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OS 205 > Respiratory Physiology > Flashcards

Respiratory Physiology Flashcards

0
Q

TRUE or FALSE

O2 transport and CO2 removal from the fetus occur by ACTIVE diffusion across the maternal circulation

A

False

PASSIVE

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1
Q

What is the goal of breathing?

A

(Mechanical perspective) Minimize work
(Physiological) Maintain blood gases
Regulate arterial PCO2
Maintain acid-base balance in the brain

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2
Q

How come:

High CO2 = Low pH (acidic)
Low CO2 = High pH (alkaline)

A

Low pH (acidic) = Higher concentration of HCO3 + H+ in the blood (bicarbonate and hydrogen ions)

Review how CO2 is transported from the tissues:
Dissolved in plasma - 10%
Carboamino Hb (CO2 in Hb) - 20%
Bicarbonate plasma - 70%

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3
Q

What are the functions of the Respiratory System?

A 
Gas Exchange (O2 and CO2)
Heat Exchange
Blood Gas Homeostasis
Phonation
Defense
Bioactive Substrate Metabolism
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4
Q

Boyle’s Law

A

Pressure Increases = Volume Decreases
LUNGS INFLATE
Inspiration

Pressure Decreases = Volume Increases
LUNGS DEFLATE
Expiration

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5
Q

When the chest expands (air goes in), what happens to the pressure?

A

Pressure decreases

NEGATIVE PLEURAL/ALVEOLAR PRESSURE

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6
Q

When air enters the cavity, the lung may collapse. The mediastinum may compress the other lung. What condition is this?

A

Tension Pneumothorax

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7
Q

In pneumothorax, intrapleural pressure becomes _____?

A

Zero

No expansion happens
The lung collapses
Compromises both lungs

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8
Q

We work to _____

We relax to _____

A

Inhale

Exhale

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9
Q

Smoking compromises the elastic recoil ability of the lungs. That leads to what condition?

A

Emphysema

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10
Q

Instrument that measures lung volume (except for residual volume)
Measures vital capacity

A

Spirometer

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11
Q

TRUE or FALSE

If you exhale hard enough, you can empty your lungs

A

FALSE

Some air remains inside = Residual Volume

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12
Q

The lungs can carry how many liters of air?

A

7

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13
Q

How can you tell if the baby died before or after birth?

A

Put the lungs in a basin of water

If it floats, then air has not yet entered the lungs
DEAD BEFORE BIRTH

If it sinks, then air has entered the lungs
DEAD AFTER BIRTH

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14
Q

Volume of air that can be maximally exhaled from the lungs

Measured by spirometry

A

Vital capacity

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15
Q

Human airways is likened to an _______?

A

Inverted Funnel Model

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16
Q

Molecules move according to their concentration gradient.
Which will move lower, CO2 or O2?
Which will move up?

A

O2, because it is needed by the body
There is less O2 in the lungs

CO2 will move up because it is being exhaled
There is high concentration of CO2 in the lungs

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17
Q

How do O2 reaches the alveoli?

A

Simpe diffusion

Higher concentration to lower concentration

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18
Q

Which has no alveoli, terminal or respiratory bronchiole?

A

Terminal

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19
Q

Conducting portion

No alveoli

A

Deadspace

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20
Q

V(alveolar) + V(deadspace)

A

V(tidal)

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21
Q

How many mm between respiratory zone and conducting zone?

A

1 mm

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22
Q

Walls of the alveoli are not smooth; there are undulations

These undulations are ________

A

Capillaries with RBC

Rolls of capillaries

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23
Q

The type of epithelium is found in the alveolus and makes gas exchange possible

A

Cuboidal epithelium

Gas exchange is between one alveolus and another alveolus

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24
Q

Flat cells found in the epithelium of the lungs

A

Type I pneumocyte

vs Type II pneumocyte

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25
Q

TRUE or FALSE

Lung changes in volume with each breath by roughly 15% only, allowing gas exchange to continue during expiration

A

True

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26
Q

TRUE or FALSE

The airway is stimulated by the parasympathetic fiber

A

True

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27
Q

Resistance is high in the trachea and main bronchi

Therefore, the flow of air here is
A. Turbulent
B. Laminar
C. Depends on the depth of inhalation and exhalation

A

A

Flow/velocity of air is faster in a narrow area (high resistance)

Resistance obeys the Ohm’s Law
E = IR

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28
Q

The flow of air in the bronchioles is termed ______.

Hint: Opposite of turbulent

A

Laminar flow

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29
Q

Relationship of airway resistance and lung volume

A

Resistance increases as lung volume decreases

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30
Q

What keeps the bronchioles open?

A

Attachment of alveoli

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31
Q

During forced expiration (cough)

A

Tubes become smaller
Secretions are removed
Dynamic airway compression

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32
Q

This theory states that the pressure is the same throughout the thoracic cavity

A

Equal Pressure Point Theory

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33
Q

Primary determinant of maximum flow rate

A

Lung elastic recoil (P)

Alveolar pressure increases

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34
Q

What is the best way to cough?

A
  1. Take a deep breath
  2. Lung elastic recoil

Airway collapses during forced expiration

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35
Q

TRUE or FALSE
Airway resistance…
1. Increases even if there is no air flow across the airway
2. Highest at the level of the smaller airways
3. Lowest at the trachea

A

All FALSE

Resistance is high at the level of larger (central) airways

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36
Q

When we cough, the intrapleural pressure becomes?

A

Positive

The bronchi will collapse in expiration because of positive infrathoracic pressure

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37
Q

If the obstruction is in the airway, sound is _________ as in the case of ________

A

Inspiratory (breathe in), tumors (?)

vs obstruction in the bronchioles, as in the case of asthma (sound is expiratory) —> wheezing when expiring

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38
Q

Normal lung compliance

A

0.2 L / cmH20

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39
Q

What is the role of elastic fibers in lung compliance?

A

Arrangement of fibers affects elastic recoil

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40
Q

Why is it harder to expand a lung distended in air than in saline?

A

Surface tension

Polarity and Surface Tension:
Water-Water Walang masyadong tension
Air-Water Tension exists to support objects (happens in all alveoli)

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41
Q

Relationship of variables?

Law of Laplace:
Pressure
Tension
Size of alveolus

A

Law of Laplace:
High pressure
High tension
Small size of alveolus (radius)

Pressure is inversely proportional to radius
P = 2T/r

If tension is high, di maeexpand ang lungs

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42
Q

Why do alveoli do not collapse due to pressure?

A

Surfactant (dipalmitoyl phosphotidyl choline)

  • reduces surface tension
  • pressure is equalized in small and large alveoli

If none: lung stiffness
Babies born preterm: no surfactant

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43
Q

Syndrome of babies born preterm, with no pneumocyte II?

Consequence?

A

NRDS
Neonatal Respiratory Distress Syndrome

No surfactant

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44
Q

Iron Lung

A

Machine that facilitates breathing when the lungs fail

45
Q

What happens to the pressure when venous return to the heart is impeded? Positive or negative?

A

Very positive intrathoracic pressure

46
Q

Gas exchange is defined as the exchange of gases between the environment and capillary blood

Respiratory quotient:
CO2
O2

A

RQ = CO2 production / O2 consumption

RQ = VCO2 / VO2
200 ml / 250 ml
= 0.8

47
Q

Relationship of variables:

PO2
FiO2
Patm

A

PO2 = FiO2 x Patm

21% x 76 mmHg

48
Q 
Terms:
PatmO2
PAO2
PcapO2
PaO2
PvO2
A 
PatmO2 - atmospheric pressure
PaO2 - alveolar pressure
PcapO2 - capillary pressure
PaO2 - arterial pressure
PvO2 - venous pressure
49
Q

Minute Ventilation

Relationship of variables?
Vtidal
Respiratory Rate
Valveolar
Vdeadspace
A 
Vmin = Vtidal x RR
Vmin = Valveolar + Vdeadspace
50
Q

Relationship of variables:

PaO2
FiO2
Patm
PH2O
PaCO2
RiQi
A

PaO2 = FiO2 (Patm-PH2O) - [PaCO2 / RiQi]

High fresh air = High opportunity to expel CO2

Carbon Dioxide Excretion Formula

51
Q

Determines the level of PaCO2

A

Alveolar ventilation

52
Q

Regional Distribution of Ventilation

A

Pleural pressure is less negative sa lower lung

53
Q

TRUE or FALSE

Upper and lower lung alveoli size are equal in size

A

False

Alveoli in the upper lung are bigger in size —> suctioned by negative pressure

54
Q

Distribution of air in the lungs

A

Mas malaki ang distribution ng air sa base (lower lobe), so mabilis maapektuhan ng mga sakit (Tuberculosis)

55
Q

Fick’s Law for Diffusion of Gases

Variables?

A

Depends on the:
Barrier
Density of Gas
Pressure Gradient

56
Q

Perfusion Rate (Q)

Distribution of Lung Perfusion?

A

High in lower lobe (?)
High ventilation (at first)
High perfusion

Alveoli at apex are underperfused (overventilated)
Alveoli at the base are underventilated (overperfused)

O2 ventilation is high at base but perfusion will carry it to the rest of the body

57
Q

Causes of Hypoxemia:

A 
Low PiO2 - low O2 in the blood
Hypoventilation
Shunt
V/Q mismatch
Diffusion block
Low PvO2

vs
Hypoxia - loss of O2 at the level of the bronchi
Hypercapnia - high CO2

Hypoxia and hypercapnia usually go together

58
Q

Henry’s Law of Gases

A

O2 dissolved in 100ml plasma = PO2 (mmHg) x 0.003 ml/100 ml blood

= 0.3 ml O2

59
Q

Hemoglobin can carry?

1.34 x Hb (grams) x %Sat

A

= 19.7 ml O2/100 ml blood

O2 saturation of 98 - 100 is NORMAL

60
Q

TRUE or FALSE

Hemoglobin will load O2 if the concentration in the surrounding area is high

A

TRUE

Affinity is high when the O2 concentration is high

Load only if: PO2 in the surrounding area is high

61
Q

TRUE or FALSE

Hemoglobin will unload O2 in the surrounding area if the surrounding area is high in O2

A

FALSE

Tendency to unload is low when concentration is high

Unload only if: PO2 in the surrounding area is low

62
Q

How to resuscitate a patient?

A

Give blood, hemoglobin

Why not O2?
Too much would burn the lungs. We are accustomed to 21% (kapag naka-mask)
Danger: 100% O2 — Toxicity

There is a saturation point, 100% O2 will not guarantee 100% saturation

63
Q

The graph shifts to the right when the affinity of Hb to O2 is increased or decreased?

A

Increased

There would be loading of O2 because of high concentration/saturation of O2 in the surroundings
TRANSPORTER > PROVIDER
Occurs in the lungs

vs shift to the LEFT, O2 will be released because concentration/saturation in the surroundings is low
TRANSPORTER < PROVIDER
Occurs in peripheral tissues

64
Q

What will happen to the pH, DPG and temperature of the exercising muscle?

A

High pH, Low DPG, Low Temp

Shift to the LEFT

O2 is supplied to the muscle because it is needed
Hb would release O2

65
Q

Bohr Effect

A

…

66
Q

Binding of O2 to hemoglobin promotes release of CO2. The effect is called?

A

Haldane effect

67
Q

Identify the types of hypoxia:

  1. O2 in the external environment is low in O2 (e.g. Mt. Everest)
  2. O2 can’t be transported because Hb is inadequate
  3. O2 concentration is good, but blood pressure is low
  4. Effect of cyanide, cytochrome problem in the mitochondria (during ETC)
A
  1. Hypoxic
  2. Anemic
  3. Stagnant
  4. Histotoxic
68
Q

Determined by the amount of H+ ions

A

pH - acidity and alkalinity

69
Q

How many grams of H+ ions per liter are there in
pH 0
pH 1

A

pH 0 1.0 g/L
pH 1 0.1 g/L
pH 2 0.01 g/L

70
Q

pH below 7.35

pH above 7.45

A

Acidemia - consequence of acidosis

Alkalemia - concequence of alkalosis

71
Q

Acid-Base Balance

A

Henderson Hasselbach Equation

72
Q

TRUE or FALSE

Our body produces more acids than bases

A

True

Acids are from:
Intake of foods
Produced by lipids and proteins metab
Cellular metabolism of CO2

73
Q

Compensatory mechanisms to regulate body mechanisms

A

Respiratory compensation

Kidney compensation

74
Q

TRUE or FALSE

Respiratory acidosis : Hyperventilate
Short, fast breaths to eliminate CO2

Respiratory alkalosis : Hypoventilate
Slow, deep breaths to conserve CO2

A

True

True

75
Q

Increased concentration of HCO3 (bicarbonate)

Decreased concentration of HCO3 (bicarbonate)

A

Metabolic alkalosis : Hypoventilation

Metabolic acidosis : Hyperventilation

CO2 + H2O H2CO3 H+ + HCO3

76
Q

Inspiratory ramp signal

A

Elastic recoil

77
Q

Volitional breathing is controlled by

A

Cerebral cortex

78
Q

Seat of breathing

A

Medulla

79
Q

Chemoreceptor which send signals regarding altitude and levels of acidity

A

Peripheral chemoreceptors

80
Q

What chemoreceptor works?
Suicide
Emphysema
Chronically hypercapnia

A

Central

Study aid: Know what chemoreceptors respond and what kind of response

81
Q

TRUE or FALSE

The brain can adjust to hypoxia

A

False

82
Q

TRUE or FALSE
Changes in the Pulmonary Circulation

Hypoxic pulmonary vasoconstriction
Capillary constriction
Less capillaries develop (Anti-angiogenesis)
Decreased tissue capillary density
Marked increase in left ventricle
Reduction of intercapillary distance in some peripheral tissues

A 
True
True
False    Angiogenesis
False    Increased
False    Right ventricle
True
83
Q

Felt when in high altitude:

Decreases judgment
Drowsiness
Mental and muscle fatigue
Headache
Nausea

What condition?

A

Hypoxia

84
Q

TRUE or FALSE

When diving, the highest change in pressure is just below the surface

A

True

85
Q

TRUE or FALSE

To avoid having decompression sickness, when diving, descend slowly and ascend rapidly

A

False

Ascend slowly (nitrogen bubbles)
May descend rapidly
86
Q

During exercise, how do we manage to be oxygenated?

A

Increase the respiratory rate

Increase cardiac output

87
Q

What happens to these factors when ventilation sharply increased?

Metabolism
Temperature
Hyperventilation

A

Increase!

88
Q

First line of defense of the lungs

  • Moist, with cilia
  • Filters
A

Aerodynamic Filtration

89
Q

Lung Defense

-Characterized by squamous epithelium

A

Mucociliary Apparatus

90
Q

Lung Defense

  • No cilia
  • Engulfs foreign particles
A

Alveoli Macrophage

91
Q

During inhalation, do all gases go inside (N2, CO2, O2)?

A

Yes but up to a certain level

Proportion is different

92
Q

Most sensitive chemoreceptor

A

Peripheral

93
Q

Ultimate stimulator of inspiration

A

Production of lactic acid

94
Q

TRUE or FALSE

It is safe to breathe in 100% O2 for 12 hours

A

False

Biochemical injury

(Except for sick patients who will die of hypoxemia without enough O2)

95
Q

High CO2
Headaches
Hypoxia

A

Hypercapnia

96
Q

2 kinds of COPD

A

Pink puffing

Blue bloater

97
Q

Stabilizes deoxyhemoglobin to release O2

Affinity decreases

A

2,3 DPG

98
Q

What is it in inspiration that needed work?

A

Expansion of lungs
Getting air inside

(Muscular work)

99
Q

To minimize the work of breathing, what to do with the factors involved?

A

Balance RESISTANCE and COMPLIANCE

100
Q

How to breathe when you have narrow airways?

A

Take SLOW, DEEP BREATHS

101
Q

How to breathe when you have stiff lungs?

A

Take FAST, SHORT/NARROW BREATHS

102
Q

Stretch receptors

A

Where signalling comes from

103
Q

Why suicide attempt by holding breathe would not be successful

A

Increase in CO2 would stimulate central receptors

Metabolism does not stop when holding breathe, O2 is continually used up

104
Q

When holding breathe, O2 stimulate what

A

Carotid receptors

105
Q

TRUE or FALSE

Hyperventilating before diving would not pose any serious consequeces
It is highly encouraged

A

False

Frequent cause of deaths
There should be balance

106
Q

Is this possible?

pH is normal
Respiratory alkalosis
Metabolic acidosis

A

Yes?

Low CO2, Low HCO3

107
Q

Differential diagnosis?

pH 7.2
CO2 50
HCO3 18

A

Acidemia
Respiratory acidosis
Metabolic acidosis

= SEVERE ACIDEMIA

108
Q

Condition wherein people afflicted suffer from respiratory arrest during sleep

Failure of the autonomic control of breathing

Derived from Greek mythology

A

Ondine’s curse

Congenital central hypoventilation syndrome (CCHS) / Primary alveolar hypoventilation

109
Q

What is the effect of hypobaric pressure?

You are a pilot in an airplane when the windows gave way. What will you do?

A

Decompression

Fly the airplane in a lower altitude

OS 205 (18 decks)

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