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156 Cards in this Set
- Front
- Back
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who defined respiratory as cellular respiration or internal respiration: utilization of oxygen at cellular level as an electron acceptor
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biochemist
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How do physiologist define respiratory?
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in terms of 4 processes:
-ventilation/breathing -diffusion of gases -transport of gases -regulation of breathing |
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functions of respiratory system
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gas exchange and non gaseous exchange
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primary, most important fxn of resp system
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gas exchange
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gas exchange fxns of resp system
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-allows for delivery of oxygen to cells
-allows for elimination of CO2 from body -regulation of acid/base balance |
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how do you control acid/base balance
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controlling CO2 levels
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What type of volatile acid does the lung release? How much per day?
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carbonic acid
approx 16000mEq/day equivalent to 2.5 L of HCL |
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CO2 + H20 =
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H2CO3, carbonic acid
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in water, what happens to carbonic acid
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readily dissociates into CO2 and H20
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after the dissociation of carbonic acid in the lungs, what happens to the CO2?
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exhale and rid from body
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how much acid is eliminated from the kidneys? what type of acids are they?
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60-80meQ/day
nonvolatile acids: fixed/keto acids lungs are quantitatively more imp in eliminating acids, but kidneys are qualitatively equally important |
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nongaseous exchange fxns of resp sys
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a. aids in venous return by thoracic pump
b. lungs serve as a blood reservoir for systemic circulation c.acts as a filter: emboli, cancer cells, cellular debris, air bubbles d.questionable role in blood clotting e. possess protective/defensive mechanisms f. lungs exhibit metabolic activity |
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what do the mast cells produce in the lungs?
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heparin, helps prevent emboli from forming and/or growing
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how does the resp sys, not just lungs, possess protective/defensive mech?
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removes pollutants and microorganisms from air (bacteria, virus, fungus)
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what is the metabolic activity exhibited by the lungs?
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its effect on certain vasoactive substances. They may be removed when pass thru the lungs.
Not referring to typical metabolic activity needed to keep cells alive |
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where does the metabolic activity of the lungs occur?
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endothelial cells lining the pulmonary vasculature
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The three levels of vasoactive activity
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-Lungs can inactivate certain vasoactive substances as they pass through pulmonary circulation
-Lungs can activate vasoactive substances -have no or little effect on vasoactive substances by lungs |
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vasoactive substances that are inactivated when passing through the lungs
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-bradykinin
-serotonin -NE |
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bradykinin is a ?
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vasodilator
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where is bradykinin inactivated, specifically?
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pulm veins
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inactivates bradykinin
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ACE
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action on vessels by serotonin
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constriction or dilation depending on vascular beds it is acting on
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NE does what to the vessels ?
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vasoconstrictor
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which vasoactive substances does the lungs inactivate the most of when they pass through pulmonary circulation?
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bradykinin and serotonin
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which vasoactive substance does the lungs inactivate the least when it passes through pulm circ?
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NE
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vasoactive substance activated by the lungs?
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Angiotension I
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Angio I + ______ = Angion II
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ACE
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2nd most potent vasoconstrictor
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angiotension II
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where is ACE found?
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endothelial cells of resp vasculature
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another name for ACE
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dipeptide hydrolase: uses water to split off two peptide bonds from Angio I, which converts it to Angio II
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vasoactive substances that have little or no effect to them from lung activity
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-vasopressin
-histamine -Epi |
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vasopressin is secreted by the?
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pituitary
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most potent naturally occurring vasoconstrictor in body
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vasopressin/ADH
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pulm effects of histamine
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bronchiole constriction and vasoconstriction
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systemic effects of histamine
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vasodilator
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vasoactive substances that have little or no effect to them from lung activity
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-vasopressin
-histamine -Epi |
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vasopressin is secreted by the?
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pituitary
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most potent naturally occurring vasoconstrictor in body
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vasopressin/ADH
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pulm effects of histamine
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bronchiole constriction and vasoconstriction
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systemic effects of histamine
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vasodilator
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effect of EPI in the lungs, constriction or dilation?
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both, depending on dose
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fxn of the defenses of the resp sys
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protect body a/g harmful airborne agents in the environment-particulate matter, microorganisms, noxious gases
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12 specific structures, substances, and mechanisms involved in defending resp sys
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-nasal hairs
-nasal conchae/turbinates -venous sinus plexus -mucus -cilia -alpha-1 antitrypsin (AAT) -resp lymph nodes -tonsils -cough reflex -sneeze reflex -parasymphathetic innervation of airways -laryngeal muscles |
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what serves as a large filter, to remove lg particulate matter?
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nasal hairs
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what facilitates the impaction of airborne particles?
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nasal conchae/turbinates
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venous sinus plexuses mainly occur where?
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middle and inferior nasal conchae
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what happens to cilia if they are cold?
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they do not beat well, will not clear contaminated mucus from airway
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what would happen if air were not warmed from the venous sinus plexus?
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air embolisms forming from the blood
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two things that produce mucus
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mucus glands and goblet cells
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how does mucus exist in the resp tract?
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as a double layer
Gel & sol |
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outer/thicker layer of mucus
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gel layer
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inner, thinner layer of mucus
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sol layer
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another name for sol layer
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periciliary fluid
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3 fxns of mucus
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-humidify inhaled air
-acts as a filter -destroy harmful agents |
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what is the removal of substances that are suspended in inhaled air?
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particle deposition
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3 methods used for particle deposition
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-impaction
-sedimentation -diffusion (brownian motion |
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removal of particles >5um from inhaled air
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impaction/inertia
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impaction/inertia primarily occurs where?
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nasal cavity, pharynx, carina
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impaction/inertia occurs particularly when there is what type of air flow?
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turbulent
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removal of medium sized particles, 1-5um from inhaled air
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sedimentation
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when air flow slows down, and gravity pulls particles down and they come in contact with mucus
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sedimentation
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sedimentation primarily occurs where?
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terminal and resp bronchioles
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removal of very small, <0.1um from inhaled air
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diffusion(brownian motion)
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continual random movement of particles causing them to come in contact w/ fluid lining of alveoli
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diffusion/brownian motion
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diffusion/brownian motion primarily occurs where?
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alveoli
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what happens to particles after the diffusion/brownian in the alveoli occurs?
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the fluid moves up to the terminal bronchioles and utilizes the mucociliary escalator to be removed
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4 substances in mucus that destroy harmful substances
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immunoglobulins
lactoferrin lysozymes interferon |
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immunoglobulins have what type of activity
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antiviral and antibacterial
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what are iimmunoglobulins and what produces them?
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antibodies produced by plasma cells
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most imp immunoglobulin found embedded in airways?
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IgA
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lactoferrin has what type of activity
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bacteriostatic
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what prevents the growth and proliferation of bacteria that gets trapped in mucus
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lactoferrin
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lysozymes have what type of activity
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bacteriocidal
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what type of activity does interferon have?
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antiviral
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what transports mucus and contaminants toward oropharynx to be expellled or swallowed?
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cilia
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two phases of the beating of the cilia
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-rapid forward stroke
-slow recovery phase |
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describe rapid forward stroke
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when cilia are erect and tips are embedded in outer thick layer of mucus
they rapidly move forward pushing mucus toward oropharynx |
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describe slow recovery phase
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cilia bend over so tips are embedded in periciliary fluid of mucus, then slowly return to their original position to become erect again.
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what happens if tips of cilia were to remain in thick layer of mucus after the rapid forward stroke?
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when the cilia returned back to original position, it would move mucus back to its original position
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factors inhibiting the beating of cilia
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-inhaled anesthetics
-cold air -humidity/dry air: removes so much mucus that it becomes crusty -cig smoke -ETT--interrupts mucociliary escalator, mucus comes to pharynx until it reaches distal end of OETT |
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how do alveolar macrophages originate ?
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from monocytes, leave vasculature through diapodesis and eventually become macrophages
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2 fxns of alveolar macrophages
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-involved w/ removal of foreign debris
-destruction of bacteria by phagocytosis of any matter/bacteria reaching alveoli |
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once the alveolar macrophage engulfs the debris/bacteria, how is it removed?
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-migrates by ameoboid locomotion to terminal bronchioles then mucociliary escalator
-enter into lymphatic vv and removed by lymphatics |
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what inhibits alveolar macrophage activity
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cig smoke
low alveolar oxygen |
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another name for alpha1-antitrypsin
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alpha-1 proteinase inhibitor
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proteolytic enzymes have to be inactivated or what could happen?
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lead to extensive lung damage
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what serves as a check to proteolytic enzymes?
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AAT: alpha-1 antitrypsin
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what releases proteolytic enzymes?
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bacteria
alveolar macrophages from monocytes leucocytes |
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how is a sm amt of proteolytic enzymes beneficial?
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-help destroy bacteria
-help remove/clean up dead/injured lung tissue after an inflammatory response |
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proteolytic enzyme released from WBCs in lungs to digest elastic lung tissue
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neutrophil elastase
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benefits of neutrophil elastase
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normally produced, helps fight bacteria and cleans up dead lung tissue
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what disease has inadequate amts of AAT present?
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alpha-1 antitrypsin deficiency emphysema
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onset of AAT deficiency emphysema
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late 30s-50s
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most pts with emphysema have what deficiency
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AAT
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what is involved with filtering out particulate matter (cellular debris and degenerate cells) from the lymph
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resp lymph nodes
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coal miners have what type of lymph nodes
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black
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tonsils do what to microorganisms of inhaled air
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destruction and detoxification
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circular band of lymphatic tissue in naso and oropharynx
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waldeyers tonsilar ring
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composes waldeyers tonsilar ring
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pharyngeal tonsils (adenoids)
tubal tonsils palatine tonsils lingual tonsils |
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location where organisms will be filtered out by impaction occurring in upper part of airway
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waldeyer's tonsilar ring
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rremoves irritating substances from airway
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cough reflex
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cough is usually initiated by?
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a result of irritation
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areas of high sensitivity and are able to initiate the cough reflex
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bronchi, carina, larynx
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3 phases of initiating a cough
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-deep inspiration: closure of glottis
-contraction of abd & internal intercostal mm's, air can't escape b/c squeezing of lungs increases intrapulm pressure -opening of airway causes release of pressure and air rushes out and propels irritants to oropharynx |
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in what pts is the cough reflex absent/depressed?
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unconscious/anesthetized
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longitudinal folds on inside of trachea are made of what?
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dense collection of elastic tissue
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what happens to the longitudinal folds of elastic tissue on the inside of the trachea when you cough?
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they are pushed inward, decreasing cross-sectional area in which air moves, helps to push air out very quickly..along w/ mucus and contaminants
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what removes irritant material from both nasal cavity and nasopharynx
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sneeze reflex
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directs air primarily through nasal passagewary
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sneeze reflex
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what is also used in the sneeze reflex
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valsava maneuver
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what promotes constriction of the airways in response to harmful agents?
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PSNS innervation of airways
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2 effects of PSNS innervation of airways?
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-increase mucus secretion by mucus glands, increases particle deposition and filtration process
-contraction of airways in response to harmful agents by decreasing radius and increasing resistance |
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2 fold benefit of PSNS effects in airways
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-you increase likelihood of impaction b/c of decreased lumen size
-decreasing the radius of lumen increases resistance to airflow and irritant might not be able to get as far down |
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promotes narrowing of laryngeal airways in response to irritating stimuli
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laryngeal mm's
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laryngeal mm contraction causes:
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closure of vocal cords (adduction) and closure of rima glottidis
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prolonged contraction of laryngeal mm's may lead to?
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non-cardiogenic pulmonary edema, also occurs if we extubate in wrong stage
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3 factors leading to laryngeal spasms
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-direct stimulation: laryngeal blade, ett, trauma, food, water..
-reflex stimulation: may be stimulated by pain in some other part of body -low ECF Ca: decreasing TP, mm's are sensitive, leads to tetany and contraction of laryngeal mm's |
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2 ways to measure lung volumes/capacities
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-spirometer (Bell's)
-plethysmograph |
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used to measure volume for changes in lung compliance
measures inspiration & expiration |
Spirometer
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best way to measure FRC, uses Boyle's law
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plethysmograph, small booth that you sit in
measures volume & pressure changes inside the booth |
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4 lung volumes
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Tidal Volume (TV)
Inspiratory reserve volume (IRV) expiratory reserve volume (ERV) residual volume (RV) |
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volume of air inhaled or volume of air exhaled with each breath
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tidal volume
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tidal volume varies depending on what
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physical activity of the person
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normal TV at rest
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500mL
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TV is what % of TLC
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10%
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more accurate estimation using kg of IBW to determine TV
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8cc/kg
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1.5 x TV is the what?
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sigh volume
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what is the IRV?
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maximal amount of air that can be inhaled following a normal passive inspiration
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how much of your TLC is your IRV?
how many mls? |
50%, 3000mls
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what is the ERV?
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maximal amt of air that can be exhaled after normal passive exhalation
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how much of your TLC is your ERV?
how many mls? |
20%, 1200mls
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what is the residual volume
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volume of air remaining in the lungs following maximal forced expiration,
air that can't be exhaled |
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can you measure your RV?
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indirectly, not directly
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how much of your TLC is your RV? how many mls?
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20%, 1200mls
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pulmonary lung capacities are made up of what?
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two are more lung volumes
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what is the TLC?
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volume of air in the lungs following a maximal exhalation
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what are the components of the TLC?
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IRV+TV+ERV+RV
6000mls |
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can you measure your TLC directly w/ a spirometer?
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no
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maximal amt of air that can be inhaled following a normal passive exhalation
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inspiratory capacity
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components of IC?
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TV + IRV
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what % of your TLC is your IC?
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60%, 3500mls
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Expiratory vital capacity is ?
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maximum volume of air that can be forcefully exhaled following a maximal inspiration
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components of EVC?
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IRV+TV+ERV
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what percent of your TLC is your EVC?
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80%, 4800mls
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maximal volume of air that can be inhaled following a maximal forced expiration?
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IVC
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% of TLC that is your IVC?
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80% or 4800mls
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what is the difference b/t the EVC & IVC of a healthy individual?
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there shouldn't be any
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in a COPD pt, which vital capacity will you use?
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IVC b/c with an EVC, you get them to forcefully exhale a max amt and it will produce air trapping
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volume of air in the lungs following a normal passive exhalation
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functional residual capacity -FRC
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why is your FRC called "functional"
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b/c at the pause at end expiration and prior to next breath, gas exchange is still occurring in across alveolar membrane
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end expiratory/resting expiratory position refers to?
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position of the lung-thorax complex following a passive exhalation, while the volume in the lungs refers to the FRC
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can you measure FRC directly?
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no
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components of FRC?
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ERV+RV
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% of TLC that is your FRC?
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40%, 2400mls
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2 lung capacities that can not be measured directly
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FRC
TLC |
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what happens to air particles that are b/t 0.1um and 1um in size?
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80% are suspended in air then exhaled w/ next breath
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