Respiratory 1 Flashcards
Attaches to the surface of the lung
Visceral Pleura:
Covers the surface of the chest wall, diaphragm, and mediastinum
Parietal Pleura:
Contains a very thin layer of pleural fluid under negative pressure.
Pleural Space:
The pressure in the pleural space is referred to as the
Intrapleural Pressure (PIP)
____ is subatmospheric pressure, which ensures that the lungs are held to the chest wall and will move with the chest wall during inspiration & expiration.
Intrapleural Pressure PIP
A _______ is excess fluid in the pleural space, which makes lung Expansion difficult so the person will breathe shallow and fast.
pleural effusion
The right lung has ____ lobes
three
The left lung has ____ lobes
2
T/F: Each lung has zones that differ in the amount of air (ventilation; V) and blood (perfusion; Q) that they receive.
True
There is greater ventilation (V) of alveoli and blood flow (Q) into capillaries in zone ___ compared to the other zones.
3
Best region for gas exchange. Normally, most of the lungs are zones ___ and ____
3 and 2
Which zone does a healthy lung not have?
Zone 1
What are the 2 zones of the airways?
Conducting zone and Respiratory zone
In what zone of airways does gas exchange of gases occur?
Respiratory zone
Amount of air in function zone of air way is called ____
anatomic dead space
The diameter of the tubes ______ as you move down
decreases
the number tubes ______ as you move down
increases
There is a large _____ in surface area as you move deeper into the conducting zone and exchange surfaces.
increase
Airways have a ______ in cartilage and an _____ in smooth muscle as you move along the airways.
decrease; increase
In the ____ Zone of airways, air is warmed, humidified and filtered.
Conducting
______ prevents collapse of airways
Cartilage
______ alters resistance to airflow of airways
Smooth muscle
The ____ Zone of airways has a Greater Surface Area to Optimize the Surface Area Available for Gas Exchange.
Respiratory
Total cross-sectional area greatly increases in the respiratory zone, so velocity of air flow this zone is ____.
low
The basement membrane of the endothelium and of the alveolar epithelium are ____.
fused
What are the 3 cells types in alveoli?
Type 1 cells, Type 2 alveolar, and Macrophages
What kind of cell is the type 1 cell in alveoli?
Simple squamous epithelial cell
What does the type 2 alveolar cell produce in alveoli?
Surfactant
The typical transit time at rest for an erythrocyte through an alveolar capillary is ____ seconds.
0.75 seconds
Gas exchange is usually complete in ____ seconds, so even during exercise when the capillary transit time is faster, there is still time for gas exchange to reach diffusion equilibrium
0.25 seconds
What is the PACO2 in diffusion equilibrium?
40 mm Hg
What is the PAO2 in diffusion equilibrium?
100 mm Hg
What types of muscles are respiratory muscles?
Skeletal muscles
Where are the neurons for respiratory located in brain?
Medulla and pons
____ Muscles: –Diaphragm, external intercostals–Contraction INCREASES the size of the thorax and lungs (causing decreasing PALV)
Inspiratory muscles
___ Muscles: used for forced expiration only–Internal Intercostals, abdominal muscles–Contraction DECREASES the size of the thorax and lungs (causing
increased PALV)
Expiratory muscles
What muscles are involved in inspiration?
SCM, scalenes, external intercostals, and diaphragm
What muscles are involved in forced expiration?
Internal intercostals, external oblique, internal oblique, transversus abdominus, and rectus abdominus
The _______ is the primary inspiratory muscle. It arches over the liver and moves down like a piston when it contracts, which increases the size of the thoracic cavity and reduces the pressure in the thorax/lungs.
diaphragm
The ______ muscles push abdominal contents up against the diaphragm (compressing the lungs)
abdominal
and the _____ depress the ribs
internal intercostals
Air moves from _____ pressure to _____ pressure
high; low
What is the equation for Boyle’s law?
P1V1 = P2V2
If pressure increases, volume will _____
decrease
For air to ENTER the lungs, the pressure in the alveoli (PALV) must be ____ than atmospheric pressure (PATM)
lower
For air to LEAVE the lungs, the pressure in the alveoli (PALV) must be _____ than atmospheric pressure (PATM)
higher
Do lungs want to recoil in or out?
In
Does chest want to recoil in or out?
Out
The elastic recoil of the lungs favors a _____ in lung volume or compression
decrease
What are the 2 reasons why The elastic recoil of the lungs favors a decrease in lung volume or compression
Elastic fibers and surface tension
The _____ fluid overcomes that recoil, keeping the two attached together, so when the chest (thorax) moves, the lungs move with it.
intrapleural
What is the equation for transmural/ transpulmonary pressure?
PTP = Palv – Pip
The transmural/ transpulmonary pressure must ____ to produce inspiration
Increase
The transmural/ transpulmonary pressure must ____ to produce expiration
Decrease
If PIP= PATM, then PTP is 0 and there is no longer a force to keep the lungs open called ___
(Pneumothorax).
____ Begin at rest when Patm = P
Inspiration
Inspiratory Muscles contract and the VOLUME of the thorax (and lungs) ____
increases.
What is the tidal volume of the lungs
500 mL
What is relaxed breathing called?
Eupnea
In expiration, how are volume and pressure changed?
Volume decreases and pressure increases
For ____, Palv < Patm
inspiration
For _____, Palv > Patm
expiration
ability of the lung to stretch
Lung compliance
lung’s ability to return to its normal, resting position.
elasticity—
Alveoli in the _____ of the lungs are more compliant and undergo greater expansion during inspiration
base
Lungs with lower compliance (ex. Pulmonary Fibrosis)require a larger ______ to increase volume
transpulmonary pressure (PTP)
____ disease (ex. Pulmomary Fibrosis) decreased compliance: Will breathe shallow and fast to reduce the work of breathing.
Restrictive Lung Disease
_______ (ex. Emphysema)Elastic fibers destroyed increased compliance: Will breathe deep and slowly to reduce the work of breathing.
Obstructive Lung Disease
Force that occurs at any gas-liquid interface due to the cohesive forces between liquid molecules.
Surface Tension:
_____ Accounts for Two-Thirds ofPulmonary Elasticity
Surface Tension
_____ Accounts for the remaining one-Third of Pulmonary Elasticity
Elastic fibers in the lungs
The _______ describes the relationship between surface tension and radius of an alveolus.
Law of LaPlace
If two alveoli are connected and the surface tension of each is equal, the pressure in the small alveolus is greater. Because of this, air will flow into the _________ alveolus.
Larger
____ reduces surface tension and equalizes pressure between alveoli of different sizes.
Surfactant
____ is secreted by Type II alveolar cells. It decreases surface tension (thus elasticity) and increases compliance.
Pulmonary surfactant
Surfactant _____ surface tension
Decreases
Surfactant _____ compliance
Increases
Surfactant is primarily made up of _____
phospholipids
Surfactant decreases the work of ______
inspiration.
Surfactant production is ______ with hyperinflation of the lungs (sighing and yawning), exercise and Beta-adrenergic agonists.
increased
Multiple pathologies are associated with decreases in _______ production – Infant Respiratory Distress Syndrome, Acute Respiratory Distress Syndrome, Chronic Smoking
surfactant
: EPI on β2, Decreased O2, IncreasedCO2
Bronchodilation
: ACH on M, Increased O2, Decreased CO2, Histamine
Bronchoconstriction
The airways with the smallest radius (r) have the ____ individual resistance (R), but the total resistance (R) of that generation is the ____.
highest; smallest
Tidal volume should be around _____
500 mL
____ mL of Anatomic dead space per pound of ideal body weight, which is the conducting zone of the respiratory system.
1 mL
____ = IRV + ERV + TV
Vital Capacity. a.VC
______ = VC + RV
Total Lung Capacity. a.TLC
_____ = TV + IRV
Inspiratory Capacity a.IC
______ = ERV + RV
Functional Residual Capacity a. FRC
Minute, Pulmonary or Total Ventilation = _____ x ____
Tidal volume (ml/breath) X Respiration Rate (breaths/minute)
____ = (Tidal volume – Dead Space Volume) X Respiration Rate
Alveolar Ventilation
______ = Tidal volume (ml/breath) X Respiration Rate (breaths/minute)
Minute, Pulmonary or Total Ventilation
It is better to breathe deeper instead or faster
deeper
T/F: It is better to breathe deeper instead of faster as deeper breaths get more air into the respiratory zone for gas exchange!
True
Volume of air forcibly expired after maximal inhalation
Forced Vital Capacity (FVC):
Fraction of FVC expired during the first second
Forced Expiration Volume 1 (FEV1):
Normal FEV1/FVC = ____
0.8 (80%)
Increased rate or volume due to higher metabolism; Ex. exercise
Hypernea
Increased rate or volume without increased metabolism; Ex. emotions; blowing up a balloon
Hyperventilation
Decreased alveolar ventilation
Hypoventilation
Rapid breathing rate usually with decreased depth
Tachypnea
Difficulty breathing; air hunger
Dyspnea
Normal, quiet breathing takes ____% of total body energy
3-5%
____ diseases •Due to increased Airway Resistance
Obstructive
___ diseases include: Asthma–Emphysema–Bronchitis–Cystic Fibrosis
Obstructive diseases
____ diseases include: Pulmonary fibrosis
Restrictive diseases
____ diseases: due to decreased lung compliance
Restrictive diseases
Do obstructive diseases primarily impact expiration or inspiration?
Expiration
Do restrictive diseases primarily impact expiration or inspiration?
Inspiration
Individuals with obstructive diseases will breathe ____ and ____
slow and deep.
Individuals with restrictive diseases will breathe ____ and ____
fast and shallow.
____ is a IgE Mediated -Type I Hypersensitivity Reaction
Atopic Asthma
In _____, An allergen leads to an inflammatory response that causes bronchospasms that obstruct airflow. Chronic inflammation can lead to impaired mucociliary response, edema and increased airway responsiveness.
Atopic Asthma
Treatment Options for ____:Quick-relief medications: β2 agonists, anticholinergic agents, etc. Long-term medications: inhaled corticosteroids, long-acting bronchodilators, etc.
Atopic Asthma
_____ can occur with respiratory infections, exercise, hyperventilation, cold air, inhaled irritants, aspirin and other NSAIDS
Nonatopic Asthma
Autosomal recessive disorder resulting in defective chloride ion transport (mutation in CFTR ion channel) that results in an abnormally thick mucus that obstructs airways.
Cystic Fibrosis
Treatments for ______: •Antibiotics•Chest Physical Therapy (percussion and postural drainage)•Mucolytic agents•Pancreatic enzyme replacement
Cystic Fibrosis
Destruction of elastic fibers & enlargement of airspaces due to destruction of airspace walls.
Emphysema
_____ Leads to…… (1)Airway collapse which increases R and decreases F (2)Damage to alveolar membrane so decreased gas exchange.(3) decreased Elasticity and increased Compliance
Emphysema
Normally the enzyme _____ inactivates elastase before it can destroy the elastic fibers.
α1-anti-trypsin
______ Diseases:
- Any pulmonary problem that limits lung expansion (decreases lung compliance)
- Tissue injury leads to chronic inflammation and the normal architecture of the lungs is disrupted and is replaced with scar tissue/fibrosis (the collagen fibers decrease lung compliance)
- Low compliance
- Work of breathing increases
Restrictive Respiratory
____ diseases:
Patient finds it much more difficult to inhale; Patient breathes fast and shallow. Because shallow breaths decrease alveolar ventilation there is decreased gas exchange.
Restrictive Respiratory
Signs and Symptoms of ____ diseases :Increased respiratory rateChronic cough (dry, non-productive)Polycythemia due to hypoxia
Restrictive Respiratory
