Ch. 22 marieb

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1

What is the major function of the respiratory system?

-to supply the body with oxygen and dispose of carbon dioxide

2

What are 4 processes called respiration?

1. pulmonary ventilation
2. external respiration
3. transport of respiratory gases
4. internal respiration

3

Pulmonary Ventilation

-air is moved into and out of the lungs (during inspiration and expiration) so the gases there are continuously changed and refreshed

4

External Respiration

-oxygen diffuses from the lungs to the blood, and carbon dioxide diffuses from the blood to the lungs

5

Transport of Respiratory Gases

-oxygen is transported from the lungs to the tissue cells of the body; and carbon dioxide is transported from the tissue cells to the lungs
-the cardiovascular system accomplishes this transport using blood as the transporting fluid

6

Internal Respiration

-oxygen diffuses from blood to tissue cells, and carbon dioxide diffuses from tissue cells to blood

7

What 2 processes is the respiration system responsible for?

-the respiratory system is only responsible for the first 2 processes

8

What happens if the last 2 processes don't occur?

-the respiratory system can't accomplish its primary goal of obtaining oxygen and eliminating carbon dioxide unless the third and fourth processes occur

9

What system works simultaneously with the respiratory system?

-the circulatory system
-if either system fails, the body's cells begin to die from hypoxia

10

Cellular Respiration

-use of oxygen and the production of carbon dioxide by tissue cells
-cornerstone of producing chemical reactions in the body

11

What two functions is the respiratory system involved in?

1. the sense of smell
2. speech

12

What are the 9 parts of the respiratory system?

1. nose
2. nasal cavity
3. paranasal sinuses
4. pharynx
5. larynx
6. trachea
7. bronchi
8. lungs
9. alveoli

13

What two zones does the respiratory system consist of?

1. respiratory zone
2. conducting zone

14

Respiratory Zone

-actual site of gas exchange
-made up of the bronchioles, alveolar ducts, and alveoli

15

Conducting Zone

-all other respiratory passageways
-allow air to reach the gas exchange sites
-cleanse, humidify, and warm incoming air

16

Why does the conducting zone humidify the air?

-so the air reaching the lungs has fewer irritants like dust and bacteria
-also so the air is warm and damp

17

Nose

-only external part of the respiratory system

18

What are 5 functions of the nose?

1. provides an airway for respiration
2. moistens and warms the entering air
3. filters and cleans inspired air
4. serves as a chamber for speech
5. house the olfactory smell receptors

19

What 2 parts is the nose divided into?

1. nasal cavity
2. external nose

20

Nasal Cavity

-air enters the cavity by passing through the nostrils
-divide by the nasal septum
-continuous through the choanae
-air comes in and meets the pharynx

21

Choanae

-funnels
-the naval cavity is continuous through here towards the pharynx

22

Palate

-separates the nasal cavity from the oral cavity below
-"floor"

23

Hard Palate

-supported by the by palatine and maxillary bones

24

Soft Palate

-unsupported and muscular

25

Nasal Vestibule

-lined with sebaceous glands and hair follicles just superior to the nostrils

26

Vibrissae

-hairs
-filter coarse particles (dust and pollen) from inspired air

27

What 2 mucosa membranes is the nasal cavity lined with?

1. Olfactory Mucosa
2. Respiratory Mucosa

28

Olfactory Mucosa

-lines the slitlike superior region of the nasal cavity
-contains olfactory receptors in the olfactory epithelium

29

Respiratory Mucosa

-lines most of the nasal cavity
-pseudostratified ciliated columnar epithelium
-contains goblet cells with supply the nasal glands

30

What do the nasal mucosa do?

-warms and humidifies the air

31

What does the epithelium do?

-its highly vascular and contains mucus cells which trap inhaled irritants, foreign objects, and bacteria

32

Seromucous Nasal Glands

-contain mucus secreting mucus cells and serous cells that secrete a watery fluid that contains enzymes
-the stickiness of the mucus traps inspired dust, bacteria, and other debris

33

Lysozyme

-mucus containing antibacterial enzyme
-chemically destroys and attacks bacteria

34

What does the epithelium do in the nose?

-the epithelium cells secrete defensins which are natural antibiotics that kill invading microbes

35

Why do we have a runny nose?

-when our nasal cilia, but when exposed to cold air they become sluggish, allowing mucus to accumulate in the nasal cavity and dribble out the nostrils
-also, the water vapor in the expired air tends to condense at lower temperatures which causes a runny nose

36

Why do we sneeze?

-the nasal mucosa is supplied with sensory nerve endings and when they contact with irritating particles it triggers a sneeze reflex
-this allows a way for the irritants to be expelled
-similar to cough reflex

37

Nasal Conchae

-increase the mucosal surface area that is exposed to air
-enhances air turbulence
-forces the air to contact the nasal mucosa which allows large foreign particles to stick to it
-filter, heat, and moisten air, and reclaim heat and moisture which allows our body minimize the loss of both helping us to survive in the cold and dry climates

38

Paranasal Sinuses

-frontal, sphenoid, ethmoid, and maxillary bones
-warm and moisten air
-they produce mucus that flows into the nasal cavity which is comes out when we blow our nose
-lighten the skull

39

Maxillary Sinuses

-when you bring your together and your teeth hurt, your gonna get a sinus infection because the maxillary sits on top of the root tips of the teeth and it drains causing pressure

40

Rhinoplasty

-nose jobs
-contour the cartilage and bone to change the shape

41

Septum

-separate the left and right nostril

42

Deviated Septum

-unequal chambers, but you can change them to make them equal

43

What does it mean when something went down the wrong tube?

-the epiglottis didn't close fast enough

44

How is the cough reflex triggered?

-columnar cilia pushes the stuff up through the wrong tube to the pharynx to trigger the reflex

45

Post Nasal Drip

-during the night, the sinus fluid drains from the maxillary sinus and drains to the back of the throat and irritates and causes the inflammatory process but as the day goes on, it drains and you feel better

46

Sinusitis

-inflamed sinuses

47

Pharynx

-funnel shaped
-throat
-composed of skeletal muscle tissue
-amplifies/enhances sound quality

48

Nasopharynx

-serves only as the air passageway
-contains the pharyngeal tonsil which traps and destroys pathogens entering the nasopharynx in air

49

Oropharynx

-both swallowed food and inhaled air pass through it
-has a protective stratified squamous epithelium to accommodate the increased friction and chemical trauma of food passages
-contains the palatine tonsil

50

Laryngopharynx

-passage for food and air
-connects food and fluids to the stomach

51

Larynx

-voice box

52

What are the 3 functions of the larynx?

1. provide an open airway
2. act as a switching mechanism to route air and food into the proper channels
3. voice production

53

Thyroid Cartilage

-large, shield shaped, is formed by the fusion of two cartilage plates

54

Laryngeal Prominence

-marks the fusion point
-obvious when you see the Adam's Apple
-crest down the middle

55

Cricoid Cartilage

-perched atop and anchored to the trachea
-1st ring of cartilage

56

Epiglottis

-made of elastic cartilage
-when air is flowing into the larynx, the larynx is wide open and epiglottis is upward
-when you swallow, the epiglottis covers the laryngeal inlets which keeps food out of the lower respiratory passages
-guardian of the airways

57

Glottis

-the vocal folds and opening between them through the air passes
-medial opening between vocal ligaments

58

Epithelium of Larynx

-stratified squamous epithelium lines the upper part of the larynx because of food contact
-below the vocal folds, the epithelium is a pseudo stratified ciliated columnar type that filters dust
-the power stroke of cilia is upward toward the pharynx which moves mucus away from the lungs

59

What happens when we clear our throat?

-we help to move mucus up and out of the larynx

60

What is speech?

-involves the release of expired air as the glottis opens and closes

61

Why does a boys voice crack as they hit puberty?

-the boys larynx enlarges during puberty his vocal folds become longer and thicker
-causes them to vibrate more slowly, his voice becomes deeper
-until he learns to control his newly enlarged vocal folds, his voice cracks

62

Laryngitis

-inflammation of the vocal folds causes the vocal folds to swell which interferes with their vibration
-caused by viral infections

63

Why do the vocal folds act as?

-acts as a sphincter that prevents air passage

64

Trachea

-windpipe
-has rings of hyaline cartilage that protect it

65

How does smoking affect the cilia?

-it inhibits and destroys the cilia and without cilia, coughing is the only way to prevent mucus from accumulating in the lungs
-smokers with respiratory congestion should avoid medications that inhibit the cough reflex

66

Oral Cavity

-air comes in and meets at the pharynx

67

ATP

-glucose + oxygen

68

Rhino virus

-rhinitis
-inflammation of nasal mucosa accompanied by excessive mucous production, nasal congestion, and post nasal drip

69

Tracheal Cartilage

-other cartilage with a superior position

70

What are the 3 pairs of small cartilages found in the larynx?

1. Arytenoid
2. Cuneifrom
3. Corniculate

71

Arytenoid Cartilage

-pyramid shaped cartilages, which anchor the vocal folds

72

True Vocal Cords

-lack blood vessels so it appears white
-vocal folds
-elastic fibers

73

Voice Production

-vibrate to produce sounds as air rushes up from lungs

74

False Vocal Cords

-vestibular folds
-no direct part in sound production but help to close the glottis when we swallow

75

What does the loudness of the voice depend on?

-the force with which the airstream rushes across the vocal folds
-the greater the force, the stronger the vibration and the louder the sound
-vocal folds don't move when we whisper, but vibrate when we yell

76

What does good enunciation depend on?

-muscles in the pharynx, tongue, soft palate, and lips that shape sound into recognizable consonants and vowels

77

Pitch

-determined by length

78

Why do we temporarily close our larynx?

-during coughing, sneezing, and Vasalva's maneuver

79

Vaslava's Maneuver

-during abdominal straining associated with defecation, the glottis closes to prevent exhalation and the abdominal muscles contract causing the intra-abdominal pressure to rise
-help empty the rectum and can stabilize the body trunk when lifting a heavy load
-common to have a heart attack during bowel movement because it gives more abdominal strength

80

What are the 3 layers of the trachea?

1. mucosa
2. submucosa
3. adventitia

81

Mucosa of the Trachea

-goblet cell containing pseudo stratified epithelium that occurs thru out most of the respiratory tacts

82

Submucosa of the Trachea

-connective tissue layer deep to the mucosa
-contains seromucous glands that produce mucus sets

83

Adventitia of the Trachea

-outer layer supported by the C shaped rings of hyaline cartilage

84

Trachealis

-smooth muscle fibers that connect the cartilage rings

85

Trachea Cartilage

-C shaped and incomplete
-allows for expansion, coughing, sneezing, and yelling
-need more air pressure, more air exhaled
-C shaped rings prevent trachea from crashing

86

Heimlich Maneuver

-a procedure in which air in the victim's lungs is used to expel an obstructing piece of food

87

Bronchial Tree

-23 times it branches
-air passageways in the lungs branch and branch again
-at the tips of the bronchial tree, conducting zones give way to respiratory zone structures

88

What does the trachea divide into?

-forms the right and left main bronchi

89

Right Main Bronchi

-wider, shorter, and more vertical than the left and it more common for a foreign object to get stuck there

90

Secondary Bronchi

-lobar
-once inside the lungs, each main bronchi divide into these
-three on the right, and two on the left supplying each lung lobe

91

Tertiary Bronchi

-secondary bronchi branch into these and they divide into bronchioles

92

Bronchioles

-"little bronchi"
-more smooth muscle
-lack cartilage support and mucus producing cells
-cuboidal epithelium

93

Terminal Bronchioles

-tiniest bronchioles
-go into alveolar sac

94

Conducting Zone Structures

-bronchi

95

Respiratory Zone Structures

-alveoli

96

How many alveoli are there?

-300 million

97

What are the 3 structural changes that occur to the conducting tubes as they get smaller?

1. support structures
2. epithelium type
3. amount of smooth muscle increases

98

Alveoli

-thin walled air sac
-air that reaches alveoli goes to blood stream
-make up most of lung volume
-tremendous surface area for gas exchange
-individual grapes
-alveolus
-essential for getting CO2 out
-one cell layer

99

Respiratory Bronchioles

-the respiratory zone begins as the terminal bronchioles feed into these
-alveoli protrude from these

100

Alveolar Ducts

-respiratory bronchioles lead into these
-walls are made of smooth muscle cells, connective tissue fibers, and out pocketing alveoli

101

Alveolar Sacs

-alveolar ducts leave into these
-similar to a bunch of grapes

102

Can alveoli be damaged?

-yes smoking can damage them
-collapse, shrivel up, and sometimes we can reinflate them

103

Pores of Kohn

-alveolar pores
-opening on alveoli
-when air comes along and there is a mucus plug, the alveolar pores offer a backdoor so air and gas can get into the alveolus

104

Carina

-where the trachea split into the bronchi

105

What are the 2 types of alveolar cells?

1. type 1 alveolar cells
2. type 2 alveolar cells

106

Type 1 Alveolar Cells

-make up alveolus
-capacity to produce different things, all organellese, produce ACE, influence blood pressure
-an ACE inhibitor can inhibit production in the lungs

107

Type 2 Alveolar Cells

-secrete surfactant and antimicrobial proteins that help immunity

108

Surfactant

-coats the alveolus and blocks the water molecules from sticking together
-only cell capable of doing this
-last thing to develop

109

Respiratory Membrane

-blood air barrier
-driven by diffusion from high to low
-blood flows past on one side and gas on the other
-gas exchange occurs through diffusion across the membrane
-oxygen pass from the alveolus to the blood, and CO2 leaves the blood to enter the alveolus

110

What happens if you have too much CO2 in your blood?

-respiratory acidosis
-hypercapnia
-affects your pH
-makes your blood acidic
-denatures proteins and can induce a coma

111

CO2 In Your Plasma

-CO2+H20-->H2CO3-->H+HCO
-when CO2 combines with water it becomes carbonic acid
-if you hold CO2 in your plasma (bloodstream) H2CO3 which is carbonic acid
-a weak acid, dissociates partially into HCO3 (bicarbonate), but it frees up hydrogen ions, which directly affects your pH level
-can cause respiratory failure
-pulmonary fibrosis can lead to this
-chronic bronchitis

112

Atelectasis

-collapsed alveoli

113

Why are alveoli covered with elastic fibers?

-can stretch, holds them open and holds their shape, shrink up alveoli which helps push air out, and helps it regain shape after being stretched

114

Elastic Recoil

-the recoil helps to squeeze air out

115

What do the capillaries on the alveoli do?

-allow time to be shaved off in diffusion

116

Alveolar Macrophages

-keep lungs sterile

117

Lymphatics

-keep lungs dry

118

What do the lungs occupy?

-all of the thoracic cavity except the mediastinum

119

How do you make CO2?

-aerobic respiration
-by product of ATP

120

External Respiration

-oxygen concentration is high in alveoli, carbon dioxide goes out and moves from capillary to alveoli

121

Root

-vascular and bronchial attachments that connect the lung to the mediastinum

122

Costal Surface

-anterior, lateral, and posterior lung surfaces lie in close contact with the ribs and form the continuously curving

123

Apex

-narrow superior tip of thel ungs

124

Base

-concave, inferior surface that rests on the diaphragm

125

Hilum

-an indentation where the pulmonary and systemic blood vessels, bronchi, lymphatics, and nerves enter and leave the lungs

126

Do the 2 lungs differ in size and shape?

-yes, because the apex of the heart is slightly to the left so the left lung is smaller than the right

127

Left Lung

-divided into superior and inferior lobes by the oblique fissure

128

Right Lung

-divided into the superior, middle, and inferior lobes by the oblique and horizontal fissure

129

Lungs

-housed in separate pleural cavities
-lined with serosa
-parietal pleura: lines the walls
-visceral pleura: covers the lungs

130

Bronchopulmonary Segments

-pyramid shaped
-has its own artery and vein and receives air from a tertiary bronchi

131

Why are the segments important?

-pulmonary disease is often confined to one or a few segments
-can removed diseased segments to be surgically removed without damaging neighboring segments or impairing blood supply

132

Stroma

-lung tissue
-elastic connective tissue
-lungs are soft, spongy, elastic organs

133

What 2 circulations are lungs perfused by?

1. pulmonary circulation
2. bronchial circulation

134

Pulmonary Arteries

-systemic venous blood that is to be oxygenated in the lungs
-branch profusely, along with the bronchi
-feed into the pulmonary capillary networks that surround the alveoli

135

Pulmonary Veins

-convey the freshly oxygenated blood from the respiratory zone of the lungs to the heart

136

Pulmonary Circulation

-low pressure, high volume circulation

137

Bronchial Arteries

-provide oxygenated systemic blood to lung tissue
-arise from the aorta and run along the bronchi
-supply all lung tissues except alveoli

138

Bronchial Circulation

-high pressure, low volume supply of oxygenated blood to all lungs tissues except the alveoli

139

Bronchial Veins

-drain some systemic venous blood from the lungs
-anastomose between the two circulations and most venous blood returns to the heart via the pulmonary veins
-dilute oxygenated blood going back to the heart

140

What happens when there is water in the lungs?

-cause the stickiness would cause alveoli to stick together causing respiratory failure
-would cause it collapse

141

What happened to premature babies before technology?

- in premature babies, they don’t have surfactant which when they try to breathe in the humidify air which causes the alveoli to collapse
-died of respiratory failure
-now they can put a premature child in an incubator that contains surfactant which allows them to breathe in surfactant that keeps the alveoli from sticking together until they can breathe by themselves

142

Pleura

-a thin, double-layered serosa

143

Parietal Pleura

-covers the thoracic wall

144

Visceral Pleura

-cover the organs

145

Inspiration

-the period when air flows into the lungs

146

Expiration

-the period when gases exit the lungs

147

What happens when you inhale?

-when you inhale, ribs rise and your diaphragm drops down which changes the volume of the thoracic cavity making it bigger
-the air pressure inside the lungs allows the cavity to expand it creates a drop in pressure
-the air pressure outside is higher than in the lungs (1 atm) and things diffuse from high to low so the air rushes in

148

What happens when the diaphragm contracts?

-exhale
-the diaphragm contracts it produces ATP
-during contraction it goes form dome to flatten shaped controlled by the phrenic nerve
it gradullay goes back into the dome shape, thoracic cavity gets smaller, pressure gets higher because you shrink the cavity down, and forces the air out

149

What is the number one muscle in respiration?

-the diaphragm

150

Medulla

-tells diaphragm to contract and flattens out by the phrenic nerve

151

Pleural Effusion

-general term for fluid accumulation in the pleural cavity
-pneumonia
-can't see lobes or diaphragm

152

What 2 forces act to pull long away from thoracic wall which promote the lung to collapse?

1. elasticity of lungs which allows them to assume possible size
2. surface tension of alveolar fluid draws alveoli to smallest size

153

Opposing Force

-elasticity of chest wall pulls thorax outward to enlarge lungs
-strong adherence between parietal and visceral pleura
-holds them open

154

Intrapleural Pressure

-pressure in the pleural cavity (750 mmHg)
-fluctuates with breathing phases
-we need negative intrapleural pressure related to intrapulmonary because it makes lungs expand

155

Intrapulmonary Pressure

-pressure in the alveoli
-rises and falls with the phases of breathing, but it always equalizes with the atmospheric pressure eventually
-760 mmHg

156

Why is pleural pressure less?

-pressure needs to be different because if the same, nothing would happen
-slight change in pressure is enough to allow lungs to expand

157

Pneumothroax

-air in the pleural cavity
-reversed by drawing air out of the intrapleural space with chest tubes
-allows pleura to heal and the lungs to reinflate and resume normal function
-but one can collapse without the other one because they are in different cavities
-punctures the intrapleural pressure
-pressure to increase because air from outside rushes in because of diffusion which will inhibit the lung from inflating which will make it collapses
-open/communicating pneumothorax

158

Spontaneous Pneumothorax

-no one hurt or touched them
-common in men
-pleural cavity remains intact
-blebs (blisters), you don’t you have them and one day the rupture causing an opening into the alveoli and lungs so when you breathe in air, the pressure causes the bleb to open and air sneaks out and goes into the pleural cavity causing a gradual pressure increase in the intrapleural pressure cavity
-noncommunicating/tension pneumthorax

159

Airway Resistance

-major source of resistance is friction

160

As air resistance increase...

-breathing movements are more strenuous

161

Severely constricted/obstructed bronchioles...

-prevent life sustaining ventilation
-can occur during an acute asthma attack which stops ventilation
-smooth muscle is very sensitive to histamine

162

Epinpehrine

-bronchiole dilator
-release through the sympathetic nervous system and dilates bronchioles and reduces air resistance

163

What is the wheezing sound?

-air trying to squeeze through the bronchioles

164

Cortisone

-shrinks up tissues, and increase air resistance

165

Lung Compliance

-ease with which lungs can be expanded
-the measure of the change in lung volume that occur with a given change in transpulmonary pressure

166

What 2 factors affect lung compliance?

1. distensibility of lung tissue and surrounding thoracic cage
2. surface tension of the alveoli

167

Distensibility

-can you fill them and will they expand

168

Surface Tension

-need people after surgeries to walk around so they can ventilate the ribs
-arthritis between the sternum and the ribs is the number one cause
-ossification of the costal cartilage

169

Reduce Lung Compliance

-scar tissue (fibrosis)
-blockage of respiratory passages
-reduced production of surfactant
-decreased flexibility of thoracic cage or its decreased ability demand

170

Anatomical Dead Space

-volume of the conducting respiratory passages (150 mL); air in bronchi

171

Does all the air find its way to the alveoli?

-no because no exchange is going on

172

Alveolar Dead Space

-alveoli that cease to act in gas exchange due to collapse or obstruction

173

Total Dead Space

-sum of alveolar & anatomical dead space

174

Alveolar Ventilation Rate

-measures flow of fresh gases into & out of the alveoli during a particular time; more accurate as it takes into account dead space
-frequency x (tidal volume(breaths/min)-dead space(ml/min))
-slow, deep breathing increase it, and rapid, shallow lower it
-decreases AVR as increase in volume increases amount of air reaching alveoli more than increase in frequency breathing rate

175

Pulmonary Function Test

-Spirometry can distinguish between:
-obstructive pulmonary disease: increased airway resistance
-restrictive disorders: reduction in total lung capacity from structural or functional lung changes

176

Total Ventilation

-total amount of gas flow into or out of the respiratory tract in 1 min

177

Normal Respiration

-12 breaths per minute (6L/min)

178

Force Vital Capacity

-gas forcibly expelled after taking a breath

179

Forced Expiratory Volume

-amount of gas expelled during specific time period of the FVC test

180

Why do we yawn?

-to delivery more oxygen to lungs
-contagious
-adrenaline racing before race
-yawn when bored
-in reality, we don't know

181

Vasovagal Response

-trips yawning
-can lead to syncopy
-no pulse at all
-major vasodilation and their heart rate drops down
-excessive yawning
-emotional response

182

Nonrespiratory Air Movement

-movements that don't allow for gas exchange
-coughing
-sneezing
-crying
-laughing
-hiccuping
-yawning

183

How fast is a sneeze and how far does it go?

-35 mph and 17 feet

184

Dalton's Law of Partial Pressure

-total pressure exerted by mixture of gases is sum of pressures exerted independently by each gas mixture
-the partial pressure of each gas is directly proportional to its percentage in the mixture

185

Henry's Law

-mixture of gas is in contact with a liquid, each gas will dissolve in liquid in proportion to its partial pressure
-the higher the concentration the faster it will go into solution and more of it will go into solution
-depends upon solubility, and temperature and pressure

186

Various Gases in Air Have Different Solubilites

-CO2 is the most
-O2 is 1/20th as CO2
-N is insoluble in plasma

187

Whats the hissing noise of pop?

-carbon dioxide by forcing it into the bottle and when you open it up it breaks out of the pressure and then it gets flat because there is no more CO2

188

Partial Pressure Gradients and Gas Solubilities

-if the concentration of 02 is 40mmHg and 30 mmHg on the other side and on the other its 40mmHg and 10 mmHg it would move faster on the second one because the concentration gradient is bigger, a steep concentration gradient
-this drives it across the membrane

189

Why is there a steep gradient between oxygen and carbon dioxide?

-partial pressure oxygen (PO2) of venous blood is 40mmHg; the partial pressure in the alveoli is 104mmHg
-steep gradient allows oxygen partial pressures to rapidly reach equilibrium (.25 seconds)
-blood can move three times as quickly (.75 seconds) through the pulmonary capillary and still be adequately oxygenated

190

Inspired Air

-oxygen is higher and carbon is lower

191

Alveoli of Lungs

-oxygen is lower but higher than oxygen because alveoli takes a few molecules
-carbon dioxide is higher

192

Blood Leaving Tissues and Entering Lungs

-oxygen is lower than carbon dioxide

193

Blood Leaving Lungs and Entering Tissue Capillaries

-oxygen is higher and carbon is lower

194

Tissues

-oxygen is less than 40 and carbon is greater than 45

195

CPR

-you are able to breathe into them because you have a lot of O2 that you breathe out

196

Ventilation vs. Perfusion

-ventilation/perfusion
-v/q
-how much air we breathe ion that get to alveoli perfuses tissue (gets to blood)
-we lose some, so not 100% get to tissues
-either too high or too low

197

Ventilation

-able to get air into lungs

198

Perfusion

-getting oxygen through respiratory membrane to the circulation
-blood supply to the lungs and ability to oxygenate the hemoglobin inside

199

Mismatch of Ventilation and Perfusion

-ventilation drop and or perfusion rise of alveoli causes local CO2 to increase and O2 rises
-pulmonary arterioles serving these alveoli constrict
-shunt the blood away from the alveolus

200

Ventilation Greater than Perfusion

-ventilation is high and or perfusion is low of alveoli causes local CO2 to be low and O2 high
-pulmonary arterioles serving these alveoli dilate
-to pick up as much oxygen as you can

201

Ventilation Perfusion Coupling

-they both must be tightly regulated for efficient gas exchange
-changes in CO2 causes changes in the diameter of the bronchioles
-where CO2 is high, dilate to get it out of the body
-where CO2 is low, constrict

202

What happens when oxygen levels are low?

-in the lungs where oxygen levels are low, the vessels will vasoconstrict in order to shunt the blood to areas where the concentration of oxygen is higher and increase the amount of oxygen and hence hemoglobin

203

Hyperventilating

-breathe really quickly, and rapidly
-frighten, pain, and anxiety
-changes in breathing rate

204

Respiratory Alkalosis

-light headedness due to breathing rapidly and hyperventilating
-caused by increase output of carbon dioxide that causes vomiting
-with profound pain, it produces vomiting as a reflex

205

VQ Scan

-order this to rule out a pulmonary embolism that usually comes from the legs to the lungs

206

What are the 3 steps to the VQ scan?

1. radioactive compound inhaled into airspace of lung. In a normal lung this will distribute evenly to all regions
2. radioactive compound injected into vein. Travels to lung tissues in blood vessels. (pulmonary embolus is a blood in a pulmonary artery)
3. mismatch of inhaled and injected compounds on the lung scan images=pulmonary embolus

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Why do lungs thicken?

-they become waterlogged and edematous, whereas by gas exchange is inadequate & oxygen deprivation results
-can be congestive heart failure or pneumonia

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Oxyhemoglobin

-oxygen bound to hemoglobin

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Deoxyhemoglobin

-reduced hemoglobin

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Saturated Hemoglobin

-when all four hemes of the molecule are bound to oxygen

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Oxygens Affinity

-ability for it to bind to hemoglobin

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Partially Saturated Hemoglobin

-when one to three hemes are bound to oxygen

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What is the rate that hemoglobin binds and releases regulated by?

-partial pressures
-temperature influences the ability for it bind
-pH
-concentration of BPG which a by product of glycolysis
-increase partial pressure: increase O2 affinity to bind HMG
-decrease partial pressure of O2 will decreae
-increase in temperature decreases the affinity
-a decrease in pH increase affinity

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CO2 Levels High

-decrease affinity

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CO2 Low

-increase affinity

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BPG High

-concentration of O2

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Lower Temp. In Lungs

-higher affinity of O2

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O2 Deep in Tissue

-drop off O2
-higher, lower affinity of O2

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Higher CO2 Concentration Deeper in Tissues

-they decrease the affinity of oxygen
-comes from aerobic respiration

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Why does breathing increase the PO2?

-saturation of hemoglobin in arterial blood increase the PO2, but has little effect on O2 saturation in Hemoglobin

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What percent of saturated arterial blood contains 20 mL O2?

-98%

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How much is released as it flows through capillaries?

-5mL of O2

223

What happens once hemoglobin is saturated?

-has nowhere to go, forms O3 stripping away electrons from healthy molecules
-antioxidants prevent O3

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At what number is hemoglobin almost completely saturated?

-PO2 of 70 mmHg
-if it increases in PO2, it will only produce small amounts of O2 in binding

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When is O2 loading and delivery to tissues adequate?

-when PO2 is below normal levels

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Carbon Monoxide Poisoning

-high pH
-not as much CO2
-affinity for hemoglobin, but carbon monoxide has greater affinity
-damage done as binding receptors for O2 with CO
-more O2 pops off
-now body is deprived of O2
-suffocate

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Hemoglobin Saturation Curve

-if O2 levels drop, we go to reserve
-more O2 dissociates from hemoglobin and used by cells
-respiratory rate or cardiac output does not increases

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High Temperature, H, PCO2, BPG

-decrease in hemoglobin affinity for O2
-enhance O2 unloading form blood

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Bohr Effect

-as cells metabolize glucose, CO2 is released causing a decline in pH (acidosis), which weakens the hemoglobin and oxygen bond
-increase in PCO2 and H concentration in capillary blood
-metabolizing cells have heat as a by product

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What 3 ways in carbon dioxide transported?

1. dissolved in plasma (7-10%)
2. chemically bound to hemoglobin (20% carried in RBCs as carbaminohemoglobin HbCO2)
3. as bicarbonate ions in plasma (70%) transported as bicarbonated

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Carbonic Acid/Bicarbonate Buffer System

-CO2+H2O<->H2CO3<->H+HCO3

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Carbonic Anhydrase

-enzyme that speeds up equation reaction

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Slow Reaction

-H binds to plasma proteins
-CO2->CO2+H2O->HCO3-HCO3+H
-free H bind to plasma protein, no enzyme

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Fast Reaction

-H binds with hemoglobin from HbO2->O2+Hb(buffer_
-O2 gives H a spot
-CO2+H2O->H2CO3->HCO3+H
-with enzyme
-bicarb rejected bring chloride shift
-H binds with Hb open b/c O2 is knocked off Bicarb to plasma

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Chloride Shift

-HCO3 moves into the plasma where it then goes to the lungs
-to balance this, chloride ions move from the plasma into the RBCs
-occurs thru an RBC protein

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Fast Reaction to Lungs

-CO2+H2O<-H2CO3->H+HCO3
-reverse chloride shift

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Haldan Effect

-the lower PO2 & Hb saturation with O3, the more CO2 can be carried in blood
-dissociation of O2 from Hb allows more CO2 to bind
-as O2 jumps off Hb, CO2 can bind because their is more and it changes the shape
-bohr effect can effect this by change in pH
-low pH affects affinity

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Shallowing Breathing

-allows CO2 to accumulate dropping pH

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Control Respiration in Medulla

-CO2 concentrations in plasma influence what happens in brain
-CO2 levels in plasma circulate and diffuse through BBB to CSF
-CO2+H2O<->H2CO3<->H+HCO3
-CSF responds to H concentration thru chemoreceptors and they response to high in CO2

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Irritant Receptor

-cause vasoconstriction (-) effect

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Positive Effect

-receptors in muscles and joints

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Central Chemoreceptors

-(+) effect
-high CO2
-high H