Respiratory Phys Flashcards
respiratory physl is the study of
how oxygen is brought into the lungs and delivered to tissue and how carbon dioxide is removed
what are 6 functions of the respiratory system?
homeostatic regulation of blood gases, protect from microbial infection, regulate blood pH, phonation (speech), olfaction, blood reservoir
what 3 structures comprise the upper resp. system?
nasal/oral cavities, pharynx, larynx
what is after the larynx?
trachea
what 6 structures comprise the lungs?
bronchi->bronchioles->alveoli, smooth muscle, connective tissue, pulmonary circ.
what is the larynx?
the vocal cords
what are the 3 sections of the pharynx?
naso, oro and laryngopharynx
what is anterior and posterior to the trachea and primary bronchi?
anterior: C-shape cartilage
posterior: smooth muscle
what changes from the primary bronchi to the bronchi of the lungs?
C-shaped cartilage to plates of cartilage (smooth muscle remains)
what changes from the bronchi to the bronchioles?
only smooth muscle (no cartilage)
what are the 2 zones of the airways beyond the larynx?
conducting and respiratory zone
what is the conducting zone?
area where gas is brought to gas exchanging region (no alveoli/gas-exchange - “anatomical dead space”)
what is the respiratory zone?
where gas exchange occurs (alveoli)
what is the smallest airway without alveoli?
terminal bronchioles
what airway occasional has alveoli?
respiratory bronchioles (after terminal)
where is generation 0 and 23 of the resp system?
0: trachea
23: alveolar sacs
what incr and decr w each generation level? (2, 2)
incr: # of branches, SA (cross sectional area)
decr: diameter and length
what are the alveoli?
tiny, thin-walled, capillary-rich sacs in lungs where gas exchange occurs
approx. how much blood do capillaries in lungs contain at rest and exercise?
70 mL and 200 mL
what are type 1 alveoli?
flat, epithelial cells
what are 2 functions of type 2 alveoli?
produce surfactant, act as progenitor cells
how can type 2 alveoli act as progenitor cells?
multiply and divide to replace damaged type 1 alveoli
what is the alveolar surfactant and its function?
detergent-like substance made of lipoproteins; reduces surface tension of alveolar fluid
how long is needed for gas exchange to occur at the level of the alveoli?
0.75 (RBC passes through pulmonary capillary system/2-3 alveoli)
what must O2 and CO2 diffuse through?
respiratory memb
what are the 6 layers of the respiratory memb?
alveolar fluid/surfactant, alveolar epi., basement memb of alveolar epi., interstitial space, basement memb of capillary endothelium, capillary endothelium
what is a con of having a thin resp memb.?
easily damaged
what is a pneumocyte?
alveolar cell
what are the 5 steps of repsiration?
ventilation, gas exchange in alveoli, gas transport, gas exchange at tissues, cellular utilization of gases
what is ventilation?
exchange of air between atmosphere and alveoli by bulk flow (O2 in, CO2 out)
what occurs during gas exchange in alveoli?
O2 and CO2 exchange btwn alveolar air and capillary blood by diffusion
what occurs during gas transport throughout the body?
O2 and CO2 circulate through pulmonary and systemic circ by bulk flow
what occurs during gas exchange in tissues?
O2 and CO2 exchange btwn blood in capillaries and tissue cells by diffusion
what occurs during cellular utilization of gases?
O2 is used and CO2 is released
how is ventilation produced? (4)
- CNS sends rhythmic excitatory drive to resp. muscles
- resp. muscles contract rhythmically
- changes in V and P allow for gas movement
- air flows in and out
what are 3 categories of resp. muscles?
pump, airway and accessory muscles
what do the pump muscles do?
make changes in P and V at level of lungs
where are the airway muscles?
upper airways (keep them open)
what are the INS (4) and EXP (2) upper airway muscles?
INS: tongue protruders (Genioglossus), alae nasi, pharyngeal and laryngeal dilators
EXP: pharyngeal and laryngeal constrictors
what do the accessory muscles do?
facilitate respiration during exercise
what are 2 INS accessory muscles?
sternocleidomastoid, scalene
what are the INS and EXP pump muscles?
INS: diaphragm, external and parasternal intercostals
EXP: internal intercostals, abdominals
what are the 5 INS muscles?
acc: sternocleidomastoid, scalene
pump: diaphragm, external and parasternal intercostals
what are the 5 EXP muscles? (4 abd.)
pump: internal intercostals, external and internal abd. oblique, transversus adb., rectus abd.
what is the diaphragm?
dome-shaped muscle that flattens during INS
what occurs when the diaphragm contracts?
forces abdominal contents down and forwards, widens rib cage, incr V of thorax
where are the external intercostals?
within the rib cage
what occurs when the external intercostals contract?
pull ribs upward, incr V of thorax (bucket handle motion)
where are the parasternal intercostals?
near sternum
what occurs when the parasternal intercostals contract?
pull sternum forward and incr anterior-posterior dimension of rib cage (pump handle motion)
what are the 4 abdominal muscles?
external oblique, internal oblique, transversus admonius, rectus abdominis
when are the expiratory pump muscles active?
deeper, faster breathing (exercise) to return lungs to resting position
what occurs when the internal intercostals contract?
pull rib cage down, decr thoracic V
what occurs when the scalenes contract?
elevate upper ribs, incr thoracic cavity
where are the scalenes?
attached on upper rib cage
where are the sternocleidomastoids?
connected to sternum
what occurs when the sternocleidomastoids contract?
raises sternum
when are the accessory INS muscles active?
during exercise or heavy respiration (little contribution to quiet/rest breathing)
what do muscles do during rest INS?
diaphragm contracts, external and parasternal intercostals pull ribs up and out
what do muscles do during forced resp. INS?
stronger diaphragm contraction, accessory muscles recruited (incr thoracic V)
what occurs during rest EXP?
no active contraction of resp muscles (diaphragm relaxes)
what do muscles do during forced resp. EXP?
abd. muscles contract, pushing abd. contents up and diaphragm higher, internal intercostals contract and push rib cage down (decr thoracic V)
what is obstructive sleep apnea?
reduction in upper airway patency during sleep (snoring, apneas, sleep disturbances) due to decr muscle tone or anatomical defects
what 2 regions are involved in the filtering action of resp?
conducting zone/”mucociliary escalator” and macrophages in alveoli
what 2 cells that line trachea are a part of the “mucociliary escalator”?
goblet (mucus-producing) and ciliated cells
what do the cells of the “mucociliary escalator” do?
entrap inhaled biological and inert particles and remove them from airways
what is periciliary fluid?
fluid produced by ciliated cells that forms the Sol layer (low viscosity/density)
what do goblet cells produce?
mucus that forms patchy gel layer above sol layer (high viscosity & elasticity)
how is mucus w/ trapped particles removed?
cilia movements (downward-nasopharynx, upward-trachea) bring mucus towards eso.
what is the last defense to inhaled particles?
macrophages in alveoli (phagocytosis)
what occurs when silica dust and asbestos are inhaled?
macrophages cannot digest these particles and die, producing chemotactic factors that recruit fibroblasts and cause pulmonary fibrosis
what is spirometry?
pulmonary function test to determine amount and rate of inspired and expired air
what is a spirometer?
device used to measure V of air inspired and expired by lungs (amount and rate/time)
what cannot be measured by a simple spirometry test? (3)
residual V, functional residual capacity, total lung capacity
what is the tidal V (TV)?
V of air moved in OR out of lungs during each resp cycle
what is the expiratory reserve V (ERV)?
max. amount of air that can be expelled after a normal expiration (max. voluntary expiration)
what is the inspiratory reserve V (IRV)?
max. amount of air that can be inhaled after a normal inspiration (max. voluntary inspiration)
what is the residual volume (RV)?
V of air remaining in lungs after max. expiration (cannot be expired or measured w spirometer)
what is RV =?
RV = FRC - ERV
what is atelectasis?
complete/partial lung/lobe collapse when alveoli become deflated/collapse (RV)
what are lung capacities?
sum of 2 or more lung volumes
what is vital capacity (VC)?
max. V of air forcibly exhaled after max. inspiration
how do you calculate VC?
VC = TV + ERV + IRV
what is inspiratory capacity (IC)?
max. V of air that can be forcibly inhaled
what do you calculate IC?
IC = TV + IRV
what is functional residual capacity (FRC)?
V of air remaining in lungs at end of normal expiration
how do you calculate FRC?
FRC = RV + ERV
what is total lung capacity (TLC)?
V of air in lung at end of max. inspiration
how do you calculate TLC?
TLC = FRC + TV + IRV = VC + RV
what cannot be measured by a spirometry test?
RV, FRC and TLC (contain RV)
what is tidal volume (Vt)?
total amount of air inspired at each breath (~500mL)
what is total/minute ventilation
total amount of air moved in and out of resp. system per min.
how do you calculate total/min ventilation?
Vt x resp. frequency (breaths per min, bpm)
what is alveolar ventilation (Va)?
amount of air moved into alveoli per min
what is the anatomical dead space (Vd)?
area in upper resp. system that contains air wo/ gas exchange (conduction zone, ~1/3, 150mL)
who do you calculate alveolar ventilation?
Va = (Vt - Vd) x freq. (bpm)
does V in anatomical dead space change with breath size?
no, it is constant
what is the most effective way to breathe to incr alveolar ventilation?
incr depth (decr bpm) rather than incr bpm (decr depth)
what is FEV1?
forced expiratory V in 1 second (FVC in 1s)
what is FVC?
forced vital capacity, total V of air that is blown out after max. INS as fast as possible (VC = IRV + TV + ERV)
what is FEV1/FVC?
proportion of air that is blown out in 1s
normal V for FVC
~5.0L
what does a patient with obstructive lung disease have trouble with?
exhaling all the air from their lungs (slower)
what 3 diseases are associated with obstructive breathing?
bronchial asthma, chronic obstructive pulmonary disease, cystic fibrosis
what is the most reduced w obstructive breathing patterns?
FEV1 (and FEV1/FVC ratio)
what drugs are used to reduce bronchospasms with asthma?
B2 adrenergic agonists
what does a patient with restrictive lung disease have trouble with?
cannot fully inhale/expand their lungs
what might cause restrictive lung patterns?
lung and chest stiffness, weak muscles, or damaged nerves
what is reduced with restrictive lung patterns?
FVC and FEV1
what appears normal with restrictive lung patterns?
FEV1/FVC ratio (both are reduced)
what 3 diseases are associated with restrictive breathing?
lung fibrosis, neuromuscular diseases, or lung tissue scarring
what can be measured using the helium dilution method?
FRC (RV + ERV)
what features of helium makes it useful for the gas dilution technique?
not taken up by vascular system (insoluble in blood) and can stay contained in lungs (reach equilibrium after a few breaths)
what do the variables in C1V1 = C2(V1 + V2) correspond to? (Helium test)
C1, V1: initial conc. and V of He in machine
C2: [He] at equilibrium after a few breaths (lungs + machine)
V2: FRC (V of He in lungs)
what does the helium dilution method only measure?
communicating gas or ventilated lung volume
what are the static properties of the lungs?
mechanical properties when no air is flowing (maintain chest and lung V)
what 4 properties are associated w static mechanics of ventilation?
intrapleural P (Pip), transpulmonary P (Ptp), static lung compliance, ST of lungs
what 3 properties are associated w dynamic mechanics of ventilation?
alveolar P (Palv), dynamic lung compliance, airway and tissue R
what is bulk flow?
movement of gas btwn high to low P
what is Boyle’s Law?
for fixed amount of ideal gas kept at constant temp, P and V are inversely proportional (P1V1=P2V2)
how does expiration demonstrate Boyle’s Law?
compression: decr V and incr P, air flows out
how does inspiration demonstrate Boyle’s Law?
decompression: incr V and decr P, air flows in
what is different btwn Boyle’s Law and the resp system?
not a sealed container (open to atm), air moves by bulk flow
what is the formula for bulk flow?
F = ΔP (= Palv - Patm) / R
what is the pleura?
thin double-layered envelope that cushions btwn lungs and thoracic wall+diaphragm
what does the visceral pleura cover?
external surface of lung
what does the parietal pleura cover?
thoracic wall and superior face of diaphragm
what separates the visceral and parietal pleura?
intrapleural fluid (~10 mL, 5-35 um)
what does the intrapleural fluid do?
allows visceral and parietal pleura to move around while breathing (decr friction)
how does the elastic recoil of lungs and chest wall balance eachother?
lung: tendency to collapse (inward)
chest: tendency to expand (outward)
(not directly attached, intrapleural space)
what is the transpulmonary P (Ptp) responsible for?
keeping alveoli open (P gradient)
what does the intrapleural P act as?
relative vacuum