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pages 1-26 in notes

What do Type I alveolar cells produce? The Alveolus
What is the Alveolus? It is the location of gas exchange in the lung (has about 150 alveoli)
What is the typical surface area of a Type I alveolar cell? 75m2 of surface area (a small tennis court)
What is the function of Type II Alveolar cells? To secrete pulmonary Srufactant
What is surfactant? A phospholipoprotein, that Reduces the surface tension of a fluid
How many membranes must O2 cross before reaching its binding site? 5
The opening between an individual alveolus, which permits fresh air to enter an alveolus whose terminal conducting airway is occluded because of disease is referred to as: The Pores of Kohn
The pressure exerted by the weight of the air in the atmosphere on objects is called the: Barometric Pressure (760 mmHg at sea level)
What is the intra-alveolar (intrapulmonary)pressure? The pressure within the aveolus
The difference between the intra-alveolar pressure and barometric pressure determines: Air flow in & out of the lungs
What is the Intra-pleural pressure? The pressure between the Visceral pleura AND the Parietal pleura
What is the pleural sac? The area between the visceral and parietal pleura that is filled with fluid.
The visceral & parietal pleura "stick" together for what 2 reasons? (1) Intrapleural fluid cohesiveness (polar quality of molecules AND (2)The transmural pressure gradient (760 mmHg vs 756 mmHg)
What are the 2 types of transmural pressures? Transmural Pressure across the Lung & Transmural Pressure across the Thorax
What is the transmural pressure gradient across the lung? (Intra-alveolar Pressure) - (Intrapleural Pressure)
What is the transmural pressure gradient across the thoracic wall? (Intrapleural Pressure) - (Atmospheric Pressure)
Define Pneumothorax: Air in the chest which results in loss of transmural pressure, possibly leads to a collapsed lung
What is simple pneumothorax? No additional air build up. If theres a small amount of air it will be reabsorbed. If theres a Large amount of air, use a needle to suck the air out
Describe Tension PNeumothorax? Large amount of air in the pleural space. The air builds up & puts pressure on the heart. Do a needle thoracostomy to release pressure, then chest tube with a vacuum bottle. THe lung tends to collapse & the chest wall expands outward
What is Traumatic Pneumothorax? Air in the intrapleural space due to trauma
What is Spontaneous Pneumothorax? Air in the intrapleural space because of a diseased lung
What is Pleurisy? Inflammation of the pleura
Describe Pleural Effusion: Increased fluid in the pleural sac. Can cause shortness of breath by compressing the lungs. Is a type of restrictive lung disease
What are the common causes of Pleural Effusion? (1)Blocked lymphatic system (2)Cardiac Failure (3) Decrease in plasma colloid pressure (4) Infection
Describe a FLail Chest: Ribs broken, thoracic cage compromised, paradoxical breathing
What is Paradoxical Breathing? One lung will deflate during inspiration, and inflate during expiration
Define Boyle's Law: At constant temp.: P1V1=P2V2
What is the function of the Phrenic Nerve? Causes the diaphragm to contract, thereby increasing the thoracic cavity vol.
These muscles play a very little role in quiet respiration However , during deep inspiration accounts for 25% of the enlargement of the thoracic cavity. External Intercostal Muscles- When contracted the diameter will increase.
What happens during Quiet Inspiration? The intra-alveolar pressure drops 1 mmHg (to 759). THe Intrapleural pressure drops by 2 mmHg (from 756 mmHg to 754 mmHg)
What is Quiet Expiration? A Passive Process. The diaphragm & external intercostal muscles relax. The elastic quality of the lung reduces the lung volume is reduced
During Quiet Expiration what happens to the intra-alveolar pressure? Increases by 1 mmHg to 761mmHg
Be able to draw and describe the graph on page 6
In a healthy lung the intra-alveolar pressure is always (>,<,= ?) the intrapulmonary pressure? The intra-alveolar pressure is always Greater Than the intrapulmonary pressure because of the recoil of the lung tissue
During Active respiration there is a greater contraction of the diaphragm as well as which muscles? External Intercostal Muscles, Sternocleidomastoid, and Scalene Muscles (anterior, posterior, and middle)
What happens during Active (forced) Expiration? Non-passive Process. Abdominal muscles, Internal Intercostal muscles contract.
What is Poiseuille's equation for air flow? Flow= (∆P∏r4)/(8ƞl); Flow=∆P/R
What is a stridor? A high pitched wheezing sound in the upper airway. Stridor is a symptom, it is NOT a diagnosis or disease.
What is the difference between inspiratory, expiratory, and biphasic stridor? Inspiratory Stridor suggests a laryngeal obstruction. Expiratory Stridor suggests tracheobronchial obstruction. Biphasic Stridor suggests glotic abnormality
The radius will (inc/dec) the Flow by a factor of 4? Increase
The radius will (inc/dec) the Resistance by a factor of 4? Decrease
What is DCA dynamic compression of airways
What are the 3 basic reasons for DCA in COPD? (1)Radial Traction (2) High compliance of the alveoli (3) The resistance of the small airways increase
During obstructive lung disease, what collapses? (bronchioles or alveoli) Bronchioles will collapse (the alveoli will NEVER collapse)
Is emphysema a type of COPD? YES
Describe the Equal Pressure Point in a lung:
What are the 2 causes of COPD? (1) narrowing of the airways (2) Restriction of the aveoli
Describe the Venturi Effect,What will eventually happen to the airway? Wen the radius decreases, the pressure increases, and the velocity(speed) increases; The airway will eventually collapse
What is the total lung capacity of an adult male? 5.7L
What is the total lung capacity of an adult female? 4.2L
Draw the lung capicity graph
Can a spirometer determine the total lung volume? NO
Give an equation for VC VC= IRV + TV + ERV
Give an equation for VC VC= IC + ERV
Give an equation for TLC TLC= IC + FRC
Give an equation for TLC TLC= VC + RV
Give an equation for FRC FRC= ERV + RV
Do Bronchioles have cartilage? NO
In TV, does the flow rate change in inspiration & expiration? NO
FRC should be Less than... VC
VC-FRC should equal 3%, if more than 10%, you have a.... Diseased lung
In a normal lung, where is most of the resistance in an airway? The Segmental Bronchi
What effect does the Parasympathetic nervous system (vagus nerve 10th cranial nerve) have on pulmonary ventilation? Bronchiolar smooth muscle contraction; acetylcholine
What effect does the Sympathetic nervous system have on pulmonary ventilation? Bronchodilation; β2 adrenic receptors; norepinephrine
What effect does Epinephrine have on pulmonary ventilation? Useful in effecting bronchodilation during bronchial spasms
What effect does histamine have on pulmonary ventilation? Bronchoconstriction
An example of local control would be high levels of CO2 effecting what process? Bronchodilation
What does COPD stand for? Chronic obstructive Pulmonary Disease
What is COPD? A group of lung diseases rha increases airway resistance due to the narrowing of the lumen of the lower airways
What are the 3 Major types of Obstructive COPD? Chronic Bronchitis, Asthma, Emphysema
Describe Chronic Bronchitis: Inflammatory disease caused by excess mucus or edema
What is Asthma? (1) Histamine, induced edema (2) excessive mucus (3) airway hyper-responsiveness due to the constriction of the smaller airways via smooth muscle spasms
Describe Emphysema: The collapse of the smaller airways & breakdown of alveolar walls. It is IRREVERSIBLE.
What are the 2 basic causes of (Etiology) of Emphysema? (1) trypsin released from alveolar macrophages as a defense mechanism in response to chronic exposure to cigarette smoke. (2) Genetic defect- unable to produce α1-antitrypsin, which protects the lung from trypsin
While having COPD, which is more difficult, inhalation or expiration? Expiration (it causes wheezing)
What are some possible treatments for asthma? (1) Albuterol-β2 against- causes airway dilation (2) Epinephrine (inhaled coriticosteroid)
70% of patients with spontaneous pneumothorax have what other disease? COPD
The elastic behavior in the lungs is comprised of what? (1) 1/3 Elastic fibers in connective tissue AND (2) 2/3 alveolar surface tension
Elastic recoil describes... the elastic quality of the lung tissue
Compliance is equal to... ∆P/∆V
Describe high compliance: The lung stretches and the recoil is lower
Describe low compliance: More work is required to produce inflation. Recoil is higher
What are the 2 factors that affect compliance? (1) Elastic connective tissue (2) Alveolar surface tension
As alveolar surface tension increases, what happens to compliance? It decreases
What would happen if the alveoli were lined with H2O? This would collapse the lung , because the surface tension would be too great
What is LaPlace's Law: Pressure (P)= (2T)/r; where T=tension & r=radius
What is a Dyne? A unit force. The force required for 1 gram to accelerate 1 cm/sec2
Give a factor that functions in preventing alveolar collapse: Interdependence
When surfactant produces the ability for fetal lungs to develop late in pregnancy ( which can cause a problem in premey's)is referred to as: New Born Respiratory Distress Syndrome
THe work of breathing usually requires what percentage of the total energy expenditure? 3%
More work is required for breathing in what 4 situations? (1)Compliance decreases (2) Elastic recoil Decreases(3)Airway resistance Increases (4)Need for Increased ventilation
During excercise respiration work increases by what factor? 25x
Poorly compliant lungs or lungs with COPD can use what percentage of the total body's work? 30%
Describe compliance (C): How much effort is required to distend the lungs.
Give the formula for compliance: C= ∆V/∆P
Which dots on the graph have the highest resistance, and in which section? The segmental Bronchi 3,4,5
Which dots have the lowest resistance, and in what airway? Dots 14-17 have the lowest resistance, located in the Terminal Bronchi.
What enzyme, if not available, can affect the collapse of the smaller airways and breakdown of alveolar walls in? Trypsin ( in emphysema patients)
Describe High Compliance. How does this effect elastic recoil. When the lung streches further due to an increase in pressure difference. Elastic recoil is lower.
When more work is required to inflate the lungs and the elastic recoil is higher, what type of compliance is shown? Low Compliance
List two factors that affect compliance: (1)Elastic Connective Tissue (2)Alveolar surface Tension
As surface tension increases, what happens to compliance? It decreases
What is the function of surfactant? To reduce surface tension
What happens to compliance in the presence of surface tension? Compliance increases
What also describes lung distensibility. Or the ease with which an object can be deformed? Compliance
What describes the opposition of an object to deformation by an external factor? Elastance
Give a formula that describes the relationship between C= 1/E
Give the equation for Elastance: E=(∆P)/(∆V)
What disease comes as a result of poor lung compliance? COPD
Draw the compliance diagram. Determine when compliance is at its highest in both inspiration, and expiration.
What is the different profile of inspiration and expiration of the compliance diagram caled? Hysteresis
Hysteresis is a function of surface tissue as well as ........ of the connective tissue Elastic qualities
???The work of inspiration can be divided into 3 parts. List them in order from largest to smallest: ???Compliance due to work> Tisue airway resistance> Tissue resistan
Surface Tension is determined by pressure and....? Volume
Increased surface tension leads to (inc/dec) Compliance? Decreased
Decreased surface tension leads to (inc/dec) compliance. Increased
Review Compliance Diagram during healthy and normal breathing
Dray compliance diagram when a patient is inhaling maximally and slowly exhaling maximally.
1 mmHg is how many cm of H2O? 1 mmHg= 1.36 cmH2O
The %TLC at the end of expiration of tidal breathing is termed as: FRC- Functional Residual Capacity
The translung pressure (pressure inside the lung - pressure in the intraplaural space) is ALWAYS (+,-,0)?? Positive
Intra-alveolar pressure is ALWAYS (>,<.=) intrapleural pressure? Greater than >
Alveolar Pressure- Intrapleural Pressure = ..? Transpulmonary Pressure (translung pressure)
When is the elastic recoil of the lung equal to the transpulmonary pressure? When there is NO airflow
Intrapleural Pressure - Pressure at the body's surface (aka atmospheric pressure) is equal to ...? Transpulmonary Pressure (transthoracic pressure)
What is the pressure in the alveoli - pressure at the body surface? Transmural Pressure across the respiratory system
When the pressure across the chest wall is positive, what happens? The chest wall wants to collapse with the lung
What happens when the pressure across the chest wall is negative? The chest wall wants to spring outward
At FRC, (end of tidal expiration) what is the pressure across the lung? (+,-,0)? Positive, meaning it wants to collapse inward
At FRC, what is the pressure across the chest wall? (+,-,0) Negative, meaning it wants to spring inward
When the translung pressure is 0, what happens to the lung? The lung collapses to well below 25% of the TLC value
When the translung pressure is 0, what happens to the chest wall? The chest wall expands outward to 65% of its TLC value.
Created by: jesswith