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Physiology > Respiratory system > Flashcards

Respiratory system Flashcards

1
Q

Fundamental unit of the respiratory system

A

The alveoli

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2
Q

Structure of trachea and primary bronchi

A
  • Semi-cartilaginous
  • C-shaped ring made of cartilage in front and smooth muscle in the back
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3
Q

Bronchi structure

A

Cartilaginous structure that is made of plates of cartilage and smooth muscle

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4
Q

Bronchioles structure

A

Made of smooth muscle

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5
Q

Conducting vs Respiratory zone

A
  • conducting: contains trachea, primary bronchi, bronchioles and terminal bronchioles. There are no alveoli or gas exchange. Anatomical dead space.
  • Respiratory: contains the alveoli, respiratory bronchioles, alveolar ducts, and alveolar sacs. Gas exchange occurs.
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6
Q

Terminal bronchioles

A

smallest airway without alveoli

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7
Q

Types of alveoli (2)

A
  1. Type 1: flat epithelial cells, internal surface is lined with surfactant. Do not divide, susceptible to toxins.
  2. Type 2: less common. Produce surfactant. Act as progenitor cells (can replicate and differentiate into type 1 cells), fixes damaged alveoli
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8
Q

Respiratory membrane

A

respiratory surface made of the alveolar epithelial cells (type 1) and the pulmonary capillary endothelial cell

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9
Q

Pneumocyte

A

One of the cells lining the alveoli of lung (type 1 and 2 alveolar cells). Name of alveolar cells

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10
Q

Steps of respiration (5)

A
  1. Ventilation: air goes from atmosphere to alveoli by bulk flow, independent of gas composition and is done due to changes in volume and pressure (high pressure to low pressure)
  2. Exchange of O2 and CO2 between alveoli and blood by diffusion at the level of the respiratory membrane
  3. transport of oxygen and carbon dioxide through pulmonary and systemic circulation by bulk flow
  4. exchange of O2 and CO2 between blood in tissue capillaries and cells in tissues by diffusion (by change in pressure)
  5. Cellular utilization of oxygen and production of CO2
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11
Q

Pulmonary muscle types (3)

A
  1. Pump muscles: make changes in pressure and volume at the level of the lungs (inspiratory/diaphragm and expiratory)
  2. Airways muscles: locates at the level of the airways and have a role in keeping airways open (mostly inspiratory)
  3. Accessory muscles: facilitate respiration during exercise when there is an increased metabolic drive
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12
Q

External intercostal muscles

A
  • inspiratory pump muscles
  • contract and lift ribcage to promote lateral increase in the thoraic volume/ expands the thorax
  • very similar to motion of a bucket handle (bucket handle motion)
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13
Q

Parasternal muscles

A
  • inspiratory pump muscles
  • contract and pull sternum forward, increasing anterior posterior dimension of the ribcage
  • pump handle motion
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14
Q

Abdominal muscles

A
  • expiratory pump muscles
  • do not contract during expiration at rest and passive during inspiration
  • required for faster and deeper breathing to return lungs to rest
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15
Q

Internal intercostals

A
  • expiratory pump muscles
  • relaxed at rest and recruited during forced expiration
  • pushes the ribcage down to reduce amount of air or reduce the volume of the thoraic cage
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16
Q

Obstructive Sleep Apnea

A
  • tone of the upper respiratory muscles is depressed and they become a floppy muscle
  • reduction in upper airway patency during sleep, o a reduction in the openness of the airway
  • results in snoring and large drops in oxygen saturation in blood
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17
Q

Muco-ciliary escalator and types of cells

A
  • the filtering action of the conducting zone in the trachea
  • they filter out inert particulates and remove them from the airways
    1. goblet cells: sparse, produce mucus, no cilia
    2. Ciliated cells: layer of cells with cilia on the apical surface
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18
Q

Periciliary fluid

A
  • fluid on the cilia of ciliated cells in the trachea
  • sits on top of the cilia and is called the SOL layer
  • allows cilia to move freely in this fluid
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19
Q

Gel layer

A
  • dense layer on goblet cells
  • distributed in patches
  • trap particulates that enter the respiratory system during inhalation
  • particulates are then eliminated via ciliated cells that push them in one direction through to the esophagus
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20
Q

silica dust/asbetos

A
  • very fine particulates that enter the alveoli
  • they get past the macrophage defense and kill them, which releases chemotactic factors that promote fibroblast recruitment into the alveoli, which increases collagen and makes lungs stiffer
  • results in pulmonary fibrosis
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21
Q

Spirometry

A
  • pulmonary function test that determines the amount and the rate of inspired and expired air
  • measure pressure
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22
Q

Atelectasis

A

complete or partial collapsing of a lung or lobe of a lung

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23
Q

Obstructive lung disease

A
  • patients have shortness of breath due to difficulty in exhaling all the air from the lungs
  • damage to the lungs or narrowing of the airways inside the lungs
  • at the end of exhalation, an abnormally large amount of air stays in the lungs
  • seen in asthmamand cystic fibrosis
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24
Q

restrictive lung disease

A
  • patients cannot fully fill their lungs with air, lungs are restricted from expanding
  • results from condition causing stiffness in the lungs, chest walls, weak muscles, or damaged nerves
  • seen in patients with lung fibrosis, neuromuscular disease like ALS, or scarring of the lung tissue
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25
Q

Helium dilution method

A
  • can measure the functional residual capacity
  • helium is an inert gas that is not taken up by the vascular system, therefore stays in the lungs
  • it measures only communicating gas or ventilated lung volume
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26
Q

Static vs Dynamic properties of the lung

A
  • static: present in the lung when no air is flowing. Necessary to maintain lung and chest wall at a certain volume. Interpleural pressure (Pip), transpulmonary pressure (Ppt), static compliance of the lung and surface tension of the lung
  • Dynamic: when lungs are changing volume and air is flowing. Alveolar pressure, dynamic lung compliance and airway and tissue resistance
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27
Q

The pleura

A
  • thin double-layered envelope that connects the lung and chest wall
  • Visceral pleura: covers the exterior of the lungs
  • parietal pleura: covers the chest wall
  • pleura are separated by interpleural fluid to allow them to slide at each inspiratory effect
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27
Q

Transpulmonary pressure

A
  • force responsible for keeping the alveoli open, expressed as the pressure gradient across the alveolar wall
  • Ptp = Palv - Pip
  • static parameter which does not cause airflow, but determines the lung volume
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28
Q

Factors that affect resistance to airflow (4)

A
  1. inertia of the respiratory system (minimal)
  2. Friction between the different alveolar sacs
  3. Friction between the lung and the chest wall (reduced by intrapleural fluid)
  4. Friction of air when it passes through the airways (80% of total resistamce)
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29
Q

Laminar airflow

A
  • flow in a linear fashion
  • invests little energy in airflow resistance
  • found in small airways that are distal to the terminal bronchioles- has the highest resistance to airflow
30
Q

Transitional airflow

A
  • it takes energy to produce vortices
  • the resistance increases
  • found in transitional areas like the bronchial tree, at the ramifications or branches of the bronchial trees
31
Q

Turbulent flow

A
  • non-smooth flow
  • found in larger airways, like the trachea, the larynx and the pharynx
  • velocity of gas is very high
32
Q

Poiseuille’s law

A
  • determines resistance to airflow
  • if the radius of the airway is reduced, resistance will increase
33
Q

What are small airways occluded by? (3)

A
  1. the smooth muscle they’re surrounded by (muscle increases resistance)
  2. Edema which alters resistance because of the presence of fluid in the small airways
  3. mucus that accumulates which reduces alveolar space at the level of the bronchioles
34
Q

Lung compliance

A
  • A measure of the elastic properties of the lungs and a measure of how easily the lungs can expand
  • determined as a dynamic property and static property
  • given by the magnitude of the change in lung volume produced by a given change in transpulmonary pressure
  • compliance is the slope of the curve
35
Q

Pulmonary fibrosis

A
  • lung compliance is low
  • overproduction of collagen makes the lungs stiff
36
Q

Emphysema

A
  • lung compliance is high
  • gradual reduction in lung elastic components
  • a small change in transmpulmonary pressure will result in large changes in lung volume
  • causes floppy lungs and less surface respiratory membranes for gas exchange
37
Q

Hysteresis

A
  • defines the difference between the inflation and the deflation compliance path
  • more pressure is needed to open an airway than keep an airway open when it’s already open
38
Q

What is lung compliance determined by? (2)

A
  1. Elastic components of lungs (elastin and collagen)
  2. Surface tension at the air-water interface within the alveoli
39
Q

Surface tension

A
  • the air-water interface within the alveoli
  • makes the lung collapse or gives the lungs the elastic recoil
  • it decreases lung compliance
  • a measure of the attracting forces acting to pull a liquid’s surface molecules together at an air-liquid interface
40
Q

Laplace’s equation

A
  • describes the equilibrium that must occur between the alveolar inner pressure and the surface tension pressure to avoid the collapsing of the alveoli
  • the smaller the bubble’s radius, the greater the pressure needed to keep it inflated
41
Q

Surfactant

A
  • lowers the surface tension at the level of the alveoli
  • improves lung compliance
  • produced by type 2 alveolar cells
  • makes alveoli stable against collapse
  • it breaks the attractive forces between water molecules at the surface o reduce tension
  • the dynamic properties of surfactant permit the alveolar tension to change with inflation and deflation and the thickness of the surfactant layer varies inversely with the surface area
42
Q

Infant respiratory distress syndrome

A
  • need artificial surfactant administered to the airways to reduce surface tension
  • premature babies that can’t produce enough surfactant and have trouble breathing
43
Q

Where is ventilation the highest and lowest?

A
  • highest in the lower zone of the lung
  • lowest in the upper zone of the lung
  • this has to do with gravity and posture
44
Q

Dalton’s law

A
  • calculates the overall pressure that the mixture of gas molecules generate
  • each gas has its specific pressure
45
Q

Fick’s law

A
  • The rate of transfer of a gas through a sheet of tissue per unit of time is proportional to the surface area of the membrane and depends on the difference in partial pressures between the two environments, and is inversely proportional to the thickness of the membrane
  • change in surface area and thickness will alter the rate of transfer of a gas
46
Q

Henry’s law

A

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

47
Q

Determinants of alveolar oxygen partial pressure (4)

A
  1. PO2 in the atmosphere
  2. Alveolar ventilation
  3. Metabolic rate
  4. Lung perfusion
48
Q

Determinants of alveolar carbon dioxide partial pressure (4)

A
  1. PCO2 in the atmosphere (essentially 0)
  2. Alveolar ventilation
  3. Metabolic rate
  4. Lung perfusion
49
Q

Ventilated alveoli that lack perfusion

A
  • high V/P ratio
  • occurs when there is a collapsing of the lung capillaries, pleurisy or other diseases
  • blood flow is obstructed
  • alveolar PO2 becomes high and PCO2 becomes low because there is no exchange with capillaries
  • the alveolar space in contact with the occlusion of vessels becomes very similar to atmospheric air
50
Q

Alveolar dead volume

A

Region of the lungs where is a high ventilation/perfusion ratio because of a pathological condition

51
Q

Perfused alveoli that are not ventilated

A
  • occurs from an obstruction in a collapsed bronchi or bronchioles
  • ventilation to perfusion ratio will decrease
  • In the alveolar space, there will be a decrease in PO2 and increase in PCO2
  • Amount of blood in this area will be called a shunt (venous blood that does not get oxygenated)
52
Q

Regional differences in lung perfusion?

A
  • perfusion is highest at the level of the base of the lung
  • associated with gravity and posture
53
Q

Polycythemia

A

increase hemoglobin amount in the blood or reduction in blood volume that increases the hemoglobin concentration

54
Q

Factors that increase metabolism will cause more oxygen unloading. These factors include? (4)

A
  1. increased body temperature
  2. increase in PCO2
  3. Increase in hydrogen ion production (associated with increase in PCO2)
  4. pH
55
Q

2, 3 diphosphoglycerate (DPG)

A
  • present in the RBCs and is an end product of RBC metabolism
  • shifts the oxygen dissociation curve to the right, therefore more oxygen unloading (less oxygen to Hb affinity)
56
Q

Carbonic Anhydrase in RBC

A
  • In a RBC, CO2 reacts with H2O to produce carbonic acid (H2CO3)
  • carbonic acid dissociates into hydrogen ions and bicarbonate (HCO3-)
  • RBCs exchange bicarbonate for chloride using an anion exchanger protein
  • “chloride shift” will occur for this exchange in order to maintain electrical neutrality in the red blood cells
  • H+ will also increase in venous blood to maintain electrical neutrality and lower the pH
57
Q

Carbamino compounds

A
  • another way to transfer carbon dioxide in the blood
  • CO2 will interact with the globin chain of hemoglobin and form a carbamino compound called carbaminoohemoblobin
  • no enzyme is required
58
Q

Important of H+ interaction with hemoglobin (2)

A
  1. Unloading of H+: at a lower pH (more H) there is a reduced % of hemoglobin saturation of oxygen and more unloading/shift to the right (H+ has more affinity for deoxyhemoglobin)
  2. Hemoglobin buggers the change in pH at the level of the venous blood: Hb has a key role in buffering the production of H+ in the peripheral tissues and capillaries
59
Q

Respiratory acidosis

A

hypoventilation (CO2production > CO2 elimination), which causes high PCO2 and high H+

60
Q

Respiratory Alkalosis

A

hyperventilation (CO2production < CO2 elimination), which causes low PCO2 and low H+

61
Q

Metabolic Acidosis

A

High H+ concentration in blood, independent of changes from PCO2

62
Q

Metabolic Alkalosis

A

Low H+ concentration in blood, independent of changes from PCO2

63
Q

Regions in the brainstem that control breathing (3)

A

pontine respiratory group, dorsal respiratory group and ventral respiratory group
- respiratory rates are generated at ventral respiratory group

64
Q

Pre-Botzinger complex

A
  • inspiratory rhythm generator
  • group of neurons in the ventral respiratory group
  • generate excitatory inspiratory rhythmic activity that excites inspiratory muscles (via polysynaptic pathway)
  • they are continuously active and fire action potentials with every breath
65
Q

Parafacial respiratory group

A
  • group of neurons in the ventral respiratory group
  • important for generation of active contraction of abdominal muscles
66
Q

Factors that influence generating rhythm (3)

A
  1. neuromodulatory factors (neurotransmitters)
  2. suprapontine influences that are volitional or emotional
  3. Sensory inputs
67
Q

Inspiratory oscillators

A
  • Excite upper airway muscles
  • generated by pre-botzinger complex
68
Q

Carotid and aortic bodies

A
  • peripheral chemoreceptors
  • sense motility changes in arterial PO2 and changes in pH
  • sense primary hypoxia (low arterial PO2)
  • high metabolic rate
69
Q

types of glomus cells (2)

A

They are carotid bodies cells
1. type 1 glomus cells: chemo sensitive, drive the response in ventilation if there are changes in artierial PO2
2. Type 2 sustentacular cells: supporting cells

70
Q

Glomus cells: how they work and process

A
  • they have voltage-gated ion channels and can generate action potentials following depolarization
  • they release neurotransmitters to the terminals of the glossopharyngeal afferents
  • this will drive input back to the dorsal respiratory group in the brainstem
  • this will excite the Pre-Botzinger complex and pFRG to increase respiratory drive to the muscles and increase ventilation
  • occurs when there are low PO2 levels
71
Q

Central chemoreceptors

A
  • specialized neurons located close to the ventral surface of the medulla (close contact with blood vessels and cerebrospinal fluid)
  • sense changes in PCO2 through hydrogen ions detection
  • neurons will start firing faster and provide an excitatory drive to the respiratory centres
72
Q

Hypercapnia

A
  • High PCO2 in body
  • principle solution is through the central chemoreceptors

Physiology (6 decks)

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