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Applied Physiology > Pulmonary physiology > Flashcards

Pulmonary physiology Flashcards

1
Q

What is the purpose respiratory system overview?

A

-Maintain systemic arterial blood gas levels
-O2 uptake and CO excretion=O2 use and CO production by cellular respiration

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2
Q

Ventilation

A

the amount of air moved in or out of the lungs per minute

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3
Q

tidal volume

A

amount of air moved per breath (during normal respiration)

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4
Q

what is the normal breathing frequency

A

12-20

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5
Q

What are the four steps of respiration

A
  1. pulmonary ventilation
  2. alveolar gas exchange
  3. gas transport
  4. systemic gas exchange
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6
Q

what is pulmonary ventilation

A

Air containing O2 coming into lungs
air containing CO2 going out of the lungs

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7
Q

What is alveolar gas exchange

A

O2 moves into blood and CO moves into alveoli

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8
Q

What is gas transport

A

blood containing O2 towards tissues
blood containing CO2 towards lungs

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9
Q

What is systemic gas exchange

A

O2 moves into systemic cells
CO2 moves into blood

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10
Q

Ventilation is synonymous with perfusion?

A

False

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11
Q

What is the alveolar vs dead space ventilation

A

-alveolar ventilation is also where gas exchange occurs
-dead space ventilation is purely ventilation

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12
Q

what is perfusion of the lungs

A

the amount of O2/blood brought to the lungs

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13
Q

What are the muscles of inspiration?

A

Diaphragm (descends during contractions to increase volume)

Accessory:
-sternocleidomastoid
-scalenes
-external/internal intercostal

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14
Q

What are the muscles of expiration?

A

Accessory muscles (at rest it is passive)
-internal intercostals
-external abdominal oblique
-transverse abdominis
rectis abdominis

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15
Q

What are the pressures that influence respiration

A

atmospheric pressure
alveolar pressure
intra pleural perssure

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16
Q

What are the conducting zones of the lungs

A

Trachae
primary bronchus
bronchial tree
terminal bronchioles

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17
Q

What are the respiratory zones of the lungs

A

Respiratory bronchioles
alveolus

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18
Q

What is Boyle’s law

A

volume of a gas varies inversely with its pressure

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19
Q

What is Dalton’s law

A

each gas in a mixture exerts a partial pressure that is proportional to its concentration

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20
Q

What is Charles’ law

A

gas volume and temperature are directly related

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21
Q

Henry’s law

A

volume of dissolved gas is proportional to partial pressure

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22
Q

Apnea

A

no breathing

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23
Q

bradypnea va tachypnea

A
  1. <10
  2. > 20
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24
Q

hypoventilation

A

inadequate ventilation results in increased material PCO2 - hypercardbia/hypercapnia (increased CO2 levels)

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25
Q

hyperventilation

A

excessive ventilation results in decreased arterial PCO2- hypocarrbia/hypocapnia (why you breath in a bag)

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26
Q

dsypnea

A

subjective sensation of Short of breath

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27
Q

Tidal volume

A

amount of air inhaled or exhaled in one breath during quiet breathing

28
Q

Inspiratory reserve volume (IRV)

A

amount of air in excess of tidal volume that can be inhaled with maximum effort (extra air in)

29
Q

expiratory reserve volume (ERV)

A

amount of air in excess of tidal volume that can be exhaled with maximum effort (extra air out)

30
Q

residual volume (RV)

A

amount of air remaining in the lungs after maximum expiration; that is the amount of air that can never be voluntarily exhaled

31
Q

Vital capacity (VC)

A

amount of air that can be forcefully exhaled following a maximum inspiration (VC=ERV+TV+IRV)

32
Q

Inspiratory capacity (IC)

A

maximum amount of air that can be inhaled following a normal expiration (IC=TV+IRV)

33
Q

Functional residual capacity (FRC)

A

amount of air remaining in the lungs following normal expiration (RV+ERV)

34
Q

Total lung capacity (TLC)

A

maximum amount of air in the lungs at the end of a maximum inspiration (TLC=RV+VC)

35
Q

what drives air flow

A

pressure gradients between mouth and alveolar

36
Q

what contributes to the work of breathing

A

compliance and resistance
(compliance is the ability to inflate the lungs or chest-elastic property)
(resistance is the gas flow along the airway)

37
Q

Where is the best compliance

A

resting lung volume or FRC

38
Q

What are the requirements for O2 to move from air to cells (systemically)

A

-ventilation of perfused alveoli with atmospheric O2 (air coming into alveoli)
-diffusion of O2 and binding to hemoglobin
-balance between ventilation and perfusion (needs time to bind to hemoglobin
-adequate blood flow to tissues
-unloading of O2 from hemoglobin

39
Q

Describe regional differences in perfusion(V/Q)

A

at the bas of the lung blood flow>ventilation (V/Q<1.0)
at the apex of the lung ventilation< blood flow (V/Q>1.0)

40
Q

What happens when alveolar pressure is greater than the arterial and venous pressure,

A

perfusion is prevented (zone 1)

41
Q

What happens when alveolar pressure is greater than venous but not arterial

A

blood flow is impeded (but not stoped) (zone 2) the optimal spot

42
Q

what happens when arterial and venous pressures are greater than alveolar

A

blood flows freely (zone 3)

43
Q

Describe the oxygen-hemoglobin dissociation curve

A

-this is how much O2 is bound to hemoglobin due to partial pressure
Rule of thumb:
-40 mmHg = 70% O2 sat
-50 mmHg=80%O2 sat
-60 mmHg = 90% O2 sat

44
Q

what happens when there is a rightward shift in the oxygen-hemoglobin dissociation curve

A

there is decrease in O2 sat and O2 gets released to tissues at a higher pressure (gets released quicker = lower affinity)

45
Q

what happens when there is a leftward shift in the oxygen-hemoglobin dissociation curve

A

there is an increase in O2 sat and O2 gets released at lower pressures (affinity increases)

46
Q

How does CO2 get transported

A

-dissolved in plasma
-Co2+H2O (carbonic anhydrase) –> H2CO3 –> HCO3- + +H

47
Q

compare myoglobin and hemoglobin dissociation curves

A

myoglobin has a higher O2 affinity and therefore is towards the left and is also steeper (myoglobin unloads at lower pressures- meaning that it takes a huge drop in pressure for O2 to be released)

48
Q

How does the pulmonary system work for acid-base balance

A

-pulmonary ventilation removes H+ from blood by the HCO3- reaction
-increased ventilation and decreased ventilation
-exhaling gets rid of H+/CO2

49
Q

what are the effects of pH on Oxygen hemoglobin dissociation curve

A

-a drop in pH results in the Bohr effect meaning that hemoglobins affinity for O2 decreases
-a raise in pH will result in a left shift meaning that hemoglobin has a higher O2 affinity

50
Q

what are the effects of Temperature and 2,3-DPG

A
  • a decrease in Temperature causes a left shift (more loading/higher affinity)
    -an increase in temperature causes a right shift (more unloading/lower affinity)
51
Q

Where is breathing initiated

A

medulla and pons initiate the breathing pattern

52
Q

What are inputs to the medulla and pons

A

-negative feedback to maintain arterial Pco2 and PO2 and pH
-sensory feedback regarding mechanical state of lung and chest wall (what’s the expansion)
-sensory receptors feedback from joints and muscles
-sympathetic nervous system integration (breathing with talking and swallowing)
-conscious control (can over rule)

53
Q

Explain central chemoreceptors and peripheral chemoreceptors

A

central chemoreceptors: ventral surface of medulla and they respond to changes in CSF not blood pH (CO2 concentration)

peripheral chemoreceptors: in carotid bodies of common carotid and aortic bodies in aortic arch (O2 and pH)

54
Q

how do the chemoreceptors control ventilation

A

-by O2 and pH by the peripheral chemoreceptors
-by CO2 is through central chemoreceptors

55
Q

Increase in ventilation is initiated by

A

-increase in arterial pCO2 or decrease in arterial pO2
-reduced arterial blood pH (increase acidity)
-arterial CO2 predominates this control
-PO2 must drop below 60 mmHg to have significant influence in ventilation

56
Q

acidemia stimulates

A

hyperventilation to reduce H+

57
Q

alkalemia stimulates

A

hypoventilation but only slightly affects ventilation because the result would be an increased arterial pCO2 which Is prevented by the feedback described above

58
Q

what are some other examples of peripheral input

A

-stretch receptors In airway (mechanoreceptors (can initiate hearing-breuer reflex - increases breathing frequency to prevent hyperinflation and get rid of excess air)
-pulmonary J receptors in blood vessels (initiate increased ventilation from lung edema)
-input from muscles and joints (sends input about workload)

59
Q

What happens to respiratory muscles during exercise

A

-diaphragm becomes the generator of flow and controls the volume
-the rib cage muscles control the pressure

60
Q

explain the effects of exercise on ventilation in transition from rest to sub maximal exercise like walking ?`

A

-pulmonary ventilation increase rapidly as the start of exercise before plateauing due to a plateau of O2 and CO2 concentrations

61
Q

What are the effects of exercise on ventilation in hot/humid evnironments?

A

during prolonged sub maximal exercises ventilation drifts upward during prolonged activity
(ventilation gradually increases even though CO says around the same)

62
Q

Explain the difference between an untrained athlete and a trained athlete in their response to incrememntal exercise?

A

-for trained athletes ventilation increases linearly as O2 uptake increases until about 75% of O2 max and then it increases exponentially
-arterial PO2 decreases 30-40 mmHG at near maximum exercise levels in 40-50% of athletes
-Untrained maintain arteiral O2 within 10-12 mmHG of resting levels
-pH drops significantly in untrained athletes
-overall it takes a higher intensity for trained athletes to increase exponentially

63
Q

What is the effect of rising PCO2 on ventilation

A

a direct linear relationship, (increase in ventilation)

64
Q

effects of decreases in arterial PO2 on minute ventilation

A

-as O2 levels drop respiration raises
-arterial PO2 changes do not significantly affect ventilation until arterial PO2 reaches the hyopxic threshold (60-75mmHg)`
-K+ can also trigger the carotid bodies and impact ventilation rate

65
Q

Effects of training on exercise ventilation

A

-endurance trained athletes have about 20-30% reduction in exercise ventilation rates
-can be due to aerobic capacity changes in skeletal muscle which decreases the amount of H+ and signals from the muscle receptors
-together this dulls the response of the central respiratory center to increase ventilation
-trained athletes take more intensity to get to Vo2 max

66
Q

what is the ventilatory threshold

A

the point in which a trained athlete starts to increase exponentially

Applied Physiology (15 decks)

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