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KIN 335 > Pulmonary Review > Flashcards

Pulmonary Review Flashcards

1
Q

What are the structural components of the pulmonary system above the Trachea?

A
  • Trachea
  • Cartilage
  • Larynx
  • Epiglottis
  • Pharynx
  • Oral Cavity
  • Nasal Passage
  • Frontal Sinus
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2
Q

What are the structural components of the pulmonary systems below the trachea and above the bronchioles?

A
  • Ribs
  • Lungs
  • Superior Lobe
  • Bronchi
  • Bronchioles
  • Diaphragm
  • Heart
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3
Q

What are the structural components of the pulmonary system after the bronchioles?

A
  • Respiratory Bronchioles
  • Smooth Muscles
  • Pulmonary Artery
  • Pulmonary Vein
  • Alveoli
  • Capillary Beds Cover All Alveoli
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4
Q

Describe the Alveoli Structure

A
  • Alveolar Ducts
  • Alveolar Sac
  • Alveolar Pores
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5
Q

Describe the Alveolar Cells Structure

A
  • Collagen Fibril
  • Elastic Fibers
  • Basal Lamina
  • Macrophage
  • Type 1
  • Type 2
  • Fibroblast
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6
Q

Describe what happens at the capillary and alveolar membrane

A
  • Alveolus
  • Alveolar Membrane
  • Capillary
  • Deoxygenated blood into capillaries
  • Oxygenated blood out of capillaries
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7
Q

How many zones do the ventilation zones consist of?

A
  • 0-23
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8
Q

What zones does the conducting zone consist of?

A
  • 0-16
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9
Q

What components of the pulmonary system make up the conducting zones?

A
  • Trachea: 0
  • Primary Bronchus: 1
  • Bronchus: 2 & 3
  • Bronchi: 4 - 10
  • Bronchioles: 11 - 16
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10
Q

What components of the pulmonary system make up the transitional and respiratory zones?

A
  • Respiratory Bronchioles: 17, 18, 19
  • Alveolar Ducts: 20, 21, 22
  • Alveolar Sacs: 23
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11
Q

What does Fick’s Law of Diffusion govern?

A
  • Gas Diffusion across a fluid membrane
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12
Q

What is the equation for VE?

A
  • VE = breathing rate x tidal volume
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13
Q

How can VE be increased?

A

Increase
- breathing rate
or
- breathing depth
or
- both

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14
Q

How high does the breathing rate increase in a healthy young adult during strenuous exercise? what about for elite endurance athletes?

A

Young Adult
- 35-40 breaths/min
Endurance Athlete
- 60-70 breaths/min

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15
Q

What % of vital capacity does tidal volume rarely exceed for trained and untrained individuals?

A
  • 60%
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16
Q

Explain how gas diffuses through a sheet of tissue.

A

At a rate
- directly proportional to tissue area, a diffusion constant, and pressure differential of the gas on each side of the membrane
- Inversely proportional to tissue thickness

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17
Q

What does the pressure differential between air in the lungs and lung-chest wall interface cause?

A
  • Lungs to adhere to the chest wall
  • Follow its every movement
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18
Q

What is minute ventilation?

A
  • Volume of air breathed each minute
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19
Q

Define Anatomical Dead Space

A
  • Air in each breath that does NOT enter alveoli
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20
Q

What does anatomical dead space not participate in?

A
  • Gaseous exchange with blood
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21
Q

What is the approximate volume of anatomic dead space?

A
  • 150-200mL
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22
Q

Define Alveolar Ventilation

A
  • Portion of inspired air that reaches the alveoli
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23
Q

What does alveolar ventilation participate in?

A
  • Gas exchange
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24
Q

What determines the gaseous concentration at the alveolar-capillary membrane?

A
  • Alveolar Ventilation
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25
Q

What is the approximate range of alveolar ventilation at rest?

A
  • 350mL
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26
Q

What enters into and mixes with existing alveolar air at rest?

A
  • 350mL of inspired Tidal Volume
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27
Q

What are the typical pulmonary ventilation values during rest?

A

Breathing Rate (breaths/min)
- 12
Tidal Volume (L/min)
- 0.5
Pulmonary Ventilation (L/min)
- 6

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28
Q

What are the typical pulmonary ventilation values during moderate exercise?

A

Breathing Rate (breaths/min)
- 30
Tidal Volume (L/min)
- 2.5
Pulmonary Ventilation (L/min)
- 75

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29
Q

What are the typical pulmonary ventilation values during intense exercise?

A

Breathing Rate (breaths/min)
- 50
Tidal Volume (L/min)
- 3.0
Pulmonary Ventilation (L/min)
- 150

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30
Q

Define the Ventilation-Perfusion (V-P) Ratio

A
  • The ratio of alveolar ventilation to pulmonary blood flow
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31
Q

How much air ventilates alveoli each min at rest?

A
  • 4.2L
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32
Q

How much blood flows through pulmonary capillaries each minute at rest?

A
  • 5L
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33
Q

What is the average V-P ratio? What does it mean?

A

Average
- 0.84
Mean
- 0.84L alveolar ventilation matches 1L of pulmonary blood flow

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34
Q

What is the average concentration of gases in ambient air?

A

O2
- 20.93%
N2
- 79.04%
CO2
- 0.03%

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35
Q

What does the body’s supply of oxygen depend on?

A
  • Concentration of Gases in Ambient Air
  • Partial Pressure of Gases in Ambient Air
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36
Q

Define Partial Pressure

A
  • Molecules of each specific gas in a mixture of gases exert their own partial pressure
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37
Q

What is the equation for partial pressure?

A

% concentration of a specific gas / total pressure of gas mixture

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38
Q

What is the partial pressure of Oxygen in dry ambient air at sea level?

A

20.93% of 760mmHg
- 159mmHg

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39
Q

What is the partial pressure of Carbon Dioxide in dry ambient air at sea level?

A

0.03% of 760mmHg
- 0.2mmHg

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40
Q

What is the partial pressure of Nitrogen in dry ambient air at sea level?

A

79.04% of 760mmHg
- 600mmHg

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41
Q

What happens to Tracheal Air?

A
  • Completely saturates with water vapor as it enters nasal cavities, mouth, and down respiratory tract
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42
Q

What is the result of the humidification of the tracheal air?

A
  • Effective PO2 in tracheal air decreases by 10mmHg from ambient value
  • From 159mmHg to 149mmHg
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43
Q

What kind of effect does humidification exert on Pco2? Why?

A

What
- Negligible
Why
- Little contribution to inspired air

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44
Q

How does alveolar air composition differ from incoming breath of moist ambient air?

A
  • CO2 continually enters alveoli from blood
  • O2 continually enters blood from the alveoli
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45
Q

What are the values of alveolar air?

A

O2
- 14.5%
CO2
- 5.5%
N2
- 80%

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46
Q

What are the average pressures exerted by O2 and CO2 against the alveolar side of the alveolar-capillary membrane?

A

PO2
- 103mmHg
PCO2
- 39mmHg

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47
Q

Define Henry’s Law

A
  • Mass of a gas that dissolves in a fluid at a given temperature varies in direct proportion to pressure of the gas over the liquid
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48
Q

What two factors govern the rate of gas diffusion into a fluid?

A
  • Pressure differential between gas above the fluid and gas dissolved in the fluid
  • Solubility of gas in the fluid
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49
Q

What is the equation for the Quantity of gas (mL/dL)?

A

Quantity of gas (mL/dL) = solubility coefficient x (gas partial pressure/total barometric pressure)

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50
Q

How does O2 travel?

A

From higher to lower pressure
- as it dissolves and diffuses through the alveolar membrane into blood

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51
Q

What causes a net diffusion of CO2 from the blood to the lungs?

A
  • Higher pressure in returning venous blood than in alveoli
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52
Q

What happens to Nitrogen in alveolar-capillary gas?

A
  • Remains Essentially unchanged
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53
Q

How quickly does alveolar gas-blood equilibrium change?

A
  • 0.25s
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54
Q

What is the PO2 in fluid outside a muscle cell at rest?

A
  • 40mmHg
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55
Q

What is the PCO2 in intracellular fluid at rest?

A
  • 46mmHg
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56
Q

What does the PO2 in active fall to during vigorous exercise?

A

towards
- 0mmHg

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57
Q

What does the PCO2 in active muscle approach during vigorous exercise?

A
  • 90mmHg
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58
Q

What establishes the diffusion gradient?

A
  • Pressure differences between gases in plasma and tissues
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59
Q

Which direction does O2 and CO2 travel in diffusion?

A

O2
- From blood towards cells
CO2
- From cells towards blood

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60
Q

What does blood do after CO2 flows from the cells into it?

A
  • passes into the venous circuit for return to the heart and delivery to the lungs
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61
Q

What does Alveolar Ventilation couple with? Why?

A

Couples With
- Metabolic demand
Why?
- maintain constant alveolar gas composition

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62
Q

What happens to alveolar gas concentration during strenuous activity?

A

Maintains
- Increases VO2 and VCO2 output
- 25x resting values

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63
Q

What two ways does blood transport oxygen?

A
  • Dissolved in fluid portion of blood
  • In loose combination with hemoglobin
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64
Q

What is hemoglobin?

A
  • Iron-containing globular protein pigment within red blood cells
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65
Q

What keeps oxygen’s concentration low within body fluids?

A
  • Oxygen’s relative insolubility in water
66
Q

What are the functions of O2 transported in physical solutions?

A
  • Establishes Po2 of plasma and tissue fluids
  • Helps to regulate breathing, particularly at altitude
  • Determined O2 loading of hemoglobin in lungs and release in tissues
67
Q

How much O2 does hemoglobin carry compared to plasma?

A
  • 65-70 times more
68
Q

How many iron atoms are in hemoglobin molecules?

A
  • 4
69
Q

How many Oxygen molecules can each of the Iron atoms in hemoglobin loosely bind to?

A
  • 1 per Iron molecule
70
Q

What dictates the oxygenation of hemoglobin to oxyhemoglobin?

A
  • Partial pressure of O2
71
Q

Describe the structure of the hemoglobin molecule

A

Protein Globin composed of 4 subunit polypeptide chains:
- Beta Polypeptide Chains
- Alpha Polypetide Chains
- Iron Atom
- O2

72
Q

What does a single polypeptide contain?

A
  • Single heme groups with a single iron atom
  • Iron atom acts as oxygen magnet
73
Q

What is the oxygen-carrying capacity of hemoglobin?

A

Men = 15g Hb/dL blood
Women = 14g Hb/dL blood

74
Q

How much O2 can each gram of Hb combine with?

A
  • 1.34mL of O2
75
Q

At full O2 saturation and normal Hb levels, how much O2 does Hb carry per dL of blood?

A
  • 20mL
76
Q

What is the equation for Blood’s O2 Capacity?

A

Blood O2 Capacity = Hb x Hb O2 Capacity

77
Q

Draw the Oxyhemoglobin Dissociation Curve

A
  • Check with Notes
78
Q

What is the oxygen transport cascade?

A
  • Changing partial pressures of O2 as it moves from ambient air at sea level to the mitochondria of maximally active muscle tissue
79
Q

Draw the Oxygen Transport Cascade

A
  • Check with Notes
80
Q

Explain the Bohr Effect

A
  • Any increase in plasma acidity and temperature causes the oxyhemoglobin dissociation curve to shift downward and to the right
81
Q

When does the reduced effectiveness of hemoglobin to hold O2 occur?

A

PO2 range of:
- 20-50mmHg

82
Q

What alters hemoglobin’s molecular structure to decrease its O2-binding affinity?

A
  • [H+]
  • CO2
83
Q

When does the Bohr effect predominate?

A
  • during intense exercise
  • As more O2 releases to tissue
84
Q

Why does more O2 release to tissue during intense exercise?

A

Associated increases in:
- Metabolic Heat
- CO2
- ACididty
(from blood lactate accumulation)

85
Q

What does Po2 average in cell fluid during rest?

A
  • 40mmHg
86
Q

What does an average Po2 of 40mmHg make dissolved O2 from plasma do?

A
  • diffuse across capillary membranes through tissue fluid into cells
87
Q

What causes Hb to lower its O2 saturation level?

A
  • Reduced plasma PO2 below PO2 in red blood cells
88
Q

How does O2 release out of blood cells?

A
  • Through the capillary membrane into tissues
89
Q

What does the a-vO2 difference describe?

A
  • The difference between the oxygen content of arterial blood and mixed-venous blood
90
Q

What does the a-vO2 difference average?

A
  • 4-5mL O2/dL blood
91
Q

Can O2 release from Hb without any increase in local tissue blood flow?

A
  • Yes
92
Q

By how much does O2 released to muscles increase during vigorous exercise?

A
  • by 3 times resting levels
93
Q

What does active muscle’s uncompromising capacity to use available O2 in its large blood flow support?

A
  • O2 supply, not muscle O2 use, limits aerobic exercise capacity.
94
Q

How does a red blood cell get its energy? Why?

A

How
- Anaerobic Glycolysis
Why
- Contains no mitochondria

95
Q

What does the red blood cell produce when it makes energy from anaerobic glycolysis?

A
  • compound 2,3-diphosphoglycerate (2,3-DPG)
96
Q

What does 2,3-DPG bind to?

A
  • subunits of Hb
97
Q

What does 2,3-DPG binding with subunits of Hb do? what does this cause?

A

Reduces Hb’s affinity for O2
- greater O2 release to tissues for given decrease in PO2

98
Q

When does increased levels of red blood cell 2,3-DPG occur?

A
  • Cardiopulmonary disorders
  • Those who live at high altitude to facilitate O2 release
99
Q

When does 2,3-DPG aid in O2 transfer to active muscles?

A
  • During Strenuous exercise
100
Q

What provides the only means for escape for CO2 once it forms?

A
  • Diffusion and subsequent transport in venous blood through lungs
101
Q

What three ways does blood carry CO2?

A
  • In physical solution in plasma
  • Combined with hemoglobin within red blood cells
  • Plasma Bicarbonate
102
Q

Explain and draw the pathway of CO2 leaving the body

A
  • Check with Notes
103
Q

What does CO2 in solution form when combined with water?

A
  • Carbonic Acid
  • CO2 + H2O —- H2CO3
104
Q

What happens once carbonic acid forms in tissues?

A
  • Most ionizes into hydrogen ions [H+] and bicarbonate ions [HCO3-]
105
Q

What % of CO2 exists in plasma bicarbonate?

A
  • 60-80%
106
Q

What enzyme catalyzes the bicarbonate buffer system?

A
  • Carbonic Anhydrase
107
Q

At the tissue level, when do carbamino compounds form?

A
  • When CO2 reacts directly with the amino acid molecules of blood protein
108
Q

What part of the Hb forms a carbamino compound?

A
  • Globin Portion of Hb
109
Q

How much CO2 does Globin carry?

A
  • 20% of the body’s CO2
110
Q

Describe the Haldane Effect

A
  • A decrease in plasma Pco2 in the lungs reverses carbamino formation
111
Q

What does a decrease in plasma Pco2 in the lungs that reverses carbamino formation do? When does this happen?

A

Causes
- CO2 moves into the solution and enter the alveoli
When
- Oxygenation of hemoglobin reduces its ability to bind CO2

112
Q

What does the Haldane Effect describe?

A
  • The ability of hemoglobin to carry increased amounts of CO2 in the deoxygenated state as opposed to the oxygenated state
113
Q

What does buffering mean in the pulmonary system?

A
  • Chemical and physiologic mechanisms to minimize changes in H+ concentration
114
Q

What does the pH of body fluids range from?

A
  • As low as 1.0 to 7.45
115
Q

Define Alkalosis

A
  • Decrease in H+ Concentration
116
Q

Define Acidosis

A
  • Increase in H+ concentration
117
Q

What mechanisms regulate internal pH?

A
  • Chemical Buffers
  • Pulmonary Ventilation
  • Renal Function
118
Q

What do chemical buffers consist of?

A
  • Weak acid and salt of that acid
119
Q

What does the buffering reaction produce when H+ concentrations remain elevated?

A
  • Weak Acid
120
Q

What does the buffering reaction do when H+ concentrations decrease?

A
  • Releases H+
121
Q

What are the Chemical Buffers?

A
  • Bicarbonate Buffer
  • Phosphate Buffer
  • Protein Buffer
122
Q

What does the Bicarbonate Buffer system consist of?

A
  • Carbonic Acid (H2CO3) and Sodium Bicarbonate (NaHCO3)
123
Q

What happens during bicarbonate buffering?

A
  • Hydrochloric Acid (HCL) converts to carbonic acid by combining with sodium bicarbonate
124
Q

What is the chemical equation for the bicarbonate buffer system?

A

HCL + NaHCO3 –> NaCl + H2CO3 <—> H+ + HCO3-

125
Q

What does the buffering of HCL produce?

A
  • small decrease in pH
126
Q

What does sodium bicarbonate have with lactic acid? What does it form?

A

Strong buffering action
- forms sodium lactate and carbonic acid

127
Q

What does additional H+ increase from carbonic acid dissociation cause?

A
  • Dissociation reaction to move to the opposite direction to release CO2 into solutions
128
Q

What stimulates VE? What does it do?

A

An increase in plasma CO2 and H+ concentration
- eliminates excess CO2

129
Q

When does the body produce greater amounts of hydrogen ions [H+]?

A

During Exercise

130
Q

What does an increase in H+ ions during exercise do?

A
  • Decreases performance
131
Q

How does the sodium bicarbonate buffer system protect exercise performance?

A
  • Buffers acids by binding with them
  • Can prolong energy metabolism in the muscle cells during exercise
132
Q

What does the buffering of Hydrogen Ions [H+] during exercise by the sodium bicarbonate buffer system do?

A
  • prolongs energy metabolism in muscle cells
  • Translates to more sustained power output
133
Q

What does the increase in extracellular fluid and plasma H+ concentration stimulate?

A
  • Respiratory center to increase alveolar ventilation
  • Reduce alveolar Pco2 and cause CO2 blow off
134
Q

What does reduced CO2 in plasma accelerate?

A
  • Recombination of H+ and HCO3-
  • Lowers H+ concentration in plasma
135
Q

Describe the Renal Buffer system

A
  • Renal tubules regulate acidity
  • Complex chemical reactions secrete ammonia
  • H+ into urine & reabsorb alkali, chlorine, and bicarbonate
136
Q

What complex mechanisms adjust breathing rate and depth to the body’s metabolic needs?

A
  • Intrinsic Neural Circuits
  • Gaseous and Chemical States
137
Q

Describe the Intricate Neural Circuits that adjust breathing rate and depth to the body’s metabolic needs

A
  • Relay information from higher brain centers, lungs, and other bodily “sensor” to coordinate ventilatory control
138
Q

Describe how Gaseous and chemical states adjust breathing rate and depth to body’s metabolic needs

A
  • Blood bathes the medulla and aortic and carotid artery chemoreceptors
139
Q

What do control mechanisms maintain for pulmonary ventilation?

A
  • relatively constant alveolar gas pressures throughout a broad range of exercise intensities
140
Q

When does the blood’s chemical state exert the greatest control on pulmonary ventilation?

A
  • At Rest
141
Q

What do variations in arterial Po2, Pco2, pH, and temperature activate?

A
  • Sensitive neural units in the medulla and arterial system
142
Q

What does the activation of sensitive neural units in the medulla and arterial system from variations in arterial Po2, Pco2, pH, and temperature do?

A
  • Adjust ventilation and maintain arterial blood chemistry within narrow limits
143
Q

What control’s the sensitivity to reduced O2 pressure?

A
  • Peripheral chemoreceptors
144
Q

What monitors the state of arterial blood just before it perfuses brain tissues?

A
  • Carotid bodies
145
Q

What does decreased arterial Po2 increase? how?

A

What
- Alveolar Ventilation
How
- Stimulation of aortic and carotid chemoreceptors

146
Q

What do aortic and carotid chemoreceptors protect against?

A
  • Reduced oxygen pressure in inspired air
147
Q

When do aortic and carotid chemoreceptors become increasingly important?

A
  • In lung disease
  • In High-altitude exposure
148
Q

What do increases in temperature, acidity, CO2, and potassium concentrations do?

A
  • Read by peripheral chemoreceptors that stimulate ventilation during exercise
149
Q

What does peripheral chemoreceptors defend against?

A
  • Arterial hypoxia in pulmonary disease
  • Ascent to higher altitudes
150
Q

What do peripheral chemoreceptors help with?

A
  • Regulate exercise hyperpnea
151
Q

What provides an important respiratory stimulus at rest?

A
  • Pco2 in arterial plasma
152
Q

What can small increases in Pco2 in inspired air trigger?

A
  • Large increases in minute ventilation
153
Q

What does plasma acidity vary with?

A
  • blood’s CO2 content
154
Q

What does variations in plasma acidity exert strong command over?

A
  • Ventilation
155
Q

What does a fall in blood pH signal? What does it reflect?

A

Signals
- Acidosis
Reflects
- CO2 retention
- Carbonic Acid Formation

156
Q

What happens as arterial pH declines and H+ accumulates?

A
  • inspiratory activity increases to eliminate CO2
  • Reduce arterial levels of carbonic acid
157
Q

What makes pH regulation progressively more difficult?

A
  • Increased H+ concentration from CO2 production and lactate formation during strenuous exercise
158
Q

When does acid-base regulation become difficult?

A
  • Repeated, brief bouts of all-out exercise that elevates blood lactate values > 30mM
159
Q

When humans tolerate pronounced disturbances in acid-base balance during maximal exercise?

A
  • Temporarily
160
Q

What can a plasma pH <7.0 cause?

A
  • Nausea
  • Headache
  • Dizziness

KIN 335 (12 decks)

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