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Physiology > Respiratory Physiology > Flashcards

Respiratory Physiology Flashcards

1
Q

The conducting zone transports gas to the lungs and is from the nose to the:

A

Terminal bronchioles

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2
Q

The respiratory zone is the site of gas exchange and consists of:

A

respiratory bronchioles, alveolar ducts, alveolar sacs

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3
Q

How many generation of airways do you find int he respiratory system?

A

23

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4
Q

How many alveoli are present in the respiratory system?

A

500 million

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5
Q

What is the sympathetic and parasympathetic effect on the smooth muscles of the airways?

A

Sympathetic: smooth muscle relaxation via B2 receptors
Parasympathetic: smooth muscle contraction via muscaric receptors

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6
Q

Type of pneumocyte which composes 96-98% of surface area, and is for gas exchange

A

Type I pneumocytes

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7
Q

Type of pneumocyte which composes 2-4% of surface area, and is for surfactant production

A

Type II pneumocytes

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8
Q

Alveolar macrophages can convert into what in CHF:

A

Siderophages/ Hemosiderin-laden macrophages

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9
Q

Cells that produce mucus:

A

Goblet cells, submucosal glands

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10
Q

May play a role in epithelial regeneration after injury by secreting protective GAGs

A

Clara cells/Club cells

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11
Q

What is the Reid’s index?

A

Ratio of submucosal gland layer to the alveolar wall.

In COPD, Reid’s index is >0.4 indicating hyperplasia and hypertrophy of the submucosal gland layer

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12
Q

Dual blood supply of the lungs:

A
  1. Pulmonary (deoxygenated blood) circulation
  2. Bronchial (oxygenated blood) circulation (1/3 returns to R atrium via bronchial veins, 2/3 returns to L atrium via pulmonary veins)
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13
Q

Amount of air inspired/expired during quiet breathing

A

Tidal volume

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14
Q

Maintains oxygenation between breaths

A

Residual volume

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15
Q

Sum of IRV, TV, ERV

A

Vital capacity

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16
Q

Sum of ERV and RV

A

Functional residual capacity

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17
Q

Sum of IRV and TV

A

Inspiratory capacity

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18
Q

Sum of all 4 lung volumes

A

Total lung capacity (Normal: 6L)

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19
Q

Cannot be measured directly by spirometry

A

Residual volume (and all lung capacities that include residual volume)

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20
Q

Equilibrium/resting volume of the lung

A

Functional residual capacity

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21
Q

Marker for lung function

A

Functional residual capacity

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22
Q

Difference in lung volumes/capacities among sexes

A

Lung volumes and capacities 20-25% lower in females

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23
Q

Factors that increase vital capacity

A

Body size, male sex, conditioning, youth

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24
Q

Total volume of the lungs that does not participate in gas exchange; anatomic dead space + alveolar dead space

A

Physiologic dead space

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25
Q

Air in the conducting zone is called the anatomic dead space. What is the normal value in healthy humans?

A

150mL

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26
Q

Air in the alveoli not participating in gas exchange due to V/Q mismatch.

A

Alveolar dead space (Normal value in healthy humans is 0 mL)

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27
Q

Total rate of air movement in/out of the lungs

A

Minute ventilation

MV = VT x RR

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28
Q

Minute ventilation corrected for physiologic dead space

A

Alveolar ventilation

VA = (VT-VD) x RR

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29
Q

25/M, healthy, 70kg with a RR of 20bpm. What is the minute ventilation and alveolar ventilation?

A 
MV = 500mL x 20 = 10, 000mL or 10L
VA = (500mL - 150mL) x 20 = 7,000mL or 7L
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30
Q 
50/M with TV = 500mL, RR = 20bpm, PCO2 arterial = 40mmHg, PCO2 expired air = 30mmHg. 
What is the minute ventilation?
What is the alveolar ventilation?
What percent of TV reaches the alveoli?
What percent of TV is dead space?
A

MV = 500mL x 20 = 10,000 mL or 10L
Physiologic dead space = (0.5L) x (40mmHg - 30mmHg)/40mmHg = 0.125L
VA = (0.5L - 0.125L) x 20 = 7.5L
Percent reaching the alveoli: (0.5 - 0.125)/0.5 = 0.75 = 75%
Dead space: 0.125/0.5 = 0.25 = 25%

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31
Q

What happens to FEV1 and FVC in patients with obstructive and restrictive lung diseases?

A

Decrease

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32
Q

What is the FEV1/FVC ratio of a healthy person?

A

0.8 / 80%

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33
Q

What happens to the FEV1/FVC ratio in patients with obstructive and restrictive lung diseases respectively?

A

Obstructive: Decrease
Restrictive: Normal to increase

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34
Q

Normal inspiration is an active process carried out by what muscle?

A

Diaphragm

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35
Q

Predominant muscle in forced expiration

A

External intercostals

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36
Q

Normal expiration is a passive process. However, forced expiration is predominantly done by what muscle:

A

Internal intercostals

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37
Q

In obstructive lung disease, the decrease in FEV1 is ___ than decrease in FVC

A

greater

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38
Q

In restrictive lung disease, the decrease in FEV1 is ___ than decrease in FVC

A

less

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39
Q 
In emphysema: 
Pathology is: loss of \_\_\_\_\_ fiber
Compliance: \_\_\_\_\_\_\_\_\_\_\_
Elasticity: \_\_\_\_\_\_\_\_\_\_\_
FRC: \_\_\_\_\_\_\_\_\_\_\_
Effects: \_\_\_\_\_\_-shaped chest
A 
elastic
increased
decreased
increased
barrel
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40
Q 
In fibrosis:
Pathology is: \_\_\_\_\_\_ of lung tissue
Compliance: \_\_\_\_\_\_\_\_\_\_\_
Elasticity: \_\_\_\_\_\_\_\_\_\_\_
FRC: \_\_\_\_\_\_\_\_\_\_\_
A

stiffening
decreased
increased
decreased

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41
Q

Force cause by water molecules at the air-liquid interface that tends to minimize surface area

A

Surface tension

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42
Q

2 reasons why preterm babies have large collapsing pressure and are prone to atelectasis:

A

Alveolar radius is 50 micrometers (adult = 100 micrometers)

Lack mature surfactant

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43
Q

Cells that produce surfactant

A

Type II pneumocytes

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44
Q

Main component of surfactant

A

Water

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45
Q

Active component of surfactant

A

Dipalmitoyl-phosphatidylcholine (DPPC)

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46
Q

Mechanism for DPPC reducing surface tension

A

Amphipathic nature

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47
Q

Effects of surfactant on lung compliance

A

Increase

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48
Q

Start of surfactant production

A

24th week AOG

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49
Q

Maturation of surfactant

A

35th week AOG

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50
Q

Test for surfactant

A

Amniotic L:S ratio

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51
Q

Treatment for newborn RDS

A

Steroids, surfactant

52
Q

Ability of the respiratory membrane to exchange gas between the alveoli and the pulmonary blood

A

Diffusing capacity

53
Q

Diffusing capacity for O2:
At rest: _____
Maximal exercise: _____

A

At rest: 21 mL/min/mmHg

Maximal exercise: 65 mL/min/mmHg

54
Q

Diffusing capacity for CO2:
At rest: _____
Maximal exercise: _____

A

At rest: 400 - 450 mL/min/mmHg

Maximal exercise: 1200 - 1300 mL/min/mmHg

55
Q

What are the forms of gases in solutions?

A

Dissolved gas, bound gas, chemically modified gas

56
Q

What is the only form of gas that contributes to partial pressure?

A

Dissolved gas

57
Q

What is the only gas in inspired air found exclusively as dissolved gas?

A

Nitrogen

58
Q

Difference between PAO2 (alveolar PO2) and PaO2 (arterial PO2)

A

A-a gradient (Normal: not zero; PAO2 > PaO2)

59
Q

Nitrogen, oxygen and CO2 under normal condition exhibit what kind of gas exchange?

A

Perfusion -limited gas exchange (gas equilibriates with the pulmonary capillary near the start of the pulmonary capillary)

60
Q

CO2 and O2 during strenuous exercise and disease states (emphysema, fibrosis) exhibit what kind of gas exchange?

A

Diffusion-limited gas exchange (gas doe not equilibriate even until the end of the pulmonary capillary)

61
Q

O2 transport in high altitude is fast or slow?

A

Slow

62
Q

Equilibration of O2 at sea level is ___ length of the pulmonary capillary

A

1/3 length

63
Q

Equlibration of O2 at high altitude is ___ length of the pulmonary capillary

A

2/3 length

64
Q

Percentage of dissolved O2

A

2%

65
Q

Percentage of O2 bound to Hgb

A

98%

66
Q

Hgb with attached O2

A

Oxyhemoglobin

67
Q

Hgb without attached O2

A

Deoxyhemoglobin

68
Q

Hgb with Fe3+ and doesn’t bind O2

A

Methemoglobin

69
Q

A2Y2, higher affinity for O2

A

Fetal hemoglobin

70
Q

A2B2, sickled RBCs, less affinity for O2

A

Hemoglobin S

71
Q

Max O2 binding with Hgb

A

O2 binding capacity

72
Q

Percent of blood that gives up it O2 as it passes through the tissues

A

Utilization coefficient

73
Q

O2-Hgb dissociation curve is sigmoidal in shape. What is the PO2 at the following percent saturation:
50% saturated, 75% saturated, 100% saturated

A 
50% = 25 mmHg (p50)
75% = 40 mmHg
100% = 100 mmHg
74
Q

Binding of first O2 molecule increases affinity for second O2 molecule and so forth

A

Positive cooperativity

75
Q

Shift to the right or shift to the left?

Increased P50

A

Right

76
Q

Shift to the right or shift to the left?

Increased unloading of O2 to Hgb

A

Right

77
Q

Shift to the right or shift to the left?

Increased CO2

A

Right

78
Q

Shift to the right or shift to the left?

Increased 2,3 BPG

A

Right

79
Q

Shift to the right or shift to the left?

Increased temperature, exercise

A

Right

80
Q

Shift to the right or shift to the left?

Acidosis

A

Right

81
Q

Shift to the right or shift to the left?

Increased binding of O2 to Hgb

A

Left

82
Q

Shift to the right or shift to the left?

Decreased p50

A

Left

83
Q

Shift to the right or shift to the left?

Increased Carbon monoxide, HbF

A

Left

84
Q

90% of chloride in the blood

A

HCO3-

85
Q

5% of CO2 in the blood

A

Dissolved CO2

86
Q

3% of CO2 in the blood

A

Carbamino Hgb

87
Q

Cl-HCO3 exchange in the RBC

A

Chloride shift (using Band 3 protein)

88
Q

O2 affecting affinity of CO2/H+ to Hgb

A

Haldane effect

89
Q

CO2/H+ affecting affinity of O2 to Hgb

A

Bohr effect

90
Q

Haldane effect happens in the:

A

Lungs

91
Q

Bohr effect happens in the:

A

Tissues

92
Q

Pressure in the pulmonary circulation is ___ than systemic circulation

A

less

93
Q

Resistance in the pulmonary circulation is ___ than systemic circulation

A

less

94
Q

Cardiac output in the pulmonary circulation is ___ than the systemic circulation

A

equal to

95
Q

Pulmonary blood flow in a supine position is lowest at the apex and highest at the base or same through the entire lung?

A

same through the entire lung

96
Q

Pulmonary blood flow in a standing position is lowest at the apex and highest at the base or same through the entire lung?

A

Lowest at the apex and highest at the base

97
Q

Effect of hypoxia (low PAO2) on pulmonary arterioles

A

vasoconstriction

98
Q

Causes of pulmonary global hypoxic vasoconstriction

A

high altitude, fetal circulation

99
Q

Called the slow reactive substances of anaphylaxis and causes bronchoconstriction in asthma

A

Leukotriene C4, D4 and E4

100
Q

Lung zone:

Local alveolar capillary pressure

A

Zone 1

101
Q

Lung zone:
Local alveolar capillary systolic pressure > alveolar air pressure during systole but less than that during diastole;
Intermittent blood flow

A

Zone 2

102
Q

Lung zone:
Local alveolar capillary pressure > alveolar air pressure throughout the cycle;
Continuous blood flow

A

Zone 3

103
Q

What lung zones do we see in the apex of the lungs at rest?

A

Zone 2 and 3

104
Q

What lung zones do we see in the base of the lungs at rest?

A

Zone 3

105
Q

What lung zones do we see in a supine position, or during exercise throughout the lungs?

A

Zone 3

106
Q

What lung zones do we see in cases of pulmonary hemorrhage or positive pressure ventilation?

A

Zone 1

107
Q

Site of highest ventilation

A

Base of the lungs

108
Q

Site of highest perfusion

A

Base of the lungs

109
Q

Site of highest V/Q ratio

A

Apex of lungs

110
Q

Ventilated area of the lungs with no perfusion (V/Q = infinity)

A

Dead space (eg. pulmonary embolism)

111
Q

Perfusion of lungs with no ventilation (V/Q = zero)

A

Shunt

112
Q

Alveolar gas has same composition as humidified inspired air (PAO2 = 150 mmHg and PACO2 = 0)

A

Dead space

113
Q

Pulmonary capillary blood has same composition as mixed venous blood: PaO2 = 40mmHg and PaCO2 = 46mmHg

A

Shunt

114
Q

Creates the basic respiratory rhythm; contains the dorsal respiratory group, ventral respiratory group, central chemoreceptors

A

Medulla

115
Q

Modifies the basic respiratory rhythm; contains the apneustic and pneumotaxic centers

A

Pons

116
Q

Inspiratory center; control basic rhythm; for normal respiration

A

Dorsal respiratory group

117
Q

Overdrive mechanism during exercise; for forced inspiration and expiration

A

Ventral respiratory group

118
Q

Found in the lower pons; for prolonged duration of inspiration –> decreases RR

A

Apneustic center

119
Q

Found in the upper pons; shorten duration of inspiration –> increases RR

A

Pneumotaxic center

120
Q

Found in the ventral medulla, respond directly to CSF H+ (increases RR)

A

Central chemoreceptors

121
Q

Responds mainly to PaO2

A

Peripheral chemoreceptors

122
Q

Stimulated by lung distention

A

Lung stretch receptors

123
Q

Decreases RR by prolonging expiratory time; prevent overinflation of the lungs

A

Hering-Breuer reflex

124
Q

Stimulated by limb movement; causes anticipatory increase in RR during exercise

A

Joint and muscle receptors

125
Q

Stimulated by noxious chemicals; causes bronchoconstriction and increases RR

A

Irritant receptors

126
Q

Found in juxtacapillary areas; stimulated by pulmonary capillary engorgement; causes rapid shallow breathing and responsible for the feeling of dyspnea

A

J receptors

Physiology (13 decks)

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