Respiratory physiology and gas transport Flashcards

1
Q

Why is surface area important in the lungs

A

Surface area is key in the lungs because it allows for diffusion– there is more room for diffusion with more capillaries

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2
Q

How many alveoli in the lungs?

A

300-500 million

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3
Q

Right vs left lung anatomy

A

Right has 3 lobes, left has 2 lobes (notch for the heart)

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4
Q

Which lung is larger

A

Right

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5
Q

Which pleura is on lungs and which is on ribs

A

Visceral pluera on lungs, parietal plura on wall of chest cavity

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6
Q

What is the function of the pleural cavity?

A

Space between parietal pleura on ribs and visceral plura on lungs- decreases friction.

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7
Q

Where is the pressure between the lungs and pleural cavity?

A

MUST have less pressure in the pleural cavity than the lungs at ALL times

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8
Q

What happens if the pressure changes between the lungs and pleural cavity (and what is it usually)

A

Typically: Pressure in lungs is > than pressure in pleural cavity
When pressure in pleural cavity >than in lungs=pneumothorax.

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9
Q

What kind of pressure is the pressure between lungs and pleural cavity called

A

Negative pressure- MUST have more pressure in lungs than pleural space

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10
Q

Path of air from nose to smallest structure

A

Nose–>pharynx–>larynx–>trachea–>main (primary) bronchus–> terminal bronchiole–>respiratory bronchiole–>Alveolar sac–>Alveoli

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11
Q

Main function of nose

A

filters out bactera, viruses, dust

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12
Q

What is nasal mucus important for

A

Warms and moistens air

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13
Q

What is the makeup of blood supply and epithelium in the nose

A

Rich blood supply, thin epithelium– gives quick access to blood (good for drugs)

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14
Q

Why is the nose better at handling cold dry air than the mouth?

A

Nose has mucus, which is better at cold dry air because mouth just has saliva

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15
Q

Tissue makeup of trachea

A

Muscular tube with mucous membrane, supported by hyaline cartilage ring
- Made up of pseudostratified, cilliated epithelium from nose–>Top of bronchus

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16
Q

What is the function of hyaline cartilage in trachea

A

every time we breathe in, we create negative pressure in the trachea. The cartilage keeps our trachea from collapsing.
Additionally, if you swollow something too big in your esophagus, it expands, which could make trachea collapse (but hyaline prevents)

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17
Q

What is a key feature of and what is the inner layer of primary bronchi called

A

Has cartilage rings in it
Inner layer is ciliated epithelium

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18
Q

How many divisions are there in bronchial tree

A

23 divisions

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19
Q

Describe the anatomy of bronchioles (muscle, cartilage, etc)

A
  • No cartilage, smooth muscle to change airway size
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20
Q

What occurs in SNS activation of the bronchioles and which receptor is responsible

A

Beta 2 receptors are activated, causing SNS activation and dialation of bronchioles (via relaxation of smooth muscle). Further inhibts goblet cells to inhibit secretions of mucus.

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21
Q

Describe PNS activation of bronchioles

A

Constrict airway size, contract smooth muscles

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22
Q

What is the last passageway before the alveoli

A

alveolar ducts

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23
Q

What are alveoli sourrounded by? Why?

A
  • Sourrounded by capillaries, function is gas exchange
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24
Q

Function and structure of type 1 pneumocytes

A

They are the alveoli!
Simple squamous epithelium (1 layer, very flat) (epithelial tissue)

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25
Function and structure of type 2 pneumocytes
Surfactant secretion- play protective roles
26
What types of organelles are on the surface of alveoli
Macrophages- present for protection
27
What type of cell type lines the nose through bronchus
pseudostratified, cilliated epithelium
28
Where can you find psuedostratified, cilliated epithelium?
Top of nose thorough broncus
29
What type of cells are at the top of the bronchioles
simple columnar epithelial
30
What type of cells are found in bottom of bronchioles
simple cuboidal
31
What type of cells are in alveoli
simple squamous type 1 pneumocytes
32
Where can you find simple columnar epithelial tissue
top of bronchioles
33
Where can you find simple cuboidal tissue
bottom of bronchioles
34
Describe club cells function and structure
Progenitor cells- replace epithelal cells along the way- noncilliated
35
What defense secretions does the immune system have
IgA in mucous Collectins (activate cells of innate immune system) Defensins ( proteins- interact with pathogens and destroy them)
36
What is the importance of cillia
move mucous- cillia move upwards and back to mouth to get anything that is cought out of
37
What is the function of sensory neurons in the airway
coughing reflex
38
PAMS and function
Pulmonary alveolar macrophages- resident macrophages of resipiratory tract
39
What is surfactant released by
type 2 pneumocytes
40
What does surfactant contain
lipids and proteins- acts like a detergent
41
Where do phospholipids face in surfactant
Phospholipid heads face out into mucous (to water) Tails are in air space
42
Function of surfactant on a broad scale with alveoli
Hydrogen bonds pull water molecules together and the alveoli will collapse without surfactant. With surfactant, hydrogen bonds are disrupted and alveoli can remain inflated.
43
What are the 3 parts of the diaphragm
Costal Crural Central tendon
44
What part of diaphragm contracts when you vomit
costal part only
45
Where are costal and crural parts of diaphragm
Costal: attach to ribs Crural: Attach to vertebrae
46
What controls the volume change of the lungs
the diaphragm accounts for 75% of the volume change when it contracts
47
What is an important metabolic feature of the diaphragm
made of the most oxidative of any skeletal muscele- doesn't get tired.
48
What part of the diaphragm does the vena cava pierce
central tendon
49
What do diaphragmatic crura wrap around
esophagus and then comes back to diaphragm
50
Where is central tendon in diaphragm
in the middle between sides of costal part
51
Where does central tendon attach to pericaridum
it's woven into the pericardium and "one with it" (pericardium is superior, heart is directly superior )
52
Where does air flow in terms of pressure
Always flows from higher pressure to lower pressure
53
What is the relationship between volume and pressure
Inverse- More volume= less pressure
54
Definition of boyle's law
When the amount of gas in a space is constant, and the temperature remains constant, pressure and volume have an inverse relationship
55
What is the relationship between volume and pressure in boyle's law
Pressure is inverse to volume If volume doubles, pressure cuts in half if volume is cut in half, pressure doubles
56
Describe what happens when inhaling/the diaphragm moves inferiorly
Diaphragm goes down when inhaling--> interpleural space volume increases--> pressure in that space decreases-->greater vaccum on lungs-->pulls lungs open - occurs in inspiration
57
Describe what happens when exhaling/the diaphragm moves superiorly
Diaphgram goes up-->decrease volume in pleural space-->Pressure in that space increases--> Smash the lungs back to be smaller - occurs in expiration
58
Which muscles are primarily relied on for passive inspiration
Diaphragm (contracting it) External intercostals
59
Is inspiration a passive or active process
Active- need to contract diaphragm and external intercostals
60
Which muscles do we need for expiration
none! Passive process. We relax everything to let our ribs and diaphragm fall. For forced expiration, we use internal intercostals and abdominal muscles
61
What is compliance a measure of
the ability to stretch and expand lungs
62
What is compliance affected by
Resistance, surface tension
63
What does increased and decreased SNS activity do to resistance in the lungs
Increased activity: leads to dialation, allows for more stretching and leads to less resistance Decreased activity: leads to constriction, more resistance.
64
What is the main contributor to surface tension in the lungs
Surfactant- decreases surface tension and allow alveoli to stretch and recoil readily. Premature babies and people with emphysema increase surface tension - Decrease compliance (harder to open lungs)
65
How do we measure lung compliance
pressure volume curves- inspire to an amount and then stop flow and measure pressure - Pressure difference between outside and inside
66
Which parts of the blood don't go through pulmonary capillaries and therefore don't get reoxygenated?
Bronchial blood flow (portion of bronchiole venous blood dumps into pulmonary vein Coronary arteries in left side of heart- dump into veins that dump into left atrium
67
What is the physiological shunt in lung blood flow?
2 portions of blood do not go through pulmonary capillaries and therefore don't get reoxygenated - Creates the 98% saturation of blood instead of 100%
68
What is the normal saturation of blood
98% O2 saturation - 2 parts of blood (physiological shunt amde of bronchial blood flow and coronary arteries) don't go through right side of heart to be oxygenated in lungs)
69
What occurs when the V/Q ratio is >.8
Blood flow is blocked- lots of ventelation into lungs but no blood/perfusion
70
What causes V/Q >.8
Pulmonary embolism, pulmonary arteritis, TB that causes loss of capilary bed
71
What occurs when the V/Q ratio is <.8
No ventelation is occuring/no air is reaching blood--> lots of blood flow, but no air in contact because air is backed up
72
What causes a V/Q of <.8
Airway limitation (asthma, bronchitis) Lung collapse loss of elastic tissue (emphysema)
73
What is a V/Q mismatch
Either the pulmonary ventelation or pulmonary blood flow is blocked and restricted, so we can't fill up blood with oxygen for either reason. Leads to a V/Q ratio of either less than or greater than normal (.8)
74
Why aren't we constantly using the top portion of our lungs
The capillaries at the top of the lungs collapse because the alveoli have so much pressure in them, so the top part of the lungs doesn't get blood perfusion (The V>Q-- lots of air, no blood, ventelation but no perfusion)
75
What is 98.5% of oxygen carried by and where is the remainding 1.5%
Most is carried in oxygen by hemoglobin 1.5% is dissolved in plasma
76
How is CO2 carried
70% is carried in form of HCO3- 20% is carried by hemoglobin 10% dissolved in plasma
77
What is the oxygen percentage of our atmosphere
20%- does not change-->always percentage of atmosphere
78
Where is hardest place for oxygen transport
between arterial blood and interstitital space-- no carrier, just need to diffuse through-- big concentration difference to move the oxygen
79
What is the bottleneck in oxygen cascade
arterial blood to interstitial space- space outside of capillaries, need to diffuse. Based on the O2 gradient.
80
What is the end point of starting with less oxygen (i.e. if you're on top of mount everest)
Much less oxygen at the start leads to a smaller push down the entire oxygen cascade-->less oxygen in mitochondria when we start out with less
81
Hemoglobin is 6x more powerful than plasma proteins as a buffer. What is the difference bewteen these?
Histadine residues (not carboxyl and amino)
82
The Response by the buffering system if pH increases: * What does the buffer system do? * Which way does the equation move? * Which way does this move pH?
You have less H+ ions if pH increases. 1) use the acid to donate H+ ion 2) equation goes right (donates H+) 3) back down CO2 + H2O <-> H2CO3 <-> H+ + HCO3-
83
The Response by the buffering system if pH decreases: * What does the buffer system do? * Which way does the equation move? * Which way does this move pH?
With a pH decrease, you have more H+ ions 1) use base (HCO3-) accepts a H+ ion 2) Left 3) back up CO2 + H2O <-> H2CO3 <-> H+ + HCO3-
84
What can lead to Respiratory Acidosis?
* Emphysema (high residual volume -> CO2 stays in system) * Overdose of narcotics (morphine) affects medulla
85
What is the MOA of Acitazolamide
High altitude has less O2 in the air. We breathe faster at higher atitudes (Hyperventilation) to compensate, which causes respiratory alkalosis. Taking Acetazolamide Boosts HCO3 excretion to prevent alttitude sickness because we have a lower HCO3 level to start.
86
What does EPO do
stimulate RBC production-- Kidneys stimulate increased secretion of EPO.
87
Increased 2,3, BPG causes what
A right shift! its a byproduct of metabolism, so increasing it causes easier unloading of O2 at tissues
88
A patient who is not used to high altitudes can have which symptoms?
- Headache, nausea, fatigue