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NYCPM Physiology > Exam 3 Part II > Flashcards

Exam 3 Part II Flashcards

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1
Q

Factors decreasing compliance

A

anything destroying lung tissue or making it fibrotic or edematous, or blocking the bronchioles or making it difficult to expand and contract.

Lung + thorax = kyphosis or fibrotic pleurisy.

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2
Q

What works against inspiration?

A

“compliance” work (expanding lung against elastic forces)

tissue work (R of tissues sliding over each other)

airway resistance (overcoming R to airflow in the air passages).

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3
Q

What is vital capacity reduced by?

A

paralysis of respiratory muscles (Guillian Barre)

reduced compliance (TB, lung cancer, bromchitis, fibrosis, excess fluid).

Pulmonary edema (L heart failure)

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4
Q

total vital capacity

A

residual + vital capacity

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5
Q

minute respiratory volume

A

respiratory rate x tidal volume

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6
Q

dead space air

A

air that is not diffused at the end of the terminal bronchioles. It is the last air breathed in during inspirtaion and the last during expiration.

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7
Q

physical measurement of dead space

A

air, when breathing out, that does not contain N2.

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8
Q

__ breaths are much better for alveolar ventilation than ___

A

deep, shallow

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9
Q

nervous control of the lungs

A

parasympathetic (vagus)

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10
Q

bronchiolar constriction

A

histamine, prostaglandins, leukotrienes.

irritants

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11
Q

Rates of gases moving

A

CO2&raquo_space; O2 > He, N2

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12
Q

Excess gas put in alveoli has T 1/2 17 sec. If ventilation rate is lower, T 1/2 is

A

longer.

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13
Q

diffusion across the respiration membrane is decreased by

A

Increased thickness of the membrane (edema, interstitial fibrosis)

decreased surface area for diffusion (removal of lung, emphysema).

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14
Q

diffusing capacity of membrane

A

the ability of the respiratory membrane to exchange a gas between the alveoli and pulmonary blood. it is also the volume of gas that difuses through the membrane each minute.

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15
Q

Diffusing capacity

A

D = VCO/PACO

VCO = rate at which CO is taken up by the lung
PACO = partial pressure of CO in alveoli.
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16
Q

chronic bronchitis and emphysema cause a

A

shunt, because many small bronchioles get completely obstructed and alveoli beyond are unventrilated.

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17
Q

Under resting conditions, each 100 mL of blood delivers 5 mL of __ and 4 mL of ___. This is the respiratory exchange ratio.

A

5 mL O2, 4 mL CO2.

R = rate of CO2 output/rate of O2 uptake.

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18
Q

What would be the effect of strong stimulation from the pneumotaxic center?

A

Limits duration of respiration and increases rate of respiration.

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19
Q

What is the effect of cutting off innervation from the medulla (dorsal respiratory group)?

A

the cells still have repetitive bursts corresponding to what would have been inspiration.

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20
Q

hering Breuer reflex

A

stretch receptors are activated which sends signals through the vagus to the dorsal respiratory group when the lungs are overstrtched.

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21
Q

The ventral respiratory group is ___ when normally breathing.

A

inactive

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22
Q

apneustic center

A

prevents the switching off of inspiration.

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23
Q

changing the levels of breathing

A

they are increased by

feedback excitation of respiratory center activity by changes in CO2, H+ and O2.

excitatory signals from other parts of the nervous system,especially during exericse.

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24
Q

the control areas of the respiratory center are not ___ to CO2 or H+ concentration.

A

not directly responsive to CO2 or H+. Instead, a chemosensitive area of the respiratory center exists beneath the surface of the ventral medulla and is sensitive to changes in blood CO2 or H+.

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25
effect of carbon dioxide on stimulating the chemosensitive area
CO2 diffuses into brain -> CO2 + H2O -> H2CO3 -> HCO3- + H+ -> H+ stimulates the central chemoreceptors directly.
26
paradoxically, more H+ arrives at the central chemoreceptors when more CO2 does than when
H+ blood levels do
27
The ____ is the only O2 mechanism in respiratory control.
peripheral chemoreceptors. Low O2 normally has no effect on alveolar ventilation until PO2 is very low (1/2 normal).
28
Why is there little increase in breathing to low PO2?
PCO2 and pH regulatory mechanisms oppose it. If for some reason CO2 and H+ are prevented from dcreasing at the same time as there is a stimulus to respiration fro mlow O2, then all 3 mechanisms support each other.
29
The low O2 mechanism may be the only mechanism driving respiration in chronic respiratory conditions because the
CO2 mechanism adapts.
30
oxygen lack mechanism at high altitude
CO2 unopposed -> CO2 adapts -> O2 mechanism unopposed.
31
Why is oxygen regulatio of respiration not normally needed?
Because O2 is always much higher than CO2 and H+. Blood and tissue changes a great deal with ventilation.
32
Regulation of respiration during exercise.
signals from motor cortex to move excitation ofjoint proprioceptors.
33
Other factors that affect respiration
increased vasomotor activity increased voluntary control increased body T diving reflex
34
respiratory center depression
cerebrovascular disease acute brain edema anaesthesia
35
Periodic breathing
Cheyne stokes breathing (no breathing for 45 sec, then overbreathes).
36
causes of periodic breathing
heart failure central sleep apnea obstuctive sleep apnea
37
Hypoventilation CO2 value
> 40 mm Hg
38
Hyperventilation CO2 value
< 40 mm Hg
39
abnormalities that cause hypoventilation
paralysis of respiratory muscles increased airway resistance increased tissue resistance decreased compliance of the lungs and chest wall.
40
paralysis of respiratory muscles
polio transsection of spinal cord depression of respiratory center by drugs.
41
increased airway resistance
asthma emphysema bronchitis
42
increased tissue resistance (increases viscosity).
pulmonary fibosis tuberculosis infections pulmonary edema
43
decreased compliance of lungs and chest wall
sliocosis, asbestosis, sarcoidosis tuberculosis cancer pneumonia restrictive diseases of the chest cage
44
diseases that decrease diffusing capcity of the lungs
decreased area of respiratory membrane increased thickness of respiratory membrane abnormal vntilation/perfusion ratio
45
abnormalities of oxygen transport to the tissues
anemia CO posioning decreased blood flow
46
compliance is __ in emphysema.
increased
47
pneumonia
any inflammatory condition in which the alveoli ar efilled with fluids and blood cells.
48
atelectasis
collapse of the alveoli or failure to inflate caused by: airway obsturction lack of surfactant puncture into thoracic cavity. spontaneous pneumothorax.
49
asthma
causes local edema in small bronchioles and spastic contraction of bronchioles.
50
tuberculosis
loss of lung tissue
51
types of hypoxia
hypoxic anemic stagnant/ischemia histotoxic
52
hypoxic hypoxia
atmospheric or hypoventilation
53
anemia
not enough Hb or abnormal Hb, so not enough O2 transported to tissues.
54
stagnant
nout enough blood flow to carry O2 to tissues
55
histotoxic
tissues cannot utilize O2 even though enough is reaching the tissues. CO and beri beri are examples.
56
oxygen therapy in hypoxia
is not sueful.
57
obstructive lung disease
FEV/FVC ratio is decreased.
58
restrictiv elung disease
FEV/FVC is close to normal (both FEV and FVC decreased).
59
Condtions associated with restrictive breathing patterns
My Goodness Please Fart My Dear! Myasthenia gravis Gullian Barre Pleural Effusion Flain Chest Massive Obesity Diaphragm paralysis Atelectatis, pulmonary, pneumonia, congestive heart failure.
60
Gi depolarization
stretch Ach parasympathetic GI hormones
61
hyperpolarization of GI
NE/Epi sympathetics
62
Contractile activity started by
spike potentials that let Ca++ in.
63
parasympathetic = stimulatory, sympathetic =
inhibitory. It inhibits forward motility by relaxing gut wall and contracting sphincters.
64
peristalsis
a propulsive movement in which a contractile ring moves in one direction.
65
The myenteric plexus is necessary for
effectual peristalsis, it includes relaxation.
66
Stomach emptying is favored by peristaltic contractions, which can increase in intensity under certain circumstances and which are called the
pyloric pump.
67
stomach signals
favor emptying by relaxing the pyloric sphincter and increasing motility of the stomach. Gastrin is released from the stomach.
68
duodenal signals
oppose emptying by depressing pumping in the stomach and increasing pyloric tone. Is caused by distention in the duodenum, irritating chyme, too much protein or fat, too solid, and CCK/secretion.
69
haustrations
severe segmentation movements that close off the canal, and turn over all the material over until it has been expossed to the surface of the intestine for absorption of fluids.
70
mass movements
they force fecal material into the rectum and the urge to defecate is felt.
71
saliva
amylase mucus lysozonyme.
72
gastric secretion
mucous neck cells (alkaline mucus) chief cells (pepsinogen) parietal cells (Hcl)
73
Intrinsic factor
allows the absorption of vitamin B12. Is produced after gastritis.
74
vagal stimulation to the enteric nervous system causes
oxyntic glands to secrete pepsin, stomach to serete gastrin.
75
distension causes
gastrin secretion. digested proteins, alcohol, Ach and caffeine cause gastrin secretion. Histamine causes gastric gland secretion.
76
gastric secretion phases
cephalic gastric intestinal
77
enterogastric reflex
distension, acid or irritating chyme inhibit secreation.
78
CCK/secretin
caused by acid, fat or irritating chyme oppose gastric secretion. They oppose gastrin.
79
Pancreatic secretion
``` trypsin, carboxypeptidase RNAse, DNAse Amylase Lipase HCO3 ```
80
Pancreatic secretion regulation
acid from stomach releases secretin from duodenum, fats cause release of CCK. Secretin and CCK absorbed into the blood stream. Vagal stmulation releases enzymes into acini. Secretin causes copious secretion of pancreatic fluid and bicarbonate. CCK causes secretion of enzymes.
81
Bile secretion
vagal stimulation causes weak contraction of gallbaldder -> secretic stimulates liver weakly -> gallbaldder contraction -> relaxation of sphincter of Oddi.
82
No bile in intestines causes failure to absorb
ADEK. Also steatorrhea.
83
Secretion of mucus
From Brunner's glands in duodenum and crypts of Lieberkuhn. Inhibited by sympathetics
84
Secretion of intestinal digestive juices
From crypts of lieberkuhn. includes peptidases, disaccharides, lipases
85
regulation in small intestine secretion
local nervous reflexes stimuilated by chyme.
86
digestion of carbohydrates
mouth - amylase stomach - blocks amylase small intestine - pancreatic amylase
87
digestion of fats
mostly in small intestine by bile salts, lipase and colipase
88
digestion of proteins
pepsin occurs in small intestine due to enzymes in pancreatic secretions and epithelial cells.
89
large surface area of the small intesines
is due to folds o mucosa, villi and microvilli.
90
absnorption in small intesine
water, ions, active transport of Na, Cl, bircarbonate, Ca, vitamin D3, Fe, K, Mg
91
CHO, monosaccharides, glucose, galactose, proteins
carried by a Na+ transport system.
92
substances absorbed in the colon
water and electrolytes.
93
No milk right after diarrhea because epithelial cells don't make lactase immediately, will be lactose inolerant with continued diarrhea.
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NYCPM Physiology (17 decks)

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