Unit 3: Respiratory Physio Flashcards by Sasha K.

Define “ventilation”.

breathing; exchange of air between the atmosphere and lungs

process of drawing fresh air into the alveolar spaces within the lungs where exchange with blood is possible

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Define “respiration”.

Distinguish between systemic respiration (both external and internal) and cellular respiration.

Cellular respiration- intracellular reaction of oxygen with organic molecules to produce Co2, water, and energy in form of ATP

Systemic:

External respiration- movement of gases between environment and body’s cells; exchange between alveoli and blood

internal respiration- exchange of gases with the internal environment; occurs in the tissues; exchange between blood and tissues

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Describe the major functions of the respiratory system.

Ventilation
Gas exchange

~moves fresh air into body while removing waste gases

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Identify the two different functional zones of the respiratory system.

conduction zone
-airways; dead air space
-pharynx, larynx, trachea, bronchi, bronchioles [not sites of exchange]
-filters, warms, humidifies

respiratory zone
-gas exchange
-external systematic respiration takes place here
-molecules mostly moving by diffusion

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Describe the roles of the conduction zone and the significance of each role.

filtration [good job of filtering out particulates so they dont make it to alveoli]

warming- up to body temp. Air that is too cold is problematic, as molecular movement is slow if cold so will not be enough gas exchange

humidifying- alveolar spaces need a water lining to work; inside of lungs must be wet and not dry out

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Describe the structure of the respiratory “exchange” zone. What are the characteristics of the respiratory zone?

respiratory bronchioles
alveolar sacs

external systemic respiration
gas exchange occurring

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Describe Boyle’s Law. Explain how Boyle’s Law relates to ventilation.

the pressure of gas is inversely related to its volume

[pressure = 1/ volume]

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Describe the process of inhalation.

Is it active or passive?

Describe the direction of airflow.
What is causing it to move?

~process of taking air into the lungs
~active phase of ventilation- result of muscle contraction. ~ ~diaphragm contracts and the thoracic cavity increases in volume.

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Describe the pressure and volume changes that are occurring during inhalation (in the lungs and in the intrapleural space).

lungs
-pressure decreases below atmospheric pressure

-thoracic/lung volume increases

intrapleural space
-pressure decreases below atmospheric pressure

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What holds the lungs against the chest wall?

The lungs are held against the chest wall by the negative pressure in the intrapleural space.

The intrapleural space is the thin space between the visceral pleura (which covers the lungs) and the parietal pleura (which lines the inside of the chest cavity). This space is filled with a small amount of intrapleural fluid.

1) negative pressure in intrapleural space
and adhesive properties of water holding lungs open

lungs are elastic enough they are pulling away from chest at all times, how much depends how much chest expands

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What is the significance of lung compliance to inhalation?

lungs must be very compliant, or easily stretched

during a restrictive R.D. hard to inhale due to reduced compliance…. allows a full easy inahle

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Describe the process of exhalation. Is it active or passive?

Describe the direction of airflow.
What is causing it to move?

Passive because it occurs during quiet breathing and involves a passive elastic recoil rather than active muscle contraction

Active expiration occurs during voluntary expirations and when ventilation exceeds 30-40 BPM. this uses the intercostal and abdominal muscles (called the expiratory muscles)

Air flows out of the lungs, due to pressure changes

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Describe the pressure and volume changes that are occurring during exhalation (in the lungs and in the intrapleural space)

lungs
-pressure increases then decreases
-volume of air decreases

intrapleural space
–pressure increases, but still negative [slightly less negative]
-volume of air decreases

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What is the significance of lung elasticity to exhalation?

it facilitates the passive recoil of the lungs during both quiet and forced breathing.

as exhalation progresses, elasticity increases

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What is the primary source of lung elasticity? Explain.

~due to rib cage, musculature of thoracic wall, and diaphram, but also–
~also due to tissue- the elastin in connective tissue; & also due to the water layer lying inside the alveoli surface

~The aleveoli thin water layer exhibits surface tension, meaning water molecules at the surface of this layer, are forming hydrogen bonds so they pull towards their neighbors on their side, creating surface tension. Surface tension creates force

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What is the Law of LaPlace?

pressure inside of a bubble formed by a fluid film is a function of 2 factors : the surface tension of fluid & radius of the bubble

P=2T/r

Collapsing force depends on diameter of alveoli
[when alveolus is larger in diameter, collapsing force is smaller, vice versa]

The smaller the diameter of alveolus, greater the collapsing force

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What is surfactant? What is the function of surfactant?

there are cells within alevolar walls that secrete an oily secretion called surfactant

~will not mix with water, so rises to surface and floats on water layer. disrupts the surface tension of water layer.

as alveolus gets smaller, surfactant molecules becomes more and more compacted to each other & have a bigger impact on breaking up surface tension

The surfactant enhances ability to reach equilibrium between alveoli and reduces the potential for them to collapse

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Why is the concentration of oxygen lower in the alveoli than in the inhaled air?

How does the conduction zone contribute to alveolar ventilation?

the air entering the alveoli is a mixture of fresh and old (air with oxygen and Co2) air

As you draw a breath, the airway air gets drawn into alveoli, as well as fresh air volume; the mixed air + air already in alveoli results in dilution of gases [oxygen concentration decreases due to diluting effect]

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What is the significance of the residual volume?

The RV is essential as it prevents alveolar collapse and provides a source of gas exchange between breaths.

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What is a partial pressure?
What is it used for?

pressure exerted by a specific gas within a mixture of gases; determined by concentration of each molecule

way of measuring driving force

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Describe the process of gas exchange

(describe the driving forces causing molecular movement, the path of molecular movement, and the mechanisms that enhance molecular movement in the desired direction).

Gas exchange- pure diffusion driven by partial pressure gradients

Gradient favors oxygen diffusion from the alveoli into the capillary blood

as the capillary blood runs around the alveoli, there is continued oxygen diffusion into the blood, even as it leaves the capillaries due to the partial pressure

Gradient consistently favors oxygen movement from the alveoli into the blood

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Describe how oxygen is transported in the blood.

What factors enhance oxygen movement into the blood when in the lungs and oxygen movement from the blood when in the tissues?

98% transported by hemoglobin
[oxygen molecule latches onto hemoglobin]

Hemoglobin

2% dissolved in plasma [first]

Factors enhancing O2 movement:

Partial Pressure of Oxygen (PaO2):
higher PP = more oxygen movement

Bohr Effect: Increased acidity (lower pH) in tissues enhances the release of oxygen from hemoglobin.

Higher temperatures

higher Co2

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Describe how carbon dioxide is transported in the blood. Where is it distributed in the blood and in what proportions?

7% dissolved in plasma
23% bound to amino groups of hemoglobin
70% transported as bicarbonate

[bicarbonate will diffuse out the cell and enter plasma]

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Describe the relationship between carbon dioxide and bicarbonate.

70% of Co2 is transported as bicarbonate

Co2 + H20 < > H2Co3 < > HCo3 + H

Bicarbonate diffuses out the cell, into plasma

Bicarbonate is a negative ion; when it leaves the cell it alters the cell’s resting potential and will be counterbalanced by negative chloride ions diffusing into cell while bicarbonate is diffusing out of the cell.

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Describe the chloride shift.

Bicarbonate is a negative ion; when it leaves the cell it alters the cell's resting potential and will be counterbalanced by negative chloride ions diffusing into cell while bicarbonate is diffusing out of the cell. [To maintain electrochemical neutrality within the red blood cell, there is an exchange of chloride ions (Cl-) for bicarbonate ions (HCO3-) across the cell membrane. Chloride ions move into the red blood cell, compensating for the outward movement of bicarbonate ions].

Describe the relationship between carbon dioxide, hemoglobin and oxygen.

Co2 will drive oxygen off of hemoglobin (binds at diff sites) Hemoglobin binds O2 Co2 also binds to hemoglobin - decreases oxygen ability to bind to hemoglobin less co2 there is, more oxygen can bind

Describe the location and chemical sensitivity of the different respiratory chemoreceptors.

Aortic & carotid bodies [peripheral chemoreceptors] -directly respond to plasma Co2 & pH -trigger reflex increase in ventilation -directly exposed to plasma -both highly sensitive to changes in plasma Co2 -can also respond to oxygen -carotid bodies: also respond to changes in pH Medulla Oblongata [central chemoreceptors] -set respiratory rate -measure pH in CSF -can only respond to plasma Co2 (not pH)

What is the primary stimulus for breathing? Describe how carbon dioxide, pH and oxygen are related to the regulation of ventilation

level of carbon dioxide (CO2) in the blood, specifically the partial pressure of carbon dioxide (PaCO2).

What is the Hering-Breuer reflex?

stretch receptors that inhibit inhalation prevents over-inhalation

Eupnea

normal respiratory rate and depth; normal total minute volume

Apnea

temporary cessation of spontaneous breathing; often due to reduced chemoreceptor stimulation

Hyperventilation

increased total minute volume which does NOT match the metabolic needs; generally caused by sympathetic NS and results in decreased pCo2 and increased pH

Hyperpnea

increased total minute volume during exercise in proportion to metabolic need; unlike hyperventilation, the blood Co2 levels do NOT change because the increased ventilation matches the metabolic demands

Hypoxia

reduced oxygen (below amount needed to meet tissue demands)

Anoxia

deprivation of oxygen (possibly to point of tissue damage)

Tachypnea

rapid breathing rate; increased rate not associated with metabolic demands and may not result in increased total minute volume

Hypercapnia

excessive concentration of carbon dioxide in blood

Dyspnea

difficult and/or painful breathing

Asphyxia

unconsciousness or death resulting from lack of oxygen

Respiration is the process of capturing, delivering, and using :

oxygen O2 during aerobic cellular production of ATP

The respiratory system's role is to :

capture oxygen for the blood to deliver to the cells and eliminate Co2 waste produced by cells

Breathing (ventilation) is the process of :

moving fresh air into alveolar spaces where exchange with blood takes place

The exchange of O2 and Co2 that occurs between alveoli and capillary blood is called

external systemic respiration

Oxygen will diffuse from the blood into the tissues and Co2 will diffuse from tissues into the blood. this is called

internal systemic respiration

External systemic respiration is: Internal systemic respiration is:

External: exchange between alveoli and blood Internal: exchange between blood and tissues

Spirometry

measures inhaled/exhaled air volumes used for measuring lung volumes, capacities, and maximum rates for air movement clinically useful assessment of pulmonary function

Co2 + H20 > ?

Co2 + H20 > H2Co3 (carbonic acid) > HCo3- (Bi-carbonate) + H+

Tidal volume

volume of air inspired or expired in a single normal breath

Expiratory reserve volume ERV

maximum volume of ai FORCIBLY exhaled after a normal tidal breath

Inspiratory reserve volume IRV

maximum volume of air FORCIBLY inspired after a normal tidal breath

Residual volume RV

volume of air REMAINING in lungs following a maximal forced expiration (air present within the lung's conducting passageways)

The volume of air exhaled in a minute in know nas

total minute volume tidal volume x respiratory rate

Alveolar minute volume =

2/3 total minute volume

vital capacity VC

TOTAL amount of air FORCIBLY exhaled following a MAXIMAL inhalation VC = TV + ERV + IRV

Total lung capacity TLC

TOTAL amount of air in lungs after a maximal FORCED inspiration TLC = TV + ERV + IRV + RV

The upper airways and bronchi play an important role in conditioning air. They:

warm air to body temp filter out foreign material Humidify by adding water vapor (so epithelium does not dry out)

alveoli are sites of

gas exchange

as you exhale, alveolar volume

decreases The collapsing force of alveoli is increasing, enhancing the purging of air out of the alveoli [Law of LaPlace]

The smaller the alveolus gets, the more forceful collapse becomes. The alveolus might exceed other forces and the alveoli can completely collapse. After this happens, it is very difficult

to get them to open up and fill with air again

The chest rises during inhalation because air enters the lungs (i.e. air entering the lungs is what causes the lungs to expand). TRUE OR FALSE?

FALSE.

The respiratory airways are associated with: transmission of air air filtration humidifying air gas exchange warming of air

ALL except gas exchange

Which of the following pressures is always the lowest: intrapleural atmospheric intra-alveolar (aka intrapulmonary)

intrapleural

When the volume of the thoracic cavity increases (due to muscle contraction):

pressure inside the alveolar spaces decreases pressure in the intrapleural space (pleural cavity) decreases

Internal systemic respiration refers to:

the exchange of oxygen and carbon dioxide between the blood and tissues

The property of water that is responsible for its collapsing force is _________1__________. This property can be disrupted and the collapsing force reduced by ________2_______ __.

1- surface tension 2- surfactant

Air moves into the lungs when:

air pressure in the lungs decreases below atmospheric pressure

The Law of LaPlace states that the collapsing forces caused by the surface tension of water lining alveoli will ____ when the diameter of the alveoli decreases.

increase

Identify 2

2- tidal volume

Identify 3, 4

3- Inspiratory reserve volume IRV 4- expiratory reserve volume ERV

Identify 5, 6

5- residual volume 6- vital capacity

Identify 8

8- total lung capacity

The air retained within alveoli and airways after a maximal expiration is called

residual volume RV

TV + ERV + IRV + RV = ? Tidal volume + expiratory reserve volume + inspiratory reserve volume + residual volume = ?

TLC total lung capacity

vital capacity is a measure of all 3 volumes capable of entering or leaving the respiratory system with voluntary breathing (TV, IRV, ERV). VC is often used to

evaluate respiratory function

Obstructive disorders, loosely, are disorders of the:

conductive zone

Obstructive disorders describe: examples?

blockage of the conductive zone; there is something obstructing air flow; ex) narrowing of airways due to constriction or mucous build up/inflammation, foreign object in the airways...

One potential sign of an _________________ is a larger residual volume (Rv) bc air tends to be trapped

obstructive disorder

A restrictive disorder is associated with

lungs (alveolar tissues) and their compliance (ability to stretch)

With a restrictive disorder, the challenge is most exaggerated during:

inhalation [hard time to take in a full breath] however, exhalation is much easier and faster

Describe exhalation with a restrictive disorder

It is easier and more rapid than in a normal individual

In a restrictive disorder, vital capacity is: FEV 1 is:

reduced FEV 1 is elevated

In an obstructive disorder, vital capacity is: FEV 1 is:

both reduced

The _________________ is essential as it prevents alveolar collapse and provides a source of gas exchange between breaths.

residual volume

Dalton's law: the pressure of a gas is equal to:

the sum of the pressures of its constituent parts

Gradient consistently favors oxygen movement from:

the alveoli into the blood

central chemoreceptors respond to:

plasma Co2 plasma levels in carbon dioxide [exclusively]

In a patient with a restrictive respiratory disorder, vital capacity would be expected to:

be exhaled faster have a reduced volume

The relationship between the concentration of a gas in solution and the pressure of that gas can be described as:

partial pressure

The volume of air moved in a single resting respiration is called the ________.

tidal volume

Review the oxyhemoglobin dissociation curve. How much does a 10 mmHg change in partial pressure of oxygen in the lungs change the amount of oxygen bound to hemoglobin?

1-2%

Compared to plasma alone, how much additional oxygen can be transported by whole blood (given a partial pressure or 100 mmHg)?

60X as much oxygen

The majority of the carbon dioxide transported in the blood is:

combined with water and converted into bicarbonate and H

After a maximal effort exhalation, there will still be air in the lungs. true or false?

Correct. The remaining air is called the residual volume

Respiratory movements are controlled by:

The respiratory center in response to chemoreceptor stimulation The respiratory center in response to stimulation from the cerebral cortex The cerebral cortex directly

A respiratory disorder where the airways are narrowed or blocked is called:

obstructive disorder

Review the oxyhemoglobin dissociation curve. How much does a 10 mmHg change in partial pressure of oxygen in the tissues change the amount of oxygen bound to hemoglobin?

10-20%

Lung elasticity (the source of alveolar collapse) is due to associated connective tissue and water lining the alveoli. As alveoli deflate and get smaller, what happens?

elasticity (collapsing force) due to connective tissue decreases elasticity (collapsing force) due to water increases

Maximum amount of air exhaled after a maximum inspiration is called

vital capacity

Asthma is a type of ?

obstructive disorder [of the airways/ conductive zone]

amount of air left in lungs after a maximum expiration is called

residual volume

what happens first chest expands or lungs inflate

chest expands first, then lungs inflate

Hyperpnea VS hyperventilation

Hyperpnea- normal adaptive increase (like due to exercise) in minute volume due to high oxygen demands hyperventilation- increase not associated with metabolic demand change

A momentary pause in resp. rhythm following hyperventilation is called

apnea

why is there apnea/ pause in resp. rhythm following hyperventiliation?

due to decreased Co2 in blood (reduced chemoreceptor stimulation)

Compare hyperventilation in an open VS closed system

Open system- apnea may occur due to decreased blood Co2 closed system- no change in blood co2 due to rebreathing air, so apnea would not occur

Rebreathing holding breath & obstruction all lead to what ?

increased Co2 levels in the blood rebreathing - breathing in exhaled air (co2 increase) holding breath - Co2 not exhaled, so it increases obstruction- air flow/ gas exchange restricted

which enzyme catalyzes the reversible hydration of carbon dioxide: CO2+ H2O<-->HCO3(-)+H+ ?

Carbonic anhydrase