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75 Cards in this Set

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Name and describe the 3 parts of respiration
1. ventilation - the movement of air between the atmosphere and the respiratory portion of the lungs 2. perfusion - the flow of blood through the lungs 3. diffusion - the transfer of gases between the air-filled spaces in the lungs and the blood
Name and describe the 2 parts of the respiratory system
1. conducting airways - where air moves as it passes between theatmosphere and the lungs 2. respiratory tissues - where gas exchange takes place
What structures make up the conducting airways?
the nasal passages, mouth & pharynx, larynx, trachea, bronchi, and bronchioles
What happens to the air as it moves through the conducting airways?
- the air is warmed by transferring heat from the blood flowing through the walls of the respiratory passasges - the air is filtered by the mucociliary blanket, which removes foreign materials - the air is moistened by water from the mucous membranes
Describe the epithelial layer of the conducting airways as it goes from the bronchi to the bronchioes to the alveoli
- the epithelial layer gradually gets thinner - pseudostratified epithelium of the bronchi --} cubiodal epithelium of the bronchioles --} squamous epithelium of the alveoli
What happens to the capacity of air to contain moisture as temperature rises?
the capacity of air to contain moisture without condensation rises as temperature rises
What type of tissue is contained in the bronchial wall?
pseudostratified epithelium, smooth muscle cells, mucous glands, connective tissue, and cartilage
What structure connects the oropharynx with the trachea?
the larynx
What are the 2 functions of the larynx?
1. those functions associated with speech 2. those functions associated with protecting the lungs from substances other than air
What are the collective actions that make up the Valsalva maneuver?
- inhaled air is temporarily held in the lungs by closing the glottis - intraabdominal muscles contract causeing both intraabdominal and intrathoracic pressures to rise
What constitutes the tracheobronchial tree?
the trachea, bronchi, and bronchioles
Describe the passageways of air from the largest tube to smallest
trachea --} bronchi --} bronchiole --} terminal bronchiole --} respiratory bronchiole --} alveolar duct --} alveolar sac
What are some other functions of the lung, besides respiration?
- inactivate vasoactive substances like bradykinin - convert angiotensin I to angiotensin II - serve as a resevior for blood storage - abundant site for heparin-producing cells
Where does the gas exchange function of the lung take place?
in the lobules of the lung
What is the lobule and what structure supply the lobules?
- the lobule is the smallest functional unit of the lung - supplied by a branch of a terminal bronchiole, an arteiole, the pulmonary capillaries, and a venule
What are pores of Kohn?
small holes in the alveolar wall that contribute to the mixing of air under certain conditions
What are the 2 types of cells in the alveoli and what are their respective functions?
1. Type I - flat squamous epithelial cells across which gas exchange takes place 2. Type II - produce surfactant
What is surfactant?
- a lipoprotein substance that decreases the surface tension in the alveoli - allows for greater ease of lung inflationand helps to prevent the collapse of smaller airways
What are the 2 types of circulation that supply blood to the lungs?
pulmonary and bronchial circulation
What is the function of the bronchial circulation?
- distributes blood to the conducting airways and supporting structures of the lung - warms and humidifies incoming air as it moves through the conducting airways
True/False: When vessels in the pulmonary circulation are obstructed, bronchial blood vessels are the only ones that undergo angiogenesis
The correct answer is: True
What factors determines the degree to which the lungs inflate and deflate?
the respiratory pressures inflating the lung, compliance of the lungs, and airway resistance
What are the 3 types of respiratory pressures?
1. intrapulmonary pressure (or alveolar pressure) 2. intrapleural pressure - always negative in relation to alveolar pressure 3. intrathoracic pressure
What nerve innervates the diaphragm?
the phrenic nerve roots which arise from the cervical level of the spinal cord (mainly C4 but also from C3 and C5)
What is paradoxical movement of the diaphragm?
- paralysis of one side of the diaphragm that cause the chest to move up on that side rather than down during inspiration because of the negative pressure in the chest
What are the accessory muscles of inspiration and what do they specifically do?
1. scalene muscles - elevate the first two ribs 2. sternocleidomastoid muscles - raise the sternum to increase the size of the chest cavity
What is lung compliance and what determines it?
- lung compliance refers to the ease with which the lungs can be inflates - determined by the elastin and collagen fibers of the lung, its water content and surface tension C = (change in Volume) / (change in respiratory pressure)
What is the normal compliance of both lungs in the average adult?
approximately 200 mL/cm H20
What occurs in interstitial lung disease and pulmonary fibrosis?
- the lungs become stiff and noncompliant as elastin fibers are replaced with scar tissue
What conditions produce a reversible decrease in pulmonary compliance?
pulmonary congestion and edema
What is elastic recoil?
- the ability of the elastic components of the lung to recoil to their original position after having been stretched
Describe what happens to elastic recoil as it relates to emphysema
in emphysema, the airways are overstretched, causing the elastic components of the lung to lose their recoil, making the lung easier to inflate but more difficult to deflate because of its inability to recoil
How does surfactant work?
- it is composed of a hydrophilic head and hydrophobic tail - the head attaches to the liquid molecules and the tail attaches to the gas molecules - this interrupts the intermolecular forces that are responsible for creating surface tension
What are 4 effects of surfactant on lung inflation?
1. lowers surface tension 2. increases lung compliance and ease of inflation 3. provides for stability and more even inflation of the alveoli 4. assists in preventing pulmonary edema by keeping the alveoli dry
What is the single most common cause of respiratory disease in premature infants?
- infant respiratory distress syndrome - premature infants, who do not produce sufficient amounts of surfactant, which can lead to alveolar collapse and severe respiratory distress
Why do people with conditions that increase airway resistance, such as asthma, usually have less difficulty during inspiration than during expiration?
the airways are pulled open as the lungs expand during inspiration, and they become anrrower as the lungs deflate during expiration
What are the 3 components of lung volume?
1. tidal volume - the amount of air that moves into and out of the lungs during a normal breath (~ 500 ml) 2. inspiratory reserve volume - the maximum amount of air that can be inspired in excess of the normal tidal volume 3. expiratory reserve volume - the maximum amount of air that exhaled in excess of the normal tidal volume
What is residual volume (RV)?
the amount of air that always remains in the lungs after forced expiration (~ 1200 ml)
What is vital capcity?
the amount of air that can be exhaled from the point of maximal inspiration (= IRV + TV + ERV)
What is inspiratory capacity?
the amount of air a person can breathe in beginning at the normal expiratory level and distending the lungs to the maximal amount (= TV + IRV)
What is functional residual capacity?
the volume of air that remains in the lungs at the end of normal expiration (= RV + ERV)
What is total lung capacity?
the sum of all the volumes in the lungs
What is maximum voluntary ventilation?
the maximum amount of air that can be breathed in a given time
What is forced vital capacity?
the maximum amount of air that can be rapidly and forcefully exhaled from the lungs after full inspiration
What is forced expiratory volume?
the expiratory volume achieved in a given time period, usually in 1 second
What is forced inspiratory vital flow (FIF)?
a measurement of the respiratory response during rapid maximal inspiration
What is minute volume?
aka total ventilation, it is the amount of air that is exchanged in 1 minute
What are the 2 types of ventilation?
1. pulmonary ventilation - the total exchange of gases between the atmosphere and the lungs 2. alveolar ventilation - the exchange of gases within the gas exchange portion of the lungs
What is the primary function of the pulmonary circulation?
to perfuse or provide blood flow to the gas exchange portion of the lung and to faciliate gas exchange
What are some other functions of pulmonary circulation, besides gas exchange (3)?
- filters all the blood that moves from the right to the left side of the circulation - removes most of the thromboembol that might form - serves as a reservoir of blood for the left side of the heard
What is the response of blood vessels in the pulmonary circulation when they undergo hypoxia?
the blood vessels constrict
What are some conditions that can cause vasoconstriction of pulmonary blood vessels?
- decreased partial pressure of oxygen at high altitudes - persons with chronic hypoxia due to lung disease - low blood pH can produce vasoconstriction
What are the 2 types of air movement in the lung?
1. Bulk flow - occues in the conductin airways and is controlled by pressure differences between the mouth and the airways of the lung 2. Diffusion - the movement of gases in the alveoli and across the alveolar capillary membrane
What is Fick's law?
Vgas = ((P1 - P2) x SA x D)/ T - P1 - P2 is the partial pressure difference of the gas, SA is surface area, D is diffusion coefficient, and T is thickness of the membrane - Vgas is the volume of a gas diffusing across te membrane per unit time
Name 2 factors that can interfere with the matching of ventilation and perfusion
1. dead air space - the volume of air that must be moved with each breath but does not participate in gas exchange 2. shunt - refers to the blood that moves from the right to the left side of the circulatio without being oxygenated
What are the 2 types of dead air space?
1. anatomic dead space - contained in the conducting airways (air contained in the nose, pharynx, trachea, and bronchi) 2. alveolar dead space - alveolar air that does not participate in gas exchange
What is physiologic dead space?
the anatomic dead space plus alveolar dead space
What are the 2 types of shunts?
1. anatomic shunt - blood moves from the venous to the arterila dise of the circulation without moving through the lungs (congenital heart defects) 2. physiologic shunt - mismatching of ventilation and perfusion with the lung, resulting in insufficient ventilation to provide the oxygen need to ocygenate the blood flowing through the alveolar capillaries
What are some causes of physiologic shunting of blood?
- usually results from destructive lung disease that impairs ventilation OR - heart failure that interferes with movement of blood through sections of the lungs
Describe the ventilation and perfusion mismatching in a shunt
- there is perfusion without ventilation - leads to a low ventilation-perfusion ratio - occurs in conditions such as atelectasis which there is airway obstruction
Describe the ventilation & perfusion mismatching in dead air space
- there is ventilation with no perfusion - results in a high ventilation/perfusion ratio - occurs in conditions such as pulmonary embolism which impairs blood flow to a part of the lung
What are 2 factors that determine that amount of gas that can dissolve in plasma?
1. the solubility of the gas in the plasma 2. the partial pressure of the gas in the alveoli
What is the normal PO2 of arterial blood?
above 80 mm Hg
What is the normal PCO2 in arterial blood?
35-45 mm Hg
What determines the efficiency of the hemoglobin transport system?
the ability of the hemoglobin molecule to bind oxygen in the lungs and release it as it is need in the tissues
What are some conditions that cause increased binding of hemoglobin with oxygen?
- increased pH (alkalosis) - decreased CO2 concentration - decreased body temperature
What are some conditions that decrease affinity of oxygen with hemoglobin?
- decreased pH (acidosis) - increased CO2 - fever
What does a shift to the right of the hemoglobin dissociation curve indicate?
- a shift to the right represents reduced affinity of the hemoglobin for oxygen at any given PO2 - caused by conditions such as acidosis, fever, or an increase in PCO2, which reflects increased tissue metabolism
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What are the 3 forms that carbon dioxide is transported in the blood?
1. dissolved carbon dioxide (10%) 2. attached to hemoglobin (30%) 3. bicarbonate (60%)
What is the respiratory center?
neurons located in the pons and medulla that control ventilation and movement of the muscles that control breathing
What are the 2 types of sensors/receptors that controll the automatic regulation of ventilation?
1. chemoreceptors - monitor blood levels of oxygen, carbon dioxide, and pH and adjust ventilation to meet the changing metabolic needs of the body 2. lung receptors - monitor breathing patterns and lung function
What are the 2 types of chemoreceptors?
1. central chemoreceptors - located near the respiratory center in the medulla and sense changes in blood carbon dioxide content 2. peripheral chemoreceptors - located in the carotid and aortic bodies, which are found at the bifurcation of the common carotid arteries and in the arch of the aorta; monitor arterial blood oxygen levels
What are the 3 types of lung receptors?
1. stretch - located in the smooth muscle layers of the conducting airways; monitor lung inflation 2. irritant - located between the airway epithelial cells; protect against the damaging effects of toxic inhalents 3. juxtacapillary receptors - located in the alveolar wall; can sense lung congestion