Respiratory Changes Pt. 1 Flashcards

1
Q

What catalyzes the reaction of water and carbon dioxide to form carbonic acid?

A

Carbonic anhydrase in red blood cells

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2
Q

What does carbonic acid dissociate into?

A

Hydrogen ions and bicarbonate ions

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3
Q

What replaces bicarbonate ions as they leave the red blood cells?

A

Chloride ions

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4
Q

What does carbon dioxide react with when bound to hemoglobin and other plasma proteins?

A

Amine radicals

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5
Q

What gas competes with oxygen for binding sites on hemoglobin?

A

Carbon monoxide (CO)

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6
Q

Which has an increased affinity for hemoglobin: CO or O2?

A

CO (250X)

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7
Q

How much CO partial pressure is required to saturate 97% of hemoglobin and decrease oxygen carrying capacity by 50%?

A

Small PP (PCO = .4 mmHg)

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8
Q

What amounts of carbon monoxide are considered lethal?

A

.1% CO or PCO = .6 mmHg

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9
Q

How is CO poisoning treated?

A

With 95% O2 and 5% CO2

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10
Q

Why is CO poisoning also treated with CO2 in addition to the expected O2?

A

Increased ventilation function

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11
Q

How does the usual CO poisoning treatment work?

A

Rapid displacement of CO

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12
Q

What is the physiologic role of CO when produced by the body in SMALL quantities?

A

Signaling molecule in nervous system

Vasodilator

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13
Q

Small quantities of CO produced by the body have an important role is what body systems?

A

Immune, respiratory, GI, kidney, and liver

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14
Q

The goals of neural regulation of ventilation are to keep arterial levels of what gasses constant?

A

Oxygen and carbon dioxide

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15
Q

The nervous system adjusts the level of ventilation to match what?

A

Perfusion of the lungs (pulmonary blood flow)

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16
Q

What makes up the level of ventilation that is regulated by the nervous system?

A

Respiratory rate and tidal volume

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17
Q

By matching ventilation with pulmonary blood flow (CO), what else is automatically matched to ventilation?

A

Overall metabolic demand

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18
Q

Where is the dorsal respiratory group located?

A

Nucleus tractus solitarius in medulla

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19
Q

The dorsal respiratory group is associated with the termination of which cranial nerves?

A

IX and X

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20
Q

From where does the dorsal respiratory group receive input?

A

Peripheral chemoreceptors
Baroreceptors
Receptors in the lungs

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21
Q

The dorsal respiratory group self excites what group of muscles?

A

Muscles of inspiration

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22
Q

What area of neural control of ventilation sets the basic drive of ventilation?

A

Dorsal respiratory group

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23
Q

Explain the ramp like signaling of the dorsal respiratory group.

A

2 seconds on followed by 3 seconds off (self-excitation)

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24
Q

Which ventilatory neural control center has the opposite effect of the apneustic center?

A

Pneumotaxic center

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25
Q

What is the location of the pneumotaxic center?

A

Dorsally in the nucleus parabrachialis of upper pons

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26
Q

What is the function of the pneumotaxic center?

A

Inhibits the duration of inspiration by turning off the dorsal respiratory group ramp signal after the start of inspiration

27
Q

What is the location of the ventral respiratory group of neurons?

A

Bilaterally on the ventral aspect of medulla

28
Q

What is the function of the ventral respiratory group of neurons?

A

Stimulation of both inspiratory and expiratory muscles during increased ventilatory drive

29
Q

What is the location of the apneustic center?

A

Lower pons

30
Q

What is the function of the apneustic center?

A

Prevent inhibition of the dorsal respiratory group under some circumstances

31
Q

Which ventilatory neural control center functions to inhibit the dorsal respiratory group? Which stimulates it?

A

Pneumotaxic center inhibits DRG

Apneustic center stimulates DRG

32
Q

How does increased stimulation of the pneumotaxic center affect respiratory rate and tidal volume?

A

Increased RR

Decreased TV

33
Q

How does inhibition of the pneumotaxic center affect respiratory rate and tidal volume?

A

Decreased RR

Increased TV

34
Q

What is the Herring-Breur Inflation reflex?

A

Stretch receptors located in the wall of airways that are stimulated when stretched at tidal volumes greater than 1500mL

35
Q

What effect does the Herring-Breur Inflation reflex have on the dorsal respiratory group?

A

Inhibition

36
Q

Which receptors are stimulated by sneezing, coughing, and possibly airway constriction?

A

Irritant receptors

37
Q

Where are the juxtaposition (J) receptors located?

A

In alveoli next to pulmonary capillaries

38
Q

When are the juxtaposition (J) receptors stimulated?

A

When pulmonary capillaries are engorged or during a state of pulmonary edema

39
Q

In what condition can pulmonary capillaries become engorged and stimulate the J receptors and what feeling can be felt?

A

During left-sided heart failure; feeling of dyspnea

40
Q

The chemosensitive area of the respiratory center is more sensitive to changes in what gas: oxygen or carbon dioxide?

A

Carbon dioxide (subtle changes needed compared to drastic changes of oxygen)

41
Q

What is the primary stimulus of the chemosensitive area of the respiratory center and what is its flaw?

A

Hydrogen ions; cannot cross the blood brain barrier

42
Q

Which respiratory gas CAN cross the BBB?

A

CO2

43
Q

When is carbon dioxide converted to hydrogen ions to stimulate the chemosensitive area of the respiratory center?

A

Once inside the cell from CO2 and H2O after crossing the BBB

44
Q

Why do rises of CO2 in CSF have a quicker effect on stimulating ventilation?

A

CSF lacks buffers (compared to plasma)

45
Q

Outside of the chemosensitive center, which has a bigger effect: CO2 or H+ ions?

A

CO2

46
Q

Inside the chemosensitive center, which has a bigger effect: CO2 or H+ ions?

A

H+ ions

47
Q

The chemosensitive area of the respiratory center is unresponsive to what situation?

A

Falls in oxygen-hypoxia (depresses neuronal activity)

48
Q

Where can we find peripheral chemoreceptors?

A

Aortic and carotid bodies

49
Q

Where can we see 70-80% of CO2 induced increase in ventilation?

A

Chemosensitive area of respiratory center

50
Q

Where can we see 20-30% of CO2 induced increase in ventilation?

A

Peripheral chemoreceptors

51
Q

What location of ventilatory chemical control IS responsive to hypoxia? Which is unresponsive?

A

Peripheral chemoreceptors - responsive

Chemosensitive area of respiratory center - unresponsive

52
Q

When is the response to hypoxia blunted in the peripheral chemoreceptors?

A

If CO2 falls as the oxygen levels fall

53
Q

What alters the sensitivity of the peripheral chemoreceptors?

A

CNS

54
Q

What effect does SNS decreasing flow have on the peripheral chemoreceptors’ ability to respond to hypoxia?

A

Increased sensitivity

55
Q

How are stroke volume and cardiac output affected by hyperventilation?

A

Decreased

56
Q

How are coronary blood flow and oxyhemoglobin affinity affected by hyperventilation?

A

Decreased

57
Q

What is neural activity impaired by hyperventilation?

A

Repolarization of the heart

58
Q

How can hyperventilation affect muscles?

A

Skeletal muscle spasms and tetany

59
Q

How does hyperventilation affect serum potassium levels?

A

Decreased

60
Q

Hypocapnic alkalosis is associated with: hyper- or hypoventilation?

A

Hyperventilation

61
Q

What is the most prevalent cause of respiratory depression?

A

Anesthesia/narcotics like sodium pentobarbital or morphine

62
Q

What effect does brain edema have on respiratory centers?

A

Depression or inactivation of them

63
Q

How is brain edema treated?

A

IV hypertonic solution (mannitol)

64
Q

How is ventilation stimulated during exercise (three ways)?

A

Increased corticospinal traffic collaterally stimulates respiratory centers in the brainstem
Reflex neural signals from active muscle spindles and joint proprioceptors
Flucuations in O2 and CO2 levels in active muscle stimulate local chemoreceptors