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Block 2; Week 7 > Physiology Review Book Notes > Flashcards

Physiology Review Book Notes Flashcards

1
Q

What are the 2 main portions of the respiratory system? And what is the general fcn of each?

A

Conducting Portion: ventilation/to warm, humidify & filter the air
Respiratory Portion: gas exchange

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2
Q

What structures are a part of the conducting portion?

A

nose, nasopharynx, larynx, trachea, bronchi, bronchioles, terminal bronchioles

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3
Q

When particles in the air are not removed in the nose…how are they removed in the conducting portion?

A

they are captured by mucus along the conducting portion b/c there are mucus-secreting cells…then they are swept upward by the rhythmic beating of the ciliated cells…

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4
Q

Explain the sympathetic & parasympathetic innervation of the conducting portion.

A

Smooth muscle lines the conducting airways.
These are innervated by nerve fibers.
Sympathetic: acts on beta 2 receptors & causes dilation.
Parasympathetic: acts on muscarinic receptors & causes constriction.

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5
Q

What are 3 substances that can be used to treat asthma? Why are they useful?

A 
Epinephrine (released by the adrenal medulla sometimes)
Isoproterenol
Albuterol
**these are all beta 2 agonists
**they cause dilation of the airways...
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6
Q

Which structures are a part of the respiratory portion?

A

Respiratory Bronchioles
Alveolar Ducts
Alveolar Sacs

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7
Q

Why are respiratory bronchioles considered a part of the respiratory portion? What characteristics do they share w/ the conducting portion?

A

They share the characteristics of cilia & smooth muscle…

But they are considered a part of the respiratory b/c sometimes alveoli bud off their walls.

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8
Q

What are the characteristics of the alveolar ducts & the alveolar sacs?

A

Alveolar Ducts: completely lined w/ alveoli
no cilia & only a little smooth muscle…
Alveolar Sacs: termination of the alveolar ducts…totally lined w/ alveoli…NO smooth muscle or cilia, however.

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9
Q

What makes alveoli a good structure for gas diffusion?

A

thin walls

large surface area for diffusion

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10
Q

What makes up the walls of the alveoli?

A

elastic fibers

epithelial cells: Type 1 & 2 pneumocytes.

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11
Q

Which epithelial cell type makes surfactant?

A

Type II pneumocytes

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12
Q

Which epithelial cell type can reproduce & regenerate both cell types?

A

Type II pneumocytes…

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13
Q

What does the body do when debris finds its way all the way down by the alveoli?

A

It uses its alveolar macrophages. Macrophages eat the debris & move toward the bronchioles.
The cilia are at this level again & they beat the debris up to be swallowed or whatever…

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14
Q

Where does the main source of blood flow to the lungs come from? What is it called?

A

Pulmonary blood flow (pulmonary arteries) pumped out of the right ventricle…basically cardiac output. This is the source of blood flow that participates in gas exchange.

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15
Q

Aside from pulmonary arteries…what is the more minor source of blood flow to the lungs?

A

Bronchial arteries…don’t participate in gas exchange…supplies the tissues of the conducting portion of the respiratory system…

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16
Q

How is pulmonary blood flow regulated?

A

Altering the resistance of the pulmonary arterioles…

controlled by local factors: mainly O2

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17
Q

T/F In the supine position, the blood flow is equal at different parts of the lungs.

A

True.

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18
Q

T/F In the standing position, the blood flow is equal at different parts of the lungs.

A

False.
due to gravitational effects…it is not equal…
Apex has low blood flow
Base has high blood flow

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19
Q

How are static volumes of the lung measured?

A

Spirometer

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20
Q

Normal breathing involves the inspiration & expiration of _______….

A

a tidal volume, about 500 mL

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21
Q

What makes up the tidal volume?

A

about 500mL the amount of air in the alveoli & the airways…

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22
Q

What is considered the inspiratory reserve volume? What is its approximate volume?

A

the extra amount above the tidal volume that you can inspire during maximal inspiration…about 3000 mL

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23
Q

What is considered the expiratory reserve volume?

What is its approximate volume?

A

the extra amount below the tidal volume that you can expire during maximal expiration….about 1200 mL

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24
Q

What is the residual volume? What is its approximate value?

A

The amount of air that is left over in the lungs even after maximal expiration…about 1200 mL

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25
Q

What is inspiratory capacity?

A

Tidal Volume + Inspiratory Reserve Volume

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26
Q

What is functional residual capacity?

A

Expiratory Reserve Volume + Residual Volume

**amount left in lungs after expiring normal tidal volume…

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27
Q

What is total lung capacity?

A

Everything added together, including residual volume.

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28
Q

What is vital capacity?

A

inspiratory reserve volume + tidal volume + expiratory reserve volume
**expiration ability after maximal inspiration

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29
Q

What are the 2 capacities that can’t be measured using spirometry? Why? Which is more important to find another way to measure?

A

Functional Residual Capacity & Total Lung Capacity

  • *both include residual volume
  • *FRC is more important
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30
Q

What are the 2 weird methods by which you can measure FRC?

A

Helium Dilution

Body Plethysmograph

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31
Q

What is dead space? What are the 2 types?

A

Volume of the airways & lungs the does not participate in gas exchange…
Anatomic Dead Space
Physiologic Dead Space

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32
Q

What is anatomic dead space?

A

The amount of air that naturally gets caught in areas of the lungs that do NOT participate in gas exchange…
Ex: conducting airways.
Volume is usu 150 mL

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33
Q

If you want to get a sample of alveolar air…which part of the air do you want to capture?

A

the end-expiratory air…b/c the air caught in the conducting airways/anatomic dead space is the air that comes out first….

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34
Q

What is physiological dead space?

A

total volume of the lungs that does not participate in gas exchange…
anatomic dead space + functional dead space…

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35
Q

What is functional dead space?

A

the amount of space in the lungs, esp the alveoli that does not participate in gas exchange…
**ventilated alveoli that don’t participate in gas exchange…

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36
Q

What is the main reason for functional dead space?

A

mismatch of ventilation & perfusion…when ventilated alveoli aren’t perfused by pulmonary capillary blood…

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37
Q

What is the idea behind measuring physiological dead space? What is the equation?

A

compare the amount of CO2 in the expired air & the capillary CO2=alveolar CO2.
Higher the dead space, lower the expired air CO2 compared to alveolar CO2.
Vdead=Vtidal volume X PaCO2-PECO2/PaCO2

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38
Q

What is minute ventilation?

A

the total rate of air movement into & out of the lungs in a minute…
Minute Ventilation = Vt X RR

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39
Q

What is alveolar ventilation?

A

ventilation rate that takes into account dead space…
Alveolar Ventilation:
Va = (Vt-Vd) X RR

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40
Q

What is the alveolar ventilation equation that includes the term PACO2? What relationship does this show?

A

VA=VCO2 X K/PACO2

**it shows that the alveolar ventilation is inversely proportional to the arterial & alveolar CO2 concentration…

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41
Q

What is K equal to in the alveolar ventilation equation?

A

K=863 mmHg normally…

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42
Q

What 2 variables determine alveolar PCO2?

A 
CO2 production in the tissues
alveolar ventilation (how much CO2 you get rid of thru expiration)
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43
Q

If CO2 production is constant, then what determines PACO2?

A

Alveolar Ventilation

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44
Q

In the alveolar ventilation equation what value can we put in for PACO2?

A

PaCO2…the arterial PCO2 b/c there is an equilibrium b/w capillaries & alveoli & PaCO2 can actually be measured…

45
Q

An increase in alveolar ventilation would do what to PACO2?

A

It would decrease it.

46
Q

How can you increase the production of CO2? In this case if you wanted to maintain a constant PaCO2 & PACO2 what would have to happen?

A

Exercise can increase metabolic demands in the tissues & give off more CO2.
This would require an increase in alveolar ventilation in order to maintain a constant PaCO2 & PACO2.

47
Q

What is the alveolar gas equation?

A

PAO2=PIO2 - PACO2/R
R=0.8
PIO2 is for the inspired air

48
Q

If you have a R=0.8…& you decrease your alveolar ventilation by half…what does this do to your PACO2 & PAO2?

A

Your PACO2 doubles.

Your PAO2 decreases by a little more than half.

49
Q

If your R value changes in your alveolar gas equation…what has changed physiologically?

A

Your CO2 production relative to your O2 consumption ratio has been altered…

50
Q

What is forced vital capacity?

A

It is the amount of air that can be forcibly expired after maximal inspiration. This is usu accomplished after 3 seconds of maximal expiration.

51
Q

What is FEV1, FEV2, & FEV3?

A

These are the forced expiratory volumes after 1, 2, & 3 seconds respectively. Usu you reach your full FVC after 3 seconds.

52
Q

What is significant about the ratio of FEV1/FVC? What is this value in a normal person?

A

This helps differentiate b/w different lung diseases.

0.8 in a normal person…

53
Q

In a person with an obstructive lung disease…such as _______…both FVC & FEV1 ______ but _____ decreases more. Thus the ratio of FEV1/FVC _____.

A

obstructive lung disease
asthma
both decrease, but FEV1 decreases more.
Ratio decreases.

54
Q

In a person with a restrictive lung disease…such as _____….both FVC & FEV1 _____ but ______ decreases more. Thus the ratio of FEV1/FVC _____.

A 
Restrictive Lung Disease
Fibrosis
both decrease
FVC decreases more
Ratio increases.
55
Q

What are the muscles of inspiration at rest? During vigorous exercise?

A

At rest: diaphragm

Exercise: external intercostal muscles & accessory muscles

56
Q

What are the muscles of expiration at rest? During vigorous exercise?

A

At rest: passive

During exercise or w/ asthma: abdominal muscles, internal intercostal muscles

57
Q

What is it that the diaphragm does when it contracts that causes inspiration?

A

When it contracts…it moves the diaphragm down & the ribs up & out. This increases intrathoracic volume & decreases intrathoracic pressure. Thus, air flows in.

58
Q

What is compliance?

A

relates to the distensibility of the lungs & chest wall…how the volume changes as a result of a pressure change…

59
Q

What is the relationship b/w elastance & compliance?

A

They are inversely proportional…think of a thick rubber band. Thicker (more elastic) the greater the recoil force & the smaller the compliance/distensibilty.

60
Q

What is transmural pressure?

A

the pressure taken across a structure…

61
Q

What is the intrapleural space?

A

the space that lies b/w the lungs & the chest wall…

62
Q

How do you determine the compliance of a lung based off of a pressure volume loop?

A

You can determine compliance by taking the slope of the curves.
Note: there will be a different compliance/slope for the inspiration curve than for the expiration curve.

63
Q

What does a negative pressure outside of the lungs do to the lung volume?

A

It expands the volume. Air rushes in.

64
Q

What does a less negative pressure outside of the lungs do to the lung volume?

A

It decreases the volume. Expiration.

65
Q

What is hysteresis?

A

It is the name for the phenomenon of the different slopes/compliances for the curves on the pressure volume loop during inspiration & expiration.

66
Q

Which has higher compliance? The inspiration or expiration curve? Why?

A

The expiration curve has a higher compliance.

Explanation is basically: surfactant/surface tension.

67
Q

Explain why the inspiration limb of the pressure volume loop has a lower compliance.

A

The surfactant can’t be laid down as fast as the surface area increases (alveoli become available)…surfactant density is low, surface tension is high, compliance is low…slope is flatter

68
Q

Explain why the expiration limb of the pressure volume loop has a higher compliance.

A

The surfactant can’t be removed as fast the surface area decreases…surfactant density is high, surface tension is low, compliance is high. Slope is steeper.

69
Q

T/F the compliance of the chest wall is also an important consideration…

A

TRUE!!

70
Q

Why is there normally a negative intrapleural pressure? What does this prevent? How does this relate to a pneumothorax?

A

2 opposing elastic forces…lungs “want” to collapse & the chest wall “wants” to spring out.
This neg. pressure actually keeps both of these things from happening.
Pneumothorax makes the pressure in the intrapleural space equal to atmospheric pressure (0)…thus, nothing prevents the lung form collapsing & the chest from expanding…

71
Q

What is atmospheric pressure considered equal to when we talk about lungs?

A

0.

Neg. pressure is pressure less than atmospheric pressure…

72
Q

In a normal individual…when the volume is FRC…what pressure is the lung & chest wall system @? What is their tendency?

A

At pressure 0–atmospheric

They balance each other & are at equilibrium & don’t have a tendency to collapse or expand.

73
Q

In a normal individual…when the volume is less than FRC…what pressure is the lung & chest wall system @? What is their tendency?

A

Pressure less than atmospheric–negative
Tendency @ neg. pressure to expand.
**less than FRC would be like maximal expiration & then you would want to inspire…

74
Q

In a normal individual…when the volume is greater than FRC…what pressure is the lung & chest wall system @? What is their tendency?

A

Pressure is greater than atmospheric–positive
Tendency @ pos. pressure to collapse.
**more than FRC would be inspiration…you’d be ready to expire

75
Q

What type of lung disease is emphysema considered? What does it do to elasticity & compliance?

A

Obstructive
Decreases elasticity & increases lung compliance.
It functions at a higher FRC
Patients have barrel chests

76
Q

What type of lung disease is fibrosis considered? What does it do to elasticity & compliance?

A

Restrictive
Increases elasticity & decreases compliance
It functions at a lower FRC

77
Q

What is the Law of LaPlace? What does this represent?

A 
P=2T/r
r--the radius of the alveolus
P-collapsing pressure in the alveolus
T-surface tension of the alveolus
**this refers to the surface tension of the alveolus
78
Q

What is the advantage & the disadvantage to a small alveolus?

A

Advantage to a small alveolus: larger surface area relative to volume–better for gas exchange
Disadvantage to a small alveolus: higher collapsing pressure

79
Q

What is surfactant made up of? What about its nature allows it to reduce surface tension?

A

Phospholipids

amphipathic

80
Q

When a baby doesn’t have surfactant b/c they are premature what syndrome is this called? What happens?

A

Neonatal Respiratory Distress Syndrome

Atelectasis: the collapsing of alveoli

81
Q

What is atelectasis? What is it considered? What does it cause?

A

Shunt

Hypoxemia

82
Q

A baby born before week ____ will surely lack surfactant. A baby born after week ____ will probably have sufficient surfactant. A baby born b/w these weeks will have an uncertain surfactant status.

A

before week 24

after week 35

83
Q

Aside from reducing surface tension, what does surfactant do?

A

It increases lung compliance.

It makes it less difficult to breathe.

84
Q

What essentially drives breathing? What equation represents this?

A 
Pressure difference. This promotes airflow.
Q=deltaP/R
Q is airflow
P is pressure difference
R is resistance to airflow
85
Q

What equation represents resistance to airflow? What is the most powerful variable here?

A

R=8nl/pir^4.

Radius is the most powerful influence here.

86
Q

Which part of the airway causes the greatest resistance? Why?

A

Medium-size bronchi b/c the smaller the greater the resistance.
However, the smallest bronchi are arranged in parallel, & therefore do not have a great resistance.

87
Q

What effects would muscarine or carbachol have?

A

They are muscarinic agonists.
This would promote parasympathetic effect on the smooth muscle of the bronchi. This would constrict them & increase airway resistance.

88
Q

What effects would atropine have on the airway?

A

This is a muscarinic antagonist.
This would block the parasympathetic effect on the smooth muscle of the bronchi. This would prevent constriction. This would decrease airway resistance.

89
Q

What effect does lung volume have on airway resistance?

A

High lung volume causes greater traction & decreases airway resistance.
This is sometimes a compensatory mechanism of asthmatics. They breathe higher lung volumes, which decreases their airway resistance from environmental irritants.

90
Q

If viscosity of inspired air increased like with deep sea diving…what would happen to airway resistance? What if it decreased like with inhaling helium?

A

Increased viscosity of air: increased airway resistance

Decreased viscosity of air: decreased airway resistance

91
Q

What are the 3 phases of the breathing cycle?

A

Rest, Inspiration, Expiration

92
Q

At rest what is the volume in the lungs?

A

FRC

93
Q

At rest what is the alveolar pressure?

A

equal to the atmospheric pressure

94
Q

At rest what is the intrapleural pressure?

A

-5 cmH20

95
Q

At rest what is the transmural pressure?

A

+5 cmH2O

Alveolar greater than intrapleural

96
Q

What prompts inspiration?

A

the contraction of the diaphragm

97
Q

What is the effect of the contraction of the diaphragm?

A

The volume of the thorax increases
the volume of the lungs increases
the lung pressure decreases
air can flow in.

98
Q

How much air flows in during inspiration normally?

A

0.5L or the tidal volume.

99
Q

Half way through inspiration, what is the alveolar pressure? At this point what is the intrapleural pressure?

A

Less than atmospheric pressure

Even more negative intrapleural pressure than during rest

100
Q

At the end of inspiration, what is the alveolar pressure?

A

equal to atmospheric pressure

101
Q

At the end of inspiration, what is the volume in the lungs?

A

FRC + Tidal volume

102
Q

What is dynamic compliance?

A

the extent to which intrapleural pressure changes during inspiration

103
Q

What happens to the transmural pressure during inspiration?

A

It becomes more positive.

Alveolar is greater than intrapleural (mainly b/c intrapleural is so negative)

104
Q

Normally expiration is a ____ process. this happens as ______ pressure becomes _____. ____ reacts b/c of the larger volume & air flows out. The end volume is ______. The expired volume = ______.

A 
passive
alveolar pressure becomes positive
elastic recoil 
end volume is FRC
expired volume is tidal volume
105
Q

What causes forced expiration?

A

expiratory muscles contractions…causes very positive pressures

106
Q

What is forced expiration like in normal lungs?

A

This makes values super positive.

Intrapleural & Transmeural pressures are positive.

107
Q

What is forced expiration like in emphysema patients’ lungs?

A

Elastic fibers are lost.
Lung compliance is increased.
The alveolar & airway pressures are lower.
Transmural pressure is positive in the alveoli.
Transmural pressure is negative in the large airways.
thus, the airways can collapse & make expiration difficult.
Thus, patients often purse their lips & expire slowly.

108
Q

What is the water vapor pressure?

A

47 mmHg

Block 2; Week 7 (2 decks)

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