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630: Medical Physiology > Respiratory Physiology (Part 1) > Flashcards

Respiratory Physiology (Part 1) Flashcards

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USMLE® Step 1 flashcards
1
Q

What is the function of the respiratory system?

A

To exchange oxygen and carbon dioxide between the environment and the cells of the body

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2
Q

The structures of the respiratory system are subdivided into 2 zones, what are they?

A
  • The conducting zone

- The respiratory zone

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3
Q

What structures are included in the conducting zone?

A
  • nose
  • nasopharynx
  • larynx
  • trachea
  • bronchi
  • bronchioles
  • terminal bronchioles
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4
Q

What are the funcitons of the conducting zone?

A

Bring air into and out of the respiratory zone for gas exchange and to warm, humidify, and filter the air before it reaches the critical gas exchange region

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5
Q

What is the main conducting airway?

A

the trachea

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6
Q

The trachea divides into how many different divisions?

A

23

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7
Q

What lines the conducting airways and what are their function?

A

Mucus-secreting and ciliated cells that function to remove inhaled particles

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8
Q

Do the walls of the conducting airways contain smooth muscle?

A

yes

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9
Q

Describe sympathetic innervation of smooth muscle in the conducting airways

A

Sympathetic adrenergic neurons activate beta2 receptors which leads to relaxation and dilation of the airways

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10
Q

Describe parasympathetic innervation of smooth muscle in the conducting airways

A

Parasympathetic cholinergic neurons activate muscarinic receptors, which leads to contraction and constriction of the airways

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11
Q

How are beta2-adrenergic agonists help treat asthma?

A

They are used to dilate the airways

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12
Q

The alveoli lined structures of the respiratory zone participate in what?

A

gas exchange

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13
Q

What structures are included in the respiratory zone?

A
  • respiratory bronchioles
  • alveolar ducts
  • alveolar sacs
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14
Q

Why are the respiratory bronchioles considered transitional structures?

A

They have cilia and smooth muscle like the conducting airways, but are also considered part of the gas exchange region because alveoli occasionally bud off their walls

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15
Q

What lines the alveolar ducts and alveolar sacs?

A

alveloi

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16
Q

What are alveoli?

A

Pouchlike envaginations found in the walls of the respiratory zone in which gas exchange occurs

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17
Q

Why can the exchange of oxygen and carbon dioxide between alveolar gas and pulmonary capillary blood occur rapidly and efficiently?

A

Because the alveolar walls are thin and have a large surface area for diffusion

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18
Q

What are the epithelial cells that line the alveolar walls called?

A

type I and II pneumocytes

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19
Q

What do the type II pneumocytes synthesize?

A

Pulmonary surfactant which have regenerative capacity for the type I and II pneumocytes

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20
Q

What are the phagocytic cells in the alveoli called?

A

alveolar macrophages

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21
Q

Why is pulmonary blood flow not distributed evenly in the lungs?

A

Because of gravitational effects

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22
Q

When a person is standing, blood flow is ____ at the apex and _____ at the base of the lungs

A

lowest

highest

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23
Q

What happens to the gravitational effects when a person is supine?

A

They disappear

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24
Q

How is the regulation of pulmonary blood flow accomplished?

A

by altering the resistance of the pulmonary arterioles

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25
Q

What controls changes in pulmonary arteriolar resistance?

A

local factors, mainly oxygen

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26
Q

What is bronchial circulation?

A

The blood supply to the conducting airways (which do not participate in gas exchange) and is a very small fraction of the total pulmonary blood flow

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27
Q

Static volumes of the lungs are measured with what?

A

a spirometer

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28
Q

What does normal tidal volume equal?

A

500 mL

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29
Q

What does normal tidal volume include?

A

The volume of air that fills the alveoli plus the volume of air that fills the airways

30
Q

What is inspiratory reserve volume?

A

The additional volume that can be inspired above tidal volume

31
Q

What does inspiratory reserve volume equal?

A

3000 mL

32
Q

What is expiratory reserve volume?

A

The additional volume that can be inspired below tidal volume

33
Q

What does expiratory reserve volume equal?

A

1200 mL

34
Q

What is residual volume?

A

The volume of gas remaining in the lungs after a maximal forced expiration

35
Q

What does residual volume equal?

A

1200 mL

36
Q

Describe inspiratory capacity (IC)

A

It is the lung capacity composed of the tidal volume plus the inspiratory reserve volume

37
Q

What does inspiratory capacity normally equal?

A

3500 mL (500 +3000)

38
Q

Describe functional residual capacity (FRC)

A

It is the lung capacity composed of the expiratory reserve volume plus the residual volume

39
Q

What does functional residual capacity normally equal?

A

2400 mL (1200 + 1200)

40
Q

Functional residual capacity can be thought of as what? Explain why

A

The equilibrium volume of the lungs, because it is the volume remaining in the lungs after a normal tidal volume is expired

41
Q

Describe vital capacity (VC)

A

It is the lung capacity composed of the inspiratory capacity plus the expiratory reserve volume

42
Q

What does vital capacity normally equal?

A

4700 mL (3500 + 1200)

43
Q

Vital capacity is the volume that can be expired after maximal ______.

A

inspiration

44
Q

What does total lung capacity include? What does it equal?

A

All of the lung values

Vital capacity (4700) + residual volume (1200) = 5900 mL

45
Q

What is dead space in the lungs considered?

A

The volume of the airways and lungs that does not participate in gas exchange.

46
Q

What are the 2 types of dead space?

A
  • anatomic

- physiologic

47
Q

What is anatomic dead space?

A

The volume of the conducting airways

48
Q

What does the volume of the conducting airways or anatomic dead space equal?

A

1/3 of each tidal volume, which is approximately 150 mL

49
Q

What is physiologic dead space?

A

The total volume of the lungs that does not participate in gas exchange

50
Q

What does physiologic dead space include?

A

Anatomic dead space of the conducting airways plus functional dead space in the alveoli

51
Q

Physiologic dead space can be thought of as what?

A

Ventilated alveoli that do not participate in gas exchange

52
Q

What is the most important reason that alveoli do not participate in gas exchange?

A

There is a mismatch of ventilation and perfusion, in which ventilated alveoli are not perfused by pulmonary capillary blood

Ventilation/perfusion defect

53
Q

What does a ventilation/perfusion defect indicate?

A

Physiologic dead space is larger than anatomic dead space

54
Q

What does physiologic dead space equal?

A

Tidal volume (500 mL) multiplied by a fraction the represents the dilution of alveolar CO2 partial pressure by dead space air

55
Q

What is ventilation rate?

A

The volume of air moved into and out of the lungs per unit time

56
Q

What is minute ventilation?

A

The total rate of air movement into and out of the lungs

57
Q

How do you calculate minute ventilation?

A

multiple tidal volume by the number of breaths per minute

58
Q

What is the difference between minute and alveolar ventilation?

A

Alveolar ventilation corrects for the physiologic dead space

59
Q

How do you calculate alveolar ventilation?

A

Multiple tidal volume minus physiologic dead space by the number of breaths per minute

60
Q

What is the alveolar ventilation equation?

A

An equation that describes the inverse relationship between alveolar ventilation and alveolar CO2 partial pressure

61
Q

State the alveolar ventilation equation

A

Alveolar ventilation = (CO2 production rate x 863) / alveolar CO2 partial pressure

62
Q

What determines alveolar CO2 partial pressure if CO2 production is constant?

A

alveolar ventilation

63
Q

Increases in alveolar ventilation cause _____ in alveolar CO2 partial pressure

A

increases

and vice versa, decreases cause decreases

64
Q

When CO2 production doubles from 200 mL/min to 400 mL/min, what happens to alveolar ventilation and why?

A

It must double to maintain the alveolar CO2 partial pressure at 40 mmHg

65
Q

What is forced vital capacity?

A

The total volume of air that can be forcibly expired after a maximal inspiration

66
Q

Describe the concept of FEV1, FEV2, and FEV3

A
  • FEV1 is the volume of air that can be forcibly expired in the first second
  • FEV2 is the cumulative amount of air that can be forcibly expired in 2 seconds
  • `FEV3 is the cumulative amount of air that can be forcibly expired in 3 seconds
67
Q

Why is there no FEV4?

A

Because the entire vital capacity can be forcibly expired in 3 seconds

68
Q

What 2 lung volumes can useful indices of lung disease?

A

FVC and FEV1, specifically the fraction of the vital capacity that can be expired in the 1st second

69
Q

Describe how FVC and FEV1 are affected in a patient with asthma

A

They are both decreased, however FEV1 is decreased more than FVC is

70
Q

Describe how FVC and FEV1 are affected in a patient with fibrosis

A

They are both decreased, however FEV1 is decreased less than FVC is

71
Q

The FEV1/FVC ratio ______ in asthma patients and ______ in fibrosis patients

A

decreases

increases

72
Q

What is normal FEV1/FVC ratio? Why does this indicate?

A

0.8, meaning 80% of the vital capacity can be expired in the first second of forced expiration

630: Medical Physiology (24 decks)

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