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respiratory Flashcards

1
Q

clara cells: structure and function

A
  • secrete surfactant
  • dome-shaped w/ microvilli
  • reserve cells for worn out epithelium
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2
Q

type I alveolar cells: structure and function

A
  • simple squamous
  • gaseous diffusion barrier
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3
Q

type II alveolar cells: structure and function

A
  • cuboidal, round nuclei, prominent nucleoli
  • secretes surfactant
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4
Q

dust cells

A

macrophages of respiratory system

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5
Q

layers of blood-air barrier

A
  • plasma membrane, cytoplasm of type I alveolar cells
  • dual basal lamina: type I alveolar, endothelial cells
  • plasma membrane and cytoplasm of endothelium
  • plasma membrane of RBCs
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6
Q

lung volumes: VT

A
  • tidal volume
  • amount of air entering/exiting lung per breath
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7
Q

lung volumes: RV

A
  • residual volume
  • volume remaining after maximal exhalation
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8
Q

lung volumes: VC

A
  • vital capacity
  • max achievable tidal volume (max inhalation and exhalation)
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9
Q

lung volumes: FRC

A
  • functional residual capacity
  • air in lungs after quiet expiration
  • elastance of lungs at rest
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10
Q

lung volumes: TLC

A
  • total lung capacity
  • maximum lung volume
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11
Q

bulk flow in inspiration

A
  • lower airways have a progressive surface area, cross sectional diameter increase
  • bulk flow velocity decreases, allowing for diffusion
  • total resistance decreases
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12
Q

respiratory cycle pressures: intrapulmonary

A
  • end of quiet exhalation: alveolar pressure = atmospheric
  • during inhalation: lungs expand, alveolar pressure decreases, bulk flow inward
  • end of inspiration: alveolar pressure = atmospheric
  • exhalation: elastic recoil of lungs pulls them in, volume decreases, pressure increases, creating outward bulk flow
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13
Q

respiratory cycle pressures: intrapleural

A

end of quiet exhalation: intrapleural pressure is negative
during inhalation: muscles expand pleural space, pressure decreases
end of inspiration: inspiratory muscles still contracting, pressure more negative
exhalation: slow return to baseline

*pressure is negative due to opposing recoil forces

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14
Q

surfactant: function in ventilation

A
  • reduces surface tension
  • increases lung compliance, reducing work of breathing
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15
Q

elastic recoil affecting ventilation

A
  • FRC pulls lungs in while chest wall has outward recoil. exactly negate each other
  • structures pull at pleural space, creating negative pressure that vacuum seals lungs, chest wall together
  • lungs and chest wall move as unit
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16
Q

minute ventilation vs alveolar ventilation

A

minute: air moved in/out of respiratory system per min
alveolar: air moved in/out of respiratory zone/minute (volume that participates in gas exchange)

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17
Q

dead spaces: anatomic vs alveolar vs physiologic

A

anatomic: VT that stays in conducting zone
alveolar: VT in resp zone that doesn’t exchange w/ blood
physiologic: total

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17
Q

pulmonary function test: obstructive vs restrictive

A

in obstructive: FEV1/FVC decreases

in restrictive: FEV1/FVC stays the same

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18
Q

lung volumes: FVC

A
  • forced vital capacity
  • amount of air that can be exhaled after max inhalation
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19
Q

lung volumes: FEV1

A

how much air a person can exhale in 1 second after max inhalation

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20
Q

lung kinetics in disease

A

gas exchange slows
- patient feels normal at rest
- notices SOB during exercise

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21
Q

lung kinetics in hypoxemia

A

slow, low supply of oxygen (less PaO2)
- patient feels fatigued, SOB

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22
Q

increased blood flow: effect on pulmonary vascular resistance

A
  • increases pressure, opens closed vessels (recruitment)
  • increases diameter of open vessels (distension)
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23
Q

lung volume: effect on PVR

A
  • pulmonary vessels compress as volume moves away from FRC
  • PVR increases
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24
Q

ventilation-perfusion in upper vs lower lungs

A
  • at FRC: alveoli in base of lungs are smaller than apex bc of gravity. when air enters, more air goes to lower lungs
  • higher Q (perfusion) in lower lungs
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25
Q

V/Q < 1

A

some blood remains deoxygenated bc there’s more blood than air can oxygenate

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26
Q

V/Q > 1

A
  • more air w/ more oxygen than blood can transport
  • exhaled
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27
Q

pulmonary edema: effects

A
  • thickened blood-air barrier
  • reduced surface area
  • decreased ventilation
28
Q

Low PiO2: effects

A

affects ventilation
- pAO2 decreases
- pACO2 decreases or stays the same
- pA-aO2 stays the same
- oxygen supplementation is useful

29
Q

hypoventilation: effects

A

affects ventilation
- pAO2: decreases
- pACO2: increases
- pA-aO2: stays the same
- oxygen supplementation useful

30
Q

how to differentiate PiO2 and hypoventilation

A

in PiO2, pACO2 decreases or stays the same
in hypoventilation, pACO2 increases

31
Q

abnormal diffusion: effects

A
  • pA-aO2 increases
  • pAO2 and pACO2 can change, not always
  • oxygen supplement is useful
32
Q

V-Q mismatch: effects

A
  • pA-aO2 increases
  • oxygen supplement is useful
33
Q

right to left shunt: effects

A
  • pA-aO2 increases
  • oxygen supplement not useful
34
Q

factors that decrease oxygen affinity

A
  • increased pH, pCO2
  • increased 2, 3- DPG
35
Q

anemic hypoxia

A
  • decreased oxygen carrying capacity in blood leads to insufficient/defective Hb
  • less oxygen enters blood, less oxygen to tissues
  • caused by hemorrhage, anemia
35
Q

factors that increase oxygen affinity

A
  • decreased pH, pCO2
  • decreased 2, 3-DPG
36
Q

hypoxic hypoxia

A
  • abnormal lung oxygenation
  • not enough saturated oxygen
  • less oxygen entering blood, less oxygen delivery to tissues
36
Q

histotoxic hypoxia

A
  • normal oxygen delivery, but cells can’t uptake oxygen due to toxic substances
  • oxygen extraction and uptake inhibited
36
Q

circulatory hypoxia

A
  • issue w/ CO: inadequate blood supply to tissues
  • heart failure, thromboembolic diseases
  • less blood flow, less oxygen delivery to tissues
36
Q

peripheral chemoreceptors: locations, functions

A
  • in carotid sinus, aortic arch
  • sense PaO2, PaCO2, pH
  • send signals to medulla, pons
37
Q

CO2 carried in blood

A
  • most converted to bicarbonate w/ carbonic anhydrase
  • some dissolves in plasma
  • unloads when oxygen pressure is high
38
Q

central chemoreceptors: locations, functions

A
  • found along spinal cord
  • sense changes in PaCO2, changing pH of CSF
39
Q

central controller: functions

A

medulla and pons
- initiates breathing, sets rhythm (modulated by signal inputs)
- receives afferent signals from chemoreceptors
- sends info to effectors to set resp rate

40
Q

effectors: functions

A

respiratory muscles, airways
- maintain resp rate set by CNS

41
Q

set points

A

PaO2, pH, PaCO2
- respiratory rate should maintain

42
Q

chemoreceptors (in relation to brainstem)

A
  • recognize changes in set points
  • send signals to CNS for modulation
43
Q

cerebral cortex: respiration

A
  • voluntary control
44
Q

airway function: air conditioning

A

upper airway warms and humidifies air

45
Q

airway function: phonation

A

voice production

46
Q

airway function: host defense

A
  • epithelium, cilia, mucus, mucociliary escalator
  • traps inhaled particles, clears by moving towards pharynx
  • coughing, sneezing: forceful exhalation
  • bronchial associated lymphoid tissue
47
Q

airway function: metabolism, conversion

A
  • angiotensin I to II
  • serotonin metabolism
48
Q

nasal cavity: lateral wall

A
  • formed by middle and inferior nasal conchae
  • create turbulent flow: all air contacts epithelium, maximizes entrapment of particles
49
Q

nasal cavity: vibrissae, sebaceous glands function

A

trap particulate matter

50
Q

nasal cavity: structure that warms air

A

blood vessels in lamina propria

51
Q

olfactory cells: portions

A

bipolar
- apical region: olfactory knob (dendrite) has olfactory receptors for odor molecules
- basal region: axons, olfactory fila pass thru cribriform plate to olfactory bulb
- sustentacular cells: support

52
Q

larynx: functions

A
  • airway passage
  • sound production
  • closing trachea during swallowing
53
Q

first portion of respiratory tract with no cartilage

A

terminal bronchioles

54
Q

trachea: mucosa characteristics

A
  • ciliated pseudostratified
  • serous and mucus glands present in lamina propria
  • elastic lamina
55
Q

trachealis muscle: fiber type

A

smooth muscle

56
Q

lobar bronchi: mucosa characteristics

A
  • ciliated pseudostratified to ciliated simple columnar
  • lamina propria w/ more elastic fibers, has serous and mucus glands, blood vessels
  • complete muscularis mucosa
57
Q

trachea: submucosa characteristics

A
  • dense irregular CT
  • fibroelastic w/ serous and mucus glands
  • MALT
58
Q

lobar bronchi: submucosa characteristics

A
  • fibroelastic, sparse glands
59
Q

segmental bronchi: mucosa characteristics

A
  • ciliated simple columnar
  • more elastic fibers in thinner lamina propria
  • complete muscularis mucosa
60
Q

terminal bronchioles: mucosa characteristics

A
  • ciliated simple columnar to ciliated cuboidal
  • clara cells present: dome shaped w/ microvilli, secrete surfactant
  • thin lamina propria, no glands
  • complete muscularis mucosa
61
Q

respiratory bronchioles: mucosa characteristics

A
  • ciliated simple cuboidal
  • clara cells
  • simple squamous alveoli interrupt wall continuity
  • no muscularis mucosa
62
Q

alveolar ducts: mucosa characteristics

A
  • low cuboidal to type I alveolar (simple squamous)
  • thin for diffusion
  • smooth muscle knobs bulge into lumen to regulate diameter of opening
63
Q

alveoli: characteristics

A
  • type I simple squamous alveolar cells: gaseous diffusion barrier, occluding junctions between cells
  • type II cuboidal, round nuclei, prominent nucleoli, granules to release surfactant

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