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Pathophysiology > Respiratory Physiology > Flashcards

Respiratory Physiology Flashcards

1
Q

Immaturity of the respiratory tract is a major cause of ______

A

mobility and mortality in premature infants

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2
Q

____ production generally begins after week 20

A

surfactant

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3
Q

by the 25th to 28th week of gestation _____ are present to permit survival

A

sufficient alveoli

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4
Q

final adult alveolar number is about _____

A

700 million total

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5
Q

lack of stiff structural support for airways makes children more susceptible to ____ and _____

A

atelectasis (lung collapse) and obstruction

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6
Q

Upper airway consists of (3)

A
  • nasopharynx
  • oropharynx
  • laryngopharynx
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7
Q

lower airway consists of (4)

A
  • larynx
  • trachea
  • bronchi
  • acinus
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8
Q

nasal cavity functions

A
  • conducts gases to and from lungs
  • filters, warms, humidifies air
  • turbinates are convoluted and vascular
  • rigid (bone/cartilage) to prevent collapse
  • vibrissae trap foreign particles
  • cilia sweeps mucous
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9
Q

What are the four paranasal sinuses

A

-maxillary, frontal, ethymoid, sphenoid

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10
Q

sinuses contribute to ____

A

speech resonance, heat and water vapor exchange , mucociliary action removes bacteria and debris

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11
Q

Eustachian tubes allow _______ of middle ear.

A

pressure equalizer

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12
Q

Eustachian tubes are open during swallowing, otherwise closed– horizontal position and shorter length in children predisposes to ________

A

ottis media in children

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13
Q

the conducting airways consists of :

A

nasal and oral pharynx, larynx, trachea, bronchi, and bronchioles

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14
Q

function of conducting airways

A
  • direct air to respiratory exchange zones of the lung
  • warm, filter, and humidify air
  • no gas exchange across conducting airways
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15
Q

conducting airway epithelium is ________ epithelial cells

A

ciliated columnar epithelial cells

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16
Q

what is the primary defense mechanism of conducting airway epithelium?

A

mucociliary transport is a primary defense mechanism- moves inhaled particles and mucous to the esophagus for swallowing or coughing

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17
Q

Goblet cells produce ____

A

mucous

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18
Q

do children have more or less goblet cells than adults ?

A

more

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19
Q

function of the larynx

A

sound production, valve to control air movement out of lungs, prevent foreign substances from entering the trachea and lungs, expel foreign substances

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20
Q

larynx anatomy: hyoid bone –

A

a horseshoe shaped bone from the larynx is suspended

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21
Q

thyroid cartilage:

A

a v-shaped cartilage containing the vocal folds (attach anteriorly)

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22
Q

cricoid cartilage:

A

a ring shaped cartilage connected to the trachea, supports the arytenoid cartilages posteriorly

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23
Q

arythenoid cartilage

A

vocal folds connect on posterior side

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24
Q

Vocal folds:

A

vibrate when air passes over them, forming sound (longer folds create lower sounds, tighter folds, create, higher sounds)

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25
Q

Cough is initiated by _________ receptors in the ____

A

trachiobronchial receptors in carina (bifurcation of right and left mainstream bronchi)

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26
Q

cough is produced when ____ and ____ close tightly against air trapped in lungs

A

vocal folds and epiglottis

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27
Q

When a cough is initiated, expiratory muscles (intercostal and abdominal) contract and ________ against closed vocal folds and epiglottis; vocal fold and epiglottic suddenly open; _____ escapes, ejecting debris and mucus

A

increase pressure; high pressure air

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28
Q

cough is a defense against _____

A

excessive secretion or foreign/irritating substance

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29
Q

diminishing cough reflex increases risk of ____

A

aspiration

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30
Q

The trachea divides in the right and left main ____ at the carina

A

bronchi

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31
Q

Right lung has ___ lobular bronchi

A

3

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32
Q

Left lung has ___ lobular bronchi

A

2

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33
Q

lobular bronchi –> ____ –>_____

A

lobular bronchi–> segmental bronchi–> the terminal bronchioles

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34
Q

each lobe is separated into ______

A

independently-ventilated bronchiopulmonary segments

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35
Q

alveoli begin to form on the ________

A

respiratory bronchioles

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36
Q

adults have _____ alveoli per lung

A

350 milllion

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37
Q

alveoli is the surface for ___ and ___ exchange

A

O2 and CO2

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38
Q

Type 1 alveolar cells:

A

squamous epithelial cells (“pneumocytes”); majority of cells, form gas exchange surface

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39
Q

Type 2 alveolar cells:

A

produce surfactant; phospholipid-containing liquid that lowers surface tension (eases opening) and facilitates gas exchange

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40
Q

Type 3 alveolar cells

A

alveolar macrophages; phagocytize particles/ microbes that reach alveoli

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41
Q

Pleura is a thin continuous membrane covering ___ and ___

A

lungs (visceral pleura) and thoracic cavity (parietal pleura)

42
Q

the visceral and parietal pleura are separated bye small amount of ______ to lubricate (around 15ml/ 1 tablespoon)

A

serous fluid

43
Q

interpleural space is maintained at positive or negative pressure? which keeps lungs pressed against thorax wall

A

negative pressure

44
Q

Parasympathetic nervous system, consists of the ___ nerve

A

vagus; stimulates constriction of bronchial smooth muscle (bronchioconstriction)

45
Q

Sympathetic nervous system consists of _____ and _____ which causes ____ of bronchial smooth muscle

A

T1-T4 and epinephrine/norepinephrine (adernal gland medulla)

46
Q

What is the sympathetic nervous system mediated by ?

A

b-2 adrenergic receptors

47
Q

Bronchial artery system arises from ______ (oxygenated arterial blood); supplies blood to ____ and support lung structures (NOT to alveoli)

A

thoracic aorta; bronchi

48
Q

Pulmonary artery system arises from ______ (delivers unoxygenated blood from ______), divides into right and left pulmonary artery

A

pulmonary artery; right ventricle

49
Q

pulmonary artery system is a huge capillary network for ______ and is a high or low pressure arterial system?

A

gas exchange; low pressure

50
Q

oxygenated blood exits through _______ into ____

A

pulmonary vein into left atrium

51
Q

two mechanisms to increase capillary perfusion:

A
  1. recruiting (opening) previously closed capillary beds (normally only 25% of capillaries are perfused)
  2. increasing arterial blood flow
52
Q

pulmonary arterioles constrict in response to____

A

alveolar hypoxia

53
Q

Fluid balance across lung tissue regulated by 3 factors:

A

hydrostatic pressure, colloid osmotic pressure, capillary permeability

54
Q

hydrostatic pressure:

A

blood pressure vs tissue pressure

55
Q

colloid osmotic pressure

A

related to protein concentration on either side of a membrane

56
Q

capillary permeability

A

leakiness between endothelial cells lining capillaries

57
Q

Ventilation is the process of ______

A

moving air into and out of the lungs

58
Q

purpose of ventilation is to allow ___ absorption from inspired air and removal of ___ to expired air

A

O2; CO2

59
Q

Ventilation is influenced by ___, ____, ____

A

body position, age, body size and shape

60
Q

Tidal Volume (TV)

A

the volume of air breathed in and out without conscious effort in a “normal” breath (500cc)

61
Q

Inspiratory reserve Volume (IRV)

A

The volume of air above TV that can be inhaled with maximum effort after a normal inspiration (~3L)

62
Q

Expiratory Reserve Volume (ERV)

A

The volume of air above TV that can be forcibly exhaled with maximal effort after normal exhalation (~1.2L)

63
Q

Residual Volume (RV)

A

The volume of air left in the lungs after a maximum exhalation (~1.2L)

64
Q

Vital Capacity (VC)

A

the total volume of air that can be exhaled after a maximum inhalation (VC= TV +IRV+ERV, ~4.7L)

65
Q

Inspiratory Capacity (IC)

A

the total volume of air that can be inspired after a normal exhalation (IC=TV+IRV, ~2.4L)

66
Q

Functional Residual Capacity (FRC)

A

The total volume of air in the lungs following a normal exhalation (FRC=ERV +RV, ~2.4L)

67
Q

Total Lung Capacity (TLC)

A

The amount of air in the lungs at maximal inspiration (TLC= IRV + TV+ ERV +RV, ~6L)

68
Q

Measure _____ as an indicator of “minute ventilation”(volume of air that is exchanged each minute)

A

respiratory rate

69
Q

Hyperventilation indicates….

A

increase minute ventilation, indicates increased need for O2 for excess CO2 or increased respiratory drive (brainstem function)

70
Q

Hypoventilation (decreased minute ventilation) indicates…

A

reduced need for O2 or low CO2, or reduced respiratory drive (brainstem function)

71
Q

Primary objective of respiration is to

A

get O2 into the blood and CO2 out

72
Q

What are the three primary contributors to gas exchange?

A
  1. neuromuscular function (maintaining mechanics of inspiration and expiration)
  2. Ventilation (gas movement in and out of lung)
  3. Diffusion/ perfusion of gases (across the gas exchange membrane)
73
Q

____ and ____ affect gas movement into and out of lungs

A

airway resistance and lung compliance

74
Q

lung ____ is the natural ability of lung tissue to collapse on itself (the magnitude of change in lung volume as a result of the change in pulmonary pressure)

A

lung compliance

75
Q

____ decreases alveolar surface tension

A

surfactant

76
Q

what is actelectasis?

A

complete or partial collapse of the lung

77
Q

what are the mechanics of inspiration

A
  1. the diaphragm contracts and moves downward
  2. negative interpleural pressure and lung expansion occurs
  3. intercostal muscles contracts, elevating ribs and expanding thoracic volume
78
Q

what are the mechanics of Expiration

A
  1. Diaphragm and intercostal muscles relax (na active expiration via diaphragm)
  2. Lungs passively recoil- increasing intrapulmonary pressure and pushing air out
79
Q

___, ___ breathing results in increased alveolar ventilation vs rapid shallow breaths

A

slow, deep

80
Q

the partial pressure of O2 in alveoli is generally slightly greater than the ____

A

arterial O2 tension (normally 95-100mmHg)

81
Q

the presence of a large difference between alveolar and arterial O2 tension indicates poor diffusion of _____ into blood

A

alveolar O2

82
Q

Anatomic dead space:

A
  • pulmonary areas that do not participate in gas exchange (bronchi and bronchioles)
  • increased with destruction or consolidation of alveoli
83
Q

Alveolar dead space:

A

ventilated bu nonperfused

84
Q

physiologic dead space:

A

anatomic dead space + alveolar dead space

85
Q

The ease with which air resistance is moved into and out of the lungs depends on _______

A

airway resistance

86
Q

Airway resistance depends on what 3 things?

A
  1. airway diameter (radius): airway resistance is inversely related to the 4th power of the radius
  2. Turbulence: more turbulent air flow created more resistance
  3. Space filling materials/ obstruction: decrease airway diameter and increase turbulence
87
Q

Effects of gravity: compared to lower portions of the lung, the upper portions have: less_____; larger_____, lesser_____

A

less blood flow (less gas exchange); larger, partially inflated alveoli; lesser ventilation capacity

88
Q

High lung compliance=

A

lung stretches and passively contracts easily

89
Q

low lung compliance=

A

stiff lungs, difficulty expanding

90
Q

O2 moves from alveoli to ____, and CO2 moves from _____ to alveoli

A

blood, blood

91
Q

O2 and CO2 diffusion is impaired by decreased ______ and increase ______ of change surface

A

surface area; thickness

92
Q

CO2 transport:

  1. small amount is dissolved in ____
  2. Some binds with ______
  3. Majority of CO2 diffuses into RBCs and converted to ______ by carbonic anhydrase
A
  1. plasma
  2. hemoglobin
  3. carbonic acid
93
Q

Increased tissue metabolism increases ____ and __ production resulting in decreased Hb affinity for O2 and increased Hb affinity for CO2

A

pCO2 and H+

94
Q

as blood reaches the alveolar capillaries, CO2 diffuses out of blood into the alveoli, increasing blood___, which increases ____ binding capacity

A

pH; O2

95
Q

affinity of ____ binding to Hb is higher than either O2 or CO2

A

carbon monoxide (CO)

96
Q

does the diaphragm have inherent pacemaker properties?

A

no

97
Q

the diaphragm requires input form the respiratory center in the ___ and ___

A

pons and medulla

98
Q

Central chemoreceptors affect the _____ center. They primarily respond to ____ extracellular pH (indicator of CO2 concentration by increasing ventilator)
- secondary response to reduced O2 concentration by ventilatory rate

A

respiratory center

99
Q

peripheral chemoreceptors affect ___ and ____. They respond to ____ (reduced O2 concentration) by triggering increased respiratory center activity

A

carotid and aortic bodies; hypoxia

100
Q

Lung receptors respond by ___, ____, ____ (junta capillary receptors sense decreased O2 result in increased ventilation)

A

stretch, irritant (cough), and hypoxia

Pathophysiology (14 decks)

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