Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Phase 1 flashcards > Respiratory > Flashcards

Respiratory Flashcards

1
Q

where does the trachea bifurcate into lobar bronchi?

A

T4 (bi-four-cates)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

where does the common carotid artery bifurcate into internal and external carotid arteries?

A

C4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

which fissures are on the right side of the lung?

A

oblique and horizontal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

which fissures are on the left side of the lung?

A

just oblique

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how many lobes do each lung have?

A

right - 3
left - 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

describe the respiratory tree

A

trachea, left and right main bronchi, lobar bronchi, segmental bronchi, terminal bronchioles, respiratory bronchioles, alveoli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

innervation of diaphragm

A

phrenic C3,4,5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is pleura?

A

specialised mesothelium lining body cavities
two continuous layers - visceral and parietal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

function of pleural fluid

A

prevents friction when pleura move against each other during inspiration and expiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

upper airways include? function?

A

nasopharynx to terminal bronchioles
conductive passage for air

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

lower airways include? function?

A

respiratory bronchioles to alveolar sacs
respiratory
exchange of oxygen and carbon dioxide in the lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is respiratory epithelium? (very likely question)

A

pseudo stratified, ciliated, columnar epithelium with interspersed goblet cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

describe inspiration

A

phrenic and motor intercostal efferent nerves firing increase
diaphragm and external intercostal contract
thoracic volume increases
thoracic pressure decreases
chest wall (pump handle) and ribs (bucket handle) move up and out, pulling parietal pleura too
alveoli expand
Pressure in alveoli decreases to below atmospheric pressure
air moves into alveoli down pressure gradient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

describe expiration

A

decreased impulses to diaphragm and external intercostals
volume of thorax decreases
pressure in thorax increases
alveoli compress and lung pressure increases
pressure in the alveoli increases to above atmospheric pressure
air passively moves out of alveoli down a pressure gradient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

which accessory muscles aid active inspiration?

A

sternocleidomastoid (sternum, clavicle, mastoid process)
serratus anterior
latissimus dorsi
pec major

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

which accessory muscles aid active expiration?

A

internal intercostals
abdominal muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

in which direction does the chest wall have a tendency to move?
in what direction does the lung have a tendency to move?
what structure ensures they both move in the same direction?

A

out
in
intrapleural space - parietal and visceral pleura move together

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is transpulmonary pressure?

A

difference between alveolar pressure and intrapleural pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

value of transpulmonary pressure

A

4mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

air in pleural space is called?

A

pneumothorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what happens to the transpulmonary pressure and lungs in a pneumothorax?

A

becomes 0
collapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

two main respiratory brain centres?

A

medullary
pontine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what are the two divisions of the pontine centre?

A

apneustic and pneumotaxic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

function of the apneustic group

A

pontine centre
acts on dorsal respiratory group to adjust inspiration and increase inspiratory intensity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

function of the pneumotaxic group

A

pontine
allows expiration
overrides apneustic if needed
increased innervation leads to shallower ventilation with increased frequency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

function of the DRG

A

inspiration
stimulate diaphragm and external intercostals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

function of the VRG

A

centre for forced inspiration and expiration
stimulates accessory muscles of ventilation
inhibits apneuistic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

other structurs involved in respiration

A

nucleus tractus solidaris and ambiguous
vagus and glossopharyngeal
limbic system
opiods - depress respiratory drive
amphetamines stimulate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

name three pulmonary receptors

A

slow adapting stretch receptors, rapid adapting stretch receptor, J receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

where are SASRs located

A

smooth muscle of the airway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what do SASRs respond to

A

distension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

effect of SASRs
what is is called?

A

end inspiration and starts expiration (logical, if airway is distended)
Hering Bruer reflex - protective

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

where are RASRs located

A

between airway epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what do RASRs respond to?

A

irritants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

effect of RASRs

A

bronchoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

where are J receptors found?

A

located in the alveolar walls in close proximity to the capillaries
J = juxtacapillary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what do J receptors respond to?

A

an increase in lung pressure because of fluid
e.g embolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

effect of J receptors

A

increase respiratory rate
rapid shallow breathing
bronchoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

which lung receptors are myelinated?

A

just SASRs and RASRs, not J receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

two types of lung chemoreceptors

A

peripheral and central

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

where are peripheral chemoreceptors located?

A

aortic arch and carotid sinus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

what do peripheral chemoreceptors detect?

A

change in partial pressure of oxygen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

when are peripheral chemoreceptors activated?

A

partial pressure of oxygen falls below 60% (a significant drop!)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

are peripheral or central chemoreceptors faster?

A

peripheral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

what gas is the driver of respiration?

A

carbon dioxide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

where are central chemoreceptors found?

A

medulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

what do central chemoreceptors detect, and how?

A

changes of pH by small changes in carbon dioxide partial pressure
H+ cannot cross the blood brain barrier and carbon dioxide can - therefore, central chemoreceptors are not affected by changes in plasma pH
carbon dioxide reacts with water to form carbonic acid, which dissociates to hydrogen carbonate ions and H+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

action of central chemoreceptors

A

increase respiratory rate to compensate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

what is V/Q mismatch?

A

alveolar ventilation and alveolar blood flow are not matched

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

what is the V/Q ratio?

A

ventilation to perfusion ratio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

in which part of the lung is there more perfusion?
why

A

bottom
gravity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

is V/Q higher of lower at the bottom of the lungs?

A

lower

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

in which part of the lung is there more ventilation?

A

apex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

what is physiologic (alveolar) dead space?

A

ventilated but not perfused alveoli
not the same as anatomical dead space
high V/Q

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

cause of physiological (alveolar) dead space

A

pulmonary embolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

what is physiologic shunt?

A

perfused but not ventilated alveoli
low V/Q

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

cause of physiologic shunt

A

pulmonary oedema - collapsed alveoli due to fluid build up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

response to dead space

A

local bronchoconstriction
air diverted to better perfused areas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

response to shunt

A

hypoxic pulmonary vasoconstriction
blood diverted to better ventilated areas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

factors shifting curve to left

A

H+ falls
temperature falls
altitude falls
fall in 2-3 BGP (2,3-diphosphoglycerate/ 2,3 bisphosphoglycerate)
HbF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

will a greater affinity for oxygen shift the curve left or right?

A

left

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

effect of low pH on the oxygen dissociation curve

A

curve shifts left
(to remember - carbon dioxide makes blood acidic and you need more oxygen)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

effect of low oxygen levels of the oxygen dissociation curve

A

shifts left

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

effect of carbon monoxide on the oxygen dissociation curve

A

shifts left

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

does HbF have a higher or lower affinity for oxygen?

A

higher
curve shifts left

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

units of partial pressure of oxygen

A

mmHg
x axis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

which gas is the driver of respiration?

A

carbon dioxide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

list the mechanisms of carbon dioxide transport in the blood, least to most common

A

dissolved in plasma
bound to Hb - carbaminohaemoglobin
as HCO3- (buffer equation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

normal pH range

A

7.35 - 7.45

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

effect of hypoventilation on blood pH
what does this cause?

A

increase in carbon dioxide
H+ increases
pH decreases
respiratory acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

effect of hyperventilation on blood pH
what does this cause?

A

decrease in carbon dioxide
H+ decreases
pH increases
respiratory alkalosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Dalton’s Law

A

pressure exerted by a mixture of gases in a fixed volume is equal to the sum of the partial pressures that would be exerted by each gas alone in the same volume

Pt = ppA + ppB …

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Boyle’s Law

A

pressure is inversely proportional to volume
P1V1 = P2V2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Henry’s Law

A

the volume of gas dissolved in a liquid depends on partial pressure and solubility of it
concentration gradient = solubility coefficient x pp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Ohm’s Law

A

pressure = flow x resistance
V = IR
for trachea, bronchi and bronchioles whereas alveoli have their own equation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

alveolar gas equation

A

PAO2 = PiO2 - PaCO2/R

PA = pressure alveolar oxygen
PiO2 = pressure of inspired oxygen
R is the respiratory coefficient - usually equal to 0.8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Laplace’s Law

A

alveolar pressure depends on surface tension and radius
P = 2T/r

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

effect of surfactant on surface tension

A

decreases surface tension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

from which cells is surfactant released?

A

type II pneumocytes - type of alveolar cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

what is lung compliance?

A

how easily the lungs expand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

which factors determine lung compliance?

A

surface tension
elasticity of lung tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

which cells regulate alveolar surface tension?

A

type II pneumocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

how is compliance increased?

A

decrease surface tension by producing surfactant
increase elasticity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

what is hypoxia?

A

low oxygen at tissue level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

what is hypoxaemia?

A

low oxygen in the blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

causes of hypoxaemia

A

hypoventilation
diffusion impairment - thickening of membrane
shunt - septal defect, perfusing unventilated alveoli
V/Q mismatch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

what is hypercapnia?

A

high carbon dioxide in the blood
constitutes respiratory drive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

what causes hypercapnia?

A

hypoventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

what is type 1 respiratory failure?

A

low PaO2
normal PaCO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

what causes type 1 respiratory failure?

A

pulmonary embolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

what is type 2 respiratory failure?

A

low PaO2
high PaCO2

92
Q

cause of type 2 respiratory failure

A

hypoventilation

93
Q

why must we be careful when administering oxygen to those with type II respiratory failure?

A

giving them lots of oxygen leads to hyperventilation
hyperventilation decreases partial pressure of carbon dioxide in the blood
as carbon dioxide constitutes respiratory drive, the patient can no longer breathe

94
Q

pressure of bronchial circulation (systemic)

A

120/80

95
Q

pressure of pulmonary circulation

A

25/8

96
Q

effect of hypoxia on bronchial circulation

A

vasodilation

97
Q

effect of hypoxia on pulmonary circulation

A

local vasoconstriction

98
Q

effect of oxygen on the bronchial circulation

A

vasoconstriction

99
Q

effect of oxygen on the pulmonary circulation

A

vasodilation

100
Q

function of the bronchial circulation

A

deliver oxygen to lung tissue

101
Q

function of the pulmonary circulation

A

pick up oxygenated blood from lungs

102
Q

what is pulse pressure?

A

difference between systolic and diastolic pressures

103
Q

Poiseuille’s law

A

a small change in radius leads to a big change in vascular resistance
resistance = 8xlxviscosity / pi x r^4

104
Q

what is forced vital capacity?

A

amount of air that can be forcibly exhaled from your lungs after taking the deepest breath possible

105
Q

what is the peak of the flow/ volume curve?

A

PEF - peak expiratory flow

106
Q

what is FEV1?

A

forced expiratory volume in 1 second
usually 0.75 FVC (FEF75 - forced expiratory flow75)

107
Q

for a flow/ volume curve, is the part above or below the x axis exhalation?

A

above

108
Q

what is FVC?

A

forced vital capacity

109
Q

what is respiratory obstruction?

A

FEV1/ FVC less than 0.7
blocked airways

110
Q

what causes respiratory obstruction

A

COPD or asthma

111
Q

what is respiratory restriction?

A

FVC less than 0.8 or 80%
decreased expansion ability

112
Q

what causes respiratory restriction?

A

pulmonary fibrosis

113
Q

what is reduced in respiratory obstruction?

A

FEV1

114
Q

what is the difference between a volume and a capacity?

A

a capacity is a combination of more than one volume

115
Q

what is inspiratory reserve volume?

A

extra volume that can be inspired above tidal volume, from normal quiet inspiration to maximum inspiration

116
Q

what is expiratory reserve volume?

A

extra volume that can be expired below tidal volume, from normal quiet expiration to maximum expiration

117
Q

what is tidal volume?

A

volume that enters and leaves with each breath, from normal quiet inspiration to normal quiet expiration

118
Q

what is residual volume?

A

air in lungs after max expiration

119
Q

what is inspiratory capacity?

A

volume breathed in from quiet expiration to maximum inspiration

120
Q

what is (forced) vital capacity?

A

volume that can be exhaled after maximum inspiration (ie. maximum inspiration to maximum expiration)

121
Q

what is functional residual capacity?

A

volume remaining after quiet expiration

122
Q

what is total lung capacity?

A

volume of air in lungs after maximum inspiration

123
Q

average tidal volume

A

0.5L

124
Q

average inspiratory reserve volume

A

2.5L

125
Q

average expiratory reserve volume

A

1.5L

126
Q

average residual volume

A

1.5L

127
Q

average vital capacity/ forced vital capacity

A

4.5L

128
Q

average inspiratory capacity

A

3L

129
Q

average functional residual capacity

A

3L

130
Q

average total lung capacity

A

6L

131
Q

how do you calculate vital capacity?

A

inspiratory reserve volume + tidal volume + expiratory reserve volume

everything except for residual volume

132
Q

how do you calculate inspiratory capacity?

A

tidal volume + inspiratory reserve volume

133
Q

how do you calculate functional residual capacity?

A

expiratory reserve volume + residual volume

134
Q

how do you calculate total lung capacity?

A

sum of all volumes
IRV + TV + ERV + RV

135
Q

what is anatomical dead space?

A

volume of air in the upper and lower respiratory tract that never reaches alveoli

136
Q

effect of ageing on the lungs

A

decreased compliance
- stiffer costal cartilages
- decrease in lung elasticity

an increase in V/Q mismatch

a decrease in immunity responses

delayed hypercapnia/ hypoxia response

FEV1 + FVC decrease
- therefore FEV/ FVC ratio decreases
- may falsely show obstruction

137
Q

types of immunity

A

innate and adaptive

138
Q

innate immunity
an example

A

primitive
non specific
immediate
e.g neutrophils and macrophages

139
Q

which cells are the main mediators of an inflammatory response?

A

neutrophils

140
Q

are neutrophils granulocytes or agranulocytes?

A

granulocytes
contain primary and secondary granules

141
Q

adaptive immunity

A

specific
uses APCs
T and B cells

142
Q

types of T cells

A

CD8 - killer cells
CD4 - helper cells induce other cell activation

143
Q

function of B cells

A

secrete antibodies
humoural immunity

144
Q

how many classes of antibodies?

A

5

145
Q

name the classes of antibodies?

A

GAMED
G - most abundant
A - in breast milk, mucosa
M - first in infections
E - allergens
D - unknown, B cell activation?

146
Q

non immune barriers to lung infection

A

respiratory epithelium - barrier, anti pathogen proteins, mucus
mucus - lubrication and protection via mucocilliary escalator
coughing - close epiglottis, increase thoracic pressure, air forced out

147
Q

immune barriers to lung infection

A

alveolar macrophages

148
Q

what is hypersensitivity?

A

allergic hyper-response

149
Q

type 1 hypersensitivity

A

IgE
acute anaphylaxis - asthma, hay fever
basophils secrete histamine and prostaglandins
bronchoconstriction and vasodilation and inflammatory response

150
Q

type 2 hypersensitivity

A

IgM and IgG mediated
cytotoxic response
autoimmune diseases
tissue damage and altered receptors

151
Q

type 3 hypersensitivity

A

IgG
immune complex formation and deposition

152
Q

type 4 hypersensitivity

A

T cell mediated
delayed response

153
Q

what nerve mediates the parasympathetic airway response?

A

vagus

154
Q

parasympathetic response on the airways

A

ACh acts on M3 (muscarinic type 3) receptors on smooth muscle in the airways

vagus

155
Q

which nerves mediate the sympathetic airway response?

A

sympathetic chain

156
Q

sympathetic response in the airways

A

noradrenaline (NAd) released from adrenal glands after sympathetic stimulation

acts on adrenal medulla to release adrenaline

adrenaline acts on beta 2 receptors on airway smooth muscle (to remember that it is beta 2 and not beta 1, you have 2 lungs and 1 heart)

157
Q

how do we treat respiratory problems?

A

bronchodilation

158
Q

what are the two ways to treat respiratory difficulties?

A

beta 2 agonists - salbutamol
muscarinic 3 antagonists

159
Q

what is an agonist?

A

a drug or substance that binds to a receptor inside a cell or on its surface and causes the same action as the substance that normally binds to the receptor

160
Q

what is an antagonist?

A

a substance that stops the action or effect of another substance

161
Q

equation for pressure of inspired gas

A

Pi (gas) = P(atm) x Fi(gas)
pressure of inspired gas = atmospheric pressure x fraction of inspired gas

162
Q

equation for alveolar oxygen

A

PAO2 = PiO2 - PaCO2/ R
R = 0.8

163
Q

equation for arterial oxygen

A

PaO2 = PAO2 - (A - aDO2)

(A - aDO2) means alveolar/ arterial concentration gradient - typically 1

arterial oxygen is usually 1kPa less than alveolar oxygen - natural V/Q mismatch

164
Q

equation for arterial carbon dioxide

A

PaCO2 = kVCO2/ VA

165
Q

typical range of PaCO2 at sea level

A

4.5 - 6 kPa

166
Q

typical range of PaO2 at sea level

A

10.5 - 13.5 kPa

167
Q

atmospheric pressure

A

100kPa

168
Q

what happens to PiO2 with altitude?

A

falls

169
Q

what happens to FiO2 with altitude?

A

stays the same

170
Q

what happens to atmospheric pressure with altitude?

A

falls

171
Q

why does the pressure of inspired oxygen decrease with altitude?

A

because atmospheric pressure falls and fraction of inspired oxygen stays the same

172
Q

respiratory response to altitude

A

hypoxia leads to hyperventilation
PaCO2 falls
heart rate increases
blood pH increases
temporary alkalosis may occur, countered by metabolic hydrogen carbonate excretion

173
Q

pathologies associated with altitude

A

acute mountain sickness - only treated by descent
high altitude pulmonary oedema (unacclimated people)
- treated by oxygen treatment and descent

174
Q

what is 1ATM equivalent to?

A

100kPa

175
Q

Boyle’s Law

A

P1V1 = P2V2

176
Q

Dalton’s Law

A

PT = PPA + PPB …

177
Q

Henry’s Law

A

the amount of dissolved gas in a liquid is directly proportional to its partial pressure

C = kP

178
Q

pathologies associated with descent

A

decompression sickness
- ascend too fast for gas excretion
- inert gas bubbles form in tissues
inert gas narcosis
CNS oxygen toxicity
arterial gas embolism - 15 mins after surfacing
pulmonary barotrauma

179
Q

what week do the lungs start to develop?

A

4th

180
Q

which parts of the embryo form the lung?

A

endoderm and splanchnic mesoderm

181
Q

embryology of the lungs

A
  1. embryonic
    - respiratory diverticulum in the 4th week
    - right and left bronchi formed
  2. pseudo glandular
    - 5-16 weeks
    - right and left bronchi form terminal bronchioles
  3. canalicular
    - 16-26 weeks
    - terminal bronchioles form respiratory bronchioles
    - respiratory bronchioles form a few alveolar ducts
  4. saccular
    - 26 weeks - 8 months
    - alveolar air ducts grow sacs
  5. alveolar
    - 8 months - birth
    - alveoli mature
182
Q

which are the last bronchioles?

A

respiratory
NOT terminal

183
Q

name the three embryological shunts

A

foramen ovale
ductus venous
ductus arteriosus

184
Q

where is the foramen ovale?

A

septal hole between the right and left atrium

185
Q

what is the ductus venosus?

A

shunt that allows oxygenated blood in the umbilical vein to bypass the liver

186
Q

what is the ductus arteriosus?

A

shunts blood from pulmonary artery to aorta

187
Q

function of umbilical arteries

A

return deoxygenated blood from foetus to mother

188
Q

function of the umbilical vein

A

supplies oxygenated blood from the mother to foetus

189
Q

how many umbilical arteries do we have?

A

2

190
Q

how many umbilical veins do we have?

A

1

191
Q

which two organs are bypassed in the foetus?

A

liver and lungs - because they are not needed

192
Q

embryology of the first breath

A

fluid is squeezed out of the lungs
surfactant produced
air inhaled
vasodilaton of pulmonary arteries

193
Q

what does the umbilical vein become?

A

ligamentum teres

194
Q

what does the ductus venosus become?

A

ligamentum venosus

195
Q

what does the ductus arteriosus become?

A

ligamentum arteriosus

196
Q

what does the foramen ovale become?

A

fossa ovale

197
Q

function of alveolar surfactant

A

decrease surface tension in alveoli
keep alveoli open

198
Q

when does alveolar surfactant begin to be produced

A

34 weeks gestation
but dramatic increase 2 weeks pre birth
premature babies often have not made enough surfactant

199
Q

pre botzinger complex

A

pacemaker cells located in superior ventral respiratory group
breathing rhythm generators

200
Q

normal minute ventilation

A

7.5L/ min but can reach 30L/ min

201
Q

which cranial nerve monitors carotid peripheral receptor?

A

glossopharyngeal

202
Q

which cranial nerve monitors aortic baroreceptor?

A

vagus

203
Q

which chemoreceptors are dominant?

A

central

204
Q

lung development

A

from respiratory diverticulum
outbranch from foregut
weeks 4-5
pseudoglandular phase
- development of conducting airways
cannalicular phase
- 16-25
- capillaries, vasculature, alveoli
surfactant produced from week 34 but large increase in production after birth

205
Q

what is atresia?

A

failure of oesophagus and trachea to separate

206
Q

lungs at birth

A

placenta closes
umbilicaal veins and arteris shut
increase in systemic pressure
amniotic fluid expelled or absorbed
entry of oxygen into lungs causes pulmonary circulation pressure to decrease and flow increases
reduced pressure prevents cardiac shunting, foramen ovale and ductus ateriosus close
oxygen vasodilates pulmonary arteries

207
Q

first breath

A

initiates adaptation
oxygen causes pulmonary vasodilation
tissue resistance reduces
vasoconstriction of ductus arteriosus and umbilical arteries

208
Q

effect of oxygen on pulmonary and systemic systems

A

pulmonary vasodilator
systemic vasoconstrictor

209
Q

non immune host defences in the lungs

A

mucus - mucociliary clearance - mucociliary escalator
coughing and sneezing
antiproteinases
anti-fungal peptides
antimicrobial peptides
opsonins

210
Q

types of defences in the lung

A

intrinsic - always present
innate - induced by infection e.g macrophages
adaptive - tailored to a pathogen e.g T cells

211
Q

consequences of too much mucus

A

mucus plugs block airways
obstructive lung disease

212
Q

is lung tissue plastic?

A

yes
functional plasticity
multipotent basal cell population can differentiate into respiratory epithelial cells if damage occurs

213
Q

Gell and Coombs Hypersensitivity

A

4 types

214
Q

type 1 hypersensitivity

A

allergies
IgE causes release of histamine from mast cells
vasodilation
gap junctions open
immediate
anaphylaxis
hayfever

215
Q

type 2 hypersensitivity

A

autoimmune
IgG binds to self antigens
attack’s body’s own cells
cytotoxic
hours to days
transfusion reactions

216
Q

type 3 hypersensitivity

A

immune complex diseases
large scale IgG precipitating, unable to bee cleared by macrophages

217
Q

type 4 hypersensitivity

A

delayed type hypersensitivity reaction
T helper cells form granulomas around pathogens with macrophages in a cell mediated response not involving antibodies
tuberculosis
contact dermatitis

218
Q

innate immunity

A

dendritic cells
Kupffer cells - liver
alveolar macrophages
initiate acute inflammation via cytokines and antigen presentation

219
Q

most common leucocyte

A

neutrophil 70%

220
Q

primary neutrophil granules

A

myeloperoxidase
elastase
cathepsins
defensins

221
Q

secondary neutrophil granules

A

receptors
lysozyme
collagenase

222
Q

action of neutrophils

A

kill bacteria through enzyme release and generation of ROS by NADPH oxidase complex

223
Q

adaptive immunity

A

acquired
B and T lymphocytes
humoural and cell mediated respectively
upon binding of receptor, somatic hypermutation occurs to select for receptors with higher affinity (affinity maturation)
T reg cells remove cells that are capable of binding self antigens - immune tolerance

224
Q

pores allowing movement of macrophages

A

pores of Kohn

225
Q

physiological deadspace

A

175ml
150 anatomical (conducting airway tissues) 25 alveolar (no perfusion)

226
Q

origin of pulmonary pleurae

A

mesoderm

227
Q

layers of gas exchange

A

apes in capes protect red riding hood
alveolar epithelium
interstitial fluid
capillary endothelium
plasma layer
RBC membrane
RBC cytoplasm
Hb binding site
7 layers

Phase 1 flashcards (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions