Unit 4 Flashcards
Respiratory tree
Larynx Trachea Primary bronchi 2ndary bronchi Tertiary bronchi Bronchioles Terminal bronchioles Respiratory bronchioles Alveolar ducts Alveolar sacs with alveoli
Trachea supplies:
Both lungs
Primary bronchi supplies:
Each lung
2ndary bronchi supplies
Each lobe
Tertiary bronchi supplies:
Each bronchopulmonary segment (lobule)
Areas of the resp tree that are capable of gas exchange
Respiratory bronchioles
Alveolar ducts
Alveolar sacs with alveoli
Active muscles of inspiration
Diaphragm External intercostals Sternopcleidomastoid Serratus anterior Scalenus muscles
Muscles of expiration (only needed for FORCEFUL expiration)
Rectus abdominus, obliques
Internal intercostals
What increases during inspiration
Vertical diameter
AP diameter
What contracts during inspiration?
External intercostals
Diaphragm
What happens to the rib cage during inspiration
It elevates (duh)
What happens with internal intercostals during inspiration
They relax
Inspiration is due to:
Muscle contraction which increases thoracic cage size
Compliant lungs inflate due to:
Negative pressure in the pleural cavity
Expiration is due to:
Decreasing thoracic cage size bc of the elasticity of the thoracic soft tissue and the lungs themselves
What happens to alveolar pressure during inspiration?
Expiration?
Decreases during insp
Increases during exp
What happens to pleural pressure during inspiration?
Expiration?
Insp- decreases
Exp- increases
Tissue gradience between alveolar and pleural pressures
Transpulmonary pressure
Lung volume during inspiration?
Expiration?
Insp- increases
Exp- decreases
Intrapulmonary (alveolar) pressure oscillates around:
What happens when negative?
0
Air enters lungs (air leaves when positive)
The lowest intrapulmonary pressure is reached:
After that:
Halfway into inspiration
After that air entering the lungs raises the pressure
The highest intrapulmonary pressure is reached at:
After that:
Halfway into expiration
After that, air leaving the lungs reduces the pressure
Intrapleural pressure is always:
This exerts:
Negative compared to the atm, oscillating around -4.
This exerts an expanding effect on the lungs due to lung compliance
The difference between the alveolar pressure and the pleural pressure
Transpulmonary pressure
Ptrans = Plv - Pip
Type I pneumocytes
Lines the alveolar walls (squamous)
Type II pneumocytes
Secrete pulmonary surfactant
Necessary to keep alveolar inflates
Purpose of pulmonary surfactant
Breaks surface tension of the fluid layer lining the alveolar walls
Premature babies lack:
Sufficient surfactant
Will develop resp distress syndrome
Commonly used pulmonary function test.
Pt breathes in a tube which is monitored
Spirometetry
Spirometer measures
Tidal volume
Ins reserve volume
Exp reserve volume
Residual volume
Tidal volume
Normal breathing at rest
Inspiratory reserve volume
Deepest breath in
Expiratory reserve volume
Breath out as much as you can
Residual volume
Amount of gas remaining in the lungs after exp. reserve volume
Capacities of spirometry
Inspiratory
Functional residual
Vital
Total lung
Inspiratory capacity
Tidal volume + insp reserve volume
Functional residual capacity
Exp reserve volume + residual volume
Vital capacity
Exp reserve volume + tidal volume + insp reserve volume — all the way in, all the way out
Total lung capacity
All 4 volumes added together
Minute resp volume =
Tidal volume X Resp rate
Looking for how much air goes in and out of your lungs within a minute
Dead air space
Air that fills respiratory passageways that are not capable of gas exchange with the blood
Anatomic dead air space
Air in trachea to the terminal bronchioles
Alveolar dead air space
Damaged or under perfused alveoli
Physiological dead air space
Sum of anatomic AND alveolar dead air space
Review slide 11
Slide 11
Alveolar ventilation rate
Total volume of new air entering the alveoli each min
Equation for alveolar ventilation rate
Va = freq (Vt-Vd)
Va = alveolar ventilation rate freq= respiration rate Vt= tidal volume Vd= Physiologic dead air space
Sympathetic effect on bronchioles
Causes bronchiolar dilation
Parasympathetic effect on bronchiolars
Causes bronchiolar constriction
Cough reflex is caused by
Irritation to bronchi and trachea
Neurons detecting bronchi and trachea irritation and efferent
Afferent neurons (vagus) To the medulla
Efferent neurons to muscles of epiglottis and abdomen
Sneeze reflex caused by
Irritation to nasal passageways
Neurons involved in sneeze reflex
Afferent neurons (trigeminal)
Goes to the medulla
Efferent- to muscles of the uvula and abdomen
How does the nose modify the air before reaching the lungs?
Air is:
Warmed
Humidified
Partially filtered
Pressure is directly proportional to the:
Concentration of gas molecules in a system
Gases in breathes air are mainly:
Oxygen, nitrogen, CO2, and water vapor
Partial pressure: The total pressure exerted by a mixture of gases is equal to:
The sum of the individual pressures of each gas
Partial pressures in water and tissue fluid is determined by:
Gas concentration and solubility in the water or tissue fluid
(CO2/O2) is more soluble in water than the other
CO2
Air in the environment
Atmospheric air
Inspired air in anatomic dead air space
Humidified air
Air in gas exchange areas
Alveolar
Air in anatomic dead airs space as it exits the body
Expired air
Speech involves:
Respiratory system
Cerebral cortex
Phonation, resonance, and articulation structures
Mechanical functions of vocalization
Phonation
Resonance
Articulation
Phonation includes:
Larynx; vocal cords
Resonance includes:
Mouth Nose Sinuses Pharynx Chest cavity
Articulation includes:
Lips, tongue, soft palate
What are responsible for controlling sound production
The intrinsic laryngeal muscles
Intrinsic laryngeal muscles
Cricothyroid muscl
Post cricoarytenoid muscles
Lateral and transverse cricoarytenoid muscles
Thyroarytenoid muscles
Cricothyroid muscles increase:
Tension on the vocal folds to raise pitch
Post. Cricoarytenoid muscle action
Abducts the arytenoid cartilages and therefore abducts the vocal cords
Lateral and transverse cricoarytenoid muscle action
Adduct and rotate arytenoid cartilages
Adduct the vocal cords
Thyroarytenoid muscle action
Shortening the vocal cords, lowering voice pitch
What do the extrinsic laryngeal muscles do?
Elevate or depress the larynx
Pressure of N2
597.0 mm Hg- 78.62%
Pressure of O2
159.mm Hg - 20.84%
Pressure of CO2
0.3 mm Hg- 0.04 %
Pressure of H2O
3.7 mm Hg- 0.50%
Total air pressure
760 mm Hg
Pressure of inspired N2
563.0 mm Hg - 74.09%
Pressure of inspired O2
149.3 mm Hg- 19.67 %
Pressure of inspired CO2
0.3 mm Hg- 0.04 %
Pressure of inspired H2O
47 mm Hg - 6.2%
Total pressure of inspired air
760 mm Hg
Pressure of Alveolar N2
569 mm Hg - 74.9%
Alveolar O2 pressure
104.0 mm Hg- 13.6%
CO2 alveolar air
40 mm Hg - 5.3 %
H2O alveolar air
47.0 - 6.2 %
N2 expired air
566.mm Hg- 74.5%
O2 expired air
120.0 mm Hg- 15.7%
CO2 expired air
27 mm Hg— 3.6 %
H2O expired air
47.0 mm Hg — 6.2 %
What is oxygen concentration in the alveoli dependent on?
Rate of absorption of O2 in the blood
And
Rate of entry of NEW O2 into the alveoli via ventilation
CO2 concentration in the alveoli is dependent on:
Rate of excretion of CO2 from the blood
And
Rate of removal of CO2 from the alveoli via ventilation
How many breaths does it take to totally replace alveolar air?
Approx 16 breaths
Respiratory membrane
The structures in between the alveolar space and the lumen of the capillary
How thick is the respiratory membrane?
0.2-0.6 micrometers
Layers of the resp membrane (6)
Fluid layer
Alveolar epithelium
Epithelial basement membrane
Thin interstitial space
Capillary basement membrane
Capillary endothelium
What does the rate of diffusion of gases through the resp membrane depend on?
Thickness (can get thicker if there is inflammation, or other issues can cause this)
Surface area (How many alveoli are present?)
Diffusion coefficient of the gas (This does not change. They fuse at whatever rate they do)
Pressure difference across the membrane
Gas concentrations equilibrate between the ___ ___ and ___ ____ as blood passes through the lung
Alveolar air
Pulmonary capillary
Gas concentrations equilibrate between the _____ _____ and ____ ____ as blood passes through the tissues
Systemic capillaries
Interstitial fluid
Atelectasis can cause alveolar:
Collapse
Alveolar fibrosis can cause:
Thickening of alveolar wall
Emphysema can cause:
Alveolar-capillary sdestruction
Pneumonia can cause
Alveolar consolidation
Pulmonary edema can cause:
Frothy secretions
Review picture in slide 35
Slide 35
An increase in blood flow through a tissue will increase:
An decrease:
(In interstitial fluid)
PO2
PCO2
An increase in tissue metabolism will (INCREASE/DECREASE) PO2 and (INCREASE/DECREASE) PCO2 in the interstitial fluid
decrease O2
Increase PCO2
Normally, as tissue metabolism changes, so does:
Blood flow (autoregulation)
As pressure of O2 in blood increases, what happens to hemoglobin saturation percentage?
It increases
Pressure of O2 with reduced blood returning from the tissues
20-45 mm Hg (approx)
Pressure of O2 in oxygenated blood leaving the lungs
Approx 80-129 mm Hg
Bohr effect shows:
PH
CO2
Temperature
BPG
Shifts to the right
What can cause a shift to the right in pressure o fO2 in blood vs hemoglobin saturation?
Increased hydrogen ions
Increased CO2 (which can also increase hydrogen ions)
Increased temperature
Increased BPG
Forms of CO2 transport
Dissolved CO2
Bicarbonate (most)
Carbaminohemoglobin
What happens in a chloride shift?
As bicarbonate diffuses out of the RBC, Cl- diffuses in to establish electrical neutrality
Review picture in slide 39
Slide 39
Rule of Haldane effect for CO2
As O2 is released from hemoglobin, the affinity for CO2 increases
This allows some CO2 to hitch a ride on deoxygenated hemoglobin (I.E. carboaminohemoglobin)
The dorsal respiratory group receives sensory input from ______ and _____ from:
CN IX and C
Peripheral chemoreceptors and Baroreceptor
In the dorsal respiratory group, efferents stimulate:
Inspiration (ramp signal)
What respiratory groups are located in the medulla oblongata?
Dorsal and ventral respiratory groups
Ventral respiratory group functions only in:
It control:
Heavy ventilation
Controls both inspiration and expiration
Where is the pneumotaxic center located?
In the pons
Pneumototaxic center controls:
Duration of inspiration set by the dorsal respiratory group therefore influencing rate and depth of breathing
What prevents excessive lung inflation?
Hering-Breuer reflex
What effects the respiratory center directly to increase respiratory rate>
Hydrogen ions and CO2
What has an indirect effect via carotid and aortic body chemoreceptors?
Oxygen
Receptor cells near the resp center respond to changes in:
Receptor cells in the carotid and aortic bodies respond to:
Higher centers in the cortex can exert:
Cerebrospinal fluid H+ caused by increases in arterial CO2
Large decreases in arterial O2
Conscious control over respiration
Obstructive lung diseases does what to airflow? Why?
Increase resistance
As a result of reduction in the diameter of airways.
Can also result from processes within the lumen, wall or supporting structures of the lung
Examples of obstructive lung diseases
Asthma
Emphysema
Obstructive lung diseases tend to have increased:
TLC, RV and decreased VC
Obstructive lung disease is characterized by:
“Air trapping”
Inflammation or scarring of the lung and airway tissues is known as:
Restricted (constricted) lung diseases
Restricted (constricted) lung diseases are associated with:
Increased lung elastic recoil and decreased compliance
Example of restricted (constricted) lung diseases
Pneumonia
Tuberculosis
Atelactasis
Restricted (constricted) lung diseases tend to have (INCREASED/DECREASED) TLC, RV and VC
Decreased
Which lung disease has trouble with inflation?
Restricted (constricted) lung disease
What is measured as a rate of air flow (L/min) during a forces maximal expiration following a maximal inspiration to total lung capacity?
Maximal excitatory flow (MEF)
What is a measurement of lung volume (L) produces by a maximal forced expiration following a maximal inspiration to total lung capacity?
Forced vital capacity (FVC)
What is a measurement of the volume of air (L) expired during the first second of maximal forced expiration following a maximal inspiration?
Forces expiratory volume (FEV1)
FEV1 / FVC X 100 =
80% normally
Lack of oxygen
Hypoxia
How can hypoxia be caused?
By inadequate delivery of oxygen to tissues by the resp system, or by a deficient utilization of O2 by the cells
Excess of CO2 in the body fluids commonly due to hypoventilation or diminished blood flow
Hypercapnia
Blueness of the skin caused by excess deoxygenated blood in the capillaries
Cyanosis
Mental anguish associated with the inability to ventilate enough to satisfy the demand for oxygen (air hunger)
Dyspnea
Obstructive lung disease
Chronic obstruction of airways (mucus, edema, infection) due to chronic bronchitis
Chronic Pulmonary Emphysema
Emphysema is typically due to
Cigarette smoking
Problems with emphysema
Destruction of alveolar walls and connective tissue
Emphysema causes
Permanent enlargement of the airspaces distal to the terminal bronchioles
Symptoms of emphysema
Decreased breath sounds
Tachycardia and pulmonary hypertension
Hyperinflation of lungs (barrel chest)
TLC and RV are increased (air trapping)
VC is decreased
FVC and FEV1 are decreased
Hypoxia and hypercapnia
Polycythemia
Emphysema and chronic bronchitis
COPD
COPD with emphysema worse
Pt is skinny with pinker skin (Pink puffer) and puffed out chest
COPD with worse bronchitis
Blue skin and bloated (Blue bloater)
What type of disease is pneumonia?
Restricted lung disease
Inflammation of the lung in which the alveoli become filled with fluid and blood cells
Pneumonia
What usually causes pneumonia?
Infection with pneumococci bacteria
T/F- Pneumonia is associated with pulmonary edema
true
It increases diffusion distance in the resp membrane
Symptoms of pneumonia
Fever
Cough (productive)
Hypoxia and hypercapnia
TLC, RV, VC are reduced
Decreased ventilation/perfusion ratio
What type of lung disease is atelectasis
Restrictive
Collapsed lung (alveoli) due to total airway obstruction, lack of surfactant, or pneumothorax
Causes tissue behind the obstruction to collapse, therefore will cause restriction
Atelectasis
Symptoms of atelectasis
Chest tightness, pain
Sydpnea
Hypoxia and hypercapnia
TLC, RV and VC decreased
FVC and FEV1 are decreased
What type of lung disease is asthma
Obstructive
Bronchial hyper responsiveness to a variety of allergens, chemicals, etc.
produces bronchoconstriction
Asthma
What can exacerbate asthma
Exercise and cold
Asthma will cause what?
Airway inflammation, hyper-secretion of mucus
Symptoms of asthma
Cough
Wheezing
Dyspnea
Chest tightness
Reduces ventilation rate and tachycardia
TLC and RV are increased
VC is decreased
FVC and FEV1 are decreased
hypercapnia and hypoxia
Respiratory acidosis
What type of lung disease is tuberculosis
Restricted
Tuberculosis is a lung infection caused by:
This causes:
M. Tuberculosis bacilli
Scarring and destruction of tissue
What happens with tuberculosis
Macrophages wall of lesion with fibrous tissue reducing surface area and thickening of the respiratory membrane
Symptoms of tuberculosis
Cough (productive)
Dyspnea
TLC, VC and RV are reduced
Muscle strength is determined by:
Strength (3-4 kg/cm3 of muscle cross-sectional area)
Power is classified as
Work per unit time
Endurance is determined by:
Glycogen stores— time to complete exhaustion
Energy generating systems
Phosphogen system
Glycogen-lactic acid system
Aerobic system
Phosphocreatine gets converted to:
Creatine and PO3-
Generates energy
Glycogen (stored in the _____) gets converted into
Liver
Lactic acid
End product of glucose, fatty acids and amino acids in the presence of O2
CO2 + H2O + Urea
Moles of ATP per minute for:
Phosphogen system
Glycogen-lactic acid
Aerobic
4 mol/min
2.5 mol/min
1 mol/min
Endurance (time until energy source runs out) for
Phosphogen system
Glycogen-lactic acid
Aerobic
8-10 sec
1.3-1.6
Unlimited as long as nutrients last
Review slide 60. Not sure how to put into a flashcard.
Slide 60
what type of diets provide high muscle glycogen content?
High carb diet
What diet gives a low glycogen content
Fat and protein diet
Contraction times for
Slow twitch:
Fast twitch A
Fast twitch B
Slow
Fast
Very fast
Size of motor neuron for
Slow twitch:
Fast twitch A:
Fast-twitch B:
Small
Large
Very large
Resistance to fatigue for
Slow twitch:
Fast twitch A:
Fast-twitch B:
High
Intermediate
Low
Activity for
Slow twitch:
Fast twitch A:
Fast-twitch B:
Aerobic
Long term anaerobic
Short term anaerobic
Force production for
Slow twitch:
Fast twitch A:
Fast-twitch B:
Low
High
Very high
Mitochondrial density for
Slow twitch:
Fast twitch A:
Fast-twitch B:
High
High
Low
Capillary density for
Slow twitch:
Fast twitch A:
Fast-twitch B:
High
Intermediate
Low
Oxidative capacity for
Slow twitch:
Fast twitch A:
Fast-twitch B:
High
High
Low
Glycotic capacity for
Slow twitch:
Fast twitch A:
Fast-twitch B:
Low
High
High
3 muscle fiber types
Slow-twitch
Fast-twitch A
Fast twitch B
Slow twitch muscles use ______ for fuel.
They provide _____ energy, offers _____ muscle contraction, fires (FAST/SLOWLY), has (HIGH/LOW) endurance, and is great for _____
Oxygen
Continuous
Extended
Slowly
High
Marathoners
Fast twitch muscles uses _____ _____ for fuel, provides _____ ____ of speed, fires (SLOWLY/RAPIDLY), fatigues more (SLOWLY/QUICKLY), great for _____
Anaerobic metabolism
Short bursts
Rapidly
Quickly
Sprinters
Look at chart on slide 66
Slide 66
What is the most important factor in endurance athletics
Oxygen delivery to the working muscle
Pulmonary ventilation (IS/IS NOT) the limiting factor in O2 delivery in healthy individuals
Is not
What is the limiting factor in O2 delivery in healthy individuals?
the hearts CO
Normal resting O2 consumption
250 ml/min
O2 consumption during max exercise
3600-5100 ml/min depending on fitness level
Max exercise pulmonary ventilation
100-110 L/min
Max breathing ability
150-170 L/min
Rate of O2 usage in maximum aerobic metabolism =
VO2 Max
Untrained people who begin training can (INCREASE/DECREASE) VO2 max by ___% in 14 weeks
Trained endurance can to a ____%
Increase
10
45% increase
Review chart in slide 68
Slide 68
Diffusing ability for:
Non-athlete:
Swimmer:
Oarsman:
48 ml/min
71 ml/min
80 ml/min
Reason for increase in diffusing ability
Due to increased blood flow and more open capillaries
What happen to blood gas concentrations during aerobic exercise?
It does not change significantly
Increase in ventilation is due to what?
Neurogenic responses:
Motor cortex
Sensory feedback from working muscles
Why does a the blood gas concentration stay roughly the same during exercise?
Heart rate and ventilation increase so it helps keep up the transfer of gases .
Work output/ O2 consumption and CO have a ____ relationship
Linear
An untrained person can increase CO by how much during exercise?
What about a trained athlete?
4x
6x
Cardiac hypertrophy can be seen in _____ training but not ______ training
Endurance
Sprint
Increased CO during exercise is due to:
Cardiac hypertrophy (heart muscle mass)
Resting stroke volume in
Non athlete:
Marathoner:
75 ml
105 ml
Stroke volume maximum in
Nonathlete:
Marathoner:
110 ml
162 ml
Resting heart rate for nonathlete:
Marathoner:
75 bpm
50 bpm
Max heart rate in non athlete:
Marathoner:
195
185
As CO increases, what happens to stoke volume?
Increases, then plateaus
What happens to heart rate as CO increases?
Increases (slowly) - will plateau but later on
CO where stroke volume tends to plateau
10-15 L/min
