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Lecture Notes - Instructor Adelson > Quiz 3 Neurology and Pulmonology > Flashcards

Quiz 3 Neurology and Pulmonology Flashcards

1
Q

Nervous System

A

Control system of body

Broken down into two major categories CNS and PNS

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2
Q

Central Nervous System - CNS

is located in

A

Brain and Spinal Cord

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3
Q

Peripheral Nervous System - PNS

is

A

Everything else: including spinal nerves and cranial nerves

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4
Q

Peripheral Nervous system breaks down into

A

Efferent Division (Motor)

&

Afferent Division (Sensory)

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5
Q

Efferent Division

A

aka Motor Division

Information traveling from Brain and Spinal Column to other parts of the body

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6
Q

Afferent Division

A

aka Sensory Division

carries information from other parts of the body to the brain and spinal cord

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7
Q

Afferent Division breaks into (unofficial categories)

A

Visceral - Internal organs sensing change in internal organ

&

Somatic - relays “something” about the environment ie table is smooth, clothes soft etc. to the brain

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8
Q

Efferent Division breaks into

A

Somatic Nervous System (SNS)

&

Autonomic Nervous System (ANS)

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9
Q

Somatic Nervous System (SNS)

controls

A

Motor Control of Skeletal Muscle

Voluntary/Involuntary - includes reflexes

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10
Q

Autonomic Nervous System - ANS

breaks into

A

Sympathetic Division - generally stimulatory (neurotransmitter at postganglionic synapse is NE - norepinephrine primary neurotransmitter for adreginic receptor sites A1 - Vasoconstriction, ß1 Increase heart rate and force of contraction, ß2 bronchodialation)

&

Parasympathetic Division - generally rest & relax, ie digestion, slows heart rate, peripherial vasodialation

(neurotransmitter at pre & postganglionic synapse is ACh- Aceytlcholine is primary neurotransmitter for muscarnic/nicotinic receptor sites)

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11
Q

Autonomic Nervous System is responsible for

A

All Motor control that is involuntary, everything but skeletal muscle

ie. Cardiac, Smooth, glandular secretions etc

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12
Q

Hirearchy of Nervous System

A

Nervous System

  • CNS - Brain & Spinal Cord
  • PNS - Everything Else
    • Afferent - Sensory
      • Somatic -
      • Visceral -
    • Efferent - Motor
      • Somatic Nervous System - Voluntary
        • Corticospinal Pathway (Pyramidal)
        • Medial & Lateral Pathway (Extrapyramidal)
      • Autonomic Nervous System - Involuntary Actions
        • Sympathetic Division -
        • Parasympathetic Division -
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13
Q

Neuron

A

The functional unit of the nervous system

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14
Q

Dendrites

A

Where the neuron recieves the information

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15
Q

Synaptic Terminal

A

aka: Synaptic Knob, Bouton

Where information is sent out

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16
Q

Axon Hillock

A

All or nothing point of Neuron

If input is large enough to reach axon hillock, charge will procede down axon to Synaptic terminal

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17
Q

Synapse

Pre/Post Synaptic Neuron

Synaptic Cleft

Neurotransmitter

A

Synapse - Location where two neurons come together and share information

Presynaptic Neuron - sending of information via chemical neurotransmitter when elicited by action potential

Postsynaptic Neuron - dendrites recieve signal which excites/inhibits signal

Synaptic Cleft -gap between pre and post synaptic neurons

Neurotransmitter - specific chemical agent released by a presynaptic cell, on excitation, that crosses the synaptic gap to stimulate or inhibit the postsynaptic cell

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18
Q

Functional Classes of Neurons

A
  • Sensory Neurons
  • Motor Neurons
  • Interneurons
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19
Q

Sensory Neurons

A

Deliver information from perriphery via sensory receptors to the CNS

  • Composed of Afferent neuron fibers relaying:
    • somatic - sensing a change in external environment
    • visceral - sensing some change in internal organ
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20
Q

Motor Neurons

A

carry instructions from CNS to peripheral effectors

  • Somatic - Skeletal Muscle movement
  • Visceral - everything else - Cardiac Muscle - cardiac/smooth muscle; glandular,
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21
Q

Sympathetic VS Parasympathetic

A
  • Oppose each other in autonomic function

Homeostasis could be described as a balance between Parasympathetic (rest and digest) & Sympathetic (Fight of Flight)

  • Generally, the sympathetic nervous system releases a chemical called norepinephrine, which is excitatory to neurons, from its postsynaptic neurons.
  • The parasympathetic nervous system releases a chemical called acetylcholine from its postsynaptic neurons.
  • Originate from different locations at the base of the brain;
  • sympathetic preganglionic fibers tend to be shorter
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22
Q

Interneurons

A
  • Coordination of information between sensory and motor neurons
  • Located primarily in brain, redirect information so appropriate response occurs
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23
Q

3 components of homeostasis and their parallels in nervous system

A
  1. Receptor - Sensory Neurons
  2. Control Center - Interneurons
  3. Effector - Motor Neurons
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24
Q

Neuroglia

A

aka: Glia Cells/Supportive Cells

Glue that holds Nervous System together

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25
Q

4 Types of Neroglia in CNS

A
  1. Apendymal Cells
  2. Astrocytes
  3. Oligodendricytes
  4. Micro Glia
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26
Q

2 Types of Neroglia in PNS

A
  1. Schwann Cells
  2. Satellite Cells
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27
Q

Apendymal Cells

A
  • Belongs to CNS
  • Forms lining of central canal and ventricles where CSF is found
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28
Q

Astrocytes

A
  • Found in CNS
  • surround capillaries responsible for blood-brain barrier
  • regulate passage of “stuff” crossing into interstitial fluid between neurons
  • regulate ion concentrations in interstitial fluid
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29
Q

Oligodendrocytes

A
  • Blongs to CNS
  • Forms Mylein Sheath that is rolled around axon; flattened out like a pancake squeezing out cytoplasm
  • Membrane is primarily lipid that creates insulation
  • Internodes are the myelin sheath between Nodes of Ranvier - the space between oligodendrocytes
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30
Q

Microglia

A
  • Belong to CNS
  • Engulf cell debris and waste products
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31
Q

Schwann Cells

A
  • Belongs to PNS
  • PNS version of Oligodendrocytes
  • Myelin sheath that wraps peripherial axons
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32
Q

Satellite Cells

A
  • Belongs to PNS
  • PNS version of Astrocytes
  • Surround cellbodies of neurons and regulate exchange with interstitial environment
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33
Q

Chemical Gradient

A
  • Concentration Gradient based on the # of ions of a particular kind
  • each chemical has its own gradient and will look to equalize it own concentration
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34
Q

Leak Channels

A
  • Allow free movement of a particular ion in/out of a cell
  • Usually specific to one type of ion
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35
Q

Electrical Gradient

A
  • Exists alongside Chemical gradient
  • Electrical gradient may move chemical in/out based on charge of ECF vs ICF environment
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36
Q

Current

A
  • movement of charges to eliminate the potential difference
  • ie fixing the electrical or chemical gradients
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37
Q

Cell membrane as it relates to Current

A
  • Becomes a barrier that creates resistance by restricting the flow of current
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38
Q

Resistance

A
  • how much the barrier restricts the flow of current
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39
Q

Electrochemical Gradient

A

Sum of all Electrical and Chemical factors that determine the direction of ion flow

For example:

  • K+ wants to move out of the cell due to concentration gradient from Hi to Low; however because the presence of the Protein Anion and the overall negative charge inside the cell, the K+ is attracted, and wants to pass back into the cell.
  • Na+ wants to move into the cell due to concentration gradient between ECF and ICF; and the electrical gradient which is negative inside cell and attractive to Na+
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40
Q

Polarized

A

meaning with charge

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41
Q

Depolarized

A
  • adding positive charge
  • Becoming less negative
  • moving toward zero
  • change in ion flow ⇒ becoming more more positive
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42
Q

Hyperpolarized

A
  • When cell moves more negative towards resting potential
    *
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43
Q

Significance of Na+K+ in maintaining

resting membrane potential

A
  • Na+K+ Pump maintains the resting membrane potential across by pumping sodium out of the cell and potassium into cell against concentration gradients.
  • Enables cells ability to depolarize and propogate an electrical impule to the synapse
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44
Q

Graded Potential

A
  • propogated in a graded and decremental fashion
    • Propogated - Charge spreads outward in all directions
    • Graded - Vary in size in relation to size of chemical input
    • Decremental - decreases in size as it moves further from point of orgin
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45
Q

Action Potential

A
  • Propogated changes in transmembrane potential
  • once initiated it will affect the entire excitable membrane
  • All or nothing, must meet threshold @ axon hillock to initiate Action Potential all the way to Synapse
  • Not decremental or graded
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46
Q

Threshold

A

minimum stimulus required to form an action potential

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47
Q

Steps to the Formation of an Action Potential

A
  1. The presynaptic neuron sends neurotransmitters to postsynaptic neuron. (A chemical message)
  2. Once the threshold of excitation is reached (Axon Hillock) the neuron will fire an action potential.
  3. Na+ channels open and Na+ is forced into the cell by the concentration gradient and the
    electrical gradient. depolarizing the neuron.
  4. K+ channels open (@ -30mV) and K+ is forced out of the cell by the concentration gradient and the
    electrical gradient. The neuron continues to depolarize.
  5. The Na+ channels close at the peak of the action potential (+30mV). The neuron starts to repolarize. The K+ channels close, but they close slowly and K+ leaks out.
  6. The neurotransmitter is released to the postsynaptic neuron
  7. The resting potential(-70mV) is overshot and the neuron falls to a -90mV (hyperpolarized)
  8. The Na+/K+ pump then starts to pump 3Na+ ions out for every 2K+ ions it pumps in, some K+ leaks out synapse.
  9. The neuron returns to resting potential
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48
Q

Absolute Refractory Period

A
  • period of time when neuron is unavailable to refire
  • From time it leaves it’s resting potential -70mV, depolarizes yo +30mV and returns to -70mV
  • Like Toilet - the time when toilet is flushed until it has minimum amt. of water necessary to flush again.
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49
Q

Relative Refractory Period

A
  • Period of time after cell has depolarized and returned to initial resting potential; however cell is now in hyperpolarization phase and is not best suited for reconduction
  • Analogous to being able to flush the toilet before it is optimal to do so.
50
Q

Characteristics of Unmylenated Neurons

A
  • Continuously Propogatate - local current depolarizes adjacent membrane
  • Can’t travel backwards (True for all AP’s)
51
Q

Myelinated Neuron

A
  • Oligodendrocytes/Schwanns Cells that wrap around axon,
  • Produces salutatory conduction/propogation as nerve impulse jumps from node to node along signal path
52
Q

Two types of synapses

A
  • Electrical - does not require chemical nerotransmitter
  • Chemical - common in cardiac cells, requires use of nerotransmitter; *makes up majority of synapses
53
Q

Ionotropic

A
  • is a special kind of effect of a hormone on its target.
  • The hormone activates or deactivates ionotropic receptors (ligand-gated ion channels).
  • The effect can be either positive or negative, whether the effect is a depolarization or a hyperpolarization respectively.
54
Q

Metabotropic

A
  • effects some sort of metabolic activity inside the cell
  • ie. second messengers are molecules that relay signals from receptors on the cell surface to target molecules inside the cell
55
Q

Arrival at the synapse

A
  1. AP arrives at synaptic knob
  2. Voltage changes allow opening of Ca2+ voltage gated chanels entry of Ca2+ions
  3. Entry of Ca2+ ions allows vessicles containing nerotransmitters to fuse with membrane and excytosis of neurotransmetters into synaptic clef
  4. Neurotransmitter binds to ligand gated channel on post synaptic membrane, inhibitory/excititory transmission follows
  5. Neurotransmitter broken down or taken up into presynaptic membrane
56
Q

Meninges

Description and purpose

A

are 3 layers of specialized membranes that Surround brain and spinal cord

Provides protection, stability, shock absorption to CNS Tissue

57
Q

1 Physiologic difference between

cranial and spinal Meninges

A

Spinal Meninges contain adipose tissue in epidural space where local anesthia can be administered.

vs.

Cranial meninges have no epidural space.

58
Q

Meninges Layers

A

Dura Matter - Outermost membrane just under bone, responsible

Subdural Space - Lymphatic fluid

Arachnoid matter -

Subarachnoid space - Blood Vessels and CSF

Pia Matter - Follows contours of the brain tissue; has blood vessels

Cerebral Cortex - Brain - Gray matter

59
Q

Types of Cranial Bleeds

A

Epidural

Subdural

Subarachnoid

Interparenchymal

60
Q

Spinal Cord

A

Relay between body and brain

Sends/receives messages to/from Brain

&

Sends/recieves messages from Periphery

Includes SPINAL & CRANIAL Nerves

61
Q

Vertebrae

A

Cervical Spine C1-C7

Thoracic Spine T1-T12

Lumbar L1-L5

Sacral S1-S5

Coccyx 3-5 Fused

62
Q

Spinal Cord stops around which vertebrae?

What structure continues from there?

A

L1 or L2

Cauda Equina - looks like horses tail extends from bottom of spinal cord

63
Q

Spinal Nerves

A

31 Pairs of spinal nerves

Spinal Nerves #’s correspond to adjacent just lower vertebrae for everything T1 and below.

ie. Just below the T1 Vertebrae is the T1 Spinal Nerve

Cervical Spinal Nerves are ontop of corresponding vertebrae

ie Spinal nerve C7 is just ontop of C7

and

Just under the C7 Vertebrae is the C8 Spinal nerve

64
Q

Spinal Nerve Layout

A

Central Canal - Contains CSF

Dorsal (posterior) Root Ganglia - carries sensory information

Ventral Root Ganglia (Anterior) - Carries motor information

Two ganglia join to form mixed (motor/sensory) for innervation of periphery

65
Q

Main components of the brain

A

Cerebrum

Diencephaion

Mid-Brain

Pons

Medulla Oblongata

Cerebellum

66
Q

Brain Germ Pg 382

A
67
Q

Cerebrum

A

Outter Shell - kind of provides protection for basal functions located in mid-brain

Responsible for all higher order functions

ie: sensation, learning, thinking and memory, storage and retrival, speech

68
Q

Corpus collosum

A

Bridge between L&R Hemispheres of Brain

Plasticity - ability of brain to compensate for left or right hemisphere damage; ability is better as you are younger

69
Q

Diencephalon

A

kind of subdivision of cerebrum, buried in that portion of the brain

Comprised of: Epithalamus/Thalamus/Hypothalamus

integration of conscious and unconcious sensory information and motor commands

Hypothalamus is responsible for temperature regulation

70
Q

Brain Stem and components

A

Brain Stem - responsible for basal functions

  • Mid Brain - processing visual and auditory information; generates involuntary motor response; contains Reticular activating system (RAS) = has affect on level of conciousness ie. being hit in the face
  • Pons - Rate and Depth of Respiration; functions as relay center; pontine pupils (pons pupils) - severely constricted pupils
  • Medulla Oblongata - connects brain to spinal cord; contains the cardiac, respiratory, vomiting and vasomotor centers and deals with autonomic, involuntary functions, such as breathing, heart rate and blood pressure.
71
Q

Cerebellum

A

Responsible for balance and gait

Ataxia - impairment in balance; controls positive muscles which aid in balance

72
Q

Lobes of the brain

A

Identified by regions of skull that they are adjacent to

  • Frontal - conscious thought; damage can result in mood changes, social differences, etc. The frontal lobes are the most uniquely human of all the brain structures.
  • Parietal - integrating sensory information from various senses, and in the manipulation of objects
  • Temporal - senses of smell and sound, as well as processing of complex stimuli like faces and scenes
  • occipital -sense of sight; lesions can produce hallucinations
73
Q

Primary Motor and Sensory Cortex

A

Motor Cortex sits in Anterior

Sensory Cortex is Posterior

Hands and Face have largest amount of sensory and motor function dedicated to them specifically.

74
Q

Broca’s and Wernicke’s area

A

Speech and language areas sometimes affected in stoke deficits

Broca’s - Area linked to speech production

Wernicke’s - Area linked to understanding of written and spoken language

75
Q

Cranial Nerves

A

Part of Peripherial Nervous System

12 pairs

Things that control the face, eyes, what you see, expressions, saliva, tears etc

76
Q

Cranial Nerve #10

A

Vagus Nerve

Longest nerve in human body

Responsible for both sensory and motor function

Parasympathetic innervation stimulatory & inhibitory

innervates soft palate, esophagus, pharanx, cardiac muscle, smooth muscle,

77
Q

Two major collections of skeletal muscle motor pathways

A 
Corticospinal Pathway (Pyrimidal System)
  - Voluntary control over skeletal muscle

Medial & Lateral Motor Pathways(Extra-Pyrimidal System) - Involuntary/subconcious control ⇒ muscle tone ⇒ trunk and limbs

Nervous System/PNS/Efferent/

78
Q

Extra Pyrimidal Syndrome

A

involuntary muscle movements or spasms that usually occur in the face and neck.

An individual may suffer from this syndrome as a result of a head injury or Parkinson’s disease, though the primary cause is an adverse reaction to antipsychotic drugs.

Some forms can be treated with Benedryl

Dystonia or dystonic reation is a disorder characterized by involuntary muscle contractions that cause slow repetitive movements or abnormal postures.

79
Q

Dual Innervation

Sympathetic

&

Parasympathetic Divisions

A

Prevalent in Autonomic nervous system

Where both Sympathetic and Parasympathetic Nervous Systems bring nerves to the same peripheral organs

actions oppose each other but can be either stimulatory or inhibitory

ie digestive system - Stimulation is initiated by parasympathetic division vs decreased activitiy initiated by sympathetic

Cardiovascular system - Stimulation is initiated by Sympathetic division; decrease in activity initiated by parasympathetic division

80
Q

What are the 5 basic fucntion of the respiratory system?

A
  1. Provides and extensive surface for gas exchange
  2. Move air to/from lungs
  3. Protection of respiratory surfaces from changes temperature and exposure to pathogens
  4. Production of Sound
  5. Facilitate olfactory
81
Q

Anatomy of Respiratory System

A

see diagram

82
Q

Anatomy of nasal and oral structures

A

See Diagram

83
Q

Pharynx: consists of

A
  • Nasopharynx
  • Oropharynx
  • Laryngopharynx

Chamber that is shared by respiratory and digestive tracts

84
Q

Trachea

A
  • main entrance to lungs
  • C-shaped cartilage protects airway
  • Trachealis muscle bridges the gap between free ends of C-shaped cartilages at the posterior border of the trachea, adjacent to the esophagus.
  • Trachealis muscle is comprised of smooth muscle and can be relaxed via sympathetic stimulation(+air flow, +diameter, -resistance) in the event of food bolus with glucagon (ß2 agonist)
  • When Trachealis Muscle contracts it plumps (gets fatter) reducing the diameter of the trachea
  • Food Bolus - large food particle stuck in esophagus
  • descends from larynx @ C6 to carina @ T5
85
Q

Larynx

A

includes:

  • epiglottis - blocks food from trachea
  • thyroid cartilage
  • cricothyroid cartilage

found between C4-C6

Seperates upper and lower airways

86
Q

Hilus

A

Entrance to lung from bronchi

Where pleural membranes attach

87
Q

Carina

A

base of trachea

Splits into Left & Right mainstem Bronchi

Right mainstem is wider and more anatomically straight down

Sits around T5

Left Bronchi is off to the side at an angle

Right lung has 3 lobes

Left lung has 2 lobes

88
Q

Bronchi breaks into

A
  • Primary Bronchi
  • Secondary Bronchi
  • The tertiary bronchi (also known as the segmental bronchi
  • Bronchioles - first structures without cartilage terminate at alveoli
89
Q

Bronchioles

A
  • Bronchioles - first structures without cartilage or glands in their submucosa
  • Wrapped in increasing amounts of smooth muscle as it descends respiratory tract
  • Smooth muscle cells have ß2 receptors on them which when sympathetically stimulated cause relaxation = bronchodialation, more space
  • Asthma - broncoconstriction and inflammation decreases airflow
90
Q

Respiratory Mucosa

A

epithelium - lining of respiratory tract

and mucous membrane plus connective tissue

nutrients must be provided by diffusion - ie from basal lamina or lumen (or airway = O2)

**will not be asked- cells of respiratory tract are primarily pseudo stratified columnar epithelium

91
Q

Lamina Propria

A

is a thin layer of loose connective tissue which lies beneath the epithelium and together with the epithelium constitutes the mucosa

contains smooth muscle cells which increase in number as it descends down respiratory tract

The lamina propria is also rich in immune cells known as lymphocytes

92
Q

Goblet Cells

A

glands that secreet mucus onto surface of epithelium of respiratory tract where cilia sweep away contaminants/pathogens towards the throat for elimination of pathogens from respiratory tract

93
Q

External/Internal Nares

A

External Nare is what you see

Internal Nares are highly vascular to warmand humidify the air entering respiratory system; blood vessesls dialate when they need to warm the air and contrict when unnecessary

Epistaxis potential due to vasculature; HTN can cause nosebleeds

Nares are seperated by septum

Lateral surfaces of the nares contain turninates which cause turbulance in air flow aiding in warming and removal of debris

94
Q

Hard and soft pallate

A

Separates oropharnyx from nasal cavity & nasopharynx

95
Q

Gillotic opening and structures

A

The opening between the vocal cords at the upper part of the larynx

  • glottis is the vocal apparatus of the larynx
  • flase vocal cords (vestibular folds) sit on eiter side of the vocal cords and glottic opening
  • Vocal cords (vocal folds) - ligaments covered by folds of epithelium
  • responsible for cough reflex hypersensitive to foreign matter; causes increase in intercranial pressure
96
Q

Lungs

A

enclosed in pleural cavity

right has three lobes, left has two

primary/secondary/tertiary bronchi followed by

Bronchioles and alveoli - are part of respiratory system but not respiratory tract

97
Q

Alveoli

A

Alveoli - plural; Alveolis - singular

the sac where bronchioles terminate and gas exchange takes place

alveolar membrane is the gas-exchange surface

98
Q

Surfactant

A
  • develops in last four weeks of fetal development
  • air/water boundary which creates surface tension in aveoli and prevents lung from collapsing at end of expiration
  • an increase in interstitial fluid can cause alveoli to collapse and not reopen preventing gas exchange
  • responsible for lung compliance
99
Q

ARDS

A

Acute Respiratory Distress Syndrome

attacks and destroys avaliability/production of surfactant

creates poor lung compliance

100
Q

Emphysema and relationship to Compliance

A

Pt’s with Emphysema have increased lung compliance because the elastic tissue has been damaged, usually due to their being overstretched by chronic overinflation

there is no problem inflating the lungs there is extreme difficulty exhaling air. In this condition extra work is required to get air out of the lungs

101
Q

ACE

A

Angiotensin Converting Enzyme

  • enzyme that participates in the conversion of Angiotensin I into Angiotensin I, which is responsible for maintaining bloodvolume and blood pressure
  • produced in the lungs
102
Q

What is the reason the body needs O2?

A

Without oxygen the is no ATP

needed for

  • Ventilation - getting air IN/OUT of Lungs
  • Difussion - getting O2 into the blood and CO2 out of the lungs
  • Perfusion - avaliability for blood supply to all tissues
103
Q

Respiration

A
  • External - exchange of O2/CO2 between environment and body fluid
  • Internal - exchange between fluids(blood) and peripheral tissues (individular cells)
    • cells ie cellular respiration
      • glycolysis
      • krebs cycle
      • oxidative phosphorylation (requires O2)

***bottom line need O2 for oxidative phosphorylation and production of ATP ⇒ energy ⇒ life

104
Q

Ventilation

A
  • Pulmonary Ventilation -Air In/Out of Lungs
  • Alveolar Ventilation -Air In/Out of the Alveoli
105
Q

Respiration physiology requires understanding of 3 gas laws

A
  • Boyle’s Law
  • Dalton’s Law
  • Henry’s Law
106
Q

Boyle’s Law

A

P = 1/V

Pressure and volume are inversely related

The greater the volume the smaller the pressure; The smaller the volume the greater the pressure

107
Q

Respiratory Cycle and Pressure gradients

A

Respiratory cycle = 1 Inhalation + 1 Expiration

  1. Lungs @ rest ie. P in lungs = P in Environment
  2. Inhalation:
    • Diaphram contracts, ribcage expands increasing volume decreasing pressure in lungs
    • Creation of pressure gradient causes air to flow into lungs until equalized
  3. Exhalation:
  • Diaphram relaxes, Ribcage contracts increasing pressure in lungs
  • Creation of pressure gradient causes air to flow out of lungs until equalized
108
Q

Compliance

A

How easily lungs expand and contract

ie how easily someone is bag or ventilate

Poor Compliance = Difficult to move air, increase in amount of force

Decreased compliance = inability to move the thoracic cage

109
Q

Resistance

A

Problem with equiptment

ie. pt clenching on tube, vomit in BVM

indicates a mechanical problem not a compliance problem

110
Q

Heavy Breathing creates

A

increases the size of the pressure gradient

allows more air in and out of lungs to provide more O2 to the body tissues

ie exercising

Hyperventilation is breathing faster than normal for sake of increasing O2 and decreasing CO2

Preoxygenation - no increase in rate, used to properly saturate O2 levels before intubation

111
Q

Components of Respiratory Cycle

A
  • Rate (f)- frequency
  • Tidal Volume (VT) - Average volume of Inspiration (5-7ml/kg of avg body weight)
  • Minute Volume (VE) - Amount of air in/out of lungs per minute

f x VT = VE

Example:

f = 12 Breaths per minute; VT = 500mL

12 x 500 = 6000mL = 6L of air/minute

112
Q

Alveolar Ventilation

A
  • Anatomic Dead Space (VD) = amount of inhaled air that does not come into contact with alveolar surface ie unable to participate in gas exchange
  • Average Adult 150mL
  • Aveolar Ventilation (VA) - amount of air able to participate in gas exchange

(VT - VD) f = VA

Example:

(500mL - 150mL) 12 = 4200mL =

  1. 2L of Alveolar ventilation
    ie. an increase in Shallow respirations = decreased tidal volume = less exchanged air

Asthma patients have trouble getting rid of air

Normally 1 sec In / 2 Sec out; asthma 1 sec in/ 4-5 out

113
Q

Lung Capacities

Chart

A
  • TV = Tidal Volume: Normal air movement in/out of lungs in one breath
  • ERV = Expiratory reserve volume: the maximal volume of air that can be exhaled from the end-expiratory position
  • IRV = Inspiratory reserve volume: the maximal volume that can be inhaled from the end-inspiratory level important allows for increased air intake during exercise
  • IC = Inspiratory capacity: the sum of IRV and Tidal volume
  • IRV + ERV + TV = Vital Capacity VC
  • RV = Residual volume: the volume of air remaining in the lungs after a maximal exhalation
  • TLC = Total lung capacity: the volume in the lungs at maximal inflation
  • Functional Residual Capacity: Important flight/critical care = Expiratory Reserve Volume + Residual volume (remaining air left in lungs) after maximum exhalation
  • Minimum Volume - still has 30-120mL when collapsed
114
Q

Dalton’s Law

A

each gas contributes to the total pressure based on the relative abundance (partial pressure) contributed by single gas

Atmosphere:

78% Nitrogen, 21% Oxygen, 1% Trace Elements

PN2 + O2 + PCO2 = 760 Hgmm

115
Q

Henry’s Law

A
  • At given temperature, the amount of a particular gas that is disolved in solution is directly proportional to the partial pressure of theat gas

The way I understand it:

  • More gas molecules are soluble at a higher pressure ie CO2 is disolved when a can of soda is closed; when opened pressure decreases and CO2 equalizes to that of the partial pressure in environment
116
Q

Gas Exchange in Alveoli

A

Partial pressures of O2 and CO2 in Blood returning from Body are:

  • PCO2 = 45mmHg
  • PO2 = 40mmHg

In Alveolar Partial Pressures of Inhaled Air are:

  • PCO2 = 40mmHg
  • PO2 = 100mmHg

***The PO2 is higher in alveoli and wants to move across to the blood; like wise the PCO2 is higher in blood and wants to move into alveoli to be exhaled by the lungs.

117
Q

Gas exchange at cellular level

A

Partial pressures of O2 and CO2 in Blood ariving from lungs

  • PCO2 = 40mmHg
  • PO2 =100mmHg

Partial pressures of O2 and CO2 of blood leaving tissues

  • PCO2 = 45mmHg
  • PO2 = 40mmHg

***Because the arriving blood has higer concentration of O2 in than cell, it moves down concentration gradient into tissues; like wise the higher levels of CO2 in cell moves into blood to be transported back to lungs for exhalation

118
Q

Sickle Cell

A
  • Genetic blood disorder in which globin protein does not fold up correctly and cannot carry the maximum number of O2
  • Is a medica
119
Q

Hemoglobin

A
  • carries oxygen from the respiratory organs to the rest of the body\
  • Optimally can carry 4 O2 molecules
  • carbaminohemoglobin is when CO2 is bound to the globin protein

Hb + O2 <-> HbO2

Hb = efficency of O2 transport

reversible action of Oxygen binding and releasing to Hemoglobin

**Oxygen can only travel in bloodstream bound to Hemeglobin or disolved (ie Henry’s Law)

120
Q

Oxygen Disassociation Curve

A

is a Relationship of Partial Pressure of O2 and SpO2

  • PO2 > 60 = SpO2 > 90%
  • if PO2 < 60 = SpO2 drops rapidly

SpO2 = % Oxygen saturation = % of Heme Units that have bound O2

*100% only means that all avaliable Hemeoglobin is saturated, there may be more free O2 circulating in blood stream.

Conditions change dissociation points: Increases in temperature/pH shifts to right ie disassociates earlier, Decreases in pH and Temperature disassociates later

**Trend to give less O2 if Pulse Ox

121
Q

CO2 Transport

3 Modes

A
  1. Bound to Heme ie Carbaminohaemoglobin
  2. Disolved
  3. converted to carbonic acid

H+ + CO3- <> H2CO3 <> H2O + CO2

  • When CO2 leaves tissues one of its options is to combine with water and make carbonic acid where it can be: transported that way and be converted back upon arrival at alveoli, or converted to H ions

Lecture Notes - Instructor Adelson (8 decks)

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