Advanced Pathophysiology > Respiratory System > Flashcards

Respiratory System Flashcards

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1
Q

What is the main function of the pulmonary system?

A

To exchange gases between the air in the environment and the bloodstream

This process occurs in three major steps: ventilation, diffusion, and perfusion.

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2
Q

List the three major steps involved in gas exchange.

A
  • Ventilation
  • Diffusion
  • Perfusion

Ventilation is the movement of air, diffusion is the transfer of gases, and perfusion is the flow of blood.

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3
Q

The pulmonary system is composed of which structures?

A
  • Two lungs
  • Upper and lower airways
  • Pulmonary blood vessels
  • Diaphragm
  • Chest wall

The right lung has three lobes, while the left lung has two lobes.

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4
Q

What is the role of the diaphragm in the respiratory system?

A

It separates the thoracic cavity from the abdomen and plays a key role in ventilation

The diaphragm is a dome-shaped muscle.

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5
Q

True or false: The lungs are protected from harmful substances by several mechanical and cellular defense systems.

A

TRUE

These defenses filter, humidify, and remove foreign particles before they can reach lung tissue.

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6
Q

What are the components of the upper airway?

A
  • Nasopharynx
  • Oropharynx
  • Related structures

These regions are lined with ciliated mucosa and have a rich blood supply.

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7
Q

The larynx connects which two parts of the respiratory system?

A

Upper and lower airways

It consists of the endolarynx and surrounding cartilaginous structures.

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8
Q

What are the two sets of folds found in the endolarynx?

A
  • False vocal cords (supraglottis)
  • True vocal cords

These folds form the glottis, the slit-shaped opening between them.

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9
Q

What is the function of the trachea?

A

It connects the larynx to the bronchi

The trachea is supported by C-shaped cartilage rings.

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10
Q

The right main bronchus is larger and more vertical than the left. True or false?

A

TRUE

This anatomical difference means aspirated materials more often enter the right lung.

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11
Q

What happens to the velocity of airflow as the total cross-sectional area of the airways increases?

A

It decreases

This allows sufficient time for gas exchange to occur efficiently in the alveoli.

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12
Q

What are the three layers of the bronchial wall?

A
  • Epithelial lining
  • Smooth muscle layer
  • Connective tissue layer

The epithelial lining contains mucus-secreting and ciliated cells.

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13
Q

What do goblet cells produce?

A

Mucus

This mucus forms a protective blanket over the airway surface.

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14
Q

The conducting airways end where the _______ begin.

A

Gas-exchange airways

These include the respiratory bronchioles, alveolar ducts, and alveoli.

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15
Q

What are the primary sites for gas exchange in the lungs?

A

Alveoli

Oxygen diffuses into the blood, and carbon dioxide is eliminated here.

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16
Q

What are the two major types of epithelial cells within the alveoli?

A
  • Type I alveolar cells
  • Type II alveolar cells

Type I cells facilitate gas diffusion, while Type II cells produce surfactant.

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17
Q

What is the role of surfactant in the alveoli?

A

Reduces surface tension and helps prevent alveolar collapse

It also contributes to innate immune defense against infection.

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18
Q

What are alveolar macrophages responsible for?

A

Phagocytosing inhaled microorganisms and particles

They provide first-line immune defense without triggering widespread inflammation.

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19
Q

What does the pulmonary circulation facilitate?

A
  • Gas exchange
  • Nutrient delivery to lung tissues
  • Acts as a blood reservoir
  • Filtering system

It removes clots, air bubbles, and debris from circulation.

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20
Q

What is the pressure in the pulmonary arteries compared to systemic circulation?

A

Much lower

Pulmonary artery pressure is approximately 18 mm Hg, while aortic pressure is about 90 mm Hg.

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21
Q

What is hypoxic pulmonary vasoconstriction?

A

Pulmonary artery constriction due to low alveolar oxygen levels

It redirects blood to better-ventilated areas to improve gas exchange.

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22
Q

The chest wall includes which components?

A
  • Skin
  • Ribs
  • Intercostal muscles

Its main function is to protect the lungs and heart from external injury.

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23
Q

What condition can cause pulmonary hypertension due to widespread vasoconstriction?

A

Chronic lung disease

This condition can be reversible if oxygen levels are restored.

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24
Q

What is the main function of the chest wall?

A

Protect the lungs and heart from external injury

It also provides the rigid structure necessary for breathing movements.

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25
Name the **muscles involved in breathing**.
* Intercostal muscles * Diaphragm * Accessory muscles * Abdominal muscles ## Footnote These muscles perform the mechanical work of respiration.
26
What is the **thoracic cavity** enclosed by?
The chest wall ## Footnote It houses the lungs and mediastinal structures, including the heart.
27
What are the two layers of the **pleura**?
* Visceral pleura * Parietal pleura ## Footnote The visceral pleura covers the surface of the lungs, while the parietal pleura lines the thoracic cavity.
28
What does the **pleural space** contain?
A thin layer of lubricating fluid known as pleural fluid ## Footnote This fluid allows the two pleural layers to slide smoothly over one another during breathing.
29
What is the normal pressure range in the **pleural space**?
−4 to −10 mm Hg ## Footnote This negative pressure keeps the lungs expanded and adhered to the chest wall.
30
What is **minute ventilation (V̇)** calculated as?
Ventilatory rate × tidal volume ## Footnote It is expressed as L/min.
31
What is **anatomic dead space**?
Air in the conducting airways ## Footnote It does not participate in gas exchange.
32
True or false: **CO₂** is the gaseous form of carbonic acid (H₂CO₃).
TRUE ## Footnote The lungs eliminate about 10,000 mEq of carbonic acid each day.
33
What is the role of the **VRG** in breathing?
Sets the automatic rhythm of breathing ## Footnote It sends impulses to the diaphragm and external intercostals.
34
What do **central chemoreceptors** monitor?
pH of the cerebrospinal fluid (CSF) ## Footnote Increased CO₂ lowers CSF pH, stimulating ventilation.
35
Where are **peripheral chemoreceptors** located?
Carotid bodies and aortic bodies ## Footnote They respond to low PaO₂ and low pH.
36
What is the **Hering–Breuer reflex** responsible for?
Stopping inspiration ## Footnote It is mediated by stretch receptors located in airway smooth muscle.
37
What does **surfactant** do in the lungs?
Reduces surface tension ## Footnote It keeps alveoli open and decreases work of breathing.
38
What is **atelectasis**?
Partial or full collapse of lung lobes (alveoli) ## Footnote Symptoms include rapid, shallow breathing, coughing, chest pain, and low oxygen levels.
39
What does **compliance** describe in the context of the lungs?
Ease of stretching ## Footnote Increased compliance occurs in emphysema and aging.
40
What is the **ventilation–perfusion ratio (V̇/Q̇)**?
Describes balance of air and blood ## Footnote Normal V̇/Q̇ is 0.8, known as the respiratory quotient.
41
What is the **partial pressure of oxygen (PO₂)** at sea level?
159 mmHg ## Footnote This is calculated from the fraction of oxygen in room air.
42
What is the **Alveolar Gas Equation** used for?
Calculating partial pressure of oxygen in alveoli (PAO₂) ## Footnote It considers barometric pressure, water vapor pressure, FiO₂, and PaCO₂.
43
What is the primary driver of ventilation when central receptors are blunted?
Peripheral chemoreceptors ## Footnote They respond to low PaO₂ and low pH.
44
What is the **function of hemoglobin** in oxygen transport?
Binds to oxygen for delivery to tissues ## Footnote Hemoglobin is essential for adequate oxygen delivery.
45
What is the **normal capillary transit time** for blood to equilibrate with alveolar oxygen?
0.25 seconds ## Footnote This is despite the capillary transit time being 0.75 seconds.
46
What is the **gradient** that drives rapid O₂ diffusion into the blood?
Capillary PO₂ (~40 mmHg) ## Footnote Blood equilibrates with alveolar oxygen in 0.25 seconds, even though capillary transit time is 0.75 seconds.
47
What percentage of oxygen is bound to **hemoglobin**?
97% ## Footnote 3% remains dissolved in plasma.
48
What are the measurements used to assess oxygen levels in the blood?
* PaO₂: partial pressure of oxygen in arterial blood * SaO₂: percent of hemoglobin saturated with oxygen * O₂ content: total oxygen in plasma + hemoglobin ## Footnote Factors needed to calculate oxygen content include hemoglobin concentration, oxygen saturation (SaO₂), and PaO₂.
49
True or false: Lower hemoglobin levels increase **oxygen-carrying capacity**.
FALSE ## Footnote Lower hemoglobin reduces oxygen-carrying capacity, while higher hemoglobin increases oxygen content.
50
What is formed when oxygen binds to hemoglobin?
Oxyhemoglobin (HbO₂) ## Footnote The binding process in the lungs is called association or hemoglobin saturation.
51
What does the **oxyhemoglobin dissociation curve** illustrate?
The relationship between oxygen saturation and partial pressure of oxygen (PaO₂) ## Footnote The curve is S-shaped, with a steep portion at PaO₂ less than 60 mmHg and a flat portion at PaO₂ greater than 60 mmHg.
52
What indicates a **right shift** in the oxyhemoglobin dissociation curve?
Hemoglobin releases oxygen more easily ## Footnote Factors causing a right shift include acidosis, hypercapnia, hyperthermia, and increased 2,3-DPG.
53
What indicates a **left shift** in the oxyhemoglobin dissociation curve?
Hemoglobin holds oxygen more tightly ## Footnote Factors causing a left shift include alkalosis, hypocapnia, hypothermia, and decreased 2,3-DPG.
54
What does the **Bohr effect** describe?
How pH and CO₂ levels shift the dissociation curve ## Footnote Low pH and high CO₂ reduce hemoglobin’s affinity for oxygen, promoting oxygen release.
55
How is CO₂ transported in the blood?
* Dissolved in plasma * As bicarbonate (HCO₃⁻) * As carbamino compounds (bound to blood proteins) ## Footnote Tissues produce ~200 mL of CO₂ per minute, which must be eliminated continuously.
56
What is the major form of CO₂ transport in the blood?
As bicarbonate (HCO₃⁻) ## Footnote Approximately 60% of CO₂ in venous blood and 90% in arterial blood is carried as bicarbonate.
57
What is the **Haldane effect**?
How oxygen binding influences CO₂ transport ## Footnote When hemoglobin binds oxygen, it releases CO₂, enhancing CO₂ pickup in tissues.
58
What does **spirometry** measure?
The volume and flow of air inhaled and exhaled ## Footnote Results are plotted as a spirogram (ventilation vs. time).
59
What is **Forced Vital Capacity (FVC)**?
Total amount of air a person can exhale forcefully after a full inspiration ## Footnote Reduced in restrictive diseases.
60
What does the **FEV₁/FVC ratio** help differentiate?
Between restrictive and obstructive patterns ## Footnote FEV₁ is reduced in obstructive diseases.
61
What characterizes **restrictive lung disease**?
Lungs cannot expand normally ## Footnote FVC decreases; examples include pulmonary fibrosis and severe scoliosis.
62
What characterizes **obstructive lung disease**?
Airflow is blocked or slowed ## Footnote FEV₁ decreases; examples include asthma, COPD, chronic bronchitis, and emphysema.
63
What is **Inspiratory Reserve Volume (IRV)**?
The maximum, extra volume of air that can be inhaled after a normal tidal volume inspiration ## Footnote It is one of the lung volumes.
64
What is **Total Lung Capacity (TLC)**?
Vital Capacity + Residual Volume ## Footnote Normal values depend on age, sex, and height.
65
What is the purpose of **helium dilution**?
To measure Residual Volume (RV), Functional Residual Capacity (FRC), and Total Lung Capacity (TLC) ## Footnote Helium is not absorbed and mixes with lung gases for volume calculations.
66
What does **Arterial Blood Gas (ABG)** analysis measure?
* pH * PaO₂ * PaCO₂ * HCO₃⁻ ## Footnote ABG is essential for diagnosing acidosis, alkalosis, ventilatory failure, and hypoxemia.
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