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PT 509 Physiology > Lecture 3 > Flashcards

Lecture 3 Flashcards

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1
Q

What are the two types of respiration?

A

External

Cellular

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2
Q

External Respiration

A

Breathing air in and out and transporting it to the circulatory via the heart

1) Ventilation (atm and air sacs)
2) O2/CO2 between alveoli and blood
3) Transport O2/CO2 by blood between lungs/tissues

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3
Q

Cellular Respiration

A

Exchange of O2 and CO2 between the blood in the systemic capillaries and the tissue cells

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4
Q

Respiratory Airways

A 
Terminal bronchiole (smooth m.)
2 branches (pulmonary artery/vein/capillaries)
Alveolar ducts
Alveolar sac
...elastic fibers (expansion/retraction)
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5
Q

Trachea/Larger Bronchi

A

rigid
non-muscular
rings of cartilage

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6
Q

Bronchioles

A

no cartilage
smooth m. walls (ANS innervated)
sensitive to hormones

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7
Q

Alveoli

A

Type I, structural support

Type II, bigger, secretes surfactant, decreases surface tension, prevents collapsing of alveoli

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8
Q

Alveolar macrophage

A

fights infection

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9
Q

Why is pulmonary capillary close to the alveolus?

A

For gas exchange

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10
Q

Lungs are housed in…

A

Thoracic cavity

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11
Q

Lungs consists of…

A

highly branched airways, alveoli, pulmonary blood vessels, large quantities of elastic C.T. (expansion/recoil)

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12
Q

Thorax

A

Outer chest wall

12 pairs of ribs/sternum/thoracic vertebrae (protects)

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13
Q

Diaphragm

A

dome-shaped sheet of skeletal m.

*Only vital for survival

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14
Q

Pleural sac

A 
Separates each lung from thoracic wall
Interpleural fluid
Generates pressure gradient
Parietal (outer)
Visceral (inner)
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15
Q

When does the lung start to develop?

A

4 weeks, epithelial lining

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16
Q

When does the bronchial buds start to develop?

A

28 days

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17
Q

When does the 2nd bronchi start to develop?

A

35 days

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18
Q

When does all the branches formed?

A

42 days

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19
Q

When does the alveoli form (Type 2 cells) start to develop?

A

24 weeks

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20
Q

When does surfactant start to produce?

A

26-28 weeks

important for baby to be born and survive

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21
Q

Respiratory distress syndrome is AKA

A

Hyaline membrane disease
alveoli collapses, damaged type 2 cells, low levels of surfactant
baby becomes hypoxia, pulmonary restrictions, damages structural support for lung cells

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22
Q

When does a baby develop muscles for chest expansion?

A

3-6 months

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23
Q

By age 8 how many new alveoli?

A

300

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24
Q

3 pressures related to ventilation

A

Patm
Pia
Pip

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25
Patm
atmospheric pressure pressure exerted by the weight of the gas in the atm 760mmHg
26
Pia
intra-alveolar pressure within alveoli 760mmHg
27
Pip
interpleural pressure pressure in the pleural sac 756mmHg
28
Muscles involved in inspiration
sternocleiodomastoid- scalenus- - forceful external intercostal* diaphragm* *major muscles for every inspiration, relax causes passive expiration
29
Muscles involved in expiration
internal intercostal | *only during ACTIVE expiration
30
Bringing air in...
pressure inside (alveoli) has to be less than atmospheric pressure lower intrapleural pressure, this allows diffusion Pia
31
Pushing air out...
higher pressure intrapleural pressure pressure inside (alveoli) has to be greater than the atmospheric pressure Pia>Patm
32
Airway resistance
bronchoconstriction, decrease radius we will increase resistance bronchodilation, increase radius we will decrease resistance
33
Main types of obstructive lung diseases
emphysema (more sever) chronic bronchitis asthma
34
Emphysema
alveolar wall destruction | overinflation
35
Chronic bronchitis
Productive cough | Airway inflammation
36
Asthma
Reversible obstruction | triggers by allergens, infection
37
Compliance
how much effort is required to stretch/distend the lungs 1) Elastic C.T. 2) Alveolar surface tension (low, prevent collapsing)
38
Elastic Recoil
how readily the lungs rebound after being stretched 1) Elastic C.T. 2) Alveolar surface tension
39
Surface tension
tendency of molecules in the fluid, to draw to the center of the fluid
40
Pulmonary surfactant function:
decrease surface tension | contributes to lunch stability
41
Pulmonary surfactant benefits:
increases pulmonary compliance | reduces lungs tendency to recoil, when we don't want it to
42
Tidal volume (TV)***
amount of air you can passively expire/inspire
43
Inspiratory reserve volume (IRV)
amount of air that's left in the lungs after forcefully inspire
44
Expiratory reserve volume (ERV)
amount of air you can expire forcefully
45
Residual volume***
amount of air in your lungs after maximal expiration (1.2L, don't want this to increase)
46
Average total lung capacity***?
6L
47
Total lung capacity
total capability of lungs to expire/inspire maximally and residual volume IRV + ERV + TV + RV
48
Minute ventilation
total amount of air moved in/out of respiratory system/min | Respiratory Rate = # breaths taken per min
49
Anatomic dead space
part of respiratory system where gas exchange does not take place
50
Alveolar ventilation
amount of air that enters the parts of the respiratory system in which gas exchange takes place/min
51
Simple diffusion
response to conc gradient
52
Diffusion depends on...
partial pressure of gas
53
Partial pressure...
total pression x fractional composition gas in mixture
54
Most O2 in the blood is transported bound to...
hemoglobin
55
Percentage of O2
1. 5% physically dissolved | 98. 5% bound to hemoglobin
56
Percentage of CO2
10% physically dissolve 20% bound to hemoglobin 60% as bicarbonate
57
% Saturation, oxygen-hemoglobin dissociation curve
full saturated in pulmonary capillaries
58
Direction of O2 and CO2 is...
opposite... high to low pressures | blood leaving lungs is high in O2 and low in CO2
59
Pulmonary circulation
high O2 low CO2 (in/out of the left heart to body)
60
Systemic circulation
low O2 high CO2 (back to the right side of the heart out to lungs)
61
Where is the brain control for respiration?
In the brain...
62
What senses the O2/CO2 changes?
peripheral chemoreceptors | in the carotid/aortic bodies
63
Decrease PO2 in the arterial blood...
stimulates P.C. when
64
Increase PO2 in the arterial blood
increase H in ECF weekly stimulates P.C. stimulates C.C.
65
Increase H in the arterial blood
stimulates P.C. in balance | cannot penetrate BBB (controls what comes in/out)
66
In aging...
Everything decreases and is less | VC decrease, increase RV
67
Symptoms of COPD
``` SOB fever (important) unable to speak full sentences productive cough audible wheezing dyspnea ```
68
Changes in Physiology (COPD)
caused by chemical irritant to lungs (smoke, pollution) inflammation/irritation in bronchioles breakdown of elastin genetic risk factor
69
Changes in Physiology
(Bronchitis) bronchial edema chronic productive cough bronchospasm (Emphysema) destruction of alveolar walls lung fibrosis air trapping
70
Leads to overtime...
abnormal ventilation(air)-perfusion(blood) ratio hypoxemia hypoventilation
71
Changes in large airways of COPD
``` neutrophils in sputum mucus hypersecretion goblet cell hyperplasia mucus gland hyperplasia squamous metaplasia of epithelium no basement membrane thickening increase macrophages increase lymphocytes little increase in airway smooth m. (loses m. tone) ```
72
Pathogenesis
decrease elasticity air sac walls destroyed walls thick and inflamed increase mucus
73
Causes of COPD
chemical irritants (#1) genetics second hand smoke chronic exposure at work
74
COPD presented with...
bronchitis and emphysema
75
Chronic bronchitis (Blue bloater)
overweight and cyanotic elevated hemoglobin peripheral edema rhonchi and wheezing
76
Emphysema (Pink Puffer)
older and thin severe dyspnea quiet chest x-ray, hyperinflation with flattened diaphragm
77
Stages of COPD (GOLD)
1) mild, 80% normal lung function 2) moderate, 50-80% normal lung function 3) severe, 30-50% normal lung function 4) very severe,
78
Clinical Manifestions
``` easily fatigued frequent respiratory infections use of accessory muscles to breathe orthopneic wheezing purse-lip breathing chronic cough dyspnea prolonged expiratory time increased sputum (bronchitis) digital clubbing thin appearance Cor Pulmonale ```
79
Cor Pulmonale
right sides heart failure, lungs backed up
80
Treatment Goals for COPD
``` relieve symptoms slow progression of disease improve exercise tolerance prevent/treat complications improve overall health ```
81
Lifestyle changes
avoid lung irritants nutritional supplements safe physical activity pulmonary rehab
82
Treatments (less to worse)
``` self management bronchodilators inhaled corticosteroids pulmonary rehab oxygen surgery ```

PT 509 Physiology (9 decks)

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