Section 5 Lectures 1 and 2 Flashcards Preview

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Flashcards in Section 5 Lectures 1 and 2 Deck (231):
1

What is the role of CO2 in the body?

Homeostatic regulation of pH

2

Inhaled gas is _% humidified.

100%

3

Respiratory area consists of:

layer of resp cells, blood, and water bw these

4

T or F? RS is a secondary defense system.

F. primary

5

Functions of respiratory system:

Host defense, vocalizaton, water and heat balance, metabolism

6

What direct role does the respiratory system have in the movement of gases?

None

7

What % of the blood flows through the lungs?

99%

8

T or F? The lungs fxn in metabolism.

T

9

Is control of respiration voluntary or involuntary?

both voluntary and autonomic

10

Pulmonary system is in (parallel/series):

series

11

Flow proportional to:

delta P

12

Flow inversely proportional to:

resistance

13

Resistance =

1/Radius

14

Most defects of RS:

inc res in airways or dec compliance

15

Lung has (high/low) compliance and (high/low) resistance.

both low

16

Lung too compliant:

can't generate enough P for in/expiration (emphysema)

17

T or F? The RS is controlled by Oxygen flow.

F. CO2 levels

18

Flow =

delta P/R

19

delta P =

inside - outside

20

What is the source of resistance in the lungs?

diameter of tubes of respiratory system

21

How is diffusion distance represented in the flow equation?

R

22

Does the body sense changes in O2 or CO2 first?

CO2

23

Effects of hyperventilating maximally:

lowers CO2 and this dec brain blood flow and gets so low you pass out

24

What type of acid is lactic acid?

fixed acid

25

energy =

O2 consumption + anaerobic glycolysis

26

Oxygen content in the lungs is:

the O2 uptake in the lungs

27

What is he O2 levels in veins determined by?

metabolism

28

Will higher metabolism lead to lower or higher levels of oxygen in veins?

lower

29

Which is fixed and which is variable, inspired O2 fraction or expired O2 fraction?

inspired: fixed, expired: variable (with O2 consumption)

30

What is the fixed inspired O2 fracton?

0.2094

31

Flow rate (?) of oxygen =

inspired ventilation - expired ventilation

32

Flow rate (?) of CO2 =

expired ventilation - inspired ventilation

33

Ambient % of CO2:

0.04 (ignored in equations)

34

How many moles of CO2 are produced for each mole of O2 consumed?

1

35

What would an increase in pulmonary pressure lead to?

pulmonary edema

36

How does the body respond to pulmonary edema?

increase R ventilation ejection or alter pulmonary capacity pressure

37

systolic and diastolic measurements in the lungs:

40/10

38

What causes pulmonary edema?

any rise in pulmonary arterial pressure

39

What causes a rise in pulmonary arterial pressure?

increase in respiratory ventilation, ejection, or increase blood pressure on left side of heart

40

True or False? Resistance and compliance are always inversely related.

F. usually

41

What is respiration?

cellular (exchange between blood and tissue) and external respiration (diffusion into blood)

42

What is ventilation?

inspiration and expiration

43

Avg lung V:

4L (60% tissue, 40% blood)

44

Avg weight of lung:

1kg

45

S.a. of lung:

85 square meters (tennis court)

46

Respiratory system is composed of:

Chest wall, diaphragm, pleural space, and lung

47

What must the lungs overcome to bring air in?

elastic recoil

48

In what circumstance would respirattion be active?

Hard exercise, high ambient pressure

49

** True or False? The lungs are very elastic and have high compliance.

T (?)

50

At rest we inspire via this structure, until about ---- fold.

nasal passage, until about 3 fold

51

Function of sinuses:

P equalization and light skull

52

Fxn of turbinate:

resistance during basal breathing, humidification

53

When does nasal breathing occur?

At low ventilations

54

What causes the release and synthesis of NO?

shear stress against the endothelium.

55

NO is important in:

vasodilation of the bronchiole airways.

56

Function of NO in the oral/naso passageway:

open airways

57

When can ciliated epi can be overwhelmed?

during cold and flu due to mucus draining

58

What creates 50% of resistance in the nasal passageway?

turbinate

59

How many mL is the Nasal-Oral Passageway?

20ml (?)

60

The Nasal-Oral Passageway clears particles of this size and smaller:

10 micron (micrometer)

61

In which orfice of the nose does mucus build up?

ostium

62

nerve supply to the nasal passageways:

superior turbinate (cribiform plate to olfactory bulb)

63

Does NO lead to the increase or decrease in flow?

increase

64

Muscles of insspiration:

SCM, scalene muscles, parasternal intercartilagenous muscles, external intercostals, diaphragm

65

What muscle controls most resp at low levels

diaphragm

66

Muscles of expiration:

internal intercostals, abdominals, rectus abdominus, transversus abdominus, external and internal obliques

67

Respiratory muscle diseases:

Guillain-Barre Syndrome, Myasthenia Gravis

68

Range of movement of diaphragm in cm:

1cm to 10cm

69

Maximum pressure in lungs generated by diaphragm:

150-200 cm H2O

70

Innervation of external intercostal muscle:

intercosal nerves

71

Muscles controlling nasal flaring:

genioglossus and arytenoid muscles

72

Poor muscle strength in the genioglossus and arytenoid muscles can lead to:

snoring

73

Which muscles increase pressure in the lungs, expiratory or inspiratory muscles?

expiratory

74

What allows for the lobes of the lungs to slide?

fissures

75

Function of pleura:

creates a liquid interface

76

This can result in a collapsed lung:

pneumothorax

77

What is a pneumothorax?

air in the pleural space

78

Fluid in pleural space is called:

pleural effusion

79

What causes emphysema?

infection

80

RS starts here:

Oral nasal passageway

81

To where do the right and left bronchii branch?

upper, middle, and lower lobes of lung

82

Function of upper lobes and trachea:

to get gas down to lower lobes

83

Gas exchange happens in these lobes:

middle and lower

84

Are the upper or lower airways more compliant?

lower

85

Parts of lungs involve in respiration

bronchioles and alveolar ducts (17-23)

86

Dead spaces:

Trachea and nronchi and nonrespiratory bronchioles (1-16)

87

The anatomic dead space contains about how many mL of air?

150mL

88

The respiratory bronchioles contain about how many mL of air?

2500mL

89

True or False? Gas exchange occurs across the terminal bronchioles.

F

90

Serial arrangement of lungs lead to:

Large resistance

91

Resistance in parallel path:

1/R

92

Resistance is mostly in what part of the respiratory system?

upper airways

93

Air flow velocity is proportional to:

cross-sectional area (very low flow in alveoli for effective exchange of gas)

94

About how many alveoli do we have?

3-6 X 10^8

95

Cross-sectional area in cm^2 of all alveoli:

> 1X 10^6

96

The cross bridges of the diaphragm are set to:

give the dome shaped structure

97

The force generated by respiratory muscles is mainly controlled by:

their length

98

When does the force of the lungs decrease?

At the end of forced inspiration or expiration

99

True or False? NO leads to flaring of the nostrils.

F. The surrounding muscles cause flaring

100

What would happen if there were no remaining air in the lung at the end of expiration?

the lung would completely collapse

101

Blood supply to the lung:

pulmonary artery

102

Airway flow in the alveolar passageways becomes:

parallel

103

True or False? There is no diffusion limitation for O2 and Co2 at the lung.

T, because of the high cross-sectional area and low velocity

104

Diseases that affect the conducting airways and categorized under COPD:

asmtha, bonchiolitis, chronic bronchitis, cystic fibrosis

105

Who does bonchiolitis affect?

young infants, small airways, RSV (respiratory syncytial virus)

106

What is involved with chronic bronchitis?

increase mucus secretion

107

What is affected at the molecular level with cystic fibrosis?

chloride channels (CFTR), poor transport

108

What is obstruction in cystic fibrosis caused by?

mucus

109

Cells of the conducting airways:

cilitated epithelium and goblet cells

110

What allows for cilia to move?

actin

111

What is actin driven by?

ATPase activity

112

Structure of cilia:

9 doublets + 2 single units

113

How do alveolar macrophages enter the aleoli?

migrate from blood

114

How are macrophages moved to the mouth for expiration?

cilia

115

2 areas of gas exchange:

Respiratory bronchioles and alveoli

116

What cells produce surfactant?

Type II

117

Shape of alveoli:

polygonal

118

Width of alveoli:

250 micrometers

119

What % of gas exchange do the Type I cells do?

96-98%

120

What type of basement membrane do Type I alveolar cells have?

fused, short diffusion

121

What is blood flow matched with?

gas exchange

122

What happens to the cells of the alveoli at birth?

Type I are converted to Type II and II to I with injury

123

Interstitium is composed of:

connective tissue, smooth muscle, lymphatics, and capillaries

124

capillaries are composed of:

fibroblasts, collagen, elastin, cartilage

125

This structure is bw the gas phases, makes the air carrying space:

interstitium (check)

126

True or False? Perfusion and ventilation are matched in the healthy individual.

T

127

Neuroendocrine cells are aka:

Kultschitzky cells

128

What provides local regulation of alveoli and circulation?

Neuroendocrine cells

129

Function of neuroendocrine cells:

release dopamine and serotonin

130

List 2 biogenic amines:

dopamine and serotonin

131

How much is the capillary area in mL?

60 mL (?)

132

Setpum is aka:

interstitium

133

There is a loss of this in emphysema:

surface area an septae

134

Alveoli numbers increase until what age?

8

135

Alveoli diameter increase until?

early adulthood

136

This disease decreases alveolar numbers:

Congenital Diaphragmatic Hernia (CDH)

137

At what age does lung function peak?

20-25 yrs

138

2 blood supplies to lungs:

pulmonary and bronchial

139

Vascular bed surface area of pulmonary blood supply to the lungs:

70-80 m^2

140

Capillary volume in pulmonary blood supply:

70 mL (check) increasing to 200 mL

141

True or False? Large pulmonary blood vessels have smooth muscle.

T

142

Does the pulmonary or bronchial blood supply to the lungs bring nutritive flow?

bronchial

143

Bronchial blood supply makes up what % of circulation?

1-2%

144

Coughing blood is aka:

hemoptysis

145

How is CO affected in cystic fibrosis?

decreased by 10-20% (check)

146

What are pulmonary vessels innnervated by?

sym nn. ,

147

blood flow to pulm circ modulated by:

autoniomic regulation, to inc large cap flow and volume

148

variable res in terms of airflow:

Elastic fibers

149

True or False? Arterioles of bronchiole circ also have s.m. to regulate flow to match ventilation w perfusion.

T

150

How is filtered plasma not returned to L atrium taken back to circulation?

lymphatic vessels

151

How is the capillary network embedded in the circulation?

perfectly surrounds the alveoli

152

True or False? The capillary network forms a continuous sheet.

F. Nearly continuous, for matching of gas and blood

153

List the components of the alveoli from the center out:

alveoli, capillary, endothelial cell, epithelium cell Type I, basement membrane, interstitial fluid

154

True or False? 96-98% of the cells of the alveoli are Type I cells.

F. equal number of both. (Type I is 96-98% of the surface area)

155

What cells repair/replace epithelial cells?

Type II

156

This disease results in the loss of elastic recoil:

emphysema

157

this can results in the excess elastic fibers:

pulmonary fibrosis, auto immune disease, injury

158

How is pressure generated in the lymphatics?

same as venous blood

159

What is surfactant secreted through?

pores

160

How many diferent kinds of fluids are within the lung epithelium?

3: periciliary fluid, mucus, surfactant

161

What fluid is found in the trachea and terminal bronchioles?

periciliary fluid and mucus

162

What cells line the lung epithelium?

pseudo stratified, ciliated columnar epithelium

163

What cells maintain the periciliary fluid?

chloride secretions and sodium absorption

164

These cells have a regenerative function:

Clara cells

165

What cells produce mucus?

goblet or surface secretor cells

166

Mucus is picked up by this and moved upwards.

periciliary fluid

167

Functions of mucus:

Move particles out and role in regeneration of goblet cells

168

How does surfactant reduce the work of breathing?

allows pleura to slide easily, can bring lung volume back down easily, respiratory muscles have to work less to inspire and expire air.

169

What is the importance in stabilizing alveoli by maintaining s. tension?

all have same access to the exchange of gas

170

What would happen if there were a defect in surfactant or other factors that changed resistance in airways?

diaphragm and respiratory muscles work harder, more force needed for same ventilation, increase work of breathing, need more oxygen, increase up to 20%

171

What % of CO normally goes to lungs to meet metabolic demands?

2-3%

172

What ensures there is no difference in tension between 2 lung layers?

Effective surfactant on 2 layers

173

3 functions of surfactant:

reduce work of breathing, prevent collapse and sticking, reduce surface tension by stabilizing alveoli

174

How to calculate surface tension of surface molecule per unit length:

(2 X wall tension) / radius

175

True or False? surfactant decreases its' surface tension at high volumes

F. increases

176

How are alveoli interconnected in the terminal airways?

pores of Kohn and canals of Lambert

177

the collapse or closure of a lung:

atelectasis

178

True or False? All alveoli have the same potential for gas exchange.

T

179

Composition of surfactant:

phospholipids, neutral lipids, fatty acids and proteins (85% lipid, 15% protein)

180

Surfactant is secreted into the airways via exocytosis of the:

lamellar body

181

What type of agonist promote the secretion of lamellar bodies?

Beta-adrenergic agonist

182

True or False? Type II cells takes up surfactant and it is cleared by macrophages after being sent to the lymphatics.

T

183

Functions of lymphatics:

host defense, removal of lymph fluid from the lung

184

True or False? Tight junctions are present between endothelial cells.

F

185

What anchors the lymphatics to the adjacent connective tissues?

fine filaments

186

What occurs with muscle contraction at the point where the fine filaments anchor the lymphatics to the adjacent connective tissues?

junctions open

187

Why is there no limitation of binding of O2 to the red blood cell?

bc of the s.a.

188

blood flow in lungs is approximately:

the cardiac output

189

What is the pressure in the alveolar space?

basically zero

190

Hormones that lead to the inactivation of endothelial cells:

serotonin, norepinephrine, bradykinin

191

Hormones produced by endothelial cells:

protaglandins, peptides

192

This is an AGII inhibitor:

Diovan

193

Name 2 ACE inhibitors:

accupril and captropril

194

What is pulmonary fibrosis?

inflammatory process of the alveolar septae and lung interstitium, causes thickening and scarring and changes in elastin and fibrin content and function

195

Causes of pulmonary fibrosis:

idiopathic, bacteria and viruses, drugs, inhalation of asbestos and other compounds

196

What drugs can cause pulmonary fibrosis?

amioderone for atrial fibrillation

197

What does asbestosis cause?

diffuse pulmonary fibrosis resulting in decreased lung volumes, decrease lung compliance and decreased diffusion of O2 and Co2 across the alveolar/capillary membrane, lung cancer (mesothelioma)

198

What does mesothelioma cause?

the single cell lining of the thoracic and abdominal cavities and their viscera to thicken into sheets that enclose gland-like spaces that produce large amounts of fluid.

199

Causes of mesothelioma:

industrial compounds such as asbestos, crocidolite, amorsite, chrysolite, and anthophyllite

200

Asbestos can cause:

pulmonary fibrosis and lung cancer, including mesothelioma, in any combination.

201

5% of carries of the recessive gene for cystic fibrosis have a defect on this chromosome:

#7

202

How many mutations have found to be associated with cystic fibrosis?

over 300, each compromises airway clearance to a certain degree

203

Most common mutation found in cystic fibrosis:

deletion of phenylalanine at position 508

204

Defects in the CFTR gene results in what?

decreased secretion of chloride ion from the ciliated epithelial cells into the sol layer (decreased water movement into sol layer)

205

Result of decreased water in the sol layer in cystic fibrosis:

decreased ability to remove dust, bacteria, etc., causing infection of the airways epithelium

206

treatments to help restore function of the mucus layer of the airways:

increased Cl- secretion with uridine triphosphate, decreased Sodium+ absorption with amiloride, decreased viscosity of mucus with drones alpha to cleave mucus proteins, inhalation of saline solutions to enhance ciliary functions

207

Innervation of lungs:

pre and postganglionic neurons in CNS and postganglioninc in gnaglia in the lungs

208

True or False? You can not feel pain in the pleura.

F. You can, just not in the lungs

209

The parasympathetic component of the lungs is responsible for:

airway constriction, blood vessels dilation, glandular secretion

210

What transmitters are involved in stimulation and inhibition in the lungs?

Non-noradrenergic, non-cholinergic transmitter (inhibitory = relaxation)

211

neurotransmitter used in the parasympathetic side of the lungs:

AcH

212

Neurotransmitter used internal he sympathetic side of the lungs:

Norepinephrine

213

Where in the CNS in the control center for ventilation?

brainstem

214

What modifies CPG pacemaker potential?

stretch receptors in lung and O2 receptors with input from the hypothalamus and amygdala

215

Info from chemoreceptors is sent to what part of the brains?

respiratory center in medulla

216

smooth muscle cell innervations in lungs (3):

parasympathetic, AcH, Vagus nerve, muscarinic receptors, subtype 3

217

Skeletal muscle innervation in lungs:

nicotinic receptor, subtype 1

218

AcH is released from:

axon vericosities

219

True or False? The bronchiole has cartilage.

T, smooth muscle surrounding

220

Activation of these receptors via this neurotransmitter leads to airway contraction:

muscarinic (M3), AcH

221

Activation of these receptors via this neurotransmitter leads to airway relaxation:

adrenergic (B2), epinephrine

222

Epithelial cell wall turnover:

6 weeks

223

6 types of asthma inhalers:

B2 adrenergic - Albuterol, M3 inhibitor - Atropine, Steroids - inhibit inflammation, Anithistamine - mast cells, leukotriene/steroid - Singulair, VIP - relaxation

224

Smoking leads to these at the cellular level:

inhibition of cilia, goblet cell hyperplasia

225

From where does the SNS release norepinephrine?

nerve endings

226

From where does the SNS release epinephrine?

adrenal medulla

227

What does the PNS release to cause constriction in the lungs?

AcH

228

Binding of norepinephrine and epinephrine to Beta 2 cells leads to:

relaxation

229

Function of atropine:

prevents AcH released from the PNS from causing construction in the airways

230

VIP stands for:

Vasoactive Intestinal Peptide Inhaled Agonists

231

What neurotransmitters work on the mucus glands?

norepinephrine (SNS) and AcH (PNS)