Respiratory COPY Flashcards
Pharynx function, regoins, Lining
- Common opening for digestive and respiratory system
- 3 region- Nasopharynx (TRE), Oropharynx (Stratified squamous epithelium), Laryngopharnyx
Resistive Work
- Work to overcome airway resistance MAJOR
- Work to overcome tissue resistance MINOR
Factors determining airway resistance
Airway Narrowing
- Dramatically ______ airway resistance what is an example of this?
- The ____ of the _____ _____ is controlled by?
- Stimulation of _____ receptors causes?
- ______ activity causes bronchoconstriction
- Increases, obstructive diseases
- Tone of the smooth muscle is controlled by the ANS
- B-adrenergic bronchodilation
- Parasympathetic activity
Hemoglobin
Hypercapnia
Increase in?
Cause by?
Symptoms?
- Increase in PaCO2
- Caused by
- Depression of the respiratory center by drugs (narcotics)
- Disease of the medulla
- Airway obstruction (sleep apnea, severe asthma, chronic bronchitis)
- Increased physiological dead space (emphysema)
- Neuromuscular diseases (amyotrophic lateral sclerosis)
- Symptoms: HA, confusion, increase cardiac output, HTN, arrythmias due to E+ abnormalitities
Gas-exchange airways
Alveolar Sacs
- Alveoli make up the wall of the alveolar sac
Effort- independent flow rate phenomenon
Explain
- 3 tests are performed A (Hard exhale), B (slow then hard), C (least forceful)
- Moral the end of exhalation is all the same for each
- The reason for this is compression of the airways by intrathoracic pressure
Anti Anemic Drugs
WHat are the 3 oral Irons
WHo is IV iron reserved for?
Iron
Overall structure of
- conducting airways
- Gas exchange airways
- Upper- Nasal cavity, pharynx, larynx
- Lower - Trachea, Bronchi, bronchioles
- Gas exchange airways- Respiratory bronchioles, alveolar ducts, alveolar sacs
Larynx function, structure, lining
- Maintain an open passageway for air movement
- Vocal cords- Are primary source of sound production
- Structure- Endolarynx and cartilage
- Epiglottis- Prevents swallowed material from moving into larynx
- Lining: TRE and stratified squamous epithelium in regoins of “wear and tear”
Pulmonary resistance
Pressure volume curve
Hysteresis
Lung Compliance
Major contributing forces to compliance
5 things
If lung volume is small what happens to surface tension?
- Pressure-volume curve of the lung
- The expiratory curve does not follow inspiration
- Hysteresis: Lung volume at a given transpulmonary pressure is higher during deflation then during inflation
- Lung compliance (CL)
- The slope of dV/dP is lung compliance, compliance decreases (the lungs become stiffer) at high lung volumes and very low lung volumes
- Lung compliance and pulmonary diseases
- Decreased compliance
- Fibrosis: Increased fibrous tissue
- Alveolar edema: prevents inflation of alveoli (surface tension change and lung volume decreases)
- Atelectasis: Collapse of alveoli
- Increased compliance
- Emyphysema: loss of alveolar and elastic tissue
- Aging lung: alteration of elastic tissue
- Asthma Attach: unknown
- Decreased compliance
- Major forces contributing to lung compliance
- Tissue elastic force
- Surface tension forces
Increases surface tension
Erythropoeisis
Leukocytes
Regulation of erythro synthesis
Nerves
- Respiratory centers control breath rate and depth
- Autonomic nervous system affects rate and depth through smooth muscle contraction/relaxation
- Parasympathetic tone: Vagus nerve connects smooth muscle cells, stimulation contricts airways by releasing acetylcholine
- Sympathetic tone: Stimulation causes release of catecholamine, which induces bronchodilation, (No innervation to smooth muscles but releases catecholamine)
Airway cross sectional area
2 things,
end result
- Individual airway diameter, decreases with branching
- Overall or total cross-sectional diameter increases a lot
This results in a decreased airflow speed and a decrease in resistnance causing optimal diffusion.
Forced Expiration
Dynamic Compression
- Airway Ptm= 10-10 = 0 airway tends to collapse (equal pressure point)
- Driving force PA-Ppl
- Increasing effort causes similat increase of PA and Ppl
- Inspiration is ____ but _____ during rest is passive. The most important muscle of respiration is the?
- The _____ curve is nonlinear and shows ____. The ____ pressure of the lung is attributable to both its ____ tissue and the _____ ___ of the alveolar linging layer
- Properties of ___ affect lung compliance and abnormal ____ production causes?
- ____ ____ of the airways during forced expiration results in flow that is ____ independent.
- Inspiration is active, but expiration during rest is passive. The most important muscle of respiration is the diaphragm.
- The pressure-volume curve of the lung is nonlinear and shows hysteresis. The recoil pressure of the lung is attributable to both its elastic tissue and the surface tension of the alveolar lining layer.
- Properties of surfactant affect lung compliance, and abnormal surfactant production causes IRDS.
- Dynamic compression of the airways during a forced expiration results in flow that is “effort independent”.
Lymphatic vessels
Deep and superficial
Main function?
- The deep lymphatic capillaries begin at the level of the terminal bronchioles, there are no lymphatic structures in the acinus
- The superficial lymphatic capillaries drain the membrane that surrounds the lungs
- Main thing keep lungs free of fluid
Platelets
Lymphoid organs
nodes
Part of the immune and ____ system
Facilitate?
Transport?
Cleanse?
- Volume of air inspired or expired during a normal inspiration or expiration.
- Amount of air inspired forcefully after inspiration of normal tidal volume.
- Amount of air forcefully expired after expiration of normal tidal volume.
- Volume of air remaining in lungs at the end of a maximal expiration.
- Maximal amount of air that can be inhaled from the end-expiratory level of a tidal volume (VT+IRV).
- Volume of air in the lung at the end of a normal expiration.
- Volume change that occurs between maximal inspiration and maximal expiration (IRV+VT+ERV).
- Volume of air in the lung at the end of a maximal inspiration (RV + VC or FRC + IC).
- Tidal Volume
- Inspiratory reserve volume
- Expiratory reserve volume
- Residual volume
- Inspiratory capacity
- Functional residual capacity
- Vital capacity
- Total lung capacity
Normal destruction of Senescent Erythrocytes
Decrease is RBC ___ production
Become _____ and lose property of _____ deformability
____ red cells, are sequestered and destroyed by ____ of the MPS Primarily?
The ____ takes over if the previous organ is absent (Kipffer cells)
_____ is reduced to billirubin and transported to the liver
_gs of Hemoglobin degraded ____?
Regulation of Erythropoiesis
Number of circulating RBCs remain?
___ stimulates the production and release of?
Erythropoietin produced in? Causes an Increase in?
Dynamic compression
End of quiet inspiration
- Flow = 0
- Airway Ptm= 0 - (-10) = 10
*
Mechanics of Breathing: How the Lung is supported and Moved
- Respiration related pressures
- Muscles of respiration
- Elastic properties of the lung (compliance)
- Flow resistance properties (airway resistance)
- Dynamic Compression
- Work of Breathing
Lung Receptors
Irritant receptors
Located? Sensitive to? Cause?
Stretch Receptors
Location, Sensitive, Slow? Due to?
J Receptors
Response is? To what pressure?
Causes?
- Locate in the epithelium of the conducting airways.
- Proximal larger airways, absent in the distal airways.
- Sensitive to noxious gases, cigarette smoke, inhaled dusts, and cold air. Cause bronchoconstriction, may play a role in asthma
STRETCH
- Locate in airway smooth muscle.
- Sensitive to distension of the lungs.
- Slow ventilatory rate and volume due to an increase in expiratory time. (Herring-Breuer reflex)
J RECEPTORS
- Respond very quickly to increased pulmonary capillary pressure.
- Result in rapid, shallow breathing.
Peripheral receptors
Location what do they respond to?
What is less important than is central chemoreceptors?
4 things
- Located in aortic bodies and carotid bodies.
- Respond to fluctuations in blood O2 levels very fast.
- Responsible for all the increase of ventilation due to arterial hypoxemia.
- Response to arterial PCO2 is less important than that of the central chemoreceptors
- Peripheral chemoreceptors are located in the carotid and aortic bodies. They mainly respond to decreased arterial PO2, but are also stimulated by increased PCO2 and H+ (rapidly responding).
Central Controller
Medullary respiratory center
2 parts
Apneaustic area in pons
Pneumotaxic center of pons
- Dorsal respiratory group (DRG): Cells have inherent rhythm that causes inspiratory cycles , controls diaphragm & external intercostals. Active for 2 sec during inspiration & quiet for 3 sec during expiration.
- Ventral respiratory group (VRG): Increased DRG activity stimulates the VRG which stimulates internal intercostals & abdominal muscle layers during forced expiration.
Apneustic: Stimulates DRG for normal inspiration (2 sec) or longer during forced inspiration (maximum inhalation)
Pneumo:
- Inhibits apneustic area to allow exhalation;
- Modifies the pace set by DRG and VRG;
- Its absence causes increase in depth of respiration and a decrease in respiratory rate.
Physiologic Deadspace
definition
Deadspace is the ____ that is ____ but not ____ with blood, so there is no ____ exchange and it does not eliminate what?
is the volume of (wasted ) air that does not eliminate CO2. Also called functional dead space. Not all of the alveoli are perfused with blood; air in these alveoli doesn’t exchange with the blood and is part of the dead space.
Dead space is the volume of lung that is ventilated, but is not perfused with blood, so there is no gas exchange, and it does not eliminate CO2
Anti Anemic Drugs
What type of anemia is it used for (2)
Vit B12
Gas-exchange airways
Alveolar Ducts
Passage of?
LINING?
Wall?
3 things
- Passage of alveolar sacs (cluster to alveoli)
- Lining: Mostly simple squamous epithelia
- Thin-walled, fibro-elastic tubes, fewer smooth muscle spirals, many alveoli from walls
Aging and Hemalogic system
Aging is normal but?
Hemoglobin Picture
Compostition of Plasma
Regional differences in ventilation
Fact:
Regions of the normal ___ do not have the same _____.
The ___ regions of the lung ventilate better than?
Reason for this?
- Lung do not have the same ventilation
- Lower ventilates better than upper
- Intrapleural pressure is less negative at the bottom of the lung than at the top because of the weight of the lung and the configuration of the chest wall.
- The lower regions of the lung are better ventilated than the upper regions because of the effects of gravity on the lung.
Muscles of Respiration
Inspiration
- Diaphragm:
- External intercostals:
- Accessory muscles:
- The most important muscle of inspiration; supplied by phrenic nerves that originate high in the cervical region
- When contract; move ribs upward and forward
- Accessory muscles: Sternocleidomastoid, scalene muscles
Airway resistance in Asthma
Airway conductance is ____ at a given recoil pressure due to _____ narrowing of ______ and ______ changes in the airways
What drug can be given to move the asthma line closer to normal?
- reduced, instrinsic narrowing, of the airways caused by contraction of smooth muscle
Bronchodilator (isoproterenol)
Concetpts
Composition of blood
Elements in blood
platelets in blank
Picture of regulation
Begin quiet expiration
Dynamic compression
Ptm = 9
holding airways open
Hematopoietic cells
Which one is normal?
Obstructive, Restrictive
N, R, O
Iron cycle
Drugs
Erythropoeitin
Hematopoiesis
Iron cycle picture
Objectives
Anti Anemic Drugs
Folic Acid
Neurochemical control of ventilation
The 3 basic eliments of the respiratory control system:
- . Sensors that gather information and feed it to the central controller.
- Central controller in the brain coordinates the information and, in turn, sends impulses to the effectors.
- Effectors (respiratory muscles) cause ventilation
Erythropoeisis
picture
Hematopoiesis
Picture
Development of leukocytes
Another picture
Mononuclear phagocyte system
Consists of? That originate?
They are transported into the bloodstream, differentiate into?
Mature in the tissue as?
What do they do to microorganisms
Mostly accumulates in?
Erythrocytes
Colony stimulating factors
Definition of Anemia
Anti Anemic Drugs
Iron
AEs
Anti Anemic Drugs
Vit B12 kinetics
Signs symptoms and classifications of Anemia
Lymphoid organs
Spleen
Splenic Pulp
Venous Sinuses?
Hemoglobin synth
