Respiratory Flashcards

1
Q

In blood circulation what direction is the pressure gradient

A

gasses move down their pressure graident

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2
Q

describe the pulmonary circuit

A

O2 enters bloood CO2 leaves

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3
Q

Describe the sysemic circuit

A

O2 leaves blood CO2 enters

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4
Q

How does gas move throughout the respiratory system

A

diffusion

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5
Q

describe different anatomical and physiological properties to facilitate gas diffusion

A

Large surface area for gas exchange.
Large partial pressure gradients.
3) Gases with advantageous diffusion properties.
4) Specialised mechanisms for transporting O2 and CO2 between lungs and tissues.

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6
Q

what is partial pressure?

A

Sum of the partial pressures (mmHg) or tensions (torr) of a gas must be equal to total pressure

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7
Q

what are the two forms O2 is carried in the blood?

A

Dissolved
Bound to Heamaglobin

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8
Q

Is it a large or small amount of blood dissolved?

A

Only a small percentage of O2 in blood is in the dissolved form.

Amount of dissolved O2 in blood is proportional to its partial pressure

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9
Q

How is dissolved O2 measured clinically?

A

in arterial blood sample PaO2- piercing of artery (very invasive)

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10
Q

what is the amount of O2 dissolved in blood proportional too?

A

it’s partial pressure

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11
Q

Transport of O2 in dissolved form is not adequate for what?

A

Body’s requirement at rest.

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12
Q

How many heme groups are attached to the globin protein?

A

4 heam groups

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13
Q

What is the binding site for oxygen?

A

Each heme group contains
iron in the reduced ferrous
form (Fe+++), which is the
site of O2 binding.

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14
Q

how much oxygen does HB molecules in red blood cells

A

280 million Hb molecules

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15
Q

why does binding and dissociation of O2 with Hb occur in milliseconds?

A

because red blood cells in capillaries for one second only

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16
Q

Does the acidity of the blood affect the binding of Haemoglobin?

A

Yes so does temperature

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17
Q

Is O2 binding to Hb reversable?

A

Yes

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18
Q

What does oxygen saturation refer to?

A

to the amount of O2 bound to Hb relative to maximal amount that can bind.

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19
Q

When is Haemoglobin almost 100% saturated?

A

100 mmHg PO2

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20
Q

At what point does a drop in partial pressure have an effect?

A

<60 mmHg

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21
Q

How would you measure O2 saturation (SaO2)?

A

Pulse oximeter- measures ration of absorption and infrared waves

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22
Q

Healthy Individuals should have what percentage if oxygen saturation?

A

96-100% saturation
total oxygen capacity- 211 mlsO2/1L

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23
Q

How much more efficent is Haemoglobin at carrying oxygen around the blood?

A

hemoglobin 208 in 1L
dissolved 3 mls/ 1L

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24
Q

What is the respiratory exchange ratio?

A

Ratio of expired CO2 to O2 uptake

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25
Q

What are the 3 forms is CO2 carried in?

A

i)7% dissolved.
ii)23% bound to
haemoglobin (Hb).
iii) 70% converted to
bicarbonate.

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26
Q

In a bicarbonate reaction what effects does the concentration gradient have?

A

Speed and direction of the reaction

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27
Q

What has an effect in maintaining the acid-base balance in the body?

A

The CO2 to HCO3- pathway plays a critical role in regulation of H+ ions and in maintaining acid- base balance in body

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28
Q

What enzyme converts CO2 to HCO3

A

H2CO3

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29
Q

What organ/organs help to regulate bicarbonate concentration?

A

the kidneys

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30
Q

What shape is the O2 dissociation curve?

A

S-shaped Curve

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31
Q

Name some factors that affect Breathing

A

sleep, phonation, emotion, cardiovascular, temperature, exercise, mechanoreception, and chemoreception.

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32
Q

What modulates Breathing?

A

vocalisation, Physiological challenges, Emotion, reflexes, Volitional control- hold breath

33
Q

Where does the brain receive neural breathing receptors from?

A

Chemoreceptors, mechanoreceptors

34
Q

What do chemoreceptors feedback?

A

provide feedback on blood PO2, PCO2 and PH

35
Q

What do mechanoreceptors provide feedback on?

A

the mechanical status of lungs, chest walls and airways

36
Q

Where are the neural signals sent to?

A

respiratory muscles to produce rhythmic breathing, upper airway muscles

37
Q

Why are reflexes important to breathing?

A

protects respiratory system and breathing

38
Q

What are chemoreceptors?

A

Chemoreceptors are sensory receptors that detect chemical changes in the surrounding environment.
respiratory- changes in PO2, PCO2 and pH in blood.

39
Q

What do peripheral chemoreceptors respond to?

A

Decrease in PO2- hypoxia

40
Q

Where are peripheral chemoreceptors located?

A

in periphery- outside CNS

41
Q

Describe Peripheral chemoreceptors

A

small, highly vascularised bodies

42
Q

What is the ventilation response to Hypoxia

A

Below 60 mmHg there is a progressive hyperventilation.
Hypoxic response originates in carotid and aortic bodies

43
Q

Where are central Chemoreceptors located?

A

brainstem

44
Q

When would central chemoreceptors be stimulated?

A

when PCO2 is increased (hypercapnia) or pH decreased.

45
Q

What is the ventilation response to hypercapnia?

A

Very small changes in PCO2 have large effects on ventilation (unlike O2). Hypercapnic response originates in central chemoreceptors in brainstem. Plays major role in moment to moment control of breathing

46
Q

What are mechanoreceptors?

A

Mechanoreceptors are sensory receptors that detect changes in pressure, movement and touch. In respiratory system mechanoreceptors detect movement of lung and chest wall.

47
Q

What activates mechanoreceptors?

A

Inflation of the lungs

48
Q

What happens when mechanoreceptors detect inflation of the lungs?

A

Neural signals sent via vagus nerve to NTS in brainstem. Ventilation adjusted accordingly.

49
Q

When the NTS receives info from mechanoreceptors and chemoreceptors where is the information processed?

A

in brainstem by respiratory neurons

50
Q

what do the cluster of respiratory neurons generate?

A

the rhythm of breathing which is sent to respiratory muscle

51
Q

What nerve innovates diaphragm

A

Phrenic nerve- exits spinal chord at level 3-5

52
Q

why is there a large portion of the motor cortex dedicated to the hand

A

refine motor movements

53
Q

What is ventilation?

A

process by which air moves in and out the lungs

54
Q

is ventilation in the lungs happen uniformly?

A

no due to gravity

55
Q

is the plural pressure more negative at apex or base

A

at apex

56
Q

what is meant by compliance of the lung?

A

refers to how much effort is required to stretch the lungs and chest wall

57
Q

What is decreased compliance a potential symptom of?

A

scarring of the lung, lung filled w fluid, deficiency in surfactant production, destruction of elatstic fibres- emphysema

58
Q

What is meant by resistance of the lung?

A

refers to narrowing or obstruction of airway which may reduce airflow

59
Q

Increased resistance is seen in what conditios?

A

asthma, COPD

60
Q

Anatomical dead space?

A

volume of gas during which each breath fills the conducting airways

61
Q

Physiological dead space?

A

total volume of gas in each breath that does not participate in gas exchange e.g. alveoli that are perfused but not ventilated

62
Q

What are the lungs 2 blood supplies?

A

Bronchial cirulation and pulmonary circulation

63
Q

is the pulmonary circulation a high or low pressure system?

A

low pressure also low resistance

64
Q

What does the V/Q ratio refer to?

A

ratio of ventilation to blood flow

65
Q

What can the V/Q ratio be defined by?

A

for single alveolus, a group of alveoli or the entire lung

66
Q

What is a healthy aveolar ventilation

A

4-6 L/min

67
Q

In a perfect model what would the V/Q equal?

A

V/Q=1

68
Q

What is hypoxia?

A

when oxygen is insufiencent PO2>60

69
Q

physiological shunt?

A
70
Q

When is V-Q mismatching most frequent

A

due to arterial hypoxia in patients

70
Q

When is V-Q mismatching most frequent

A

due to arterial hypoxia in patients

71
Q

What is COPD?

A

a condition in which airflow is obstructed, encompasses emphysema and chronic bronchitis, long term smoking is a cause

71
Q

What is COPD?

A

a condition in which airflow is obstructed, encompasses emphysema and chronic bronchitis, long term smoking is a cause

71
Q

What is COPD?

A

a condition in which airflow is obstructed, encompasses emphysema and chronic bronchitis, long term smoking is a cause

72
Q

Symptoms of COPD?

A

tight cough, inflammation of lungs

73
Q

What is emphysema?

A

structures in alveoli over inflated, lungs loose elasticity cannot fully expand and contract, patients inhale but exhalation is difficult due to decreased recoil

74
Q

What is chronic bronchitis?

A

inflammation of bronchi causing mucus production and excessive swelling, prone to infections

75
Q

what is pulmonary fibrosis?

A

a type of interstitial lung disease, scarring and thickening of lung, decreased elasticity and gas exchange- usually die within 4 years.