Physiology of the Respiratory System

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Questions and Answers

What is the primary function of anatomical dead space in the respiratory system?

  • To increase lung compliance
  • To conduct air to the alveoli without gas exchange (correct)
  • To measure airway resistance
  • To facilitate gas exchange in the alveoli

Which factors can affect lung compliance?

  • Airway resistance and respiratory rate
  • Body mass index and age only
  • Alveolar ventilation and anatomical dead space
  • Surface tension and surfactant levels (correct)

In the calculation of alveolar ventilation, which of the following is subtracted from tidal volume?

  • Residual volume
  • Anatomical dead space (correct)
  • Expiratory reserve volume
  • Inspiratory reserve volume

What is one primary cause of increased airway resistance?

<p>Bronchoconstriction (C)</p> Signup and view all the answers

How does pulmonary ventilation differ in athletes compared to non-athletes?

<p>Athletes typically have increased lung volumes (D)</p> Signup and view all the answers

What does FEV1 measure in lung function tests?

<p>The volume of air expelled in one second (D)</p> Signup and view all the answers

What is the significance of the FEV1/FVC ratio?

<p>It is used to evaluate airflow obstruction (C)</p> Signup and view all the answers

Which lung volume represents the air remaining in the lungs after a normal exhalation?

<p>Functional Residual Capacity (D)</p> Signup and view all the answers

What device is primarily used to measure the speed of airflow during exhalation?

<p>Peak flow meter (A)</p> Signup and view all the answers

How does airway resistance typically change in asthma patients?

<p>It increases due to inflammation (C)</p> Signup and view all the answers

What characteristic of breathing mechanics applies to the measurement of tidal volume?

<p>It represents the average volume of air moved per breath (A)</p> Signup and view all the answers

Which lung volume is primarily assessed to evaluate changes in lung compliance?

<p>Vital Capacity (C)</p> Signup and view all the answers

What is the primary purpose of measuring Forced Vital Capacity (FVC)?

<p>To evaluate maximum expiration capability (C)</p> Signup and view all the answers

What primarily determines airway resistance in the respiratory system?

<p>Radius of the bronchi (C)</p> Signup and view all the answers

How does surfactant contribute to lung function in alveoli?

<p>Equalizes pressure among alveoli of varying sizes (B)</p> Signup and view all the answers

Which factor would NOT decrease airway resistance?

<p>Parasympathetic stimulation (D)</p> Signup and view all the answers

What is the primary consequence of reduced compliance in the lungs?

<p>Alveoli collapse on exhalation (D)</p> Signup and view all the answers

According to Laplace's Law, how is pressure (P) within an alveolus related to surface tension (T) and its radius (r)?

<p>P = 2T/r (D)</p> Signup and view all the answers

What would be the effect of surfactant concentration in smaller alveoli?

<p>Lower surface tension (A)</p> Signup and view all the answers

Which of the following best describes the condition of neonatal respiratory distress syndrome?

<p>Lack of surfactant secretion (D)</p> Signup and view all the answers

What is the effect of bronchoconstriction on gas flow within the respiratory system?

<p>Increases airway resistance (B)</p> Signup and view all the answers

What is the main function of the Haldane effect in blood gas transport?

<p>Facilitates the release of oxygen from hemoglobin (C)</p> Signup and view all the answers

Which statement best describes Dalton's Law of Partial Pressure?

<p>The total pressure is the sum of the partial pressures of each gas in the mixture (C)</p> Signup and view all the answers

What factor does NOT affect the diffusion of gases during blood gas transport?

<p>Atmospheric pressure (B)</p> Signup and view all the answers

Which gas has the highest partial pressure in the alveoli?

<p>Carbon dioxide (D)</p> Signup and view all the answers

How does the solubility of gases impact their transport in the bloodstream?

<p>Higher solubility increases the rate of gas diffusion (C)</p> Signup and view all the answers

What is the primary mechanism by which carbon dioxide is transported in the blood?

<p>Converted to carbonic acid and transported as bicarbonate ions (A)</p> Signup and view all the answers

Which statement best describes the Haldane effect?

<p>Deoxygenated hemoglobin has a higher affinity for carbon dioxide. (B)</p> Signup and view all the answers

What is the role of carbonic anhydrase in carbon dioxide transport?

<p>It catalyzes the formation of carbonic acid from carbon dioxide and water. (C)</p> Signup and view all the answers

Which factor influences the buffering capacity of hemoglobin the most?

<p>The oxygenation state of hemoglobin (C)</p> Signup and view all the answers

How is most of the carbon dioxide transported in the human body?

<p>As bicarbonate ions in plasma (B)</p> Signup and view all the answers

What primarily happens to the carbon dioxide concentration in the lungs?

<p>It is exchanged for oxygen through diffusion. (A)</p> Signup and view all the answers

What is the contribution of the imidazole groups in hemoglobin?

<p>They act as a buffer for excess hydrogen ions. (A)</p> Signup and view all the answers

What occurs in the tissues during the Haldane effect?

<p>Deoxygenated hemoglobin promotes CO2 transport. (B)</p> Signup and view all the answers

What is the relationship between carbon dioxide and pH levels in the blood?

<p>Higher CO2 levels cause decreased pH. (C)</p> Signup and view all the answers

Which of the following best describes the affinity of fetal hemoglobin for oxygen?

<p>Higher than adult hemoglobin. (A)</p> Signup and view all the answers

How does increased altitude affect the partial pressure of oxygen?

<p>It decreases as altitude increases. (D)</p> Signup and view all the answers

Which gas is predominantly more soluble in water than oxygen?

<p>Carbon Dioxide (A)</p> Signup and view all the answers

According to Henry's Law, what primarily determines the amount of gas that dissolves in water?

<p>The pressure of the gas in the air (D)</p> Signup and view all the answers

What is the average partial pressure of oxygen (PO2) in the pulmonary veins at sea level?

<p>100 mmHg (C)</p> Signup and view all the answers

What would happen to the transport of oxygen in blood if the solubility of oxygen in plasma increased significantly?

<p>More dissolved oxygen would be available in the plasma. (D)</p> Signup and view all the answers

Under which condition is the Haldane effect most apparent?

<p>At higher concentrations of carbon dioxide. (B)</p> Signup and view all the answers

If atmospheric pressure at 10,000 feet is 523 mmHg, what would be the approximate partial pressure of oxygen at that altitude?

<p>109 mmHg (A)</p> Signup and view all the answers

What does Dalton's Law state about the behavior of gases in a mixture?

<p>Total pressure is equal to the sum of the partial pressures of each gas. (D)</p> Signup and view all the answers

Which factor plays a critical role in the Haldane effect?

<p>Increased oxygen saturation in hemoglobin (A)</p> Signup and view all the answers

Which gas transport mechanism primarily influences carbon dioxide transport in the blood?

<p>Binding to hemoglobin at low pH (A)</p> Signup and view all the answers

According to Dalton's Law, what can be inferred about gases in a mixture?

<p>The total pressure is the sum of individual pressures of all gases (A)</p> Signup and view all the answers

What primarily determines the amount of gas that dissolves in water as per Henry's Law?

<p>The partial pressure of the gas above the liquid (C)</p> Signup and view all the answers

Which gas exhibits a significantly higher solubility in water compared to oxygen?

<p>Carbon dioxide (A)</p> Signup and view all the answers

Which factor is most crucial for the functioning of the Haldane effect in blood gas transport?

<p>The affinity of hemoglobin for oxygen (C)</p> Signup and view all the answers

In a gas mixture, which statement accurately reflects Dalton's Law of Partial Pressure?

<p>Each gas in a mixture exerts pressure proportional to its concentration. (A)</p> Signup and view all the answers

What primarily determines the amount of gas that dissolves in a liquid according to Henry's Law?

<p>The partial pressure of the gas above the liquid (C)</p> Signup and view all the answers

Which gas is predominantly more soluble in water than oxygen, playing a significant role in blood gas transport?

<p>Carbon dioxide (A)</p> Signup and view all the answers

What effect does increasing altitude have on the partial pressure of oxygen in the atmosphere?

<p>It decreases the partial pressure of oxygen, leading to hypoxia. (D)</p> Signup and view all the answers

What does the Haldane effect primarily describe?

<p>The relationship between oxygen loading and carbon dioxide unloading in the lungs (D)</p> Signup and view all the answers

How does carbon dioxide affect the buffering capacity of blood?

<p>By reducing the pH, causing hemoglobin to release more oxygen (B)</p> Signup and view all the answers

What primarily determines how much oxygen dissolves in blood according to Henry's Law?

<p>The solubility coefficient of oxygen in plasma (A)</p> Signup and view all the answers

According to Dalton's Law, what is the behavior of gases in a mixture?

<p>The total pressure equals the sum of the partial pressures of each gas (D)</p> Signup and view all the answers

How does increased altitude primarily affect the transport of oxygen in the blood?

<p>By decreasing the partial pressure of oxygen (D)</p> Signup and view all the answers

What is the primary mechanism for carbon dioxide transport in the human body?

<p>Bound to hemoglobin as carbamino compounds (A)</p> Signup and view all the answers

What physiological changes are associated with the Haldane effect at high altitudes?

<p>Enhanced oxygen binding due to reduced carbon dioxide levels (B)</p> Signup and view all the answers

What effect does hypercapnia primarily have on respiration?

<p>It stimulates an increase in respiratory rate (D)</p> Signup and view all the answers

What is the role of mechanoreceptors in the control of breathing?

<p>To monitor the stretch of lung tissues (A)</p> Signup and view all the answers

How does gas solubility primarily influence oxygen transport in blood?

<p>It determines the quantity of oxygen that can be dissolved in plasma (C)</p> Signup and view all the answers

What is a primary distinguishing feature of obstructive lung diseases such as asthma and COPD?

<p>Increased airway resistance (A)</p> Signup and view all the answers

Which of the following is NOT a known cause or precipitating factor for asthma?

<p>Chronic bacterial infections (D)</p> Signup and view all the answers

Which of the following describes the mechanism by which asthma symptoms occur?

<p>Bronchoconstriction and mast cell activation (B)</p> Signup and view all the answers

What are common intrinsic causes of restrictive lung disease?

<p>Long-term exposure to dust and drugs (A)</p> Signup and view all the answers

What is a common cause that leads to decreased lung compliance in restrictive lung diseases?

<p>Inhalation of environmental pollutants (D)</p> Signup and view all the answers

Which group is most commonly affected by asthma, according to recent statistics?

<p>Children under 16 years (D)</p> Signup and view all the answers

Which of the following conditions is classified as an obstructive respiratory disease?

<p>Cystic fibrosis (D)</p> Signup and view all the answers

What is the primary characteristic associated with honeycomb lung formation?

<p>Replacement of alveoli with fibrotic tissue (C)</p> Signup and view all the answers

Which treatment approach is commonly effective for patients with idiopathic pulmonary fibrosis?

<p>No effective treatments available (C)</p> Signup and view all the answers

What is a significant consequence of lower respiratory tract infections compared to upper respiratory tract infections?

<p>They often lead to systemic symptoms. (C)</p> Signup and view all the answers

What primarily characterizes obstructive respiratory disease?

<p>Impeded flow rate into and out of the lungs (B)</p> Signup and view all the answers

Which of the following is a consequence of chronic bronchitis?

<p>Chronic inflammation and mucus hypersecretion (D)</p> Signup and view all the answers

What is the effect of chronic obstructive pulmonary disease (COPD) on residual volume (RV)?

<p>Increase in RV (C)</p> Signup and view all the answers

Which of the following is a known risk factor for developing emphysema?

<p>Exposure to secondhand smoke (D)</p> Signup and view all the answers

How is forced expiratory volume in 1 second (FEV1) affected in obstructive lung diseases?

<p>Decreased FEV1 (D)</p> Signup and view all the answers

What symptom is commonly associated with emphysema?

<p>Shortness of breath on exertion (C)</p> Signup and view all the answers

In COPD, what happens to outflow pressure during expiration?

<p>Decreases due to loss of recoil (A)</p> Signup and view all the answers

Which type of lung disease is primarily characterized by reduced lung volume?

<p>Restrictive lung disease (A)</p> Signup and view all the answers

What is the primary cause of inflammation in chronic bronchitis?

<p>Environmental irritants and smoking (D)</p> Signup and view all the answers

What type of medications are commonly used to treat chronic bronchitis?

<p>Antibiotics and bronchodilators (C)</p> Signup and view all the answers

Which statement best describes the role of elastase in emphysema development?

<p>It destroys alveolar walls when not properly inhibited (D)</p> Signup and view all the answers

Which of the following accurately describes restrictive lung diseases?

<p>Associated with reduced pulmonary compliance (A)</p> Signup and view all the answers

What is commonly observed during spirometry in patients with severe COPD?

<p>Decreased FEV1 with increased residual volume (C)</p> Signup and view all the answers

Flashcards

Anatomical Dead Space

The volume of air in the conducting airways that doesn't participate in gas exchange.

Alveolar Ventilation

The amount of air that reaches the alveoli each minute. It is calculated as: Respiratory rate x (Tidal volume - Anatomical dead space).

Lung Compliance

The ability of the lungs to expand and contract, influenced by factors such as surface tension and surfactant.

Airway Resistance

The resistance to airflow in the airways. It depends on factors like airway diameter, mucus presence, and muscle tension.

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Tidal Volume (TV)

The volume of air inhaled or exhaled during a normal breath.

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Forced Vital Capacity (FVC)

The maximum amount of air that can be forcefully exhaled after taking in a deep breath.

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Forced Expiratory Volume in 1 second (FEV1)

The volume of air exhaled in the first second of a forced expiration.

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FEV1/FVC Ratio

A measure of how effectively your lungs exchange oxygen and carbon dioxide.

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Peak Flow Meter

A device used to measure the speed at which air can be exhaled.

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Spirometry

A technique used to measure lung volumes and capacities.

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Functional Residual Capacity (FRC)

The amount of air remaining in the lungs after a normal exhalation.

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Mechanics of Breathing

The process of breathing, which includes inhalation and exhalation.

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Surface Tension

An attractive force between molecules at the surface of a liquid, minimizing surface area. Think of a stretched membrane.

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Laplace's Law

The relationship between pressure, surface tension, and radius of a sphere. Higher surface tension means higher pressure needed to expand.

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Surfactant

A substance that reduces surface tension, particularly in the alveoli, allowing them to remain inflated.

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Neonatal Respiratory Distress Syndrome (NRDS)

A condition in premature babies due to lack of surfactant, resulting in collapsed alveoli and difficulty breathing.

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Bronchoconstriction

Increased airway resistance due to narrowing of airways, caused by factors like smoke or allergens.

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Bronchodilation

Relaxation of airway muscles, leading to wider airways and easier breathing. Often triggered by sympathetic nerves or adrenaline.

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Gas Diffusion

The movement of a gas from an area of high concentration to an area of low concentration. In the context of blood gas transport, it's how oxygen moves from the alveoli to the blood and carbon dioxide moves from the blood to the alveoli.

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Partial Pressure

The pressure exerted by a single gas in a mixture of gases. It's directly proportional to the percentage of that gas in the mixture.

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Solubility of Gases

The ability of a gas to dissolve in a liquid, like blood. Different gases have different solubilities.

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Partial Pressure Gradient

The difference in partial pressures of a gas between two areas. This drives the diffusion of gases across membranes.

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Haemoglobin

A protein found in red blood cells that binds to oxygen and transports it through the bloodstream. It's crucial for delivering oxygen to tissues.

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Fetal hemoglobin

Fetal hemoglobin has a higher affinity for oxygen compared to adult hemoglobin. This allows for efficient oxygen transfer from the mother to the fetus across the placenta.

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CO2 transport

Carbon dioxide, produced during metabolism, is transported in the blood in three main ways: 1) dissolved in plasma, 2) bound to hemoglobin forming carbaminohemoglobin, and 3) as bicarbonate ions.

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Carbonic anhydrase

The enzyme carbonic anhydrase helps convert CO2 and water into carbonic acid (H2CO3), which then dissociates into bicarbonate ions (HCO3-) and hydrogen ions (H+). This is the primary way CO2 is transported in the blood.

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Chloride shift

The chloride shift is a process that maintains the balance of ions during CO2 transport. Bicarbonate ions move out of red blood cells, while chloride ions move in. This ensures that the electrical neutrality of the cell is maintained.

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Hemoglobin as a buffer

Hemoglobin, a protein in red blood cells, acts as a buffer to minimize changes in blood pH caused by the production of hydrogen ions (H+) during CO2 transport.

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Haldane effect

Deoxygenated hemoglobin has a higher affinity for hydrogen ions (H+) compared to oxygenated hemoglobin. This plays a role in CO2 unloading from the lungs and CO2 uptake in the tissues.

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Haldane effect: lungs vs tissues

The Haldane effect states that in the lungs, oxygenated hemoglobin releases H+ ions, promoting CO2 unloading. In the tissues, deoxygenated hemoglobin binds to H+ ions, facilitating CO2 uptake.

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Bohr effect

The Bohr effect describes the relationship between oxygen affinity and hemoglobin's sensitivity to pH changes. Lower pH (more acidic) results in decreased oxygen affinity, promoting oxygen release in tissues.

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Importance of CO2 transport

Carbon dioxide transport is crucial for removing waste products from the body and maintaining proper blood pH levels.

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CO2 transport: significance in physiology

Understanding the mechanisms of CO2 transport is fundamental for understanding how the body regulates blood pH and gas exchange.

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Henry's Law

The amount of a specific gas dissolved in a liquid is proportional to its partial pressure in the air above the liquid. Think of a soda bottle. When you open it, the dissolved CO2 escapes because the pressure inside the bottle is higher than the atmospheric pressure.

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Partial Pressure Differences Across the Respiratory Membrane

The difference in partial pressures of gases across the respiratory membrane is significant. This drives the diffusion of gases between the alveoli and the blood. Imagine a hill with a steep incline. The steeper the incline, the greater the pressure difference.

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Partial Pressure of Oxygen at Sea Level

At sea level, oxygen makes up approximately 20.9% of the atmosphere. This means that for every 760 mmHg of atmospheric pressure, 159 mmHg is due to oxygen. This is the partial pressure of oxygen at sea level.

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Atmospheric Pressure and Oxygen Availability at Altitude

Atmospheric pressure decreases as altitude increases. At 10,000 feet, atmospheric pressure is about 523mmHg, and the partial pressure of oxygen is about 109mmHg. This means that the amount of oxygen available for breathing is significantly less at higher altitudes. Think of breathing on a mountaintop, you might feel short of breath because there is less oxygen available.

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Hypoxia and Altitude Sickness

A decrease in the partial pressure of oxygen (PO2) in the alveolar gas and arterial blood below 60mmHg, leading to a condition known as acute mountain sickness.

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Chemoreceptors and Ventilation

Specialized cells in the brain (medulla oblongata) and peripheral tissues (e.g., carotid and aortic bodies) that monitor the levels of carbon dioxide (CO2), hydrogen ions (H+), and oxygen (O2) in the blood and cerebrospinal fluid (CSF).

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Central Control of Ventilation

The brain's control center for breathing located in the pons and medulla, coordinating signals from chemoreceptors and other input to adjust the rate and depth of respiration.

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Central Chemoreceptors and CSF

The central chemoreceptors located in the medulla, sensitive to changes in the acidity (pH) of the cerebrospinal fluid (CSF).

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CO2 and CSF pH

The process by which carbon dioxide (CO2) crosses the blood-brain barrier into the cerebrospinal fluid (CSF), affecting its pH. This change triggers the central chemoreceptors to increase ventilation.

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Peripheral chemoreceptors

Specialized sensory cells located in the carotid body at the bifurcation of the carotid arteries and in the aortic bodies above and below the aortic arch. They detect changes in arterial blood oxygen levels (PO2), carbon dioxide levels (PCO2), and pH.

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Discharge rate of peripheral chemoreceptors

The rate at which peripheral chemoreceptors fire action potentials, increasing as PO2 decreases, PCO2 increases, or pH decreases. This signals the brain to increase breathing rate and depth to restore blood gas balance.

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Respiratory acidosis

A condition characterized by a decrease in blood pH due to an increase in carbon dioxide levels. This can occur when gas exchange in the lungs is impaired.

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Respiratory Control

The process of adjusting breathing rhythm to meet changing physiological demands, like metabolic, mechanical, and non-ventilatory needs.

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Local Control of Gas Transport

The ability of active tissues to directly influence blood flow and oxygen delivery, ensuring efficient gas transport.

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Central Chemoreceptors

Specialized cells within the brain that monitor blood pH, carbon dioxide, and oxygen levels, triggering changes in breathing rate and depth.

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Lung Mechanoreceptors

Receptors within the lungs that respond to stretching and pressure changes during breathing, providing feedback to the brain about lung volume and airflow.

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Respiratory Centers

Regions in the brain stem, specifically the pons and medulla oblongata, that control the rhythm and depth of breathing.

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Hypoxia

The state of having a dangerously low oxygen level in the blood, which can stimulate breathing.

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Hypercapnia

The condition of elevated carbon dioxide levels in the blood, which can trigger an increase in breathing rate.

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Change in pH

A change in pH, typically a decrease (more acidic), can trigger a breathing response to eliminate excess CO2.

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Integrated Respiratory Control

The coordinated action of multiple factors, including central and peripheral chemoreceptors, lung mechanoreceptors, and respiratory centers, working together to regulate breathing.

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What is asthma?

A condition affecting the airways, causing inflammation and narrowing, leading to difficulty breathing. Triggers include allergens, air pollution, exercise, and stress.

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What are bronchodilators?

This medication relaxes the muscles in the airways of asthma sufferers, widening the passage and making breathing easier.

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What is pneumoconiosis?

Long-term dust exposure can cause this condition, leading to lung tissue scarring and breathing difficulties.

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What is the mechanism in asthma?

This process involves mast cells releasing histamine and cytokines in response to triggers, leading to airway inflammation and narrowing in asthma.

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Why does fetal hemoglobin have a higher affinity for oxygen than adult hemoglobin?

A higher affinity for oxygen allows the fetus to efficiently get it from the mother's blood across the placenta.

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Pulmonary Fibrosis

A type of restrictive lung disease where scar tissue forms in the lungs, making it difficult to breathe. This is often caused by exposure to environmental pollutants, cigarette smoke, or autoimmune diseases.

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Honeycomb Lung

A serious complication of pulmonary fibrosis where alveoli (tiny air sacs in the lungs) are replaced by scar tissue, reducing lung capacity and oxygen diffusion. This leads to shortness of breath and decreased gas exchange.

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Oxygen Diffusion Capacity

The ability of the lungs to transfer oxygen from the air to the bloodstream. This is reduced in pulmonary fibrosis due to the thickened alveolar walls.

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Methotrexate

A drug used in the treatment of rheumatoid arthritis. It can also be used to treat some forms of pulmonary fibrosis, but it's not a cure.

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What is Chronic Obstructive Pulmonary Disease (COPD)?

A group of lung diseases that make it difficult to breathe, including chronic bronchitis and emphysema.

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What is Chronic Bronchitis?

Inflammation of the bronchi, characterized by excessive mucus production.

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What is Emphysema?

Destruction of the alveoli, leading to reduced lung elasticity and airflow.

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What is Forced Expiratory Volume in 1 second (FEV1)?

A measure of how much air can be forcefully exhaled in one second, indicating airway resistance.

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What are Restrictive Lung Diseases?

Conditions that prevent the lungs from expanding to their full capacity, affecting lung volume and vital capacity (VC).

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What is Fibrosis?

A condition that causes the body to develop scar tissue in the lungs, leading to reduced lung compliance.

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What is Lung Compliance?

The ability of the lungs to expand and contract.

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What is Respiratory Infection?

An inflammatory process in the respiratory system, often caused by infections.

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What is Pneumonia?

Inflammation of the lungs, often caused by bacterial or viral infections.

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What is Tuberculosis (TB)?

A contagious disease caused by bacteria, affecting the lungs and causing coughing, fever, and weight loss.

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What is COVID-19?

A viral respiratory illness that can cause severe respiratory problems, including pneumonia.

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What is Residual Volume (RV)?

The volume of air that remains in the lungs after a normal exhalation.

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What is Forced Vital Capacity (FVC)?

The volume of air that can be forcefully exhaled after a deep inhalation.

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What is FEV1/FVC Ratio?

The ratio of FEV1 to FVC, indicating the effectiveness of air movement.

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What is Bronchoconstriction?

A condition that causes the narrowing of airways, leading to difficulty breathing.

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Study Notes

Physiology of the Respiratory System

  • Respiratory system involves gas exchange between the atmosphere, blood, and cells.
  • This process contributes to homeostasis and regulates internal pH.

Lectures

  • Lecture 18: Mechanics of breathing, including lung function assessment.
  • Lecture 19: Blood gas transport.
  • Lecture 20: Control of breathing.
  • Lecture 21: Respiratory system malfunctions.

Learning Objectives

  • Part 1: Mechanics of breathing – pressure and volume changes.
  • Part 2: Physical factors affecting pulmonary ventilation (resistance to breathing):
    • Lung compliance – factors like surface tension and surfactant.
    • Airway resistance – its impact on airflow, affecting factors (lung volume, bronchiole smooth muscle, stimuli (smoke, irritants, histamine)), and measurement methods (e.g., Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 second (FEV1)).
    • Mobility of the chest wall. This includes the flexibility and movement of the rib cage and the surrounding muscles.
  • Part 3: Assessment of lung function – explaining and calculating respiratory rates, volumes, and capacities (including anatomical dead space, pulmonary and alveolar ventilation).

What is Respiration?

  • Exchange of gases (oxygen and carbon dioxide) between the atmosphere, blood, and cells.
  • Contributes to homeostasis.
  • Regulates internal environment pH.

Steps of Respiration

  • Pulmonary ventilation (breathing): Inspiration and expiration of air between the atmosphere and lungs (alveoli).
  • External (pulmonary) respiration: Exchange of gases between alveoli and blood in pulmonary capillaries. Blood absorbs oxygen and releases carbon dioxide.
  • Internal (tissue) respiration: Exchange of gases between blood in systemic capillaries and tissue cells. Blood releases oxygen and absorbs carbon dioxide.

Mechanics of Breathing (Lecture 18, Part 1)

  • Movement of air into and out of lungs is due to pressure differences. The driving force for exchange of gases is differences in pressure between atmospheric and intrapulmonary pressure.
  • Inhalation (active): Rib muscles contract, diaphragm flattens, increasing thoracic volume and decreasing intrapulmonary pressure. Air flows in.
  • Exhalation (passive): Rib muscles relax, diaphragm curves upward, decreasing thoracic volume and increasing intrapulmonary pressure. Air flows out.

Boyle's Law

  • When temperature is constant, pressure of a gas varies inversely with its volume.
  • Expanding volume decreases pressure; decreasing volume increases pressure.
  • Drives air movement during breathing.

Airflow

  • Air flows from high pressure to low pressure.
  • Changing lung volumes changes pressure, causing airflow.

Intrapleural Pressure

  • Pressure within the pleural cavity.
  • Always lower than atmospheric and intrapulmonary pressures.
  • Maintained by elastic recoil of the lungs.
  • Important for lung expansion and function and to prevent collapse.

Resistance to Breathing (Lecture 18, Part 2)

  • Forces to overcome:
    • Lung (pulmonary) compliance – ease of lung expansion.
      • Elasticity of lung tissue (connective tissue structure).
      • Surface tension of alveoli. This is reduced by pulmonary surfactant.
      • Mobility of the chest wall. This includes the flexibility and movement of the rib cage and the surrounding muscles.
    • Airway resistance – main non-elastic source is friction.
      • Resistance mainly determined by radius.
      • Factors affecting airway resistance: lung volume, bronchiole smooth muscle, stimuli (smoke, irritants, histamine). This also includes the diameter of the airways (bronchi, bronchioles), and the presence of mucus or obstructions.

Pulmonary Surfactant

  • Reduces surface tension in alveoli, especially smaller ones.
  • Equalizes pressure differences between different-sized alveoli. This helps ensure uniform inflation of the alveoli and prevents collapse.
  • Important for effective lung function. Prevents alveoli from collapsing, especially small alveoli. Surfactant is essential for newborns to prevent neonatal respiratory distress syndrome.

Neonatal Respiratory Distress Syndrome

  • Premature babies (28-32 weeks gestation) lack surfactant.
  • Reduced lung compliance, alveolar collapse on exhalation, difficulty inflating lungs.
  • High mortality rate without treatment.

Mobility of Thoracic Cage

  • Important for efficient breathing movement. The flexibility and stability of the rib cage and associated muscles are critical for proper breathing mechanics.

Measuring Airway Resistance

  • Forced Vital Capacity (FVC): Maximum amount of air that can be forcibly exhaled after maximum inhalation.
  • Forced Expiratory Volume in 1 second (FEV1): Volume of air forcibly exhaled in one second.
    • Used to assess changes in resistance to airflow (e.g., asthma).
    • Expressed as a percentage of FVC. This ratio (FEV1/FVC) helps quantify airway obstruction.

Assessment of Lung Function (Lecture 18, Part 3)

  • Breath sounds: Auscultation (listening with a stethoscope) to assess the presence of fluid, mucous, or lung collapse sounds.
  • Pulmonary function tests:
    • Peak flow meter: Measures air speed during exhalation.
    • Spirometer: Measuring lung volumes and capacities. Spirometry also measures various other lung capacities (e.g. anatomical dead space.)

Lung Volumes and Capacities

  • Tidal volume (TV): Amount of air inhaled or exhaled in normal breathing.
  • Expiratory reserve volume (ERV): Amount of air forcefully exhaled after a normal exhalation.
  • Inspiratory reserve volume (IRV): Amount of air forcefully inhaled after a normal inhalation.
  • Residual volume (RV): Amount of air remaining in lungs after maximal exhalation.
  • Vital capacity (VC): Maximum amount of air exhaled after maximum inhalation.
  • Inspiratory capacity (IC): Maximum amount of air inhaled after a normal exhalation.
  • Functional residual capacity (FRC): Volume of air remaining in lungs after normal exhalation, equal to RV + ERV.
  • Total lung capacity (TLC): Maximum volume of air the lungs can hold, equal to TV + IRV + ERV + RV.

Respiratory Rates and Volumes

  • Pulmonary ventilation rate: Respiratory rate x tidal volume.
  • Also called respiratory minute volume – amount of air moved per minute.

Alveolar Ventilation

  • Amount of air reaching alveoli each minute.
  • Respiratory rate x (tidal volume – anatomic dead space).

Why Might These Measurements Be Important?

  • Lung volumes and capacities vary depending on factors like height, athleticism, altitude, and smoking.
  • Helps diagnose and assess the health of a person's respiratory system. Provides valuable information for clinical assessment and treatment planning.

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