Week 3-4 Study Guide Flashcards
Another name for nostrils
External nares
Internal nares
Opening from the nasal cavity into the pharynx
Nasal Cavity
Interior chamber of the nose
Choanae
The Choanae are the posterior nasal aperture, separated by the vomer. It is the opening between the nasal cavity and the nasopharynx.
The choanae are the internal nares which connect the oral cavity to the nasal passages and are crucial for proper nasal respiration
Nasal Septum
Divides nose into two parts
External Nares
Openings through which air enter the nasal cavity
Palate
separates the nasal cavity from the oral cavity
Pulmonary ventilation
Breathing
Inhalation
process of taking air into lungs
Purpose of the diaphragm
Dome-muscle separates thoracic cavity from abdominal cavity
Respiratory Center
Consists of groups of neurons located in the following regions:
Pons
Medulla Oblongatta
When Carbon Dioxide is increased in blood, What happens?
Stimulates respiratory center to increase rate and depth of breathing.
Cause muscle contractions
The exchange between blood and tissue
Ventilation, External Respiration, Internal Respiration
What makes up the lower respiratory tract?
Trachea
Bronchial Tree
Lungs
What lines the paranasal sinuses?
Mucous membrane
What function does mucous membrane have in the respiratory tract?
Traps microorganisms, dust, & other foreign particles
What propels mucus towards the pharynx?
cilia
What does the Eustachian tube open into?
Nasopharynx – helps to equalize air pressure on both sides of the tympanic membrane
What is the purpose of the oropharynx?
Receives air, food, and water form the oral cavity
What is the purpose of the epiglottis?
Prevents food and water from entering the trachea
Lay term for the thyroid cartilage
Adam’s apple
What are the vocal cords made up of?
Two pairs of ligaments, upper and lower
What supports the trachea?
15-20 C-shaped pieces of hyaline cartilage
The correct division of the bronchial tree
Primary Bronchi
Secondary bronchi (lobar)
Tertiary bronchi (segmental)
bronchioles
Aveoli
Characteristics of the right lung
- shorter
- broader
- greater volume than left lung
- divided into three lobes by two fissures
three lobes:
1. superior
2. middle
3. inferior
What is the purpose of the pleura?
Double-layered serous membrane that encloses the lungs
What partially divide the fossa?
2 names that are interchangeable
- Turbinates
- Conchae
What is the purpose of the highly vascularized mucous membrane that lines the nose?
- Filters air
- Moistens (warms) the air
Respiration:
Pulmonary Ventilation -
Breathing
Respiration:
Gas exchange
Blood to lungs
Happens at the aveoli
O2 & CO2
Respiration:
What are the functions of the respiratory system?
Pulmonary Ventilation
Gas exchange
Respiration:
What are the functions of the circulatory system?
Transport (O2 & CO2 in the blood)
Internal Respiration (Blood –> tissues –> ATP
Where is the location of the pharyngeal (adenoid) tonsils?
Nasopharynx
Nasopharynx (what enters)
Air only
above soft palate & posterior to. internal nares
Auditory tube opens into nasopharynx
Location of adenoids (pharyngeal tonsils)
Oropharynx (what enters)
Air, liquid, solid
from soft palate to hyoid bone
At rear of oral cavity
Location of the palatine and lingual tonsils
What is the location of the palatine & lingual tonsils?
Oropharynx
Laryngopharynx - what enters?
air, liquid, solid
extends to trachea & larynx
Esophagus - food & liquids
Trachea - air
What directs food and liquid to the esophagus?
Layrynx - the pathway
What is the superior opening into the larynx?
Glottis
What is the moveable flap that opens and closes eating and breathing?
Epiglottis
Is Nervous system controlled
Swallow - flap over the lung pathways
What do infants do to the epiglottis so they can drink and breathe at the same time?
Lock the soft palate and epiglottis together
Put in order the Pathways for air coming into the glottis
- Conchae
- Venous Plexus
- Internal nares
- Nasopharynx
- Oropharynx
- Laryngopharynx
- Epiglottis
- Glottis
Voice refers to…
Production (vocalization) of sound created by vocal fold production
Sound production happens where?
Vocal folds
How is pitch determined?
Pitch is determined by the tension on the folds.
More tension = higher ptch
Lower tension - lower pitch
How is loudness determined?
Loudness is determined by air pressure
More volume - more air pressure
Measured in decibels - loudness
What has smooth muscle and C-shaped cartilage that allows expansion of the esophagus?
Trachea
What is the trachea lined with?
Ciliated pseudostratified epithelium
with goblet cells
What is the function of goblet cells?
secretion
Produces mucous
What is the coughing muscle?
Trachealis
Are the lungs symmetrical or asymmetrical?
asymmetrical
Which lung has three lobes?
Right Lung
Which lung has two lobes?
Left lung
Which lobe of the lung is most likely to have inhaled objects lodge there?
Right lung
Because of its larger size
Which lobe of lung has larger bronchus?
Right lung
Which lobe of lung has smaller and narrower bronchus?
Left lung
What part of lung lacks cartilage but has smooth muscle?
Bronchioles
Where is the beginning of the respiratory zone?
Terminal bronchioles
Where is the end of the respiratory zone where gas exchange occurs?
aveoli
What kind of pipe is the trachea?
Reinforced pipe
because of the c-shaped cartilage and smooth muscle
How many branches are in the bronchiole tree?
23 branches
Order of respiratory zone –
Terminal Bronchioles –> respiratory bronchioles –> alveoli
Respiratory zone is the site of-
Gas exchange
What reduces pulmonary tension?
pulmonary surfactant
The pleura - serous membranes have…
2 layers and a cavity
- Parietal pleura
- Visceral Pleura
- Pleural cavity filled with - Pleural fluid
Parietal pleura –
(ON) – Lines thoracic wall & diaphragm
Visceral pleura –
(ON) – Lines external lung surface
On the organ - lungs
The pleural cavity - space between the two pleuras helps what?
Maintain the pressure gradient
It’s pressure is a bit lower than te atmospheric pressure allowing for pressure gradient
What is important about the pleural fluid?
it reduces friction
Do the respiratory muscles touch the lungs?
NO
What are the respiratory muscles?
Intercostal and
Diaphragm
Intrapleural pressure is higher or lower than atmospheric pressure?
slightly lower - 756 mmHg
VS
Atmospheric pressure of 760 mmHg
Shape of lungs and alveoli make them want to…
collpase
Shape of the thoracic cavity makes it want to…
expand
What influences the volume in lungs?
Suction/atmospheric pressure
Space
What happens to the pressure when the lungs increase in volume?
pressure goes down
What happens to the pressure when the lungs decrease in volume?
Pressure goes up
What are the three steps of respiration?
- Ventilation (breathing)
- External respiration
- Internal respiration
Ventilation =
Breathing - air in and out of lungs
Relies on pressure, but we cannot control the air
In Ventilation what manipulates the volume and changes the pressure?
Muscle contraction (intercostals & diaphragm)
What is the formula for Boyles Law?
P1V1 = P2V2
P1V1 = inspiration
P2V2 = expiration
What happens during inspiration
with volume and pressure?
Inspiration
Volume up – Pressure down
What happens during expiration
with volume and pressure?
Expiration
Volume down – Pressure up
Boyles Law
as the volume of a container increases
the pressure within it decreases
and vice versa
P1V1 = P2V2
Pressure is the
force gas molecules put on walls of a container or walls of a blood vessel
Where is the gas exchange between blood and cells happening in the steps of respiration?
Inspiration
Diaphragm does 50-80% of the work depending on position
Supine requires more work
Where is the gas exchange between air and blood happening in the steps of respiration?
Expiration
at rest = mostly passive due to lung recoil & muscle relaxation (concaved diaphragm)
With activity = active muscle - contraction required
What shape are alveoli?
C-shaped
which creates massive surface area = 35 m2
What creates surface tension on the aveoli?
Surface area and small diameter creates surface tension
And the tendency to want to collapse
What is produced to reduce surface tension on the alveoli?
surfactant
Where is the surfactant to reduce surface tension on the alveoli produced?
The cuboidal alveoli cells produce surfactant
What happens in infant respiratory distress syndrome?
Premature birth –> lack of surfactant –> alveolar walls stick together
What are the components of the respiratory membrane?
- Lung & capillary epithelium
- Pulmonary capillary
- Surfactant (made by type II alveolar cells)
- Fluid & connective tissue
- Fused basement membranes
What is Dalton’s Law?
The total atmospheric pressure is the sum of the partial pressure of individual gases that make up the atmosphere
What is the formula for Dalton’s Law?
Total Pressure = P1 + P2 + P3 +….
% [gas A] * (Total Pressure) = partial pressure of gas A
At sea level, what is the pressure?
760 mmHg
What percentage of Nitrogen comprises the air?
78.10%
What percentage of Oxygen comprises the air?
20.93%
What percentage of Carbon Dioxide comprises the air?
0.03%
To find ppO2 at sea level where total pressure = 760 mmHg?
% [gas A] * (Total Pressure)
example:
ppO2 = (0.209) (760 mmHg) = 158.84 mmHg
Percent of Oxygen in atmosphere is 20.9%
Applying Dalton’s Law:
As we go up in elevation what changes?
Pressure changes
as elevation increases - pressure decreases
and vice versa
What is the O2 concentration at Denali?
20,000 ft = 360 mmHg
% [gas A] * (Total Pressure)
(0.209) (360 mmHg) = 75.24
Availability of oxygen is lower because of pressure change
High elevation =
Lower pressure
Fick’s law of diffusion
get across the membrane
` (A) (P1-P2) (D)
Vg = ——————–
(T)
` (A) (P1-P2) (D)
Vg = ——————–
(T)
Inversely proportional to —
Vg = Diffusion Rate
Thicker the membrane = less diffusion
Vg = Diffusion Rate
` (A) (P1-P2) (D)
Vg = ——————–
(T)
Directly Proportional to —
Vg = Diffusion Rate
Surface Area increases - more diffusion
Pressure decrease = less diffusion
Vg = Diffusion Rate
` (A) (P1-P2) (D)
Vg = ——————–
(T)
A =
A = Surface area of the membrane
Area up = Diffusion up
This is the number one thing!!!
More SA = gas exchange is up
` (A) (P1-P2) (D)
Vg = ——————–
(T)
P1-P2 =
P1-P2 = the difference in partial pressures across the membrane
P up - diffusion up
High low values
Only care about O2 & CO2
` (A) (P1-P2) (D)
Vg = ——————–
(T)
D =
D = Diffusion coefficient of the gas
Diffusion unique to the gas
` (A) (P1-P2) (D)
Vg = ——————–
(T)
T =
T = thickness of the membrane
Thick up = diffusion down
Scar tissue reduces surface area
Thickness up - area down = less diffusion
KNOW:
Partial pressure gradient of CO2 is small
But due to the unique diffusion coefficient
CO2 diffuses 20x faster than O2
CO2 = small gradient - easily crosses
O2 = big gradient - does not cross easily
How many more times does CO bind to hemoglobin VS oxygen?
200X
Applying Fick’s Law: how things go wrong
Pulmonary Edema
Issue - Left Ventricular weakness - fluid backs up to pulmonary circuit and builds up in lungs
Bad in gas exchange
- too much fluid
- CO2 retention - cannot get rid of it
- increase thickness
- hard to breathe
- increase pressure pushes fluid out of capillaries and into lungs – drowning in fluids
Decrease of diffusion = decreased surface are (scarring) & increased thickness
Gas (CO2) gets through membrane and Fluid
Applying Fick’s Law: how things go wrong
Chronic Obstructive Disorder (COPD)
End Stage Disease - complication
Issue - Smoking or irritants cause loss of lung elasticity, wall destruction, inflammation, and mucus.
- wall destruction - breakdown is a loss of surface area
- Excess mucus produced
- loss lung elasticity
Decrease diffusion = decreased surface area & increased thickness
External respiration -
Graph of Lungs
Alveoli. – Capillary
High PPO2 104 —-»—> 40
40. <——-«—— 45. High PPCO2
Internal Respiration -
Graph of Tissues
Capillary – Cells
High PPO2 104 —->—-> 40
40 <——–<—— 45 High PPCO2
External Respiration - Lungs
What is the driving force of diffusion?
Partial Pressure (CO2 & O2) is the driving force of Diffusion
External Respiration - Lungs
What is the difference between O2 & CO2 pressures?
O2 is hard to get across the membrane – need bigger pressure difference
CO2 easy to cross membrane – do not need a big pressure difference
External Respiration - Lungs
Blood –> Alveoli –> Air (out to lungs)
CO2 Partial Pressure Gradient levels for:
- Atmospheric Air. (breathe in)
- Alveolar Air. (once in body - has not p/u CO2 yet
- Venous Blood (just p/u CO2 from body - back to lungs to get rid of it)
- Arterial Blood. (just got rid of it @ lungs)
CO2 Partial Pressure Gradient levels for:
- ppCO2 Atmospheric Air = 0.3 mmHg – (breathe in)
- ppCO2 - Alveolar Air = 40 mmHg (once in body - has not p/u CO2 yet)
- ppCO2 Venous Blood = 45mmHg - (just p/u CO2 from body - back to lungs to get rid of it)
- ppCO2 Arterial Blood = 40 mmHg - (just got rid of it @ lungs)
External Respiration - Lungs
Air–> Alveoli –> Blood (into lungs)
O2 Partial Pressure Gradient levels for:
- Atmospheric Air. (lots of O2 in blood - body cells)
- Alveolar Air. (air moving from H to L)
- Venous Blood (Low O2 in blood - just delivered - deoxygenated blood)
- Arterial Blood. (just picked up O2)
O2 Partial Pressure Gradient levels for:
- ppO2 Atmospheric Air = 160 mmHg. - (lots of O2 in blood - body cells)
- ppO2 Alveolar Air = 104 mmHg. - (air moving from H to L)
- ppO2 Venous Blood = 40 mmHg - (Low O2 in blood - just delivered - deoxygenated blood)
- ppO2 Arterial Blood = 104 mmHg - . (just picked up O2)
Internal Respiration = Tissues
Blood <–> Tissues
ppO2 of body cells
ppaO2 of arterial blood
ppCO2 of body cells
ppCO2 of arterial blood
Internal Respiration = Tissues
Blood <–> Tissues
- ppO2 of body cells = 40 mmHg. (O2 low - just used O2 to make ATP)
- ppaO2 of arterial blood = 104 mmHg (just p/u O2 at lungs - should be high)
- ppCO2 of body cells = 45 mmHg (High because everytime you make ATP CO2 is produced - CO2 is high)
- ppCO2 of arterial blood = 40 mmHg (low because it has not p?u yet from capillary bed to head to lungs)
What helps deliver oxygen?
Hemoglobin
We need RBCs and Hemoglobin
O2 not very soluble
How many heme groups bind to an O2
4 heme groups bind to one O2
Meaning it is saturated.
Dissociation Curve:
At rest - what is the utilization coefficient?
25%
100% AT LUNGS -
RESTING STRIPS SOME = 25%
EXERCISE STRIPS MOST = 75%
Dissociation Curve:
Exercising - what is the utilization coefficient?
75%
100% AT LUNGS -
RESTING STRIPS SOME = 25%
EXERCISE STRIPS MOST = 75%
Dissociation Curve:
Lungs have what percent of oxygen?
100%
100% AT LUNGS -
RESTING STRIPS SOME = 25%
EXERCISE STRIPS MOST = 75%
Dissociation Curve:
Resting cells paO2 is how. much?
40 mmHg
Dissociation Curve:
Arterial paO2 is
100 mmHg
Dissociation Curve:
What happens with exercise?
Cellular paO2 falls
larger gradient
More O2 delivered
Internal Tissues
High –> Low PO2 & PCO2
Cap ————————— cells
PO2 104 mmHg –>–> 40 mmHg
40 mmHg <—-<—–<— PCO2 45 mmHg
CO2 transported three ways and percentages
- Dissolved in plasma = 10%
- Bound to Hemoglobin = 20%
- Bicarbonate (HCO3-) = 70%
O2 transported two ways and percentages
- Dissolved in plasma = 2%
- Bound to Hemoglobin = 98%
Chloride shift happens 2 ways:
- CO2 from tissues into RBC = HCO3- (bicarbonate) (dissociates from Carbonic Acid) shifts out and Chloride (CL-) enters the cell
- CO2 from RBC to lungs = HCO3- (bicarbonate) comes back in the cell and Chloride (Cl-) goes back out of cell. HCO3- combines with H+ to create carbonic acid to then dissociate and become CO2 and H2O
Why does CO2 need to get into blood?
to control pH and get rid of it
Slow respiration (Hypoventilation)
pH affect?
Not getting enough CO2
H+ goes up, HCO3- goes up
pH goes down
Kidney stops filtering out HCO3-
One H+
What is the ratio 20 to 1:
20 bicarb ions for 1 carbonic acid
How many binding sites on hemoglobin for oxygen?
4 heme groups for Oxygen
What parts of the brain work together in breathing?
medulla & pons
How does the body respond when it detects high CO2?
Sends signals to muscles to breathe more
What monitors the CO2 and regulates breathing?
Medulla
Diffuse system of neurons with pathways for inspiration & expiration
What is the normal range of paCO2?
PaCO2 range is 35-45 mmHg
What are the higher cortical centers in breathing?
Cortex - limited voluntary control
Hypothalamus - emotional influence (crying and laughing) - hyperventilate - calm down
What receptor monitors CO2?
Chemoreceptor
Medulla Oblongata
It responds to high CO2
Increases ventilation rate
What chemoreceptors monitor paCO2, paO2, & pH?
Peripheral Chemoreceptor
common carotid artery & aorta
Monitors Oxygen
High Altitude hypoxia
low paO2. & low pressure
Climbers hyperventilate to acquires O2
Relies on chemoreceptors - harder for body to know if O2 is correct in the body
Chronic Alkalosis
What are the symptoms of Acute mountain sickness?
- Heavy breathing
- Nausea
- Dizziness
- Hallucintaion
- Headache
- Upset stomach
Uses chemoreceptors
Usually happens after gaining 8000feet
What receptors do COPD use
chemoreceptors
What can happen to a COPD patient if excess O2 was delivered?
Apnea & Death
Body shifts from monitoring oxygen instead of CO2
It tells the body that no more need to breathe. It thinks
Blood Pressure Increased
what happens to ventilation
Decreases ventilation - slow breathing
Blood Pressure Decreased
what happens to ventilation
Increases ventilation - more breathing
What hormone increases Blood Pressure and Respiration during fight or flight?
Epinephrine
What happens to ventilation when you exercise?
Ventilation increases slight;y but depth increases greatly
pCO2 can decrease
Why can PCO2 decrease during exercise?
- Psychological- anticipation
- Skeletal muscle & respiratory centers may activate simultaneously
- Joint & Tendon Receptors could signal resiratory centers
What can the lungs only deal with?
CO2
What can the urinary system deal with in respiration equation?
H+ & HCO3-
What is the direct relationship in acid-based disturbances?
Bicarb (HCO3-) ⬆️ & pH ⬆️
Bicarb ⬇️ & pH ⬇️
What is the inverse relationship in acid-based disturbances?
CO2 ⬆️ & pH ⬇️
CO2 ⬇️ & pH ⬆️
Values to know in the acid-base disturbances
pH
paCO2
HCO3-
pH = 7.35-7.45
paCO2 = 35-45 mmHg
HCO3- = 22-26 mEq/L
paO2 = 80-100 mmHg
SO2 = 95-100%
Remember that
pH 7.35 & paCO2 35
pH 7.45 & paCO2 45
What drives respiratory acid-based disturbances?
CO2 drives respiratory
CO2 ⬆️
pH ⬇️
What drives metabolic acid-based disturbances?
HCO3- drives metabolic
HCO3- ⬇️
pH. ⬇️
Respiratory Acidosis
CO2 ⬆️
pH ⬇️
Inverse
pH 7.35 (below) = acidosis
Made H+
producing HCO3-
(CO2 + H2O) <–> H2CO3 <–> (HCO3- + H+)
respiratory. ∆. metabolic
Respiratory Alkalosis
CO2 ⬇️
pH ⬆️
Inverse
pH 7.45 (above) = alkalosis
producing HCO3-
(CO2 + H2O) <–> H2CO3 <–> (HCO3- + H+)
respiratory. ∆. metabolic
Metabolic Acidosis
HCO3- ⬇️
pH. ⬇️
Direct relationship
(CO2 + H2O) <–> H2CO3 <–> (HCO3- + H+)
respiratory. ∆. metabolic
Metabolic Alkalosis
HCO3- ⬆️
pH. ⬆️
Direct relationship
(CO2 + H2O) <–> H2CO3 <–> (HCO3- + H+)
respiratory. ∆. metabolic
What pH is acidosis?
low pH
7.35 ⬇️
What pH is alkalosis?
high pH
7.45 ⬆️
Emphysema = Inflation
Alveolar walls destroyed & elasticity lost
Damage & Elastic recoil loss –>
contributes to airway collapse
Can lead to Right Ventricle enlargement due to overworking
KEY CHARACTERISTICS:
1. smoking inhibits the production of enzyme that stabilizes lysozomal membrane. -
- Due to lack of enzyme…lysozomes rupture & release digestive enzymes and eat alveolar walls, etc.
Pulmonary capillaries destroyed
⬆️ resistance, ⬇️ BF to long
Bronchial Asthma. (to Pant)
Bronchospasms
Contraction/spasm of smooth muscle of bronchioles → reducing air flow
Coughing, dyspnea, wheezing, and chest tightness
Inflammation of the airways precedes bronchospasms
Airways thickened with inflammatory exudate magnify the effect of bronchospasms & interfere with diffusion
Often treated with epinephrine OR albuterol. → bronchodilation via inhibition of smooth muscle
Pneumonia (edema in lungs)
Scarring
Often associated with bacterial or viral infections
Can result from aspiration of foreign objects or chemicals/solvents. - anything that should not be in the lungs
Fluid increases thickness of respiratory membranes
Decrease diffusion rate of gases
TB
Infectious disease caused by the bacterium Myocabacterium tubercolosis (related organism that causes leprosy)
Can get better and then get sick again later in life
Pathogen can survive inside the macrophage (does not breakdown)
Reactivate during immune suppression years after initial infection
Macrophage suppresses growth, but can disperse the bacteria to other body locations
Genetic - Cystic Fibrosis
inflammatory in lungs
impacts digestive, UTI, reproductive - risky/zilch
Most common disease in caucasians
Homozygous will show it
CF results in abnormal secretory activity of exocrine glands → symptoms include mutliple systems
FYI - protein channel involved in movement of specific ions is involved
Salty, sweaty, mucus in lungs & digestive system
Smoking - complications/impacts
Nicotine = vasoconstriction → stresses heart
turns off/sensitizes goblet cells - lowers mucus
Paralyzes cilia → smokers cough
inhibits AT enzyme → leads to emphysema
CO binds to Hb → reducing O2 carrying capacity
Inhibits collagen production (age poorly)
Cancer of lung
COPD
endstage condition → chronic bronchitis, emphysema, or asthma (generally smokers)
Irreversible decrease in the ability to force air out of the lungs
Common features of COPD
History of smoking in 80% of patients
Dyspnea - labored breathing - air hunger
Coughing and frequent pulmonary infections
Develop respiratory failure (hypoventilation) accompanied by respiratory acidosis
