Respiration Part 1 Flashcards
What is the magic number for Carbon dioxide?
40
What is the magic number for Oxygen?
100
What muscles are used for expiration?
Abdominal muscles and internal intercostals
What additional muscles are used for inspiration?
External intercostals
SCM
Anterior Serratous
Scaleni
What two ways can the lungs be contracted?
- Elevation and depression of the ribs to increase/decrease the anteroposterior diameter of the chest cavity
- Downward and upward movement of the diaphragm to lengthen or shorten the chest cavity. (normal quiet breathing)
What is the outside membrane of the lungs called ?
Visceral plueral membrane
What is the membrane on the thoracic cavity?
Parietal pleural surface
How can you increase the volume in the chest?
by increasing the diaphragm space
OR
pulling the diaphragm down
What is pleuracy?
The inflammation of the fluid between the 2 layers
What keeps the lungs from collapsing?
Because the fluid between the 2 membranes
There is _____ pressure in the thoracic cavity at rest
low
When the pressure is higher in the atmosphere than in your lungs, how does the air get in your lungs?
through bulk flow, naturally will flow to where there is less pressure by creating more volume aka decreasing the pressure inside your lungs
Muscles that aid inspiration are attached to ?
attached to the ribs
at rest, exhale is ____
passive, very little work needs to be done
During ______ alveolar pressure falls about 1cm of water
inspiration
During ______ the alveolar pressure increased by about 1cm of water
expiration
Recoil pressure is the difference between the ______ pressure and the _____ pressure
alveolar and pleural
_______ is a measure of the elastic forces in the lungs that tend to collapse the lungs at each instant of respiration
recoil pressure
Elastin fibers at rest look like _____, when they expand they look like _____
a zig zag, a straight line
What is ventilation?
When you increase the pressure in your lungs by decreasing the volume, so the pressure is higher than the atmospheric pressure and the air flows out of your lungs
What is keeping the lungs from collapsing?
because the fluid between the parietal and visceral membranes has a negative pressure keeping them from collapsing
The tendency for the lungs to want to collapse is described as?
Trans-pulmonary pressure/ recoil pressure
One type of lung disease that is caused by permanent scaring of the alveolar, causes them to get stiff
What is surface tension?
When water forms a surface with air, the water molecules on the surface of the water have a strong attraction for one another
_____ are interwoven among the lung parenchyma
collagen
As the lungs expand, _____ fibers become stretched and unkinked exerting more force
collagen
Elastic forces caused by _____ of the fluid that lines the inside walls of the alveoli
surface tension
What is surfactant? What type of cell is it produced by?
surface active agent in water that reduces surface tension
Type II alveolar epithelial cells - 6-7 months of gestation
inside of the alveoli, water causes _____ which causes the alveoli to want to shrink up
surface tension
Why at the end of inspiration, is it so much harder?
because the rib cage is already expanded, the more you pull it apart the harder it is to pull apart
Obstructive lung disease, traps air inside the lungs
Emphysema
Which one has a greater affect on breathing. surface tension or elastic recoil? why?
Surface tension- 2/3
Elastic forces -1/3
A _________ is one that occurs without an apparent cause and in the absence of significant lung disease
primary pneumothorax
a ________ occurs in the presence of existing lung pathology.
secondary pneumothorax
Very tall and thin people are more prone to ? What syndrome is associated with it?
Primary pneumothorax
Marfarn syndrome
What is tidal volume?
Volume inspired or expired per breath
What is the magic number for tidal volume?
500mL
How much air does a normal human breathe in one minute?
6 Liters of air
What is minute ventilation? How is it expressed?
total amount of air you breath in 1 minute,
VE (there is a dot above the V)
What is total lung capacity? What is the magic number associated with it?
the max amount of air you can take your lungs
4000mL- 4200mL
Describe boxes 1 and 2
1: TV: Tidal Volume- Volume inspired or expired per breath
2: IRV: Inspiratory Reserve Volume- Max inspiration at end of tidal inspiration
Describe boxes 3 and 4
3: ERV: Expiratory Reserve Volume: Max expiration at end of tidal inspiration
4: FRC: Functional Residual Capacity- Volume in lungs after tidal expiration
Describe box 5
5: RLV: Residual Lung Volume- Volume in lungs after max expiration
Describe box 6 and 7
6: FVC: Forced Vital Capacity- Max volume expired after max inspiration
7: TLC: Total Lung Capacity- Volume in lungs after max inspiration
What percent of of air can you NOT exhale from your lungs no matter how hard you try? What is this called?
25%, Residual lung volume
*** What are the limiting factors when a person is exercising heavily?
The heart and muscle metabolism, it is NOT breathing/lungs (unless they have lung disease)
What is minute ventilation?
The volume of air breathed each minute
Breathing rate (12bpm) * tidal volume (0.5 L)
How can minute ventilation be increased?
increase in the rate or depth of breathing (or both)
Breathing deeply uses (more/less) energy?
more energy, not as efficient
At max exercise the oxygen is ____ and CO2 is _____. Why?
110
30
The lungs are better than the heart
About _____ of the air does not participate in the gas exchange process. **How many mL is it (magic number)
1/3- 150ml of the 500ml taken in
What is considered the anatomical dead space?
Trachea, bronchial tubes, bronchi and smaller airways
What is another name for the anatomical dead space?
Conduction zone
What is the physiologic dead space?
Space not currently being perfused with blood
Breathing deeply causes ____ in the muscles
fatigue
Why is shallow breathing not ideal?
because the air just goes into the anatomical dead space, not the alveoli
_____ multiple cartilage rings for most of the diameter to prevent collapse
Trachea
_____ are less extensive cartilages but have more ability to expand and contract
Bronchi
______ have diameters less than 1.5 mm, are NOT prevented from collapsing by the rigidity of their walls, kept expanded by the transpulmonary pressures that expand the alveoli
Bronchioles
_____ walls are almost entirely smooth muscle
bronchioles
Many _____ of the lung result from narrowing of the smaller bronchi and larger bronchioles, often because of excessive contraction of the smooth muscle itself.
obstructive diseases
As you breath in, the diameter of the airway _____, and the pressure ______
Increases, decreases
The harder you breath out, what happens to the airway?
the airway diameter decreases because the pressure increases
Direct control of the bronchioles by sympathetic NS is _____
weak
Why is the direct control of the bronchioles by sympathetic NS weak?
because few Syn. Neurons penetrate to the central portions of the lung
Epinephrine caused _____ because of its greater stimulation of _____
Dilation of the bronchial tree
beta-adrenergic receptors
Parasympathetic control on the bronchioles causes ____
bronchiconstriction
Some Parasympathetic nerve fibers penetrate the lung parenchyma. These nerves secrete _____ and, when activated, causes ????
acetylcholine
mild to moderate contraction of the bronchioles
_____ sometimes relax the respiratory passages enough to relieve the obstruction.
What does it block?
Atropine
Blocks Ach
What two things cause the mast cells to degranulate?
Drying or cooling of airways
Mast cells deganulate (quickly/slowly)? Fatigue (quickly/slowly)?
Very quickly
They fatigue very quickly
Name the 2 circulations in the lungs?
High pressure/Low Flow
Low pressure/High Flow
The high pressure/low flow circulation supplies what things?
bronchial arteries
tissues of the lung
Trachae, bronchial tree and terminal bronchioles
Which circulation originates from the systemic circulation?
High Pressure/Low flow
Which circulation is responsible for 1-2% of total cardiac output?
High Pressure/Low flow
Which circulation empties into the pulmonary veins and enters the Left atrium?
High Pressure/Low flow
What is the “correct” definition of an artery?
vessel that takes blood away from the heart
High pressure/Low flow circulation is a pressure of ? What side does it dump into?
120/80
Left
Low pressure/High flow has a pressure of ? What side does it dump into?
25/8
Give two reasons why the pulse ox is never at 100?
- High pressure/Low flow that supplies the lungs with nutrients and oxygen will be extracted and go to the left side of the heart
- Normal V/Q mismatch with the lungs
What is pulmonary hypertension? What is it due to?
When the low pressure/high flow circulation is higher than 25/8
Weak left ventricle/ left side heart failure
What is another reason for pulmonary hypertension?
Fluid build up in the alveoli
In the Low pressure/High flow system, it supplies ?
Where does it dump into?
venous blood from all parts of the body to the alveolar capillaries where oxygen is added and CO2 is removed
Left atrium
Describe the Pulmonary Capillary Wedge Pressure
Test used to determine pulmonary pressure by inflating a balloon inside the pulmonary artery
When people are dying of high altitude what is really going on?
Pulmonary hypertension due to release of unknown vasoconstrictor substance in the alveoli causing your body to redistribute air to better ventilated areas but at high altitude there are no better ventilated areas
What is ventilation?
How much air are you taking in and out of your lungs
What is perfusion?
How much blood is coming out of your heart going to your lungs
What is normal VE/CO?
4200mL/5000mL= 0.8
Do all areas of the lung when standing upright have the same V/Q?
No, the top of the lung has more air and the bottom has more blood
The bottom of the lung has a (high/low) V/Q ratio?
Low ration
The top of the lung has a (high/low) V/Q ratio?
High
True/False: There is plenty of time during peak exercise and at rest for the oxygen to become saturated
True, have about .5 second of buffer
Our blood CANNOT be pumped fast enough to exceed the lungs ability for gas exchange
Pulmonary capillary walls are distended by the ______ inside them
blood pressure
Pulmonary capillary walls are compressed by the _____ on their outsides
alveolar air pressure
If ______ becomes greater than ______ the capillaries close and there is no blood flow
alveolar air pressure
capillary blood pressure,
3 zones of blood distribution
Zone 1:
No blood flow during all portions of the cardiac cycle
3 zones of blood distribution
Zone 2:
Intermittent blood flow only during the peaks of pulmonary arterial pressure (systolic)
3 zones of blood distribution
Zone 3:
Continuous flow because capillary pressure remains greater than alveolar air pressure during the entire cardiac cycle.
During exercise what happens to the zone 2 pattern of flow?
Zone 2 becomes continuous flow because capillary pressure remains greater than alveolar air pressure during the entire cardiac cycle
How does scar tissue affect diffusion?
Decreases diffusion by increasing the distance oxygen has to go to get to the alveoli
What increases distance during diffusion?
Build up of fluid
Why is pneumonia dangerous?
because they are wet and full of fluid
What causes the distance between the capillary and the alveolus to remain dry?
What pressure causes fluid to leak from the capillaries?
-Hydrostatic (+7) and Cardiac output (forces plasma out into the interstitial space)
- Interstitial Colloid Osmotic Pressure (-14)
- Negative Interstitial fluid pressure (-8)
What causes the fluid to want to stay inside the capillaries?
Plasma colloid osmotic pressure (-28)
Net of +1 between the capillary and alveolus pressure causes what ???
Fluid to leak outside the capillary and causes the lung to be wet
How does the body respond to the +1 pressure?
The lymphatic system drains the +1 pressure keeping the lungs dry
What can cause there to be an increase in the fluid leaking from the capillaries?
Pulmonary hypertension causing more fluid to leak that the lymphatic system cannot drain fast enough
Blood clots
Pneumonia
Breathing noxious substances
How can you help to reduce fluid on the lungs?
give a diuretic to help the patient pee out the excess
