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Physiology > Respiratory System > Flashcards

Respiratory System Flashcards

1
Q

upper airway muscles (33)

A

active during inspiration, keep airway open
nasal and oral cavities, pharynx, larynx (vocal cords)
Trachea
Lungs
- bronchi –> bronchioles –> alveoli
smooth muscle and connective tissue
pulmonary circulation

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2
Q

Sleep apnea

A

reduction in upper airway path during sleep. Airflow is blocked.
caused by loss of muscle tone, anatomical defects

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3
Q

Risk factors of sleep apnea

A

Lack of excitatory drive - reduction in muscle tone

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4
Q

Filtering Action regions

A

conducting zone - mucus-producing (goblet) cells and ciliated cells
trap and remove inhaled particles
muco-cilliary escalator

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5
Q

Role of goblet cells and ciliated cells

A

Trap inhaled particles and remove them. Prevent it from reaching respiratory zone

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6
Q

SOL layer

A

low density. Free cilia movement

CILIATED cells that have free movement

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7
Q

GEL layer

A

Goblet cels (mucous)
high viscosity and elastic properties
traps inhaled particles

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8
Q

Removal of mucous

A

cilia movements
downward (nasopharynx)
upward (trachea)
eliminated through esophagus

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9
Q

Smoking affect on cilia and goblet cells

A

chemicals/tar effect cilia movement, preventing the removal of particles

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10
Q

Where are macrophages located

A

Alveoli

Last defence to inhaled particles

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11
Q

Pulmonary fibrosis

A

silica duct and abestos

lungs cannot expand due to collagen buildup over time

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12
Q

Spirometry

A

Pulmonary function test
rate of insp and exp air
measure volume of air inspired and expired by the lungs

AMOUNT AND RATE OF AIR BREATHED IN AND OUT OVER TIME

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13
Q

Atelectasis

A

complete or partial collapse of lung (or lobe of lung)

Occurs when alveoli become delated/flat

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14
Q

Can you measure residual lung volume?

A

NO it cannot be measured via spirometry

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15
Q

Tidal volume

A

volume of air moved IN or OUT of respiratory tract during each ventilation cycle

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16
Q

inspiratory reserve volume

A

additional volume of air that can be forcibly inhaled following NORMAL RESP
simply inspire maximally, MAXIMAL POSSIBLE INSPIRATION

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17
Q

expiratory reserve volume

A

additional volume of air that can be forcibly exhaled following normal expiration
simply expire maximally MAXIMUM VOLUNTARY EXPIRATION

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18
Q

residual volume RV = FRC - ERV

A

the volume of air remaining in the lungs after a MAXIMAL EXPIRATION. cannot be expired at all (no matter what)

RV = FRC - ERV

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19
Q

Capacities

A

SUM of two or more lung volumes

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20
Q

VC = TV + IRV + ERV

A

VITAL CAPACITY - maximal amount of air that can be forcibly exhaled after maximal inspiration

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21
Q

IC = TV + IRV

A

INSPIRATORY CAPACITY - maximal volume of air that can be forcibly exhaled

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22
Q

FRC = RV* + ERV

A

FUNCTIONAL RESIDUAL CAPACITY - volume of air remaining in the lungs at the end of a normal expiration
cannot be measured by spirometry

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23
Q

TLC = FRC + TV + IRV = VC + RV*

A

TOTAL LUNG CAPACITY - the volume of air in the lungs at the end of a maximal inspiration
cannot be measured by spirometry

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24
Q

Lung volume

A

Tidal volume - 0.5 L

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25
Q

Flow (calculation)

A
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26
Q

Total/minute ventilation

A

total amount of air moved into the respiratory system per minute
Total/minute ventilation = TV x resp frequency = 0.5L x 15bpm = 7.5L/min

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27
Q

Alveolar ventilation (Va)

A

amount of air moved into alveoli per minute
depends on the anatomical dead space - constant, not available for gas exchange
AV = (0.5 - 0.15) L x 15/min = 5.25 L/min

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28
Q

Which sis more effective - DEEP breathing or INCREASED RATE (shallow)?

A

Deep breathing - higher alveolar ventilation

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29
Q

FEV1

A

FORCED EXPIRATORY VOLUME in 1 sec

health person can empty most air out of their lungs in one second

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30
Q

FVC

A

FORCED VITAL CAPACITY

amount of air that is blown out in one breath after max inspiration as fast as possible

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31
Q

Spirometry Test Patterns (3)

A
  1. normal (age, gender, weight, height)
  2. obstructive (difficulty exhaling - asthma)
    shortness of breath, air comes out slowly
  3. restrictive (difficulty fully expanding - fibrosis, ALS, MS)
    stiffness in lungs
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32
Q

Helium dilution technique

A

helium is insoluble in blood, EQb after a few breaths, Measure the concentration at the end of expiratory effort

measures communicating gas or ventilated lung volume

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33
Q

Mechanics of Ventilation

A
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34
Q

Static properties of lung (mechanics of ventilation)

A 
NO AIR IS FLOWING 
maintains chest wall volume 
Intrapleural ressuer (Pip), transpulmonary pressure (Ptp)
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35
Q

Dynamic properties of lung (mechanics of ventilation)

A

LUNGS ARE CHANGING VOLUME
air flows in and out
permits airflow
Alveolar pressure (Palv)

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36
Q

Boyle’s Law

A

for a fixed amount of an ideal gas; fixed temperature
Pressure and volume are INVERSELY proportional
P1V1 = P2V2 (contant T)

gas molecules are in constant motion, creating pressure:
EXPIRATION: decrease volume, increased pressure (alv)
INSPIRATION: increased volume, decreased pressure (alv)

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37
Q

Ventilation

A

exchange of air between the atmosphere and alveoli
Bulk flow: gas moves from HIGH pressure to LOW pressure
F = deltaP / R
deltaP —> (Palv-Patm)

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38
Q

What creates pressure

A

movement of gas molecules in a container

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39
Q

How ia airflow created

A

change in volume and pressure produces airflow
pressure difference is generated, air moves via bulk flow HIGH to LOW pressure
F = deltaP / R

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40
Q

Elastic recoil

A

interaction between lung and thoracic caste determines lung volume
Lungs tend to collapse due to elastic recoil
chest wall - pulls thoracic cage outward due to elastic recoil

EQb –> inward recoil balanced with outward recoil

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41
Q

Intrapleural Pressure (Pip)

A

Intrapleural fluid - reduces friction of lung against thoracic wall during breathing

PRESSURE IN THE PLEURAL CAVITY
always subatmospheric

if Pip = Palv —> lungs would collapse

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42
Q

Transpulmonary pressure

A

FORCE RESPONSIBLE FOR KEEPING ALVEOLI OPEN
grater than 0 to keep lungs expanded
determines lung volume (static) not airflow

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43
Q

airway resistance

A
  1. Inertia of respiratory system (negligible)
  2. Friction
    - lung tissue with itself
    - lung and chest wall tissue
    - resistance of air flow
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44
Q

Laminar flow

A

relatively little energy in airflow RESISTANCE, small airway are distal to terminal bronchioles

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45
Q

Transitional flow

A

extra energy needed to produce vortices, resistance increases
airflow is transitional throughout bronchial tree

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46
Q

Turbulent flow

A

effective resistance to airflow is highest
LARGE AIRWAYS (trachea, larynx, pharynx)
radius is large and linear air velocities may be extremely high

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47
Q

Poiseuille’s law

A

laminar flow

R = 8nl / pi r^4

airway resistance is proportional to the viscosity of the gas and the length of the tube, but inversely proportional to fourth power of the radius

R to airflow is highly sensitive to the airway radius

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48
Q

Disease conditions of Airway resistance

A

typically impacted by small airways more than large ones

  • smooth muscle wall contraction
  • edema occurring on the walls of alveoli and bronchioles
  • mucus collection in lumens of bronchioles
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49
Q

Lung compliance

Dynamic vs static

A

measure of elasticity of lungs, lung expansion
CHANGE IN LUNG VOLUME produced by change in TRANSPULMONARY PRESSURE

static - measured during no gas flow
dynamic - measured during gas flow

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50
Q

Static compliance

A

no air flow through

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51
Q

Dynamic compliance

A

measured during air flow

reflection of lung stiffness and airway resistance

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52
Q

Emphysema - high compliance

A

loss of alveolar tissue (less gas exchange)

floppy lungs, less elastic recoil

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53
Q

Hysteresis

A

defines the difference between inflation and deflation compliance paths
Grater pressure difference is required to open a previously closed (narrowed) pathway than to keep an open airway from closing

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54
Q

Elastic components of lungs

A

elastin - weak spring, LOW tensile strength, extensible

collagen - strong twine, HIGH tensile strength, inextensible

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55
Q

What determines Lung Compliance

A

Elastic components - elastin, collagen

Surface Tension - air/-water interface within the alveoli

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56
Q

alveolar surface tension

A

water molecules at the surface of a gas-liquid interface are attracted strongly to the water molecules within the liquid mass
surface tension measures the attractive forces acting to pull a liquid’s surface molecules together

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57
Q

Factors that affect pressure-volume relation

A

air inflation

liquid inflation

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58
Q

Laplace’s equation

A

describes EQb:
P=2T/r
the smaller the bubbles radius is, the grater pressure needed to stay inflated

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59
Q

Alveolar surfactant

A

Produced by Type II alveolar cells
Lowers surface tension ( level of alveoli)
Stable against collapse

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60
Q

Surfactant and surface tension

A

Phospholipids mixture
Dipalmitol-phosphatidylcholine
breaks the strong attractive forces at the surface of water

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61
Q

T/F - there is a constant amount of surfactant in every alveoli

A

True

Equalizes pressures between alveoli of different sizes

62
Q

T/F - More dense/concentrated surfactant equalizes alveloi

A

TRUE
no pressure gradient
small alveoli will not collapse

63
Q

Infant Respiratory Distress

A

Premature infants - lack of surfactant decreases compliance, increases work required to breathe

64
Q

Regional differences in ventilation -

A

Gravity and Position

Radioactive Xenon inhaled

65
Q

Highest amount of ventitialtion

A

Back of lungs

66
Q

What explains Regional Differences in Pip

A

Weight of lungs increases pressure near bottom of

67
Q

How is Inter-pleural pressure created

68
Q

Gas Exchange

69
Q

Partial pressure of Gases

70
Q

Dalton’s Law

A

In a mixture of gases - each gas operates independently

Ptotal = P1 + P2 + P3 …

71
Q

Partial pressure of Gases at atmosphere at SEA LEVEL

A

760 mmHg = Patm

72
Q

Diffusion: how gas crosses the Blood-gas barrier

A

Ficks law explains the rate of transfer of has through a sheet of tissue/unit of time

73
Q

Respiratory Membrane

A

minimal thickness

74
Q

Solubility of gases in Liquids

A 
Diffusion constant (D)
CO2 solubility is much highter than O2
75
Q

Henry’s Law

A

the amount of gas dissolved in a liquid is direction proportional to the partial pressure of gas in which the liquid is in equilibrium

76
Q

Diffusion of gases in liquids

A

amount of gas in the liquid is dependent on the solubility

77
Q

PP of oxygen decreases in alveoly

PP of CO@ increases in alveoli

78
Q

Why does CO2 partial pressure decrease?

79
Q

slide 128

A

Air is warmed up and humidified

80
Q

Determinants of alveolar Po2:

A

1 Po2 in atmosphere
2 alveolar ventiliation
3 metabolic rate
4 perfusion

81
Q

Gas exchange between alveoli and blood

A

Blood gasses EQb quickly

82
Q

Perfusion of the Lung

83
Q

Systemic circulation

A

High pressure system

84
Q

Why do we need a low pressure system? What is it called

A

Pulmonary system
Delivery blood only to lungs and high pressure is risky
Resp membrane damage

85
Q

Low pressure system

86
Q

Low resistance system

87
Q

high compliance vessels

88
Q

Positive to alveoli collapse

A

redirect blood to regions where gas exchange can still occur

89
Q

Ventilation-perfusion relationship

90
Q

Ventilation and perfusion matching

91
Q

Bronchoconstriction

A

Diameter of the airway has become smaller. reduction in ventilation

92
Q

Oxygen transport in blood

A

O2 - gas molecule with LOW solubility

93
Q

Hemoglobin

A

2 alpha chain
2 beta chains
4 heme groups

94
Q

Oxygen Dissociation curve

A

interaction between Hb and the arterial partial pressure of oxygen

95
Q

porphoryn ring

A

iron atom binds to oxygen

96
Q

O2 + Hb HbO2

A

reversible process

97
Q

O2 CAPACITY

A

max amount of oxygen that can combine with Hb.
Depends on how much Hb is present in blood
1 g Hb combines with 1.39 mL O2

98
Q

Hb SATURATION

A

Percentage of the available Hb binding sites that have O2 attached
O2 combined with Hb / O2 capacity X 100

99
Q

What is the Dissociation curve sensitive to?

A

Arterial pO2 ***
pH
Temperature
pCO2

100
Q

What influences the sigmoidal dissociation curve?

A

Cooperative binding

101
Q

Cooperative Binding

A

When O2 binds - confirmation change of the HEME group

TENSE —> RELAXED

102
Q

significance of sigmoidal dissociation curve

A
  1. Flat portion 60-100 mmHg

2. Steep portion

103
Q

sigmoidal dissociation curve plateau

A

Reduced alveolar Po2

104
Q

Tense vs Relaxed state

105
Q

Tense vs Relaxed state steep portion

A 
10-40 mmHg
40-60 mmHg
Unload large amounts of oxygen
Advantage - reduction of CO2 and PO2 
UNLOAD OXYGEN TO PERIPHERAL TISSUE
106
Q

anemia

A

reduction in amount go Hb in blood

107
Q

Polycythemia

A

increase in Hb amount in blood or reduction of blood volume (increases Hb concentration)

108
Q

Carbon monoxide poisoning (and affect on O2 dissociation curve)
HbCO

A

Binds to Hb tighter than O2
reduced O2 binding to Hb
LEFT SHIFT = decreased unloading of O2 to tissues; conformational change

109
Q

saturation

A

Hb cannot hold more O2, sigmoidal curve flattens

110
Q

Oxygen movement in lungs and tissues

A

driven by pressure gradient generated by two different environments

111
Q

pH change on O2 dissociation curve

A

RIGHT shift

112
Q

Oxygen movement at level of respiratory membrane

A

Po2alv&raquo_space; po2blood

113
Q

Oxygen movement in peripheral tissue

A

capillary
peripheral tissue cells consumed dissolved O2
intracellular space –> mitochondria

114
Q

Temp change on O2 dissociation curve

A

Favour oxygen unloading

RIGHT shift

115
Q

PCO2 change on O2 dissociation curve

A

Favour oxygen unloading

RIGHT shift

116
Q

Right shift

A

lower percentage of Hb that has bound oxygen
More unloading of oxygen
higher metabolism

117
Q

Left shift

A

less oxygen unloading

cell/body metabolism

118
Q

2,3-diphosphoglycerate (DPG)

A

end product of RBC metabolism
RIGHT SHIFT
increase - chronic hypoxia
high altitude, lung disease

119
Q

Carbon dioxide transport in blood

A

CO2 is much more soluble in water than oxygen is

Peripheral tissue –> respiratory system

120
Q 
Carbonic anhydrase (CA)
Carbonic acid - H2CO3
A

In RBC
Decrease pH
Catalyzes reaction where CO2 reacts with water

121
Q

CO2 forms in blood (3)

A

Dissolved (5%)
Bicarbonate HCO3- (60-65%)
Carbamino compounds (25-30%0

122
Q

Bicarbonate HCO3-

123
Q

what does Carbonic acid dissociate into

A

H2CO3

dissociates into bicarbonate and H+ ions

124
Q

Chloride Shift

A

HCO3- (bicarbonate) leaves RBC, stays in plasma

Cl- move into RBC, maintaining electrical neutrality in RBC

125
Q

Carbamino Groups

A

CO2 interacts with amino groups in blood proteins

Periphery –> alveolar tissue

126
Q

Carbaminohemoglobin

A

Hb + CO2 HbCO2

No enzyme required

127
Q

T/F - DeoxyHb has higher affinity for CO2

128
Q

High levels of CO2 results in large in increased oxygen unloading

129
Q

Respiratory Acidosis

A

hypoventilation
CO2 is produced faster than it is eliminated
decreased PCO2, increased H+

130
Q

Respiratory alkalosis

A

Hyperventilation
Co2 is removed faster that it is produced
decrease in both PCO2 and H+

131
Q

Metabolic acidosis

A

Increased H+ in blood (independent from PCO2 changes)

132
Q

Metabolic alkalosis

A

Decreased H+ in blood

independent from PCO2 changes

133
Q

Physiological pH

A

7.4

venous blood is slightly more acidic(7.3)

134
Q

What buffers the blood

135
Q

What controls the automatic rhythm of breathing

A

Central nervous system
Pontine respiratory group
Dorsal respiratory group
***Ventral respiratory group

136
Q

What does the medulla do

A

Initiates breatihing via specialized neurons

137
Q

What modifies breathing

A

Higher CNS structures via CNS and input from central and peripheral chemo/mechano receptors

138
Q

PreBotzinger complex

A

neurons in ventral respiratory group

Excitatory INSPIRATORY RHYTHMIC ACTIVITY (polysynaptic pathway)

139
Q

Parafacial respiratory group (pFRG)

A

active contraction of abdomen muscles

140
Q

Possible changes that need to accommodate breathing

141
Q

Rhythm of Breathing

A

Generated in Ventral Resp Group (VRG)
PreBotC and pFRG neurons drive activity in premotor neurons
these excite motoneurons which active rhythmically respiratory muscles
Rhythmic activity is influenced by sensory and neuromodulatory (NT) units organization from different regions within and outside CNS

142
Q

Neuro-Repiratory Pathways - Inspiration

143
Q

Neuro-respiratory Pathways - Active Respiration

144
Q

Control of ventilation by PO2, PCO2, H+

A 
TV and rest rate respond to these changes
Hypoxia
hypercapnia
acidosis
INCREASE ventilation, raise PO2, dec CO2
145
Q

Peripheral Chemoreceptors

A

Carotid and Aortic bodies
Carotid - baroreceptors
sense hypoxia, sensitive to pH

146
Q

Carotid bodies

A 
small
chemsensitive
vascularized
high metabolic rate
Type 1 - Glomus cell (chemosensitive)
Type 2 - Sustentacular cells - support
147
Q

Glomus cells

A

Neuron-like characteristics

148
Q

What stimulates chemoreceptors

A

Arterial PO2 value below 60 mmHg

149
Q

Central chemoreceptors

A

indirectly sense changes in PCO2
Rostral, intermediate, caudal regions of medulla
medullary raphe, hypothalamus
excitatory drive

150
Q

hypercapnia

A

too much CO2 in blood

response is mediated dorsal and ventral group (change ventilation)

151
Q

Lactic acid

A

reduce blood pH, increase H+ concentration
during exercise
hyperventilation

Physiology (3 decks)

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