pages 1-26 in notes
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| What do Type I alveolar cells produce? | The Alveolus
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| What is the Alveolus? | It is the location of gas exchange in the lung (has about 150 alveoli)
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| What is the typical surface area of a Type I alveolar cell? | 75m2 of surface area (a small tennis court)
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| What is the function of Type II Alveolar cells? | To secrete pulmonary Srufactant
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| What is surfactant? | A phospholipoprotein, that Reduces the surface tension of a fluid
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| How many membranes must O2 cross before reaching its binding site? | 5
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| 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
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| The pressure exerted by the weight of the air in the atmosphere on objects is called the: | Barometric Pressure (760 mmHg at sea level)
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| What is the intra-alveolar (intrapulmonary)pressure? | The pressure within the aveolus
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| The difference between the intra-alveolar pressure and barometric pressure determines: | Air flow in & out of the lungs
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| What is the Intra-pleural pressure? | The pressure between the Visceral pleura AND the Parietal pleura
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| What is the pleural sac? | The area between the visceral and parietal pleura that is filled with fluid.
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| 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)
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| What are the 2 types of transmural pressures? | Transmural Pressure across the Lung & Transmural Pressure across the Thorax
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| What is the transmural pressure gradient across the lung? | (Intra-alveolar Pressure) - (Intrapleural Pressure)
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| What is the transmural pressure gradient across the thoracic wall? | (Intrapleural Pressure) - (Atmospheric Pressure)
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| Define Pneumothorax: | Air in the chest which results in loss of transmural pressure, possibly leads to a collapsed lung
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| 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
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| 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
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| What is Traumatic Pneumothorax? | Air in the intrapleural space due to trauma
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| What is Spontaneous Pneumothorax? | Air in the intrapleural space because of a diseased lung
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| What is Pleurisy? | Inflammation of the pleura
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| 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
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| What are the common causes of Pleural Effusion? | (1)Blocked lymphatic system (2)Cardiac Failure (3) Decrease in plasma colloid pressure (4) Infection
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| Describe a FLail Chest: | Ribs broken, thoracic cage compromised, paradoxical breathing
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| What is Paradoxical Breathing? | One lung will deflate during inspiration, and inflate during expiration
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| Define Boyle's Law: | At constant temp.: P1V1=P2V2
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| What is the function of the Phrenic Nerve? | Causes the diaphragm to contract, thereby increasing the thoracic cavity vol.
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| 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.
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| 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)
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| 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
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| During Quiet Expiration what happens to the intra-alveolar pressure? | Increases by 1 mmHg to 761mmHg
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| Be able to draw and describe the graph on page 6 |
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| 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
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| 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)
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| What happens during Active (forced) Expiration? | Non-passive Process. Abdominal muscles, Internal Intercostal muscles contract.
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| What is Poiseuille's equation for air flow? | Flow= (∆P∏r4)/(8ƞl); Flow=∆P/R
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| What is a stridor? | A high pitched wheezing sound in the upper airway. Stridor is a symptom, it is NOT a diagnosis or disease.
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| 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
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| The radius will (inc/dec) the Flow by a factor of 4? | Increase
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| The radius will (inc/dec) the Resistance by a factor of 4? | Decrease
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| What is DCA | dynamic compression of airways
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| 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
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| During obstructive lung disease, what collapses? (bronchioles or alveoli) | Bronchioles will collapse (the alveoli will NEVER collapse)
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| Is emphysema a type of COPD? | YES
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| Describe the Equal Pressure Point in a lung: |
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| What are the 2 causes of COPD? | (1) narrowing of the airways (2) Restriction of the aveoli
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| 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
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| What is the total lung capacity of an adult male? | 5.7L
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| What is the total lung capacity of an adult female? | 4.2L
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| Draw the lung capicity graph |
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| Can a spirometer determine the total lung volume? | NO
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| Give an equation for VC | VC= IRV + TV + ERV
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| Give an equation for VC | VC= IC + ERV
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| Give an equation for TLC | TLC= IC + FRC
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| Give an equation for TLC | TLC= VC + RV
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| Give an equation for FRC | FRC= ERV + RV
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| Do Bronchioles have cartilage? | NO
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| In TV, does the flow rate change in inspiration & expiration? | NO
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| FRC should be Less than... | VC
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| VC-FRC should equal 3%, if more than 10%, you have a.... | Diseased lung
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| In a normal lung, where is most of the resistance in an airway? | The Segmental Bronchi
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| What effect does the Parasympathetic nervous system (vagus nerve 10th cranial nerve) have on pulmonary ventilation? | Bronchiolar smooth muscle contraction; acetylcholine
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| What effect does the Sympathetic nervous system have on pulmonary ventilation? | Bronchodilation; β2 adrenic receptors; norepinephrine
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| What effect does Epinephrine have on pulmonary ventilation? | Useful in effecting bronchodilation during bronchial spasms
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| What effect does histamine have on pulmonary ventilation? | Bronchoconstriction
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| An example of local control would be high levels of CO2 effecting what process? | Bronchodilation
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| What does COPD stand for? | Chronic obstructive Pulmonary Disease
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| What is COPD? | A group of lung diseases rha increases airway resistance due to the narrowing of the lumen of the lower airways
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| What are the 3 Major types of Obstructive COPD? | Chronic Bronchitis, Asthma, Emphysema
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| Describe Chronic Bronchitis: | Inflammatory disease caused by excess mucus or edema
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| 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
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| Describe Emphysema: | The collapse of the smaller airways & breakdown of alveolar walls. It is IRREVERSIBLE.
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| 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
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| While having COPD, which is more difficult, inhalation or expiration? | Expiration (it causes wheezing)
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| What are some possible treatments for asthma? | (1) Albuterol-β2 against- causes airway dilation (2) Epinephrine (inhaled coriticosteroid)
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| 70% of patients with spontaneous pneumothorax have what other disease? | COPD
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| 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
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| Elastic recoil describes... | the elastic quality of the lung tissue
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| Compliance is equal to... | ∆P/∆V
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| Describe high compliance: | The lung stretches and the recoil is lower
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| Describe low compliance: | More work is required to produce inflation. Recoil is higher
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| What are the 2 factors that affect compliance? | (1) Elastic connective tissue (2) Alveolar surface tension
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| As alveolar surface tension increases, what happens to compliance? | It decreases
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| What would happen if the alveoli were lined with H2O? | This would collapse the lung , because the surface tension would be too great
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| What is LaPlace's Law: | Pressure (P)= (2T)/r; where T=tension & r=radius
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| What is a Dyne? | A unit force. The force required for 1 gram to accelerate 1 cm/sec2
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| Give a factor that functions in preventing alveolar collapse: | Interdependence
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| 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
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| THe work of breathing usually requires what percentage of the total energy expenditure? | 3%
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| 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
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| During excercise respiration work increases by what factor? | 25x
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| Poorly compliant lungs or lungs with COPD can use what percentage of the total body's work? | 30%
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| Describe compliance (C): | How much effort is required to distend the lungs.
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| Give the formula for compliance: | C= ∆V/∆P
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| Which dots on the graph have the highest resistance, and in which section? | The segmental Bronchi 3,4,5
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| Which dots have the lowest resistance, and in what airway? | Dots 14-17 have the lowest resistance, located in the Terminal Bronchi.
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| What enzyme, if not available, can affect the collapse of the smaller airways and breakdown of alveolar walls in? | Trypsin ( in emphysema patients)
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| 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.
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| When more work is required to inflate the lungs and the elastic recoil is higher, what type of compliance is shown? | Low Compliance
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| List two factors that affect compliance: | (1)Elastic Connective Tissue (2)Alveolar surface Tension
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| As surface tension increases, what happens to compliance? | It decreases
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| What is the function of surfactant? | To reduce surface tension
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| What happens to compliance in the presence of surface tension? | Compliance increases
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| What also describes lung distensibility. Or the ease with which an object can be deformed? | Compliance
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| What describes the opposition of an object to deformation by an external factor? | Elastance
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| Give a formula that describes the relationship between | C= 1/E
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| Give the equation for Elastance: | E=(∆P)/(∆V)
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| What disease comes as a result of poor lung compliance? | COPD
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| Draw the compliance diagram. Determine when compliance is at its highest in both inspiration, and expiration. |
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| What is the different profile of inspiration and expiration of the compliance diagram caled? | Hysteresis
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| Hysteresis is a function of surface tissue as well as ........ of the connective tissue | Elastic qualities
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| ???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
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| Surface Tension is determined by pressure and....? | Volume
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| Increased surface tension leads to (inc/dec) Compliance? | Decreased
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| Decreased surface tension leads to (inc/dec) compliance. | Increased
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| Review Compliance Diagram during healthy and normal breathing |
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| Dray compliance diagram when a patient is inhaling maximally and slowly exhaling maximally. |
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| 1 mmHg is how many cm of H2O? | 1 mmHg= 1.36 cmH2O
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| The %TLC at the end of expiration of tidal breathing is termed as: | FRC- Functional Residual Capacity
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| The translung pressure (pressure inside the lung - pressure in the intraplaural space) is ALWAYS (+,-,0)?? | Positive
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| Intra-alveolar pressure is ALWAYS (>,<.=) intrapleural pressure? | Greater than >
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| Alveolar Pressure- Intrapleural Pressure = ..? | Transpulmonary Pressure (translung pressure)
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| When is the elastic recoil of the lung equal to the transpulmonary pressure? | When there is NO airflow
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| Intrapleural Pressure - Pressure at the body's surface (aka atmospheric pressure) is equal to ...? | Transpulmonary Pressure (transthoracic pressure)
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| What is the pressure in the alveoli - pressure at the body surface? | Transmural Pressure across the respiratory system
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| When the pressure across the chest wall is positive, what happens? | The chest wall wants to collapse with the lung
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| What happens when the pressure across the chest wall is negative? | The chest wall wants to spring outward
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| At FRC, (end of tidal expiration) what is the pressure across the lung? (+,-,0)? | Positive, meaning it wants to collapse inward
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| At FRC, what is the pressure across the chest wall? (+,-,0) | Negative, meaning it wants to spring inward
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| When the translung pressure is 0, what happens to the lung? | The lung collapses to well below 25% of the TLC value
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| When the translung pressure is 0, what happens to the chest wall? | The chest wall expands outward to 65% of its TLC value.
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