Physiology 16
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Tracheostomy
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Insertion of a tube into the trachea to permit breathing and insertion of a tube into the trachea to permit breathing and keep passageway open.
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Lung compliance
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The change in lung volume per change in transpulmonary pressure, expressed symbolically. A given transpulmonary pressure will cause greater or lesser expansion.
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Pulmonary Fibrosis
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Infiltration of lung tissue with connective tissue proteins; decreases lung compliance
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Elasticity
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Tendency of a structure to return to its initial size after being distended.
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Pneumothorax
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As air enters the intrapleural space, the intrapleural pressure rises until it is equal to the atmospheric pressure
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Muscles between the bony portions of the ribcage
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External intercostal and internal intercostal (parasternal intercostals)
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Classifications of lung disorders
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Restrictive and obstructive
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Restrictive lung disorders
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Vital capacity is reduced to below normal, but rate at which vital capacity can be forcibly exhaled is normal. ex) pulmonary fibrosis
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Obstructive lung disorders
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Vital capacity is normal because lung tissue isn't damaged, but expiration is more difficult and takes longer because bronchoconstriction increases resistance to airflow. ex) asthma
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Tidal volume
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Quiet breathing; amount of air expired in each breath
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Vital capacity
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Max. amount of air that can be exhaled after max. inhalation Equal to sum of IRS, TV, and ERV
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Residual volume
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Volume of air you can't expire, even after max. forced expiration
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Functional residual capacity
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Sum of residual volume and ERS
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Asthma cause
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Inflammation
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Asthma symptoms
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Dyspnea, wheezing, and other symptoms are produced by obstruction of air flow through bronchioles that occurs in \"attacks\"
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Asthma
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Pulmonary constriction; increases airway resistance, which makes breathing difficult
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Asthma treatment
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Glucocorticoid drugs: inhibit inflammation Epinephrine stimulates beta-adrenergic receptors in bronchioles which promotes bronchodilation Used as inhaled spray
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Emphysema
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Alveolar tissue is destroyed in a chronic, progressive condition.
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Emphysema results in ___ and ___ alveoli
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Fewer; larger Reduces surface area for gas exchange
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Loss of alveoli ___ ability of bronchioles to remain open during ___:
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Reduces; expiration
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Collapse of bronchioles as a result of compression of ___ during expiration produces ___ ____
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Expiration; air trapping
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Air-trapping
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Decreases efficiency of gas exchange
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Most common cause of emphysema
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Direct and indirect cigarette smoke- causes release of inflammatory cytokines
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Chronic inflammation with narrowing of airways and destruction of alveolar walls
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COPD
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A cause of COPD
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Smoking
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Cigarette smoke contains over ___ foreign compounds and many ___ ___- including reactive oxygen species that promotes inflammation and activate ___ ____:
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2,000; free radicals; alveolar macrophages
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Pulmonary fibrosis
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Anthracosis produced by inhalation of carbon particles from coal dust
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Anthracosis
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Black lung
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Under certain conditions, lung damage can lead to ___ ___ rather than ___:
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Pulmonary fibrosis; emphysema
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Dalton's Law
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Total pressure of gas mixture is equal to the sum of pressures that each gas in mixture would exert independently
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Pulse Oximeter
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Measures oxyhemoglobin saturation; usually clips finger or pinna and gives readings of oxygen saturation and pulse rate
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Although breathing 100% oxygen at _ or _ atmospheres pressure can be safely tolerated for a few hours, higher is ___:
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1; 2; dangerous
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___ ___ may develop when Po2 ___ above 2.5 atmospheres pressure; this is caused by ___ of ___:
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Oxygen toxicity; rises; oxidation; enzymes
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Hyperbaric oxygen therapy
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Patient is given 100% oxygen gas at 2-3 atmospheric pressures to breath; helps kill anaerobic bacteria, wound healing, and reduce gas bubbles
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4 targets of hyperbaric oxygen therapy
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Carbon monoxide poisoning, decompression sickness, severe traumatic injury (crush), and infections leading to gas gangrene
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Respiratory rhythm is generated by a loose ___ of ___ in ventroalteral region of the ___ ___, which forms ___ ___:
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Aggregation; neurons; medulla oblongata; rhythmicity center
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Rhythmicity Center
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Control of automatic breathing
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Apneustic center
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Promotes inspiration by stimulating the I neurons in medulla
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2 respiratory control centers in the pons:
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Apneustic center and pneumotaxic center
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Pneumotaxic center
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Antagonize apneustic center and inhibit inspiration
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Autonomic control of breathing is also controlled by input from ____:
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Chemoreceptors
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Chemoreceptors
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Collectively sensitive to changes in pH of brain interstitial fluid and cerebrospinal fluid, and Pco2 and Po2 of blood
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2 groups of chemoreceptors that respond to changes in pco2 and po2 :
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Central chemoreceptors- in medulla oblongata Peripheral chemoreceptors- in small nodules associated with aorta and carotid arteries, they receive blood via arterial branches
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If hypoventilation occurs, pco2 quickly ___ and pH ___
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Rises; falls
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During hyptoventilation, a fall in __ occurs because __ combines with __ to create ___ ___ which is weak and releases __ into solution:
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pH; co2; water; carbonic acid; H+
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Hyptoventilation; o2 content of blood isn't significantly __ by hyperventilation because ___ in arterial blood is 97% saturated with __ during normal ventilation:
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Increased; hemoglobin; o2
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Hypercapnia
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Results from hypoventilation causing increase in pco2
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Hyperventilation results in:
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Hypocapnia (pH rising)
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Aortic and carotid bodies aren't stimulated directly by blood co2, instead they are stimulated by a __ in __ concentration (fall in pH) of arterial blood:
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Rise; H+
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People who hyperventilate during psychological stress are told to:
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Breathe into a paper bag
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Why does breathing into a paper bag help hyperventilation?
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Rebreathing expired air that is saturated with co2, it helps raise blood pco2 back to normal, and relieves hypocapnia and stops hyperventilation
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SIDS
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1 in 1,000 babies 2-5 months old Failure in respiratory control Babies should sleep on backs rather than stomachs, this has decreased cases by 50%
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Obstructive sleep apnea
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Cerebral vasodilation- morning headaches
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Carboxyhemoglobin
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Reduced heme is combined with carbon monoxide instead of oxygen
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Carboxyhemoglobin; bond with carbon monoxide is __ x stronger than with oxygen. Carbon monoxide tends to displace __ in ___ and remains attached:
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210; o2; hemoglobin
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Carbon Monoxide Poisoning
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Carboxyhemoglobin concentration >3% in nonsmokers or >10% in smokers Treated with hyperbaric o2 therapy- 100% o2 at more than 1.4 atmospheres pressure within hyperbaric chamber
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Hemoglobin __ is the major form of hemoglobin until 11 weeks after conception to week 38, when hemoglobin __ predominates
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F; A
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___ derived from destroyed RBCs is converted into bile pigment ____, which is eliminated by fetus by transfer through ___. After birth, the fetal liver must eliminate ___ (through bile). Since it's not often developed enough, plasma levels of ___ rise causing ___ ___ ___. Put child under __ light- it converts ___ to more __ soluble form so ___ can eliminate it in ___:
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Heme; bilirubin; placenta; bilirubin; bilirubin; physiological neonatal jaundice; blue; bilirubin; water; kidneys; urine
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