Costanzo-Respiratory Physiology
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| show | nose, nasopharynx, larynx, trachea, bronchi, bronchioles, terminal bronchioles
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| conducting zone structure & fxn | show 🗑
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| show | B2-adrenergic agonist used to dilate airways to treat athsma
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| show | respiratory bronchioles, alveolar ducts, alveolar sacs
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| show | participates in gas exchange-->thin walls & large surface area
lined with alveoli
walls lined with elastic fibers & epithelial cells
contain type I & II pneumocytes and alveolar macrophages
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| show | synthesizes pulmonary surfactant necessary to reduce alveoli surface tension
has regenerative capacity for type I and II pneumocytes
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| show | phagocytic cells fill with debri then migrate to bronchioles-->keeps alveoli free of dust & debri
imp. bc respiratory zone has no cilia
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| show | blood flow not evenly distributed in lungs
when standing blood flow lowest at apex and highest at base
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| spirometer | show 🗑
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| tidal volume | show 🗑
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| show | additional volume inspired above tidal volume
approx. 3000 mL
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| expiratory reserve volume | show 🗑
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| show | volume of gas remaining in lungs after maximal forced expiration
approx. 1200 mL
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| show | volume of airways and lungs that don't participate in gas exchange
-anatomic dead space
-physiologic dead space
both values should be nearly equal in normal persons-->functional dead space should be small
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| anatomic dead space | show 🗑
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| show | total volume of lung that doesn't participate in gas exchange = anatomic dead space + functional dead space in alveoli
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| type of air in alveoli at end-inspiration | show 🗑
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| show | tidal volume + inspiratory volume
approx. 3500 mL
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| show | expiratory reserve + residual volume
approx. 2400 mL
also known as equilibrium volume: volume remaining in lungs after normal tidal volume expired
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| vital capacity (VC) | show 🗑
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| forced vital capacity | show 🗑
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| show | *diaphragm
during exercise also use external intercostal muscles and accessory muscles
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| show | *normally passive process
during exercise/disease use abdominal muscles and internal intercostal muscles
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| show | describes change in lung volume for given change in pressure
higher during expiration than inspiration due to surface tension between liquid-air interface
inversely correlated with elastic properties
ex) thick and thin rubber band
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| show | created by opposing forces between collapsing lung and chest wall that springs out
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| pneumothorax | show 🗑
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| show | increased lung compliance due to loss of elastic fibers leading to decreased elastic recoil
pt needs to breathe at higher lung volumes to increase elastic recoil
class symptom: barrel-shaped chest
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| fibrosis | show 🗑
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| show | created by attractive forces between adjacent liquid molecules lining alveoli
creates high collapsing pressure in small alveoli
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| surfactant | show 🗑
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| show | neonates lacking surfactant-->imp. because increases lung compliance and reduces work of expanding lungs
surfactant synthesis produced early as gestational WK24-almost always present by WK35
atelectasis and hypoxemia develops
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| show | transpulmonary press. = alveolar pressure - intrapleural pressure
(+) value is expanding pressure on lungs
(-) value is collapsing pressure on lungs
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| physiologic shunt | show 🗑
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| show | gas exchange limited by diffusion process
diffusion will continue as long as partial pressure for gas maintained
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| show | gas exchange limited by blood flow
partial pressure gradient not maintained-->blood flow must increase to increase gas exchange
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| perfusion-limited O2 transport | show 🗑
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| diffusion-limited O2 transport | show 🗑
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| show | Po2 in alveolar gas decreases because barometric pressure decreases; partial pressure gradient greatly reduced along with O2 diffusion
equilibration is slower
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| show | approx. 2% of total O2 in blood-->insufficient meet demands of tissue
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| O2 bound to hemoglobin | show 🗑
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| methemoglobin | show 🗑
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| fetal hemoglobin | show 🗑
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| hemoglobin S | show 🗑
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| show | sigmoidal shape-->affinity increases with each successive O2 molecule bound-->phenomenon called positive cooperativity
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| P50 on O2-hemoglobin dissociation curve | show 🗑
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| O2-hemoglobin dissociation curve shift to the right | show 🗑
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| show | byproduct of glycolysis in RBC
binds to beta chains of deoxyhemoglobin-->reduces O2 affinity
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| show | reflects increased O2 affinity-->decreased P50-->makes O2 unloading harder
result of decreased Pco2, temperature, 2,3-DPG/hemoglobin F and increased pH
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| carbon monoxide | show 🗑
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| oxygen transport in blood | show 🗑
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| carbon dioxide transport in blood | show 🗑
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| hypoxic vasoconstriction | show 🗑
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| thromboxane A2 | show 🗑
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| prostacyclin (prostaglandin I2) | show 🗑
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| leukotrienes | show 🗑
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| blood flow distribution in lung | show 🗑
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| right-to-left-shunt | show 🗑
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| left-to-right shunt | show 🗑
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| V/Q distribution in lungs | show 🗑
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| V/Q mismatches | show 🗑
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| show | 1)inspiratory center: controls basic breathing rhythm; input from CNIX and X; output via phrenic n.
2)expiratory center: inactive during quiet breathing because expiration passive process; active during exercise
located in reticular formation
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| show | produces abnormal breathing pattern with prolonged inspiratory gasps due to prolonged contraction of diaphragm
located in lower pons
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| show | turns off inspiration;limits tidal volume
located in upper pons
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| show | hypoxemia-->decrease in arterial Po2
hypoxia-->decrease in O2 delivery
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| show | 1)decreased CO
2)anemia
3)carbon monoxide poisoning
4)cyanide poisoning
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| causes of hypoxemia | show 🗑
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