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PGY 206 > Exam 4 > Flashcards

Exam 4 Flashcards

1
Q

two ways that “respiration” term can be used

A

mitochondrial O2 utilization (aerobic metabolism) & ventilation

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2
Q

Components of the thorax

A

chest wall, thoracic cavity, pleural cavity

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3
Q

diaphragm

A

skeletal muscle sheet

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4
Q

thorax

A

rib cage, spinal column, trunk muscles

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5
Q

pleural cavity

A

space between visceral and parietal pleurae

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6
Q

conducting zone functions

A

conducts air flow (bulk flow) to respiratory zone; warms and humidifies inspired air; cleans air

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7
Q

how does the conducting zone clean air

A

secretes mucus that cilia move

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8
Q

conducting zone components

A

larynx, trachea, right and left primary bronchius, respiratory bronchioles

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9
Q

how does mucus clear debris from the inspired air

A

mucus layer traps inhaled particles and a watery saline layer between the mucus and cilia allows the cilia to push the mucus towards the pharynx

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10
Q

cystic fibrosis

A

thick, sticky mucus blocks the airway

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11
Q

respiratory zone components

A

terminal bronchiole and alveolus

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12
Q

number of alveoli

A

300 million

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13
Q

alveoli function

A

primary site of gas exchange

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14
Q

alveolar type I cells

A

where gas exchange occurs; lined with a thin layer of water; epithelial cells with structural function (80-90% of cells in alveoli); thin & interconnected by pores

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15
Q

type II alveolar cells

A

secrete surfactant

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16
Q

surfactant function in alveoli

A

detergent-like substance that lowers the surface tension of water on the alveoli, preventing their collapse

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17
Q

alveolar macrophages

A

clean debris

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18
Q

how does air move between the alveoli and respiratory bronchioles

A

diffusion

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19
Q

what is the total surface area of all alveoli

A

60-80 m^2; half a tennis court

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20
Q

what is the barrier to diffusion in alveoli

A

2 cells across; 2 micrometers

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21
Q

where is resistance to air flow highest

A

upper airways; as bronchioles branch, total cross-sectional resistance decreases and velocity of flow decreases

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22
Q

Intrapulmonary or alveolar pressure (Pa)

A

equals atmospheric pressure at rest but is altered by changes in lung volume; pressure in the lungs

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23
Q

intrapleural pressure (Ppl)

A

subatmospheric (negative) at rest; determined by lungs and chest wall; the pressure between the chest wall and lung; always more negative than Pa & affected by the forces of gravity

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24
Q

transpulmonary pressure

A

pressure difference across lung (Pa-Ppl); determines lung volume

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25
Q

ideal gas law

A

PV=nRT; a constant if temperature and number of molecules is unchanged, a “closed container”)

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26
Q

Boyle’s Law

A

P1V1=P2V2

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27
Q

understanding pressure change in lung using Boyle’s Law

A

changes in lung volume alter Pa because gas pressure is inversely proportional to container volume; with lung expansion, Pa falls below (Patm) so air flows in; with lung compression, Pa increases above Patm so air flows out

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28
Q

active process of inspiration

A

diaphragm contracts, increasing thoracic volume & parasternal/external intercostals contract, pulling the ribs up and out

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29
Q

how is Ppl changed during inspiration

A

becomes more negative

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30
Q

how is Pa changed during inspiration and why

A

becomes more negative because lung volume is increased

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31
Q

passive process of expiration

A

inspiratory muscles relax

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32
Q

how is Pa changed during expiration and why

A

becomes positive because lung volume decreases

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33
Q

how is Ppl changed during expiration

A

becomes less negative

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34
Q

active process of expiration

A

internal intercostal and abdominal muscles contract; expiratory pressures increase; air flow is faster and more variable

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35
Q

when is expiration active

A

exercise, speech, coughing, panting, etc.

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36
Q

pressure changes in inspiration in quiet breathing

A

Pa is less than Patm; approximately -3mmHg

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37
Q

pressure changes in expiration in quiet breathing

A

Pa is greater than Patm; approximately +3mmHg

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38
Q

pneumothorax

A

air enters the pleural space causing the lung to collapse because it can no longer hold its shape due to positive Ppl

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39
Q

open pneumothorax

A

air enters via open wound to chest wall

40
Q

closed pneumothorax

A

air enters via lung injury, chest wall remains intact

41
Q

lung resistance defn

A

ease with with air flows through airways

42
Q

air flow equation

A

flow = change in pressure/resistance

43
Q

what determines airway resistance

A

airway diameter

44
Q

what determines airway diameter

A

smooth muscle tone and support by surrounding tissue

45
Q

surrounding tissue for support in conducting zone

A

cartilage and muscle

46
Q

airway diameter support in respiratory zone

A

held open by surrounding tissue by tethering that pulls airways open

47
Q

compliance

A

the ability to stretch

48
Q

compliance equation

A

C = delta(V)/delta(P); change in lung volume per change in transpulmonary pressure

49
Q

how compliant are lungs (comparison)

A

100x more compliant than a toy balloon

50
Q

what is compliance determined by

A

lung structure and surface tension

51
Q

how does surface tension affect compliance

A

alveoli are lined by a thin liquid layer that generates tension at the air-liquid surface and acts like a pressure pulling alveoli closed; resists lung expansion

52
Q

respiratory distress syndrome

A

occurs in premature babies; type II alveoli cells are not mature enough to produce surfactant so alveoli collapse and have to reinflate every breath

53
Q

treatment for respiratory distress syndrome

A

steroids to stimulate production or artificial surfactant

54
Q

elastic recoil

A

result of elastin fibers in lung tissue; allows the lung to recoil back to its original shape

55
Q

gas exchange mechanism

A

gases move between air and blood by diffusion due to concentration gradient

56
Q

how is diffusion a rapid process in the lungs

A

large surface area and short diffusion distance

57
Q

how does each gas move

A

down its concentration or partial pressure gradient

58
Q

Dalton’s Law

A

pressure of a gas mixture = sum of pressures each gas exerts independently

59
Q

partial pressure

A

pressure exerted by one gas in a mixture

60
Q

atmospheric PO2

A

150mmHg

61
Q

PH2O, CO2, O2, and N2 of inspired air

A

H2O=variable; CO2=negligible; O2=~150; N2=600

62
Q

PH2O, CO2, O2, and N2 of alveolar air

A

H2O=47; CO2=40; O2=~100; N2=568

63
Q

Henry’s Law

A

gas dissolved in liquid exerts a pressure; in liquid equilibrated with a gas mixture, partial pressures are equal in the two phases

64
Q

what determines the amount of each gas dissolved in liquid

A

temperature of the fluid, partial pressure of the gas, and solubility of the gas

65
Q

PO2 and PCO2 in the pulmonary vein

A

PO2=100; PCO2=40

66
Q

PO2 and PCO2 in the systemic arteries

A

PO2=100; PCO2=40

67
Q

PO2 and PCO2 in the systemic veins

A

PO2=40; PCO2=46

68
Q

PO2 and PCO2 in the pulmonary artery

A

PO2=40; PCO2=46

69
Q

plasma O2 content without hemoglobin

A

0.3mL

70
Q

plasma O2 content with hemoglobin

A

20.0mL

71
Q

red blood cells

A

flattened biconcave discs with a large surface area to promote diffusion of gases

72
Q

how many hemoglobin molecules are in each RBC

A

hundreds of millions

73
Q

what part of hemoglobin transports O2

A

iron group of the heme

74
Q

normal systemic venous blood oxygen saturation

A

75%

75
Q

oxyhemoglobin dissociation curve properties

A

s-shape, upper plateau, steep slope

76
Q

why does the oxyhemoglobin dissociation curve have an s-shape

A

binding cooperativity; conformation changes make hemoglobin more likely to bind O2 in other spots once one or more are filled

77
Q

why does the oxyhemoglobin dissociation curve have an upper plateau

A

O2 loading in lungs, there is a maximum

78
Q

why does the oxyhemoglobin dissociation curve have a steep slope

A

unloading in tissues

79
Q

relation between PO2 and hemoglobin saturation %

A

as PO2 increases, % of hemoglobin saturated with bound oxygen increases until all of the oxygen-binding sites are occupied (100% saturation)

80
Q

things that cause a left shift in O2 binding affinity (more affinity)

A

pH rise/H+ drop; PCO2 drop; temperature drop; 2,3-DPG drop

81
Q

things that cause a right shift in O2 binding affinity (less affinity)

A

pH drop/H+ rise; PCO2 rise; temperature rise; 2,3-DPG rise

82
Q

when would you see a PCO2 rise and why would it affect O2 binding affinity

A

when exercising; metabolically active-> O2 goes to mitochondria to make ATP so PO2 is lower, and more CO2 is produced as a byproduct

83
Q

2,3-DPG

A

byproduct of anaerobic metabolism

84
Q

how is CO2 transported in blood (with percentages)

A

HCO3- (70%); dissolved (10%); carbaminohemoglobin (20%)

85
Q

carbonic anhydrase

A

enzyme that converts water and CO2 to bicarbonate

86
Q

eupnea

A

normal quiet breathing

87
Q

hyperpnea

A

increased respiratory rate and/or volume in response to increased metabolism; ex: exercise

88
Q

hyperventilation

A

increased respiratory rate and/or volume without increased metabolism; ex: emotional hyperventilation, blowing up a balloon

89
Q

hypoventilation

A

decreased alveolar ventilation; ex: shallow breathing, asthma, restrictive lung disease

90
Q

tachypnea

A

rapid breathing; usually increased respiratory rate with decreased depth; ex: panting

91
Q

dyspnea

A

difficulty breathing (a subjective feeling sometimes described as “air hunger”); ex: various pathologies or hard exercise

92
Q

apnea

A

cessation of breathing; ex: voluntary breath-holding, depression of CNS control centers

93
Q

emphysema

A

destructive disease; decreased alveoli decreases the surface area for gas exchange; decreased elastic recoil of lung; increased lung compliance

94
Q

emphysema PO2 levels

A

normal or low in alveoli and low in capillaries

95
Q

fibrotic lung disease

A

restrictive disease; thicker alveoli increase distance for diffusion and slows gas exchange; loss of lung compliance; black lung

96
Q

fibrotic lung disease PO2 levels

A

normal or low in alveoli and low in capillaries

97
Q
A

PGY 206 (4 decks)

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