single breath

108
Q

value of tidal volume

A

500 ml

109
Q

what is inspiratory reserve volume

A

extra volume of air that can be maximally inspired over and above the typical resting tidal volume

110
Q

value of inspiratory reserve volume

A

3000ml

111
Q

what is inspiratory capacity

A

maximum volume of air that can be inspired at the end of normal quiet expiration

112
Q

value of inspiratory capacity

A

3500 ml

113
Q

what is expiratory reserve volume

A

extra volume of air that can be actively expired

114
Q

value of expiratory reserve volume

A

1000ml

115
Q

what is residual volume

A

minimum volume of air remaining in the lungs after a maximal expiration

116
Q

value of residual volume

A

1200 ml

117
Q

what is functional residual capacity

A

volume of air in the lungs at the end of a normal passive expiration

118
Q

what is value of functional residual capacity

A

2200 ml

119
Q

what is vital capacity

A

maximum volume of air that can be moved out during a single breath following maximal inspiration

120
Q

what is value vital capacity

A

4500 ml

121
Q

what is total lung capacity

A

maximum volume of air that the lungs can hold

122
Q

what is value of total lung capacity

A

5700 ml

123
Q

what is FEV1

A

volume of air that can be expired during the first second

124
Q

what is pulmonary ventilation

A

volume of air breathed in and out in one minute

125
Q

how to calculate pulmonary ventilation

A

tidal volume x respiratory rate

126
Q

what is anatomic dead space

A

parts that remain in the conducting airways that aren’t available for gas exchange

127
Q

what is alveolar ventilation

A

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

128
Q

what is alveolar dead space

A

ventilated alveoli that are inadequately perfused

129
Q

what happens to pulmonary arterioles in decreased O2

A

vasoconstriction

130
Q

what happens to pulmonary arterioles in increased O2

A

vasodilation

131
Q

what happens to systemic arterioles in decreased O2

A

vasodilation

132
Q

what happens to systemic arterioles in increased O2

A

vasoconstriction

133
Q

where are ventilation and perfusion less when someone stands up

A

at the top

134
Q

how does the ventilation perfusion ratio differ

A

decreases from top to bottom

135
Q

what is the blood a transport system for

A

CO2 and O2

136
Q

what is largest portion of air

A

nitrogen

137
Q

value of atmospheric pressure

A

760 mmHg

138
Q

what is partial pressure

A

the individual pressure exerted independently by a particular gas within a mixture of gases

139
Q

what does it mean if the greater the partial pressure of a gas in a liquid

A

the more the gas is dissolved

140
Q

Fick’s law of diffusion

A

the diffusion rate of a gas through a sheet of tissue also depends on the surface area and thickness of a membrane

141
Q

what happens to surface area during exercise

A

increased to enhance the rate of gas transfer

142
Q

what happens to thickness when alveolus stretches

A

becomes thinner

143
Q

what condition causes surface area to decrease

A

emphysema

144
Q

why is surface area decreased in emphysema

A

alveolar walls are lost

145
Q

what about the thickness can cause decreased gas exchange

A

an increased thickness

146
Q

what diseases causes thickened walls

A
  • pulmonary oedema
  • pulmonary fibrosis
  • pneumonia
147
Q

what is pulmonary oedema

A

an excess accumulation of interstitial fluid between the alveoli and capillaries

148
Q

what causes pulmonary oedema

A

left sided heart failure

149
Q

what happens in pulmonary fibrosis

A

replacement of delicate lung tissue with thick fibrous tissue

150
Q

what is pneumonia

A

inflammatory fluid accumulation within or around the alveoli

151
Q

what is pneumonia due to

A

bacterial or viral infection of the lungs

152
Q

what has a greater diffusion constant CO2 or O2

A

CO2 twenty times more than O2

153
Q

when diffusion is impeded what gas is more affected

A

O2

154
Q

how does oxygen move

A

by diffusion down its partial pressure gradient

155
Q

how is most O2 transported

A

bound to haemoglobin

156
Q

by what methods is O2 transported

A
  • solution

- haemoglobin

157
Q

what is dissolved O2 related to

A

Po2

158
Q

how much O2 is transported in solution

A

1.5%

159
Q

where is haemoglobin

A

in red blood cells

160
Q

is O2 binding to haemoglobin reversible or irreversible

A

reversible

161
Q

how much O2 is transported bound to haemoglobin

A

98.5%

162
Q

what determines haemoglobin saturation

A

Po2

163
Q

how many iron molecules in haemoglobin

A

4

164
Q

how many O2 molecules can haemoglobin transport

A

4

165
Q

what can cause Po2 to fall

A
  • high altitudes

- O2 deprived environments

166
Q

does O2 in haemoglobin contribute to Po2

A

no only dissolved O2

167
Q

what does Hb do when Po2 falls

A

Hb must unload some O2

168
Q

other factors that affect O2 unloading in Hb

A
  • CO2
  • acidity
  • temperature
  • 2,3 bisphosphoglycerate
169
Q

in what direction does increased Pco2 shift the O2 curve

A

to the right

170
Q

what direction does increased acid shift the O2-Hb curve

A

to the right

171
Q

what is increased release of O2 known as

A

Bohr effect

172
Q

what does a rise in temperature shift the O2-Hb curve

A

to the right

173
Q

where is 2,3 BPG

A

in the red blood cell

174
Q

when is 2,3 BPG produced

A

red blood cell metabolism

175
Q

when can 2,3 BPG increase

A
  • high altitudes

- anaemia

176
Q

haemoglobin has a higher affinity for O2 than CO2

true or false

A

FALSE

haemoglobin has a higher affinity for CO2 than O2

177
Q

how is most CO2 transported in the blood

A

as bicarbonate

178
Q

how is carbon dioxide transported in the blood

A
  • solution
  • carbamino haemoglobin
  • bicarbonate
179
Q

what does amount of CO2 dissolved depend on

A

Pco2

180
Q

what is formed when CO2 combines with Hb

A

carbamino haemoglobin

181
Q

what does reduced Hb have a higher affinity for

A

CO2

182
Q

what does unloading of O2 from Hb facilitate

A

picking up of CO2 by Hb

183
Q

how is CO2 transported by bicarbonate

A
  1. CO2 combines with H2O forming carbonic acid

enzyme = carbonic anhydrase

184
Q

is the membrane permeable or impermeable to H+

A

impermeable

185
Q

Haldane effect

A

removing O2 from Hb increases ability of Hb to pick up CO2

186
Q

what does Haldane effect work with

A

Bohr effect

187
Q

how does chloride move

A

into red blood cells down the electrochemical gradient

188
Q

what is hypoxia

A

insufficient O2 at cell level

189
Q

what is hyperoxia

A

above normal arterial Po2

190
Q

what is hypercapnia

A

excess CO2 in arterial blood

191
Q

what causes hypercapnia

A

hypoventilation

192
Q

what can trigger hyperventilation

A
  • anxiety
  • fever
  • aspirin poisoning
193
Q

what type of muscle are the respiratory muscle

A

skeletal

194
Q

what is the primary respiratory control centre

A

medulla

195
Q

what is in the pons

A
  • pneumotaxic centre

- apneustic centre

196
Q

what is in the medulla

A
  • dorsal respiratory centre

- ventral respiratory centre

197
Q

what does dorsal neurones stimulate

A

inspiration

198
Q

are ventral neurones activated during normal breathing

A

no

199
Q

what stimulates ventral neurones

A

dorsal neurones

200
Q

what is ventral neurones important in

A

active expiration

201
Q

what generates the respiratory rhythm

A

pre-Botzinger complex

202
Q

where is pre-Botzinger complex located

A

in upper end of medulla

203
Q

what kind of activity does pre-Botzinger complex have

A

spontaneous pacemaker activity

204
Q

where does pneumotactic centre send its impulses

A

to dorsal neurone

205
Q

what does stimulation of pneumotactic centre cause

A

inhibits inspiration

206
Q

what does apneustic centre do

A

prevents inspiration neurones from being switched off = prolongs inspiration

207
Q

what is apneusis

A

prolonged breathing

208
Q

when does apneusis occur

A

in some cases of severe brain damage

209
Q

when is Hering-Breur reflex triggered

A

when tidal volume is large e.g. during exercise

210
Q

what does Hering-Breur reflex prevent

A

overinflation of lungs

211
Q

how is arterial Po2 monitored

A

peripheral chemoreceptors

212
Q

where are peripheral chemoreceptors

A
  • carotid

- aortic

213
Q

are peripheral chemoreceptors sensitive

A

no

214
Q

what is the most important magnitude of ventilation under resting conditions

A

Pco2

215
Q

where are central chemoreceptors

A

in the medulla near respiratory centre

216
Q

what do central chemoreceptors detect

A

CO2 induced H+ in ECF

217
Q

how is movement of materials restricted in ECF

A

by blood brain barrier

218
Q

what is the blood brain barrier permeable to

A

CO2

219
Q

can H+ permeate the blood brain barrier

A

no

220
Q

what removes H+

A

HCO3-

221
Q

what can cause an increase in H+ concentration

A

diabetes mellitus

222
Q

can joint and muscle movement stimulate the respiratory centre

A

yes

223
Q

what does epinephrine release stimulate

A

ventilation

224
Q

how does inhalation of noxious particles affect ventilation

A

ceases it

225
Q

how does pain affect respiratory centre

A

stimulates it ‘gasp’

226
Q

how do hiccups occur

A

when involuntary spasmodic contractions of diaphragm occur

227
Q

when is respiratory centre inhibited

A

during swallowing (prevent food entering the lung)

228
Q

what is dyspnoea

A

short of breath

229
Q

when can dyspnoea be seen

A
  • obstructive lung disease

- pulmonary oedema (assoc cardiac failure)

respiratory (20 decks)

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