Human Physiology Week 10 - Respiratory (Week 10 Study Guide)
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Questions and Answers

What is the primary method of oxygen transport in the blood?

  • Converted to carbonic acid
  • Bound to myoglobin
  • Bound to hemoglobin (correct)
  • Dissolved in plasma
  • Which of the following statements about carbon dioxide transport is accurate?

  • Carbon dioxide is mainly dissolved in the plasma.
  • Bound to hemoglobin constitutes approximately 20% of carbon dioxide transport.
  • Carbon dioxide is primarily transported as carbonic acid.
  • Bicarbonate accounts for roughly 70% of carbon dioxide transport. (correct)
  • What limitation of pulse oximetry can lead to misinterpretation in patients with low hemoglobin levels?

  • It does not indicate what is bound to hemoglobin. (correct)
  • It measures carbon dioxide saturation instead of oxygen.
  • It shows the total volume of blood present.
  • It can accurately quantify the amount of hemoglobin in blood.
  • Which statement accurately describes the role of central chemoreceptors in regulating ventilation?

    <p>They are the major controller stimulated by increased hydrogen ions and carbon dioxide.</p> Signup and view all the answers

    What significant factor can affect the accuracy of pulse oximeter readings?

    <p>Skin pigmentation levels.</p> Signup and view all the answers

    Which statement accurately describes the distribution of cartilage and smooth muscle in the respiratory system?

    <p>Trachea contains the most cartilage, while bronchioles have none.</p> Signup and view all the answers

    What contributes to the greatest resistance in airflow within the respiratory tract?

    <p>The bronchioles because they can constrict and lack cartilage.</p> Signup and view all the answers

    How does expiration affect airway resistance?

    <p>Airway resistance increases due to airway compression.</p> Signup and view all the answers

    Which factor primarily causes bronchoconstriction?

    <p>Parasympathetic release of Acetylcholine.</p> Signup and view all the answers

    Which of the following is NOT a mechanism that increases airway resistance in disease states?

    <p>Muscle relaxation in bronchial smooth muscle.</p> Signup and view all the answers

    What is the role of bronchodilators in managing airway resistance?

    <p>They decrease smooth muscle contraction.</p> Signup and view all the answers

    Which factor is associated with decreased lung compliance?

    <p>Chronic inflammation and presence of scar tissue.</p> Signup and view all the answers

    What is the effect of stiffer lung tissue on lung function?

    <p>Requires more effort to inflate the lungs</p> Signup and view all the answers

    How is partial pressure of oxygen in the blood described?

    <p>It denotes only the oxygen dissolved in plasma</p> Signup and view all the answers

    What happens to oxygen diffusion from the alveoli during high altitude?

    <p>It decreases due to reduced gas concentration gradient</p> Signup and view all the answers

    What is one consequence of increased distance between the alveoli and capillaries during gas exchange?

    <p>Decreased rate of diffusion</p> Signup and view all the answers

    Which of the following describes the concept of 'dead space' in respiration?

    <p>Air that does not reach the area of gas exchange</p> Signup and view all the answers

    What changes occur to pulmonary blood flow during exercise?

    <p>It increases and decreases resistance</p> Signup and view all the answers

    What is the primary problem caused by a pulmonary embolism?

    <p>Inadequate blood perfusion to alveoli</p> Signup and view all the answers

    What does FiO2 represent in a clinical context?

    <p>Fraction of oxygen in the inhaled air</p> Signup and view all the answers

    What happens to the partial pressure of carbon dioxide (PACO2) in the alveoli when blood flow is inadequate?

    <p>It increases due to accumulation from blood</p> Signup and view all the answers

    What physiological condition is indicated by the presence of anatomic dead space?

    <p>Sections of the respiratory tract with non-exchangeable air</p> Signup and view all the answers

    Study Notes

    Airway Anatomy

    • Cartilage decreases distally; most cartilage is in the trachea, no cartilage in the bronchioles
    • Smooth muscle is present where cartilage is absent
    • Bronchioles are almost entirely smooth muscle, except respiratory bronchioles

    Airway Resistance

    • Bronchioles have the greatest resistance due to the presence of smooth muscle, allowing for bronchoconstriction, while lacking cartilage for structural support.

    Ventilation and Airway Resistance

    • Inspiration decreases airway resistance as lung inflation pulls tissue apart and opens airways.
    • Expiration increases airway resistance due to compression of airway during lung deflation.
    • High airway resistance causes turbulent airflow, resulting in wheezing.

    Factors Influencing Bronchoconstriction and Bronchodilation

    • Sympathetic nervous system (neuroepinephrine and epinephrine) causes bronchodilation.
    • Parasympathetic nervous system (acetylcholine) causes bronchoconstriction.

    Airway Resistance in Disease States

    • Muscle contraction: Bronchoconstriction (acute or chronic).
    • Inflammation: Presence of blood and edema in airway walls.
    • Blockages in airway lumen: Mucus, tumors, foreign objects.

    Reducing Airway Resistance

    • Bronchodilators: Activate β-adrenergic receptors for bronchodilation.
    • Inhaled steroids: Reduce inflammation.

    Decreased Lung Compliance

    • Causes: Chronic inflammation and scar tissue.
    • Effects:
      • Increased effort to inflate lungs, leading to increased metabolic rate.
      • Incomplete lung inflation, potentially impacting gas exchange.
      • Reduced recoil during expiration, possibly requiring active expiration, which increases metabolic rate.

    Partial Pressure

    • Blood gases are measured in terms of partial pressure, reflecting the amount of dissolved gas in the blood.
    • Partial pressure is calculated as the product of atmospheric pressure and the percentage of a given gas in the atmosphere.

    Partial Pressure Abbreviations

    • Air:
      • PO2: Partial pressure of oxygen in the air we breathe in (about 160mmHg at sea level).
      • FO2: Fraction of oxygen in the air (about 21% regardless of elevation).
      • FiO2: Fraction of oxygen in the air we breathe in (21% for normal air).
    • Body:
      • PAO2: Alveolar partial pressure of oxygen (about 100-105mmHg at sea level).
      • PaO2: Systemic arterial partial pressure of oxygen (about 100mmHg at sea level).
      • PvO2: Systemic venous partial pressure of oxygen (about 40mmHg at rest, decreases during exercise).

    Gas Exchange

    • Gases move from high partial pressure to low partial pressure.
      • Oxygen moves from alveolus to blood.
      • Carbon dioxide moves from blood to alveolus.
    • Oxygen transport:
      • Any fluid in lungs.
      • Alveolar epithelium.
      • Epithelial basement membrane.
      • Interstitial space.
      • Capillary basement membrane.
      • Capillary endothelial membrane.

    Factors Limiting Gas Exchange

    • Reduced gas concentration gradient:
      • High altitude, reduced PO2.
      • Pulmonary pathology, difficulty exchanging air.
    • Reduced surface area of membrane:
      • Fluid or mucus in alveoli.
      • Reduced number of active alveoli
      • Reduced total surface area, e.g. emphysema.
    • Increased distance between alveoli and capillary:
      • Fluid or mucus in alveoli.
      • Fluid in interstitium.
      • Scar tissue

    Ventilation-Perfusion Matching

    • For gas exchange, both ventilation and perfusion must be adequate.
      • Ventilation: Air in the alveolus.
      • Perfusion: Blood flow through the capillary.

    Pulmonary Blood Flow During Exercise

    • Increased by more than four times during exercise.
    • Increases number of open capillaries.
    • Distends open capillaries, both decreasing vascular resistance.

    Dead Space

    • Air that never reaches the area of gas exchange.
    • Removed first, creating difficulties in removing expiratory gases from the alveoli.

    Anatomical vs. Physiological Dead Space

    • Anatomical dead space: Areas of the respiratory tract where gas exchange cannot occur.
    • Physiological dead space: Alveoli with incomplete perfusion for gas exchange.

    Pulmonary Embolism

    • Blood clots in the pulmonary vessels, potentially leading to:
      • Blocked perfusion of alveoli, preventing gas exchange.
      • Increased pulmonary vascular resistance, increasing workload on the right ventricle.

    Oxygen Transport in Blood

    • Bound to hemoglobin (97%).
    • Dissolved (3%).

    Carbon Dioxide Transport in Blood

    • Bicarbonate (most, ~70%).
    • Bound to hemoglobin (95% during exercise).

    Pulse Oximetry Limitations

    • Only measures the percentage of saturated hemoglobin, not overall hemoglobin levels.
    • Does not differentiate between oxygen and other molecules bound to hemoglobin, e.g. carbon monoxide.
    • Affected by skin pigmentation, leading to potential overestimation of saturation level.

    Blood Gases in Regulation of Ventilation

    • Increased carbon dioxide levels in blood stimulate ventilation.
    • Central chemoreceptors in the medulla are the major controllers, stimulated by increased hydrogen ions and carbon dioxide.
    • Peripheral chemoreceptors in the carotid bodies and aortic play a minor role, being stimulated by decreased PaO2.

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