LUNGS

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alveolus

main location of gas exchange in lungs

75m^2

typical person has about ____of surface area ( size of tennis court)

150 million

each lung has about ____ alveoli

0.5 microns (um)

space between alveolus and pulmonary capillary is ____.

Type 2

____ alveolar cells secretes pulmonary surfactant.

phospholipoprotein

surfactant is a _____

lower

the main point of surfactant is to ____ the surface tension on the lungs.Allowing the lungs to over come the polarity of water that holds it closed.

pores of Kohn

opening between individual alveoli, which allows fresh air to enter an alveolus whose terminal conducting airway is occluded due to disease.

Barometric pressure

pressure exerted by weight of the air in atmosphere on objects.

pressure gradient

How does respiration work...whats the mechanism?

760

At sea level barometric pressure is _____mmHg. ( atmospheric pressure)

Intra-alveolar (intrapulmonary) pressure

Pressure within the alveolus.

intra-alveolar, barometric

the difference between _____pressure and ____pressure determines airflow in/out of lungs.

intrapleural pressure ( intrathoracic)

Pressure between visceral pleura and parietal pleura.

756,4

Intrapleural pressure is usually ____mmHg ( - ___mmHg)

Pleural sac

area between visceral and parietal pleura is not empty space. It's very thin and filled with fluid in a space called

intrapleural fluids cohesiveness- polar qualities of molecules i.e. 2 plates of glass with water between them, &

transmural pressure gradient( this is the major factor keeping the 2 pleura is apposition) 760mmHg vs 756mmHg

2 reasons why the pleura of the pleural sacs "stick" to each other.

across lung wall (transpulmonary pressure), across thoracic wall

2 types of transmural pressure gradients

transmural pressure gradient across lung wall

intra-alveolar pressure minus intrapleural pressure. (expanding out)

transmural pressure gradient across thoracic wall

atmospheric pressure minus intrapleural pressure (squeeze in or compress the chest)

Pneumothorax

air in the chest results in loss of transmural pressure gradient,possibly leading to collapsed lung

contract

if you inhale you _____ the diaphragm

down, high, low

Air moves __ its pressure gradient. From ___ to Low

elastic

the lung tissue has a ___ quility making it want to shrink.

pleurisy

inflammation of the pleura

pleural effusion

lungs fill with fluid in (not good). Pleursiy leads to this. associated with filling of fluid in pleural space (patient complains of shortness of breath, because you have inhibited the ability of lung to expand)

T

T or F if there is no pressure gradient, there is no movement of air into/out of lungs.

pressure gradient, -4 from outside to inside.

Hole in thoracic wall would cause air to come into the lungs because of the ______

tension pneumothorax

Hole in thoracic wall, large amt of air in interpleural cavity pushing lung on heart. compromise cardiac output, cardivascular problem is more then the problem of collapsed lung! because now the collapsed lung is squeexing on the heart from teh outside preventing the heart from being able to contract and relax ( push out)

needle thoracostomy or tube hooked up to vacuum bottle creating negative pressure, taking pressure off lungs allowing chest wound to heal.

how to fix tension pneumothorax

spontaneous/ pneumothorax

diseased lung( lung rotting away); allows air to get into pleural cavity space.

intralveolar, barometric ( atmospheric)

In a resting state neither inhaling,exhaling then _____ and _____ will be the same because no pressure gradient, so no air movement.

simple pneumothorax

small amount of air getting in, but the tissue will quickly seal itself off. Nothing to really worry about

paradox breathing

One lung deflate during inspiration and inflate during expiration. One lung compromised, so the one thats working normally is pushing against the other one...

Flail Chest

multiple ribs broken, thoracic cage compromised which compromises respiration.

Boyles Law

at any constant temp, the pressure exerted by a gas varies inversely with the volume of gas.

Boyle's Law

As volume of gas increases, pressure exerted byh the gas decreases proportionally and conversely, the pressure increases proportionally as the volume decreases. P1V1=P2V2

volume,volume,pressure

Inspiration/Expiration involves the changing in ______. If ______ changes then _____ will change.

Diaphragm and external intercostal muscle ( during quiet respiration)

What causes an increase in teh volume of the alveoli (thoracic cavity)?

Phrenic nerve

____ cause diaphragm muscle to contract thereby increasing thoracic cavity volume

75

_____%of enlargement of the thoracic cavity is via diaphragm contraction

volume

As you inhale you contract the diaphragm( phrenic nerve), you pull the lungs down ( less dome-like/neg pressure) and increase the ____ of the lung, thus decreasing the pressure creating a pressure gradient, allowing air to come into the lungs.

relax,decreases,pressure

During exhalation you ____ the diaphragm, and the lung ______ in volume, thus increasing _____. Now pressure in lungs is greater then atmosphere so you push air out.

External intercostal muscles

These muscles; when contracted the lateral and anterior-posterior diameters increase. Innervation is intercostal nerves

quiet

During _____ inspiration, intra-alveolar pressure drops 1 mmHg to 759mmHg ( thats all it takes to move air into your lungs!)

diaphragm

Which is used more during quiet respiration diaphragm or external intercostal muscles?

intercostal

muscle between the ribs

no, by intercostal nerves coming from spine

Are the external intercostal muscles innervated by the phrenic nerves?

quiet

during ______ inspiration intaplerural pressure drops by 2 mmHg below resting pressure (76mmHg) to 754mmHg.

elastic

During quiet expiration, the _____ quality of the lung reduces lung volume causing the lung to contract.

761, passive

during quiet expiration, intra-alveolar pressure increases to ____mmHg. This is a ____ process

start. (last half of time has less volume change)

During normal inspiration, is there more volume change in the lungs in the start or end time of inspiration?

start ( most volume change at front Half)

During normal expiration, is there more volume change in the lungs at the start or end time or expiration?

drop

During inspiration cycle there is a modest pressure _____ in intra-alveolar pressure

volume, pressure

During inspiration the ____ change in the lungs is causing the ______ drop in the intra-alveoli.

Its not a closed system, air is always moving...

Why is boyles law not fully shown in the lung system during inspiration/expiration?

negative

You develop a _______ pressure in the intra-pleural space during inspiration because the diaphragm is contracting pulling away form the lung tissue.

transpulmonary,elastic

(Intra-alveolar pressure) - (intra pleural pressure) =
This is a measure of the _____ forces of the lung.

active

____ respiration is what you do when your exercising

diaphragm,external,sternocleidomastoid, scalene

During active inspiration you have greater contraction of _____ and _______ intercostal muscles. Other muscles that come into play ______ and ______ muscles ( anterior, middle, posterior)

internal intercostal muscles, abdominal

During active ( forced) expiration ( non-passive) what 2 muscles contract.

angled down

Are your ribs horizontal or angled down?

Bucket- handle effect

The mechanism by which the external intercostal muscles draw the rib cage up when they contract. This increases the distance and expands the volume of the thoracic wall/ lungs. This is called.

sternocleidomastiod, scalene

Upper region of rib cage has series of muscles that come from skull and cervical spine and attaches to upper portion of ribs which inserts on clavical ( menubrium) to lift up portion of rib cage. These muscles lift upper portion of rib cage.

external intercostal, sternocleidomastoid, scalene.

Muscles involved in bucket handle effect that allows expansion of lungs ( lifting thoracic cage) ( forced inspiration)

lowering volume of adbomin, shoving liver and stomach into thoracic cavity. Developing maximum pressure in lungs to get the air out

Why do abdominal muscles contract during forced ( active) expiration?

Poiseuille's equation

Flow =change in P x pie x radius of air flow ^4/ 8 x viscosity x length

power of 4

In Poiseuille's equation does the radius affect flow rate by a factor of 4 or power of 4?

great

modest change in radi of bronchioles will have a _______ (great or small) change in airflow?

resistance

Flow rate is the opposite of _____

decreases

increasing the radius ____ the resistance.

change in Pressure/Resistance

combining the resistance and flow rate equation you get Flow=

Ohm's Law

Voltage= current x resistance is called

electrons

current is flow rate of ______

( cmH20) = (L/sec) x (cmH2)/L/sec)

units of change in P = Flow x Resistance

Laminar Flow

assumptions for the equation change in P=FxR

Laminar Flow

no turbulance.

all molecules are going in same direction, low gas velocity ( slow), small airways

You have laminar flow when ( 3 things)

large

You get turbulence in ___ airways.

Ausculate Breathing

to hear lung sounds with sthethascope.

2000

You get turbulent flow if reynolds number is greater then ______

reynold's number

Re= 2x radius x velocity x denisty / viscosity

T

T or F there must be a gradient for air to flow either into or out of lung?

abdominal muscles squeezing lungs

In forced exhalation why does the intra-alveolar pressure rise?

When you exercise you are not exhaling as hard as you can

When you are forced to exhale as hard as you can ( max forced exhale), your intra-alveolar pressure rises higher then when you exercise. Why?

your decreasing the radius which increases the resistance

When you do Max forced exhalation, your soft tissue bronchioles collapse. Why do the airways collapse?

No, becuase your not exhaling to max capacity.

Do airways typically collapse during exercise?

recoil

A large portion of the energy from exhaling is coming from the _____of lung tissue ( elastic property)

exhaling

If you have a sick lung, that the elastic fibers of the lung tissue is less- now ____ becomes a challenge. Now, to push air out, you have to rely more on squeezing the lung from external forces instead of the elastic qualities of the lung.

airways to collapse

Because of COPD the intrapleural space pressure is higher ( because your squeezing more to get the air out) which is going to cause more _______

no, exhaling is cuz you lost the elastic recoil of lung...

Is inhaling a challenge for patients with COPD?

narrowing of the airways, loss of elastic qualities

Obstructive Lung disease can be caused by (2) things

Emphysema

Narrowing of airways and loss of elastic quality of lung is characteristic of what lung disease?

Spirometer

machine that monitors change in volume ( of lung) as you breath in and out

500

Normal tidal volume is _____ml

Tidal Volume

Air you breath in and out during normal respiration

Expiratory Reserve Volume

Reserve that you could exhale if you had to. Exhale as much as possible after normal exhalation

Inspiratory Reserve Volume

how much air you can inhale beyond normal. The reserve that you could inhale if you had to, then u exhale and return to normal breathing. (the top end of a normal inhale to max inhale)

No- Residual volume

Once you exhale maximally, have you exhaled all of your lung?

Residual volume

The amount of air left in the lung after maximum exhale.

inspiratory capacity

the distance from the end point of normal exhale to maximum inhale

Vital capacity

maximum amount of air you can move from a maximum inhale and maximum exhale

functional residual capacity

Expiratory reserve volume + Residual volume

total lung capacity

inspiratory capacity + functional residual capacity

5.7,4.2

total lung capacity in young adult males _____L and _____L in females.

exhaling

In emphysema the wheezing occurs when the patient is ______

Total lung capacity

Vital capacity + residual volume

Eupnea

quiet breathing

forced vital capacity

FVC

...

The flow rate for expiration will peak very

external intercostal

______ muscles aid in inspiration.

abdominal, internal intercostal

During max foced expiration, muscles of ____ wall and ____ muscles play an important role.

Effort Independence

During forced vital capacity, __________ shows that expiration exibits dynamic compression which becomes more flow limiting as lung volume decreases. This shows collapse of airways. Even if you exhale harder, it'll be the same becuase airways are collapsing

exhaling, inhaling

During forced vital capacity, the flow rate is higher when _____ forcefully compared with _____.

vacuum, exhaling ( blowing)

During forced vital capacity, the flow rate is higher when exhaling forcefully compared with inhaling. This makes sense because when you inhaling maximally all your creating is a _____,but when your _____ maximally there are more ways to sqeeze the air out, so it should not surprise you can move air out more rapidly in terms of exhaling.

Volume change

Forced vital capacity is really showing a Volume change or pressure change?

levels off, decreases

During maximum inspiration ( forced vital capacity) you initially have a high flow rate ( rapid increase of air in), then it ______ at a pretty high flow rate, and then the flow rate_____.

maxium exhalation

During _________ at forced vital capacity, you intially have a rapid increase in flow rate and then through most of the cycle you get this linear realtionship between change in volume and change in flow rate as the flow rate approached zero.

Effort Indepedence

Whether you blow sort of hard, or really hard, you are still collapsing airways and it will still be linear.

slowly

If you want to get all the air out that you can during exhalation, is it better to exhale forced, as hard as you can or slowly?

forcefully, rapid ( maximally)

You are collapsing airways when you breath/exhale _____ because airwaysare collapsing and air is getting trapped in that normally could have gone out if you had exhaled slowly.

smaller

Forced vital capacity will be slightly _____ then vital capacity. Vital capctiy is when you can push all the air out tha you can without trapping or collapsing anything.

3,10

In a healthy lung the difference between forced vital capacity and vital capacity will be maybe ____% difference. In a diseased lung ( loss of elasticity) the dispartiy between forced vital capacity and vital capacity is _____% or more. The disparity grows as the lung is more sick.

collapsed airways

The linear area on the forced vital capacity graph is a fucntion of _________.

segmental bronchi

In a normal lung, most of the resistance in airway is in the ______.

cm H20/L/sec

Resistance to airflow Units.

cartilage, parallel

Bronchioles have no ____. have smaller radii but are in _____ therefore total resistance is lower.

65,000

There are _____ parallel bronchioles.

trachea, segmental bronchi

Resistance to air flow changes with airway generation, where 0 is the _______. Resistance is gretest in the ________ and decreases rapidly in smaller but more numerous peripheral airways.

Terminal bronchioles ( higher airway generation, 15)

Where is resistance the lowest?

airway generation

the branching pattern of your bronchioles

branching

significant drop off of resistance as you have more __________.

lower

the further down the line you go ( higher airway generation) in the branching pattern the ___ the reisistance

resistance

Unlike series, if you have a system in parallel, you drop the total ______ of the system by the parallel arrangment.

add the total flow rates of the parallels!

if you wan tot know the total flow rates of the system then just do what?

parallel

In your bronchiole tree you have a _____ array of branching, which is why the resistance drops as the bronci branch

Parallel branching arrangement beats out the decrease in radius, therefore the total resistance decreases.

Your bronchioles are getting smallar as they branch, which is decreasing the radius, thus increases the resistance, but you have it in a parallel branching pattern. Which beats out the other in terms of increasing/decreasing the resistance?

Parasympathetic ( vagus nerve, CN 10)

Which autonomic influence on the lungs causes bronchiolar smooth muscle contraction?

Acetylcholine

Which neurotransmitter causes bronchiolar smooth muscle contraction via parasympathetic autonomic influence?

sympathetic

Which autonomic influence on the lungs causes bronchodilation via beta2 adrenergic receptors?

epinephrine

which neurotransmitter causes bronchodilation during bronchial spasms ( asthma attack)?

bronchoconstriction

Histamine will cause _____ in the lungs.

bronchodialtion

High levels of CO2 in the alveoli will effect _____. This is an example of local control.

dilate

In a bear in the woods moment is it in your intrest to have the lungs dilate or constrict?

beta 2

SO during an asthma attack if you inject the patient with epinephrine, it will attach to the ______ adrenergic receptors and cause broncodialtion.

histamine

If you have an allergic reaction ______ is released that causes your bronchial smooth muscle to contract

Epinephrine

___ will counteract the effect of histamine

ventilating, dilate

In the alveolus you have the blood coming in dumping the CO2. If you have a build up of CO2 in an alveoli, that means you probably not _______ that aveloi well enough. This will cause the bronchioles in the alveoli to _____ so you can have increased ventiallation in that alveolus, thereby bringing the CO2 level back to normal.

Chronic Obstructive Pulmonary Disease ( COPD)

A group of lung disease characterized by increased airway resistance resulting from the narrowing of the lumen of the lower airways.

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