11-1: Structure Of Pulmonary System, Lung Capacities

Front 1

In the respiratory system, cartilage is present from the ______ to the _______.

Back 1

Trachea to Bronchi

Front 2

In the respiratory system, cilia is present from the ______ to the _______.

Back 2

Trachea to Respiratory Bronchioles

Front 3

How does cartilage distribution differ in the trachea and bronchi?

Back 3

Trachea: anterolateral distribution

Bronchi: distributed as plates of cartilage

Front 4

Goblet cells are located between ______ cells.

Back 4

Ciliated

Front 5

Which glands contribute most to mucus production in the respiratory system?

Back 5

Mostly submucosal gland contribution, but some goblet cell contribution

Front 6

K Cells:
Function
Clinical Significance

Back 6

Neuroendocrine cells with processes extending in lumen; may play a role in regional control of ventilation and perfusion

Potential to become neoplastic

Front 7

How does epithelial cell type differ along the tracheobronchial tree?

Back 7

Goes from pseudostratified columnar to single layer of cuboidal at level of terminal bronchioles

Front 8

How do the presence/number of Goblet Cells differ along the tracheobronchial tree?

Back 8

Decrease in number and are replaced by clara cells a TERMINAL bronchiole

Front 9

Role of Clara Cells

Back 9

Produce liquid layer of bronchiolar epithelium

Front 10

How does airway size and proportion of smooth muscle change along the tracheobronchial tree?

Back 10

Dec'd airway size, larger proportion of tree composed of cartilage

Front 11

Pleura:
What cells line it?
Static function?
Dynamic function?

Back 11

Lined by mesothelial cells
Static fn: couples to chest wall
Dynamic fn: lubricant, allows lung to move freely

Front 12

Acinus vs Secondary Pulmonary Lobule

Back 12

Acnius = primary pulmonary lobule; functional gas exchange unit of lung--consists of respiratory bronchiole, its alveola ducts and alveoli

Secondary Pulmonary Lobule = collection of 3-5 respiratory bronchioles bordered by interlobar septa

Front 13

Conducting Zone:
Function
ANS Innervation, NTs, and Effects

Back 13

Bring air into/out of lungs (Trachea-->Terminal Bronchioles)

Symp Innerv: beta-2 receptors act'd by epi-->dilation

Psymp: muscarinic receptors act'd by Ach-->constriction + inc'd mucosal secretions

Front 14

Function of Type II Pneumocytes

Back 14

1) Synthesize surfactant to reduce surface tension of alveoli

2) Regenerative capacity for Type 1 and Type 2 pneumocytes

Front 15

Why do alveoli require macrophages?

Back 15

Alveoli lack cilia; need macs to remove debris/dust

Front 16

What is tidal volume?

Back 16

Volume of air that fills alveoli and airways during quiet breathing

Front 17

What is inspiratory reserve volume?

Back 17

Add'l volume that can be inspired above tidal volume

Front 18

What is expiratory reserve volume?

Back 18

Add'l volume that can be expired above tidal volume

Front 19

What is residual volume?

Back 19

Volume remaining in lungs after maximal forced expiration; cannot be measured by spirometry

Front 20

What is inspiratory capacity?

Back 20

Tidal Volume + Inspiratory Reserve Volume

Front 21

What is functional residual capacity?

Back 21

Expiratory reserve volume + residual volume

AKA equilibrium volume--volume remaining after normal tidal volume expired

Front 22

What is vital capacity?

What factors increase/decrease it?

Back 22

Inspiratory capacity + expiratory reserve volume

Increases with size, male gender, physical conditioning; dec'd with age

Front 23

What mechanical factors determine total lung capacity?

Back 23

Inc'd inward respiratory recoil = reduced inspiratory muscle strength

Front 24

What mechanical factors determine residual volume?

Back 24

In children: Inc'd outward respiratory recoil = reduced expiratory muscle strength

In adults: determined by airway closure

Front 25

Back 25

Front 26

What tests are used to measure FRC? Why can't spirometry be used?

Back 26

Spirometry can't measure lung volumes that can't be exhaled (that remain in lung).

Use Helium dilution (breathe in known [ ] of He, breathe out diluted concentration of He, calculate volume of air in lungs that correlates with that concentration)

Body plethysmograph: employs Boyle's Law (P1V1=P2V2); patient in airtight box, inspires, volume decreases in box, calculate FRC from pressure change.

Front 27

Anatomic vs Physiologic Dead Space

Back 27

Anatomic Dead Space = volume of conducting airways; doesn't include respiratory bronchioles or alveoli. Doesn't participate in gas exchange and will be first air expired.

Physiologic Dead Space: total volume of lungs that doesn't participate in gas exchange. Includes FUNCTIONAL DEAD SPACE in alveoli (V/Q mismatch).

In normal persons, physiologic dead space = anatomic dead space

Front 28

For a tidal volume of 500 mL, how much of the volume is in anatomic dead space?

Back 28

150 mL

Front 29

How is alveolar air sampled?

Back 29

Must sample END-expiratory air (first air to be expired is air that was lingering in conducting airways--anatomic dead space)

Front 30

Causes of elevated physiologic dead space.

Back 30

Emphysema
PE
Mechanical Ventilation
Anesthesia

Front 31

Equation for determining Volume of Dead Space.

Back 31

VD = VT x [PaCO2-PECO2]/PaCO2

If no dead space, VD = 0
If dead space = tidal volume, VD=1.0

Front 32

What is minute ventilation?

Equation?

Back 32

Air moved into and out of lungs per unit time (minute)

VT x Breaths/Min

Front 33

What is alveolar ventilation?

Equation?

Back 33

Alveolar ventilation = minute ventilation corrected for physiologic dead space.

VA = (VT-VD) x breaths/min

Front 34

If CO2 production is constant, PACO2 is determined by ______.

Back 34

Alveolar ventilation

Front 35

When alveolar ventilation is halved, _________ is doubled.

Back 35

PACO2

Front 36

When alveolar ventilation is halved, _________ is halved.

Back 36

PAO2; slightly more than halved FYI

Front 37

What is forced vital capacity?

Back 37

Total volume of air that can be FORCIBLY expired after MAXIMAL INSPIRATION.

Front 38

Normal value of FEV1/FVC.

What does this volume mean?

Back 38

Normally 0.8, meaning, 80% of vital capacity expired in first second of forced expiration.

Front 39

When is FEV1/FVC decreased?

Back 39

Obstructive lung disease (asthma)

Front 40

When is FEV1/FVC increased?

Back 40

Restrictive lung disease (fibrosis)

Front 41

What is senile emphysema?

Back 41

Enlargement of alveolar ductal airspaces in elderly; dilation without destruction.