Respiratory Part I Flashcards
Lung surface area? How much and why?
How many alveoli?
How long are the airways?
Which lung is larger?
How many lobes each?
What is the parietal, visceral pleura?
What is the pleural cavity?
Pleural cavity function? 2
Function: create a vacuum that holds the lungs open
List the respiratory pathway from mouth to end point in the lungs
Trachea
Bronchi
Terminal bronchioles
Respiratory bronchioles
Alveolar ducts
Alveolar sacs
What is the function of the nose?
How much mucous per day?
What is the function of the epithelium?
What is olfaction?
What is the trachea made of?
What is its function?
Describe the bronchial tree, how many branches?
What are two characteristics of the bronchioles?
How do they change size?
SNS activation via? Give receptors
PNS activation via?
Think: Beta 2 because we have 2 primary Bronchi
Where are the alveoli?
What is their function?
What is the function of Type I and Type II cells?
What are present for protection?
type 1 cell: squamous epithelium
type 2 cell: surfactant, two goo
Answer these questions relating to histology and cytology of the airways
Pay attention to: primary type and club
What are the 3 defence secretions?
Club cells are referred to as the secondary stem cell
Surfactant is released by ?
How does it interact with water?
What does it contains? 2 (like which household item?)
Which way do the heads of the phospholipids face?
What is their effect on the alveoli?
Surfactant keeps the H2O molecules apart so they can’t form H bonds and this keeps the alveoli open
What are the 3 parts of the diaphragm?
Which part contracts during vomiting?
What percentage of volume change can it account for?
Most {……} of any skeletal muscle
What and where is the central tendon in the pericardium?
[short answer]
How do we breathe
Which direction does air flow?
What is the relationship between volume and pressure? Explain the 5 steps
How do you define Boyle’s Law
If you increase pressure, you decrease volume
If you increase volume, you decrease pressure
Answer the following questions relating to breathing
Internal intercostals, think internal, inwards, getting smaller
Which muscles are inspiratory (5) and which are expiratory (4)
Inspiration
— Sternocleidomastoid
— Scalenes
— External IC muscles (think external, pulling out which lets air in)
— Pectoralis minor
— Diaphragm
Expiration
— Internal IC muscles
— Diaphragm
— Rectus Abdominis
— External abdominal oblique
Boyle’s Law and the lungs NO breathing
What is atmospheric pressure?
Boyle’s law and the lungs Inspiration
Boyle’s Law and the lungs expiration
Recap the major branches in the airway, the cells and the changes in pressure and volume during inspiration
Respiratory volumes, provide the ml
Tidal: 500
IRV: 3100
ERV & Residual: 1200
What are these measurements?
And the amounts in ml
MVV
FEV1
3100 IRV
500 TV
1200 ERV
1200 RV
MVV is for a full minute
FEV1 1st second
Complete these calculations
Note: VE in is litres
What is compliance?
What is it affected by? 2
Which conditions decreases compliance?
How is it measured?
What is compliance?
What is it affected by? resistance and surface tension
Which conditions decreases compliance? emphysema, lung disease, obesity and pregnancy
How is it measured? pressure volume curve
What is a physiologic shunt?
Which two locations ?
What vital sign is this related to?
— Bronchial blood flow
— Coronary arteries
— 98% saturation
What is the V/Q ratio?
What is normal V in L/min?
What is normal Q in L/min?
What is the normal ratio?
What is the term when it’s above/below normal?
And could cause these?
< 0.8
— Physiological shunT
— no venTilation
— asthma/bronchitis/lung collapse
Normal: ~ 0.8
> 0.8
— Physiological dead sPace
— no Perfusion
— PE/TB/some pulm issue
Above/below = V/Q mismatch
What is the alveolar pressure, pulmonary arterial pressure and pulmonary venous pressure in different parts of the lungs?
When the patient lays down, what happens?
Above the heart — low arterial pressure, high alveolar pressure, blood not passing thru capillaries when we’re standing up — vessel collapses
Middle portion of the heart — “waterfall”
Lower portion of the heart — high arterial pressure, low alveolar pressure. vessel distends
What % of oxygen is carried by hemoglobin?
How much dissolved in plasma?
_______________
What % of CO2 is carried in the form of HCO3-
What about the rest? (2)
_______________
What is the equation?
Hydrogen ions + bicarbonate > carbonic acid > water and CO2
What is the partial pressure % of nitrogen, oxygen and CO2?
Know how to calculate the partial pressure of gas with atmospheric pressure (760mmHg):
Learn these
- % nitrogen
- % oxygen
- % CO2
78.6% nitrogen
20.9% oxygen
0.04% CO2
What would this look like for Mt Everest?
What is the key takeaway/concept here?
key takeaway — there is less oxygen to mitochondria when you start with less! (I.e up Everest)
Gas movement with gradient
Gas movement summary
Oxyhemoglobin dissociation curve
What is the saturation at these points?
— Exercise
— Rest in venous blood
— Arterial blood
X axis is partial pressure, concentration of oxygen around the cell. So when there is more oxygen in the blood, more saturation of o2 on hemoglobin
— Exercise: hemoglobin is only 25% saturated at the tissues, because it unloads it all for use
— At rest: hemoglobin is 75% saturated in venous blood system
— In arterial blood: 100% saturated because it hasn’t dropped anything off yet
Oxygen hemoglobin dissociation curve
What benefit does the plateau convey?
Greater partial pressure, greater hemoglobin saturation
Between 80-100 partial pressure, we can still stay pretty saturated
Shifting the curve
What shifts it to the right?
What does the rightward shift mean in terms of affinity and O2 unloading?
These things shift the curve to the right:
— Acidosis/increase in H+
—Increase in temperature
which means lower hemoglobin saturation
= decreased affinity
= increased O2 unloading
What do these things do to the affinity for oxygen?
All associated with increased metabolism
decreases affinity for oxygen because we want to drop more oxygen off if we’re doing metabolism
Because we want to drop off a lot of oxygen. More CO2 is going to be produced if we’re doing more metabolism
Myoglobin saturation curve
— What is myoglobin’s affinity for O2 in comparison to hemoglobin?
— How many binding sites does it have?
— When can it release O2?
Myoglobin key takeaways:
— myoglobin has a greater affinity for O2 (the curve has shifted left) Mmmyoglobin/Mmmore affinity
— It only has one binding site for O2
— It will only release O2 in muscle when PO2 in blood is low, during exercise.
— Remember myoglobin is an O2 storage molecule, whereas hemoglobin is an O2 transporting molecule.
Steep decline is happening at much lower partial pressures. Needs greater affinity to pull the oxygen off the hemoglobin
[short answer]
The Chloride Shift in the tissues
— How is CO2 transported?
— What does that dissociate into?
— What happens to the bicarb?
— How is this counteracted?’
In the pulmonary system?
— Most CO2 is transported as carbonic acid
— Carbonic acid dissociates into bicarbonate and H+ ion
— The bicarbonate HCO3- is negatively charged
— In order to counterbalance the large efflux of HCO3- from the erythrocyte, an anion exchanger AE1 brings in Cl- to restore the charge to the RBC.
— In the pulmonary system, bicarb is going to move into the RBC, in order to counterbalance the influx of negative charge, Cl- is transported out of the RBC. Bicarb binds with H+ ions to form carbonic acid, carbonic acid dissociates into CO2 and water. CO2 diffuses into the alveolus and is expired.
[short answer]
Chloride shift at the tissues
Three ways of transporting CO2?
- Dissolves gas
- Bound to hemoglobin
- As carbonic acid
[short answer]
Chloride Shift in the lungs
