Respiratory Physiology: Ventilation (Exam IV) Flashcards
What are the five functions of the respiratory system?
- Exchange of gases between atmosphere & blood
- Regulation of pH
- Protection of inhaled pathogens & irritants
- Vocalization
- Route for water & heat loss
Exchange of gases between atmosphere and the blood
External respiration
Moves air in and out of lungs
Ventilation
Gases diffuse between:
Alveoli & blood
What systems work collaboratively to regulate blood pH?
Renal & respiratory systems
Pleural membrane that attaches to the surface of the lung:
Visceral pleura
Pleural membrane that covers the surface of the chest wall, diaphragm, & mediastinum:
Parietal pleura
Pleural membrane that contains a thin layer of pleural fluid (serous fluid) under negative pressure:
Pleural space
The pressure in the pleural space is referred to as:
Intralpleural pressure (Pip)
It is critical that intrapleural pressure (Pip) remains:
At a subatmospheric pressure
Intrapleural pressure remains at a subatmospheric pressure to ensure that:
The lungs are held to the chest wall and will move with the chest wall during inspiration & expiration
What happens to the value of intrapleural pressure during inspiration & expiration?
It changes
Excess fluid in the pleural space
Pleural effusion
Effects of a pleural effusion:
Makes lung expansion difficult so the person will breath shallow & fast
The extra fluid in a pleural effusion can be:
Blood, lymph or etc.
Each lung is located in:
Its own pleural cavity
Describe the pressure in the lung tissue compared to the pleural space:
Always greater
The greater pressure of the lung tissue compared to the pleural space allows for:
Holds lung open & prevents collapse
During contraction what happens to the diaphragm, what does this cause?
Diaphragm flattens which changes volume of thoracic cavity
Lung expansion is necessary for:
Inhalation
Describe the breathing pattern of an individual with a pleural effusion:
Breathing= shallow & fast
The right lung has ___ lobes while the left lung has ___ lobes
Three
Two
Each lung has zones that differ in:
- amount of air (ventilation)
- amount of blood received (perfusion)
Ventilation is represented by:
Perfusion is represented by:
V
Q
A perfect scenario for the lung is a VQ ratio of:
One
A VQ ratio of one would mean:
Ventilation is equal to perfusion
The lung is divided into ____ zones
Three
All lung zones differ in the amount of:
Airflow & blood flow
The most narrow portion of an organ:
The broadest surface of an organ:
Apex
Base
The base of the lung is located _______ while the apex is located _____
Inferiorly; superior
Zone 1 is located at the _____
Zone 3 is located at the ____
Apex; base
There is a greater ventilation (V) of alveoli and blood flow (Q) into capillaries in zone ____ compared to other zones:
Zone 3
Which zone is the best region for gas exchange?
Zone 3
T/F: Normally, most of the lungs are in zone 2 & 3
True
In a healthy individual zone 1 is likely insignificant/nonexistant
The respiratory system is divided into what two functional zones:
Conducting zone
Respiratory zone
When we divide the respiratory system into the conducting zone and the respiratory zone we are doing this based on:
Functional distinction
The trachea, bronchi, bronchioles & terminal bronchioles are all part of the:
Conducting zone
The respiratory bronchioles, alveolar ducts & alveolar sacs are al part of the:
Respiratory zone
Where does the conducting zone end?
Where respiratory zone begin?
Terminal bronchioles
Respiratory bronchioles
As you move down the respiratory system from the conducting zone to the respiratory zone, the diameter of tubes ______ and the number of tubes ____
Decreases
Increases
There is a large ______ as you move deeper into the conducting zone and exchange surfaces
Increase in surface area
What is significance of the increase in surface area as you move deeper into the conducting zone and exchange surfaces:
Increased ability to do gas exchange
As you move down the respiratory system from the conducting zone to the respiratory zone, airways have a ____ in cartilage and a ______ in smooth muscle as you move along the airways
Decrease
Increase
Benefit of cartilage in the respiratory system:
Keeps airway from collapsing
What does the smooth muscle in the terminal bronchioles & respiratory bronchioles allow for?
Bronchoconstriction & Bronchodilation
Bronchoconstriction & bronchodilation allow us to match:
Ventilation to areas of good blood flow
T/F: The conducting zone has cartilage. The conducting zone has smooth muscle
Both statements true
What three functions occur in the conducting zone?
- Air is warmed
- Air is humidified
- Air is filtered
In the conducting zone, describe the functions of cartilage and smooth muscle:
Cartilage prevents collapse; smooth muscle alters resistance to air flow
Smooth muscle alters ____ to airflow in the conducting zone
Resistance
What are some factors that allow smooth muscle to alter the resistance to airflow in the conducting zone?
Beta-2 receptors
Muscarinic receptors
Allergen activation (asthma)
The ____ zone has a greater surface area to optimize the surface area available for gas exchange
Respiratory zone
Equation for velocity:
Velocity= Flow / Cross-sectional area
Total cross-sectional area greatly increases in the respiratory zone. so velocity of airflow in this zone is:
low
What is the significance of the low velocity of airflow in the respiratory zone?
The slower air moves (velocity) the more time we have for gas exchange
Describe the total cross-sectional area of the conducting zone compared to the respiratory & why?
Total cross sectional area of the respiratory zone is much greater due to numerous bronchioles compared to ONE trachea
Describe the basement membrane of the endothelium & of the alveolar epithelium
Fused
Describe where the fusion of the basement membrane occurs in the respiratory zone:
Between the simple squamous endothelium of the capillary & alveolar epithelium
What is the purpose of the fusion between the basement membrane of the endothelium and alveolar epithelium?
Allows for faster diffusion process
The respiratory membrane is made of:
Two squamous epithelial cells back to back
Types of cells in alveoli include: (3)
- Type 1 cells
- Type 2 alveolar cells
- Macrophages
The type-1 cells in the alveoli are:
Simple squamous epithelial cells
The type-1 cells in the alveoli make up:
The wall of the alveoli
Describe what occurs through the type-1 cells, making up the wall of the alveoli:
Gas exchange
Describe the function of the type-2 alveolar cells in alveoli:
Produce surfactant
What type of function is provided by the macrophages in the alveoli?
Immune function, specifically phagocytosis
The typical transit time at rest for an erythrocyte through an alveolar capillary is:
0.75 seconds
How much time is available for gas exchange to occur for a RBC through the alveolar capillaries?
0.75 seconds
Gas exchange is usually complete in:
0.25 seconds
Diffusion equilibrium occurs when PAO2 and PaO2= _____ & when PACO2 and PaCO2= ____
PAO2 & PaO2= 100
PACO2 & PaCO2= 40
Since the partial pressure of oxygen in the alveoli is higher than in the blood, (100 vs. 40) what will occur?
Oxygen will move down its gradient from the alveoli into the blood
Since the partial pressure of CO2 is higher in the blood than in the alveoli (45 vs. 40) what will occur?
CO2 will move down its concentration gradient from the blood into the alveoli
When talking about partial pressures:
A=
a=
A= Alveolar
a= blood
Moving air in and out of the lungs:
Ventilation
Respiratory muscles are ____ muscles
Skeletal
In respiratory muscles, neurons in the medulla and pons control their:
Alpha motor neurons
List the key inspiratory muscles:
- Diaphragm
- External intercostals
The contraction of inspiratory muscles _____ the size of the thorax and lungs resulting in a:
Increases; Decrease in alveolar pressure
When are expiratory muscles used?
Forced expiration ONLY
List the key expiratory muscles:
Internal intercostals
Abdominal muscles
Contraction of the expiratory muscles ____ the size of the thorax & lungs resulting in:
Decreases; Increase in alveolar pressure
If the lungs appear shrunken on an X-ray what is occurring?
Expiration
If the lungs appear inflated on an X-ray what is occurring?
Inspiration
If the chest wall and lungs are expanded what process is occurring?
Inspiration
During inspiration, the expansion of the ribs has what affect on the sternum?
Moves sternum upward & outward
If the chest cavity and lungs are contracted, what process is occurring?
Expiration
During expiration what happens to the ribs and sternum?
Ribs and sternum depress
The sternocleidomastoid & scalene are muscles involved in:
Inspiration
The external oblique, internal oblique, transversus abdominus & rectus abdomens are muscles involved in:
Active expiration
Active expiration occurs if you want to breath out more than:
500 mL of air
Doe does active expiration occur when you are calmly breathing during class?
NO
The primary inspiratory muscle:
Diaphragm
The diaphragm arches over the _____ and moves ____ like a piston when it contracts, which ___ the size of the thoracic cavity and _____ the pressure in thorax/lungs
liver; down; increases; reduces
During active expiration. the ____ muscles push abdominal contents against the diaphragm (compressing the lungs) and the ____ depress the ribs
Abdominal muscles; internal intercostals
Pressure-Volume Relationship:
- Air is a mixture of ______
- Gases have different ______
- Air moves from _____ to _____
- Gases
- Pressures
- High pressure to low pressure
According to Boyles Law, in a sealed container, pressure times volume equals a _______
Constant
According to Boyles Law, if pressure increases, volume will ______
Decrease
According to Boyles Law, what variable will change first? What variable will change first with respiration?
Pressure; Volume
How does the respiratory system get a change in volume?
Contraction of muscles
For air to ENTER the lungs, the pressure in the alveoli (Palv) must be _______ than atmospheric pressure (Patm)
Lower
If volume is increasing and pressure is decreasing what aspect of respiration is being described?
Inspiration
For are to LEAVE the lungs, the pressure in the alveoli (Palv) must be _____ than the atmospheric pressure (Patm)
higher
A decrease in volume, and an increase is pressure is describing what aspect of respiration?
Expiration
Humans are ______ pressure breathers, what does this mean?
Negative; We have to suck air into the lungs DOWN a pressure gradient
A premature baby is put on positive pressure ventilation, what does this mean?
Air is being pushed into the lungs rather than pulled into it
What is the purpose of contracting respiratory muscles during inspiration?
To get a volume change, which will then allow for the pressure to change in the opposite direction
What allows for the gradient for airflow?
Increase in alveolar pressure
Lungs and chest walls are:
Elastic
The chest walls and lungs both wish to:
Recoil apart
What is the desired direction of recoil for the chest wall?
Outward
What is the desired direction of recoil for the lungs?
Inward
When the chest wall recoil outward, this moves it:
Away from the lungs
The inward recoil of the lungs is due to:
Alveoli
The elastic recoil of the lung favors:
a decrease in lung volume or compression
The elastic recoil of the lungs favors a decrease in lung volume or compression, which is ultimately favoring what aspect of respiration?
Expiration
The elastic recoil of the chest wall favors:
An increase in lung volume or expansion
The elastic recoil of the chest wall favors an increase in lung volume or expansion, which is ultimately favoring what aspect of respiration?
Inspiration
The ______ overcomes the recoil of the lungs and chest wall
Intrapleural fluid
The intrapleural fluid overcomes the recoil of the lungs and chest wall keeping the two:
Attached together, so when the chest moves the lungs move with it
Recoilability=
Stretchability=
Elasticitiy
Compliancy
Why do we consider the intrapleural pressure to be -5, when in reality it is 755 mmHg?
Because we set atmospheric pressure which is 760 mmHg equal to 0, and the intrapleural pressure is five less than that
A calculated value describing the pressure across the lung wall
Transmural/Transpulmonary pressure
How can transpulmonary pressure be calculated?
Ptp = Palv - Pip
(Pressure of alveolus - intrapleural pressure)
An increase in transpulmonary (Ptp) is needed for:
Inspiration
A decrease in transpulmonary pressure (Ptp) is needed for:
Expiration
The bigger the value of Ptp, the bigger the ____ is
Volume change
What must always be a positive value in order to hold the lung open?
Transpulmonary pressure
If: Pip = Patm
Then Ptp = ______
Describe what is happening during this situation
Ptp= 0
There is no longer a force to keep the lungs open (Pneumothorax)
The lungs want to naturally recoil inward and _____ is what prevents this
Transpulmonary pressure
Why does one collapsed lung not cause the other lung to collapse?
Due to the lungs being in their own cavity
When beginning inspiration described the relationship between Patm and Palv:
Patm = Palv
During inspiration, inspiratory muscles _____ causing the volume of the thorax (and lungs) to _______
Contract; increase
During inspiration, the increase in volume of the lungs causes what to happen to the Pip?
A decrease in Pip
What is the starting value (at rest) of Pip?
What happens to Pip with the initial change in volume?
-5
-5 decreases to -7.5
During inspiration the increase in volume of the lungs that causes a decrease in Pip cause what to happen to the Ptp? Explain why using equation
Ptp will increase;
Ptp= Palv-Pip
Ptp= 0 - 7.5
Where we are getting these values:
Palv starts at 0 at rest
Pip started at -5 and with the initial change in volume decreased to -7.5 (which is why we get an increase in Ptp - we are subtracting a larger negative number)
During inspiration, after Ptp has increased, this causes what to happen with Palv?
Palv decreases to -1 mmHg (from 0 where it started at rest)
When Palv<Patm, air:
Flows into the lungs
When Palv<Patm, air flows into the lungs:
a. As air enters the lungs, Palv:
b. Air flow continues until:
a. Palv begins to increase again
b. Palv = Patm
During inspiration when Palv<Patm air flows down its concentration gradient into the lungs. What eventually will happen as air flows in?
Palv = Patm so no more air will flow into the lungs because no difference in pressure = no difference in flow
During resting breathing what amount of air is moved into the lungs? What is this considered?
500 mL; Tidal volume
Why is expiration considered a passive process?
Because we just have to relax our inspiratory muscles
Expiration begins after inspiration when:
Patm = Palv
Relaxed breathing is repaired to as:
Eupnia
In expiration, the thorax (and therefore the lungs) ______ in volume:
Decrease
In expiration, the lung volume decreases because the decrease in thorax volume causes a ______ in Pip
Increase
In expiration, an increase in Pip causes Ptp to:
Decrease
During expiration, because volume decreases, lung pressure (Palv):
Increases (to +1 mmHg)
During expiration, as soon as Palv > Patm, air flows:
Doen pressure gradient and out of the lungs
What happens to Palv as air is leaving the lungs?
Palv decreases
During expiration, when Palv = Patm, air flow:
Stops
Compliance equation:
Compliance = Change in volume / Change in pressure
If the lung stretches easily it has a _____compliance
High
If the lung is difficult to stretch it has a _____ compliance
Low
Describe the compliance of the alveoli in the base of the lung; what does this allow for?
The alveoli in the base of the lung are more compliant and therefore undergo greater expansion during inspiration
The opposite of compliance is elasticity which describes the lungs ability
To return to its normal resting position
Easy stretch describes:
Easy recoil describes:
High compliance
High elasticity
Lungs with lower compliance require ______ to _____
A larger transpulomnary pressure; increase volume
Disease characterized by the destruction of elastic fibers resulting in increased compliance.
Obstructive lung disease
Give an example of obstructive lung disease:
Emphysema
Describe the pattern of breathing for an individual affected by obstructive lung disease:
Deep slow breaths
Why might someone with obstructive lung disease take slow, deep breaths?
To reduce the work of breathing
A disease characterized by a decreased compliance of the lungs
Restrictive lung disease
Give an example of a restrictive lung disease:
Pulmonary fibrosis
Describe the breathing pattern of an individual affected by a restrictive lung disease:
Shallow and fast breaths
Why might someone with a restrictive lungs disease take shallow, light breaths?
To reduce the work of breathing
Accounts for 2/3 of pulmonary elasticity:
Surface tension
Forces that occur at any gas-liquid interface due to the cohesive forces between liquid molecules:
Surface tension
Surface tension describes the force that occurs at any _____ interface due to the _____ forces between ______ molecules
gas-liquid; cohesive; liquid
The fluid covering the alveoli exerts a constant force favoring:
Contraction
The fluid covering the alveoli exerts a constant force favoring contraction which means:
Collapse of alveoli
Describes the relationship between surface tension and radius of an alveolus:
The Law of LaPlace
Equation for the Law of LaPlace:
Collapsing pressure = 2(surface tension) / radius of alveolus
If two alveoli are connected and the surface tension of each is equal, the pressure in the small alveolus is:
greater
If two alveoli are connected and the surface tension of each is equal, the pressure in the small alveolus is greater. Due to this:
Air will flow into the larger alveolus
If two alveoli are connected and the surface tension of each is equal, the pressure in the small alveolus is due to this air will flow into the larger alveolus. Is this ideal?
NO
If two alveoli are connected and the surface tension of each is equal, the pressure in the small alveolus is greater. Because of this air will flow into the larger alveolus. The respiratory system does not want this to happen and compensates for this by:
Altering surface tension via surfactant
______ reduces surface tension and equalizes pressure between alveoli of different sizes (compensates for radius differences)
Surfactant
Surfactant reduces surface tension and ____ between alveoli of different sizes
Equalizes pressure
Pulmonary surfactant is secreted by:
Type II alveolar cells
Pulmonary surfactant _______ surface tension, (thus _____ ) and ______ compliance
Decreases; Elasticity; Increases
You really need surfactant for breathing in to be easier, because every time we breath in we are fighting against:
The elastic nature of the lungs
Surfactant is primarily made up of:
Phospholipids
Surfactant spreads over the fluids lining of the alveolar surface to:
Disrupt surface tension forces
What is surfactants effect on hydrogen bonding?
Decreases
Some components of surfactant are companies of:
Innate immunity
Surfactant is particularly important for reducing surface tension in ______ alveoli
Small
Surfactant decreases the work of:
Inspiration
Surfactant production is increases with:
Hyperinflation of the lungs (such as sighing and yawning), exercise, and Beta-adrenergic agonists
Multiple pathologies are associated with a decrease in surfactant production such as:
Infant respiratory distress syndrome, Acute respiratory distress syndrome (ARDS), and chronic smoking
Explain why beta receptors function to increase surfactant production:
Beta receptors function in fight or flight response, which requires more oxygen and there more breathing (so it makes sense that we would want to make breathing easier)
Equation for airflow:
Air flow = (Patm - Palv) / Resistance
In the respiratory system, how might we change the resistance of the airways?
By changing the radius of the airways
List the determinants of resistance of the respiratory system: (3)
- Radius of bronchi/bronchioles
- Viscosity of substance
- Length of tube
How might we alter the radius of bronchi/bronchioles?
a. bronchodilaton
b. bronchoconstriction
c. mucous accumnulation
- Epinephrine on beta-2 receptors
- Decreased oxygen
- Increased CO2
These all have what affect on the radius of airways?
Bronchodilation
- Acetylcholine on M3 receptors
- Increased oxygen
- Decreased CO2
- Histamine
These all have what affect on the radius of airways?
Bronchoconstriction
Increasing resistance & decreasing flow in bronchi/bronchioles:
Bronchoconstriction
The airways with the smallest radius (r) have the highest _____ resistance, but the ____ resistance (R) of that generation is the smallest
Individual; Total
Describe the effects each of the following have on bronchi/bronchiole radius:
- SNS
- PNS
SNS= Bronchodilation
PNS= Bronchoconstriction
Pathologies that increase airway resistance:
Obstructive diseases
Asthma, Emphysema & bronchitis are all:
Obstructive diseases
If the resistance increases, what must happen to the difference in pressure (Patm- Palv) to maintain normal airflow?
How does this affect work of the lung?
We need to make the change in pressure greater & do this by recruiting more muscles which causes more work on the lung
(Flow = Change in pressure / Resistance)
Surface tension accounts for 2/3 of pulmonary elasticity, what is the cause of the other 1/3?
Elastic fibers in lung tissue
The lungs want to naturally recoil inward due to:
- Surface tension
- Elastic fibers
What are the average values for a pulmonary function test for a 70 kg man (women 20-25% less):
- Inspiratory reserve volume
- Tidal volume
- Expiratory reserve volume
- Residual volume
- IRV= 3000 ml
- TV= 500 ml
- ERV= 1100 ml
- RV= 1200 ml
Label the following image:
a) IRV
b) TV
c) ERV
d) RV
The air that comes in as a result taking a deeper breath (moreso than regular breathing)
IRV
The upward portion of the TV wave is a result of ______ while the downward portion of the TV wave is a result of ______
Inspiration; Expiration
The volume of air that you can NEVER get out of your lungs:
RV
Forcing out additional air beyond the typical TV amount:
ERV
In a healthy individual, there is around ______ of anatomic dead space per _____ of ideal body weight
1 ml ; pound
The volume of air in the conducting zone:
Anatomic deadspace
If you take in 500 ml of, around ______ stays in the conducting zone, and ______ goes to the respiratory zone
~150 ml
~350 ml
Why is the air that remains in conducting zone considered “ anatomic dead space”
Because this air is NOT available for gas exchange
Equation for physiologic dead space:
Physiologic dead space = anatomic DS + Alveolar DS
Everyone has _____ dead space, however healthy individuals do NOT have ____ dead space
Anatomic; Alveolar
The parts of the lungs where the amount of air and blood flow do not match:
(VQ mismatch)
alveolar deadspace
Give an example of an individual that might have a lot of alveolar dead space:
Someone with low cardiac output
Lung capacities is a combination of:
Volumes
Total lung capacity is considered a ______ value for a given individual
fixed
Which is a better indicator of gas exchange:
- Minute/pulmonary/total ventilation
- Alveolar ventilation
Why?
Alveolar ventilation
- Because this tells us how much air is going to get to the respiratory zone
Total ventilation may also be called:
Minute ventilation or Pulmonary ventilation
Equation for minute/pulmonary/total ventilation:
Tidal volume (ml/breath) x respiration rate (breaths/minute)
Equation for alveolar ventilaton:
(Tidal volume- Dead space volume) x respiration rate
If you take in a 2000 ml breath what will the deadspace volume be?
If you take in a 200 ml breath what will the deadspace volume be?
150 ml regardless of the size of the breath
In order to get more air into the respiratory zone for gas exchange which is better:
Deep breaths or faster breaths
Deeper breaths
Forced vital capacity and forced expiration volume both are measurements that reflect air flow within:
Large airways
What measurements of expiratory flow are used to test for increased airways resistance?
Forced vital capacity (FVC) & Forced expiration volume1 (FEV1)
The volume of air that is forcibly expired after maximum inhalation:
Forced vital capacity (FVC)
The fraction of FVC expired during the first second:
Forced expiration volume1 (FEV1)
Explain how we would measure the forced expiration volume1:
Patient takes deepest breath possible, holds it for a second, and they then breath out as fast & hard as they can
What is a normal value for FEV1/FVC?
0.8 (80%)
FEV1 reflects flow in:
Large airways
If an individual has an FEV1 <80% what is this indicative of?
Obstructive lung disease (increased airway resistance)
Normal, quiet breathing:
Eupnia
Increase rate or volume of breathing due to higher metabolism:
Hypernea
Increased rate or volume of breathing WITHOUT increased metabolism:
Hyperventilation
Decreased alveolar ventilation:
Hypoventilation
Rapid breathing rate (usually with decreased depth):
Tachypnea
Difficulty breathing; air hunger:
Dyspnea
What type of ventilation may occur with exercise?
Hypernea
What type of ventilation may occur with an extreme emotional response:
Hyperventilation
Describe the effects of metabolism on hyper- & hypoventilation:
They don’t have anything to do with changes in metabolism:
Panting is an example of:
Tachypnea
If you are blowing up a balloon _____ may occur:
Hyperventilation
Shallow breathing, asthma & restrive lung disease are examples of what pattern of ventilation:
Hypoventilation
Various pathologies or hard exercise may result in what pattern of ventilation:
Dyspnea
Normal, quiet breathing takes ~ _____ % of total body energy
3-5
The energy requirement of breathing will significantly increase if a patient has a respiratory condition that alters:
Compliance/elasticity and/or resistance
Patients with various pulmonary conditions may require additional energy to fuel adequate ventilation up to:
a 50-fold increase
Obstructive vs. Restrictive Diseases:
Occur due to increased airway resistance
Obstructive
Obstructive vs. Restrictive Diseases:
Occur due to decreased lung compliance
Restictive
Obstructive vs. Restrictive Diseases:
Example: Pulmonary fibrosis
Restrictive disease
Obstructive vs. Restrictive Diseases:
Examples: Asthma, Emphysema, Bronchitis, Cystic fibrosis
Obstructive diseases
Obstructive vs. Restrictive Diseases:
Primarily impacts expiration
Obstructive
Obstructive vs. Restrictive Diseases:
Primarily impacts inspiration
Restrictive
Individuals with obstructive pulmonary diseases will breath:
Slow & deep
Individuals with restrictive pulmonary diseases will breath:
Fast & shallow
Describe what is a result of the shallow breaths associated with restrictive pulmonary diseases:
Decrease in tidal volume
Atopic asthma is a _______ disease:
Obstructive
Atopic asthma is a _____ mediated _____ reaction
IgE; Type I hypersensitivity
An allergen leads to an inflammatory response that causes bronchospasms and obstructive airflow in this disease:
Atopic asthma
In atopic asthma the chronic inflammation can lead to (3):
- impaired mucociliary response
- Edema
- Increased airway responsiveness
Describe what occurs in the early phase response of atopic asthma hypersensitivity reaction:
Bronchospasm & increased mucous production
Describe what occurs in the late phase response of atopic asthma hypersensitivity reaction:
Continued bronchospasma & increased mucous production + increased vascular permeability & edema
What are the quick-relief medications used to treat atopic asthma? Describe what they do: (2)
Beta-2-agonist: causes bronchodilation
Anticholinergic agents: causes bronchodilation
What are the long-term medications used to treat atopic asthma? Describe what they do: (2)
Inhaled corticosteroids: suppress inflammatory response
Long-acting bronchodilators
A disease that can occur with respiratory infections, exercise, hyperventilation, cold air, inhaled irritants, aspirin, and other NSAIDS, an immune system hypersensitivity reaction is NOT involved:
nonatopic asthma
In atopic asthma what do the mast cells release and what does this cause?
Mast cells release cytokines; contraction of smooth muscle
An autosomal recessive disorder resulting in defective chloride ion transport that results in an abnormally thick mucus that obstructs airways:
Cystic fibrosis
Cystic fibrosis is a ______ disease
Obstructive
The mutation that causes cystic fibrosis is in the:
CFTR ion channel mutation
Mutation that causes cystic fibrosis and location of it:
CFTR ion channel mutation; chromosome 7
What are the treatment options for cystic fibrosis?
- Antibiotics
- Chest PT (Percussion & Postural drainage)
- Mucolytic agents
- Pancreatic enzyme replacement
Due to the defection chloride ion channel in the epithelial tissue of the airway, there is defective _______ secretion & excessive ______ & _____ absorption
Cl-
Na+ & H2
Due to the defection chloride ion channel in the epithelial tissue of the airway, there is defective _______ secretion & excessive ______ & _____ absorption
Cl-
Na+ & H2O
Describe the secretions as a result of the defective chloride ion channel in cystic fibrosis (excessive Na+ & H2O absorption)
Abnormally thick & viscid respiratory tract secretions
In CF the abnormally thick & viscid respiratory tract secretions result in (2):
- Development of a microenvironment that is protective of microbial agents
- Defective mucociliary clearance
In CF, the chronic airway obstruction & bacterial infection can lead to: (2)
Neutrophil influx; release of elastase & inflammatory mediators
What might develop secondarily to CF?
- Chronic bronchitis
- Bronchiectasis
- Respiratory failure
Emphysema is a _____ disease
Obstructive
Emphysema results from:
- Destruction of elastic fibers
- Enlargement of airspaces due to destruction of airspace walls
What is the biggest risk factor emphysema
Smoking
In emphysema, the destruction of elastic fibers causes:
Increased lung compliance
How does smoking lead to emphysema?
- Creates reactive oxygen species
- Recruits neutrophils to area (which also create reactive oxygen species)
Smoking can cause tissue damage to the alveolar membrane which:
Decreases the surface area available for gas exchange
The reactive oxygen species released as a result of smoking causes inactivation of ____ leading to an increase in _______
antiproteases; neutrophill elastase
In a normal healthy lung, the enzyme ______ functions to inactivate _____ before it can _______
Alpha-1-anti-trypsin
Elastase
Destroy elastin fibers
What enzyme is in decreased amounts in lungs affected by emphysema:
Alpha-1-anti-trypsin
What is the function of alpha-1-anti-trypsin in the lungs?
Inactivates elastase before its able to destroy elastic fibers
A disease characterized by increased mucous production & inflammatory reaction (may be acute or chronic):
Bronchitis
Any pulmonary problems that limits lung expansion (decreases lung compliance)
Restrictive respiratory diseases
Restrictive respiratory disease make ______ much more difficult:
Inspiration
In restrictive respiratory diseases, tissue injury leads to _______ and the normal architecture of the lungs is disrupted and is replaced with _____
Chronic inflammation; scar tissue/fibrosis
In restrictive respiratory diseases, when the normal lung tissue is replaced with scar tissue/fibrosis, this leads to a:
Decrease in lung compliance
In restrictive respiratory disease, patients breath fast & shallow and because shallow breaths decrease alveolar ventilation there is:
A decrease in gas exchange
Pulmonary fibrosis (idiopathic, drug-induced, environmental), pneumonia, & pulmonary edema are all examples of:
Restrictive respiratory disease
List the signs & symptoms of a restrictive respiratory disease:
- Increased respiration rate
- Chronic cough (dry & non-productive)
- Polycythemia due to hypoxia
