Term
1) deliver O2 to cells, remove CO2
2) pH balance
3) Warm the Air
4) Humidify the Air
5) Filter the air |
|
Definition
| 5 functions of the pulmonary system |
|
|
Term
ciliated epithelium that secrete mucose, saline
Nasal cavity has turbinates |
|
Definition
| what 2 things aid in filtering the air you breath in? |
|
|
Term
alveoli have high O2 and low CO2 concentration, blood has low O2 and high CO2
this is significant because it makes a gradient allowing DIFFUSION of these molecules. |
|
Definition
| do alveoli have high O2 concentration or low? the blood coming to them? why is this important? |
|
|
Term
|
Definition
| what compound is a pH buffer for blood? |
|
|
Term
| remove CO2, left shift, increase pH, decrease H+, respiratory alkylosis |
|
Definition
| hyperventilation causes left or right shift? alkylosis, or acidosis? |
|
|
Term
| CO2 builds up, right shift, increased H+, decrease pH, respiratory acidosis |
|
Definition
| hypOventilation causes left or right shift? alkylosis, or acidosis? |
|
|
Term
| nasal cavity, pharynx, larynx |
|
Definition
| what does the upper respiratory tract consist of? |
|
|
Term
| hair cells filter, turbinates in the nasal cavity mix and slow the air to give more time for the air to warm up and humidify |
|
Definition
| what helps filter particles? and what helps slow air down to humidify it? |
|
|
Term
mucous: traps inhaled particles
saline: allows cilia to push mucus toward pharynx |
|
Definition
| what are the functions of the mucous and saline layers of the cilia of the trachea? |
|
|
Term
|
Definition
| what cells secrete mucus in the trachea? |
|
|
Term
| the mucus layer gets too thick due to less H20 to water down the mucus, so bacteria colonize the lungs |
|
Definition
| what happens in cystic fibrosis? |
|
|
Term
| trachea, bronchi, bronchioles, respiratory bronchioles, alveoli |
|
Definition
| what makes up the lower respiratory tract? |
|
|
Term
| anything without alveoli (trachea, bronchi, bronchioles |
|
Definition
| what does anatomical dead space consist of? |
|
|
Term
| both respiratory bronchioles and alveoli do gas exchange |
|
Definition
| what part of the lower respiratory tract is NOT anatomical dead space? |
|
|
Term
|
Definition
| what part of the lower respiratory tract is lined with smooth muscle and subject to ANS regulation? |
|
|
Term
|
Definition
| how many alveoli does the average person have? |
|
|
Term
Type 1 cells: thin epithelia for gas exchange
Type 2 cells: produce surfactant |
|
Definition
| what are the 2 cell types that make up alveoli? what do they do? |
|
|
Term
| single layer of epithelial cells |
|
Definition
| how many cells thick are alveoli? |
|
|
Term
| elastic fibers around them, also inhaled water molecules |
|
Definition
| why do alveoli want to close naturally? |
|
|
Term
reduces surface tension by decreasing density of H2O molecules (at the air-water interface)
also hydrophobic tails pull the surfactant molecule upward |
|
Definition
| how does surfactant keep alveoli open? |
|
|
Term
| they don't have enough surfactant so their alveoli close |
|
Definition
| what happens with respiratory distress syndrome in the neonate? |
|
|
Term
|
Definition
| what percent of alveoli are covered with capillaries? |
|
|
Term
| both alveoli and their capillaries are lost which alters blood pressure |
|
Definition
| what happens in emphysema? |
|
|
Term
0.1 to 1.5 uM
buildup of fibrous tissue or edema can make this distance bigger, so diffusion is difficult |
|
Definition
| what is the diffusion distance between the alveoli and capillary (the interstitial space)? what disease processes effect this? |
|
|
Term
helps 2 pleura layers slide across each other
acts as a cohesive force to keep the pleura layers together so lungs expand with the thoracic cavity |
|
Definition
| what is the purpose of pleural fluid? |
|
|
Term
diaphragm
external/internal intercostals
scalenes
sternocleidomastoids
abdominal muscles |
|
Definition
| what are the muscles involved in ventilation? |
|
|
Term
|
Definition
| what muscles pull the 1st 2 ribs up? |
|
|
Term
|
Definition
| what muscles pull sternum and 1st rib up? |
|
|
Term
|
Definition
| what muscles help with forced expiration, or when you are breathing heavy and need help getting air out? |
|
|
Term
P1V1 = P2V2
basically decrease the volume and you increase the pressure (rate of collisions) |
|
Definition
|
|
Term
|
Definition
| what is atmospheric pressure? |
|
|
Term
| atmospheric, so air moves in to equalize the pressure |
|
Definition
| during inspiration what pressure is greater? atmospheric or alveolar? |
|
|
Term
| the pressure between visceral and parietal pleura |
|
Definition
| what is intrapleural pressure? |
|
|
Term
|
Definition
| as you inhale does intrapleural pressure increase or decrease? |
|
|
Term
|
Definition
| as you exhale, what does intrapleural pressure do? |
|
|
Term
| the difference between alveolar and intraleural pressure Trans=Pa-Pip |
|
Definition
| what is transpulmonary pressure? |
|
|
Term
| at the end of inspiration intrapleural is most negative, halfway through expiration alveolar is greatest |
|
Definition
when is alveolar and intrapleural pressure the greatest?
(most negative for intrapleural) |
|
|
Term
|
Definition
| if you get in a knife fight, how many times should you stab someone in the lungs? |
|
|
Term
| pulmonary volumes and capacities |
|
Definition
| what does a rotary wet spirometer measure? |
|
|
Term
|
Definition
| the lung volume representing the normal volume of air displaced between normal inspiration and expiration when extra effort is not applied |
|
|
Term
| inspiratory reserve volume |
|
Definition
| amount of air you can forcibly inhale beyond normal tidal volume |
|
|
Term
| expiratory reserve volume |
|
Definition
| amount of air you can forcibly exhale (after tidal volume out) |
|
|
Term
|
Definition
| amount of air still in lungs after maximum expiration (~1200) |
|
|
Term
|
Definition
| IRV + Tidal + ERV (air that moves in a single inspiration/expiration voluntarily |
|
|
Term
|
Definition
| Tidal volume + IRV (amount of air a person can breathe in starting at a normal exhale all the way to max forced capacity) |
|
|
Term
| functional residual capacity |
|
Definition
| ERV + residual volume (amount of air left in lungs at end of normal expiration) |
|
|
Term
|
Definition
| Vital capacity (IRV + Tidal + ERV) + Residual volume |
|
|
Term
|
Definition
| name for normal quiet breathing |
|
|
Term
|
Definition
|
|
Term
| tidal volume < expiratory reserve volume < residual volume < inspiratory reserve volume < functional residual capacity < inspiratory capacity < vital capacity < total lung capacity |
|
Definition
put these terms in order of least to most air volumes (in a normal person)
tidal volume, expiratory reserve volume, inspiratory capacity, vital capacity, residual volume, inspiratory reserve volume, functional residual capacity, total lung capacity |
|
|
Term
|
Definition
| an abnormal increase in respiratory volume; an abnormal increase in the rate and depth of breathing. (in response to metabolism) |
|
|
Term
|
Definition
| rapid shallow breathing (increase rate, not volume) so there is not optimal O2, CO2 exchange |
|
|
Term
|
Definition
| absence of spontaneous breathing |
|
|
Term
|
Definition
| decrease in respiratory intake with no metabolic change (leads to respiratory acidosis) |
|
|
Term
|
Definition
| increased rate and depth of breathing, no metabolic changes |
|
|
Term
| Total Pulmonary Ventilation |
|
Definition
| ventilation rate * tidal volume |
|
|
Term
| 6000 ml/min (12 breaths/min * 500ml/breath) |
|
Definition
| what is normal total pulmonary ventilation? |
|
|
Term
|
Definition
| anatomical dead space + alveoli not receiving proper or optimal blood flow |
|
|
Term
|
Definition
| ventilation rate * (tidal volume - dead space volume) |
|
|
Term
|
Definition
| how much is alveolar ventilation usually? |
|
|
Term
|
Definition
| what is the amount of total dead space in a normal person? |
|
|
Term
|
Definition
| where does the first 150 ml go that is inhaled? |
|
|
Term
|
Definition
| how much air of 500 mL inhaled exchanges with the alveoli? |
|
|
Term
| air left in the anatomical dead space (not fresh air) |
|
Definition
| where does the first 150 mL that hits the alveoli come from? |
|
|
Term
| 150 mL from anatomical dead space, and only 350 mL goes out the alveoli following so 150 remains |
|
Definition
| where does the first bit of air that is exhaled come from? |
|
|
Term
| 150 mL of air that was not exhaled from the alveoli is moved to the anatomical dead space |
|
Definition
| at the end of expiration, what air, and from where is left in the lungs? |
|
|
Term
1) compliance (elastic) work
2) tissue resistance work
3) airways resistance work |
|
Definition
| what are the 3 types of work during breathing? |
|
|
Term
change in V / change in P
SLOPE of the graph!
it changes throughout the breath |
|
Definition
|
|
Term
| since P is inversely related, it will decrease, but volume (V) will increase |
|
Definition
| as compliance increases, what happens to volume and pressure? |
|
|
Term
| at the start of inspiration |
|
Definition
| when is lung compliance highest? |
|
|
Term
| emphysema -as opossed to normal or fibrotic tissue (there are not as many alveoli to do gas exchange so it requires less force to prevent the lung from shutting closed-and so the lungs inflate easier) |
|
Definition
| what type of lung tissue is most compliant? why? |
|
|
Term
|
Definition
| what is the only "good" thing smoking does? |
|
|
Term
|
Definition
| the extent to which the lungs will expand for each unit increase in transpulmonary pressure |
|
|
Term
it helps close the lung(keep it closed), so it is harder to breathe in
there is a big change in pressure for not as much of a change in volume as would be ideal |
|
Definition
| why does fibrotic tissue decrease compliance? |
|
|
Term
volume of the lung (# of elastic forces)
surfactant |
|
Definition
| what are the dertermining factors for lung compliance? |
|
|
Term
Tissue resistance
20% of inspiratory work |
|
Definition
| term for viscous forces within tissues as they slide over each other, and what percent of inspiratory work does it create? |
|
|
Term
|
Definition
| when is apnea a problem lately? |
|
|
Term
| change in pressure/resistance (Ohm's law) |
|
Definition
| what is flow proportional to? |
|
|
Term
|
Definition
| you need to expend WORK to create a greater change in pressure to get more ____ |
|
|
Term
length of respiratory system
viscosity
radius of the tubes
(& airflow-turbulent/laminar flow) |
|
Definition
| what 3 things determine airway resistance? |
|
|
Term
| radius, it is to the 4th power, and it has an inverse relationship to resistance |
|
Definition
| what is the most important part of Poiseuille's law in affecting airway resistance? |
|
|
Term
| decreases by a factor of 16 |
|
Definition
| doubling the radius does what to the resistance factor? |
|
|
Term
mechanical-connective tissues (pull tubes open)
physical-mucous
neural control-ANS
paracrine/endocrine agents- lots |
|
Definition
| what 4 things determine the radius of the respiratory tubes? |
|
|
Term
CO2, histamine, prostaglandins, leukotrienes
-these are usually released in an inflammatory response |
|
Definition
| what are the paracrine/endocrine agents that affect radius of respiratory tubes? |
|
|
Term
| expiration, body has trouble opening airways, so wheezing is heard on expiration |
|
Definition
| is asthma a disease of expiration or inspiration? |
|
|
Term
epinephrine->beta 2 receptor -> bronchodilation
acetylcholine-> muscarinic -> bronchoconstriction |
|
Definition
| what are the receptors for airway control of the ANS? |
|
|
Term
it determines flow with the equation reynolds # = v*d*p / n
v=velocity
p=density
d = diameter
n= viscosity |
|
Definition
| what is reynold's number? |
|
|
Term
high = turbulent flow, in large airways (bronchi, large bronchioles)
low = laminar flow, small airways |
|
Definition
| what does a high reynold's number mean (>2000)? a low reynold's number? |
|
|
Term
| turbulence, which increases resistance |
|
Definition
| what is the compromise for increased airflow with large diameter airways? |
|
|
Term
| square root of change in pressure |
|
Definition
| when airflow is turbulent, flow is proportional to what? |
|
|
Term
| COPD and bronchoconstriction |
|
Definition
| when is the largest resistance not in the largest airways? |
|
|
Term
normally - phaynx/larynx
COPD - airways <2mm |
|
Definition
| which airways have the most resistance normally? in COPD? |
|
|
Term
ventilation to perfusion ratio, It is defined as: the ratio of the amount air reaching the alevoli to the amount of blood reaching the alevoli.
"V" - ventilation - the air which reaches the alveoli
"Q" - perfusion - the blood which reaches the alveoli
These two variables constitute the main determinants of the blood oxygen concentration. In fact since V determines the quantity of oxygen mass reaching the alveoli per minute (g/min) and Q expresses the flow of blood in the lungs (l/min), the V/Q ratio refers to a concentration (g/l). |
|
Definition
|
|
Term
ventilation = perfusion
this is the ideal state |
|
Definition
| what does a V/Q ratio of 1 mean? |
|
|
Term
| perfusion is low (due to physiological dead space-air inhaled but not involved in gas exchange-blocked capillary) |
|
Definition
| what does a V/Q > 1 mean? |
|
|
Term
| ventilation is low, meaning there is a right to left shunt -blood moves from right to left heart without being oxygenated properly) |
|
Definition
| what does a V/Q < 1 mean? |
|
|
Term
it goes toward infinity
PO2 is high because it's not getting exchanged with deoxygenated blood |
|
Definition
| if perfusion stops to an alveoli, what happens to the V/Q ratio? so why is the PO2 high in this alveoli |
|
|
Term
smooth muscle is affected causing bronchocontriction so that the V/q ratio is decreased
(decreased ventilation, the lung is compensating for low perfusion to make V/Q = 1)
example scenario: 1 alveoli is blocked, so 2x blood is shunted to the nearby alveoli) |
|
Definition
| if there is low CO2, high pH, or high O2, what happens in an alveoli? |
|
|
Term
| they produce less surfactant and cause compliance & decrease ventilation |
|
Definition
| if there is decreased bloodflow to an alveoli, what do type 2 pneumocytes do? |
|
|
Term
V/Q ratio will go to 0, hypoxia will cause vasoconstriction
blood vessels constrict to decrease perfusion, to match low ventilation |
|
Definition
| what happens to V/Q if the ventilation to 1 alveoli is blocked, but perfusion continues? |
|
|
Term
vasodilation in skeletal musc
vasoconstriction in lungs to that perfusion or veintilation are not wasted |
|
Definition
| hypoxia(high CO2, low O2) in skeletal muscle usually causes what? in the lung? |
|
|
Term
high altitude=whole lung hypoxic
this increases pulmonary arteriole pressure
(this is why cow's get Brisket disease at high altitude-human's don't?) |
|
Definition
| when can hypoxic vasoconstriction happen to the entire lung, and what does this do to pulmonary aterial pressure? |
|
|
Term
upper has -15mmHg less pressure
lower has 8mm Hg more pressure
due to hydrostatic pressure (like how pressure is greater in feet than head-gravity makes more weight of blood on itself) |
|
Definition
| does the upper part of lung has more or less pressure than the part of lung level with the heart? the lower part ? how much? why? |
|
|
Term
Zone 2, V/Q = close to 1 or > 1
(ignore systole diastole junk says Wacker->intermittent blood flow, systolic arterial pressure> alveolar pressure, but diastolic arterial pressure pCAP basically capillaries collapse |
|
Definition
| what zone of breathing is the apex or top of the lung? what does this mean the V/Q ratio is? |
|
|
Term
| capillaries always open due to hydrostatic pressure pCAP always > pALV V/Q ratio < 1 |
|
Definition
| in the base of the lung, what zone of breathing is it, and what is V/Q? |
|
|
Term
a disease state, pALV is ALWAYS > pCAP
could be hemhorrage etc where blood supply is really low so no blood |
|
Definition
| what is Zone 1 breathing? |
|
|
Term
close to Zone 3
very base of the lung where pressure distends the artery a lil because pCAP > pALV |
|
Definition
| what is Zone 4 breathing? where is it? |
|
|
Term
| they dissapear because lung is basically all on the same plane so hydrostatic forces do not affect it as much |
|
Definition
| what happens to the Zones when you lay down? |
|
|
Term
| about the same or you get backup = bad |
|
Definition
| how much blood do the left and right heart pump compared to each other? |
|
|
Term
| left heart is on the systemic side so there is greater pressure due to higher resistance |
|
Definition
| which side of the heart is thicker? why? |
|
|
Term
|
Definition
| what has more volume, pulmonary or systemic circulation? |
|
|
Term
| the pulmonary circulation can store a decent amount of blood, works as a reservoir |
|
Definition
| if there is a hemhorrage, where can blood come from to help compensate for the blood loss? |
|
|
Term
| hemorrhage, heavy excercise, left heart failure |
|
Definition
| what are reasons would the pulmonarie arteries would shift blood to the systemic circulation? |
|
|
Term
|
Definition
| what percent of blood is in the pulmonary circulation? |
|
|
Term
the heart doesn't pump enough blood, so blood backs up in the left atrium, pulmonary veins, pulmonary capillaries, and eventually increase pulmonary artery pressure
this can cause fluid buildup and lack of oxygentation to tissues, such as the lungs, which just makes the problem worse |
|
Definition
| what happens in congestive heart failure? |
|
|
Term
pulmonary capillary pressure 7mmHg
interstitial osmotic pressure 14 mmHg
negative interstitial pressure 8 mmHg
total of 29 mmHg |
|
Definition
| describing the fluid dynamics of the pulmonary arteries, what 3 things create an "outward" force, and how much? |
|
|
Term
| plasma osmotic pressure 28 mmHg |
|
Definition
| describing the fluid dynamics of the pulmonary arteries, what creates an "inward" force, and how much? |
|
|
Term
| 1 mmHg, outward forces - inward forces |
|
Definition
| what is the net filtration pressure in the pulmonary capillaries typically? how is it calculated? |
|
|
Term
| it is absorbed by the lymphatic system or evaporates through the alveoli |
|
Definition
| what happens to fluid in the lungs? |
|
|
Term
left heart failure (left atrial pressure rises, pulmonary artery pressure rises, capillary pressure rises)
pulmonary capillary membrane damage (causing protein leakage into the interstitial space and alveoli)
nephrotic syndrome (protein lost in urine) |
|
Definition
| list the 3 causes of pulmonary edema Wacker listed |
|
|
Term
| pulmonary capillaries and venuoles open |
|
Definition
| what normally keeps pulmonary artery pressure low during left atrium increases in pressure? |
|
|
Term
|
Definition
| when pulmonary arterial pressure increases with left atrial pressure, what do you worry about? |
|
|
Term
the existance of a shunt in the lungs between bronchial artery and pulmonary vein
in other words, the blood that supplies the long tissue itself dumps back into the arterial after oxygenating the tissue instead ot going to venous circulation |
|
Definition
| what accounts for 1-2% of cardiac output |
|
|
Term
some to the coronary sinus (right atrium)
some to the left atrium via the pulmonary vein |
|
Definition
| where does the blood from the lungs travel? |
|
|
Term
Tidal Volume
IRV
ERV
REsidual volume
together they are the maximum volume to which the lungs can be expanded |
|
Definition
| list the pulmonary volumes, what are they added together? |
|
|
Term
Inspiratory capacity
Functional Residual capacity
Vital Capacity
Total lung capcacity
each is a combination of 2 or more volumes |
|
Definition
| list the pulmonary capacities, what are they a combination of? |
|
|
Term
| so the blood can go to the systemic circulation and combat low blood pressure? so say guyton chapter 38 ~p. 485 |
|
Definition
| why do sympathetics constrict pulmonary blood vessels? |
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|
