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bmsc 208 > Respiratory System I > Flashcards

Respiratory System I Flashcards

1
Q

There are 4 primary functions of the respiratory system:
1. Exchange of gases between the _____ and the ____
2. ______ regulation of body pH
3. Protection from inhaled ______ and _____ ______
4. ______

A
  1. atmosphere, blood
  2. Homeostatic
  3. pathogens, irritating substances
  4. Vocalization
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2
Q

Air exchange occurs by ____ ____ and follows many of the principles that govern the CV system

A

bulk flow

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3
Q

Air exchange occurs by bulk flow and follows principles:
i. Flow occurs from region of ____pressure to ___ pressure
ii. ______ ____ creates the pressure gradients
iii. Resistance is primarily influenced by _____ of tubes through which air is flowing

A

i. high, low
ii. Muscular pump
iii. diameter

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4
Q

What is external respiration?

A

The movement of gases between the environment and the cells within the body.

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5
Q

External respiration requires coordination between the ______ and ______ systems

A

respiratory, cardiovascular

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6
Q

External respiration is a 4 step process: ?

A
  1. Exchange I: atmosphere to lung (ventilation)
  2. Exchange II: lung to blood
  3. Transport of gases in the blood
  4. Exchange III: blood to cells
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7
Q

What are the 3 main structures involved in ventilation and gas exchange?

A
  1. Conducting system or airways
  2. Alveoli
  3. The bones and muscles of the thorax (chest cavity)
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8
Q

What are the 4 structures considered as the Upper respiratory system?

A

Nasal cavity
Mouth
Pharynx
Larynx

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9
Q

What are the 2 structures considered as the Lower respiratory system?

A

Trachea and lungs

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10
Q

The lungs are composed of light spongy tissue whose volume is occupied mostly by ____-filled spaces

A

air

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11
Q

The _____ lung is slightly larger than ____ due to the _____ ____

A

right, left, cardiac notch

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12
Q

The ____ lung is divided into 3 lobes, and the ____ lung is divided into 2 lobes

A

right, left

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13
Q

What are the 3 lobes of the right lung?

A

Superior, middle, inferior

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14
Q

What are the 2 lobes of the left lung?

A

Superior, inferior

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15
Q

Each lung is surrounded by a double-walled _____ ___

A

pleural sac

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16
Q

One layer of the pleural sac is connected to the outside surface of the lungs which is called the _____ ____ and the other to the inside surface of the thoracic cavity _____ ____

A

visceral pleura, parietal pleura

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17
Q

Pleural fluid in the pleural cavity acts like water between two glass panes, where it is very easy to slide against one another, but very difficult to ?

A

pull apart

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18
Q

What are the 2 main functions of the pleural sac?

A
  1. Created a moist slippery surface
  2. Holds lungs tight to the thoracic wall
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19
Q

______ connect lungs to the external environment

A

Airways

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20
Q

Air enters the _____ through the nasal cavity and/or mouth, from there air flows through the _____ (vocal cords) to the _____ (wind pipe)

A

pharynx, larynx, trachea

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21
Q

The trachea is a semi-flexible tube held open with ?

A

15-20 cartilage rings

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22
Q

Arrange these in order of “branching of the airways:”
smaller bronchi, bronchioles, trachea, alveoli, primary bronchi

A

Trachea, primary bronchi, smaller bronchi, bronchioles, alveoli

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23
Q

What 3 components of the airway is considered the “conducting system”?

A

Trachea, primary bronchi, smaller bronchi

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24
Q

What 2 components of the airway is considered the “exchange surface”?

A

Bronchioles, alveoli

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25
Q

A major difference between bronchi and bronchioles is that bronchi have _____ (either rings or plates the further down you go) but bronchioles have _____ _____ that selectively controls

A

cartilage, smooth muscle

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26
Q

The upper _____ and _____ play an important role in conditioning air before it reaches the alveoli

A

airways, bronchi

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27
Q

What are the 3 important roles of conditioning air before it reaches the alveoli?

A

Warming air to body temperature
Adding water vapor
Filtering out foreign material

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28
Q

These three processes in conditioning air before reaching the alveoli are more efficient with _____ ______

A

nose breathing

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29
Q

The nasal cavity has a large surface area, has rich blood supply and nasal hair, the ____ of nasal airway tends to cause particles to embed in ____ in the back of the _____ and slide down to the esophagus

A

shape, mucus, pharynx

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30
Q

Air is filtered in the _____ and ____

A

trachea, bronchi

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31
Q

Epithelial cells lining the airways and submucosal glands secrete ____ and ____

A

saline, mucus

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32
Q

______ move the mucus layer toward the pharynx, removing trapped pathogens and particulate matter

A

Cilia

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33
Q

Saline is produced by the epithelial cells and overtop of the saline is a layer of mucus produced by ____ _____, the mucus contains _________

A

goblet cells, immunoglobulins

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34
Q

The epithelial cells contain cilia which push the mucus towards the pharynx, this phenomenon is called the ?

A

mucocilliary escalator

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35
Q

______ is necessary for mucocillary escalator function

A

Saline

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36
Q

Without the saline layer, cilia would become ? and ?

A

embedded in thick mucus, unable to move

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37
Q

Arrange these statements in order of “one model of saline secretion by airway epithelial cells:”
1. Apical anion channels, including CTFR, allow Cl- to enter the lumen
2. NaCl movement from ECF to lumen creates a concentration gradient so water follows into the lumen
3. Na+ goes from ECF to lumen by the paracellular pathway, drawn by the electrochemical gradient
4. NKCC brings Cl- into epithelial cells from ECF

A

4, 1, 3, 2

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38
Q

Cystic Fibrosis is caused by reduced production of ____. The mucus cannot be cleared properly allowing bacteria to colonize in the airways leading to reoccurring ____ _____. It also affects the _____

A

saline, lung infections, pancreas

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39
Q

_____ are the site of gas exchange

A

Alveoli

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40
Q

Alveoli are clustered at the ends of _______

A

bronchioles

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41
Q

Alveoli are heavily _______ (80-90% alveoli covered) and huge _____ ___ optimal for gas exchange

A

vascularized, surface area

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42
Q

Type __ alveolar cells: majority (95%) of the cells, very thin, act as the exchange epithelium

A

I

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43
Q

Type __ alveolar cells: other ~5% of the cells, thicker, specialized and produce a detergent like substance called surfactant

A

II

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44
Q

? : just in case there are any pathogens left that have avoided filtration already, can neutralize them and prevent damage or destruction done by them

A

Resident alveolar macrophages

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45
Q

_______ reduces surface tension and prevents the alveoli from collapsing

A

Surfactant

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46
Q

The pulmonary circulation has ____ flow but ___ pressure

A

high, low

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47
Q

The pulmonary circulation contains about 0.5 L or ___% of the total blood volume (75ml in capillaries)

A

10

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48
Q

Low pressure due to low ______ (shorter length circuit, more distensible and larger total cross sectional area of arterioles)

A

resistance

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49
Q

Low pressure means minimal _____ of fluid out of capillaries but there are lymphatics to remove any fluid that does get filtered and keep the diffusion distance to a minimum

A

filtration

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50
Q

Respiratory air flow is similar in many aspects to blood flow in the cardiovascular system, mainly the pressure gradients created to cause ____

A

flow

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51
Q

Normal sea level atmospheric pressure is considered to be ____ mmHg but is usually set to 0 cm H2O or mmHg by respiratory physiologists

A

760

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52
Q

What is Daltons law?

A

The total pressure exerted by a mixture of gases is the sum of the pressure exerted by each gas.

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53
Q

Daltons law is also dependent on the ______ of the air

A

humidity

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54
Q

The pressure exerted by one gas is known as its _____ _____ (interested in PO2 and PCO2 specifically)

A

partial pressure

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55
Q

What is the formula for Partial Pressure of a Gas?

A

Patm × % of gas in atmosphere

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56
Q

What is the formula for Partial Pressure of a Gas that takes humidity into account?

A

Pgas in humid air = (Patm - Ph2o) × % of gas

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57
Q

We are concerned with atmosphere pressure because it is the difference between ______ ______ and the ? that drive airflow

A

atmospheric pressure, pressure in the lungs

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58
Q

We are also concerned with partial pressures, which is exerted by a single gas, usually oxygen or carbon dioxide specifically, which drives ______

A

diffusion

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59
Q

To get a true partial pressure, _______ always needs to be considered as true dry air is rare on earth

A

humidity

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60
Q

Gases move ______ pressure gradients

A

down

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61
Q

Air moves by ____ flow

A

bulk

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62
Q

What is the symbol for Alveolar pressure?

A

Palv

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63
Q

What is the formula for flow?

A

F = (Palv - Patm) / R

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64
Q

In inspiration, Palv ? Patm?

A

<

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65
Q

In expiration, Palv ? Patm?

A

>

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66
Q

What is the formula describing Boyle’s Law?

A

P1V1 = P2V2

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67
Q

______ law helps explain how a change in lung volume results in a change in lung pressure driving the bulk flow of air

A

Boyle’s

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68
Q

During ventilation, air flows because of _____ _____

A

pressure gradients

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69
Q

During inspiration we make the volume of our alveoli _____ resulting in a _____ in pressure below atmospheric pressure resulting in air flow from the atmosphere ____ our alveoli

A

larger, drop, into

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70
Q

_______ is the bulk flow exchange of air between the atmosphere and the alveoli

A

Ventilation

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71
Q

A single respiratory cycle consists of a single ______ followed by an ______

A

inspiration, expiration

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72
Q

What instrument could we use to measure changes in lung volume?

A

Spirometer

73
Q

The amount of air enter and exiting the lungs during quiet respiration (resting respiration) is the _____ _____

A

tidal volume (TV)

74
Q

The total ventilation during rest represents the product of _____ _____ and ?

A

tidal volume, frequency of breaths

75
Q

Total pulmonary ventilation = ?

A

TV x frequency of breaths

76
Q

? : ~3000ml, the additional air that could still be inspired after quiet inspiration

A

Inspiratory reserve volume (IRV)

77
Q

? : ~1100ml, at the end of quiet expiration, the volume of air that still remains within the lungs that can be expired

A

Expiratory reserve volume (ERV)

78
Q

? : ~1200ml, and cannot be measured with spirometer. Even with maximal expiratory effort air always remains in the lungs

A

Residual Volume

79
Q

What are the four primary lung volumes that do not overlap?

A
  1. Tidal volume
  2. Inspiratory reserve volume
  3. expiratory reserve volume
  4. residual volume
80
Q

What are the 2 most important functions of Residual Volume?

A
  1. Prevents airway collapse, after a collapse it takes an unusually large pressure to re-inflate it.
  2. It allows continuous exchange of gases.
81
Q

The capacities of the lung are made up of different combinations of the four primary volumes: ?

A
  1. Total lung capacity
  2. Functional residual capacity
  3. Inspiratory capacity
  4. Vital capacity
82
Q

What is Total lung capacity?

A

The sum of all 4 volumes

83
Q

What is functional residual capacity?

A

The capacity of air remaining in the lungs after quiet expiration, the sum of ERV and RV

84
Q

What is inspiratory capacity?

A

The sum of IRV and TV representing the maximal amount of air that one can inspire

85
Q

What is Vital capacity?

A

The sum of IRV, TV, and ERV representing the maximal achievable tidal volume

86
Q

What is the Pulmonary Function Test?

A

Involves testing an individuals forced vital capacity (FVC) and comparing it to their Forced expired volume in one second (FEV1)

87
Q

Low initial FVC is indicative of ?

A

restrictive pulmonary disease (decrease in lung compliance)

88
Q

FEV1 is normally ~80% of vital capacity, so < 80% is indicative of ?

A

obstructive pulmonary disease (increased resistance)

89
Q

What is another word for atmospheric?

A

Barometric

90
Q

Inspiration occurs when alveolar pressure ______.

A

decreases

91
Q

How do we change alveolar pressure?

A

We use our inspiratory muscles (skeletal) to increase the volume of alveoli, resulting in a decrease in pressure

92
Q

60-75% of inspiratory volume change due to ____

A

diaphragm

93
Q

At rest, the diaphragm is _____; while during inspiration the thoracic volume _____

A

relaxed, increases

94
Q

Main muscle of resting respiration/quiet respiration is the _____, it is a sheet of skeletal muscle. When contracted it ____ and pulls the lungs _____-

A

diaphragm, flattens, downward

95
Q

The last 25-40% of inspiratory volume change due to ___ ____

A

rib cage

96
Q

What are the 2 main muscles associated with the rib cage and are important for inspiration?

A

External intercostals
Scalenes

97
Q

The external intercostals of the upper ribs and the scalenes cause a ?

A

“pump handle” motion

98
Q

The external intercostals in the lower ribs cause a ?

A

“bucket handle” motion

99
Q

The ? are important for creating an increase in thoracic volume while the ? extend from neck to upper ribs, lifting the upper ribs up

A

external intercostals, Scalenes

100
Q

Expiration occurs when alveolar pressure _____

A

increases

101
Q

Quiet expiration is _____ (relaxation of the inspiratory muscles)

A

passive

102
Q

During expiration, the diaphragm ____, and thoracic volume ______

A

relaxes, decreases

103
Q

During _____, the external intercostals and scalene muscles relax as well

A

expiration

104
Q

As alveolar volume decreases, the pressure inside increases above ______ ______

A

atmospheric pressure

105
Q

During expiration, the thoracic volume decreases which causes a ______ in alveolar volume and an _____ in pressure that drives the air flow ___

A

decrease, increase, out

106
Q

At the end of inspiration and expiration, when you’re not breathing that’s when the atmospheric pressure and the alveolar pressure are _____

A

equal

107
Q

Additional accessory or secondary muscles become activated during forced inspiration, which include: ?

A
  1. Sternocleidomastoids
  2. Neck and back muscles
  3. Upper respiratory tract muscles
108
Q

What is the the role of the Sternocleidomastoids?

A

Lift the sternum outward, contributing the water pump handle effect

109
Q

What is the the role of the Neck and back muscles?

A

Elevate pectoral girdle increasing thoracic volume

110
Q

What is the the role of the Upper respiratory tract muscles?

A

Decrease airway resistance

111
Q

To tap into the respiratory reserves, you need the ?

A

accessory/secondary muscles

112
Q

What are the 3 accessory muscles of forced expiration?

A
  1. Abdominal muscles
  2. Internal intercostals and triangularis sterni
  3. Neck and back muscles
113
Q

What is the the role of the triangularis sterni?

A

Depresses the sternum, further decreases thoracic volume

114
Q

What is the the role of the Internal intercostals?

A

Cause downward contraction of the ribs, further decreases thoracic volume

115
Q

Is the lung directly attached to the diaphragm or thoracic wall?

A

No

116
Q

For simplicity sake intrapleural pressure is ?

A

~-3 mmHg

117
Q

Thoracic wall and lungs have a _____ ____, and the ____ holds both in place, which gives it a negative pressure

A

natural recoil, pleura

118
Q

The pressure that exists in the intrapleural cavity is or is not uniform around the entire lungs?

A

is not

119
Q

The pressure that exists in the intrapleural cavity is more ____ at the base of the lung, this is due to ?

A

positive, gravity in a standing position

120
Q

Inspiratory muscles pull the _____ layer of pleura away from _____ layer, ______ the volume of the intrapleural cavity and thus ______ the intrapleural pressure. This creates a more _____ pressure pulling lungs outward

A

parietal, visceral, increasing, decreasing, negative

121
Q

The lungs do or do not expand at the same degree that the diaphragm and the thoracic cavity

A

do not

122
Q

Order these statements in accordance to Inspiration:
1. Lungs expand
2. Palv becomes subatmospheric
3. Thorax expands
4. Air flows into alveoli
5. Diaphragm and inspiratory intercostals contract
6. Pip becomes more subatmospheric

A

5, 3, 6, 1, 2, 4

123
Q

Order these statements in accordance to Expiration:
1. Air in alveoli becomes compressed
2. Chest wall recoils inwards
3. Diaphragm and inspiratory intercostals stop contracting
4. Air flows out of lungs
5. Pip moves back towards pre-inspiration value
6. Palv becomes greater than Patm
7. Lungs reoil toward pre-inspiration size

A

3, 2, 5, 7, 1, 6, 4

124
Q

An interruption in intrapleural pressure results in ________

A

pneumothorax (collapsed lung)

125
Q

_____ pneumothorax is air in the pleural space resulting from trauma and causing partial or complete lung collapse.

A

Traumatic

126
Q

______ pneumothorax can be caused by an underlying disease, breakdown of the visceral layer where is ruptures then air can leak from your lungs into the intrapleural cavity, which eventually causes collapse

A

Spontaneous

127
Q

Pneumothorax only occurs on the ? and why?

A

affected side, as the pleural layer is separate for each lung

128
Q

The degree of lung expansion at any time is proportional to the ?

A

change in pressure

129
Q

How much any given change in P expands the lungs depends on the ?

A

compliance of the lungs

130
Q

The reciprocal of compliance, lung elastance (elastic recoil) is the ?

A

ability to resist being deformed

131
Q

What is a mathematical formula representing compliance?

A

ΔV / ΔP

132
Q

________ pressure: the pressure across the wall of the lung itself, the difference between intrapleural pressure and alveolar pressure

A

Transpulmonary

133
Q

Compliance is _______: more stretchable, smaller change to increase it faster, inspire very easily, but its hard to expire

A

increased

134
Q

Compliance is _______: less stretchable, bigger change to increase it, a lot of effort to inhale air, very stiff, but expiration is easier

A

decreased

135
Q

What is pulmonary fibrosis?

A

Formation or development of excess fibrous connective tissue in the lungs

136
Q

Is pulmonary fibrosis an example of increased or decreased compliance?

A

decreased

137
Q

Is emphysema an example of increased or decreased compliance?

A

Increased

138
Q

_______ : proteolytic enzymes secreted by leukocytes attack alveolar tissue. The alveoli merge: loss of capillaries and reduction of surface area. There is a loss of lung recoil, and weakens alveoli walls creating airway resistance

A

Emphysema

139
Q

What is the main cause of an emphysema?

A

Cigarette smoking

140
Q

The main determinant of compliance isn’t the _____ themselves or the _____ tissue its ____, it’s the ? of the alveoli is the main determinant of the elastic recoil

A

alveoli, connective, water, fluid that lines the inner walls

141
Q

An equally important determinant of compliance and a major determinant of the lungs elastic recoil is ______ ____ at the air water interface of the airways.

A

surface tension

142
Q

True or False: all alveoli are the same size?

A

False

143
Q

What is Laplace’s equation and what are the variable represented?

A

P = 2T/r
T = surface tension (at pure air water interface ~70dynes/cm)
r = bubble radius

144
Q

According to Laplace’s law, ______ as much pressure is needed to keep the small bubble inflated

A

twice

145
Q

In our alveoli, we do not have a pure air-water interface, we have ______ that helps to reduce the surface tension, and help that all alveoli inflate equally

A

surfactant

146
Q

Surfactant is a detergent-like molecule secreted by ?

A

Type II alveolar cells

147
Q

Surfactant is ~90% ______ and ~10% _____

A

phospholipids, protein

148
Q

Is surfactant hydrophobic, hydrophilic, or amphipathic?

A

amphipathic

149
Q

Surfactant reduces surface tension by decreasing ____ of water molecules at air-water interface

A

density

150
Q

If we have 2 bubbles shown to have the same surface tension, according to Laplace’s law, the pressure is greater in the larger/smaller bubble

A

smaller

151
Q

In the lungs, _____ alveoli have more surfactant, which equalizes the pressure between large and small alveoli

A

smaller

152
Q

What is Infant Respiratory Distress Syndrome?

A

In premature infants: developmental insufficiency of surfactant production and immaturity of the lungs

153
Q

Prevalence of Infant Respiratory Distress Syndrome decreases with ______ age:
__% 26-28 weeks
__% 30-31 Weeks

A

gestational, 50, 25

154
Q

What is the prevention of Infant Respiratory Distress Syndrome?

A

Glucocorticoid injection

155
Q

What are the 3 treatment options for Infant Respiratory Distress Syndrome?

A
  1. Artificial surfactant
  2. Continuous Positive Airway Pressure (CPAP)
  3. Intubate
156
Q

In a healthy individual ~90% of airway resistance occurs in _____ and _____ and is _____

A

trachea, bronchi, constant

157
Q

What is Poiseuille’s Equation?

A

R = (8nl)/(πr^4)

158
Q

Length of the airway system is affected by?

A

Nothing, it is considered constant so is not considered a factor

159
Q

Viscosity of the air is affected by?

A

Nothing, it is usually constant and not considered a factor; humidity and altitude may alter slightly

160
Q

Diameter of the upper airway system is affected by? and is mediated by?

A

Physical obstruction
Mucus and other factors

161
Q

____ levels of CO2: bronchioles relax, increases the diameter, increases flow

A

High

162
Q

____ levels of CO2: bronchioles contract, decreases the diameter

A

Low

163
Q

Slight changes in bronchoconstriction/dilation are commonly due to ?

A

paracrine control, CO2 being the major one

164
Q

________ : parasympathetic nerves innervate bronchiole smooth muscle and activate PLC-IP3 pathway via M3 muscarinic receptor

A

Bronchoconstriction

165
Q

_________: circulating epinephrine binding B2 adrenergic receptors (dilation)

A

Bronchodilation

166
Q

_______: characterized by chronic inflammation of the airways, and intermittent sensitivity of the smooth muscle

A

asthma

167
Q

What is the treatment for asthma with more infrequent attacks?

A

β2-adrenergic agonist, opposes bronchoconstriction

168
Q

What is the treatment for asthma with more frequent attacks?

A

Weekly inhaled corticosteroid

169
Q

In respiratory system effectiveness of ventilation is determined by ?

A

total pulmonary ventilation

170
Q

What is total pulmonary ventilation?

A

The volume of air moved into and out of the lungs each minute (minute ventilation)

171
Q

What is the normal ventilation rate?

A

12-20 breaths/min, tidal volume = 500ml

172
Q

How do calculate total pulmonary ventilation?

A

Ventilation rate × tidal volume

173
Q

Is Total pulmonary ventilation a good indicator of how much fresh air reaches the alveoli?

A

No, because air always remains within the conducting air space and does not take part in gas exchange

174
Q

What is Alveolar Ventilation?

A

Ventilation rate × (tidal volume - dead space)

175
Q

Anatomic dead space is constant at roughly ?

A

~150ml

176
Q

What is the normal total pulmonary ventilation value?

A

6 L/min

177
Q

What is the normal Total alveolar ventilation value?

A

4.2 L/min

178
Q

What is the normal Maximum voluntary ventilation value?

A

125-170 L/min

bmsc 208 (11 decks)

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