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Respiratory Function
Gas exchange, disorders
67
Physiology
Undergraduate 4
03/04/2007

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Term
Forms CO2 is carried in blood
Definition
4
Term
Forms O2 is carried in the blood
Definition
2
Term
Which is faster and more soluble at diffusing, O2 or CO2
Definition
CO2
Term
Hypoventilation
Definition
air delivery into alveoli is insufficient to meet the need to provide O2 and remove CO2. This results in hypercapnia and a pCO2>45mmHg. This is a response following pain secondary to abdominal/thoracic surgery. Also occurs secondary to opioid/barbiturate use. Normal response to high altitude.
Term
Acute respiratory failure
Definition
pH <7.3, pO2<60mmHg, pCO2>50mmHg (hypercapnia)
Term
Purpose of Upper respiratory system
Definition
as air is taken through upper airways, it picks up moisture from mucus memb of nose and sinuses. nose and upper airways warms air as it passes across the membrane. airways are designed to conduct air to lower airways and finally to alveoli where gas exchange occurs.
Term
How gas exchange occurs
Definition
alveoli allow air to come in indirect contact with bloodstream through the pulmonary capillary system. alveolar membrane which is one-celled thick allows CO2 to diffuse into alveoli from the bloodstream and O2 to diffuse to the bloodstream from the alveoli
Term
Lung compliance
Definition
this is a measure of resistance of the lung bing infiltrated. a stiff lung means too little compliance, therefore the lung will be difficult to inflate.
Term
hypoxic vasoconstriction
Definition
lungs match blood flow with ventilation and O2 delivery to the alveoli occurs to optimize O2 delivery to the bloodstream. area of lung tissue with little ventilation will constrict and area of lung tissue with more ventilation will dilate. resulting in efficient gas exchange.
Term
What diffusion problems such as pneumonia and pulmonary edema will cause
Definition
tachypnea (rapid breathing) and hypoxemai (decreased blood O2). This usually occurs before other abnormalities in gas exchange develop.
Term
major risk factor for lung cancer development
Definition
cigarette smoking
Term
upper airway structure
Definition
oropharynx
Term
lower airway structure
Definition
trachea, larynx, bronchi
Term
long hair cells that filter air
Definition
vibrissae
Term
cells that beat in sweeping motion like oars to move mucus upward.
Definition
cilia
Term
cells lining trachea and bronchi
Definition
epithelium
Term
terminal portion of the tracheao bronhial tree that's not located in the larynx
Definition
acinus
Term
marjor cartilage structure that's also called the thyroid cartilage.
Definition
adam's apple
Term
Carina
Definition
site where a majority of cough receptors lie. this is the point of tracheal division into 2 main branches.
Term
age at which lung is fully developed, and number of alveoli present.
Definition
8 years old. 300 millions
Term
these cells make up the alveoli and are the site where gas exchange occurs.
Definition
type I pneumocytes
Term
responsible for making surfactant
Definition
type II pneumocytes
Term
help prevent particles from entering trachea
Definition
cilia
Term
types of dead space
Definition
anatomic, alveolar, physiologic
Term
mechanics of breathing
Definition
function residual capacity is the air that remains in the alveoli at the end of expiration. alveoli collapse (atelectasis) occurs when there's a lack of surfactant. during exhalation there is elastic recoil of the lungs and the muscles relax. muscles contract during inspiration.
Term
this will increase as a result of alveoli loss
Definition
lung compliance and emphysema
Term
Activities in zones 1, 2, and 3
Definition
zone 1 - alveolar pressure > capillary pressure, causing minimal blood flow through the apices.
zone 2 - pulmonary arterial pressure > pressure inside alveoli during ventricular systole, with intermittent perfusion.
zone 3 - pulmonary arterial pressure> pulmonary venous pressure, there's continuous perfusion throughout the cardiac cycle.
Term
Lack of erythropoeitin will result in
Definition
anemia of chronic disease and chronic renal failure
Term
Hemoglobin desaturates (releases O2 more readily) in
Definition
decreased pH (acidosis) and increased pCO2 (hypercapnia).
Term
Dissociation curve will shift to the right when
Definition
increased H+, pCO2, Temperature, 2,3 DPG and decreased pH
Term
Dissociation curve will shift to the left when
Definition
decreased H+, pCO2, Temperature, 2,3-DPG and increased pH.
Term
major obstructive airway diseases
Definition
bronchitis, emphysema, asthma
Term
Asthma
Definition
characterized by airway inflammation, airway obstruction that is reversible, and incrased airway responsiveness to stimuli. extrinsic asthma is child-onset asthma.
Term
exercise-induced asthma
Definition
bronchospasm that occurs after activity or exercise. common in children and adolescents.
Term
occupational-induced asthma
Definition
exposure to allergens and mimics extrinsic asthma.
Term
drug-induced asthma
Definition
occurs after reaction to medication. can be very severe and may require mechanical ventilation.
Term
cardiac-induced asthma
Definition
results from bronchospasm precipitated by congestive heart failure.
Term
intrinsic asthma
Definition
adult onset and develops in middle age with less favorable prognosis. attacks may be severe and are not IgE mediated.
Term
medication required for status asthmaticus
Definition
epinephrine, terbutaline, an aminophylline may be required. IV corticosteroids are most appropriate. beta blockers are contraindicated in asthma because they worsen bronchospasm.
Term
viral causes of acute bronchitis
Definition
influenza A, coxsackie virus, adenovirus.
Term
bacterial causes of acute bronchitis
Definition
staphylococcus pneumoniae
Term
pathogenetic changes associated with acute bronchitis
Definition
inflamed airways, swelling from exudation of fluid, increased mucus production, loss of ciliary function.
Term
most common cause of chronic bronchitis
Definition
smoking causes 90% of chronic bronchitis cases. remaining 10% caused by viral/bacterial infections and chemical irritants.
Term
cellular changes seen with chronic bronchitits
Definition
increased Il-8 and CD8T lymphocytes, increase (30X) in eosinophils, hypertrophy of bronchial glands and goblet cells.
Term
bronchiectasis
Definition
destruction of bronchial walls from dilation of airway sacs.
Term
cyanosis
Definition
a symptom of decreased oxygenation which is manigested by bluish or pallor of skin.
Term
Aspergillus fumigatus
Definition
a mold that can cause infection
Term
cor pulmonale
Definition
congestive heart failure
Term
COPD type A
Definition
emphysema (pink puffer) often associated with chronic bronchitis
Term
major classification of emphesyma
Definition
centriacinar, panacinar, paraseptal
Term
α1-antitrypsin deficiency
Definition
characterized by low serum levels of this particular antitrypsin. this enzyme is normally protective and inhibits the proteolytic breakdown of alveolar tissue. This is usually the cause of emphysema in individuals that have never smoked (either first or second hand), and is thus hereditary
Term
bronchiectasis
Definition
associated with cystic fibrosis. children are at a higher risk because of anatomic factors such as small, soft, elastic bronchi. cystic fibrosis primarily affects both pancreas and lungs. the mucus-producing glands of both organs hypertrophy and produce excessive secretions that are thick mucoproteins.
Term
cystic fibrosis
Definition
most common genetic disease in the US, affects primarily Caucasians. affects exocrine glands, is autosomal recessive.
Term
primary cause of airway obstruction in patients with chronic bronchitis
Definition
hypertrophy of mucosal glands and goblet cells leads to increased mucus production, the mucus combines with purulent exudate to form bronchial plugs.
Term
what causes the immune system to respond to the presence of allergens in extrinsic asthma?
Definition
asthma is a reactive airway disease. when the antigen reacts with the antibody on the surface of the mast cell, packets of chemical mediator substances stored in the cell are released. hypertrophy of mucosal glands and goblet cells leads to increased mucus production, the mucus then combines with purulent exudate to form bronchial plugs.
Term
physiologic abnormality characteristic of emphysema
Definition
emphysema leads to a loss of elastic tissue in the lung, which leads to a decrease in the size of the smaller bronchioles. the loss of lung tissue leads to a loss of radial traction which normally holds the airway open and to increasing pressure around the outside of the airway lumen, which in turn increases airway resistance and decreases air flow.
Term
major characteristic of bronchiolitis
Definition
infections agents such as respiratory synctial virus, influenza, and bacteria cause an inflammatory response that results in production of thick, tenacious mucus, which leads to airway obstruction, atelectasis, and hyperinflation.
Term
Haemophilus influenzae type B
Definition
primary organism associated with epiglottis, invades the supraglottic structures (epiglottis and arytenoids), causing inflammation and edema, which leads to obstruction.
Term
what happens fduring acute asthma attack?
Definition
air becomes trapped because of the inflammatory changes that occur.
Term
A restrictive disease that is associated with the formation of an antigen-antibody complex that causes fibrosis of the lung
Definition
hypersensitivity pneumonitis. causative dust acts as an antigen, which combines with serum antibodies in the alveolar walls, leading to type III hypersensitivity reaction.
Term
pulmonary function testing for restrictive diseases will reveal
Definition
limitation of chest expansion, resulting in decreased vital capacity, total lung capacity, and diffusing capacity.
Term
. honeycomb lung
Definition
a lung destructive pattern that is manifested by loss of alveolar walls. this is a common radiologic diagnostic manifestation of fibrotic restrictive disease.
Term
pathogenesis of adult respiratory distress syndrome
Definition
.– injury to the alveolar-capillary membrane will result in increased alveolar-capillary permeability, impaired diffusion, and decreased lung compliance, and increased interstitial and alveolar edema.
Term
abnormal fluid accumulation in the pleural space cause
Definition
dyspnea, cough, pleuritic pain, diminished breath sounds over effusion, and dullness of percussion.
Term
pathogenesis of pneumonia
Definition
microbial agents enter lung, multiply, and trigger pulmonary inflammation. alveolar air spaces fill with exudative fluid, and inflammatory cells invade alveolar septa. alveolar exudates tend to consolidate.
Term
pneumothorax, clinical features
Definition
clinical features include tachycardia, decreased or absent breath sounds on the affected side, hyperresonance, and sudden chest pain on the affected side.
Term
How tubercular bacilli is transmitted
Definition
.– tuberculosis is an airborne disease spread by droplets.
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