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RESP > physiology & anatomy > Flashcards

physiology & anatomy Flashcards

1
Q

main anatomical features of airways

A

mucosa
basement membrane
smooth muscle matrix extending to alveolar entrances
fibrocartilaginous or fibroelastic-supporting connective tissue

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2
Q

main anatomical features of lung

A

cartilaginous bronchi
membranous bronchi
gas-exchanging bronchi - resp bronchioles and alveolar ducts

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3
Q

classes of airways

upper and lower

A

upper airways :
nose , nasal cavity
pharynx

lower airways :
larynx
trachea
bronchial tree
lungs
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4
Q

two types of alveolar cells and functions

A

pneumocytes
type 1 : makes up majority of alveoli , gas exchange occurs - air passes through into capillaries

type 2 : secretes pulmonary surfactant
important in preventing collapse of lungs

macrophages - dust cells, clean up alveoli of lungs

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5
Q

functions of resp system

A 
inhalation and exhalation of gases 
gas exchange - move fresh air into body while removing waste gases 
protect
acid-base balance 
olfactory
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6
Q

pulmonary v systemic circulation

A

pulmonary : between heart and lungs
- RV - pulm arteries - lungs - pulm veins - LA
systemic : between heart and body
- LV - aorta - body - IVC/SVC - RA

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7
Q

points of gas exchange between resp and cardio systems

A

walls of alveoli share membrane with capillaries - allows oxygen and CO2 to diffuse/move freely
O2 molecules attach to RBCs, which travel to heart

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8
Q

why, and how, does resistance to air flow vary across resp tree?

A

as radius increases, resistance to airflow decreases during inspiratory phase
conversely
in expiration, intrathoracic pressure increases due to lower volume of thoracic cavity -> leads to narrowing of small airways, so resistance is higher

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9
Q

define ventilation

A

refers to flow of air in and out of alveoli

higher at base

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10
Q

define perfusion

A

refers to flow of blood into alveolar capillaries

increases due to gravity, higher at apex

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11
Q

ventilation rate

A

refers to volume of gas inhaled and exhaled from lungs in given time period, usually 1 min

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12
Q

calculating ventilation rate

A

tidal volume x resp rate

avg man = 6L/min

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13
Q

tidal volume

A

volume of air inhaled and exhaled in a single breath

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14
Q

V/Q ratio =

A

ventilation/perfusion ratio

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15
Q

V/Q ratio

A

varies depending on part of lung - higher at apex, decreased toward base

ventilation exceeds perfusion towards apex, perfusion exceeds ventilation towards base

1 for maximally efficient pulm function
avg = 0.8

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16
Q

PA

A

alveolar pressure

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17
Q

Pa

A

pulmonary artery pressure

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18
Q

Pv

A

pulmonary vein pressure

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19
Q

pleural cavity

A

fluid filled space surrounding lungs
bounded by a double layered serous membrane called pleura
2 pleural cavities - one for each lung - L is smaller
potential space

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20
Q

boundaries of pleural cavity

A

superior
inferior
medial
anterior, posterior, lateral

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21
Q

two layers of pleura

A

parietal

visceral

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22
Q

parietal pleura

A

outer , lines inner aspect of thoracic cavity and mediastinum
thicker and more durable

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23
Q

visceral pleura

A

inner layer, lines outer surface of the lungs

more delicate

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24
Q

parietal and visceral pleura relationship - important for inflation/deflation

A

continuous with each other at the hilum of the lung

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25
Q

how do muscles of respiration act to increase/decrease thoracic volume

A

active inspiration - contraction of accessory muscles of breathing , all act to increase volume of thoracic cavity =
scalenes, sternocleidomastoid, pectoralis major and minor, serratus anterior and latissimus dorsi

active expiration - contraction of several thoracic and abdominal muscles , act to decrease volume of thoracic cavity =
anterolateral abdominal wall, internal intercostal, innermost intercostal

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26
Q

Boyle’s law and mechanics of breathing, inspiration and expiration

A

pressure and volume are always inversely proportional at a given temp of a gas

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27
Q

state mechanical factors that affect resp minute volume

A

temperature
exercise
pregnancy
blood pressure

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28
Q

why is intrapleural pressure always less than alveolar pressure

A
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29
Q

state role of pulmonary surfactant and the law of Laplace

A

reduces surface tension on alveolar surface membrane thus reducing tendency for alveoli to collapse

30
Q

define compliance

A

ability of lungs and pleural cavity to expand and contract based on changes in pressure

31
Q

factors affecting compliance

A

elasticity of lung tissue

surface tensions at air-water interfaces

32
Q

functional difference between pulmonary and alveolar ventilation

A 
pulmonary  = volume of air entering the lungs in unit time 
alveolar = exchange of gas between alveoli and external environment
33
Q

describe impact dead space has on alveolar ventilation

A

body will tend to combat increased dead space by raising the frequency of breaths to try and maintain sufficient levels of alveolar ventilation

34
Q

normal values for alveolar and arterial gas partial pressures

A 
PAO2 = 100mmHg
PaO2 = 80-100mmHg (systemic), 40-50mmHg (pulmonary, deoxygenated)
PACO2 = 35mmHg
PaCO2 = 40-45mmHg (systemic), 50mmHg (pulmonary)
35
Q

describe blood supply to lungs

A

lungs supplied with deoxygenated blood by the paired pulmonary arteries. once blood has received oxygenation, leaves lungs via four pulmonary veins (2 for each)

36
Q

describe factors that influence diffusion of gases across alveoli

A

thickness of membrane - faster when thinner
surface area of membrane - faster when larger
diffusion coefficient
pressure difference

37
Q

how can spirometry be used to identify abnormal lung function

A

measures how much air you can breathe in and out in one forced breath
measures how well your lungs work well
how much you inhale, exhale and how quickly you exhale

38
Q

characteristic results of lung function tests in obstructive lung disease patients

A

reduced FEV1 (<80% of predicted normal)
reduced FVC
FEV1/FVC ratio reduced (
<0.7)

39
Q

characteristic of results of lung function tests in restrictive lung disease patients

A

reduced VC, reduced TLC

isolated reduction of RV

40
Q

inspiratory reserve volume

A

avg = 2.5L

extra volume that can be inspired above tidal volume, from normal quiet inspiration to max

41
Q

expiratory reserve volume

A

avg = 1.5L

extra volume that can be expired below tidal volume, from normal quiet to max

42
Q

residual volumes

A

avg = 1.5L

volume remaining after max expiration

43
Q

inspiratory capacity

A

avg = 3L

44
Q

functional residual capacity

A

avg = 3.0L

45
Q

vital capacity

A

avg = 4.5L

46
Q

total lung capacities

A

avg = 6.0L

47
Q

minute ventilation (VE)

A

amount of air entering the lungs per minute

VE = TV x Breaths per min

48
Q

alveolar ventilation (VA)

A

amount of gas per unit of time that reaches the alveoli and becomes involved in gas exchange
VA = (TV - DSV) x RR

49
Q

dead space ventilation (VD)

A

amount of air per unit of time that is not involved in gas exchange, such as the air that remains in the conducting zones
VD = DSV x RR

50
Q

difference between partial pressure and gas content

A
51
Q

what is role of haemoglobin in transport of O2 in blood

A
52
Q

explain why shape of oxyhaemoglobin dissociation curve is important to O2 loading in lungs and unloading in tissues

A

when oxyhaemoglobin reaches a tissue with a low pO2 it will dissociate into O2 and haemoglobin resulting in increased local pO2. Inversely, when it reaches a tissue with high pO2, haemoglobin will continue to take up more O2, resulting in lowered pO2.

53
Q

factors that affect the oxyhaemoglobin dissociation curve

A

pH/pCO2

2,3-diphosphoglycerate (2,3-DPG)

temperature

54
Q

compare oxyhaemoglobin dissociation for adult haemoglobin with that of foetal haemoglobin and myoglobin in relation to their physiological roles

A
55
Q

identify forms in which CO2 is transported in blood

A

dissolved in solution
buffered with water as carbonic acid (bicarbonate)
bound to proteins, particularly haemoglobin

diffuses into RBCs

56
Q

explain action of carbonic anhydrase in CO2 transport

A

converts CO2 into carbonic acid , subsequently hydrolysed into bicarbonate and H+

57
Q

identify factors which favour CO2 unloading to alveoli at lungs

A

surface area of alveolar membrane
partial pressure gradients of gasses
matching of perfusion/ventilation

58
Q

define shunt

A

passage made to allow blood or other fluid to move from one part of the body to another

59
Q

define alveolar dead space

A

difference between the physiologic dead space and anatomic dead space

contributed by all terminal resp units that are over-ventilated relative to perfusion

60
Q

define physiologic dead space

A

anatomical dead space plus alveolar dead space

61
Q

define anatomical dead space

A

volume of air located in resp tract segments that are responsible for conducting air to alveoli and resp bronchioles but do not take part in process of gas exchange itself

62
Q

define 5 different types of hypoxia

A

hypoxic hypoxia - lack of O2 in blood flowing to tissues
anemic hypoxia - insufficient amount of RBC
stagnant hypoxia - poor blood flow , less O2 available
histiotoxic hypoxia - body finds hard to utilise oxygen
cytopathic hypoxia - higher demand for O2

63
Q

explain how resp motor movements are affected by CNS

A

medulla oblongata helps send signals to muscles that control resp to cause breathing to occur and thereby controls voluntary resp

therefore both voluntary and involuntary resp are controlled by CNS

64
Q

describe location of 2 classes of chemoreceptors

A 
peripheral = aortic and carotid bodies
central = brain
65
Q

identify stimuli which activate 2 classes of chemoreceptors

A

changes in arterial CO2, O2, and pH

central respond to increase in CO2 or acidity
peripheral respond to changes in arterial blood oxygen and initiate reflexes important for maintaining homeostasis during hypoxemia

66
Q

list factors involved in changing ‘resp drive’ , rate and depth of breathing

A

CO2 levels main influence - increase = resp centre (medulla and pons) stimulated to increase rate and depth of breathing

67
Q

how do the central chemoreceptors serve to regulate the arterial pCO2 by monitoring pH of CSF

A

HCO3- levels remain relatively constant, whereas CO2 freely diffuses across the BBB, from arterial blood supply into CSF
CO2 reacts with H2O, producing carbonic acid, lowering pH - therefore, pH of CSF inversely proportional to arterial pCO2

small decrease in pCO2 -> increase in pH of CSF - stimulates resp centre to decrease ventilation

small increase in pCO2 -> decrease in pH of CSF - stimulates resp centre to increase ventilation

68
Q

how do the peripheral chemoreceptors become important during hypoxia and acid-base imbalance

A

detect large changes in pO2 as arterial blood supply leaves heart

low levels of O2, afferent impulses travel via glossopharyngeal and vagus nerves to medulla oblongata and the pons in brainstem - number of responses coordinated to restore pO2

69
Q

outline role of resp system in acid-base disturbance

A

alters resp rate to change conc of CO2 in blood

70
Q

explain how CO2 affects acid-base balance

A

amount of CO2 expired can cause pH to increase or decrease , due to CO2 forming carbonic acid in the body when combining with water

71
Q

how can resp system both create, and compensate, for acid-base disturbances

A

RESP (7 decks)

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