Respiratory Physiology: Ventilation & Resp Physiology II- pulmonary circulation (Exam 4) Flashcards

1
Q

What are the 5 functions of the respiratory system?

A
  1. Exchange of gases between atmosphere and blood
  2. Regulation of pH
  3. Protection of inhaled pathogens and irritants
  4. Vocalization
  5. Route for water and heat loss
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2
Q

Exchange of gases between atmosphere and blood:

A

external respiration

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3
Q

Moves air in and out of lungs:

A

ventilation

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4
Q

Gases diffuse between:

A

alveoli and blood

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5
Q

What systems work together to regulate blood pH?

A

renal and respiratory system

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6
Q

Pleural membrane that attaches to the surface of the lung:

A

visceral pleura

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7
Q

Pleural membrane that covers the surface of the chest wall, diaphragm, and mediastinum

A

Parietal pleura

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8
Q

pleural membrane that contains a thin layer of pleural fluid (serous fluid) under negative pressure:

A

pleural space

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9
Q

The pressure in the pleural space is referred to as:

A

intrapleural pressure (Pip)

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10
Q

It is critical that intrapleural pressure remains at a:

A

subatmospheric pressure

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11
Q

Intrapleural pressure remains at a subatmospheric pressure which ensures:

A

the lungs are held to the chest wall and will move with the chest wall during inspiration and expiration

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12
Q

What happens to the value of intrapleural pressure during inspiration and expiration?

A

value changes

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13
Q

excess fluid in the pleural space:

A

pleural effusion

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14
Q

Effects of a pleural effusion:

A

makes lung expansion difficult so the person will breath shallow and fast

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15
Q

The extra fluid of a pleural effusion can be:

A

blood or lymph or etc

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16
Q

Each lung is located:

A

in its own pleural cavity

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17
Q

Describe the pressure in the lung tissue compared to the pleural space:

A

pressure is always greater in the lung tissue

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18
Q

The greater pressure of the lung tissue compared to the pleural space allows for:

A

holds the lung open, prevents collapse

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19
Q

During contraction what happens to the diaphragm?

A

flattens which changes volume of thoracic cavity

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20
Q

Lung expansion is necessary for:

A

inhalation

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21
Q

Describe the breathing pattern of an individual with a pleural effusion:

A

breathing= shallow and fast

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22
Q

the right lung has ___ lobes; the left lung has ____ lobes

A

right =3
left =2

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23
Q

Each lung has zones that differ in:

A
  1. amount of air (ventilation)
  2. amount of blood received (perfusion)
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24
Q

Ventilation is represented by:

Perfusion is represented by:

A

V; Q

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25
Q

The perfect scenario for a lung is a VQ ratio=

A

1

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26
Q

A VQ ratio of 1 would mean:

A

ventilation equal to perfusion

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27
Q

The lung is divided into ____ zones

A

3

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28
Q

All lung zones differ in the amount of:

A

airflow and bloodflow

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29
Q

The most narrow portion of an organ:

The broadest surface of an organ:

A

apex; base

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30
Q

The base of the lung is located ____ while the apex is located ____.

A

inferiorly; superiorly

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31
Q

Zone 1 is located at the ____; Zone 3 is located at the _____.

A

apex; base

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32
Q

There is a greater ventilation (V) of alveoli and blood flow (Q) into capillaries in zone ____ compared to other zones

A

zone 3

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33
Q

Which zone is the best region for gas exchange?

A

zone 3

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34
Q

T/F: Normally most of the lungs are zones 2 and 3

A

True: in a healthy individual zone 1 is likely nonexistant

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35
Q

The respiratory system is divided into what two functional zones?

A
  1. conducting zone
  2. respiratory zone
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36
Q

When we divide the respiratory system into the conducting zone and respiratory zone we are doing this based on:

A

functional distinction

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37
Q

The trachea, bronchi, bronchioles, and terminal bronchioles are all part of the:

A

conducting zone

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38
Q

The respiratory bronchioles, alveolar ducts, and alveolar sacs are all part of the:

A

respiratory zone

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39
Q

Where does the conducting zone end? Where does the respiratory zone begin?

A

terminal bronchioles; respiratory bronchioles

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40
Q

As you move down the respiratory system from the conducting zone to the respiratory zone, the diameter of tubes _____ and the number of tubes _____.

A

decreases; increases

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41
Q

There is a large ____ as you move deeper into the conducting zone and exchange surfaces

A

increase in surface area

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42
Q

What is the significance of the increase in surface area as you move deeper into the conducting zone and exchange surfaces?

A

Increased ability to do gas exchange

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43
Q

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

A

decrease; increase

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44
Q

Benefit of cartilage within the respiratory system=

A

keeps airway from collapsing

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45
Q

What smooth muscle in the terminal bronchioles and respiratory bronchioles allow for?

A

bronchoconstriction and bronchodilation

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46
Q

Bronchoconstriction and bronchodilation allow us to match:

A

ventilation to areas of good blood flow

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47
Q

T/F: The conducting zone has cartilage. The conducting zone has smooth muscle.

A

both statements true

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48
Q

What 3 functions occur in the conducting zone?

A

air is warmed, air is humidified, air is filtered

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49
Q

In the conducting zone, describe the functions of cartilage and smooth muscle:

A

cartilage prevents collapse; smooth muscle alters resistance to airflow

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50
Q

Smooth muscles alters _____ to airflow in the conducting zone

A

resistance

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51
Q

What are some factors that allow smooth muscle to alter the resistance to airflow in the conducting zone?

A
  1. beta 2 receptors
  2. muscarinic receptors
  3. allergen activation
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52
Q

The ____ zone has a greater surface area to optimize the surface area available for gas exchange

A

respiratory zone

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53
Q

Equation for velocity:

A

Velocity= flow / cross-sectional area

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54
Q

Total cross-sectional area greatly increases in the respiratory zone, so velocity of airflow in this zone is:

A

low

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55
Q

What is the significance of the low velocity of airflow in the respiratory zone?

A

The slower air moves (velocity), the more time we have for gas exchange

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56
Q

Describe the total cross-sectional area of the conducting zone compared to the respiratory zone:

A

The total cross sectional area of the respiratory zone is much greater due to numerous bronchioles compared to ONE trachea

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57
Q

Describe the basement membrane of the endothelium and of the alveolar epithelium:

A

fused

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58
Q

Describe where the fusion of the basement membrane occurs in the respiratory zone:

A

between capillary endothelium and alveolar epithelium

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59
Q

What is the purpose of the fusion between the basement membrane of the endothelium and of the alveolar epithelium:

A

faster diffusion

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60
Q

The respiratory membrane is made of:

A

2 squamous epithelial cells back to back

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61
Q

Types of cells in the alveoli: (3)

A
  1. Type 1 cells
  2. Type 2 alveolar cells
  3. macorphages
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62
Q

The type 1 cells in the alveoli are:

A

simple squamous epithelial cells

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63
Q

The type 1 cells in the aveoli make up:

A

the wall of the alveoli

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64
Q

What occurs through the type 1 cells making up the wall of the alveoli:

A

gas exchange

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65
Q

Describe the function of the type 2 alveolar cells in the alveoli:

A

produce surfactant

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66
Q

What type of function is provided by the macrophages in the alveoli:

A

immune fxn- phagocytosis

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67
Q

The typical transit time at rest for an erythrocyte through an alveolar capillary is:

A

0.75 seconds

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68
Q

How much time is available for gas exchange to occur for a RBC through the alveolar capillary?

A

0.75 seconds

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69
Q

Gas exchange is usually complete in:

A

0.25 seconds

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70
Q

Diffusion equilibrium occurs when PAO2 and PaO2= ______ and when PACO2 and PaCO2 = _____

A

PAO2 & PaO2= 100

PACO2 & PaCO2= 40

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71
Q

Since the partial pressure of oxygen in the alveoli is higher than it is in the blood ( 100 vs 40) what will occur?

A

Oxygen will move down its gradient from the alveoli and into the blood

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72
Q

Since the partial pressure of Co2 is higher in the blood than in the alveoli (45 vs 40), what will occur?

A

Co2 will move down its concentration gradient from the blood into the alveoli

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73
Q

When talking about partial pressures,

A=
a=

A

A= alveolar
a= blood

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74
Q

Moving air in and out of the lungs:

A

ventilation

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75
Q

Respiratory muscles are ____ muscles

A

skeletal muscles

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76
Q

In respiratory muscles, neurons in the medulla and pons control their:

A

alpha motor neurons

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77
Q

List the key inspiratory muscles:

A
  1. diaphragm
  2. external intercostals
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78
Q

Contraction of the inspiratory muscles ____ the size of the thorax and lungs resulting in:

A

increases; decrease in alveolar pressure

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79
Q

When are expiratory muscles used?

A

forced expiration ONLY

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80
Q

List the key expiratory muscles:

A

internal intercostals, and abdominal muscles

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81
Q

Contraction of the expiratory muscles ____ the size of the thorax and lungs resulting in:

A

decreases; increase in alveolar pressure

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82
Q

If lungs appear shrunken on an x-ray, what is occuring?

A

expiration

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83
Q

If the lungs appear inflated on an x-ray, what is occuring?

A

inspiration

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84
Q

If the chest wall and lungs are expanded what process is occuring?

A

inspiration

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85
Q

During inspiration the expansion os the ribs has what effect on the sternum?

A

moves sternum upward and outward

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86
Q

If the chest cavity and lungs are contracted, what process is occuring?

A

expiration

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87
Q

During expiration what happens to the ribs and sternum?

A

ribs and sternum depress

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88
Q

The sternocleidomastoid and scalenes are muscles involved in:

A

inspiration

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89
Q

The external oblique, internal oblique, transversus abdominus and rectus abdominis are muscles involved in:

A

Active expiration

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90
Q

Active expiration occurs if you want to breathe out more than:

A

500ml of air

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91
Q

Does active expiration occur if you are calmly breathing in class?

A

NO

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92
Q

The ____ is the primary inspiratory muscle:

A

diaphragm

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93
Q

The diaphragm arches over the _____ and moves ____ like a piston when it contracts, which ____ the size of the thoracic cavity and _____ the pressure in the thorax/lungs

A

liver; down; increases; reduces

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94
Q

During active expiration, the _____ Muscle push abdominal contents against the diaphragm (compressing the lungs) and the ____ depress the ribs

A

abdominal muscles; internal intercostals

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95
Q

Pressure-Volume Relationships:

  1. Air is a mixture of:
  2. Gases have different:
  3. Air moves from ___ to ___.
A
  1. gases
  2. pressures
  3. high pressure to low pressure
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96
Q

According to Boyle’s Law, in a sealed container, pressure times volume equals:

A

a constant

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97
Q

According to Boyle’s Law, if pressure increases, volume will:

A

decrease

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98
Q

According to Boyle’s law, what variable will change first? What variable will change first with respiration?

A

pressure; volume

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99
Q

How does the respiratory system get a change in volume?

A

contraction of muscles

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100
Q

For air to ENTER the lungs, the pressure in the alveoli (Palv) must be _____ than atmospheric pressure (Patm)

A

lower

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101
Q

If volume is increasing and pressure is decreasing, this is describing aspect of respiration?

A

inspiration

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102
Q

For air to LEAVE the lungs, the pressure in the alveoli (Palv) must be ____ than the atmospheric pressure?

A

higher

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103
Q

A decrease in volume and and increase in pressure is describing what aspect of respiration?

A

Expiration

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104
Q

Humans are ____ pressure breather; what does this mean?

A

negative, for us to breathe in we have to suck air into the lungs DOWN a pressure gradient

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105
Q

A preemie baby is put on positive pressure ventilation, what does this mean?

A

Air is being pushed into the lungs rather than pulled into it

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106
Q

What is the purpose of contracting the respiratory muscles during inspiration?

A

To get a volume change which will allow for the pressure to change in the opposite direction

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107
Q

What allows for the gradient for airflow?

A

Increase in alveolar pressure

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108
Q

The lungs and chest wall are:

A

Elastic

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109
Q

The chest wall and lungs both wish to:

A

recoil apart

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110
Q

What is the natural direction of recoil for the chest wall?

A

outward

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111
Q

What is the natural direction of record for the lung?

A

inward

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112
Q

When the chest wall recoils outward this moves it:

A

away from the lungs

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113
Q

The inward recoil of the lungs is due to:

A

alveoli

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114
Q

The elastic recoil of the lungs favors:

A

a decrease in lung volume or compression

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115
Q

The elastic recoil of he lungs favors a decrease in lung volume or compression which is ultimately favoring:

A

expiration

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116
Q

The elastic recoil of the chest wall favors:

A

an increase in lung volume or expansion

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117
Q

The elastic recoil of the chest wall favors an increase in lung volume or expansion which ultimately is favoring:

A

inspiration

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118
Q

The ____ overcomes the recoil between the lungs and chest wall

A

intrapleural fluid

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119
Q

The intrapleural fluid overcomes the recoil of the lungs and chest wall, keeping the two:

A

attached together so when the chest moves, the lungs move with it

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120
Q

Recoilability=

Stretchability=

A

elasticity

compliancy

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121
Q

Why do we consider the intrapleural pressure to be -5 when in reality it is 755mmHg?

A

Because we set atmospheric pressure which is 760mmHg equal to 0 and the intrapleural pressure is 5 less than that

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122
Q

A calculated value describing the pressure across the lung wall:

A

Transpulmonary pressure/ transmural pressure

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123
Q

How can transpulmonary pressure be calculated?

A

PTP= PALV - PIP

(Pressure of alveolus - intrapleural pressure)

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124
Q

An increase in transpulmonary pressure (PTP) is needed for:

A

Inspiration

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125
Q

A decrease in transpulmonary pressure (PTP) is needed for:

A

expiration

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126
Q

The bigger the value of PTP, the bigger the ____ is.

A

volume change

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127
Q

What value must always be positive in order to hold the lung open?

A

transpulomary pressure (PTP)

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128
Q

It PIP=PATM, then PTP = ____.

Describe this situation

A

PTP= 0

There is no longer a force to keep the lungs open (pneumothorax)

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129
Q

The lungs want to naturally recoil inward and ____ is what prevents this

A

Transpulmonary pressure (PTP)

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130
Q

Why does one collapse lung not cause the other lung to collapse?

A

Due to each lung being in their own cavity

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131
Q

When beginning inspiration, describe the relationship between Patm and Palv:

A

Patm= Palv

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132
Q

During inspiration, the inspiratory muscles ____ and causing the volume of the thorax (and lungs) to ____.

A

contract; increase

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133
Q

During inspiration, the increase in volume of the lungs causes what to happen to the PIP?

A

decrease in PIP

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134
Q

What is the starting value at rest for PIP? What happens with the initial change in volume?

A

-5; it goes to -7.5

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135
Q

During inspiration, the increase in volume of the lungs that causes a decrease in PIP, causes what to happen to PTP? Explain why:

A

Increase in PTP; because PTP= Palv- Pip

where we are getting these values:
Palv = 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 (because we are subtracting a larger negative number)

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136
Q

During inspiration, after PTP has increase, this causes what to happen with Palv?

A

Palv decreases to -1mmg (from 0 where it started at rest)

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137
Q

When Palv<Patm, air:

A

flows into the lungs

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138
Q

When Palv<Patm, air flows into the lungs:

a: as air enters the lungs, Palv:
b: Air flow continues until:

A

a: Palv begins to increase again
b: Palv = Patm

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139
Q

During inspiration, when Palv is less than Patm air flows down its concentration gradient into the lungs. What eventually will happen as air flows in?

A

Palv= Patm so no more air will flow into the lungs because no difference in pressure = no difference in flow

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140
Q

During resting breathing, what amount of air is moved into the lungs? What is this considered?

A

500ml; tidal volume

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141
Q

Why is expiration considered a passive process?

A

because we just have to rely out inspiratory muscles

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142
Q

Expiration begins after inspiration when:

A

Patm= Palv

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143
Q

Relaxed breathing is referred to as:

A

eupnea

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144
Q

In expiration, the thorax (and thus the lungs) ____ in volume

A

decrease

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145
Q

In expiration, the lung volume decrease because the decrease in thorax volume causes a ____ in PIP

A

increase

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146
Q

In expiration, an increase in PIP causes PTP to:

A

decrease

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147
Q

In expiration, an increase in PIP causes PTP to:

A

decrease

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148
Q

In expiration, because volume decrease, lung pressure (Palv):

A

increases (to +1mmHg)

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149
Q

During expiration, as soon as Palv> Patm, air flows:

A

down pressure gradient and out of the lungs

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150
Q

What happens to Palv as air is leaving the lungs:

A

Palv decreases

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151
Q

During expiration, when Palv=Patm:

A

airflow stops

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152
Q

Compliance =

A

Change in volume / change in pressure

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153
Q

if the lung stretches easily it has a ____ compliance

A

high

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154
Q

If the lung is difficult to stretch it has a ___ compliance

A

low

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155
Q

describe the compliance of the alveoli in the base o the lung; what does this allow for?

A

the alveoli in the base of the lungs are more compliant and undergo greater expansion during inspiration

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156
Q

The opposite of compliance is elasticity which describes the lungs ability:

A

to return to its normal, resting position

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157
Q

Easy stretch describes:

Easy recoil describes:

A

high compliance

high elasticity

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158
Q

Lungs with a lower compliance require _____ to _____.

A

larger transpulmonary pressure to increase volume

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159
Q

Disease characterized by the destruction of elastic fibers resulting in an increased compliance

A

Obstructive lung disease

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160
Q

An example of an obstructive lung disease:

A

emphysema

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161
Q

describe the pattern of breathing for an individual effected by an obstructive lung disease:

A

deep slow breaths

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162
Q

Why might someone with obstructive lung disease take slow deep breaths?

A

to reduce the work of breathing

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163
Q

A disease characterized by decreased compliance of the lungs:

A

restrictive lung disease

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164
Q

What is an example of a restrictive lung disease?

A

pulmonary fibrosis

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165
Q

describe the breathing pattern of an individual effected by a restrictive lung disease:

A

shallow and fast breaths

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166
Q

Why might someone with a restrictive lung disease take shallow, fast breaths?

A

to reduce the work of breathing

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167
Q

accounts for 2/3s of pulmonary elasticity:

A

surface tension

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168
Q

forces that occur at any gas-liquid interface due to cohesive forces between liquid molecules

A

surface tension

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169
Q

Surface tension describes the force that occurs at any ____ interface due to the ___ forces between ___ molecules

A

gas-liquid; cohesive; liquid

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170
Q

The fluid covering of alveoli exerts a constant force favoring:

A

contraction

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171
Q

The fluid covering of alveoli exerts a constant force favoring attraction which means:

A

collapse of alveoli

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172
Q

Describes the relationship between surface tension and radius if an alveolus:

A

The Law of LaPlace

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173
Q

Equation for The Law of LaPlace:

A

Collapsing pressure= 2(surface tension)/ radius of alveolus

174
Q

If two alveoli are connected and the surface tension of each is equal, the pressure in the smaller alveolus is:

A

greater

175
Q

If two alveoli are connected and the surface tension of each is equal, the pressure in the smaller alveolus is greater. Because of this:

A

air will flow into the larger alveolus

176
Q

If two alveoli are connected and the surface tension of each is equal, the pressure in the smaller alveolus is greater. Because of this, air will flow into the larger alveolus . Is this ideal?

A

No

177
Q

If two alveoli are connected and the surface tension of each is equal, the pressure in the smaller alveolus is greater. Because of this, air will flow into the larger alveolus. The respiratory system compensates for this by:

A

altering surface tension via surfactant

178
Q

______ reduces surface tension and equalizes pressure between alveoli of different sizes (compensates for radius differences)

A

surfactant

179
Q

surfactant reduces surface tension and ______ between alveoli of different sizes

A

equalizes pressure

180
Q

Pulmonary surfactant is secreted by:

A

Type II alveolar cells.

181
Q

Pulmonary surfactant _____ surface tension, (thus ______) and _____ compliance

A

decreases ; elasticity; increases

182
Q

You really need surfactant for breathing in to be easier because every tie you breathe in , you’re fighting against:

A

the elastic nature of the lungs

183
Q

Surfactant is primarily made up of _______.

A

phospholipids

184
Q

Surfactant spreads over the fluid lining of the alveolar surface to:

A

disrupt surface tension forces

185
Q

What is surfactants effect on hydrogen bonding?

A

decreases

186
Q

Some components of surfactant are components of:

A

innate immunity

187
Q

Surfactant is particularly important for reducing surface tension in _____ alveoli

A

small

188
Q

Surfactant decreases the work of:

A

inspiration

189
Q

Surfactant production is increased with:

A

hyperinflation of the lungs (such as sighing and yawning), exercise, and Beta-adrenergic agonists

190
Q

Multiple pathologies are associated with decreases in surfactant production such as:

A

Infant Respiratory Distress syndrome, Acute Respiratory distress syndrome (ARDS), and chronic smoking

191
Q

Explain why beta receptors function to increase surfactant production:

A

Beta receptors function in fight or flight response, which requires more oxygen an therefore more breathing (so it makes sense we would want to make breathing easier this way)

192
Q

equation for airflow:

A

airflow= (Patm-Palv) / Resistance

193
Q

In the respiratory system, how might we physiologically change the resistance in airways?

A

by changing the radius of the airways

194
Q

List the determinants of resistance in the respiratory system: (3)

A
  1. radius of bronchi/bronchioles
  2. viscosity of substance
  3. length of tube
195
Q

How might we alter the radius of bronchi/bronchioles?

A

a: bronchodilation
b: bronchoconstriction
c: mucus accumulation

196
Q
  • epinephrine on beta-2 receptors
  • decreased oxygen
  • increased CO2

These would all have what affects on there radius of airways?

A

bronchodilation

197
Q
  • acetylcholine on M3 receptors
  • increased oxygen
  • decreased CO2
  • histamine
A

bronchoconstriction

198
Q

increasing resistance and decreased flow in bronchi/bronchioles =

A

bronchoconstriction

199
Q

The airways with the smallest radius (r) have the highest ____ resistance; but the _____ resistance (R) of that generation is the smallest.

A

highest individual resistance; total

200
Q

Describe the effects each of the following have on bronchi/bronchiole radius:

  1. SNS
  2. PNS
A
  1. SNS- bronchodilation
  2. PNS- bronchoconstriction
201
Q

Pathologies that increase airway resistance:

A

Obstructive diseases

202
Q

Asthma, Emphysema, and Bronchitis are all examples of:

A

Obstructive diseases

203
Q

If resistance increases, what must happen to the difference in pressure (Patm-Palv) to maintain normal airflow? How does this effect work of the lung?

A

We need to make the change in pressure greater and do this by recruiting more muscles, causing more work for the lung

(flow = change in pressure / radius)

204
Q

Surface tension accounts for 2/3 of pulmonary elasticity and the other 1/3 is due to:

A

elastic fibers in lung tissue

205
Q

What is the average values for a pulmonary function test for a 70kg man (women 20-25% less)?

  1. Inspiratory reserve volume
  2. Tidal volume
  3. Expiratory reserve volume
  4. Residual volume
A
  1. IRV= 3000 ml
  2. TV= 500 ml
  3. ERV= 1100 ml
  4. RV= 1200 ml
206
Q

Label the following image:

A

A: IRV
B: TV
C: ERV
D: RV

207
Q

The air that comes in as a result of taking a deeper breath (more so than a regular breath)

A

Inspiratory reserve volume

208
Q

The upward portion of a TV wave is a result of ___ while the downward portion of a TV wave is a result of ____.

A

inspiration, expiration

209
Q

The volume of air that you can NEVER get out of your lungs:

A

Residual volume (RV)

210
Q

Forcing out more air (past tidal volume)

A

expiratory reserve volume

211
Q

In a healthy individual, there is around _____ of anatomic dead space per ____ of ideal body weight.

A

1ml; pound

212
Q

The volume of air in the condo tin zone:

A

anatomic deadspace

213
Q

If you take in 500 ml of air, around ____ will stay in the conducting zone and ____ will go to the respiratory zone

A

150ml; 350ml

214
Q

Why is air that remains in the conducting zone considered “anatomic dead space”

A

because this air is NOT available for gas exchange

215
Q

Equation for physiological dead space:

A

Physiologic dead space = anatomic DS + alveolar DS

216
Q

Everyone has _____ dead space; however healthy individuals do NOT have ____ dead

A

anatomic; alveolar

217
Q

The parts of the lung where the amount of air and blood do not match (VQ mismatch)

A

alveolar deadspace

218
Q

Give an example of someone that might have a lot of alveolar deadspace:

A

someone wit low cardiac output

219
Q

Lung capacities is a combination of:

A

Volumes

220
Q

Total lung capacity is considered a _____ value for a given individual

A

fixed

221
Q

Which is a better indicator of gas exchange:

minute/pulmonary/total ventilation or alveolar ventilation and why?

A

Alveolar ventilation because this tells us how much air is going to get to the respiratory zone

222
Q

Total ventilation may also be called?

A

minute ventilation or pulmonary ventilation

223
Q

Equation for minute/pulmonary/total ventilation:

A

Tidal volume (ml/breath) x Respiration rate (breaths /min)

224
Q

Equation for alveolar ventilation:

A

(Tidal volume - Dead space volume) x respiration rate

225
Q

If you take in a 2000 ml breath, what will the dead space volume be? If you take in a 200 ml breath, what will the headspace volume be?

A

150 ml regardless of the size of breath

226
Q

In order to get more air into the respiratory zone for gas exchange, which is better: deeper breath or faster breath?

A

Deeper breath

227
Q

Forced vital capacity and forced expiratory volume are both measurements that reflect airflow within:

A

large airways

228
Q

What measurements of expiratory flow are used to test for increased airway resistance?

A
  1. forced vital capacity (FVC)
  2. forced expiration volume 1
229
Q

The volume of air forcibly expired after maximal inhalation:

A

Forced vital capacity (FVC)

230
Q

Fraction of FVC expired during the first second:

A

Forced expiration volume 1 (FEV1)

231
Q

Explain how we would measure the forced expiration volume 1:

A

Patient takes deepest breath possible, holds it for a second, and then they breathe out as fast and hard as they can

232
Q

What is the normal volume for FEV1/FVC:

A

0.8 (80%)

233
Q

FEV1 rejects flow in:

A

Large airways

234
Q

If an individual has an FEV1 less than 80% what is this indicative of? This is a sign of:

A

obstructive lung disease; increased airway resistance

235
Q

Normal quiet breathing

A

eupnea

236
Q

increase rate or volume of breathing due to higher metabolism

A

hypernea

237
Q

Increased rate or volume breathing WITHOUT increased metabolism

A

Hyperventilation

238
Q

Decreased alveolar ventilation

A

hypoventilation

239
Q

Rapid breathing rate (usually with decreased depth)

A

tachypnea

240
Q

Difficulty breathing; air hunger

A

dyspnea

241
Q

What type of ventilation may occur with exercise

A

Hypernea

242
Q

What type of ventilation may occur with an extreme emotional response

A

hyperventilation

243
Q

Describe the effects of metabolism on hyper- and hypoventilation:

A

Don’t have anything to do with changes in metabolism

244
Q

Panting would be an example of:

A

tachypnea

245
Q

If you are blowing up a balloon, _____ may occur

A

hyperventilation

246
Q

Shallow breathing, asthma and restrictive lung disease are examples of what pattern of ventilation?

A

Hypoventilation

247
Q

Various parthologies or hard exercise may result in what pattern of ventilation:

A

dyspnea

248
Q

Normal quiet breathing takes ~ ____% of total body energy

A

3-5

249
Q

The energy requirement of breathing will significantly increase if a patient has a respiratory condition that alters:

A

compliance/elasticity and or resistance

250
Q

Patients with various pulmonary conditions may require additional energy to feel adequate ventilation up to:

A

a 50 fold increase

251
Q

Obstructive vs. Restrictive Diseases:

occur due to increased airway resistance

A

obstructive diseases

252
Q

Obstructive vs. Restrictive Diseases:

occur due to decreased lung compliance

A

restrictive diseases

253
Q

Obstructive vs. Restrictive Diseases:

Example: pulmonary fibrosis

A

restrictive disease

254
Q

Obstructive vs. Restrictive Diseases:

Examples: asthma, emphysema, bronchitis and cystic fibrosis

A

Obstructive diseases

255
Q

Obstructive pulmonary disease primarily impacts:

A

expiration

256
Q

Obstructive vs. Restrictive Diseases:

Primarily impacts expiration

A

obstructive

257
Q

Obstructive vs. Restrictive Diseases:

Primarily impacts inspiration

A

restrictive

258
Q

Individuals with obstructive pulmonary diseases will breathe:

A

slow and deep

259
Q

Individuals with restrictive pulmonary diseases will breathe:

A

fast and shallow

260
Q

Describe what is a result of the shallow breaths associated with restrictive pulmonary diseases:

A

decrease in tidal volume

261
Q

Atopic asthma is a ____ disease

A

obstructive

262
Q

Atopic asthma is a ___ mediated _____ reaction

A

IgE mediated- Type 1 hypersensitivity reaction

263
Q

An allergen leads to an inflammatory response that causes bronchospasm that obstruct airflow

A

atopic asthma

264
Q

In atopic asthma the chronic inflammation can lead to: (3)

A
  1. impaired mucocilliary response
  2. edema
  3. increased airway responsiveness
265
Q

Describe what occurs in the early phase response of atopic asthma:

A

bronchospasm & increased mucus production

266
Q

Describe what occurs in the late phase response of atopic asthma:

A

continued bronchospasm and increased mucus product a + increased vascular permeability and edema

267
Q

What are the quick relief medications used to treat atopic asthma and describe what they do: (2)

A
  1. Beta-2 agonists: causes bronchodilation
  2. anticholinergic agents: bronchodilation
268
Q

What are the long term medications used to treat atopic asthma and describe what they do: (2)

A
  1. inhaled corticosteroids: suppress inflammatory response
  2. long-acting bronchodilators
269
Q

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.

A

Nonatopic asthma

270
Q

In atopic asthma what do the mast cells release and what does this cause?

A

Mast cells release cytokines; contraction of smooth muscle

271
Q

An autosomal recessive disorder resulting in defective chloride ion transport that results in an abnormally thick mucus that obstructs airways:

A

Cystic fibrosis

272
Q

Cystic fibrosis is a ____ disease

A

obstructive

273
Q

mutation that causes cystic fibrosis and location of it:

A

CFTR ion channel mutation on chromosome 7

274
Q

What are the treatment options for cystic fibrosis?

A
  1. antibiotics
  2. Chest PT (percussion and postural drainage)
  3. Mucolytic agents
  4. Pancreatic enzyme replacement
275
Q

Due to the defective chloride ion channel in the epithelial tissue of the airway, there is defective ____ secretion and excessive ___ & ___ absorption

A

chloride (Cl-)

Na+ and H20 absorption

276
Q

Describe the secretions as a result of the defective chloride ion channel (excessive Na+ and H20 absorption) in CF:

A

abnormally thick and viscid respiratory tract secretions

277
Q

In CF, the abnormally thick and viscid respiratory tract secretions results in: (2)

A
  1. development of a microenvironment that is protective of microbial agents
  2. defect mucocilliary clearance
278
Q

In CF, the chronic airway obstruction and bacterial infection results in: (2)

A

Neutrophil influx; release of elastase and inflammatory mediators

279
Q

What might develop secondarily to CF:

A
  1. chronic bronchitis
  2. bronchiectasis
  3. respiratory failure
280
Q

Emphysema is a ____ disease

A

obstructive

281
Q

Emphysema results from :

A
  1. destruction of elastic fibers
  2. enlargement of airspace’s due to destruction of airspace walls
282
Q

What is the biggest risk factor for emphysema?

A

smokin ciggies

283
Q

In emphysema, the destruction of elastic fibers causes:

A

increased lung compliance

284
Q

How does smoking lead to emphysema?

A
  1. releases reactive oxygen species
  2. recruited neutrophils to area (which also create reactive oxygen species)
285
Q

Smoking ciggies can cause tissue damage to the alveolar membrane which:

A

decreases the surface area available for gas exchange

286
Q

The reactive oxygen species released as a result of smoking causes inactivation of _____ leading to an increase in _____.

A

inactivation of antiproteases; increase in neutrophil elastase

287
Q

In a normal healthy lung, the enzyme ____ functions to inactivate ____ before it can _____.

A

alpha1-anti-trypsin ; inactivates least before it can destroy elastic fibers

288
Q

What enzyme is in decreased amounts in lungs affected by emphysema:

A

alpha-1 antitrypsin

289
Q

What is the function of alpha-1 antitryspin in the lungs?

A

Inactivates elastase before it is able to destroy elastic fibers

290
Q

Disease characterized by increased mucus production and inflammatory reaction (may be acute or chronic):

A

bronchitis

291
Q

Any pulmonary problem that limits lung expansion (decreased lung compliance)

A

restrictive respiratory diseases

292
Q

Restrictive respiratory diseases make ____ much more difficult

A

inspiration

293
Q

In restrictive respiratory diseases, tissue injury leads to ___ and the normal architecture of the lungs is disrupted and is replaced with ___

A

chronic inflammation; scar tissue/fribrosis

294
Q

In restrictive respiratory diseases, the the normal lung tissue is replaced with scar tissue/fibrosis, this leads to:

A

a decrease in lung compliance

295
Q

In restrictive respiratory diseases, patients breathe fast and shallow and because shallow breaths decrease alveolar ventilation there is:

A

a decrease in gas exchange

296
Q

Pulmonary fibrosis (idiopathic, drug induced, or environmental), pneumonia, and pulmonary edema are all examples of:

A

restrictive respiratory diseases

297
Q

List the signs and symptoms of a restrictive respiratory disease:

A
  1. increased respiration rate
  2. chronic cough (dry & non-productive)
  3. Polycythemia due to hypoxia
298
Q

An increased number of red blood cells due to a decreased partial pressure of oxygen:

A

polycythemia

299
Q

It takes a red blood cell about ____ to travel through pulmonary circulation at resting cardiac output; about ____ of this time is spent in pulmonary capillaries; when in reality gas exchange takes only about ____.

A

4-5 seconds

0.75 seconds

0.25 seconds

300
Q

List the order of blood flow from start to finish circulating:

A
  1. vena cava
  2. right atrium
  3. tricuspid valve
  4. right ventricle
  5. pulmonary valve
  6. pulmonary artery
  7. pulmonary capillaries
  8. pulmonary vein
  9. left atrium
  10. bicuspid valve
  11. left ventricle
  12. aortic valve
  13. aorta
301
Q

Compared to systemic circulation, pulmonary circulation has: (4)

A
  1. lower pressures
  2. lower resistance
  3. higher compliance
  4. lower volume
302
Q

Pulmonary arteries and arteriole diameters are ___ than systemic arteries and arterioles:

A

larger

303
Q

Pulmonary artery and arteriole walls are ___ and ___ which results in ____.

A

thin & distensible; large compliance

304
Q

Compared to systemic circulation in which only the veins have a high compliance, in pulmonary circulation what has the high compliance?

A

arteries, capillaries, AND veins all have high compliance

305
Q

What is unique about the pulmonary capillaries in pulmonary circulation:

A

there is a population of capillaries in the lungs that are closed at rest that can be recruited when necessary

306
Q

Bronchial circulation is part of ____ circulation

A

systemic

307
Q

Supplies oxygen and nutrients to the tracheolbronchial tree down to the terminal bronchioles and also pulmonary blood vessels, visceral pleura, nerves, and hilar lymph nodes

A

bronchial circulation

308
Q

What supplies the nutrients and oxygen to the conducting zone of the respiratory system?

A

bronchial circulation

309
Q

Bronchial flow is about ___% of cardiac output of the left ventricle

A

2%

310
Q

Since bronchial flow is about 2% of cardiac output of the left ventricle, this means that the blood in the left atrium has a _____ than the blood in the pulmonary capillaries

A

a slightly lower O2 concentration

311
Q

Since bronchial flow is about 2% of cardiac output of the `left ventricle, this means that the blood in the left atrium has a slightly lower O2 concentration (PaO2 = 95) than the blood in the pulmonary capillaries since:

A

some deoxygenated blood from the bronchial veins mixes with the oxygenated blood in the pulmonary veins

312
Q

Describe bronchial flow:

A

blood flows from the LEFT VENTRICLE through the AORTA in the same way oxygenated blood would get to the organs BUT some of the blood is deposited into the BRONCHIAL ARTERY where it will oxygenate the non- alveolar tissue of the LUNGS

The resulting deoxygenated blood will then get mixed into the PULMONARY VEIN’S (oxygenated blood) lowering the oxygen content from 100 —> 95 and then will dump into the LEFT ATRIUM

313
Q

Structures in the respiratory zone receive oxygen directly by ____ from the ____ and receive nutrients from the ____ in pulmonary circulation.

A

diffusion from the alveolar air; mixed venous blood

314
Q

The pulmonary circulation has ___ pressure & ___ resistance

A

Low pressure and low resistance

315
Q

Pulse pressure equation:

A

pulse pressure = systolic pressure - diastolic pressure

316
Q

Mean arterial pressure equation (2):

A

MAP = Diastolic pressure + 1/3 pulse pressure

MAP = CO x TPR

317
Q

Give the averages for MAP of systemic circulation and MAP of pulmonary circulation as well as blood pressure for each:

A

Systemic circulation: MAP= 93mmHg and BP= 120/80

Pulmonary circulation: MAP= 14mmHg and BP= 25/8

318
Q

Describe the pressure patterns from the pulmonary artery to the pulmonary capillary to the left atrium:

A

pulsatile from pulmonary artery to pulmonary capillaries and not pulsatile from pulmonary capillaries to left atrium; pressure decreases a long the way

319
Q

By the time the blood moves through pulmonary circulation and reaches back to the left heart, the pressure is only about:

A

5mmHg

320
Q

List the average MAPs for the following

Pulmonary artery:
Pulmonary capillary:
Left atrium:

A

pulmonary artery= 14

pulmonary capillary= 7

left atrium= 2-5

321
Q

The filtration force in the pulmonary capillaries:

A

pulmonary capillary pressure

322
Q

Pulmonary blood volume accounts for ~ ___ % of blood volume but is ___.

A

9%; highly variable

323
Q

What are three ways in which pulmonary blood volume varies:

A
  1. volume increases during inspiration
  2. lying down increases the blood volume
  3. disease states (ex. heart failure) can increase blood volume
324
Q

Describe why pulmonary blood volume increases during inspiration:

A

Because PIP because more negative (-5 to -7.5 mmHg) and this actually pulls extra blood back into the thoracic cavity (vacuum suction)

325
Q

describe why lying down increases the pulmonary blood volume?

A

due to gravity

326
Q

Describe why disease states like heart failure can increase blood volume?

A

because blood can get backed up into the lungs

327
Q

Because pulmonary vessels are far more distensible/compliant, they are able to alter their size and adjust to _____.

A

changing pulmonary volumes

328
Q

Cardiac output increases 4-7 times with heavy exercise. What effect does this have on pulmonary artery pressure?

A

only a small increase

329
Q

When pulmonary capillaries are recruited, what will opening more capillaries do to the total resistance?

A

This will result in an increase in surface which decreases resistance

330
Q

The pulmonary circulation is not as prone to ____ as the systemic circulation

A

hypertesnion

331
Q

During exercise, CO (flow) may increase 7 fold but MAP in the pulmonary circulation will only increase 1-2 mmHG. How is that possible?

A

An increase in blood flow will cause a decrease in PVR

332
Q

Describe the difference of the MAP equation in systemic circulation vs. pulmonary circulation

A

MAP= CO x TPR in systemic circulation

MAP= CO x PVR in pulmonary circulation

333
Q

What is a mechanisms that produces a decrease in PVR with an increase in blood flow (CO)?

A
  1. recruitment of pulmonary capillaries
  2. distension of pulmonary capillaries
334
Q

Why do we have mechanisms to decrease PVR in times of increased blood flow?

A

To keep MAP stable

335
Q

An increase in blood flow = a ____ in PVR

A

decrease

336
Q

When PAO2 (alveolar concentration of O2) drops 70% below normal, what occurs:

A

adjacent blood vessels constrict which will increase the resistance (up to 5x increase in R)

337
Q

When PAOS (alveolar concentration of O2) is high, what occurs?

A

Adjacent vessels will dilate (bringing more blood to alveolus)

338
Q

What is the functional result of constricting and dilating vessels with changes in PAO2?

A

blood is delivered to alveoli where it will be most effective at gas exchange

339
Q

What happens through out the pulmonary circulation at a high altitude where PAO2 is reduced?

A

we will constrict blood vessels all through out the lungs to decrease blood flow because all areas of alveoli are getting reduced airflow

340
Q

When PAO2 is reduced and we constrict blood vessels through out the lungs to decrease blood flow (in a situation like high altitude), this can lead to:

A

Pulmonary HTN

341
Q

What response occurs in systemic circulation when PaO2 levels drop?

A

In systemic circulation if blood O2 drops (PaO2) to a tissue, this produces the opposite effect resulting in vasodilation (active hyperemia)

342
Q

What situation is this showing?

A

perfusion of well ventilated alveoli and maximal gas exchange

343
Q

What situation is this showing?

A

Perfusion of a hypoventilated alveolus with no response of vasoconstriction = decrease PaO2

344
Q

What situation is this showing?

A

hypoxic pulmonary vasoconstriction (HPV) in response to a decreased PAO2 (which works to reduce blood flow to hypoventilated alveoli)

345
Q

Compare the effects of systemic capillaries vs. pulmonary capillaries?

A

Opposite effects; systemic = delivers O2 to tissue and pulmonary = pick up O2 and drop off CO2

346
Q

What mechanisms occurs to reduce blood flow to hypoventilated alveoli?

A

hypoxic pulmonary vasoconstriction (HPV)

347
Q

List the vasodilators for pulmonary arterioles: (7)

A
  1. High O2 in alveoli
  2. Dopamine
  3. Bradykinin
  4. Prostacyclin
  5. Nitric oxide
  6. Histamine (H2)
  7. Acetylcholine
348
Q

List the vasoconstrictors for pulmonary arterioles: (7)

A
  1. Low O2 in alveoli
  2. High CO2 in alveoli
  3. Norepinephrine
  4. Angiotensin II
  5. Endothelin
  6. Vasopressin
  7. Thromboxane A2
349
Q

What is significant about the following vasoactive substances for the pulmonary arterioles?

Vasodilators: high O2 in alveoli

Vasoconstrictor: low O2 in alveoli & high Co2 in alveoli?

A

Opposite response in pulmonary arterioles than what is produced in systemic arterioles with the same changes in gas concentration

350
Q

Lung volumes have a ___ effect on pulmonary vascular resistance (PVR)

A

passive effect

351
Q

the ___ vessels include pulmonary capillaries, smallest arterioles, and venules

A

alveolar vessels

352
Q

The ___ vessels are all the other vessels not including the pulmonary capillaries, smallest arterioles, & venules

A

extra-alveolar vessels

353
Q

= the total of alveolar vessels + extra-alveolar vessels resistance

A

PVR (pulmonary vascular resistance)

354
Q

When the alveoli expand during inspiration:

1) _____ are compressed/elongated and their resistance increases

2) ____ have decreased resistance

A

1) alveolar vessels

2) extra-alveolar vessels

355
Q

Why do the extra-alveolar vessels have a decreased resistance in times of inspiration?

A

Because when you breathe in, PIP gets more negative and resulting in a pressure difference across the wall, which therefore pulls the vessel open and ultimately decreases resistance

356
Q

Why do the alveolar vessels have an increased resistance in times of inspiration?

A

Because alveolar vessels get compressed with inspiration as the alveolus gets bigger, and will passively compress the alveolar vessel; ultimately increasing the resistance

357
Q

Resistance in the pulmonary circulation is lowest when:

A

lung volume is equal to FRC (functional residual capacity)

358
Q

The volume of air in the lungs after normal (TV) expiration:

A

FRC

359
Q

At low lung volumes, extra-alveolar volumes resistance ____ which has what effect on total PVR?

A

increases; increases

360
Q

At high lung volumes, alveolar vessel resistance ____ which has what effect on total PVR?

A

increases; increases

361
Q

Hydrostatic pressure gradients in the lung alter _____ pulmonary blood flow

A

regional

362
Q

When in an upright position, there is a ____ difference in pulmonary arterial pressure from the apex to the base of the lung. This is due to ______.

A

23 mmHg; gravity

363
Q

Zone 3 of the lung has the highest ____ and thus the highest ___ per alveolus

A

hydrostatic pressure; blood flow

364
Q

What zones of the lung does exercise increase blood flow to?

A

All zones of the lung though the bottom of the lung still receives the most blood flow

365
Q

Pulmonary capillaries in the zones of the lung experience force from fluids inside _____, and outside the vessel ___.

A

Inside vessel: Pa= hydrostatic pressure

Outside vessel: PALV= alveolar air pressure

366
Q

The hydrostatic pressure of blood inside the capillaries (how do we abbreviate this)?

A

Pa

367
Q

The hydrostatic pressure of blood inside the capillaries favors ___ and functions to ____

A

filtration; keep the vessel open

368
Q

Pa is greater in zone ___ of the lungs compared to zone ____ due to _____.

A

Zone 3; Zone 1; gravity

369
Q

The tissue pressure of the lungs is largely based on:

A

alveolar air pressure (PALV)

370
Q

The tissue pressure (largely based on alveolar air pressure - PALV) outisde of the capillary opposes ____ and favors ____.

A

Opposes filtration; favors vessel collapse

371
Q

Only the capillaries & smallest of the arterioles & venues (alveolar vessels) are altered by:

A

PA (Pressure-Alveolar)

372
Q

A pressure that can compress and close the vessel:

A

PALV

373
Q

A pressure that can hold the vessel open because it is the pressure inside the vessel:

A

Pa (sometimes referred to as Pc)

374
Q

The capillaries at the base of the lungs have a higher ____ meaning it will hold the vessel open more efficiently

A

hydrostatic pressure

375
Q

The pulmonary capillaries near the alveoli can become ____ during ____.

A

compressed during inspiration

376
Q

What happens to the resistance of the vessel in the alveolus when there is more air in the alveolus and why?

A

The resistance of the alveolus goes up if the alveolus has more air in it because there is more external pressure from the outside compressing that vessel.

377
Q

In zone 1: P-arterial (Pa) is _____ than P-Alveolar (PA). This means that the capillaries are ______.

A

Pa lower than PA

compressed

378
Q

If P-arterial (Pa) drops or P-Alveolar (PA) increases (positive pressure breathing), a greater portion of the lung is converted to:

A

zone 1

379
Q

Compared to zone 1, zone 2 has a higher ____ due to ___.

A

P-arterial (Pa) due to gravity

380
Q

Because zone 2 has a higher p-arterial (Pa) due to gravity, this means that P-arterial (Pa) is ____ than P-Alveolar (PA) during _____.

A

higher; systole

381
Q

In zone 2, during diastole what occurs with the P-arterial (Pa) and P-alveolar (PA)

A

During diastole, P-arterial (Pa) will drop lower than (PA).

382
Q

In zone 2, because of the pressure differences during systole and diastoles, we call this the region of:

A

intermittent blood flow

383
Q

In zone 2, during systole (heart contraction) the vessels are _____ and during diastole (heart relaxation) the vessels are _____.

A

systole- open
diastole- closed

384
Q

Zone 3 has the highest ____ due to ____.

A

P-arterial (Pa) due to gravity

385
Q

Zone 3 is considered the region of:

A

continuous blood flow

386
Q

Why is zone 3 considered the region of continuous blood flow?

A

Because P-arterial is higher than P-Alveolar (PA) during both systole and diastole

387
Q

When does gas exchange occur in zone ? When does gas exchange occur in zone 2? When does gas exchange occur in zone 3?

A

Zone 1- never

Zone 2- During systole (Pa> PA) - opposite in diastole

Zone 3- All of the time (Pa> PA) - during both systole and diastole

388
Q

The majority of healthy lungs have ____ & ____ blood flow:

A

Zone 2 & Zone 3

389
Q

The majority of healthy lungs have ____ & ____ blood flow:

A

Zone 2 & Zone 3

390
Q

Exercise converts ___ into ____ blood flow

A

Zone 2 to Zone 3

391
Q

When in the supine position, the lungs have mostly ____ blood flow because ____.

A

Zone 2; because gravity is reduced

392
Q

How might someone with diseased lungs be positioned when they sleep or when they are in your dental chair?

A

More upright if possible

393
Q

Index of the match between airflow (alveolar ventilation) and pulmonary blood flow (perfusion)

A

V/Q match

394
Q

Normal whole lung V/Q =

A

0.8

395
Q

Because the normal whole lung V/Q is 0.8 this means that there is more ____ than ____.

A

blood flow than airflow

396
Q

In a normal individual, the ____ of the lung has a higher V/Q than the rest of the lung.

A

apex

397
Q

As one moves from Zone 1 to Zone 3, there is a ____ in ventilation than blood flow.

A

slower increase

398
Q

Fast, shallow breaths = lower _____

A

tidal volume

399
Q

Fast, shallow breaths in an upright position causes V/Q mismatch because:

A

air flows to upper lobes and blood flows to lower lobes

400
Q

The V/Q ratio at the apex of the lung is ______, meaning:

A

greater than 1.0; meaning that overall the apex receives more venilation than blood flow

401
Q

Ventilation in Zone 1:

  1. Intrapleural pressure is more _____
  2. Transmural pressure gradient is ______
  3. Alveoli are ____ and ____
  4. Overall ____ ventilation

Perfusion in Zone 1:
1. _____ intravascular pressures
2. ____ recruitment
3. _____ resistance
4. Overall _____ blood flow

A
  1. negative
  2. greater
  3. larger & less
  4. less
  5. lower
  6. less
  7. higher
  8. less
402
Q

Ventilation in zone 1 compared to zone 3:

Ventilation in zone 1 compared to perfusion in zone 1:

A

Less ventilation in zone 1 compared to zone 3

Ventilation in zone 1 compared to perfusion is more because V/Q ratio is greater than 1

403
Q

Ventilation in Zone 3:

  1. Intrapleural pressure is _____.
  2. ______ transmural pressure gradient
  3. Alveoli are ____ and ____
  4. overall ____ ventilation

Perfusion in Zone 3:

  1. _____ vascular pressures
  2. ____ recruitment
  3. ____ resistance
  4. Overall, ____ blood flow
A
  1. less negative
  2. less
  3. smaller and more compliant
  4. more
  5. greater
  6. more
  7. lower
  8. more
404
Q

Ventilation in Zone 3 compared to ventilation in zone 1:

Ventilation in zone 3 compared to perfusion in zone 3:

A

greater ventilation in zone 3 compared to zone 1

Greater perfusion in zone 3 compared to ventilation in zone 3

405
Q

Alveoli at the ___ of the lungs receive more ventilation than those in the ____.

A

base; apex

406
Q

The pulmonary capillaries at the ____ of the lungs receive more blood flow than those in the _____

A

base; apex

407
Q

Describe the intrapleural pressure (PIP) at the apex of the lungs compared to the base?

A

PIP at apex is more negative and at base is less negative ad these average out to ~-5

408
Q

Responses to V/Q mismatch are:

A

negative feedback responses

409
Q

The respiratory and circulatory systems are working to deliver air and blood to the ____ portions of the respiratory membrane

A

SAME

410
Q

If ventilation is limited:

  1. V/Q is _____
  2. Thus O2 is ____ & CO2 is ____
  3. Smooth muscles in the _____ constrict
A
  1. low
  2. low; high
  3. blood vessel
411
Q

In times of an airway obstruction, we are not getting proper air into that alveolus, therefore what do we want to occur?

What is this referred to as?

A

We want the blood vessel that is serving this alveolus to constrict

hypoxic pulmonary vasoconstriction

412
Q

If perfusion is limited:

  1. V/Q is ____
  2. Thus O2 is ___ & CO2 is _____
  3. Smooth muscles in the ______ constrict
A
  1. high
  2. high; low
  3. bronchioles
413
Q

In times of low perfusion, why would we want smooth muscles in the bronchioles to constrict?

A

We would rather send that air to an alveoli that is perfused with blood

414
Q

What is an example of a condition that may cause low perfusion?

A

Pulmonary embolus

415
Q

Pulmonary Capillary Exchange:

Blood traverse pulmonary capillaries in _______ and _____ must occur during this time frame.

A

0.3-0.8 seconds; gas exchange

416
Q

Pulmonary Capillary Exchange:

In addition to gas exchange, ____ also occurs and is dictated by ____.

A

fluid exchange; starling’s forces

417
Q

Pulmonary Capillary Exchange:

Fluid filtration (F) is determined by _____ and _____.

A

hydrostatic fluid forces and capillary and interstitial colloid

418
Q

What are the hydrostatic pressures?

A

capillary pressure (Pc) & Interstitial fluid pressure (Pif)

419
Q

What are the osmotic pressures?

A

Plasma colloid osmotic pressure (pi-p) & interstitial fluid colloid osmotic pressure (pi-if)

420
Q

movement of things OUT of the capillary bed:

A

Filtration

421
Q

movement of things IN to the capillary bed:

A

Absorption

422
Q

Determine whether the following pressures result in filtration or absorption:

  1. Capillary pressure (Pc)
  2. Plasma colloid osmotic pressure (pi-p)
  3. Interstital fluid pressure (Pif) - negative
  4. Interstitial fluid pressure (Pif)- positive
  5. Interstitial fluid colloid osmotic pressure (pi-if)
A
  1. filtration
  2. absorption
  3. filtration
  4. absorption
  5. filtration
423
Q

Filtration pressures = a total of:

A

29mmHg

424
Q

Describe what makes the total filtration pressure of 29mmHg:

A

Capillary pressure (Pc) = 7mmHg
Interstitial fluid pressure (Pif)= -8 (use absolute value)
Interstitial colloid osmotic pressure (pi-if)= 14 mmHg

425
Q

The value of interstitial fluid pressure (Pif) = -8. The negative tells us:

A

that this is a filtration pressure

426
Q

The absorptive pressures = a total of:

A

28mmHg

427
Q

What makes up the total absorptive pressure of 28mmHg:

A

plasma colloid osmotic pressure (pi-p)

428
Q

Because normal filtration pressures are greater than absorptive forces by +1 mmHg (29-28), there is a slight continual flow of fluid from the:

A

pulmonary capillaries into the interstitial spaces

429
Q

Fluid that leaves the capillaries is absorbed by ____ and returned to _____.

A

lymphatic circulation; circulation

430
Q

Extra fluid that enters the alveoli will be sucked into the interstitial space due to the ____ and then picked up by lymphatic capillaries to keep the alveoli dry

A

slight negative pressure

431
Q

The balance of pulmonary capillary and interstitial hydrostatic and colloid pressures can be disrupted resulting in _____.

Describe this phenomenon

A

Pulmonary edema- large increase in net capillary filtration

432
Q

Pulmonary edema can occur with: (3)

A
  1. left sided heart failure
  2. mitral valve stenosis
  3. damage to pulmonary capillary membranes