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CVP > Unit 4 > Flashcards

Unit 4 Flashcards

1
Q

Respiratory tree

A 
Larynx
Trachea
Primary bronchi 
2ndary bronchi
Tertiary bronchi
Bronchioles
Terminal bronchioles
Respiratory bronchioles
Alveolar ducts
Alveolar sacs with alveoli
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2
Q

Trachea supplies:

A

Both lungs

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3
Q

Primary bronchi supplies:

A

Each lung

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4
Q

2ndary bronchi supplies

A

Each lobe

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5
Q

Tertiary bronchi supplies:

A

Each bronchopulmonary segment (lobule)

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6
Q

Areas of the resp tree that are capable of gas exchange

A

Respiratory bronchioles

Alveolar ducts

Alveolar sacs with alveoli

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7
Q

Active muscles of inspiration

A 
Diaphragm
External intercostals
Sternopcleidomastoid
Serratus anterior
Scalenus muscles
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8
Q

Muscles of expiration (only needed for FORCEFUL expiration)

A

Rectus abdominus, obliques

Internal intercostals

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9
Q

What increases during inspiration

A

Vertical diameter

AP diameter

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10
Q

What contracts during inspiration?

A

External intercostals

Diaphragm

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11
Q

What happens to the rib cage during inspiration

A

It elevates (duh)

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12
Q

What happens with internal intercostals during inspiration

A

They relax

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13
Q

Inspiration is due to:

A

Muscle contraction which increases thoracic cage size

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14
Q

Compliant lungs inflate due to:

A

Negative pressure in the pleural cavity

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15
Q

Expiration is due to:

A

Decreasing thoracic cage size bc of the elasticity of the thoracic soft tissue and the lungs themselves

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16
Q

What happens to alveolar pressure during inspiration?

Expiration?

A

Decreases during insp

Increases during exp

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17
Q

What happens to pleural pressure during inspiration?

Expiration?

A

Insp- decreases

Exp- increases

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18
Q

Tissue gradience between alveolar and pleural pressures

A

Transpulmonary pressure

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19
Q

Lung volume during inspiration?

Expiration?

A

Insp- increases

Exp- decreases

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20
Q

Intrapulmonary (alveolar) pressure oscillates around:

What happens when negative?

A

0

Air enters lungs (air leaves when positive)

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21
Q

The lowest intrapulmonary pressure is reached:

After that:

A

Halfway into inspiration

After that air entering the lungs raises the pressure

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22
Q

The highest intrapulmonary pressure is reached at:

After that:

A

Halfway into expiration

After that, air leaving the lungs reduces the pressure

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23
Q

Intrapleural pressure is always:

This exerts:

A

Negative compared to the atm, oscillating around -4.

This exerts an expanding effect on the lungs due to lung compliance

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24
Q

The difference between the alveolar pressure and the pleural pressure

A

Transpulmonary pressure

Ptrans = Plv - Pip

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25
Q

Type I pneumocytes

A

Lines the alveolar walls (squamous)

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26
Q

Type II pneumocytes

A

Secrete pulmonary surfactant

Necessary to keep alveolar inflates

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27
Q

Purpose of pulmonary surfactant

A

Breaks surface tension of the fluid layer lining the alveolar walls

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28
Q

Premature babies lack:

A

Sufficient surfactant

Will develop resp distress syndrome

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29
Q

Commonly used pulmonary function test.

Pt breathes in a tube which is monitored

A

Spirometetry

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30
Q

Spirometer measures

A

Tidal volume

Ins reserve volume

Exp reserve volume

Residual volume

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31
Q

Tidal volume

A

Normal breathing at rest

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32
Q

Inspiratory reserve volume

A

Deepest breath in

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33
Q

Expiratory reserve volume

A

Breath out as much as you can

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34
Q

Residual volume

A

Amount of gas remaining in the lungs after exp. reserve volume

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35
Q

Capacities of spirometry

A

Inspiratory

Functional residual

Vital

Total lung

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36
Q

Inspiratory capacity

A

Tidal volume + insp reserve volume

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37
Q

Functional residual capacity

A

Exp reserve volume + residual volume

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38
Q

Vital capacity

A

Exp reserve volume + tidal volume + insp reserve volume — all the way in, all the way out

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39
Q

Total lung capacity

A

All 4 volumes added together

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40
Q

Minute resp volume =

A

Tidal volume X Resp rate

Looking for how much air goes in and out of your lungs within a minute

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41
Q

Dead air space

A

Air that fills respiratory passageways that are not capable of gas exchange with the blood

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42
Q

Anatomic dead air space

A

Air in trachea to the terminal bronchioles

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43
Q

Alveolar dead air space

A

Damaged or under perfused alveoli

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44
Q

Physiological dead air space

A

Sum of anatomic AND alveolar dead air space

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45
Q

Review slide 11

A

Slide 11

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46
Q

Alveolar ventilation rate

A

Total volume of new air entering the alveoli each min

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47
Q

Equation for alveolar ventilation rate

A

Va = freq (Vt-Vd)

Va = alveolar ventilation rate
freq= respiration rate
Vt= tidal volume 
Vd= Physiologic dead air space
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48
Q

Sympathetic effect on bronchioles

A

Causes bronchiolar dilation

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49
Q

Parasympathetic effect on bronchiolars

A

Causes bronchiolar constriction

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50
Q

Cough reflex is caused by

A

Irritation to bronchi and trachea

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51
Q

Neurons detecting bronchi and trachea irritation and efferent

A 
Afferent neurons (vagus) 
To the medulla

Efferent neurons to muscles of epiglottis and abdomen

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52
Q

Sneeze reflex caused by

A

Irritation to nasal passageways

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53
Q

Neurons involved in sneeze reflex

A

Afferent neurons (trigeminal)

Goes to the medulla

Efferent- to muscles of the uvula and abdomen

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54
Q

How does the nose modify the air before reaching the lungs?

A

Air is:
Warmed

Humidified

Partially filtered

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55
Q

Pressure is directly proportional to the:

A

Concentration of gas molecules in a system

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56
Q

Gases in breathes air are mainly:

A

Oxygen, nitrogen, CO2, and water vapor

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57
Q

Partial pressure: The total pressure exerted by a mixture of gases is equal to:

A

The sum of the individual pressures of each gas

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58
Q

Partial pressures in water and tissue fluid is determined by:

A

Gas concentration and solubility in the water or tissue fluid

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59
Q

(CO2/O2) is more soluble in water than the other

A

CO2

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60
Q

Air in the environment

A

Atmospheric air

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61
Q

Inspired air in anatomic dead air space

A

Humidified air

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62
Q

Air in gas exchange areas

A

Alveolar

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63
Q

Air in anatomic dead airs space as it exits the body

A

Expired air

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64
Q

Speech involves:

A

Respiratory system

Cerebral cortex

Phonation, resonance, and articulation structures

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65
Q

Mechanical functions of vocalization

A

Phonation
Resonance
Articulation

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66
Q

Phonation includes:

A

Larynx; vocal cords

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67
Q

Resonance includes:

A 
Mouth
Nose
Sinuses
Pharynx
Chest cavity
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68
Q

Articulation includes:

A

Lips, tongue, soft palate

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69
Q

What are responsible for controlling sound production

A

The intrinsic laryngeal muscles

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70
Q

Intrinsic laryngeal muscles

A

Cricothyroid muscl

Post cricoarytenoid muscles

Lateral and transverse cricoarytenoid muscles

Thyroarytenoid muscles

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71
Q

Cricothyroid muscles increase:

A

Tension on the vocal folds to raise pitch

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72
Q

Post. Cricoarytenoid muscle action

A

Abducts the arytenoid cartilages and therefore abducts the vocal cords

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73
Q

Lateral and transverse cricoarytenoid muscle action

A

Adduct and rotate arytenoid cartilages

Adduct the vocal cords

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74
Q

Thyroarytenoid muscle action

A

Shortening the vocal cords, lowering voice pitch

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75
Q

What do the extrinsic laryngeal muscles do?

A

Elevate or depress the larynx

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76
Q

Pressure of N2

A

597.0 mm Hg- 78.62%

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77
Q

Pressure of O2

A

159.mm Hg - 20.84%

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78
Q

Pressure of CO2

A

0.3 mm Hg- 0.04 %

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79
Q

Pressure of H2O

A

3.7 mm Hg- 0.50%

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80
Q

Total air pressure

A

760 mm Hg

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81
Q

Pressure of inspired N2

A

563.0 mm Hg - 74.09%

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82
Q

Pressure of inspired O2

A

149.3 mm Hg- 19.67 %

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83
Q

Pressure of inspired CO2

A

0.3 mm Hg- 0.04 %

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84
Q

Pressure of inspired H2O

A

47 mm Hg - 6.2%

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85
Q

Total pressure of inspired air

A

760 mm Hg

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86
Q

Pressure of Alveolar N2

A

569 mm Hg - 74.9%

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87
Q

Alveolar O2 pressure

A

104.0 mm Hg- 13.6%

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88
Q

CO2 alveolar air

A

40 mm Hg - 5.3 %

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89
Q

H2O alveolar air

A

47.0 - 6.2 %

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90
Q

N2 expired air

A

566.mm Hg- 74.5%

91
Q

O2 expired air

A

120.0 mm Hg- 15.7%

92
Q

CO2 expired air

A

27 mm Hg— 3.6 %

93
Q

H2O expired air

A

47.0 mm Hg — 6.2 %

94
Q

What is oxygen concentration in the alveoli dependent on?

A

Rate of absorption of O2 in the blood

And

Rate of entry of NEW O2 into the alveoli via ventilation

95
Q

CO2 concentration in the alveoli is dependent on:

A

Rate of excretion of CO2 from the blood

And

Rate of removal of CO2 from the alveoli via ventilation

96
Q

How many breaths does it take to totally replace alveolar air?

A

Approx 16 breaths

97
Q

Respiratory membrane

A

The structures in between the alveolar space and the lumen of the capillary

98
Q

How thick is the respiratory membrane?

A

0.2-0.6 micrometers

99
Q

Layers of the resp membrane (6)

A

Fluid layer

Alveolar epithelium

Epithelial basement membrane

Thin interstitial space

Capillary basement membrane

Capillary endothelium

100
Q

What does the rate of diffusion of gases through the resp membrane depend on?

A

Thickness (can get thicker if there is inflammation, or other issues can cause this)

Surface area (How many alveoli are present?)

Diffusion coefficient of the gas (This does not change. They fuse at whatever rate they do)

Pressure difference across the membrane

101
Q

Gas concentrations equilibrate between the ___ ___ and ___ ____ as blood passes through the lung

A

Alveolar air

Pulmonary capillary

102
Q

Gas concentrations equilibrate between the _____ _____ and ____ ____ as blood passes through the tissues

A

Systemic capillaries

Interstitial fluid

103
Q

Atelectasis can cause alveolar:

A

Collapse

104
Q

Alveolar fibrosis can cause:

A

Thickening of alveolar wall

105
Q

Emphysema can cause:

A

Alveolar-capillary sdestruction

106
Q

Pneumonia can cause

A

Alveolar consolidation

107
Q

Pulmonary edema can cause:

A

Frothy secretions

108
Q

Review picture in slide 35

A

Slide 35

109
Q

An increase in blood flow through a tissue will increase:

An decrease:

(In interstitial fluid)

A

PO2

PCO2

110
Q

An increase in tissue metabolism will (INCREASE/DECREASE) PO2 and (INCREASE/DECREASE) PCO2 in the interstitial fluid

A

decrease O2

Increase PCO2

111
Q

Normally, as tissue metabolism changes, so does:

A

Blood flow (autoregulation)

112
Q

As pressure of O2 in blood increases, what happens to hemoglobin saturation percentage?

A

It increases

113
Q

Pressure of O2 with reduced blood returning from the tissues

A

20-45 mm Hg (approx)

114
Q

Pressure of O2 in oxygenated blood leaving the lungs

A

Approx 80-129 mm Hg

115
Q

Bohr effect shows:

A

PH

CO2

Temperature

BPG

Shifts to the right

116
Q

What can cause a shift to the right in pressure o fO2 in blood vs hemoglobin saturation?

A

Increased hydrogen ions

Increased CO2 (which can also increase hydrogen ions)

Increased temperature

Increased BPG

117
Q

Forms of CO2 transport

A

Dissolved CO2

Bicarbonate (most)

Carbaminohemoglobin

118
Q

What happens in a chloride shift?

A

As bicarbonate diffuses out of the RBC, Cl- diffuses in to establish electrical neutrality

119
Q

Review picture in slide 39

A

Slide 39

120
Q

Rule of Haldane effect for CO2

A

As O2 is released from hemoglobin, the affinity for CO2 increases

This allows some CO2 to hitch a ride on deoxygenated hemoglobin (I.E. carboaminohemoglobin)

121
Q

The dorsal respiratory group receives sensory input from ______ and _____ from:

A

CN IX and C

Peripheral chemoreceptors and Baroreceptor

122
Q

In the dorsal respiratory group, efferents stimulate:

A

Inspiration (ramp signal)

123
Q

What respiratory groups are located in the medulla oblongata?

A

Dorsal and ventral respiratory groups

124
Q

Ventral respiratory group functions only in:

It control:

A

Heavy ventilation

Controls both inspiration and expiration

125
Q

Where is the pneumotaxic center located?

A

In the pons

126
Q

Pneumototaxic center controls:

A

Duration of inspiration set by the dorsal respiratory group therefore influencing rate and depth of breathing

127
Q

What prevents excessive lung inflation?

A

Hering-Breuer reflex

128
Q

What effects the respiratory center directly to increase respiratory rate>

A

Hydrogen ions and CO2

129
Q

What has an indirect effect via carotid and aortic body chemoreceptors?

A

Oxygen

130
Q

Receptor cells near the resp center respond to changes in:

Receptor cells in the carotid and aortic bodies respond to:

Higher centers in the cortex can exert:

A

Cerebrospinal fluid H+ caused by increases in arterial CO2

Large decreases in arterial O2

Conscious control over respiration

131
Q

Obstructive lung diseases does what to airflow? Why?

A

Increase resistance

As a result of reduction in the diameter of airways.

Can also result from processes within the lumen, wall or supporting structures of the lung

132
Q

Examples of obstructive lung diseases

A

Asthma

Emphysema

133
Q

Obstructive lung diseases tend to have increased:

A

TLC, RV and decreased VC

134
Q

Obstructive lung disease is characterized by:

A

“Air trapping”

135
Q

Inflammation or scarring of the lung and airway tissues is known as:

A

Restricted (constricted) lung diseases

136
Q

Restricted (constricted) lung diseases are associated with:

A

Increased lung elastic recoil and decreased compliance

137
Q

Example of restricted (constricted) lung diseases

A

Pneumonia
Tuberculosis
Atelactasis

138
Q

Restricted (constricted) lung diseases tend to have (INCREASED/DECREASED) TLC, RV and VC

A

Decreased

139
Q

Which lung disease has trouble with inflation?

A

Restricted (constricted) lung disease

140
Q

What is measured as a rate of air flow (L/min) during a forces maximal expiration following a maximal inspiration to total lung capacity?

A

Maximal excitatory flow (MEF)

141
Q

What is a measurement of lung volume (L) produces by a maximal forced expiration following a maximal inspiration to total lung capacity?

A

Forced vital capacity (FVC)

142
Q

What is a measurement of the volume of air (L) expired during the first second of maximal forced expiration following a maximal inspiration?

A

Forces expiratory volume (FEV1)

143
Q

FEV1 / FVC X 100 =

A

80% normally

144
Q

Lack of oxygen

A

Hypoxia

145
Q

How can hypoxia be caused?

A

By inadequate delivery of oxygen to tissues by the resp system, or by a deficient utilization of O2 by the cells

146
Q

Excess of CO2 in the body fluids commonly due to hypoventilation or diminished blood flow

A

Hypercapnia

147
Q

Blueness of the skin caused by excess deoxygenated blood in the capillaries

A

Cyanosis

148
Q

Mental anguish associated with the inability to ventilate enough to satisfy the demand for oxygen (air hunger)

A

Dyspnea

149
Q

Obstructive lung disease

Chronic obstruction of airways (mucus, edema, infection) due to chronic bronchitis

A

Chronic Pulmonary Emphysema

150
Q

Emphysema is typically due to

A

Cigarette smoking

151
Q

Problems with emphysema

A

Destruction of alveolar walls and connective tissue

152
Q

Emphysema causes

A

Permanent enlargement of the airspaces distal to the terminal bronchioles

153
Q

Symptoms of emphysema

A

Decreased breath sounds

Tachycardia and pulmonary hypertension

Hyperinflation of lungs (barrel chest)

TLC and RV are increased (air trapping)

VC is decreased

FVC and FEV1 are decreased

Hypoxia and hypercapnia

Polycythemia

154
Q

Emphysema and chronic bronchitis

A

COPD

155
Q

COPD with emphysema worse

A

Pt is skinny with pinker skin (Pink puffer) and puffed out chest

156
Q

COPD with worse bronchitis

A

Blue skin and bloated (Blue bloater)

157
Q

What type of disease is pneumonia?

A

Restricted lung disease

158
Q

Inflammation of the lung in which the alveoli become filled with fluid and blood cells

A

Pneumonia

159
Q

What usually causes pneumonia?

A

Infection with pneumococci bacteria

160
Q

T/F- Pneumonia is associated with pulmonary edema

A

true

It increases diffusion distance in the resp membrane

161
Q

Symptoms of pneumonia

A

Fever

Cough (productive)

Hypoxia and hypercapnia

TLC, RV, VC are reduced

Decreased ventilation/perfusion ratio

162
Q

What type of lung disease is atelectasis

A

Restrictive

163
Q

Collapsed lung (alveoli) due to total airway obstruction, lack of surfactant, or pneumothorax

Causes tissue behind the obstruction to collapse, therefore will cause restriction

A

Atelectasis

164
Q

Symptoms of atelectasis

A

Chest tightness, pain

Sydpnea

Hypoxia and hypercapnia

TLC, RV and VC decreased

FVC and FEV1 are decreased

165
Q

What type of lung disease is asthma

A

Obstructive

166
Q

Bronchial hyper responsiveness to a variety of allergens, chemicals, etc.
produces bronchoconstriction

A

Asthma

167
Q

What can exacerbate asthma

A

Exercise and cold

168
Q

Asthma will cause what?

A

Airway inflammation, hyper-secretion of mucus

169
Q

Symptoms of asthma

A

Cough

Wheezing

Dyspnea

Chest tightness

Reduces ventilation rate and tachycardia

TLC and RV are increased

VC is decreased

FVC and FEV1 are decreased

hypercapnia and hypoxia

Respiratory acidosis

170
Q

What type of lung disease is tuberculosis

A

Restricted

171
Q

Tuberculosis is a lung infection caused by:

This causes:

A

M. Tuberculosis bacilli

Scarring and destruction of tissue

172
Q

What happens with tuberculosis

A

Macrophages wall of lesion with fibrous tissue reducing surface area and thickening of the respiratory membrane

173
Q

Symptoms of tuberculosis

A

Cough (productive)

Dyspnea

TLC, VC and RV are reduced

174
Q

Muscle strength is determined by:

A

Strength (3-4 kg/cm3 of muscle cross-sectional area)

175
Q

Power is classified as

A

Work per unit time

176
Q

Endurance is determined by:

A

Glycogen stores— time to complete exhaustion

177
Q

Energy generating systems

A

Phosphogen system

Glycogen-lactic acid system

Aerobic system

178
Q

Phosphocreatine gets converted to:

A

Creatine and PO3-

Generates energy

179
Q

Glycogen (stored in the _____) gets converted into

A

Liver

Lactic acid

180
Q

End product of glucose, fatty acids and amino acids in the presence of O2

A

CO2 + H2O + Urea

181
Q

Moles of ATP per minute for:

Phosphogen system

Glycogen-lactic acid

Aerobic

A

4 mol/min

2.5 mol/min

1 mol/min

182
Q

Endurance (time until energy source runs out) for
Phosphogen system

Glycogen-lactic acid

Aerobic

A

8-10 sec

1.3-1.6

Unlimited as long as nutrients last

183
Q

Review slide 60. Not sure how to put into a flashcard.

A

Slide 60

184
Q

what type of diets provide high muscle glycogen content?

A

High carb diet

185
Q

What diet gives a low glycogen content

A

Fat and protein diet

186
Q

Contraction times for

Slow twitch:

Fast twitch A

Fast twitch B

A

Slow

Fast

Very fast

187
Q

Size of motor neuron for

Slow twitch:

Fast twitch A:

Fast-twitch B:

A

Small

Large

Very large

188
Q

Resistance to fatigue for

Slow twitch:

Fast twitch A:

Fast-twitch B:

A

High

Intermediate

Low

189
Q

Activity for

Slow twitch:

Fast twitch A:

Fast-twitch B:

A

Aerobic

Long term anaerobic

Short term anaerobic

190
Q

Force production for

Slow twitch:

Fast twitch A:

Fast-twitch B:

A

Low

High

Very high

191
Q

Mitochondrial density for

Slow twitch:

Fast twitch A:

Fast-twitch B:

A

High

High

Low

192
Q

Capillary density for

Slow twitch:

Fast twitch A:

Fast-twitch B:

A

High

Intermediate

Low

193
Q

Oxidative capacity for

Slow twitch:

Fast twitch A:

Fast-twitch B:

A

High

High

Low

194
Q

Glycotic capacity for

Slow twitch:

Fast twitch A:

Fast-twitch B:

A

Low

High

High

195
Q

3 muscle fiber types

A

Slow-twitch

Fast-twitch A

Fast twitch B

196
Q

Slow twitch muscles use ______ for fuel.
They provide _____ energy, offers _____ muscle contraction, fires (FAST/SLOWLY), has (HIGH/LOW) endurance, and is great for _____

A

Oxygen

Continuous

Extended

Slowly

High

Marathoners

197
Q

Fast twitch muscles uses _____ _____ for fuel, provides _____ ____ of speed, fires (SLOWLY/RAPIDLY), fatigues more (SLOWLY/QUICKLY), great for _____

A

Anaerobic metabolism

Short bursts

Rapidly

Quickly

Sprinters

198
Q

Look at chart on slide 66

A

Slide 66

199
Q

What is the most important factor in endurance athletics

A

Oxygen delivery to the working muscle

200
Q

Pulmonary ventilation (IS/IS NOT) the limiting factor in O2 delivery in healthy individuals

A

Is not

201
Q

What is the limiting factor in O2 delivery in healthy individuals?

A

the hearts CO

202
Q

Normal resting O2 consumption

A

250 ml/min

203
Q

O2 consumption during max exercise

A

3600-5100 ml/min depending on fitness level

204
Q

Max exercise pulmonary ventilation

A

100-110 L/min

205
Q

Max breathing ability

A

150-170 L/min

206
Q

Rate of O2 usage in maximum aerobic metabolism =

A

VO2 Max

207
Q

Untrained people who begin training can (INCREASE/DECREASE) VO2 max by ___% in 14 weeks

Trained endurance can to a ____%

A

Increase

10

45% increase

208
Q

Review chart in slide 68

A

Slide 68

209
Q

Diffusing ability for:

Non-athlete:

Swimmer:

Oarsman:

A

48 ml/min

71 ml/min

80 ml/min

210
Q

Reason for increase in diffusing ability

A

Due to increased blood flow and more open capillaries

211
Q

What happen to blood gas concentrations during aerobic exercise?

A

It does not change significantly

212
Q

Increase in ventilation is due to what?

A

Neurogenic responses:

Motor cortex

Sensory feedback from working muscles

213
Q

Why does a the blood gas concentration stay roughly the same during exercise?

A

Heart rate and ventilation increase so it helps keep up the transfer of gases .

214
Q

Work output/ O2 consumption and CO have a ____ relationship

A

Linear

215
Q

An untrained person can increase CO by how much during exercise?

What about a trained athlete?

A

4x

6x

216
Q

Cardiac hypertrophy can be seen in _____ training but not ______ training

A

Endurance

Sprint

217
Q

Increased CO during exercise is due to:

A

Cardiac hypertrophy (heart muscle mass)

218
Q

Resting stroke volume in

Non athlete:

Marathoner:

A

75 ml

105 ml

219
Q

Stroke volume maximum in

Nonathlete:

Marathoner:

A

110 ml

162 ml

220
Q

Resting heart rate for nonathlete:

Marathoner:

A

75 bpm

50 bpm

221
Q

Max heart rate in non athlete:

Marathoner:

A

195

185

222
Q

As CO increases, what happens to stoke volume?

A

Increases, then plateaus

223
Q

What happens to heart rate as CO increases?

A

Increases (slowly) - will plateau but later on

224
Q

CO where stroke volume tends to plateau

A

10-15 L/min

CVP (4 decks)

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