Org Sys - 2 - Respiratory

Front 1

Tidal Volume

Back 1

(Vt)
500mL of air in and out during quiet respiration/rest

Front 2

Vital Capacity =

Back 2

(VC)
total amt of air that we can bring into the lungs in forced breathing all the way up to TLC

Front 3

Residual Volume

Back 3

(RV)
amt of air that always remains in the dead space of the lungs so that they don’t collapse

Front 4

Total Lung Capacity

Back 4

(TLC)
absolute TOTAL MAXIMUM amount of lung volume

Front 5

Functional Reserve Capacity

Back 5

(FRC)
vol of gas in lungs after end of normal expiration

changes in sickness and disease

Front 6

atmospheric air composition

Back 6

21% O2 and 0.03% CO2

Front 7

what drives the diffusion of gases from alveoli into bloodstream

Back 7

Partial pressure differences

Front 8

partial pressure of O2 in dry air at sea level

Back 8

Partial Pressure = its fractional concentration (x) total barometric pressure

(0.21) x 760mmHg = 160mmHg

Front 9

partial pressure of O2 in Denver at a higher altitude

Back 9

Partial Pressure = its fractional concentration (x) total barometric pressure

(0.21) x 625mmHg = 131mmHg

Front 10

partial pressure of O2 in moist air (like inside alveoli)

Back 10

Must factor water vapor

Partial Pressure = its fractional concentration (x) total barometric pressure

(0.21) x (760 – 47 mmHg) = 149mmHg

Front 11

What is diffusion constant is influence by

Back 11

Solubility

Surface area

Thickness

Front 12

alveoli PA O 2

Back 12

100

Front 13

alveoli PA CO 2

Back 13

40

Front 14

pulmonary capillaries Pa O 2

Back 14

40

Front 15

pulmonary capillaries Pa CO 2

Back 15

46

Front 16

systemic capillaries Pa O 2

Back 16

100

Front 17

systemic capillaries Pa CO2

Back 17

40

Front 18

tissues Pt O2

Back 18

<40

Front 19

tissues Pt CO2

Back 19

>46

Front 20

Partial pressures in ideal lung

Back 20

partial pressures of O 2 and CO 2 in arterial blood and alveoli would equilibrate to equal values

100% effective gas exchange

but this does not happen in real life outside of theory because of the right-to-left shunt

Front 21

Ventilation

Back 21

volume of air moving in / out of the lungs per unit time

Ventilation = tidal volume (x) breaths per minute

Must account for dead space in alveolar ventilation, so subtract dead space from tidal volume

ventilation = (500mL – 150mL) (x) 12 breaths per minute = 4.2L of air per minute being inspired / expired

Front 22

Which circulation has lower vascular pressure

Back 22

Pulmonary circulation is lower. It has vascular pressure of 25/8

Systemic circulation has vascular pressure of 120/80

Front 23

Right-to-Left Shunt

Back 23

Venous blood from bronchiole circulation gets shunted into pulmonary vein

It mixes with oxygenated blood and returns to left atrium

This is the reason why the theoretical lung never holds true, and Pa O2 is LESS than PA O2

Front 24

Hypoxic Pulmonary Vasoconstriction

Back 24

arterioles will automatically vasoconstrict in areas that have a low partial pressure of O 2

divert O 2 away from any areas that have poor ventilation

Front 25

Zone-1 of lung

Back 25

there is no blood flow because Pa > PA

Front 26

Capillary hydrostatic forces

Back 26

push fluid OUT of the capillary

Front 27

Zonal Model for Blood Flow

Back 27

There is different levels of functional ventilation based on gravity

Since Lung extends 15 cm above heart, heart must pump against will of gravity

There is more blood flow at the bottom of the lungs

Front 28

Interstitial hydrostatic forces

Back 28

push fluid INTO the capillary

Front 29

Capillary osmotic forces

Back 29

hold fluid INSIDE the capillary

Front 30

Interstitial osmotic forces

Back 30

pulls fluid OUTSIDE the capillary

Front 31

How does fluid move

Back 31

From HIGH hydrostatic to LOW

From LOW osmotic to HIGH

Front 32

What does movement of air depend on?

Back 32

Bulk flow

depends on the difference b/t alveolar pressure & barometric pressure
Alveolar < Barometric = Inspiration
Alveolar > Barometric = Expiration
Alveolar = Barometric then no air flow

Front 33

Compliance

Back 33

measure of how easily the lung can expand

Compliance = ∆ volume ÷ ∆ pressure

More compliant requires less work, expands more and fills up to larger volume

Less compliant requires more work, expands less, fills up to smaller volume

Front 34

Elastance

Back 34

opposite of compliance

measure of how stiff the lung is

ability to resist being stretch

More elastic tissue
harder to stretch (less compliant)
but easier to recoil back

Front 35

More elastic tissue

Back 35

harder to stretch (less compliant) -- but easier to recoil back

Front 36

Less elastic tissue

Back 36

easier to stretch (more compliant) -- but difficult to recoil back

Front 37

Trypsin enzyme

Back 37

digests the elastin protein

Increases compliance
Decreases elastance

Front 38

Smoking

Back 38

Destroys α1-Antitrypsin Inhibitor which prevents digestion of elastin protein

Therefore lung decreases in elastance and increase in compliance

Easier to stretch lungs but difficult to recoil back

Front 39

Emphysema

Back 39

less elastic tissue = decreased elastance
increased compliance
= more functional reserve capacity

Front 40

Fibrosis

Back 40

more connective tissue = increased elastance
decreased compliance
= less functional reserve capacity

Front 41

Surface Tension

Back 41

holds the liquid against the internal walls of the alveolus

tends to compress the alveolus inward so that they shrink

Smaller alveolus has greater surface tension

Front 42

Dipalmitoylphosphatidylcholine (DPPC)

Back 42

Surfactant

reduce the amount of surface tension

produced by Type-II alveolar cells

Front 43

Infant Respiratory Distress Syndrome

Back 43

Pre-term babies lack production of DPPC surfactant

increased surface tension  alveoli collapse

lungs are stiff, less compliant therefore more work required to inspire

Front 44

asthma

Back 44

increased secretions will increase airway resistance because radii of bronchi decreased

Decreases compliance

Front 45

Hemoglobin's affinity to CO

Back 45

240x greater than oxygen

Reduces capacity for O2 binding (left shift)

Front 46

Why is Hemoglobin % saturation curve sigmoid

Back 46

because Hb’s affinity for oxygen increases once one oxygen molecule binds

the more it binds, the more it likes to bind some more

Front 47

Concentration of normal hemoglobin

Back 47

15g/dL

Front 48

Saturation curve and anemia

Back 48

O 2 carrying capacity will of course be lower

but the shape of the Hb-O 2 saturation curve would still look the same because it is independent of RBC/hemotocrit concentration

Front 49

p50

Back 49

the point of PO 2 where Hb saturation is at 50%

Front 50

Taller saturation curve

Back 50

Increased oxygen carrying capacity

Front 51

Shorter saturation curve

Back 51

decreased O2 carrying capacity (like in anemia)

Front 52

Right shifted curve

Back 52

Hb has a decreased affinity for O2 (like in exercise or ↑↑↑ 2,3-DPG)

Front 53

Left shifted curve

Back 53

Hb has an increased affinity for O2 (like in fetal Hb)

Front 54

What environmental factors can leads to Hb having a decreased affinity for O 2

Back 54

Increased temperature

Increases CO2

Decreased pH

(All seen during exercise)

Makes it easier to unload oxygen to working tissues

Front 55

Maintenance of pH

Back 55

pH=6.1+log ([HCO3-] / 0.03 PCO2)

Maintain 20:1 HCO3- : CO2 ratio

Front 56

Respiratory acidosis/alkalosis

Back 56

Any alteration in lung ventilation changing PCO2

Decreased PCO2 due to hyperventilation causes increase in plasma pH = alkalosis

Increase in PCO2 due to hypoventilation decreases plasma pH = acidosis

Front 57

Hyperventilation

Back 57

Increases PO2
Decreases PCO2
Increases plasma pH

Leads to alkalosis

Front 58

Hypoventilation

Back 58

Decreases PO2
Increases PCO2
Decreases plasma pH

Leads to acidosis

Front 59

Metabolic acidosis/alkalosis

Back 59

Any alteration in kidneys ability to remove bicarbonate

Decreased bicarbonate due to less resorption causes decrease plasma pH = acidosis

Increases bicarbonate due to more resorption causes increased plasma pH = alkalosis

Front 60

why is there a PO2 drop between alveolar & arterial?

Back 60

right-to-left shunt

difficulties in the diffusion process due to gas solubility, surface area and thickness of membrane

mismatch of ventilation (air flow) to perfusion (blood flow)

Front 61

why is there a PO 2 drop between alveolar & venous?

Back 61

due to the mitochondria’s use of O2

Front 62

What area of the brain is responsible for the ability to breathe

Back 62

Medulla

Front 63

What area of the brain is responsible for the fine-tuning of breathing patterns?

Back 63

Pons

Front 64

What is responsible for the Hering Breuer Reflex

Back 64

Vagus Nerve

Front 65

What occurs if the brainstem is cut below the medulla

Back 65

Breathing stops

Front 66

What occurs if if brainstem is cut ABOVE medulla

Back 66

Breathing is still ok

Front 67

What occurs if brainstem is cut BELOW pons

Back 67

you can still breathe, but breathing patterns are erratic

Front 68

What occurs if brainstem is cut ABOVE pons

Back 68

you can still breathe, and breathing patterns are still OK

Front 69

Hering-Breuer Reflex

Back 69

controls termination of inhalation, based on stretch mechanoreceptors in the lung

Controlled by Vagus

Front 70

If occurs if vagus nerve is cut

Back 70

your inspiratory tidal volume will be abnormally increased

Front 71

Central Pattern Generator

Back 71

located in the medulla

sets your basic breathing rhythm via the Phrenic innervation to the diaphragm

Two divisions
Ventral Respiratory Group
Dorsal Respiratory Group

Front 72

I-Neurons

Back 72

Responsible for inspiration

Front 73

E-Neurons

Back 73

Responsible for expiration

Front 74

Central Chemoreceptors

Back 74

located in the ventral medulla

responds very slowly to changes in PaCO2 in the brain

Cannot respond to Oxygen or pH changes

Front 75

Peripheral Chemoreceptors

Back 75

responds very quickly to everything: changes in PaCO 2 , PaO 2 , pH in the arterial blood

Consists of carotid bodies and aortic bodies

Front 76

carotid bodies

Back 76

Peripheral Chemoreceptors

sends afferent nerves to the CNS via the Glossopharyngeal Nerve (IX)

Front 77

aortic bodies

Back 77

Peripheral Chemoreceptors

sends afferent nerves to the CNS via the Vagus Nerve (X)

Front 78

hypercapnia

Back 78

Increased carbon dioxide levels

Ventilation increases to bring carbon dioxide levels back to normal

Front 79

hypocapnia

Back 79

Decreased carbon dioxide levels

Ventilation decreases to bring carbon dioxide levels back to normal

Front 80

What occurs if you go below Apneic CO 2 threshold

Back 80

Breathing reflex stops

Front 81

Which lung side has 3 major lobes

Back 81

Right side

(Left has 2 lobes)

Front 82

Where is the entry point for conducting portion

Back 82

Hilus/root of lung

Front 83

Where is the transit point for pulmonary arteries

Back 83

Hilus/root of lung

Front 84

What consists in the Tetrad

Back 84

Pulmonary artery
Pulmonary vein
Phrenic nerve

Lymphatics

Front 85

Pneumothorax

Back 85

perforation caused by gun shot wound, trauma, etc.

allows air to enter the pleural cavity and expands the cavity

prevent lung from properly expanding

Front 86

Hydrothorax

Back 86

edema caused by pneumonia

expansion of pleural cavity

Pressure pushes lungs and can't expand

Front 87

Hemothorax

Back 87

torn BV causing cavity to fill with blood

expansion of pleural cavity

Pressure pushes lungs and can't expand

Front 88

Conduction Portion

Back 88

Functions – preparation of air (filtration, humidification, and warming), olfaction and
phonation

no gas exchange of any kind

Front 89

Nasal passages

Back 89

Thin, keratinized, stratified squamous epithelium

Front 90

Vestibule

Back 90

transition area of wet membrane

transition from stratified squamous to stratified columnar to cubiodal to pseudostratified columnar w/goblet cells

Front 91

Nasal cavity

Back 91

ciliated pseudostratified columnar epithelium w/ goblet

Serous and mucous glands

Vascular lamina propria

Contains olfactory organ which contains olfactory mucosa (lacks goblet and cilia)

Front 92

Olfactory Organ

Back 92

on posterior ½ of upper nasal cavity

CN I

Epithelium is modified to olfactory mucosa (lacks goblet and cilia)

Taller and thicker than the rest of the respiratory tree

Consists of three layers where olfactory receptor is in middle and stem cells are in lower layer

Front 93

Paranasal sinuses

Back 93

Maxillary, sphenoid, frontal and ethmoid

ciliated pseudostratified columnar epithelium w/ goblet

Front 94

NasoPharynx

Back 94

ciliated pseudostratified columnar epithelium w/ goblet

Muscle supporting wall (not bone)

Has mixed glands (sero-mucous glands)

Front 95

What is the only place in the body that has a mixed gland

Back 95

Nasopharynx

Front 96

Oropharynx

Back 96

Part of oral cavity

Lined with non-kertatinized stratified squamous epithelium

minimal glands

contains epiglottis

Front 97

Epiglottis

Back 97

ciliated pseudostratified columnar epithelium w/ goblet on one side

Non-keratinized stratified squamous epithelium on other

Front 98

Larynx

Back 98

False vocal cords covered by ciliated pseudostratified columnar epithelium w/ goblet

True vocal cords covered by non-keratinized stratified squamous epithelium

Lamina propria contains skeletal muscles to control pitch of voice

Glands throughout

Front 99

Trachea

Back 99

ciliated pseudostratified columnar epithelium w/ goblet

Supporting wall is hyaline cartilage

Splits into 2 primary bronchi

Front 100

Primary Bronchi

Back 100

One for each lung

ciliated pseudostratified columnar epithelium w/ goblet

Splits into secondary bronchi

Front 101

Secondary bronchi

Back 101

One for each lobe

Partially extrapulmonary and partially intrapulmonary

Thinner C-shaped hyaline cartilage

Front 102

Tertiary bronchi

Back 102

One for each segment

All intrapulmonary

ciliated pseudostratified columnar epithelium w/ less goblet

Supporting wall is islands of hyaline cartilage with smooth muscle in between

Front 103

Primary Bronchioles

Back 103

ciliated pseudostratified columnar epithelium w/ less goblet

All cartilage is gone

Smooth muscle is supporting wall

Front 104

Secondary Bronchiole

Back 104

Pre-terminal Bronchiole

One for each lobule

**Simple columnar epithelium

**Clara cells

Front 105

Tertiary Bronchiole

Back 105

Terminal Bronchiole

One for each acinus

**Simple cuboidal epithelium w/ cilia

**Clara cells

Front 106

Lambert’s sinus

Back 106

interconnections between acini in case one gets blocked (alveoli are also interconnected to other alveoli)

Front 107

Upper main layer of surfactant

Back 107

phospholipids made in respiratory system

Front 108

Lower watery layer of surfactant

Back 108

made by clara cells

Front 109

Where is a frequent site of tumors

Back 109

Ventricle of Larynx

It traps carcinogens

Front 110

Clara cells

Back 110

Found in secondary, tertiary, and respiratory bronchioles

Makes hypolayer of surfactant

Front 111

Respiratory Portion

Back 111

All contain alveoli which allows gas exchange

Front 112

Respiratory bronchiole

Back 112

1 st place of Gas exchange

Last place of Clara cells

Simple Cuboidal Epithelium

Front 113

What is the 1 st place of Gas exchange

Back 113

Respiratory Bronchiole

Front 114

Alveolar duct

Back 114

Long Hallway with Alveoli in walls

Front 115

Alveolar Sac

Back 115

Surrounded by Alveoli (Atrium of the hall)

Front 116

Alveolus

Back 116

separated by Septal Walls that contains Modified areolar CT with a lot of capillaries running in

Mesothelium (Simple squamous epithelium) for diffusion

Lines by suufactant

Front 117

Type I Pneumocyte

Back 117

Septal Cell

Squamous epithelial cell

Covers 90% Surface Area of Lung

Involved in gas exhange

Front 118

Type II Pneumocyte

Back 118

Great Alveolar Cell

Near entrance to Alveolus

Secretory cell (lamellar bodies) that contains granules with Phosphatidyl choline

Makes main layer of Surfactants (lipid – derivative - DPPC)

Front 119

Type III Pneumocyte

Back 119

Alveolar macrophage or Dust cell (when it has ingested foreign materials)

Does not touch Basement Membrane

Cleans Alveolus