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RUSVM Physiology I 2016 > Respiratory > Flashcards

Respiratory Flashcards

1
Q

The exchange of O2 and CO2 between external environment and the cells of the body is what type of respiration?

A

External

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2
Q

Metabolic processes within the mitochondria using O2 and producing energy is what kind of respiration?

A

Internal respiration

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3
Q

What airways make up the conducting zone?

A

Trachea
Bronchi (primary bronchus)
Bronchi (secondary bronchus)
Tertiary bronchus

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4
Q

What airways make up the respiratory zone?

A

Respiratory bronchioles
Alveolar duct
Alveolar sac

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5
Q

How does ANS control airways?

A

Changes the diameter of conducting airways

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6
Q

SNS innervation of the airways causes ___________

A

Dilation

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7
Q

PSNS innervation of the airways causes _____________

A

Constriction

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8
Q

What is the structure of the alveoli?

A

Large surface area
Lined with epithelium and type II and type II pneumocytes
Closely associated with capillaries

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9
Q

What must respiratory gases pass through from alveoli to capillary?

A

Surfactant -> type I pneumocytes -> basement membrane -> capillary endothelium -> RBC

0.5um - 1.5um thickness

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10
Q

What is the kinetic theory of gases?

A

Pressure of a gas is the force per unit area exerted by the impact of the molecules when they collide with the walls of the container

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11
Q

What is atmospheric pressure at sea level?

A

750mmHg

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12
Q

Daltons Law

A

The total amount of pressure exerted by a mixture of a gases is equal to the sum of the partial pressures of the individual gases.

Ptotal = PO2 + PCO2 + PN2

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13
Q

What percentage of air does oxygen occupy?

A

21%

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14
Q

If atmospheric pressure is 750mmHg and air is 21% oxygen, what is the partial pressure of oxygen?

A

750mmHg x 0.21 = 159.6mmHg

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15
Q

What two factors determine the amount of gas that will be dissolved in a liquid?

A

Pressure of gas at the surface

Solubility of gas

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16
Q

Moisture in lungs has a partial pressure of 47mmHg.
If atmospheric pressure is 750mmHg and the composition of air is 21% oxygen, what is the partial pressure of oxygen in the lungs?

A

P02 = (Patmos - Ph2o) x Fo2

(750 - 47) x 0.21 = 149.mmHg

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17
Q

Boyles Law

A

At a constant temperature, the volume of gas is inversely proportional to pressure.

P = 1/V

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18
Q

Charles Law

A

The volume of a gas is directly proportional to absolute temperature

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19
Q

Movement of air into the alveoli is facilitated by________________, due to expansion of the thoracic cavity

A

Negative pressure (draw air in)

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20
Q

During expiration the thoracic cavity volume ________________ and the intra-alveolar pressure ___________ .

A

Decreases, increases

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21
Q

Describe air flow when Palveolar = Patmospheric

A

No air movement

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22
Q

Describe air flow when Palveolar is less than Patmospheric

A

Air moves into alveoli

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23
Q

Describe air movement when Palveolar is greater than Patmospheric

A

Air moves out of the lungs

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24
Q

What are the 4 pressures involved in a breathing cycle?

A

Atmospheric
Intra-alveolar
Intrapleural
Transmural (difference between intra-alveolar and intrapleural)

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25
Q

What prevents the outward movement of the chest wall and inward collapse of the lungs?

A

Intrapleural pressure

Pressure is negative sucking the two walls together. The opposing forces prevent expansion and collapse

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26
Q

An opening into the intrapleural space will cause what?

A

Pneumothorax

Negative pressure is lost. Chest cavity expands and the lung collapses

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27
Q

During inspiration will intrapleural pressure become more positive or negative? Why?

A

Negative.

Chest wall expands outward, force moving outward. Less pressure within the cavity

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28
Q

What two physiological properties must the lungs have in order to breath?

A

High compliance - lungs can expand in inspiration

Elasticity - lungs can recoil when force is released

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29
Q

Condition of lung stiffness

A

Fibrosis

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30
Q

Condition of lost recoil

A

Emphysema

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31
Q

The volume of gas in conducting airways is called?

A

Anatomical dead space

Takes no part in gas exchange

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32
Q

The volume of air that is breathed in passively is called?

A

Tidal volume (10-20ml/kg)

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33
Q

The volume air in conducting airways and alveolar volume that is not taking place in gas exchange is called?

A

Physiological dead space

Anatomical + alveolar dead space

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34
Q

In a restrictive lung disease what happens to the volumes of the lung? Why?

A

Decreased volume.

Decreased compliance causes a decreased expansion

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35
Q

What is an example of an obstructive lung disease? What effect will this have on respiration?

A

Asthma (narrowed airways), or chronic bronchitis (mucus plugs/ inflammatory swelling)

And increased resistance to movement of air
Respiration is more difficult
Not necessarily a change in volume

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36
Q

What is functional residual capacity of a lung?

A

The total volume of air left in the lungs after a tidal expiration.

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37
Q

If elastic forces increase and compliance decreases what is happening to the lungs?

A

Lungs are getting stiffer (fibrosis)

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38
Q

If elastic forces decrease and compliance increases what is happening to the lungs

A

Lungs are getting more elastic

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39
Q

Hookes Law

A

Force exerted by a spring is proportional to its extension

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40
Q

Law of Laplace

A

P=2T/r
Pressure is related to surface tension and radius

Radius effect- pressure is greater in smaller alveoli
Consequence - air will flow from smaller alveoli into larger alveoli

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41
Q

What produces surfactant?

A

Type II pneumocytes

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42
Q

What does surfactant do?

A

Phospholipid that breaks up bonding between water molecules in alveoli.
Decrease surface tension.
In smaller alveoli the effective concentration of surfactant is larger decreasing surface tension even more -> due to law of LaPlace no pressure difference between large and small alveoli

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43
Q

What occurs when surfactant is deficient?

A

Lungs become less compliant (stiff) and areas of alveolar collapse

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44
Q

Two effects of surfactant on lungs

A

Increased pulmonary compliance

Decreased tendency to recoil

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45
Q

What is the purpose of Type I pneumocytes

A

Gas exchange

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46
Q

What do type II pneumocytes produce

A

Surfactant *

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47
Q

Chronic obstructive pulmonary disease (COPD) and oedema increase ____________ of airway

A

Resistance

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48
Q

What factors impact airflow?

A

Change in pressure (mouth - alveolar gradient)

Resistance of airway (RAW)

49
Q

In laminar airflow, what equation applies to airflow?

A

Poseuilles equation

R= 8(viscosity)(length) / (pi)(r^4)

50
Q

How is resistance of airways changed under normal conditions?

A

ANS acts on smooth muscle to dilate or contract smooth muscle

51
Q

Bronchomotor tone is controlle primarily by the PSNS or the SNS?

A

PSNS

52
Q

What is released in PSNS action on smooth muscle of the airways? What receptor does it activate?

A

Neurons release Acetylcholine (ACh) which activate muscarinic receptors causing bronchoconstriction

53
Q

During SNS innervation on airway, what is released? What receptor does it act on?

A

Neuron releases adrenaline which acts on B2 receptors causing bronchodilation

54
Q

What holds open the airway of trachea and alveolar ducts

A 
Cartilagenous rings (trachea) 
radial traction (alveolar)
55
Q

In forced expiration, what could happen to the airway?

A

High force on lung (coughing) causes rise in intrapleural pressure and collapse of lung

56
Q

In ventilation, which region of the lung is able to have more ventilation

A

Bottom

At top of lung, it is more expanded/ distended. Lower lung has more ability to expand and fill during inspiration

57
Q

Does the top or bottom of the lung have a greater intrapleural pressure?

A

Bottom P= -2.5 (more squished)

Top P= -8

58
Q

What is ventilation rate?

A

Volume of air / time

59
Q

What is respiratory minute volume?

A

Total rate of air movement in and out of lungs in a minute

Tidal volume (ml/breath) x respiratory rate (breath/min)

60
Q

If dead space increases, will a increased respiratory rate or increased depth of breathing be more effective?

A

Depth of breathing.

Increase amount of air taking place in gas exchange

61
Q

Alveolar ventilation

A

Air that takes place in gas exchange

Tidal volume - dead space x respiratory rate

62
Q

What is atelectasis?

A

Lung collapse

63
Q

If disease changes the thickness of alveolar membrane, what happens to gas diffusion

A

Slower / decreases

Ficks law. Diffusion in inversely related to membrane thickness

64
Q

Is oxygen exchange diffusion or perfusion limited?

A

Perfusion limited

65
Q

Explain the PO2 gradient change from airway to tissue.

Why is it important for PO2 to remain high?

A

Airway 150mmHg
Alveolus 100mHg
Tissue 50mmHg
Mitochondria 1mmHg

As blood moves throughout body oxygen is lost to various processes/ tissues. A high PO2 is required to make sure enough O2 gets to mitochondria to generate energy.

66
Q

What is the anatomical R-L shunt?

A

Bronchial circulation goes to airways and lung tissue and returns to left heart creating a venous admixture (oxy = deoxy)
Via Thebesian veins

67
Q

What is a physiological shunt?

A

Perfusion is normal but the alveolus is not ventilated

Creates a venous admixture

68
Q

What is the A-a gradient

A

The difference between PAO2 and PaO2

Aveolar partial pressure of oxygen and arterial partial pressure of oxygen. Due to R-L anatomical shunt

69
Q

How is blood flow in lungs increased?

A

Recruitment of previously closed vessels

Open in response to increased CO2

70
Q

Why do you not want a high capillary pressure within the lungs?

A

Oedema

Capillary rupture and clotting

71
Q

What effect will hypoxia have on pulmonary vascular resistance?

A

Vasoconstriction to increase flow

Hypoxia pulmonary vasoconstriction

72
Q

Why is it a good idea to shut down blood flow to hypoxia regions of the lungs?

A

Increase flow to where oxygenation in good

73
Q

Why is it a bad idea to shutdown blood flow to hypoxic regions at high altitudes?

A

At high altitudes, all the lung is receiving a lower PO2. All lung is hypoxic

74
Q

In optimal gas exchange V/P =?

A

V/P= 1

There is no ventilation -perfusion mismatch

75
Q

What is a ventilation - perfusion mismatch?

A

When either flow is greater than ventilation or ventilation is greater than flow

76
Q

If ventilation is normal and Flow (Q) is decreased, what is occurring?

A

Physiological dead space

V/Q = 1/0 = infinity

77
Q

If ventilation is not occurring and flow (Q) is normal, what is occurring?

A

Physiological shunt

Perfusion occurs but no ventilation

78
Q

What is a normal A-a difference caused by?

A

R-L anatomical shunt

Under normal conditions about 2% of cardiac output

79
Q

What is occurring in a physiological shunt

A

Perfusion is occurring but the alveoli is not ventilated

Creates a venous admixture

80
Q

The condition of low blood O2 is called?

A

Hypoxia

81
Q

If cardiac output is halved, what would V/Q be?

A

Ventilation is normal (1)
Cardiac output is 1/2

1/ (1/2) = 2

82
Q

___________________ is the volume of air left in the lungs after a forced expiration

A

Residual volume

83
Q

After a tidal volume expiration, the amount of air that can be forcible pushed out of the lungs is ____________________

A

Expiratory reserve volume

84
Q

The amount of air that can be inhaled after a tidal volume inspiration is _________________

A

Inspiratory reserve volume

85
Q

Within the blood, oxygen can be bound or dissolved. What contributes to the partial pressure of oxygen

A

Free dissolved oxygen

86
Q

How is most of the oxygen transported around the body?

A

Bound by hemoglobin in RBC

87
Q

What is P50?

A

The partial pressure of oxygen at which 50% of the binding sites on hemoglobin are filled. (50% saturated)

88
Q

The oxygen dissociation curve is sigmoidal, what does the steepness of the curve demonstrate about hemoglobin binding to oxygen

A

There is cooperative binding of hemoglobin and oxygen. The binding of one oxygen to hemoglobin makes it easier for other oxygen to bind. (Affinity for oxygen increases)

In reverse, the dissociation of oxygen from hemoglobin will cause hemoglobin to give up its oxygen (affinity decreases)

89
Q

At high PO2 in the pulmonary capillaries hemoglobin will _____________ oxygen, and _____________ in tissues where PO2 is low

A

Bind, unload

90
Q

If the oxygen dissociation curve is shifted to the right, does hemoglobin have a higher or lower affinity for oxygen.

A

Lower affinity

At the same PO2, a right-shifted curve will have a lower percent of oxygen bound than a normal curve.

91
Q

What are some causes of a right-shifted curve?

A

Acidosis
Increased CO2
Increased temperature

92
Q

Does a left-shifted curve, demonstrate hemoglobin with increased or decreased affinity for oxygen?

A

Increased.

At the same PO2, a left shifted curve will have a higher percent of oxygen bound than a normal or right shifted curve

93
Q

What causes a left-shifted curve

A

Alkalosis
Decreased CO2
Decreased temperature

94
Q

Highly active tissues produce what byproduct of glycolysis that will alter hemoglobin binding of oxygen?

A

2,3-DPG

95
Q

Production of 2,3-DPG causes the oxygen dissociation curve to shift what direction? Why?

A

Right

Binds to hemoglobin, takes up binding sites so oxygen cannot bind therefore hemoglobin has a lower affinity to oxygen.

96
Q

Who is the best at physiology?

A

YOU ARE! :)

97
Q

Does hemoglobin or myoglobin give up oxygen more readily?

A

Hemoglobin

Myoglobin has a higher oxygen affinity. Takes up oxygen from blood and stores it in muscle until tissue oxygenation is super duper low.

98
Q

Does fetal hemoglobin or adult hemoglobin have a higher affinity for oxygen?

A

Fetal hemoglobin

Because fetus is a little parasite that must steal oxygen away from mother … so their hemoglobin is more greedy and stronger and pulls oxygen off of momma hemoglobin

99
Q

In what three forms is CO2 transported around the body?

A

Dissolved
Reversible bound to hemoglobin
Bicarbonate

100
Q

What do you call a hemoglobin with a carbon dioxide attached?

A

Carboxihemoglobin

101
Q

How is it that a RBC can constantly produce bicarbonate and never reach equilibrium?

A

Chloride shift- chloride moves into cell and bicarbonate moves out

Any H+ ions produces are bound by hemoglobin

102
Q

What is the Haldane effect?

A

For any given PCO2, the CO2 content of deoxygenated blood is higher than oxygenated blood.

Seems reasonable right?

Why does this happen? Let me tell you. When oxygen dumps hemoglobin, hemoglobin is sad and goes to the bar and finds a rebound molecule H+, H+ and hemoglobin leave the bar. The bouncer then lets in more CO2 (sober people), which then turn into drunk people and dissociate from their friends becoming H+. Which then again go home with random hemoglobin and more CO2 is taken up …

103
Q

Decreased CO2 is called _________

A

Respiratory alkalosis

104
Q

Increased CO2 is called _____________

A

Respiratory acidosis

105
Q

How is PCO2 related to ventilation

A

PCO2 is inversely related to alveolar ventilation

PCO2 = 1/ (alveolar ventilation)

106
Q

Hypoventilation leads to_____________, which results in peripheral ________________.

A

Hypercapnia, vasodilation

107
Q

Hyperventilation leads to ___________________, causing cerebral ___________________

A

Hypocapnia, vasoconstriction

108
Q

What 3 factors are monitored by chemoreceptors?

A

Decreased arterial PO2
Increased arterial PCO2
Increase concentration of H+

109
Q

Where are peripheral chemoreceptors located and what signals them?

A

Carotid and aortic bodies
Low PO2
High PCO2
Low pH

110
Q

Peripheral chemoreceptors respond to hypoxia by _______________

A

Increasing ventilation

Ventilation will also increase in response to increase in PCO2

111
Q

Where are central chemoreceptors located?

A

Medulla

112
Q

Central chemoreceptors respond to what stimulus?

A

High PCO2

Acidosis (low pH)

113
Q

Central chemoreceptors causes what action?

A

Increased ventilation

114
Q

What does it mean to be normoxic?

A

The central chemoreceptors are driven by changes in PCO2.

If PCO2 remains constant a change in PO2 will not produce a ventilation change until about 60mmHg (out of norm)

115
Q

What effect will a V-Q mismatch have on gases and what will the respiratory system do to compensate?

A

A V-Q mismatch causes partial pressure of O to decrease and partial pressure of CO2 to increase. The increase in CO2 causes stimulation of ventilation which will restore gas partial pressures.

116
Q

What receptors response to lung over inflation

A

Pulmonary stretch receptors

117
Q

Which receptors respond to a inhaled irritant?

A

Irritant receptors

118
Q

Lung receptor signals all travel to the respiratory center and travel back to the lungs on the ____________ nerve

A

Vagus

119
Q

Which receptors respond to oedema or substances released due to lung damage / allergy?

A

Juxtapulmonary ‘J’ receptors

RUSVM Physiology I 2016 (2 decks)

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