Respiratory Physiology Part 1 Flashcards

1
Q

The whole purpose of the respiratory system is to ?

Three exmples?

A

support cellular respiration

  1. Delivery of oxygen to the cells
  2. Removal of CO2
  3. Without oxygen all tissues are affected
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2
Q

Four processes that supply the body with O2 and dispose of CO2

A
  1. Pulmonary ventilation (air in and out)
  2. External respiration (exchange of gas at lungs)
  3. Transport in the systemic circulation
  4. Internal respiration (exchange of gas at the tissues)
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3
Q

Major Organs of theh respiratory system?
6

Funcitonal anatomy can be divided into 3 categories. What are they?

A
  1. Nose, nasal cavity, and paranasal sinuses
  2. Pharynx
  3. Larynx
  4. Trachea
  5. Bronchi and their branches
  6. Lungs and alveoli

conducting zone
respiartory zone
respiarotyr muscles

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4
Q

What is the conducting zone and what does it include?

A

Conducting zone: conduits to gas exchange sites
Includes all respiratory structures that do not participate in gas exchange

(just the highway!)

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5
Q

What is the respiratory zone?

What are the microscopic structures involved? 3

A

Respiratory zone: site of gas exchange

Microscopic structures:

  1. respiratory bronchioles,
  2. alveolar ducts, and
  3. alveoli
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6
Q

What are the muscles involved (1)?

A

Respiratory muscles:

diaphragm and other muscles that promote ventilation

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7
Q

What are the three layers of the trachael wall?

A

mucosa
submucosa
hylaine cartilage

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8
Q

What is the mucosa made of?

2

A
1. Pseudostratified
  ciliated columnar
  epithelium
2. Lamina propria
  (connective tissue)
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9
Q

What is found in the submuscosa?

A

Seromucous gland

in submucosa

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10
Q

Conducting zone structures of the upper airway 5

Whats it important for?

A
Nose and sinuses
Pharynx
Nasopharyx 
Oropharynx
Laryngopharynx

heating and mositening the air

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11
Q

Funtion of the nose and sinuses? 2

Location of the nasal musocsa?

A

Produce mucus,
warm, humidify and filter the air

Nasal mucosa
Continuous with the mucosa of the lower respiratory tract and extends into the nasolacrimal ducts

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12
Q

What is contained in the nasopharynx? 1

Oropharyx? 3

Layngopharynx? 1

A
Nasopharynx
-adenoids
Oropharynx
-Palatine tonsils, 
-lingual tonsil
-Epiglottis
Laryngopharynx
-Vocal cords
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13
Q

compare the right and left main stem bronchi

Each main bronchus separates how?
entrance, braching pattern

A

Right main bronchus is wider, shorter, and more vertical than the left

Enters hilum of one lung
Each main bronchus branches into lobar (secondary) bronchi (three right, two left)
Each lobar bronchus supplies one lobe

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14
Q

Air passages undergo how many orders of branching?

Branching pattern is called the what?

A

Air passages undergo 23 orders of branching

bronchial (respiratory) tree

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15
Q

What does each lobar bronchus branch into?

How big are bronchioles?

Which are the smallest?

A
  1. Segmental (tertiary) bronchi
    Segmental bronchi divide repeatedly

Bronchioles are less than 1 mm in diameter
Terminal bronchioles are the smallest, less than 0.5 mm diameter

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16
Q

The smooth muslces does what during when?

What medicine works on this?

What structures helps with the flexibility with air moving in and out?

A

constricts during bronchoconstriction

bronchodilators

elastic fibers (connective tissues disorder pts develop restrictive disorders with this)

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17
Q

From bronchi through bronchioles, structural changes occur. Name these.

4

A
  1. Cartilage rings give way to plates; cartilage is absent from bronchioles
  2. Epithelium changes from pseudostratified columnar to cuboidal;
  3. cilia and goblet cells become sparse
  4. Relative amount of smooth muscle increases
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18
Q

Whats the main site for gas exchage?

What kind of cells are they (alveolar wall) made of?

A

alveolar sacs

type 1 alveolar cells basement membrane
1 cell layer thick

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19
Q

What are type 2 cells and what do they produce?

A
Type II (surfactant-
secreting) cell
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20
Q

HOw thick is the air blood barrier?

A

~0.5-μm

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21
Q

What is the respiratory membrane made of?

A

Alveolar and capillary walls and their fused basement membranes

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22
Q

Scattered type II cuboidal cells secrete what? 2

A

surfactant and antimicrobial proteins

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23
Q

What are alveoli surrounded by?

They contain open pores that do what? 2

What do alveoli house and what are the purpose of these?

A

Surrounded by fine elastic fibers

Contain open pores that

  1. Connect adjacent alveoli
  2. Allow air pressure throughout the lung to be equalized

House alveolar macrophages that keep alveolar surfaces sterile

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24
Q

In COPD what would the alveoli look like?

A

grapes are popped to make one big one. really large alveoli. disrupting the funtion of the alveolar wall

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25
Q

Lungs occupy all of the thoracic cavity except for what?

A

mediastinum

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26
Q

What is the root of the lungs?

What is the costal surface made of? 3

A

site of vascular and bronchial attachments

anterior, lateral, and posterior surfaces

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27
Q

Compare the left and right lung?

Number of Bronchopulmonary segments on each?

A

Left lung is smaller, separated into two lobes by an oblique fissure

Right lung has three lobes separated by oblique and horizontal fissures

Bronchopulmonary segments (10 right, 8–9 left)

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28
Q

What are the smallest subdivisions and what are they served by?

How many segments does each lobe of the lungs have:

Right superior lobe?

Right middle lobe?

Right inferior lobe?

Left superior lobe?

Left inferior lobe?

A

Lobules are the smallest subdivisions; served by bronchioles and their branches

Right
superior
lobe (3
segments)

Right
middle
lobe (2
segments)

Right
inferior lobe (5 segments)

Left superior
lobe
(4 segments)

Left inferior
lobe (5 segments)

Gotta cut like broccoli or cauliflower. and then tie up the vessels to that area (for surgery)

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29
Q
  1. Describe the pressure and volume of pulmonary circulation?
  2. Pulmonary arteries deliver what kind of blood?
  3. where do they feed into?
  4. pulmonary veins carry what kind of blood and from where?
A
  1. low pressure, high volume
  2. Pulmonary arteries deliver systemic venous blood
  3. Branch profusely, along with bronchi and feed into the pulmonary capillary networks
  4. Pulmonary veins carry oxygenated blood from respiratory zones to the heart
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30
Q

Describe the pressure and volume of systmeic circulation?

Bronchial arteries provide what kind of blood and to where?

Where do they arise from?

They supply all lung tissue exacept what?

Bronchial veins anastomose with what?

Pulmonary veins carry what kind of blood and where?

A

Systemic circulation (high pressure, low volume)

Bronchial arteries provide oxygenated blood to lung tissue

Arise from aorta and enter the lungs at the hilum

Supply all lung tissue except the alveoli

Bronchial veins anastomose with pulmonary veins

Pulmonary veins carry most venous blood back to the heart

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31
Q

Describe the pleura?

What are the two kinds?

What is in between and how does it function?

A

Thin, double-layered serosa

Parietal pleura on thoracic wall and superior face of diaphragm

Visceral pleura on external lung surface

Pleural fluid fills the slitlike pleural cavity
Provides lubrication and surface tension

32
Q

What nerve systems are responsibe for constriction of the bronchioles and dilation?
2

A

Parasympathetic stimulation
= constriction of the bronchioles
Sympathetic stimulation
= dilation of the bronchioles

33
Q

Pulmonary ventilation consists of two phases. Describe them

A

Inspiration: gases flow into the lungs
Expiration: gases exit the lungs

34
Q

The mechanics of breathing is reliant on the following principles:
2

A

Pressure relationships in the thoracic cavity

Pulmonary ventilation

35
Q

Pressure relationships in the thoracic cavity can be described as? 2

Pulmonary ventilation depends on what? 4

A

Intrapulmonary vs. intrapleural pressures

Boyle’s law
Airway resistance
Alveolar surface tension
Lung compliance

36
Q

What is transpulmonary pressure?

A

Transpulmonary pressure is the difference between the alveolar pressure (intrapulmonary) and the intrapleural pressure in the lungs.

37
Q

43

A

43

38
Q

43

A

43

39
Q

What is atmospheric pressure?
2

Respratory pressures are descirbed realtive to what?

Negative respiratory pressure is less than what?

Positive respiratory pressure is greater than what?

A

Pressure exerted by the air surrounding the body
760 mm Hg at sea level

Respiratory pressures are described relative to Patm

Negative respiratory pressure is less than Patm

Positive respiratory pressure is greater than Patm

Zero respiratory pressure = Patm

40
Q

Intrapulmonary (intra-alveolar) pressure (Ppul) is what?

When does it flucuate?

What does it always equalize with?

A

Pressure in the alveoli

Fluctuates with breathing

Always eventually equalizes with Patm

41
Q

What is intrapleural pressure? (Pip)

When does it flucuate?

Is it positive or negative?

A

Pressure in the pleural cavity

Fluctuates with breathing

Always a negative pressure (

42
Q

Intrapleural pressure is always negative (Pip). This is caused by opposing forces. Describe this.

A

Two inward forces promote lung collapse

One outward force tends to enlarge the lungs

43
Q

Which two forces promote lung collapse?

Which force tends to enlarge the lungs?

A
  1. Elastic recoil of lungs decreases lung size
  2. Surface tension of alveolar fluid reduces alveolar size
  3. Elasticity of the chest wall pulls the thorax outward
44
Q
  1. The transpulmonary pressure does what?
  2. The greater the transpulmonary pressure equals what?
  3. How do we lose transpulmonary pressure?
A
  1. keeps the lungs open
  2. the larger the lungs
  3. A hole! collapse lungs
    Pip = Ppul
    0 transpulmonary pressure
45
Q

If loss of integrity of the pleura what results?

What is the transpulmonary pressure here?

A

Results in the equalization of the intrapleural pressure
Lung collapse

0

46
Q

What is lung collapse called?

Can be due to what two causes?

A

Atelectasis

  1. Lack of air delivery
    Plugged bronchioles → collapse of alveoli
  2. Lack of integrity of the pleura
    Wound that allows air entry into pleural cavity (pneumothorax)
47
Q

Name some conditions that cause atelectasis?

Break it down into 2 categories

A

Pleural problems

Ventilation problems

48
Q

Pulmonary Ventilation
is what?
2

A
  1. Inspiration and expiration

2. Mechanical processes that depend on volume changes in the thoracic cavity

49
Q

Volume changes cause what?

Pressure changes cause what?

A

Volume changes → pressure changes

Pressure changes → gases flow to equalize pressure

50
Q

Describe boyles law?

A

The relationship between the pressure and volume of a gas
Pressure (P) varies inversely with volume (V):
P1V1 = P2V2

51
Q
  1. Inspration can be described as what kind of process?
  2. Inspiratory muscles ______?
  3. Thoracic volume ______?
  4. Lungs are _____ and intrapulmonary volume ______?
  5. Intrapulmonary pressure ____ (to ____mm Hg)
  6. Air flows into the lungs, down its pressure gradient, _____=_____?
A
  1. An active process
  2. contract
  3. increases
  4. stretched
    increases
  5. drops
    −1
  6. until Ppul = Patm
52
Q

Expiration can be described as what kind of process?

A

active or passive

  • Quiet expiration is a passive process
  • Forced expiration is an active process using abdominal and internal intercostal muscles
53
Q

During expiration:

  1. Inspiratory muscles ____?
  2. Thoracic cavity volume _____?
  3. Elastic lungs _____and intrapulmonary volume ______?
  4. Ppul _____ (to___mm Hg)
  5. (______ then Atm P)
  6. Air flows out of the lungs _____ its pressure gradient until 7. Ppul = ___.
A
  1. relax
  2. decreases
  3. recoil
    decreases
  4. rises
    +1
  5. greater
  6. down
  7. 0
54
Q
Intrapulmonary 
pressure: Pressure 
inside lung \_\_\_\_\_\_ as 
lung volume increases 
during inspiration; 
pressure \_\_\_\_\_\_\_ 
during expiration.
A

decreases

increases

55
Q
Intrapleural pressure:
Pleural cavity pressure 
becomes more \_\_\_\_\_\_\_ 
as chest wall expands 
during inspiration. 
Returns to \_\_\_\_\_ \_\_\_\_\_.
A

negative

initial value

56
Q
Volume of breath:
During each breath, the 
pressure gradients move 
how much air into and out 
of the lungs?
A

0.5 liter

57
Q

57

A

57

58
Q

58

A

58

59
Q

59

A

59

60
Q

Inspiratory muscles overcome three factors that hinder air passage and pulmonary ventilation

A

Airway resistance
Alveolar surface tension
Lung compliance

61
Q

Friction is the major nonelastic source of what?

A

resistance to gas flow

62
Q

What is the realtionship between flow pressure and resistance?

A

Flow=ΔP/R

bigger change in pressure = bigger change in flow

63
Q

What is ΔP?

How are gas flow and resistance related?

A
  1. the pressure gradient between the atmosphere and the alveoli (2 mm Hg or less during normal quiet breathing)
  2. Gas flow changes inversely with resistance
64
Q

Resistance is usually insignificant because of what factors?

2

A
  1. Large airway diameters in the first part of the conducting zone
  2. Progressive branching of airways as they get smaller, increasing the total cross-sectional area
65
Q

Where does resistance disappear at?

A

Resistance disappears at the terminal bronchioles where diffusion drives gas movement

66
Q

Where is the greatest resistance to flow seen?

2

A
  1. medium sized bronchi
  2. also in the conducting zone
    (almost no resistance in the terminal bronchiole and respiratory zone. Branching goes way up, surface area goes way up, no resistance)
67
Q

When airway resistance rises how does this affect breathing movements?

A

they become more strenuous

68
Q

What can Severe constriction or obstruction of bronchioles? 2

How can we treat this? (and how does it work 2)

A
  1. Can cause respiratory failure
  2. Can occur during acute asthma attacks and stop ventilation

Epinephrine (sympathetic nervous system)

  1. dilates bronchioles and
  2. reduces air resistance
69
Q

Forces at work that increase airway resistance

3

A
  1. Bronchospasm
  2. secretions
  3. muscosal edema
70
Q

Why do COPD patients have to generate active expiration?

A

Lungs with COPD showed 72-89% reduction in number of terminal bronchioles per lung

They have to compensate for this

71
Q

Conditions with increased airways resistance

A
  1. COPD
  2. Emphysema
  3. Chronic bronchitis
  4. Asthma
  5. Cystic Fibrosis
  6. Sleep apnea (upper airway resistance)
72
Q

Alveolar surface tension attracts what?

resists what?

A

Attracts liquid molecules to one another at a gas-liquid interface

Resists any force that tends to increase the surface area of the liquid

73
Q

What is surfactant and what is it produced by?

What does it prevent?

What will an insufficeient quantity in premature infants cause?

A

Detergent-like lipid and protein complex produced by type II alveolar cells

Discourages alveolar collapse

infant respiratory distress syndrome

74
Q

What is lung compliance?

A

A measure of the change in lung volume that occurs with a given change in transpulmonary pressure

75
Q

What three things are lung compliance normally due to?

A
  1. Distensibility of healthy lung tissue
  2. Ability of the thoracic cage to expand during inspiration under normal circumstances
  3. Reduction of alveolar surface tension secondary to surfactant
76
Q

High compliance relates to lung expantion how?

A

much easier to expand

77
Q

Conditions that decrease lung compliance?

6

A
  1. Nonelastic scar tissue
  2. Reduced production of surfactant
  3. Decreased flexibility of the thoracic cag
  4. Deformities of thorax
  5. Ossification of the costal cartilage
  6. Paralysis of intercostal muscles