Unit 4 Flashcards

1
Q

Respiratory tree

A
Larynx
Trachea
Primary bronchi 
2ndary bronchi
Tertiary bronchi
Bronchioles
Terminal bronchioles
Respiratory bronchioles
Alveolar ducts
Alveolar sacs with alveoli
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2
Q

Trachea supplies:

A

Both lungs

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3
Q

Primary bronchi supplies:

A

Each lung

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4
Q

2ndary bronchi supplies

A

Each lobe

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5
Q

Tertiary bronchi supplies:

A

Each bronchopulmonary segment (lobule)

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6
Q

Areas of the resp tree that are capable of gas exchange

A

Respiratory bronchioles

Alveolar ducts

Alveolar sacs with alveoli

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7
Q

Active muscles of inspiration

A
Diaphragm
External intercostals
Sternopcleidomastoid
Serratus anterior
Scalenus muscles
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8
Q

Muscles of expiration (only needed for FORCEFUL expiration)

A

Rectus abdominus, obliques

Internal intercostals

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9
Q

What increases during inspiration

A

Vertical diameter

AP diameter

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10
Q

What contracts during inspiration?

A

External intercostals

Diaphragm

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11
Q

What happens to the rib cage during inspiration

A

It elevates (duh)

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12
Q

What happens with internal intercostals during inspiration

A

They relax

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13
Q

Inspiration is due to:

A

Muscle contraction which increases thoracic cage size

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14
Q

Compliant lungs inflate due to:

A

Negative pressure in the pleural cavity

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15
Q

Expiration is due to:

A

Decreasing thoracic cage size bc of the elasticity of the thoracic soft tissue and the lungs themselves

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16
Q

What happens to alveolar pressure during inspiration?

Expiration?

A

Decreases during insp

Increases during exp

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17
Q

What happens to pleural pressure during inspiration?

Expiration?

A

Insp- decreases

Exp- increases

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18
Q

Tissue gradience between alveolar and pleural pressures

A

Transpulmonary pressure

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19
Q

Lung volume during inspiration?

Expiration?

A

Insp- increases

Exp- decreases

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20
Q

Intrapulmonary (alveolar) pressure oscillates around:

What happens when negative?

A

0

Air enters lungs (air leaves when positive)

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21
Q

The lowest intrapulmonary pressure is reached:

After that:

A

Halfway into inspiration

After that air entering the lungs raises the pressure

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22
Q

The highest intrapulmonary pressure is reached at:

After that:

A

Halfway into expiration

After that, air leaving the lungs reduces the pressure

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23
Q

Intrapleural pressure is always:

This exerts:

A

Negative compared to the atm, oscillating around -4.

This exerts an expanding effect on the lungs due to lung compliance

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24
Q

The difference between the alveolar pressure and the pleural pressure

A

Transpulmonary pressure

Ptrans = Plv - Pip

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25
Type I pneumocytes
Lines the alveolar walls (squamous)
26
Type II pneumocytes
Secrete pulmonary surfactant Necessary to keep alveolar inflates
27
Purpose of pulmonary surfactant
Breaks surface tension of the fluid layer lining the alveolar walls
28
Premature babies lack:
Sufficient surfactant Will develop resp distress syndrome
29
Commonly used pulmonary function test. Pt breathes in a tube which is monitored
Spirometetry
30
Spirometer measures
Tidal volume Ins reserve volume Exp reserve volume Residual volume
31
Tidal volume
Normal breathing at rest
32
Inspiratory reserve volume
Deepest breath in
33
Expiratory reserve volume
Breath out as much as you can
34
Residual volume
Amount of gas remaining in the lungs after exp. reserve volume
35
Capacities of spirometry
Inspiratory Functional residual Vital Total lung
36
Inspiratory capacity
Tidal volume + insp reserve volume
37
Functional residual capacity
Exp reserve volume + residual volume
38
Vital capacity
Exp reserve volume + tidal volume + insp reserve volume — all the way in, all the way out
39
Total lung capacity
All 4 volumes added together
40
Minute resp volume =
Tidal volume X Resp rate Looking for how much air goes in and out of your lungs within a minute
41
Dead air space
Air that fills respiratory passageways that are not capable of gas exchange with the blood
42
Anatomic dead air space
Air in trachea to the terminal bronchioles
43
Alveolar dead air space
Damaged or under perfused alveoli
44
Physiological dead air space
Sum of anatomic AND alveolar dead air space
45
Review slide 11
Slide 11
46
Alveolar ventilation rate
Total volume of new air entering the alveoli each min
47
Equation for alveolar ventilation rate
Va = freq (Vt-Vd) ``` Va = alveolar ventilation rate freq= respiration rate Vt= tidal volume Vd= Physiologic dead air space ```
48
Sympathetic effect on bronchioles
Causes bronchiolar dilation
49
Parasympathetic effect on bronchiolars
Causes bronchiolar constriction
50
Cough reflex is caused by
Irritation to bronchi and trachea
51
Neurons detecting bronchi and trachea irritation and efferent
``` Afferent neurons (vagus) To the medulla ``` Efferent neurons to muscles of epiglottis and abdomen
52
Sneeze reflex caused by
Irritation to nasal passageways
53
Neurons involved in sneeze reflex
Afferent neurons (trigeminal) Goes to the medulla Efferent- to muscles of the uvula and abdomen
54
How does the nose modify the air before reaching the lungs?
Air is: Warmed Humidified Partially filtered
55
Pressure is directly proportional to the:
Concentration of gas molecules in a system
56
Gases in breathes air are mainly:
Oxygen, nitrogen, CO2, and water vapor
57
Partial pressure: The total pressure exerted by a mixture of gases is equal to:
The sum of the individual pressures of each gas
58
Partial pressures in water and tissue fluid is determined by:
Gas concentration and solubility in the water or tissue fluid
59
(CO2/O2) is more soluble in water than the other
CO2
60
Air in the environment
Atmospheric air
61
Inspired air in anatomic dead air space
Humidified air
62
Air in gas exchange areas
Alveolar
63
Air in anatomic dead airs space as it exits the body
Expired air
64
Speech involves:
Respiratory system Cerebral cortex Phonation, resonance, and articulation structures
65
Mechanical functions of vocalization
Phonation Resonance Articulation
66
Phonation includes:
Larynx; vocal cords
67
Resonance includes:
``` Mouth Nose Sinuses Pharynx Chest cavity ```
68
Articulation includes:
Lips, tongue, soft palate
69
What are responsible for controlling sound production
The intrinsic laryngeal muscles
70
Intrinsic laryngeal muscles
Cricothyroid muscl Post cricoarytenoid muscles Lateral and transverse cricoarytenoid muscles Thyroarytenoid muscles
71
Cricothyroid muscles increase:
Tension on the vocal folds to raise pitch
72
Post. Cricoarytenoid muscle action
Abducts the arytenoid cartilages and therefore abducts the vocal cords
73
Lateral and transverse cricoarytenoid muscle action
Adduct and rotate arytenoid cartilages | Adduct the vocal cords
74
Thyroarytenoid muscle action
Shortening the vocal cords, lowering voice pitch
75
What do the extrinsic laryngeal muscles do?
Elevate or depress the larynx
76
Pressure of N2
597.0 mm Hg- 78.62%
77
Pressure of O2
159.mm Hg - 20.84%
78
Pressure of CO2
0.3 mm Hg- 0.04 %
79
Pressure of H2O
3.7 mm Hg- 0.50%
80
Total air pressure
760 mm Hg
81
Pressure of inspired N2
563.0 mm Hg - 74.09%
82
Pressure of inspired O2
149.3 mm Hg- 19.67 %
83
Pressure of inspired CO2
0.3 mm Hg- 0.04 %
84
Pressure of inspired H2O
47 mm Hg - 6.2%
85
Total pressure of inspired air
760 mm Hg
86
Pressure of Alveolar N2
569 mm Hg - 74.9%
87
Alveolar O2 pressure
104.0 mm Hg- 13.6%
88
CO2 alveolar air
40 mm Hg - 5.3 %
89
H2O alveolar air
47.0 - 6.2 %
90
N2 expired air
566.mm Hg- 74.5%
91
O2 expired air
120.0 mm Hg- 15.7%
92
CO2 expired air
27 mm Hg— 3.6 %
93
H2O expired air
47.0 mm Hg — 6.2 %
94
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
95
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
96
How many breaths does it take to totally replace alveolar air?
Approx 16 breaths
97
Respiratory membrane
The structures in between the alveolar space and the lumen of the capillary
98
How thick is the respiratory membrane?
0.2-0.6 micrometers
99
Layers of the resp membrane (6)
Fluid layer Alveolar epithelium Epithelial basement membrane Thin interstitial space Capillary basement membrane Capillary endothelium
100
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
101
Gas concentrations equilibrate between the ___ ___ and ___ ____ as blood passes through the lung
Alveolar air Pulmonary capillary
102
Gas concentrations equilibrate between the _____ _____ and ____ ____ as blood passes through the tissues
Systemic capillaries Interstitial fluid
103
Atelectasis can cause alveolar:
Collapse
104
Alveolar fibrosis can cause:
Thickening of alveolar wall
105
Emphysema can cause:
Alveolar-capillary sdestruction
106
Pneumonia can cause
Alveolar consolidation
107
Pulmonary edema can cause:
Frothy secretions
108
Review picture in slide 35
Slide 35
109
An increase in blood flow through a tissue will increase: An decrease: (In interstitial fluid)
PO2 PCO2
110
An increase in tissue metabolism will (INCREASE/DECREASE) PO2 and (INCREASE/DECREASE) PCO2 in the interstitial fluid
decrease O2 Increase PCO2
111
Normally, as tissue metabolism changes, so does:
Blood flow (autoregulation)
112
As pressure of O2 in blood increases, what happens to hemoglobin saturation percentage?
It increases
113
Pressure of O2 with reduced blood returning from the tissues
20-45 mm Hg (approx)
114
Pressure of O2 in oxygenated blood leaving the lungs
Approx 80-129 mm Hg
115
Bohr effect shows:
PH CO2 Temperature BPG Shifts to the right
116
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
117
Forms of CO2 transport
Dissolved CO2 Bicarbonate (most) Carbaminohemoglobin
118
What happens in a chloride shift?
As bicarbonate diffuses out of the RBC, Cl- diffuses in to establish electrical neutrality
119
Review picture in slide 39
Slide 39
120
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)
121
The dorsal respiratory group receives sensory input from ______ and _____ from:
CN IX and C Peripheral chemoreceptors and Baroreceptor
122
In the dorsal respiratory group, efferents stimulate:
Inspiration (ramp signal)
123
What respiratory groups are located in the medulla oblongata?
Dorsal and ventral respiratory groups
124
Ventral respiratory group functions only in: It control:
Heavy ventilation Controls both inspiration and expiration
125
Where is the pneumotaxic center located?
In the pons
126
Pneumototaxic center controls:
Duration of inspiration set by the dorsal respiratory group therefore influencing rate and depth of breathing
127
What prevents excessive lung inflation?
Hering-Breuer reflex
128
What effects the respiratory center directly to increase respiratory rate>
Hydrogen ions and CO2
129
What has an indirect effect via carotid and aortic body chemoreceptors?
Oxygen
130
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
131
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
132
Examples of obstructive lung diseases
Asthma | Emphysema
133
Obstructive lung diseases tend to have increased:
TLC, RV and decreased VC
134
Obstructive lung disease is characterized by:
“Air trapping”
135
Inflammation or scarring of the lung and airway tissues is known as:
Restricted (constricted) lung diseases
136
Restricted (constricted) lung diseases are associated with:
Increased lung elastic recoil and decreased compliance
137
Example of restricted (constricted) lung diseases
Pneumonia Tuberculosis Atelactasis
138
Restricted (constricted) lung diseases tend to have (INCREASED/DECREASED) TLC, RV and VC
Decreased
139
Which lung disease has trouble with inflation?
Restricted (constricted) lung disease
140
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)
141
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)
142
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)
143
FEV1 / FVC X 100 =
80% normally
144
Lack of oxygen
Hypoxia
145
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
146
Excess of CO2 in the body fluids commonly due to hypoventilation or diminished blood flow
Hypercapnia
147
Blueness of the skin caused by excess deoxygenated blood in the capillaries
Cyanosis
148
Mental anguish associated with the inability to ventilate enough to satisfy the demand for oxygen (air hunger)
Dyspnea
149
Obstructive lung disease Chronic obstruction of airways (mucus, edema, infection) due to chronic bronchitis
Chronic Pulmonary Emphysema
150
Emphysema is typically due to
Cigarette smoking
151
Problems with emphysema
Destruction of alveolar walls and connective tissue
152
Emphysema causes
Permanent enlargement of the airspaces distal to the terminal bronchioles
153
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
154
Emphysema and chronic bronchitis
COPD
155
COPD with emphysema worse
Pt is skinny with pinker skin (Pink puffer) and puffed out chest
156
COPD with worse bronchitis
Blue skin and bloated (Blue bloater)
157
What type of disease is pneumonia?
Restricted lung disease
158
Inflammation of the lung in which the alveoli become filled with fluid and blood cells
Pneumonia
159
What usually causes pneumonia?
Infection with pneumococci bacteria
160
T/F- Pneumonia is associated with pulmonary edema
true It increases diffusion distance in the resp membrane
161
Symptoms of pneumonia
Fever Cough (productive) Hypoxia and hypercapnia TLC, RV, VC are reduced Decreased ventilation/perfusion ratio
162
What type of lung disease is atelectasis
Restrictive
163
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
164
Symptoms of atelectasis
Chest tightness, pain Sydpnea Hypoxia and hypercapnia TLC, RV and VC decreased FVC and FEV1 are decreased
165
What type of lung disease is asthma
Obstructive
166
Bronchial hyper responsiveness to a variety of allergens, chemicals, etc. produces bronchoconstriction
Asthma
167
What can exacerbate asthma
Exercise and cold
168
Asthma will cause what?
Airway inflammation, hyper-secretion of mucus
169
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
170
What type of lung disease is tuberculosis
Restricted
171
Tuberculosis is a lung infection caused by: This causes:
M. Tuberculosis bacilli Scarring and destruction of tissue
172
What happens with tuberculosis
Macrophages wall of lesion with fibrous tissue reducing surface area and thickening of the respiratory membrane
173
Symptoms of tuberculosis
Cough (productive) Dyspnea TLC, VC and RV are reduced
174
Muscle strength is determined by:
Strength (3-4 kg/cm3 of muscle cross-sectional area)
175
Power is classified as
Work per unit time
176
Endurance is determined by:
Glycogen stores— time to complete exhaustion
177
Energy generating systems
Phosphogen system Glycogen-lactic acid system Aerobic system
178
Phosphocreatine gets converted to:
Creatine and PO3- Generates energy
179
Glycogen (stored in the _____) gets converted into
Liver Lactic acid
180
End product of glucose, fatty acids and amino acids in the presence of O2
CO2 + H2O + Urea
181
Moles of ATP per minute for: Phosphogen system Glycogen-lactic acid Aerobic
4 mol/min 2.5 mol/min 1 mol/min
182
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
183
Review slide 60. Not sure how to put into a flashcard.
Slide 60
184
what type of diets provide high muscle glycogen content?
High carb diet
185
What diet gives a low glycogen content
Fat and protein diet
186
Contraction times for Slow twitch: Fast twitch A Fast twitch B
Slow Fast Very fast
187
Size of motor neuron for Slow twitch: Fast twitch A: Fast-twitch B:
Small Large Very large
188
Resistance to fatigue for Slow twitch: Fast twitch A: Fast-twitch B:
High Intermediate Low
189
Activity for Slow twitch: Fast twitch A: Fast-twitch B:
Aerobic Long term anaerobic Short term anaerobic
190
Force production for Slow twitch: Fast twitch A: Fast-twitch B:
Low High Very high
191
Mitochondrial density for Slow twitch: Fast twitch A: Fast-twitch B:
High High Low
192
Capillary density for Slow twitch: Fast twitch A: Fast-twitch B:
High Intermediate Low
193
Oxidative capacity for Slow twitch: Fast twitch A: Fast-twitch B:
High High Low
194
Glycotic capacity for Slow twitch: Fast twitch A: Fast-twitch B:
Low High High
195
3 muscle fiber types
Slow-twitch Fast-twitch A Fast twitch B
196
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
197
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
198
Look at chart on slide 66
Slide 66
199
What is the most important factor in endurance athletics
Oxygen delivery to the working muscle
200
Pulmonary ventilation (IS/IS NOT) the limiting factor in O2 delivery in healthy individuals
Is not
201
What is the limiting factor in O2 delivery in healthy individuals?
the hearts CO
202
Normal resting O2 consumption
250 ml/min
203
O2 consumption during max exercise
3600-5100 ml/min depending on fitness level
204
Max exercise pulmonary ventilation
100-110 L/min
205
Max breathing ability
150-170 L/min
206
Rate of O2 usage in maximum aerobic metabolism =
VO2 Max
207
Untrained people who begin training can (INCREASE/DECREASE) VO2 max by ___% in 14 weeks Trained endurance can to a ____%
Increase 10 45% increase
208
Review chart in slide 68
Slide 68
209
Diffusing ability for: Non-athlete: Swimmer: Oarsman:
48 ml/min 71 ml/min 80 ml/min
210
Reason for increase in diffusing ability
Due to increased blood flow and more open capillaries
211
What happen to blood gas concentrations during aerobic exercise?
It does not change significantly
212
Increase in ventilation is due to what?
Neurogenic responses: Motor cortex Sensory feedback from working muscles
213
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 .
214
Work output/ O2 consumption and CO have a ____ relationship
Linear
215
An untrained person can increase CO by how much during exercise? What about a trained athlete?
4x 6x
216
Cardiac hypertrophy can be seen in _____ training but not ______ training
Endurance Sprint
217
Increased CO during exercise is due to:
Cardiac hypertrophy (heart muscle mass)
218
Resting stroke volume in Non athlete: Marathoner:
75 ml 105 ml
219
Stroke volume maximum in Nonathlete: Marathoner:
110 ml 162 ml
220
Resting heart rate for nonathlete: Marathoner:
75 bpm 50 bpm
221
Max heart rate in non athlete: Marathoner:
195 185
222
As CO increases, what happens to stoke volume?
Increases, then plateaus
223
What happens to heart rate as CO increases?
Increases (slowly) - will plateau but later on
224
CO where stroke volume tends to plateau
10-15 L/min