Unit 3: Respiration Flashcards
(163 cards)
1
Q
The respiratory system is analogous to the cardiovascular system:
Pump & pump rate - pump are the ______
Fluid & flow - pertain to ____ in pulmonary system
Site of regulation of _____
Exchange surface - Cardiovascular –> _____ exchange waste and oxygen
Pulmonary –> _____ exchange CO2 and oxygen
A
skeletal muscles around ribcage
vessels
resistance
capillaries, alveoli
2
Q
Part of the role of the heart is to bring _______ blood to the lungs to get ______.
A
deoxygenated, oxygenated
3
Q
Path of air:
____ pressure –> ___ pressure
A
Trachea
Bronchi
Bronchioles
Terminal bronchioles
Respiratory bronchioles
Alveolar ducts
Alveolar sacs
High –> Low pressure
4
Q
Conducting zone:
Main role is to…
A
Trachea
Bronchi
Bronchioles
Terminal bronchioles
Main role is to bring air down to lower portion of pulmonary, NO oxygen exchange
5
Q
Respiratory zone:
A
Respiratory bronchioles
Alveolar ducts
Alveolar sacs
CAN have exchange of oxygen
6
Q
Ventilation occurs when oxygen reaches ______
Interplay between _____ and ______
- Mechanics of ______
- In ____, out ____
Exchange I: atmosphere to _____
A
alveoli
inspiration, expiration
breathing
In O2, out CO2
lung
7
Q
Gas exchange occurs during the interface between _____ and _______
Interplay between _____ and _____
Exchange II: _____ to _____
A
alveoli, vascular system
perfusion (meaning blood, vascular system), ventilation
lung, blood
8
Q
Transport of ____ in the blood is _______, which delivers oxygen to the necessary areas of your body
A
gases
cardiovascular system
9
Q
Gas transport in blood: oxygen travels on ______ of your ______ and travels down to _____ for exchange
Exchange III: _____ to _____
A
hemoglobin
RBCs
tissues
tissues, cells
10
Q
Cellular respiration is the conversion of _____ into ______
Each cell produces _____ ATP/s
A
oxygen
ATP (energy currency of body)
~10^7 - 10^8 ATP/s
11
Q
External respiration: How oxygen travels from ______ to become utilized by _____
-
-
A
outside world, tissues
- Ventilation
- Gas Exchange
- Cardiovascular System
- Gas transport in blood
12
Q
_______ is driving force as to how air moves from outside world into your alveoli
A
Pressure gradient
13
Q
Patm = 0
therefore alveoli pressure needs to be _____ in order for air to move from out to in
A
negative
Palveolar = negative
14
Q
For air flow, the bigger the volume, the _____ the pressure
A
lower
Increased volume, decreased pressure
15
Q
Air flow (Q) = ∆P/R
Higher resistance (R) =
A
Higher resistance (R) = Less air flow (Q)
16
Q
R = 1/r^4
Bigger radius =
Autonomic _____ of conducting airways
A
Bigger radius = less resistance
regulation
17
Q
Chest/abdominal skeletal muscles is the muscular ____ that changes _____ and creates ______
A
pump
volume
pressure gradients
18
Q
Inspiration (air from out –> in) is ______, goal is to make thoracic volume _____ to ______ pressure
A
ACTIVE
bigger, decrease
19
Q
Quiet inspiration involves the active contraction of _________ to make thoracic cage bigger
Forced/deep inspiration additionally requires _______
A
scalenes
external intercostals
diaphragm
sternocleidomastoid
20
Q
Expiration is a ______ process
Relaxation of ______
Forced/active expiration additionally requires _______
A
PASSIVE
scalenes
external intercostals
diaphragm
(muscles required for quiet inspiration) RELAX
internal intercostals
abdominal muscles
CONTRACT
21
Q
Inspiration: ______ volume, _____ pressure
Expiration: _____ volume, _____ pressure
A
Increased volume, decreased pressure
Decreased volume, decreased pressure
22
Q
Process of QUIET inspiration:
Pacemakers of _____ fire
Signal ______ to fire
_______ contract
Volume ______, pressure _____
Air moves in
_______ with atmospheric pressure
A
RCC (in pons/medulla)
somatic motor neurons
Diaphragm, scalenes, and external intercostals
Volume increases, pressure decreases
Equilibration
23
Q
What is the efferent in the respiration pathway?
A. Somatic motor neurons
B. Sympathetic motor neurons
C. Parasympathetic motor neurons
D. Sensory motor neurons
A
A. Somatic motor neurons
somatic –> skeletal muscle
24
Q
In quiet expiration, the _______ relax
______ pressure becomes greater than ______
The elastic aspects of the lung _____
A
diaphragm and external intercostals
Intra-alveolar, atmospheric
recoil
25
In active expiration, the ______ contract
internal intercostals and abdominals
26
______ and ______ exists between the lungs and thoracic cavity (ribs)
Pleural membranes, pleural space
27
Function of pleural space:
-
-
- Reduces friction
- Allows lungs to follow movement of the thoracic cage
28
Lung elastic recoil + surface tension of alveoli - lungs want to _____
Elastic recoil of chest wall - chest wants to ______
These opposing forces creates _____ pressure
collapse (inwards)
splay open (outwards)
negative pressure (intrapleural pressure)
29
Transpulmonary pressure (TPP) gradient =
TPP = intra-alveolar - intrapleural
TPP = IAP - IPP
Normally
TPP = IAP - IPP
= 0 - (-5)
= +5 mm Hg
30
How does the pulmonary pressures graph change with forced respiration?
A. IAP beginning and ending values are greater
B. Curves significantly change shape
C. IPP is lower at end of inspiration
C. IPP is lower at end of inspiration
31
IAP beginning and ending values are ALWAYS _____
zero
32
Positive TPP b/c intrapleural pressure (IPP) is always ______ than intra-alveolar pressure (IAP), which is critical to keep lungs ______
more negative
inflated
33
Transpulmonary pressure (TPP) is GREATEST at _______
the end of inspiration
34
What happens when transpulmonary pressure = zero?
A. Lung expands
B. Lung collapses
C. No change
B. Lung collapses (pneumothorax)
35
Pneumothorax is when _____ is in pleural space, making it equilibrate to 0
This is due to ________
No way of _____ and keeping lungs _____, can't introduce air because lung ______
TPP = IAP - IPP
outside air
external rupture (knife) or internal rupture (ex. men that are tall)
expanding
inflated
collapses
TPP = IAP - IPP
TPP = 0 - 0
= 0 mm Hg
36
Work of Breathing
Two major factors:
- Lung compliance:
- Airway resistance:
- Lung compliance:
Tissue integrity - the amount of elastin and collagen present
Surface tension/surfactant
- Airway resistance:
obstructive diseases
37
Compliance is the amount of ____ needed to _____ the lungs AKA how easy for lungs to _____
Equation:
A high compliance lung =
______ related to elastance
force, deform/stretch
stretch
∆V/∆P
A high compliance lung = more volume change with less pressure/force
inversely related to elastance
38
Elastance is the ability of the lungs _____
Related to the amount of ______ in connective tissue
to return to their original shape
AKA elastic properties/recoil
Collagen and Elastin
39
Using the rubber band analogy:
Describe high compliance/low elastance:
Describe low compliance/high elastance:
Describe high compliance/low elastance:
Takes little force to expand but when you let go it does not go back to original shape
Describe low compliance/high elastance:
Takes a lot of force for me to expand, when I let go it goes back to its original shape
40
Emphysema is ____ compliance, _____ elastance
Caused by ______ --> less ____ --> difficult for _____ --> _____ in lungs
High compliance, low elastance (like a stretched out rubber band)
loss of elastin (+ collagen) --> less lung recoil --> difficult for air to leave lungs --> trapped air in lungs
Seen with smokers
41
Fibrosis is ____ compliance, ____ elastance
Caused by _____ --> difficult _____
Low compliance, high elastance (like a thick rubber band)
increased collagen/scar tissue --> difficult to expand and fill lungs
Seen with vaping, chronic exposure to irritants causes lungs to want to repair leading to large areas of scarring
42
High compliance is ______ volume change with _____ pressure change
Large volume change
Low pressure change
43
Alveolus lined with thin layer of fluid
Surface tension:
Exerts _____ pressure
Makes alveoli difficult to ____
inward
expand
44
Inward/Collapsing Pressure described by law of La Place:
P =
P = 2T/r
P = inward pressure
T = surface tension
r = radius of alveolus
45
Smaller alveoli...
A. Have greater inward-directed pressure than large alveoli
B. Have less inward-directed pressure than large alveoli
C. Have same pressure as large alveoli
A. Have greater inward-directed pressure than large alveoli
46
Because of surface tension, small alveoli are not ideal because of their tendency to _____. However, from the standpoint of gas exchange, alveoli needs to be as small as possible because of their high _____.
How does your body solve this problem?
collapse
surface area
Surfactant --> Surfactant breaks up H-bonding and surface tension
Small alveolus with surfactant = low collapsing pressure
47
Surfactant:
- 80% ______
- Secreted by ______ cells
- Forms interface between _____ and ____ in alveolar lumens
- increases ______
phospholipid (polar hydrophilic head, non-polar hydrophobic tail)
type II cells
water, air
compliance
48
Neonatal Respiratory Distress Syndrome (NRDS):
If premature + no ______ production -- >
Small alveoli _____ -->
No _____ exchange -->
Hypoxemia (low _____ in blood)
surfactant
collapse
gas
O2
49
Acute Respiratory Distress Syndrome (ARDS) in adults
______ --> Reduced ______ synthesis (destruction of _____ cells) + Increased _______ --> No _____ exchange --> Hypoxemia (low _____ in blood)
Inflammatory process
surfactant
type II cells
surfactant breakdown
gas
O2
50
Treatment for NRDS:
Providing surfactant, give fetus or infant surfactant
51
Treatment for ARDS:
NEVER give surfactant, they would just break it down
Treatment involves addressing the cause of inflammation
52
Causes of bronchoconstriction (narrowing of airways):
Parasympathetic
Histamine/Leukotrienes (released in response to allergins --> asthma)
53
Bronchitis can contribute to bronchoconstriction by producing _____ that narrows path
mucus buildup
54
Emphysema can contribute to bronchoconstriction b/c...
when trying to exhale, you'll have a collapse of conducting airways
55
Causes of bronchodilation (increases radius):
Sympathetic (beta 2)
Increased CO2 signals I am metabolizing a lot, want to dilate for efficient gas exchange
56
Choose all true re: work of breathing:
A. Compliance and elastance are inversely related
B. Emphysema is the only high compliance disorder
C. Fibrosis, ARDS, NRDS, obstruct air into lung
D. High elastance = great ability to stretch
E. None true
A. Compliance and elastance are inversely related
B. Emphysema is the only high compliance disorder
57
Restrictive diseases (low compliance):
-
-
-
- Fibrosis
- NRDS
- ARDS
58
Obstructive diseases:
-
-
-
- Emphysema
- Asthma
- Bronchitis
59
Fibrosis, ARDS, and NRDS _____ compliance, making it harder for _____
lower (restrictive diseases)
lungs to expand
60
Respiratory Disorders:
Obstructive:
- Affects the ______
- Air flow is _____ because of _____
Restrictive:
- Affects the _____
- ______ is reduced
- More work to _____ the lungs
airways
diminished, increased airway resistance
alveoli and lung tissue
Lung compliance
inflate (sometimes too much work)
61
Associated with ARDS, the resulting increase in interstitial fluid in the lungs is known as ______
pulmonary edema
62
In terms of ARDS, what is the effect on diffusion of gases from alveoli into capillaries?
Rate of diffusion decreases because diffusion distance increases
63
In terms of ARDS, if the fluid enters the alveoli, what is the effect on surface tension and recoil?
Both increases
ARDS - decreased surfactant synthesis + increased surfactant breakdown would INCREASE surface tension (since surfactant works to decrease surface tension), making it easier to collapse INCREASES recoil
64
What happens if the inward-directed pressure of surface tension is greater than the outward-directed transpulmonary pressure gradient?
Lung collapses
65
Lung volumes:
- Almost all lung volumes can be measured by a ______
- Only lung volume that can't be measured by spirometry is ______
Lung capacities:
- Combination of ______
spirometry
residual volume (RV)
lung volumes
66
Tidal Volume (VT):
Quiet Breathing (quiet inspiration and expiration)
500 mL
67
Inspiratory Reserve Volume (IRV):
Forced Inspiration
3000 mL
68
Expiratory Reserve Volume (ERV):
Forced Expiration
1200 mL
69
Residual volume is the amount of air that _______ after a ______ that participates in _______.
Most of this residual volume exists because the lungs are held stretched against the ribs by the _____ fluid.
remains within lungs
forced exhalation
gas exchange
pleural
70
Functional residual capacity (FRC) =
Functional residual capacity (FRC) = ERV + RV
70
Inspiratory capacity =
Inspiratory capacity = Tidal Volume (VT) + IRV
Quiet and forced inspiration
71
Functional residual capacity (FRC) is the volume in the lungs after a normal tidal volume is expired and can be thought of as the _________ of the lungs
Equilibrium volume: ______
equilibrium volume
Equilibrium volume: inward elastic recoil force of the lungs = outward force of the thoracic wall (no exertion by the diaphragm or other respiratory muscles)
72
Vital Capacity =
Vital Capacity = IRV + VT + ERV
73
Vital capacity is the max volume someone can exhale from _____
______ with body size and physical conditioning; ______ with age
forced inspiration
Increases
Decreases
74
Dead space is the volume of the airways and lungs that...
anatomical dead space (______) + physiologic dead space (________)
does NOT participate in gas exchange
conducting airways
alveoli that are not perfused or poorly perfused
75
The dead space to tidal volume ratio in healthy lungs is constant at about _____
0.3
30% of tidal volume
76
The volume of fresh air entering the alveoli:
Tidal Volume (VT) - Dead space (VDS)
77
Total pulmonary ventilation (TPV) =
TPV = ventilation rate (breaths/min) x tidal volume (VT)
78
Alveolar ventilation is the volume of fresh air that reaches the alveoli per minute =
Alv Vent = ventilation rate (breaths/min) x (tidal volume - dead space)
79
Given the following information:
weight = 120 lb
tidal volume = 400 mL
expiratory reserve = 0.8 L
residual volume = 1 L
For a resting, normal breath in, what volume of air is inhaled?
400 mL
Asking what tidal volume is, quiet breathing
80
Given the following information:
weight = 120 lb
tidal volume = 400 mL
expiratory reserve = 0.8 L
residual volume = 1 L
How much of that air remains in the airways?
How much of that air enters the alveoli?
Dead space = 30% of tidal volume
Dead space = 120 mL
Amount of fresh air that enters alveoli = VT - VDS
Amount of fresh air that enters alveoli = 280 mL
81
Given the following information:
weight = 120 lb
tidal volume = 400 mL
expiratory reserve = 0.8 L
residual volume = 1 L
The air that enters the alveoli is well-oxygenated, whereas the air that was already in the airways and alveoli is oxygen-depleted. The dead space air from the previous breath is "bumped" into the alveoli upon inspiration.
What volume of air, then, is oxygen-depleted?
What volume and percent of the air now in the lungs is well-oxygenated?
Oxygen depleted = expiratory reserve + residual volume + dead space
Oxygen-depleted = 1920 mL
1920 + 280 = 2200
Well-oxygenated = 280/2200 = 12.7%
82
In a normal lung, in powerful forced expiration IPP may become positive but it is still ______ IAP, making TPP still ______
______ prevent it from fully collapsing
In emphysema, _____ allow for _____ at bronchioles
less than, positive
Elastic fibers
loss of elastic fibers, dramatic collapse
83
How are obstructive disorders diagnosed?
FEV1 pulmonary function:
Volume of _____ vital capacity expired in one second
forced
Typically, entire vital capacity can be expired in 3 sec
84
Normal:
FEV1/FVC is approximately ____
____ of the vital capacity can be expired in the first second of forced expiration
0.8
80%
85
Obstructive disease (asthma):
FEV1/FVC _____
____ FEV1 because of _____ resistance to expiratory airflow
____ FVC
decreased
decreased, increased
decreased
86
Restrictive disease (fibrosis):
FEV1/FVC ______
____ FEV1 (_____)
_____ FVC
increased
decreased (though relatively normal)
dramatic decrease in (restricted ability to inflate)
87
Ventilation-perfusion (V/Q) matching refers to the coordination between the amount of air (_______) reaching the alveoli and the amount of blood (______) flowing
ventilation
perfusion
88
Which type of arteriole CONSTRICTS in the presence of low O2?
A. Pulmonary
B. Systemic
C. Both
D. Neither
A. Pulmonary
In systemic, would want to dilate to allow more blood to go to muscles when running from a tiger lets say in response to low O2, high CO2
Opposite for pulmonary - body does not want to waste energy perfusing areas that are not well-ventilated
89
For successful gas exchange/the sequence of oxygen movement:
_____ determines
_____ determines
_____ determines
_____
Atmospheric O2
Alveolar O2
Plasma O2
HbO2
90
Atmospheric O2 is affected by:
Alveolar O2 is affected by:
Plasma O2 is affected by:
altitude (less O2 at higher altitudes), humidity
lung compliance, airway resistance
factors affecting diffusion
91
What is responsible for these pressure gradients, why O2 is high in alveoli and low in tissues?
Opposite for CO2
Metabolism
92
In peripheral/systemic, we aim to optimize tissue oxygenation
High O2, low CO2 -->
High CO2, low O2 -->
High O2, low CO2 --> Vasoconstriction
High CO2, low O2 --> Vasodilation
93
In pulmonary, it is the opposite to optimize gas exchange
High CO2, low O2 -->
High O2, low CO2 -->
High CO2, low O2 --> Vasoconstriction
High O2, low CO2 --> Vasodilation
94
Ideal V/Q =
0.8
95
PAO2 =
PaO2 =
PAO2 = alveolar oxygen pressure
PaO2 = arterial oxygen pressure
96
Pulmonary arterioles _____ in hypoxia (_____); ____ in hyperoxia (_____)
constrict (underventilated)
dilate (well-ventilated)
97
Avg RR =
Avg TV/breath =
Avg TPV =
Avg RR = ~15 br/min
Avg TV/breath = 500 mL/br
Avg TPV = 6-9 L/min
*similar to cardiac output
98
V/Q is _____ at the apex of lung because...
V/Q is _____ at base of lung because...
highest
working against gravity, significantly low blood flow (Q)
lowest
high blood flow (Q) because not working against gravity
99
Low V/Q occurs due to ______
_____ "wasted"
Examples:
Low ventilation
Perfusion "wasted"
COPD, pulmonary edema
100
High V/Q occurs due to ______
____ "wasted"
Examples:
low blood flow/perfusion (Q)
ventilation "wasted"
Emphysema, PARTIAL pulmonary embolism
101
V/Q = 0 occurs due to ______
Examples:
Ventilation = 0
shunt
Airway, Obstruction, Pneumonia
102
V/Q = infinite occurs due to ______
Examples:
Q = 0
Dead space
no blood flow, COMPLETE pulmonary embolism
103
Low V/Q indicates that something went wrong in step ____ of gas exchange where oxygen needs to reach _____
1
alveoli
104
High V/Q indicates that something went wrong in step ___ of gas exchange where oxygen needs to reach _____
3
blood
105
There is not really a pathology for ____ Q
High
106
The lower the V/Q ratio, the closer the outflowing blood composition gets to _____, aka ______
mixed venous blood
"true" shunt
107
The higher the V/Q ratio, the closer the outflowing blood composition gets to ____
alveolar gas
108
We want to send blood to ______ area
well-ventilated
109
If V/Q < 0.8, what happens to plasma gas content?
A. O2 increases, CO2 increases
B. O2 increases, CO2 decreases
C. O2 decreases, CO2 decreases
D. O2 decreases, CO2 increases
D. O2 decreases, CO2 increases
Ventilation is lower -> less O2 at alveoli
110
Total Blood Oxygen (TBO) =
TBO = O2 dissolved in plasma (PaO2) ~2% + O2 bound to hemoglobin (HbO2) ~98%
111
Our body uses O2 bound to hemoglobin and not dissolved O2 because...
Oxygen is not very soluble in liquid!
112
One hemoglobin can bind up to _____ oxygen molecules
4
113
The more oxygen I have (PO2), the more _______ my hemoglobin molecules become
% saturated
114
O2-hemoglobin dissociation curve displays a _____ shape because of _______: as more O2 binds to Hb, affinity of Hb to O2 _____
sigmoidal
cooperative binding
increases
115
Hemoglobin is at _____ saturation when it returns to the lungs, possessing the _______ affinity to O2 -- perfect for ______ at the lungs
75%
HIGHEST
O2 binding to Hb
116
When there is less O2 bound, Hb's affinity to O2 ______, so more O2 will _____. This is perfect for when you need to _____ quickly
decreases
unbind
offload O2 quickly (think running from tigers)
117
When do you need to change the affinity to O2 aka unload more O2?
Running away from tigers aka increased ______ in which you are ______
metabolic state
using up lots of O2
118
Factors that change the affinity of Hb:
Metabolic byproducts:
Metabolic byproducts:
- CO2
- pH (think in terms of H+)
- Temperature
- 2,3 BPG
119
A decreased affinity of Hb for O2 causes a _____ shift
An increase in metabolic byproducts, causes a _____ affinity of Hb for O2
right
decrease
120
An increased affinity of Hb for O2 causes a ____ shift
left
121
Which causes a left shift?
A. Hypothermia
B. Alkalosis
C. Hypocapnia
D. Anaerobic metabolism
A. Hypothermia - low temp
B. Alkalosis - low H+
C. Hypocapnia - low CO2
122
When running away from a tiger, you want ____ affinity to O2 so you can ____ more O2 (____ shift)
less
unload
right
123
Causes of shift to the right:
increased PCO2
lower pH (increased H+)
increased temp
increased 2,3-DPG
124
Causes of shift to the left:
decreased PCO2
higher pH (decreased H+)
decreased temp
decreased 2,3-DPG
125
If plasma O2 is lower than normal...
A. Alveolar PO2 will be lower than normal
B. Atmospheric PO2 will be lower than normal
C. Percent saturation of Hb with O2 will be less
C. Percent saturation of Hb with O2 will be less
*sequence of oxygen movement
126
Anemia is ______ in hemoglobin
reduction
127
Anemia does NOT affect _____
percent saturation
128
change in # of hemoglobin does NOT change ______
of plasma oxygen
129
Which are normal in anemia?
A. Plasma PO2
B. % Saturation
C. Total amount of HbO2 in blood
D. Total blood oxygen
A. Plasma PO2
B. % Saturation
Decreased hemoglobin would decrease amount of O2 bound to hemoglobin (HbO2)
130
% Saturation is ONLY affected by ______
affinity
131
Carbon monoxide poisoning so deadly because it displaces _____ on ____
Binds with _____ affinity
Increases affinity of Hb for O2 that is bound, preventing ______
Shifts curve _____
O2 on Fe2+
>> (200-300x)
offloading
both directions
132
CO poisoning only changes _____
amount of O2 bound to hemoglobin (HbO2)
133
Carbon monoxide poisoning is like anemia in that...
A. Plasma gases are normal
B. Hemoglobin is reduced
C. Oxygen is displaced on Fe2+ binding site
D. Volume of O2 bound to Hb is lower
E. Total blood oxygen is significantly reduced
A. Plasma gases are normal
D. Volume of O2 bound to Hb is lower
E. Total blood oxygen is significantly reduced
134
Carbon monoxide poisoning has left shift because oxygen bound has ______ affinity
ALSO right shift because _____ is bound
increased
less oxygen
135
An increase in altitude ______ plasma oxygen
DECREASES
136
Responses to altitude (hypoxia):
Immediate:
_____ventilation - ______ reflex activated at plasma PO2 = 60 mm Hg
Systemic ______ and ______
Increased _______ output
Pulmonary _______
Hyperventilation - chemoreceptor reflex
arteriolar dilation, cerebral edema
sympathetic
arteriole constriction
137
Responses to altitude (hypoxia):
Acclimization (days to weeks):
Increased ______
_____ # mitochondria and mitoch enzymes
_____ myoglobin (muscle form of Hb)
Angiogenesis
erythopoietin -> RBC synthesis
Increased
Increased
138
Altitude Acclimation increases ______ to counter _____
hemoglobin, decrease in plasma oxygen
139
What are some physiological responses to high altitude?
A. Hyperventilation
B. Pulmonary arterioles dilate
C. Systemic arterioles constrict
D. Increase in # RBCs
A. Hyperventilation
D. Increase in # RBCs
Pulmonary arterioles CONSTRICT
Systemic arterioles DILATE
140
RCC located in the ______
pons and medulla oblongata
141
The medulla _____ respiration
The pons _____ respiration
initiates
modulates
142
Dorsal respiratory group (DRG) controls muscles of ______
quiet inspiration
143
Ventral respiratory group (VRG) controls muscles of _______, ______ during quiet breathing
forced inspiration and forced expiration
NOT active during quiet breathing
144
_______ is the pacemaker for the respiratory rhythm
pre-Botzinger complex
145
The _______ reflex modulates respiration
CO2, H+, O2 activate ______ chemoreceptors
H+ activates _____ chemoreceptors
chemoreceptor
peripheral (carotid/aortic)
central (medullary)
146
______ in plasma in order to activate the chemoreceptor reflex
PO2 < 60 mm Hg
147
A COPD patient has to use abdominals and internal intercostals to expire. The integrating center for this expiratory effort is the:
A. RCC
B. pre-Botzinger complex
C. Ventral Respiratory Group
D. Dorsal Respiratory Group
E. Pons/medulla
A. RCC
C. Ventral Respiratory Group
E. Pons/medulla
*Forced respiration
148
When plasma oxygen is low...
A. K+ channels open, cell hyperpolarizes
B. K+ channels open, cell depolarizes
C. K+ channels close, cell hyperpolarizes
D. K+ channels close, cell depolarizes
D. K+ channels close, cell depolarizes
cell more positive
149
The efferent in the chemoreceptor reflex is...
A. A hormone
B. Sensory or afferent neuron
C. Sympathetic neuron
D. Parasympathetic neuron
E. Somatic motor neuron
E. Somatic motor neuron
150
The primary drive for ventilation is due to...
A. Plasma O2 levels
B. HbO2
C. Plasma CO2
D. Voluntary control
C. Plasma CO2
CO2 part of chemoreceptor reflex
151
Steps of quiet expiration:
Pacemakers in RCC decrease firing rate
Action potential frequency decreases in somatic motor neurons
Less acetylcholine is released onto nicotinic receptors
Diaphragm, external intercostals, scalenes relax
Volume of thoracic cage decreases
Intrapleural pressure increases
Intra-alveolar pressure increases
Air flows out down pressure gradient
Pressure in lungs equilibrates with atmospheric pressure
152
Steps of chemoreceptor reflex:
Low oxygen or high CO2 causes chemoreceptors to depolarize
Chemoreceptors release neurotransmitter onto sensory neurons
Action potential in afferent neuron signals brain to increase inspiration
Activity is upregulated in Respiratory Control Center in pons/medulla
Somatic motor neurons increase firing (efferent pathway)
Acetylcholine is released onto nicotinic receptors on skeletal muscles
Diaphragm and other respiratory muscles depolarize and contract
Volume of thoracic cage increases
Air moves in during inspiration
153
Transpulmonary pressure...
increases if intrapleural pressure _____ more than intra-alveolar pressure
must be ______ for the alveoli to remain open
decreases
positive
154
TPP at BEGINNING of inspiration for:
Normal person =
In an open (simple) pneumothorax =
In a tension pneumothorax (IPP = +5 mm Hg) =
Normal person = +3 mm Hg
In an open (simple) pneumothorax = 0 mm Hg
In a tension pneumothorax (IPP = +5 mm Hg) = -5 mm Hg
155
Asthma is characterized by ______
bronchoconstriction
156
Bronchitis is usually _____ in origin, causing ______
infectious
mucus and inflammation
157
Low FEV1/FVC is seen in ______ diseases such as....
obstructive
asthma, bronchitis, emphysema
158
Fibrosis causes ______ elastance, also ______ diffusion distance
increased, increased
159
_____ is best treated by inhaled surfactant
NRDS
160
ARDS is characterized by ______
alveolar edema
161
The primary determinant of percent saturation is the ______ in the blood.
partial pressure of oxygen (PO2)
162
The HbO2 curve implies a normal pH of ____, normal arterial PCO2 of _____ and normal levels of 2,3 DPG.
What happens to percent saturation if pH drops or PCO2 or 2,3 DPG increase?
This change in % saturation is called a _____ shift.
7.4
40 mm Hg
Decreases
right
