Term
| What are the 3 main reasons we need to breathe? |
|
Definition
1) Living tissue needs E from oxidative combustion
2) Must provide O2 from atmosphere for combustion
3) Must remove combustion wastes, thus CO2 released into atmosphere |
|
|
Term
| What are the two functional divisions of the respiratory tract? |
|
Definition
-Conducting airways
-Gas exchange surfaces |
|
|
Term
| What is the primary goal of the Respiratory Tract? Sencondary? |
|
Definition
-Primary: gas exchange
-Secondary: thermoregulation, endocrine processes, acid-base balance |
|
|
Term
| What are the conducting airways? |
|
Definition
| -nares to terminal bronchiole |
|
|
Term
| What are the main goals of the Conducting Airways? |
|
Definition
-condition air to body core conditions (>98F, 100% humidity)
-filter pathogenic and nonpathogenic debris
-impose the least workload possible while accomplishing the first two goals |
|
|
Term
| The upper airway consisting of the _____, _____, and _____ of the _____ airway(s) receives the most severe environmental stress. Why? |
|
Definition
-nares, nasal passages, and nasopharynx
-Conducting
-Because air is least conditioned and is exposed to particulates, allergens, etc. |
|
|
Term
| Describe the epithelium of the upper airway of the conducting airways. Its primary reason for this? |
|
Definition
-Squamous epi=> pseudostratified ciliated epi
-to increase turbulaence to improve filtering of particles |
|
|
Term
| Definition: Pharynx/ Larynx |
|
Definition
| -common pathway for food, water, and air |
|
|
Term
| Is the pharynx normally optimized for air or food/water? What reflex switches it? |
|
Definition
|
|
Term
| What is the goal of the pharynx/larynx? How is this goal met? |
|
Definition
-to avoid airway contamination
-the epiglottis swings back to cover larynx and arytenoid cartilages provide a backup seal |
|
|
Term
| What are the 3 components of the Lower Airways? |
|
Definition
| -trachea, bronchi, bronchioles |
|
|
Term
| Describe the epithelium of the Lower Airways. How is it well-suited to its job? |
|
Definition
-pseudostratified ciliated epi
-mucus-secreting cells and glands provide surface layer that traps inhaled debris
-cilia assist in clearing inhaled debris |
|
|
Term
| _________ is within the wall of the Lower Airways to regulate airway diameter |
|
Definition
|
|
Term
| Function(s) of Airway Epithelium |
|
Definition
--prevents penetration of noxious substances into the airway wall
-secrete mediators to maintain bronchodilation
|
|
|
Term
| True or False: Damage to airway epithelium is not a major component of most respiratory diseases |
|
Definition
| -FALSE, viral infections often result in damaged epithelium for up to 6 weeks |
|
|
Term
| Airway smooth muscle is innervated by _______ nervous system |
|
Definition
|
|
Term
| ACh receptors (____) on myocyte= contraction |
|
Definition
|
|
Term
| ACh receptors (___) on presynaptic nerve ending= decrease ACh release |
|
Definition
|
|
Term
| Which nerve is the primary source of nerves in lower conducting airways? |
|
Definition
|
|
Term
| _(alpha or beta)_ (1,2,3)__ receptors on smooth muscle= relaxation |
|
Definition
|
|
Term
| __(alpha/ beta)__(1,2,3)___ receptors on nerve ending= decrease ACh release |
|
Definition
|
|
Term
| Airway smooth muscle is NOT directly innervated. Then how does it function? |
|
Definition
| -Catecholamines come from adrenal medulla via the blood stream |
|
|
Term
| Requirement(s) of Alveoli |
|
Definition
-must provide enough SA for gas exchange
-must be thin enough to allow rapid gas exchange
-must minimize the E needed
-must allow for increases in capacity during periods of excerise |
|
|
Term
| How do alweoli meet their strict requirements? |
|
Definition
| -lots of little blind sacs |
|
|
Term
| True or False: With the exception of nuclei, both Type I alveolocytes and pulmonary endothelial cells are quite thick |
|
Definition
| -FALSE: they are quite thin (total thickness only about 0.4 um |
|
|
Term
| Definition: Tidal volume (Vt) |
|
Definition
| -the amount of air moved in a single breath |
|
|
Term
| Exhaled volume slightly ______ than inhaled volume. Why? |
|
Definition
-larger
-addition of water vapor and usually warmer when exhaled |
|
|
Term
| Definition: Maximal Volunatry Capacity (MVC) |
|
Definition
| -volume of lung during maximal inhalation |
|
|
Term
| Definition: Functional Residual Capacity (FRC) |
|
Definition
| -amount of air remaining at the end of passive exhalation |
|
|
Term
Definition: Anatomic Dead Space Volume (Vd)
=> Is it constant? |
|
Definition
-the air contained in the conducting airways
-yes, it is essentially constant for each breath |
|
|
Term
Definition: Alveolar Volume (Va)
=>this is the air involved in..... |
|
Definition
-the air contained by the alveoli
-involved in gas exchange
|
|
|
Term
| Normally, Vd= about ____% Vt |
|
Definition
|
|
Term
| Definition: Minute Ventilation |
|
Definition
| -Tidal volume X breathing rate |
|
|
Term
| Definition: Minute alveolar ventilation |
|
Definition
| -alveolar volume X breathing rate |
|
|
Term
| Definition: Minute dead space ventilation |
|
Definition
| -dead space volume X breathing rate |
|
|
Term
|
Definition
| -something moves proportionally to the driving force and inversely proportionally to the resistance to movement |
|
|
Term
| What is the driving force of air movement? |
|
Definition
|
|
Term
| If air is moving from outside the body into the lungs, then the P inside the lungs must be ____ than outside |
|
Definition
|
|
Term
| -During exhalation, pressure inside the lungs must be ____ than outside |
|
Definition
|
|
Term
| Describe the intrathoracic pressure in the pleural space. How is this accomplished? |
|
Definition
-slightly negative pressure holds lungs partially expanded
-pleural space is filled with fluid that transits pressure signals perfectly
|
|
|
Term
| Describe the intrathoracic pressure of the thoracic cavity. |
|
Definition
| -thoracic cavity formed by a diaphram in a dome shape, thus contraction flattens the dome, creating negative pressure in thorax |
|
|
Term
| Increases in Vt translate almost completely to ________ Va |
|
Definition
|
|
Term
| A single breath is effecient until Vt starts to approach _______. This allows for what? |
|
Definition
-the mechanical limit of lung expansion
-this allows for a slower rate while maintaining Va |
|
|
Term
| Decrease in Vt translates almost completely to a _______ Va |
|
Definition
|
|
Term
| What are the two ways to increase capacity? |
|
Definition
-increase minute ventilation (increase rate, depth)
-increase cardiac output (unless increase vees limited)in blood gasntilation, improvement) |
|
|
Term
| What are the limits to increase capacity? |
|
Definition
-costs E
-mechanical constraints |
|
|
Term
| Once air is in alveoli, what happens? |
|
Definition
| -must exchange O2 and CO2 with pulmonary blood |
|
|
Term
| Air exchange in the alveoli occurs with/without expenditure of E. How does this work? |
|
Definition
-without
-goes down concentration gradients
-High alveolar O2 to low blood O2
-High blood CO2 to low alveolar CO2 |
|
|
Term
|
Definition
-the total pressure of a gas is the sum of the partial pressures of its components
-ex: if air is at a pressure of 1 atmosphere and is composed of 20% O2 and 80% N2, then the pressure of O2 in the air is 0.20 atmosphere |
|
|
Term
|
Definition
| -the amount of gas dissolved in a liquid is proportional to the partial pressure of the gas and the solubility of the gas |
|
|
Term
| Outline the Pulmonary Diffusion Path |
|
Definition
| -O2 must travel across alveolar epi, interstitium, endothelium, plasma, RBS membrane to bind to hemoblobin |
|
|
Term
|
Definition
|
|
Term
| If Oxygen has a low solubility, how does the body balance this? |
|
Definition
| -balance is bound to hemoglobin |
|
|
Term
| 1 molecule of Hb can carry up to ___ molecules of O2 via its ___ heme groups, each containing an atom of Ferrous iron (___+) |
|
Definition
|
|
Term
| Affinity of the molecule is governed by protein conformations induced by ___, ___, ___, and other compounds |
|
Definition
|
|
Term
| Definition: The Bohr Effect |
|
Definition
-shifts of the O2-Hb curve to increase or decrease affinity of binding
Shift to the right: decreases affinity
-Shift to the left: increases affinity
|
|
|
Term
______ in pH, ______ in CO2, _____ in temp shifts to the right (Bohr Effect)
Where is this found? |
|
Definition
-decrease
-increase
-increase
-metabolically active tissue |
|
|
Term
| What effect does 2,3-DPG have? |
|
Definition
| -shifts the O2-Hb curve to the right, thus improving delivery of O2 to the tissues |
|
|
Term
______ in pH, ______ in CO2, _____ in temp shifts to the left(Bohr Effect)
Where is this found? |
|
Definition
-increase
-decrease
-decrease
-lung |
|
|
Term
| 2,3-DPG is produced in response to what? |
|
Definition
| -chronic low grade acidosis |
|
|
Term
| How does 2,3-DPG affect the O2=Hb curve? |
|
Definition
| -shifts it to the right, thus improving delivery of O2 to the tissues |
|
|
Term
| Fetal Hb also shifted to the ____, relative to adult Hb |
|
Definition
|
|
Term
| Why are RBCs well-suited as oxygen transporters? |
|
Definition
| -they have minimal consumption of O2 themselves |
|
|
Term
| True or False: oxygen content in pulmonary vein is much higher that systemic capillary O2 content |
|
Definition
| FALSE, essentially the same due to the minimal consumption of O2 by RBCs themselves |
|
|
Term
| Compare/contrast diffusion of gases in systemic capillaries and in the pulmonary capillaries |
|
Definition
OPPOSITE
-In Systemic: soluble O2 diffuses into the tissue, Hb-bound O2 released as pP drops, CO2 diffuses into blood |
|
|
Term
| In what 3 forms is CO2 transported? |
|
Definition
- physically dissolved: 5%
-Bicarbonate/ Carbonic acid: 90%
-Carbaminos: 5-6% |
|
|
Term
| What is the main difference in CO2 distribution between the plasma and erythrocytes? |
|
Definition
| -WAY more CO2 in form of carbamino in RBC than in plasma |
|
|
Term
| CO2 as carbaminos primarily complexed to amino groups on ___ |
|
Definition
|
|
Term
| True or False: the amount of CO2 as carbaminos primarily complexed to amino groups on HB is directly dependent on pCO2 |
|
Definition
| FALSE, not particularly dependent |
|
|
Term
| Definition: Haldane effect |
|
Definition
| -binding of O2 to Hb decreases availability of amino groups |
|
|
Term
| The Haldane Effect delivers about __% of the exhaled CO2 |
|
Definition
|
|
Term
| Bicarbonate/ Carbonic Acid is the result of the hydration of what? |
|
Definition
|
|
Term
| Equilibration of Bicarbonate/ Carbonic Acid occurs fastest in RBCs in the presence of ______ |
|
Definition
|
|
Term
| Outline the Pulmonary Diffusion Path of CO2 |
|
Definition
| RBCs=> plamsa=> endothelium=> interstitium=> Type 1 alveolocyte=> into alveoli |
|
|
Term
| True or false: CO2 is not very soluble and thus always demonstrates a diffusion limitation |
|
Definition
| -FALSE: CO2 is very soluble and never demonstrates a diffusion limitation |
|
|
Term
| Full equilibration of CO2 requires conversion of chemical storage forms of CO2 to _______ |
|
Definition
|
|
Term
| True or False: Normal mammalian lungs are not efficient and very much is wasted |
|
Definition
| FALSE; they are quite efficient and little is wasted |
|
|
Term
True or False: very slight disease can cause dramatc decreses in V/Q matching
How does this affect gas exchange? |
|
Definition
TRUE
-it results in a dramatic decrease in gas exchange |
|
|
Term
| Areas of the lung which will normally have reduced ventilation have vessels with higher/lower resistance, thus restricting blood flow. This system provides limited/ extensive capactiy for V/Q matching. |
|
Definition
|
|
Term
| What type of sensors in the pulmonary precapillaires detect the pO2 in the region of the alveolus |
|
Definition
|
|
Term
| How does low pO2 affect precapillary sphincters? |
|
Definition
| -causes them to shut, hence restricting blood flow to an alveolus presumed to be unventilated |
|
|
Term
| How does high alveolar pO2 affect precapillary bessels? |
|
Definition
| -causes precapillary bessels to relax, thus allowing flow of blood |
|
|
Term
| What is the Va-Q of a non-ventilated precapillary vessels? |
|
Definition
|
|
Term
| What is a non-perfused precapillary vessel? What is the Va/Q of a non-perfused precapillary vessels? |
|
Definition
-blood clot as an exaple
-infinitty |
|
|
Term
| What is the optimal Va/Q for a precapillary vessel? |
|
Definition
|
|
Term
| What causes high altitude pulmonary edema? |
|
Definition
| -low inspired pO2 causes alveoli to have low pO2 |
|
|
Term
| What is the net effect of high altitude pulmonary edema? |
|
Definition
| -all capillaries constrict, causing pulmonary hypertension and edema (fluid fills the lungs due to the increase in back pressure) |
|
|
Term
| What physiologically causes multiple organ system failure? |
|
Definition
| -widespread, inappropriate activation of vasodilating messenger (NO) |
|
|
Term
| What is the physiological effect of multiple organ system failure? |
|
Definition
| -extensive capillary dilation, causes ventral pooling of blood in the lung |
|
|
Term
| What common species is high altitude pulmonary edema a common issue? How does it differ from the typical case? |
|
Definition
-cattle
-backs up all the way to the system vessels, thus fluid fills lungs and systemic tissues |
|
|
Term
| What are the forces responsible for the work of breathing? |
|
Definition
|
|
Term
| Resistance is proportional/inv proportional to Length of Passageway and proportional/inv prop to radius raised to the 4h power |
|
Definition
-proportional
-inversely proportional |
|
|
Term
| Is most of the airway resistance is in the upper or lower airways? What structure specifically? |
|
Definition
|
|
Term
| To avoid high resistance in the nares, the organism will do what? What is the one exception? |
|
Definition
-breath through mouth
-horses, because they are obligate nasal breathers |
|
|
Term
| Most airways can/cannot actively expand. What are the exceptions? |
|
Definition
-cannot
-Exceptions: nares, larynx, and pharynx |
|
|
Term
| During inhalation, the pressure in the pharynx but be higher/lower than pleural pressure and higher/lower than atmospheric pressure. Why? |
|
Definition
-higher
-lower
-need a PRESSURE GRADIENT to go from atm--> pharynx-->pleura |
|
|
Term
Out of the following, which will collapse if the pressure in the pharynx is cranked up to create negative pressure?
nose
trachea
larynx
pharynx |
|
Definition
-None will collapse except pharynx, which resists it
**However, the larynx can swing back in the wrong direction |
|
|
Term
| How does smooth muscle contracting in the lower airways affect radius and resistance? How does it affect bronchiole compliance? |
|
Definition
-Dec radius
-Inc resistance
-decrease compliance in the bronchioles |
|
|
Term
|
Definition
|
|
Term
| Is edema more on an issue in the upper or lower airways? |
|
Definition
|
|
Term
| How does increased airway resistance affect the work of breathing? How would this be affected by a lesion in the lung? |
|
Definition
-increases work of breathing both going in and going out
-lesion would make it more serious due to airway collapse |
|
|
Term
| How does structural failure affect the airways? |
|
Definition
-nasal masses, trachea collape
-soft palate displacement on exhalation
-laryngeal paresis on inhalatoin |
|
|
Term
| How do soft palet problems affect horses? |
|
Definition
| -soft palete will physicaly acclude the nasal passages on exhalation, but horses will exhale through its mouth |
|
|
Term
| Name a few examples of smooth muscle constrictors/agonists (4) |
|
Definition
-histamine
-prostaglandins, leukotrienes
-ozone
-avid vapor |
|
|
Term
| What is airway hyperactivity? What is it a sign of? |
|
Definition
-airways overreact to a completelynormal stimulus THUS narrowing of the aiways more than usual
-one of the first signs of disease |
|
|
Term
| How can airway hyperreactivity used as a diagnostic test? What does a higher response indicate? |
|
Definition
-administer a fixed dose of agonist to patient, then measure response
-disease |
|
|
Term
Definition: Compliance
What does low compliance mean in terms of stiffness and energy requirements? high? |
|
Definition
-the ease with which the lung and thorax expands
-low=sitff= more E
-high= loosy goosey= less E |
|
|
Term
| Where does most of the E used to overcome compliance come from? |
|
Definition
| -it is recoverable E stored in the lung |
|
|
Term
| True or False: Compliance is linear |
|
Definition
| FALSE, compliance is NOT linear |
|
|
Term
| Which receptors kick in to prevent inappropriate wasting of E in the lungs? |
|
Definition
| -pulmonary and thoracic stretch receptors |
|
|
Term
| When lung volumne is high, compiance is high/low |
|
Definition
|
|
Term
|
Definition
| -the maginitude of the E that was lost during the cycle of lung expansion and inflation |
|
|
Term
| Definition/Equation: Law of LaPlace |
|
Definition
-small wer structures require E to avoid collapse
-P=2T/R
T=surface tension
R=radius
P=pressure |
|
|
Term
| In small wet structures, ________ reduces surface tension, allowing for less pressure to maintain resistance |
|
Definition
|
|
Term
| Definition/Effects/Clinical Signs: Pulmonary Fibrosis |
|
Definition
-Definition: inc fibrous tissue in lungs
-Effects: lower compliance, thus inc inspiratory effort
-Clinical Signs: shallow breathing with rapid exhalation |
|
|
Term
| Is pulmonary fibrosis or surfactant deficiency more common? |
|
Definition
|
|
Term
| Describe the effects of surfactant deficiency. When does it occur? |
|
Definition
-low surfactant causes high surface tension, inability to expand alveoli
=>Two instances: young animal (not needed in utero) OR degradation of surfactant completey/ degraded faster than synth'd
|
|
|
Term
Definition/Clinical Signs: Pulmonary emphazema
-->What group of people commonly have this problem? |
|
Definition
-disease of lungs characterized by an enlargment of the airways, increasing compliance (makes inhaling waaaaay easier but exhaling a bitch)=>makes every exhale a forced exhale (will collapse airways)
-Clinical Signs: hyperinflated chest and tidal volume reduction
=>Commonly affects smokers
|
|
|
Term
| True or False: An inflamed airway is functionally the same as emphazema, hoever it does not distend and store E as effectively as normal airway |
|
Definition
|
|
Term
| What 3 general types of sensors control breathing? |
|
Definition
-medulary sensors
-extramedullary sensors
-lung sensors |
|
|
Term
| The lungs contain_______ similar to those in the heart. |
|
Definition
|
|
Term
| What are the primary goals of the respiratory system? |
|
Definition
-supply of O2
-removal of CO2 |
|
|
Term
| True or False: The body can survive a while without the ability to absorb O2 but will die within minutes of losing its ability to degrade CO2. |
|
Definition
| FALSE; O2 is absolutely necessary (die within minutes) and CO2 is onlly dangerous in the acidosis that it inevitably creates (will live for a while) |
|
|
Term
| In most species, inhalation/exhalation is the active process except in horses where inhalation/exhalation is the active process. |
|
Definition
-inhalation
-in horses, BOTH |
|
|
Term
| A signal from where stops inhalation? |
|
Definition
| -from lung stretch receptors via vagus nerve |
|
|
Term
| A signal from which nerve starts inhalation? |
|
Definition
|
|
Term
| Under normal tidal breathing, only in ________ is a motor signal generated for active exhalation. |
|
Definition
|
|
Term
| What 2 primary sensors tell us when to breathe? |
|
Definition
-respiratory sensor (CNS medulla)
-carotid bodies (outside CNS) |
|
|
Term
| Definition: Carotid Bodies |
|
Definition
small paired sinusoids located along the carnotid arteries, near bifucation
-innervated |
|
|
Term
| Describe the perfusion rate of carotid bodies |
|
Definition
| -extremely high, much higher than necessary to survive, allows sensitive monitoring of dissolved gases |
|
|
Term
| Definition: Glomus caroticum |
|
Definition
|
|
Term
| Definition: Glomus aorticum |
|
Definition
| -aortic body, back-up system |
|
|
Term
| How is afferent nerve activity detected? |
|
Definition
-decreased arterial oxygen tension
-acidosis
-rapid increases in arterial CO2
-blood stagnation
-increased temperature |
|
|
Term
| True or False: Breathing in humans without carotid bodies is often obvious during mild exercise |
|
Definition
| FALSE, breathing without carotid bodies is unchanged |
|
|
Term
| Where are central chemoreceptors located? |
|
Definition
| -on the ventral surtace of the medulla |
|
|
Term
| Central chemoreceptors are bathed in what fluid? |
|
Definition
|
|
Term
| Central Chemoreceptors are acutely sensitive to what? |
|
Definition
|
|
Term
| What does increased [CO2] cause? |
|
Definition
|
|
Term
| True or False: H+ diffuses poorly across the blood-brain barrier |
|
Definition
|
|
Term
| True or False: Because CO2 to Acidosis is a multistep. indirect process, thus it occurs very slowly |
|
Definition
| FALSE; it is multistep and indirect, but occurs REALLY fast |
|
|
Term
| Definition: Hering-Breuer Reflex |
|
Definition
-stretch receptors that detect expansion of lungs
-as lung expands, afferent activity increases, trying to override inspiratory stimulus |
|
|
Term
| Describe the function of the receptors opposite of the Hering-Breuer Reflex |
|
Definition
| -will gradually increase inspiratory efforts if lung is not allowed to completely deflate |
|
|
Term
| Definition: Reflex of Head |
|
Definition
| -causes accentuated inspiratory efforts during inhalation (sighing) |
|
|
Term
| Under conditions of apnea, rapid inflation of lung can produce a related reflex of increased/decreased inspiratory efforts. How is this clinically useful? |
|
Definition
-increased
-clinical useful for resuscitating anesthetized patients |
|
|
Term
| True or False: The relationship of CO2 and ventilation is not linear |
|
Definition
| -linear, normally pretty steep |
|
|
Term
| Small changes in CO2 cause small/large changes in vantilation. Slope gets steeper/less steep with hypoxia. |
|
Definition
|
|
Term
| What is the primary drive for integrated receptor signals? Secondary? |
|
Definition
-Primary: arterial CO2
-Secondary: arterial O2 |
|
|
Term
| Curve of Integrated Receptor Signals is displaced to the right/left (more ventilation) with exercise or hypercapnia |
|
Definition
|
|
Term
| What is the final drive to the muscles of inspiration? Expiration? |
|
Definition
-Inspiration: diaphram, intercostals
-Expiration: abdominals |
|
|
Term
| What are the secondary functions of the respiratory tract? |
|
Definition
-filtrations
-immune function
-humidifcation
-thermoregulation |
|
|
Term
| Inspired air is/is not compatible with the health of the gas exchange surfaces |
|
Definition
|
|
Term
| How is air affected by its passage over surfaces of the nose and upper airways? |
|
Definition
| -it is warmed and humidified |
|
|
Term
| During exercise/rest, unconditioned air may penetrate all the way to the bronchioles. |
|
Definition
|
|
Term
| How does the respiratory tract used for thermoregulation? |
|
Definition
| -thermosensory inputs increase resp rate without increasing gas exchange |
|
|
Term
| Which airways are used for thermoregulation? |
|
Definition
|
|
Term
| Describe how inspired air is filtered in the respiratory tract. |
|
Definition
-The tract twists and turns and its walls are covered with sticky mucus thus:
-large particles (that are more difficult to turn) will get caught on the sides of the nares and upper airways
-smaller particles settle out in the smaller aiways |
|
|
Term
| How are particles depositied on airway surfaces booted out? How does this affect the peripheral lung? |
|
Definition
-moved towards the pharynd by the mucociliary function and swallowed
-it is very efficient and keeps the peripheral lung virtually sterile |
|
|
Term
| What does the mucociliary apparatus consist and what does it do? |
|
Definition
-consists of cilia on mucosal epi cells from nares to bronchioles and a surface liquid (aqueous layer+ mucoid layer)
-funtion to rhythmically beat in the aqueous layer to propel the mucoid layer towards the pharynx |
|
|
Term
| Mucociliary transport can by increased by which drugs? How does this work? |
|
Definition
-Beta-adrenergic agonsists
-decreasing viscosity of mucus |
|
|
Term
| Mucociliary transport inc/dec by damage to cilia and/or ciliated cels. What can cause this? |
|
Definition
-dec
-viruses (up to 3m) and irritants (oxidants, etc) |
|
|
Term
| Mucus is secreted by ____ cells that secrete it continuously and _____ glands that secrete it depending on the situation |
|
Definition
-mucus (ex= goblet)
-submucosal |
|
|
Term
| The density of mucus cells and glands inc/dec down the respiratory tract. |
|
Definition
|
|
Term
| What is the purpose of the mucus in the respiratory tract? |
|
Definition
| -used to protect the conducting airway surfaces and trap inhaled debris |
|
|
Term
| Submucosal glands in the resp tract are responsive to stimuli from the _____ nerve (inc/dec production by cholinergic stimuli) |
|
Definition
|
|
Term
| _________ is the primary method of clearing out mucus. ________ is the secondary. |
|
Definition
-mucociliary clearance
-coughing |
|
|
Term
| What is the function of the surface antibodies in the respiratory tract? What kind(s) of antibodies is found here? |
|
Definition
-responsible for opsonizing inhaled pathogens
-primarily IgA, some IgG |
|
|
Term
|
Definition
| -non-specific proteins which bind to other organic substances |
|
|
Term
| What is the key difference between antibodies and opsonins? |
|
Definition
| -opsonin is specifc only to a chemical group found in only bacterial cells while antibodies are specific to an exact antigen |
|
|
Term
| Surfactant is secreted by what type of cell? |
|
Definition
|
|
Term
| True or False: Surfactant is capable of opsonizing bacteria and thus deficiences of these proteins due to prematurity and/or sepsis contributes to decreased immune competence. Expain. |
|
Definition
| TRUE, activates neutrophils |
|
|
Term
| What are the main methods of molecular defense in the resp tract? Cellular? |
|
Definition
-Molecular: suface antibodies, opsonins, surfactant
-Cellular: alveolar macrophages, bronchial epi cells, BALT and other lympoid collections |
|
|
Term
| What type of cell is the primary resident immunocyte of the respiratory tract? |
|
Definition
|
|
Term
| Function: Alveolar macrophages |
|
Definition
| -phagocytosis of cells and non-cellular debris |
|
|
Term
| Function: Bronchial epi cells |
|
Definition
-barrier b/n airway and tissue
-capable of granulocyte recruitment |
|
|
Term
| Function: BALT (and other inflammatory cells/ lymph collections) |
|
Definition
-positioned at sites of particle deposition (corners)
-act as sentries for specific immune resistance |
|
|
Term
| Bronchial Epi Cells are responsible for the recruitment of other leukocytes, when in doubt they simply start secreting secondary messengers for ________ cells, even if not required. |
|
Definition
|
|
Term
| Where are nodes of responsive cells located? |
|
Definition
| -in every location that air suddenly turns |
|
|
Term
| Describe the mechanics of coughing |
|
Definition
| -during forced exhalation, there is a point in the intrathoracic airways at which pressure outside the airway starts to exceed pressure inside the airway, this rapid movement of air through this point can shear stuff away from airway walls |
|
|
Term
| What is the purpose of serial coughing during exhalation? |
|
Definition
| -moves mucus from periphery to the central airways much faster than plain old mucociliary clearance, particularly when cilia are damaged |
|
|
Term
| What kind of nerve sense irritants in larger airways? |
|
Definition
|
|
Term
| When your patient is coughing, most likely has a component of _________ |
|
Definition
|
|
Term
| What are the two major factors of clinical concern when pulmonary protection fails? |
|
Definition
-weakened defenses
-increased pathogenic challenges |
|
|
Term
| What are the 5 causes of hypoxemia? |
|
Definition
-low inspired O2
-right-to-left shunting
-hypoventilation
-diffusion impairment
-V/Q mismatching |
|
|
Term
| What is the proper clinical response to hypoxemia due to low inspired O2? |
|
Definition
|
|
Term
| What of the 5 causes of hypoxemia are the most uncommon? |
|
Definition
-low inspired O2
-Right-to-left shunting: congenital |
|
|
Term
| What of the 5 causes of hypoxemia are mildly common? |
|
Definition
-hypoventilation: low respiration rate
-diffusion impairment: rarely occurs alone |
|
|
Term
| Which cause of hypoxemia occurs as the sole cause in neuromuscular diseases? |
|
Definition
|
|
Term
| When is diffusion impairment a major factor for hypoxemia? |
|
Definition
| -during strenuous exercise in extremely fit athletes |
|
|
Term
| What is the most common cause of hypoxemia? |
|
Definition
| -redirecting of blood or airflow due to V/Q mismatching: outstrips the adjusting mechanisms, physiologic limits of correction |
|
|
Term
| What makes V/Q mismatching the most concerning cause of hypoxemia? |
|
Definition
| -drastically reduces capacity for adjustment due to tissue damage and release of broncho- and vaso-active mediators |
|
|
Term
| Give a few examples of broncho- and vaso-active mediators |
|
Definition
-leukotrienes
-amines (histamine, serotonin)
-NO |
|
|
Term
| How is the adequacy of the respiratory system? |
|
Definition
| -evaluated by the success in achieving its goals: elimination of CO2, Absorption of O2, minimal work of breathing |
|
|
Term
| How is gas exchange evaluated? |
|
Definition
-endogenous sensors: respirator center, carotid bodies
-Externally visible indicators: Resp rate and effort |
|
|
Term
| What are the drawbacks of the endogenous systems? |
|
Definition
-not entirely specific for resp system
-not quantitative |
|
|
Term
| What is the best way for precise respiratory evaluation? |
|
Definition
| -single best tool is arterial blood gas analysis: O2 and CO2 in blood that has just left the lungs |
|
|
Term
| Is hypoxemia always caused by respiratory failure? What about hypercapnia? |
|
Definition
-not necessarily, many potential reasons
-Hypercapnia is resp failure! only causes by hypoventilation |
|
|
Term
| True or False: Alveolar air is the same as atmospheric air. |
|
Definition
| FALSE, alveolar air is different than atmospheric air. |
|
|
Term
| Inspired air contains about __% O2 and __% N2 |
|
Definition
|
|
Term
| At sea level (760 mmHg), partial pressure of O2 is ___mmHg |
|
Definition
|
|
Term
| What is the rule of thumb regarding the change in mmHg per change in elevation? |
|
Definition
| decrease of 1 mmHg per 100 meters |
|
|
Term
| Definition: Effect of humidification |
|
Definition
| -subtract water vapor from barometric P |
|
|
Term
| When is the only metabolic time that CO2/O2=1? What is the ratio used when burning a mixture? |
|
Definition
-during carbohydrate metabolism
-CO2/O2= 0.8 |
|
|
Term
| How is the Alveolar Air Equation used? |
|
Definition
| -used to compare the calculated alveolar O2 with the measured arterial O2 to determine how well gas exchange is proceeding |
|
|
Term
| What is the normal A-aO2 gradient? What does an increased value indicate? |
|
Definition
-Normal A-aO2 gradient is <5 mmHg
-increased A-aO2 gradient can be due to pulmonary disease |
|
|
Term
| Ideal V/Q matching is expressed as a ratio of ___. What does a ratio >1 indicate? <1? |
|
Definition
1
>1=alveolar underperfusion or overventilation
<1=alveolar overperfusion or underventilation |
|
|
Term
Definition: Physiologic Shunt Fraction (Qs/Qt)
-how is it expressed? |
|
Definition
-compares the ideal arterial O2 content with the actual arterial O2 content=> expresses how much was actually transferred AND how much could have been transferred
-expressed as percentage of the ideal O2 transfer |
|
|
Term
| What is the normal range of physiologic shunt fraction in horses? |
|
Definition
|
|
Term
| Why would the physiologic shunt fraction increase? |
|
Definition
| -due to areas of relative overperfusion or underventilation (v/Q<1) |
|
|
Term
| True or False: All expired air which was utilized will have CO2 equal to arterial CO2. |
|
Definition
|
|
Term
| What is the major assumption of Physiologic Dead Space Fraction (Vd/Vt)? |
|
Definition
| -assumes complete equilibration of CO2 at gas exchange surfaces |
|
|
Term
| What is the normal value of Vd/Vt? |
|
Definition
|
|
Term
| What is the normal value of pCO2? |
|
Definition
|
|
Term
Definition: Physiologic Dead Space Fraction (Vd/Vt)
-how is it calculated |
|
Definition
-% of gas that participated in gas exchange
-pCO2 exhaled/ pCO2 inhaled |
|
|
Term
| What does a decreased Physiologic Dead Space Fraction (vd/Vt) indicate? Increased? |
|
Definition
-lower= increased tidal volume (deep breath)
-higher= disease (more of lung not participating in gas exchange) OR shallow breath (dec tidal volume) |
|
|
Term
| Concerning Physiologic Dead Space Fraction (Vd/Vt), dilution of expired air CO2 will be ______ to amount of unutilized air. |
|
Definition
| -proportional (accounts for all of anatomic dead space air and any alveolar air not exposed to blood) |
|
|
Term
| What does the Bohr Dead Space Fraction compare? |
|
Definition
| -compares arterial CO2 with end-tidal CO2 |
|
|
Term
| What does the Bohr Dead Space Fraction assume? How is this justified? |
|
Definition
-assumed that arterial CO2 is the mean alveolar CO2
-if all alveoli were being appropriately ventilated, then the last gas out would be alveolar gas and end-tidal CO2= alveolar CO2= arterial CO2 |
|
|
Term
| During slow deep breathing, alveolar air equilibrates with mixed _____ blood at the end of the tidal cycles. Thus venous CO2 is _______ than arterial CO2. |
|
Definition
|
|
Term
| What does a high Bohr Dead Space Fraction indicate? |
|
Definition
| -higher= worse lung disease |
|
|
Term
| True or False: Faster respiration causes turbulent flow. Explain. |
|
Definition
| TRUE; mixing of alveolar air (hich CO2) with anatomic dead space air (low CO2) |
|
|
Term
|
Definition
| -chronic lower airway inflammation |
|
|
Term
| How does inflammation of bronchi affect compliance? In bronchioles? |
|
Definition
-no change in compliance b/c diameter does not change with inflation and deflation of the lungs
-decrease compliance |
|
|
Term
| What does high paCO2 indicate? |
|
Definition
| -indadequate ventilation: hypoventilation= dec minute alveolar ventilation |
|
|
Term
| What are the physiologic effects of damage to airway epi due to airway disease? |
|
Definition
-Dec mucociliary clearance=> accumulation of intraluminal debris=> inc airway resistance
-dec barrier b/n lumen and interstitium=> inc penetration of irritants=> inc vagal reflex=> mucus release and smooth muscle spasm |
|
|
Term
| What are the physiologic effects of damage to the lower airways due to airway disease? |
|
Definition
-inc granulocyte recruitment=> release of inflammatory agonists=> direct and indirect neuromuscular dysfunction=> bronchospasm
-dec pdn of bronchorelaxing prostanoids=> bronchospasm |
|
|
Term
| What are the physiologic effects of pulmonary parenchymal damage/ inflammation? |
|
Definition
-release of vasoactive mediators=> inappropriate constriction and dilation of pulmonary vasculature=> V/Q mismatching=> hypoxemia
-Release of bronchoactive mediators=> inappropriate constriction of small airways=> V/Q mismatching
-release of bronchoactive mediators=> constriction of small airways=> dec compliance=> inc work of breathing
-release of proinflammatory mediators=> inc vascular permeability=> interstitial edema=> dec compliance
-release of proinflammatory mediators=> interstitial edema=> diffusion impairment=> hypoxemia |
|
|
Term
| Outline the effects of decreased mucociliary clearance due to airway disease |
|
Definition
| Decreased mucociliary clearance accumulation of intralumenal debris increased airway resistance |
|
|
Term
| Outline the effects of decreased barrier b/n lumen and interstitium due to airway disease |
|
Definition
| Decreased barrier between lumen and interstitium increased penetration of irritants Increased vagal reflex mucus release and smooth muscle spasm |
|
|
Term
| Ouline the effects of increased granulocyte recruitment due to airway disease |
|
Definition
| Increased granulocyte recruitment release of inflammatory agonists direct and indirect neuromuscular dysfunction bronchospasm |
|
|
Term
| Outline the effects of decreased production of bronchorelaxing prostanoids due to airway disease |
|
Definition
| Decreased production of bronchorelaxing prostanoids bronchospasm |
|
|
Term
| Outline the effects of vasoactive mediators due to parenchymal disease |
|
Definition
| Release of vasoactive mediators inappropriate constriction and dilation of pulmonary vasculature V/Q mismatching hypoxemia |
|
|
Term
| Outline the effects of release of bronchoactive mediators due to parenchymal disease |
|
Definition
-Release of bronchoactive mediators inappropriate constriction of small airways V/Q mismatching
-Release of bronchoactive mediators constriction of small airways decreased compliance increased work of breathing |
|
|
Term
| Outline the effects of release of proinflammatory mediators due to parenchymal disease |
|
Definition
| Release of proinflammatory mediators increased vascular permeability interstitial edema decreased compliance |
|
|
Term
| Outline the effects of release of proinflammatory mediators due to parenchymal disease |
|
Definition
| Release of proinflammatory mediators interstitial edema diffusion impairment hypoxemia |
|
|
Term
| Definition: Relevant Lesion of Nasal Aspergillosis |
|
Definition
| -space-occupying mass in the nasal passages |
|
|
Term
| Describe the relevant physiologic process of Nasal Aspergillosis |
|
Definition
| -inc work of brathing due to increased airway resistance |
|
|
Term
| Describe the resolution of Abnormal Physiology of Nasal Aspergillosis |
|
Definition
| -reduction of mass, either through surgery or medical removal of fungi |
|
|
Term
Definition: Tracheal Collapse
-how is this resolved? |
|
Definition
-stenosis of tracheal due to defective cartilage
-prosthetic trachea |
|
|
Term
| Descrbie the relevante physiologic process of Tracheal collapse |
|
Definition
| -inc work of breathing due to inc airway resistance |
|
|
Term
| When will the extrathoracic trachea collapse? Intrathoracic? |
|
Definition
-E: neg P during inhalation, thus this is when it will collapse
-I: pos P during exhalation, thus ihis is when it will collapse (higher P ouside of wall b/c pleural P) |
|
|
Term
|
Definition
|
|
Term
| Give a few examples of increased airway resistance during Bronchitis |
|
Definition
-bronchospasm
-intraluminal mucus
-secondary to inflammatory stimulation of muscle and glands |
|
|
Term
| How do you treat Bronchitis? |
|
Definition
| -remove cause thus use anti-inflammatory drugs (bronchodilators, mucolytics provide symptomatic relief) |
|
|
Term
| Study slides concerning Bronchitis and Pneumonia |
|
Definition
|
|
