Test 3 week 5 Flashcards
(229 cards)
1
Q
The whipp and wasserman model are ____ models
A
Gas exchange models
2
Q
The gas exchange models is between the ____, ____, and the ___ works together for normal output
A
Muscle, circulation, and ventilation
3
Q
What happens If there any blocks along the gas exchange models?
A
It will impair the other systems as well to get back to normal with the other working hard to get it so
4
Q
In perspective, there is a ____ reserve in the lungs and capacity to diffuse gases
A
High
5
Q
The surface area of the lung is approximately ___
A
750 ft
6
Q
What is viscera pleura?
A
The internal serous membrane initmately attached to the surface of each lung. It is insensitive to pain
7
Q
What is parietal pleura(rough surface)?
A
The external membrane lining the internal surface (wall) of the the thoracic cavity.
8
Q
____produces pleural fluid into the pleural space to coat the lungs
A
Parietal pleura
9
Q
The pleural space is located between ___ and ____. It is a ___ space
A
The pleural space is located between parietal and visceral pleurae. It is a closed space
10
Q
True or false. There is no communication between the right and left pleural spaces
A
True
11
Q
___ lubricates the glide of lungs during expansion
A
Pleural fluid
12
Q
____ is a layer of fluid located between the parietal and visceral pleurae in the pleural space
A
Pleural fluid
13
Q
What lubricates the surface of the pleurae?
A
Pleural fluid
14
Q
___ facilitates the movement of the lungs across the thoracic wall during inspiration and expiration
A
Pleural fluid
15
Q
What is pneumothorax?
A
If air is introduced into the pleural space as a result of chest trauma (ex: knife wound) the coupling between the parietal pleura and visceral pleura may be broken, causing the lung to collapse
16
Q
What is hemothorax?
A
If blood is introduced into the pleural space as a result of chest trauma, the coupling between the parietal pleura and visceral pleura may be broken, causing the lung to collapse
17
Q
What is pleural effusion?
A
If fluid is introduced into the pleural space as a result of chest trauma, the coupling between the parietal pleura and visceral pleura may be broken, causing the lung to collapse
18
Q
When are the lungs under slight negative pressure?
A
When it is conatined in a patent pleural space
19
Q
What does negative pressure do to the lungs?
A
It keeps the lungs expanded
20
Q
What happens if air is introduced into the lungs?
A
It normalizes pleural pressure to atmospheric pressure, then pressure increases, causing the lungs collapse
21
Q
What is included the upper respiratory tract? (proximal to bifurcation, at the angle of louie)
A
- Nose
- Pharaynx
- Nasopharynx
- Larynx
- Trachea
22
Q
What is the pressure of the lung/pleura?
A
755 mmHg
23
Q
What is the atmospheric pressure of the air?
A
760 mmHg
24
Q
The upper tract is the ____ and ____ of air entering the lungs
A
The upper tract is the first line of filter and humidifier of air entering the lungs
25
The lungs prefer ___ air. ___ air creates brochiospasms and secretions in the lungs
The lungs prefer warm, moist and clean air. Cold air creates brochiospasms and secretions in the lungs
26
___ prevents food from entering the respiratory tract
Epiglottis
27
What is phonation?
Movement of air across vocal cords
28
Where does phonation occur?
In the laryngeal vocal cord
29
How does pulmonary disease affect phonation?
It lowers the tone and pitch, because less air is moving over the vocal cords
30
What is ventilation?
The movement of gas (conducting airways)
31
What is respiration?
The diffusion of gas across a membrane and into blood. (acinar airways)
32
The lower airway is also known as the ___
The lower respiratory tract
33
The lower airway/respiratory tract is defined as ____
Defined as everything below the tracheal bifurcation, which occurs at the angle of louis
34
What are the two zones in the lower airway?
- Conducting airways
| - Acinar airways
35
What is a conducting airway?
Where gas travels through (no respiration)
36
What is an acinar airway?
Where gas exchange occurs. (respiration)
37
What are included in acinar airways?
- Respratory branchioles
- Alveolar ducts
- Alveolar sacs
38
After the bifurcation of the trachea into the main bronchi, the conducting airways enter the ___
Hilum (the roof of the lung)
39
What happens to conducting airways after they enter the lungs?
They continue to bifurcate and become smaller and contain less cartilage and smooth muscles
40
The more superior the structures are within the pulmonary system, the ____ the velocity and ____ the pressure
The higher the velocity and the higher the pressure
41
The left lung has how many lobes?
2. Upper and lower (plus lingula)
42
The right lung has how many lobes?
3. Lower, middle, and upper
43
Why is the right lung shorter and broader than the left?
Shorter due to the liver being on the right and broader, because the heart is on the left
44
Which lung is bigger in volume and in weight?
The right
45
What defines the borders of the lobes in the lungs?
Fissures
46
What does the oblique fissure do in the right lung?
It separates the right upper lobe and the right middle lobe from the right lower lobe
47
What does the oblique fissure do in the left lung?
Separates the left upper lung from the lower lung
48
The oblique fissure runs ___
Runs obliquely from the 6th rib anteriorly to approximately T3 posteriorly
49
___ fissure is only on the right
Horizontal fissure
50
The horizontal fissure separates ___ from ___
Separates the right upper lobe from the right middle lobe
51
The horizontal fissure is located ___
approxiately at the 4th rib
52
The right lung has ___ segments and the left ___
10.
| 8.
53
What are the segments in the upper lobe of the right lung?
Apical
Anterior
Posterior
54
What are the segments in the middle lobe of the right lung?
Lateral
| Medial
55
What are the segments in the lower lobe of the right lung?
```
Superior
Medial basal
Lateral basal
Anterior basal
Posterior basal
```
56
What are the segments in the upper lobe of the left lung?
Apico-Posterior
| Anterior
57
What are the segments in the lingular of the left lung?
Superior
| Inferior
58
What are the segments in the lower lobe of the left lung?
Superior
Anterior-medial basal
Lateral basal
Posterior basal
59
Why must the cells lining the alveoli remain moist?
This is what is conducive for gas exchange
60
What happens when 2 wet surfaces in the lungs touch?
They become stuck together by surface in the layer of water between. Especially in smaller structures
61
What is the risk of 2 wet surfaces touching in the lungs?
It may cause the alveoli to collapse and may be impossible to reinflate
62
Where is the location of gas exchange?
In Type 1 alveolar cells.
63
___ cells cover most of the alveoli wall, are thin and flat(squamous)
Type 1 alveolar cells
64
What about type 1 alveolar cells allow for gas change to occur?
Their physical properties. (thin and flat)
65
What type of alveolar cells are plump in size, secrete surfactant when stretched, makes the alveoli easy to re-inflate if it collapse and is formed at 28 weeks of gestation?
Type 2 alveolar cells
66
What is surfactant?
A phospholipid- rich material that forms a film and reduces surface tension.
67
Why do type 2 alveolar cells produce surfactant?
- To keep the alveoli paten and inflated.
| - To reinflate the alveoli if it collapse
68
What do deep breaths do?
They stretch type 2 alveolar cells which causes surfactant production
69
What do goblet cells do and where are they found?
Secret mucus, which forms a blanket over the tops of the ciliated cells.
Mostly found in the conducting airways
70
The regular coordinated beating of the cilia does what?
Sweeps the mucus up and out of the airways, carrying any debris that is stuck to it
71
Mucus is escalated up and out to the ____, which is the ___ and the location of the ___
Mucus is escalated up and out to the carina, which is the bifurcation of the trachea and the location of the cough reflex
72
Mucus traps ___ and ___
Traps waste and toxin
73
What can mucus overproduction cause?
Can plug airways causing temporary alveolar collapse
74
____ keeps the lungs clean
The mucociliary escalator
75
What causes the cilia to be weak/ paralyzed?
Opiates
76
What happen when the cilia is weak or paralyzed?
The cilia doesn't beat, mucus build up will develop, leading to an alveolar collapse resulting in pneumonia
77
What is the alveoli?
A cell thick membrane sac filled with air and surrounded by capillary
78
When there is no escalator, and inhaled particles reach alveoli, what removes them?
Macrophages
79
When overworked, the macrophages _____, which causes damage to the lung tissue, because macrophages are filled with ____
When overworked, the macrophages rupture, which causes damage to the lung tissue, because macrophages are filled with enzymes that break down proteins, so the enzymes will eat away at the alveoli
80
Muscles of the ____ must contract rhythmically and intermittently throughout life. They work under both voluntary and involuntary control
Muscles of the ventilatory pump
81
The muscles of the ventilatory pump works against ___ and not gravity
Works against airway resistance and elastic recoil
82
Inspiration happens in the __ and ____
Diaphragm, intercostals, and accessory muscles
83
The diaphragm is responsible for ___ of inspiratory effort
75%
84
____ is primarily passive and is done by abdominals and intercostals
Expiration
85
Forced efforts for either inspiration or expiration will change ____
The energy expenditure
86
What is the magic muscle?
The diaphragm
87
The blood volume of the lungs is about 450ml which is ____ of the total blood volume of the entire circulatory system
9%
88
What are the autonomic input of control of airway smooth muscles?
- Parasympathetic: Bronchoconstriction
| - Sympathetic (Beta 2): bronchodilation
89
During exercise the bronchioles ____, causing the volume of air to ___, which will produce ATP to generate metabolic work. This is facilitated by ____
During exercise the bronchioles dilate, causing the volume of air to increase, which will produce ATP to generate metabolic work. This is facilitated by Beta 2 receptors
90
What are the local factors: released by mast cells in response to infection or allergy that control the airway of smooth muscles?
- Histamine: bronchoconstriction
| - Leukotriene: bronchoconstriction
91
What are the environmental factors that control the airway of smooth muscles?
Cold air and smoke. Both are bronchonstricters
92
Primary passive expiration is done by ____
recoil
93
In the relaxed state, the diaphragm is ___
Dome shaped
94
When the diaphragm contracts, it ___ and ___. Increasing the volume of the ______
When the diaphragm contracts, it flattens and descends. Increasing the volume of the thoracic cavity
95
As thoracic dimensions increase during inspiration, pleural pressure becomes more _____ and pulls on the lungs as thoracic volume _____
As thoracic dimensions increase during inspiration, pleural pressure becomes more negative and pulls on the lungs as thoracic volume increases
96
During inspiration, the lungs expand (fill with gas) and intrapulmonary volume ___
Increases
97
Inspiration ends when ____ ceases to increases, resulting in no further reduction in _____. Gas flow ceases and thus ____ does not change
Inspiration ends when thoracic volume ceases to increases, resulting in no further reduction in pleural pressure. Gas flow ceases and thus lung volume does not change
98
During the deep or forced inspirations the volume of the thoracic cavity is further increased by activation of the ____
Accessory muscles
99
Bucket handle movement happens in the lateral ribs, so when you breathe in and the diaphragm ______, your rib cage expands ____ and ____
Bucket handle movement happens in the lateral ribs, so when you breathe in and the diaphragm descends down, your rib cage expands superiorly and laterally.
100
Expiration is typically a ___ process that depends more on the natural elasticity of the ___ and ____ than on muscle contraction
Expiration is typically a passive process that depends more on the natural elasticity of the thoracic wall and lungs than on muscle contraction
101
As the inspiration muscles relax, the diaphragm ___, the rib cage ____ the volume of the thoracic cavity ____ and the stretched elastic tissue of the lungs ____
As the inspiration muscles relax, the diaphragm ascends, the rib cage descends, the volume of the thoracic cavity decreases and the stretched elastic tissue of the lungs recoils
102
Decreased lung volume ____ the alveoli, resulting in _____ above atmospheric pressure, thereby forcing gas flow out of the lungs
Decreased lung volume compresses the alveoli, resulting in increases above atmospheric pressure, thereby forcing gas flow out of the lungs
103
During expiration thoracic and lung volumes ___
decreases
104
What is PPL?
Numbers outside of airway: intrapleural pressure = interthoracic pressure
105
Numbers in the airways =
PA, intrapulmonary pressure
106
When PA = 0, there is ___ air flow
No air flow
107
When there is a (+) PA, air flows ___
Out
108
If transpulmonary pressure is positive, pressure ____
Keeps the airways open
109
If transpulmonary pressure is negative, airways have a tendency to ____
Tendency to close
110
As we draw air in, we ___ the volume in the thoracic cavity and in our interpleural pressure which will allow us to ___ pressure to allow air to come in. As the lungs fills a lot, they exert a force against the interpleural space so there still maintained open
As we draw air in, we increase the volume in the thoracic cavity in our interpleural pressure which will allow us to decrease pressure to allow air to come in. As the lungs fills a lot, they exert a force against the interpleural space so there still maintained open
111
As we breathe out, the pressure in the interpleural space would be so much greater that it may begin to compress the ___
As we breathe out, the pressure in the interpleural space would be so much greater that it may begin to compress the interpulmonary components
112
As we breathe in pressure begins to ____ (pleural and alveolar) allowing air to into the alveoli, our lung volume ____ as our chest wall begins to expand our lungs begin to expand. At the end of inspiration the pressure in the alveoli will still begin to ____
As we breathe in pressure begins to drop (pleural and alveolar) allowing air to into the alveoli, our lung volume increases as our chest wall begins to expand our lungs begin to expand. at the end of inspiration the pressure in the alveoli will still begin to increase
113
What are pleural pressures during rest and inspiration
Rest: -5 cm H2O
Inspiration: - 8 cm H2O
114
What are alveolar pressures during rest, inspiration, and expiration
Resting: 0 cm
Inspiration: -1 cm
Expiration: 1 cm
115
How to calculate compliance
Changing volume/changing pressure
116
What are the 3 mechanical events of a cough?
- Inspiratory phase
- Compression phase
- Expiratory phase
117
What happens in the inspiratory phase of coughing?
Inhalation, which generates the volume necessary for an effective cough
118
What happens in the compression phase of coughing?
Closure of the larynx combined with contraction of
| muscles of chest wall, diaphragm, and abdominal wall result in a rapid rise in intrathoracic pressure.
119
What happens in the expiratory phase of coughing?
The glottis opens, resulting in high expiratory airflow and
the coughing sound. Large airway compression occurs. The high flows dislodge mucus from the airways and allow removal from the tracheobronchial tree
120
Inspiratory reserve volume (IRV) is ___
how much air you can take in
121
Tidal volume (TV) is ___
the volume moved through regular breathing, how much you breathe in and out
122
Expiratory reserve volume (ERV) is ___
how much air you can breathe out
123
What is vital capacity (VC)?
The ability of a person to draw a full breath in and force a full breath out
124
What is total lung capacity (TLC)?
The total amount of air that can be contained in a person's lungs at the end of maximum inspiration
125
What is residual volume (RV)
The little bit of air that can't be moved after max expiration
126
What are the factors that influences lung volumes?
Age, height and gender
127
What is full vital capacity (FVC)?
How much air that can be completely forced out of the lungs after an act of maximum inspiration
128
Anything that will impair gas exchange will also impair ___
Diffusion capacity
129
Approximately 70mL of the blood in the lungs is in the ____. The remainder is divided about equally between the ____
Pulmonary capillaries.
Between the pulmonary arteries and veins
130
A shift of blood from the pulmonary to the systemic circulation or vice versa affects the ___ more than the ____
Affects the pulmonary system more than the systemic system
131
During periods of high thoracic and pulmonary pressures (ie when a person blows
a trumpet) as much as 250 milliliters of blood can be expelled from the ____
pulmonary circulatory system into the systemic circulation
132
Loss of blood from the systemic circulation by hemorrhage can be partly compensated for by the automatic shift of blood from the ___
lungs into the systemic
| vessels.
133
Blood flow through the lungs is essentially equal to the _____
Cardiac output
134
The factors that control cardiac output, also control ____
pulmonary blood flow
135
What are the factors that control cardiac output?
Vessel dilation, constriction, vascular tone will influence blood flow
136
Under most conditions, the pulmonary vessels act as
passive, distensible tubes that
| enlarge with increasing pressure and narrow with decreasing pressure
137
For adequate respiration to occur, it is important for the blood to be distributed to
those segments of the lungs where the alveoli are _____
alveoli are best oxygenated or where the most ventilation is occuring
138
V/Q matching is the need to match blood flow to ____ to allow for ____
The need to match blood flow to ventilation to allow for optimal respiration
139
In the normal, upright adult, the lowest point in the lungs
| is about _____ the highest point. This represents a ____ pressure difference
30 centimeters below.
| This represents a 23mmHg pressure difference
140
In standing, the pulmonary arterial pressure in the uppermost portion of the lung of is about 15 mmHg less than the _____ at the level of the heart
pulmonary arterial pressure
141
The pressure in the lowest portion of the lungs is about 8
| mm Hg greater than the ____
level of the heart
142
In the standing position at rest, there is little flow in the
top of the lung but about five times as much flow in the
____
bottom
143
The capillaries in the alveolar walls are distended by
the _____ inside them, but simultaneously, they are compressed by the _____ on
their outsides.
The capillaries in the alveolar walls are distended by
the blood pressure inside them, but simultaneously, they are compressed by the alveolar air pressure on
their outsides.
144
Any time the lung alveolar air pressure becomes greater than the capillary blood pressure,
the capillaries _____
close and there is no blood flow.
145
Why is there no blood flow during all portions of the cardiac cycle (zone 1)?
Because the local alveolar capillary pressure in that area
of the lung never rises higher than the alveolar air pressure
during any part of the cardiac cycle
146
In zone 2, why is intermittent blood flow only during the pulmonary arterial pressure peaks?
Because the systolic pressure is then greater than the alveolar air pressure, but the diastolic pressure is less than the alveolar air pressure
147
Why is there continuous blood flow in zone 3?
Because the alveolar
| capillary pressure remains greater than alveolar air pressure during the entire cardiac cycle
148
Normally, the lungs have only zones ___ and ___ blood flow
Normally, the lungs have only zones 2 and 3 blood
| flow
149
Zone 2 (intermittent flow) is found in the ___
Apices
150
Zone 3 (continuous flow) is found ___
In all the lower areas
151
In supine no part of the lung is more than a few cm above the level of the heart, hence blood flow in a normal person is ____. This normalizes blood flow and makes things easier on the heart
entirely zone 3 blood flow
152
When the concentration of oxygen in the air of the alveoli decreases below normal
especially when it falls below 70% of normal (below 73 mm Hg Po2) the adjacent
blood vessels _____
constrict, with the vascular resistance increasing more than five fold at extremely low oxygen levels.
153
Low oxygen concentration causes a vasoconstrictor substance to
be released from the lung tissue, which promotes _____
Promotes constriction of the small arteries and arterioles.
154
If we have areas of the lung where there's a low amount of oxygen, we want to move blood flow ____
away from that and move it to areas where there is a lot of oxygen
155
What is function of the low oxygen (hypoxia) on pulmonary vascular resistance?
To distribute blood flow where it is most effective.
156
If some alveoli are poorly ventilated which causes their oxygen concentration
becomes low, the local vessels _____
constrict.
157
During exercise, blood flow through the lungs ___
Increases 4-7 fold
158
How is the extra blood flow as a result of exercise accommodated in the lungs?
1. Increasing the number of open capillaries, sometimes as much as threefold;
2. Dilating all the capillaries and increasing the rate of flow through each capillary more
than twofold
3. Increasing the pulmonary arterial pressure.
159
Increasing the number of open capillaries and dilating all capillaries, _____ the pulmonary vascular resistance
Decrease pulmonary vascular resistance
160
This ability of the lungs to accommodate greatly increased blood flow during
exercise without increasing the pulmonary arterial pressure conserves the energy of
the _____
right side of the heart and also preventing the development of pulmonary edema.
161
What is distention?
The dilation of blood vessels that are already open, giving them the ability to take in more blood volume to accommodate the increase blood flow that happens during exercise
162
What is recruitment?
The increase of the amount of open capillaries as a result of exercise
163
During exercise the blood flow in all parts of the lung ____
increases
164
Vascular pressures rise enough during exercise to
convert the lung apices from a ____ pattern into a zone
3 pattern of flow.
Zone 2 to zone 3
165
What is isogravimetric?
measurement of pulmonary capillary pressure
166
When the cardiac output is normal, blood passes through the pulmonary capillaries in
about ___
0.8sec
167
What is transit time?
The time it takes for blood to travel through the capillary system.
168
What happens when transit time is too short?
There won't be enough time for diffusion
169
When cardiac output increases, transit time ____
decreases
170
What is the slow replacement of alveolar air of particular importance?
It prevents sudden changes in gas concentrations in the blood
171
_____ prevents excessive increases and decreases in tissue oxygenation, tissue carbon dioxide concentration, and tissue pH when respiration is temporarily interrupted
Alveolar ventilation
172
The diffusion coefficient of carbon dioxide is approx. ____ that of oxygen
20 times
173
Blood flow is higher at ____ due to ____
Higher at base, due to impact of gravity and hydrostatic pressure
174
Ventilation is higher at ____.
Higher at base
175
Gravity and weight of lungs ____ alveolar volume, but alveoli at base is more ____
Gravity and weight of lung reduce alveolar volume, but
| alveoli at base more compliant and capable of oxygen exchange.
176
Normal ventilation (V) to perfusion (Q) ratio (V/Q) as a whole is ___
0.8
177
What does it mean when V/Q is higher 0.8
Ventilation exceeds perfusion
178
When V/Q is 0, indicates ___
Shunt
179
What is dead space?
The volume of air which is inhaled that does not take part in the gas exchange, either because it remains in the conducting airways or reaches alveoli that are not perfused or that are poorly perfused
180
What are the 4 steps in gas transport to tissue?
1. Inspired to alveolus: affected by barometric pressure, increased with FiO2 (increases the PP of O2 in air that we breathe)
2. Alveolar to arterial(respiration):
- via diffusion, decreased by anything that increases distance between alveolus and capillary
- Fick's law
- Transit time
3. Gas transport by blood: via hemoglobin
4. Capillary and tissue exchange: bohr effect and haldane effect
181
What is fick's law?
Rate of transfer of a gas through a membrane is proportional to the tissue area and difference in gas partial pressure between the two sides
182
Oxygen is continually being absorbed from the ____ into the blood of the lungs, and new
oxygen is continually being breathed into the alveoli from the _____
Oxygen is continually being absorbed from the alveoli into the blood of the lungs, and new oxygen is continually being breathed into the alveoli from the atmosphere.
183
The more rapidly oxygen is absorbed, the _____ its concentration in the alveoli becomes; conversely, the more rapidly new oxygen is breathed into the alveoli from the atmosphere, the ____ its concentration becomes
The more rapidly oxygen is absorbed, the lower its concentration in the alveoli becomes; conversely, the more rapidly new oxygen is breathed into the alveoli from the atmosphere, the
higher its concentration becomes
184
Alveoli oxygen concentration and partial pressure is controlled by
1. The rate of absorption of oxygen into the blood and
| 2. The rate of entry of new oxygen into the lungs by the ventilatory process.
185
Blood becomes almost saturated with oxygen by the time it has passed through 1/3 of ___, and little additional oxygen normally enters the blood during
the latter 2/3 of its transit.
the pulmonary capillary.
186
About 98% of the blood that enters the left atrium from the lungs has passed through the ____
Alveolar capillaries
187
Because of the difference in PO2 pressure in the capillaries and interstitial fluid, there is an ____ from the capillary blood into the tissue. So rapid that the pressure____ to match that or the interstitium
Rapid diffusion.
| decreases
188
The pressure differences required to cause carbon dioxide diffusion are, far
_____ the pressure differences required to cause oxygen diffusion.
less than
189
CO2 can diffuse ___ than oxygen
Faster
190
Our body has safety factors or resiliency factors that allow ___
That allows us to continue on with metabolic work if there's a slight interruption in the diffusion of oxygen from a tissue capillary to the cells
191
Why don't we need large concentrations of CO2?
Because it is going to rapidly diffuse
192
What does right shift of the oxygen hemoglobin dissociation curve?
lowers hemoglobin’s affinity for O2, displaces O2 from hemoglobin, and makes more O2 available to tissues;
193
What does left shift of the oxygen hemoglobin dissociation curve?
increases hemoglobin’s affinity for O2, reducing its availability to tissues.
194
What can cause right shift of the oxygen hemoglobin dissociation curve?
• Increased [H+], PaCO2 (Bohr effect), temperature, and 2,3-DPG concentration
195
What can cause left shift of the oxygen hemoglobin dissociation curve?
Decreased [H+], PaCO2 (Bohr effect), temperature, and 2,3-DPG concentration
196
What is the haldane effect?
deoxygenated hemoglobin has a higher affinity for CO2 than does
oxyhemoglobin.
197
When hemoglobin is deoxygenated (i.e., at tissues due to the right shift) it increases the
_____ which can be transported by hemoglobin back to the lungs to be exhaled.
amount of CO2
198
With oxygenation at the lungs, ___ dissociates more readily from hemoglobin, as
higher concentrations of O2 allow for dumping of CO2.
CO2
199
___ is extremely useful when we are trying to deliver O2 to working tissues
Right shift of the oxygen hemoglobin dissociation curve
200
Respiratory drive is generated in the ___
Brainstem
201
The control of breathing is modulated by inputs including:
* Conscious inputs from the cortex
* Influences from the limbic system and reticular activating system
* Chemoreceptors: that sense changes in the chemical constituents of blood, primarily CO2 and H+
* Metaboreceptors in muscle
* Mechanoreceptors in lung
202
Where are the chemoreceptors that modulate control of breathing found?
* Central (brainstem)
| * Peripheral (carotid and aortic bodies)
203
____ helps regulate HR and sympathetic response to exercise due to concentration to certain metabolites in the muscle
MSNA(muscle sympathetic nerve afferents) - type 3 & 4 sympathetic afferents contained in the muscle
204
What is the hering-breuer reflex?
reflex inhibition of inspiration triggered by pulmonary stretch
receptors upon expansion of the lungs and mediated by the vagus nerve
205
_____ are probably the most important inputs to
the ventilatory control system in establishing the breath-to-breath levels of tidal
volume and ventilatory frequency. (what keeps your normal rate of breathing)
Arterial and cerebrospinal fluid PaCO2
206
Chronic obstructive lung diseases ___ the ventilatory response to hypercapnia, patients become more reliant of PaO2
depress
207
Changes in the ____, result in alterations in alveolar ventilation that return these variables to their normal values.
PaCO2, pH, and PaO2
208
Changes in oxygen concentration have virtually ____ effect on the respiratory
center itself to alter respiratory drive
No direct
209
Oxygen changes _____ effect, via peripheral chemoreceptors, because our bodies has a large range of PO2 that allows us to oxygenate tissues and deliver O2 efficiently
do have an indirect
210
The _____ delivers almost exactly normal amounts of
| oxygen to the tissues even when the pulmonary Po2 changes from a low value to a high value.
Hemoglobinoxygen buffer system
211
Both the blood and tissue Pco2 changes ____ with the rate of pulmonary ventilation. This is why CO2 is the main controller of respiration
inversely
212
What forms rCPG and what does it do?
Formed by interconnected neuronal networks within the medulla and pons.
It generates the respiratory rhythm
213
Afferent signals from lung mechanoreceptors and peripheral chemoreceptors enter
this rCPG network via the _____
nucleus of the solitary tract (nTS)
214
The rhythmic output of the rCPG drives the activity of _____ that innervate the muscles of respiration.
The rhythmic output of the rCPG drives the activity of spinal phrenic, intercostal,
and lumbar motor neuron pools that innervate the muscles of respiration.
215
The rCPG can be influenced by higher CNS structures, to allow for ____
conscious control of the ventilatory pattern
216
What are the two components of rCPGs?
- The pre-Botzinger complex (pre-BotC)
| - Botzinger complex (BotC
217
The pre-Botzinger complex (pre-BotC), located within the ____ is considered a major source of ___ activity
The pre-Botzinger complex (pre-BotC), located within the medullary ventral respiratory
column (VRC) is considered a major source of rhythmic inspiratory activity
218
The Botzinger complex (BotC) containing mostly
| __ neurons
```
Botzinger complex (BotC) containing mostly
expiratory neurons
```
219
The nervous signal that is transmitted to the inspiratory muscles, mainly the
diaphragm, is not an instantaneous burst of action potentials instead it functions as a ____
ramp signal
220
What does the cycle of the nervous signal that is transmitted to the inspiratory muscles look like?
• It begins weakly and gradually ramps up over a period of 2secs.
• Then it ceases abruptly for approximately the next 3 seconds, which turns off the excitation of the diaphragm and allows elastic recoil of the lungs and the chest wall to cause
expiration.
• The inspiratory signal begins again for another cycle; and repeats with expiration occurring in between
221
What is the advantage of the ramping of the nervous signal that is transmitted to the inspiratory muscles?
it causes a steady increase in the volume of the lungs during inspiration, rather than inspiratory gasps which helps
keeps flow of air more consistent
222
What modulates breathing during emotions?
Periaqueductalgray (PAG)
223
Exercise____ O2 consumption and CO2 production
increases
224
Minute ventilation (MVV) increases with the level of exercise; it increases linearly with ____ up to a level of about 60% VO2max
Minute ventilation (MVV) increases with the level of exercise; it increases
linearly with both oxygen consumption and carbon dioxide production up to a
level of about 60% VO2max
225
Above that, MVV increases ____ than oxygen consumption but continues to rise proportionally to the increase in carbon dioxide production
faster
226
What causes the increase in ventilation above oxygen consumption at high work levels?
the increased metabolites from anaerobic metabolism.
227
The increase in minute ventilation is usually a result of increases ____
both tidal volume and rate.
228
Initially, ___increases more than the ____
Initially, tidal volume increases more than the rate of respiration
229
As metabolic acidosis develops, the increase in ____
breathing rate predominates.
