How can we help?

You can also find more resources in our Help Center.

546 terms

LUNGS

STUDY
PLAY
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.
Chronic Obstructive Pulmonary Disease ( COPD)
Chronic bronchitis, Asthma, Emphysema are all examples of what type of disease?
Chronic bronchitis
Type of COPD:
inflammatory condtion ( of the bronchioles) caused by excess mucus or edema. [ this will cause a decrease in radii thus increase in resistance making it harder to breath. }
Asthma
Type of COPD: a. inflammation, histamine induced edema b. excessive mucus c. airway hyper-responsiveness characterized by profound constriction of the smaller airways via smooth muscle spasms.
Emphysema
Type of COPD: collapse of the smaller airways and breakdown of alveolar walls. It is irreversible.
trypsin,alpha1-antitrypsin, trypsin
Etiology of Emphysema; ____ released from alveolar macrophages as a defense mechanism in response to chronic exposure to cigarette smoke. OR genetic defect- inability to produce ____, which protects the lungs from ___.
albuteral
If you have an acute asthma attack, the drug of choice is ______.
beta 2
Albuterol is a ____ agonist working to relax bronchial muscles to allow normal breathing.
corticosteriods
If there is an inflammation issue, for longerterm control you would give _____. This is an anti-inflammatory agent and works to supress the immune response. This allows you to breath and is best for long term control, allowing the bronchials to relax and let you breath.
macrophages
____ work to clean up all the crap in your lungs
trypsin
______ breaks down protiens and elastic fibers in lungs.
yes, genetic
Can you get emphysema without smoking or being around someone that smokes?
alpha 1-antitrypsin
The enzyme that makes trypsin go away in the lungs is _______.
70
___% of all spontaneous pneumothroaxes are in patients with COPD. compromsed tissue, air gets in space...
expiration, instpiration
In COPD ___ is more difficult than ____; causes wheezing.
elastic fibers in connective tissue of lung , alveolar surface tension of the fluid
Elastic behavior of lungs is a function of ( 2 things)
alveolar surface tension of fluid
Most of the elastic behavior of lungs comes from ____
surface tension of fluid, elastic fibers
2/3 of elastic behavior of the lung is due to _____ while 1/3 of elastic behavior of lungs is due to ____
elastic recoil
elastic quality of lung tissue
compliance
how much effort is required to distend the lungs. This is a measure of the magnitude of change in lung volume from pressure.
compliance
_____ is the opposite of resistance
compliance
_____ is accomplished by given change in transmural pressure gradient, the force that stretches the lung.
High compliance
lung stretches further for a given increase in pressure difference. ( higher or lower compliance)
low compliance
more work ( more pressure change) required to produce inflation. ( high or low compliance)
elastic connective tissue, alveolar surface tension
Two factors that affect compliance:
T
T or F; the most important factor that affects compliance is alveolar surface tension?
Alveolar surface tension
tension within the liquid film that lines each alveolus.
decreases
increasing the alveolar surface tension ____ the compliance.
harder, compliance decreases
If your short on surfactant then your alveolar surface tension increases. Does this make it easier or harder to stretch the lungs?
collapse
If the alveoli were lined with H20, this would ____ the lung becuase the surface tension would be too great.
2,reduces
Type ____ alveolar cells produce pulmonary surfactant, which ___ surface tension.
C= change in volume/change in pressure
Equation for compliance
La Place's Law
Pressure = (2 x surface tension)/radius
La Place's Law
This law describes the magnitude of inward directed pressure in a bubble with a given sruface tension and radius.
72 dynes/cm
surface tension of water
50 dynes/cm
surface tension of normal body fluid
5-30 dynes/cm
surface tension of normal body fluid plus surfactant ( value)
gram
Dyne is a unit of force. Its the force required for one ___ to accelerate one cm/sec^2
less
Is there more or less surface tension when surfactant is added to a fluid?
surface tension, radius of alveoli ( sphere)
In La Place's law the magnitude of inward-directed pressure ( that makes alveoli collapse inward) depends on what 2 things?
down
we can understand where the air will flow if we can understand the pressure inside the spheres (alveoli) because the air will flow _____ the pressure gradient
Surfactant,increases
______ has an impact on surface tension and that surface tension is variable relative to the size of the inflated alveoli. The fact of inflating actually ____ the tension because your pushing the the surfactant molecules furher away.
surface tension
Surfactant plays a role in allowing a more equal distribution of the gas as the alveoli inflate and it does this by making the ________ variable.
interdependence. The interconnected alveoli help keep alveoli open
Another factor besides surfactant that prevents alveolar collapse ________.
Surfactant
______ allows air flow into the alveoli at the same rate.
New born respiratory distress syndrome
surfactnat producing ability of fetal lungs develops late in pregnancy. This can cause a problem is the baby is born prematurely.
3
The work of breathing normally requires only about ___% of total energy expenditure.
compliance decreases, airway resistance increases ( mucus plug), elastic coil decreases, need for increased ventilation ( exercise)
4 situations that increase the work of breathing.
25,5
During exercise, respiration work increases up to ____x. But work of rest of body also increases so that the net result is only up to ___% of work toward respiration.
30
In poorly compliant lungs or COPD; respiration can take up to as much as ____% of total body work.
compliance
____ describes lung distensibility. It is the ease with which an object can be deformed.
mom, 7th
fetus doesn't have a whole lot of use for lungs, ____ is supplying O2. When baby is born needs lungs. Type 2 alveolar cells not producing surfactant ( no need) till about ____ month. As baby developers after this time, more surfactant is being made.
non-functional lungs because no surfactant-Surface tension of baby's lungs is too great for pulmonary function
Biggest fear of premature baby being born?
compliance
how much pressure change i need to have a volume change.
harder, more volume change needed to get the effective pressure
if compliance decreases, is it harder or easier to breath?
increase in compliance
another way of saying "elastic coil decreases"
yes the work of exhaling will be more difficult.
Can an increase in compliance make it difficult to breath?
exhale,inhale
Increasing and decreasing compliance can make it difficult to breath. Increasing compliance can make it difficult to _____ while decreasing compliance can make it difficult to _____.
elastance ( C=1/E)
___ is the inverse of compliance
Elastance
opposition of an object to deformation by an external force.
E= change in P/change in volume
equation for elastance
no. variable
Is compliance constant?
less
The compliance of the lung during the first half of the inspiration phase is ____ than the 2nd half.
compliance
______ is how much volume change I get relative to pressure change.
no, different
Is compliance the same for inspiration and expiration?
less, more
The compliance of the lung during the first half of the expiration phase is _____ and ____during the last half.
hysteresis
the different profile of inspiration and expiration of the compliance diagram is called _______.
surface tension, elastic qualities of connective tissure
Hysteresis is a function of _____ and _____
decrease
Will hysteresis increase or decrease if you remove surfactant?
surfactant
whats a major player in the hysteresis ( the disparity of inspiration/expiration in the compliance diagram)
surfactant,increasing, decrease, increasing
Theory of hysteresis: fluid around the lung tissue has ________ molecules. Not all of them are on the surface of the fluid. As you stretch the fluid, more surfactant gets inserted into the surface of the fluid thus ______ compliance.
Then when lung is decreasing in volume (shrink-exhale) molecules crowd on each other & cause _______of compliance in 1st phase & they start getting squeezed & migrate back into below the surface of the fluid thereby _______ compliance.
work
change in pressure x change in volume =
Joules = L x cmH20
work can be expressed as the product of pressure and volume ( W= change p x change v) UNITS?
Watts
amount of work done per unit time/ rate of work done.
compliance work or elastic work, tissue resistance work, airway resistance work
Work of inspiration divided into 3 parts
compliance
Work for ____ is greater than tissue resistance work or airway resistance work.
compliance work or elastic work
work needed to expand lungs against the lung and chest elastic forces
tissue resistance work
work needed to overcome viscosity of lung and chest wall structures. Function of tissue on tissue friction ( even though pleural sac is in between)
airway resistance work
work required to overcome airway resistance during movement of air
pressure and volume
___ and ___ are factors that determine surface tension.
no, you can't exhale all the air in the lungs
is vital capacity the total volume of air that can be in lungs?
pulmonary ventilation ( minute ventilation)
amount of air one can move per minute
Tidal volume x respiratory rate
pulmonary ventilation =
500
During normal quiet respiration, normal tidal volume is _____ml/breath
12
during quiet respiration, normal respiratory rate is ____breaths/minute
6000
during normal quiet respiration, normal pulmonary ventilation is ____ml/min
anatomical dead space
The volume in pulmonary system of space where there is no gas exchange. Space in trachea, bronchi and bronchioles ( except respiratory bronchioles)
trachea, bronchi and bronchioles
3 places ( tubes) in the lung where there is no gas exchange, just channels art of pulmonary system.
150
a typical average anatomical dead space is about ____ml.
350
Of the Tidal volume ( 500ml) only about ____ml is available for gas exchange.
Physiological dead space
anatomical dead space plus alveolar dead space (assuming patient is in supine position)
volume in lung that is not available for gas exchange
upright
When a person is in a _____ position ( supine or upright) you create more physiological dead space.
supine
A normal person in a ________ ( supine or upright) position there is very little alveolar dead space.
alveolar dead space
In a diseased lung, you have compromise of alveoli function, therefore greater than normal ____________.
physiological dead space
Anatomical dead space and physiological dead space are roughly the same if you healthy, but if your ill ______ is greater.
physiological, anatomical
If you have a mucus plug in a particular area that is not your trachea,bronchi, or bronchiole then your not ventilating your lung in that area. The volume is additional ________dead space, NOT ______ dead space.
physiological
____ dead space can vary due to the health of your lung.
alveolar ventilation
how much air I am moving into my alveoli. how much air per minute is available for gas exchange.
alveolar ventilation
(TV- anatomical dead space) x Respiratory rate
alveolar
which ventilation rate are you most interested in clinically; pulmonary ventilation or alveolar ventilation?
0
When you do shallow rapid breathing the air doesn't get into your alveoli so your simply moving air in and out of the anatomical dead space ( trachea,broncioles,bronchi). If your Tidal volume is 150ml/breath and you dead space is 150ml/breath your alveolar ventilation in ml/min will be _____.
150
Anatomical dead-space volume is _____ml.
fresh air, air that stayed in the anatomical dead space and never mixed with your alevoli
what first comes out when your exhaling fresh or old air?
350, 150
Effect of dead space volume on exchange of tidal volume between atmosphere and alveoli:
Even though 500ml of air are moving in and out of alveoli with each breath only _____ml are actually exchanged between atmosphere and alveoli because ____ml is staying in dead space.
alveolar dead space. ( physiological dead space).
normally all alveoli are perfused with blood. Pathology: compromised blood volume to lungs will create significant _________
1/7
During quiet respiration only ___ air is replaced. (new air/fraction)
6/7
During quiet respiration ____ is old air. ( fraction)
old ( 6/7)
During quiet respiration is more air new or old?
alveolar ventilation
The air moving in and out of the alveolus.
perfusion
blood flow
air, blood
There needs to be a match between _______ & _________. The whole point of breathing is to have gas exchange between the ____ you breath and the _______ flowing in your body. You want them to match so you have optimum exchange in gas.
up
If the CO2 level in the alveoli goes ____, this will cause dilation of airways. ( bronchiodilation)
down
If the CO2 level in the alveoli goes _______, this will cause constriction of the bronchioles.
decreases
If O2 level in the alveoli _______, that will cause vasoconstriction of arterioles leading to the capillary beds.
increases
If the O2 level in the alveoli _______, that will cause vasodilation of arterioles leading to capillary beds.
increase
Holding your breath, or a mucus plug in the brochioles ( impeding ventilation to the bronchioles) will cause an _______ in CO2 in the alveoli.
the blood ( perfusion)
Where does CO2 ( the alveoli) come form?
CO2
if you have normal perfusion, but attenuated ventilation this will drive up the ______ level in the alveoli.
mismatch
An increase in CO2 indicates that you have a ______ in ventilation and perfusion.
dilate,increasing
The response the lung tissue ( bronchioles) gives when there is an increase in CO2 in the alveoli, ____ bronchioles ____ the ventilation to match perfusion.
O2, CO2,O2
The whole point of you breathing is to have gas exchange between the air that you breath (lungs) and blood. _____ is going to move from alveoli to blood, while ______ is going to move from blood to alveoli. also ___ is entering from atmosphere to alveoli.
CO2, O2
if you have decreased perfusion ( compromised blood flow to alveoli) _______ level goes down in the alveoli and ___ level goes up in the alveoli. ( gases)
blood,CO2,dilation,ventilation
If you have an increase CO2 level there is a mismatch in ventilation and perfusion. The CO2 came form the ____, and if you have normal perfusion and attenuated ventilation, it drives your ____ level up. This causes _____ of broncioles to increase the _______ to make it match the perfusion.
O2,CO2,constrict
If your alveoli is not getting proper blood flow the ___ level would go up in the alveoli and ___ level would go down in the alveoli. The response of the bronchiole tissues would be to _____ the airways.
because if you dont have proper blood flow, its not a good use of your energy to continue to ventilate the alveolus. No point in ventilating the bronchiole if you have low blood flow. You would be wasting the ventilation in an area that doesn't have proper blood flow mismatch of perfusion/ventilation Thus your body constricts the airways to prevent you from wasting energy!
If you don't have proper blood flow ( low perfusion) to the alveoli then you have increase O2 and decreased CO2in the alveoli. The bronchiole tissue ( airways) will constrict WHY?
vasoconstriction
If you have a drop in O2 to the alveolus, ie mucus plug or something blocking air from going to alveolus, you have attenuated the ventialation. The response to the blood flow in that area would be ______.
No,constrict
If you have a mucus plug you have lowered airflow ( drop in O2) to those alveoli is it energy efficient to sending blood to that alveoli? ____ ( yes or no) because the ventilation perfusion will be at a mismatch so you ______ the arterioles.
perfusing
If there is no ventilation to an alveoli, there is no point ______ it.
vasodialtion
If you have an increase in O2 ( exercise) to alveoli, you have _______ of arterioles to increase in perfusion as well. ( goal = match perfusion/ventilation)
airflow, bloodflow
The goal of breathing is to match ____ (ventilation) and ____ ( perfusion).
concentration gradient ( diffusion)
Gas exchange, in terms of where molecules go is all about ________.
partial pressures
In gas terms how do you articulate concentration?
760
Normal atmospheric pressure is _____mmHg.
N2
Almost 80% of what you breath is _____.
diffusion , down
Gas exchange at both pulmonary and systemic capillaries involves simple passive _____of gases ____ their partial pressure gradients.
partial pressure
concentration in gas terms
opposite
The O2 effect on blood flow in the lung is ______ to systemic arterioles.
21
____% of air is O2.
partial pressure
multiply the percent of a gas in the air times the normal atmospheric ( 760mmHg) to find ______ of the gas.
dilation,more
If CO2 is elevated, it will cause ____ ( dilation/constriction) of airways cuz need to move ____ air in ( relax bronchiole)
solubility,pressure gradient
How much gas you can dissolve in a liquid is going to relative to be of the _____ of that gas in the liquid and what kind of ______ am I driving that gas into the liquid.
T
T or F : Gas can dissolve in liquid
constant
In mammals, is the solubility of O2 and CO2 the same or constant?
partial pressure
The solubility of O2 and CO2 is constant, therefore the amount of blood gas at a given time is function of ______.
20
CO2 is ___x more soluble than O2 in blood ( plasma).
diffuse
If Po2 in the alveolus is greater than Po2 in the blood, then O2 will _____ down its partial pressure gradient.
T
T or F: Partial pressure of gases in the alveoli is not the same as in the air.
H20 vapor
Alveoli air is saturated with ______.
lower
Po2 in alveoli is ____ than Po2 in the air because alveolar air is a mixture of fresh air and old air.
15
In quiet respiration only about ____% of air in lung is fresh ( new air).
100
Average Po2 in alveoli is ___ mmHg.
160
Average Po2 in atmospheric air is _____mmHg.
40
Average Po2 in venous blood is ___mmHg.
46
Average PCo2 in venous blood is ____mmHg.
air in lungs saturated with water vapor
Why is the Po2 ( partial pressure of O2) lower in the alveoli/lungs (100mmHg) compared to atmospheric (160mmHg)?
water
A large portion of the air in your lungs is saturated with _____.
40
PCo2 in lungs is ____mmHg.
0.03
Pco2 in atmospheric air is ____mmHg.
60 ( 100-->40)
O2 flows from the alveoli to the (venous) blood to make it oxygenated blood because of its partial pressure gradient of ____mmHg.
4 (46-->40)
Co2 flows from the venous blood out into the lungs ( alveoli) because of its partial pressure gradient ___mmHg.
partial pressures
When we speak of blood gases, concentration gradient is in terms of ______.
Alveoli
arterial blood mirrors exactly the same gas concentration gradients as what is found in the ______.
100,40
Arteriole blood has a gas concentration of Po2____mmHg and PCo2_____mmHg
oxygenated
arteriole blood is oxygenated or deoxygenated blood?
deoxygenated
venous blood is oxygenated or deoxygenated?
O2, Co2
systemic cells in the tissue have been busy and have been using ___ for metabolic functions and converting it to ____.
40
The partial pressure of O2 in non-lung tissue cells ____mmHg.
into, out
Will O2 diffuse into or out of the non-lung tissue cells? Co2 in or out of non-lung tissue cells?
Henry's Law
the amount of gas dissolved in liquid will be directly proportional to the partial pressure gradient of the gas.
increase
If you want to put more gas into a liquid you just have to ______ the partial pressure and it will flow there.
Ficks's Law
___ law is relative to fluid molecules ( salt)/gas diffusion rate . Now in terms of gas.
Ficks's Law
The diffusion rate (J) is contingent upon the concentration difference (partial pressure difference) times the solubility of the gas in the liquid./ thickness times square root of MW
soluble
the more _____ the greater the diffusion rate of the gas in and out of a liquid.
increase
Increasing the area will ___ the diffusion rate.
decrease
Pathology; reducing surface area ( lower durface area) like in emphysema will ___ the gas diffusion rate.
thickness
Pulmonary edema ( fluid in the membrane), pulmonary fibrosis, and pneumonia will increase the _____ of the membrane, thus lowering the ability for O2 to diffuse.
pulmonary fibrosis
replacement of delicate lung tissue with thick fibrous tissue in response to certain chronic irritants.
greater
If you have a greater area, you will have a ____ diffusion rate.
diffusion rate
The ______ is defined as the volume of gas passing through the membrane per minute for partial pressure difference of 1 mmHg.
21
The diffusion rate of O2 is ___ ml/min/mmHg.
100-40 = 60mmHg
The partial pressure gradient of O2 is
46-40=6mmHg
The partial pressure gradient of CO2 is
400, 21
The diffusion rate of CO2 is ____ml/min/mmHg while the diffusion rate of O2 is only ___ml/min/mmHg
250
The average person consumes ___ ml of O2 per minute.
equilibrates,250
The actual diffusion rate over time for O2 is 21 ml/min x 60mmHg =1260ml/min. BUT this is not the actual amount that the body uses because the partial pressure gradient is only this high at the start of the lung tissues, but as you move on to the other non-lung tissues the blood _______. The actual amount ( average) of O2 your body consumes is ___ml/min.
concentration gradient
Because CO2 has a higher solubility (which is driving a superior diffusion rate), you don't need a high partial pressure gradient/difference to move a lot of CO2. In Fick's Law you have a smaller change in ________which is ok because you have a larger solubility.
increase,increase,increase
When you exercise, you have an _____ in blood-alveolar surface areas. You ______ your lung volume ( breathing more heavily) and hence have more area. You also _____ your cardiac output when you exercise.
Perfusion, ventilation
During exercise you again have a need to match _____(blood flow) and ______ (breathing).
no cuz there is a match between ventilation and metabolic need.
Is the increase in respiration due to exercise considered "hyperventilation"?
hyperventilation
When the breathing ( alveolar ventilation rate) exceeds the metabolic demands of the body. Increase in alveolar ventilation rate without an increase metabolic demand.
2
How long it takes for red blood cells to make their way through capillary beds is about ____ seconds at rest.
faster
Gas equilibrium or gas exchange happens much faster or slower than the 2 seconds that blood cells spend in the capillary bed?
.75 or 3/4, yes
A given amount of blood spends about ____ seconds passing though a capillary bed during exercise. Is this enough time to achieve gas equilibration?
PO2, PCO2
During exercise, the partial pressure in venous blood is altered ____ is lower and ____is higher.
O2,CO2
If the lung is diseased, equilibration may be achieved at rest because there is time for gas exchange, but physical exertion will increase Cardiac output, which may not give ___time to equilibration. ___tends not to be a problem.
rapidly,disease, exercise
It is advantageous that the diffusion rate (gas exchange between RBC and alveoli) occurs more _____ then it needs to be at rest because now you have some toleration if you have a _____ or when you ________, when it can take much longer for the diffusion of gases to occur or when the rbc are passing by too quickly.
ventilation
the air moving in and out of the alveolus
airways ( bronchioles)
So in matching ventilation and perfusion, you have local mechanisms regulating airflow and blood flow. For either an increase or decrease in CO2 you would open or close the ______.
arterioles leading to capillary beds
So in matching ventilation and perfusion, you have local mechanisms regulating airflow and blood flow. For either an increase or decrease in O2 you would open or close the ______.
physically dissolved ( in plasma),bound to Hemoglobin
O2 is present in the blood in 2 forms:
1.5%
percentage of O2 in physically dissolved form _____.
98.5%
percentage of O2 bound to Hemoglobin ____.
bound to hemoglobin
Is more O2 in the blood bound to hemoglobin or physically dissolved?
partial pressure
The amount of gases dissolved in fluid is a function of ________.
3
At 100 mmHg ( arterial blood), about _____mL of O2 can dissolve in 1L of blood.
5
Normal pulmonary blood flow ( blood flow going to the lungs) is ____L/min.
15
At normal pulmonary blood flow ( 5 L/min) ___ml of O2 can be dissolved. (per min)
250,25
At resting conditions cells consume ____ml of O2/min. This can go up by ____x during strenuous exercise.
83.3
At normal pulmonary blood flow ( 5L/min), 15 ml of O2 can be dissolved. at rest cells consume 250ml of O2/min. At rest, Cardiac output would have to be _______L/min if O2 could only be transported in dissolved form.
T
T or F: O2 bound to Hb does not contribute to PO2 of blood.
No
Does the oxygen bound to hemoglobin contribute to the partial pressure of blood?
hemoglobin
globular protein + heme molecules
1,4,4
One heme can combine with ___ O2 molecule(s). Each hemoglobin has ___heme moieties. Therefore one hemoglobin molecule can combine with ___ O2.
T
T or F: reduced hemogobin ( deoxyhemoglobin) is not bound to O2?
deoxyhemoglobin
Reduced hemoglobin, not bound to Oxygen.
Oxyhemoglobin
hemoglobin abound to O2.
100
1 deciliter ( dL) = ____ml
RBC
The reason why you have ____ is because your plasma can't contain enough O2 to meet the 250ml/min. You need ____ to hold and deliver the needed amount of O2 to be carried to your tissues to meet their metabolic demands.
dissolved
only O2 in ____ form directly contributes to PO2 ( partial pressure) of blood.
1.34
Amount of O2 per gram of Hb is ( that can be bound) _____ml O2/gm Hb. The max amout of O2 that can be bound by 1 Hb.
15
Typically you have ___ gram of Hemoglobin per deciliter of blood. or ____gm Hb/100ml blood
20
You carry about ____ ml O2/100ml blood that is bound to hemoglobin. or ___ ml of oxygen per deciliter of blood.
Anemic
reduction of normally functioning hemoglobin
10
An anemic patient, only has _____grams of Hemoglobin per deciliter of blood . or ____gm Hb/100 ml blood.
13
An anemic patient has only ___ml of oxygen per 100 ml of blood total. or ___ml O2/100ml blood.
Hemoglobin, O2
An anemic person will have less ____ in their blood which carries the O2, therefore they will have a reduction-in the total amount of ___ they can can carry.
% Hb saturation
how much of the Hb is bound to Oxygen.
% Hb saturation
amount of Hb bound to O2/ (amount of Hb bound to oxygen + amount of Hb not bound to O2)
PO2
% Hb saturation is a function of ________.
O2
The amount of saturation of Hb is dependent upon the amount of ____ dissolved in plasma.
increase
If you want to have more O2 on hemoglobin just ______ the of partial pressure of oxygen in plasma and that will drive more O2 onto hemoglobin.
decrease
If you want to pull of the O2 from Hemoglobin, you just have to ______ the partial pressure in plasma.
erythrocyte, ferrous ( Fe 2+)
_____ enzymes keep iron in a reduced state. Is this ferrous or ferric?
ferous
Fe2+
ferric
Fe 3+
Methemoglobin
hemoglobin with ferric iron ( fe3+) it cannot bind to O2.
1 ( less)
About ___% of hemoglobin is methemoglobin.
ferric, ferrous
____ has a lower affinity for O2 then ____. ( ferric or ferrous)
ferric
If Hb is in a ___ state, then we call it methemoglobin.
methemoglibinermia
If you have an abnormally high amount of methemoglobin. ( if you have greater then 1% methemoglobin).
O2
If you have a high amount of methemoglobin you have compromised your blood's ability to carry ___ which can lead to anemia.
Law of Mass action
If the concentration of 1 of the substances involved in a reversible reaction is increased, then the reaction is driven toward the opposite direction.
yes.
is Hb + O2 --> HbO2 a reversible reaction?
O2 bound to Hb
If you increase the amount of unbound oxygen, the reaction goes in the direction such that you increase the amount of ______.
hemoglobin + O2 <----> HBO2
____ reaction has a pKa value i.e. dissociation constant.
variable
is the pKa value of the reaction Hb + O2 <---> HbO2 constant or variable?
L, releasing O2 from Hb
When O2 in the blood is in tissue of low O2 content, then dissolved O2 goes down its partial pressure concentration gradient driving the reaction to the ____ R or L? ( Hb +O2<--> HbO2)
increase,increasing
If you _____ the PO2, then you drive more O2 on the Hb, therefore ______ the % saturation.
decrease, decreasing
If you ___ the PO2, then more O2 is released from the Hb, therefore ____ the % saturation.
on
If you raise the PO2 ( partial pressure of Oxygen) does more O2 go on or off the Hb?
varies, constant
The s shape ( sigmoidness) of the O2-Hb dissociation ( saturation curve) tell yous that the Pka value ____ depending on the partial pressure of O2. If the Pka value was _____ then it would be a straight line.
high
The % saturation of Hb of arterial blood ( 100mmHg of PO2) is ____ ( high or low)
low
The % saturation of Hb of venous blood ( Po2= 40mmHg) is _____. ( high or low)
a lot
When you have blood going into tissue and the partial pressure in the tissue is 40 mmHg ( venous blood) you note that venous blood has ___ of Oxygen.
no, its pretty linear
Is there a huge difference between the % Hb saturation in arterial versus venous blood?
half or 50%
P50 is partial pressure of O2 where hemoglobin is ___ saturated.
O2
If you exercise ( increase metabolic demand of O2 for tissues) and partial pressure of metabolically active tissue now goes from 40mmHg to 20mmHg? You have greater partial pressure and means that the blood is going to equilibrate at the 20 mm Hg point. the blood that leaves the tissue (that is now metabolically active) is now less then 40% Hb saturated. A fair amount of _____ has been dumped off the Hb into the tissue.
venous
The nature of the curve tells you that once you get too far in the range of ________ value partial pressure, any further drop is going to give a greater drop of O2 coming off of Hb ( more O2 coming off the Hb)
O2
If you increase exercise and your using muscle tissue where the metabolic demand is greater, it is advantageous that there is more ____ being dumped off from the Hb, because your tissue needs it!
cooperative binding
As you remove an O2 form Hb ( plasma) and put it into tissue, it causes more and more O2 to be removed form Hb( lowering the partial pressure of O2)and go into tissue.
hemoglobin
___ is a carrier of O2 and is there when the tissue needs it.
less
As the partial pressure drops the o2 saturation becomes ______.
60-100
The upper end of the O2-Hb dissociation ( saturation curve) between ____ mmHg ( Po2 found in pulmonary capillary) shows only a small increase in Hb saturation
0-60
The lower end of the curve ____ mmHg has a significant change in Hb saturation.
significant (big), 10
The plateau curve means there can be a _______ drop in alveolar PO2 with little change in Hb saturation. 40% drop ( 100 to 60 mmHg) means less than ____% drop in Hb saturation.
40, 75,75
Normal PO2 in systemic capillary bed is ___mmHg. Hb is still ____% saturated. Thus venous blood Hb is ___saturated.
30, more
If cells are metabolically active ( using more O2) and have a PO2 of 20 mmHg, then Hb saturation goes from 75% to ____% and much ___ O2 is released.
the tissue the needs the O2
If you exercising or increasing your metabolic demand on a specific area ( tissue). Does your whole body drop its partial pressure when there is an increase in metabolic demand or just the tissue that is needs the additional O2?
the total amount of O2 in blood
amount dissolved in plasma + the amount bound to hemoglobin gives you
not really
If you move your Po2 from 100 mmHg to 600mmHg, then do you increase the percent saturation ( of Hb)?
Cooperative binding of O2 to Hb, sigmoid
binding of the first O2 to Hb increases Hb for binding of the 2nd-4th O2. This is why the curve is ___ shaped
no
Is our body designed to breath pure O2?
myoglobin
An example of non-cooperative binding would be _____. ( molecule that binds O2 in muscle)
hyperbolic, cooperative binding
The curve of myoglobin ( molecule that binds O2 in muscles) is ____ instead of sigmoidal because myoglobin doesn't follow ______.
volume percent
O2 concentration is also called ______. ( anything per dL)
Hb, O2
The affinity of ____ for _____ is variable (cooperative binding) therefore the pKa is variable.
variable,
You have a _____ affinity for O2 and Hb depending on the number of O2 on Hb. ( saturation)
sigmoidal
Cooperative binding dynamic is the reason for the _____ shape of the O2-Hb dissociation ( saturation curve)
No
Does the O2-Hb dissociation ( saturation curve) which graphs the relationship between the partial pressure of O2 and % Hb saturation have anything to do with the amount of Hb?
still hold regardless of the amount of Hb
If you cut the amount of Hb in half or if you double the amount of Hb will the O2-Hb dissociation (saturation curve) still hold or will it be affected?
Hb
The O2 concentration or volume percent is assuming normal amount of ____ in the blood.
T
T or F: The Hb/O2 dissociation curve has nothing to do with how much Hb there is in the blood.
O2
A small drop in systemic capillary PO2 can make a large amount of ____ immediately available.
Oxygen content equation
CaO2 ml O2/dL = (% saturation of Hb x Hb gm/dL x 1.34 ml O2/gmHb) + 0.003 (PaO2)
total oxygen content
CaO2
bound to Hb
If you want to know the total amount of oxygen in blood, take the percent saturation of hemoglobin x amount of Hemoglobin in the blood x 1.34. This will get you the amount of O2 thats __________ in the blood. then add to the amt of Hb that is dissolved. you do this by taking the partial pressure of O2 times .003. add them both and you get the total amount of O2 in the blood.
anemia
reduction of Hb will result in reduction in blood's ability to carry O2.
solubility constant
0.003 ml O2/dL/mmHg is
7.4
normal body pH is around ____
CO2, pH, temperature, 2/3-bisphosphoglycerate (BPG) (DPG)(GBP)
Factors that affect Hb-O2 binding ( Hb-O2 dissociation curve) ( 4)
increased H+, increased Co2, increased temperature,increased DPG
Factors that shift the curve to the right ( 4)
decrease, more
Shifting the Hb-O2 dissociation curve to the right causes ___ in percentage of hemoglobin saturation. This means ____ O2 released and not bound to Hb.
O2,Hb
Increase in CO2 shifts the curve to the right. This means that the increased Co2 causes more ______ to be released from ______.
decrease
Does an increase or decrease in pH shift the Hb-O2 binding( dissociation) curve to the right (and release more O2 from Hb)?
Decrease, decrease, H+
___ in pH shifts the curve to the right. During strenuous exercise, increased CO2 results in ___pH and also ___ may be produced adding to ___ concentration.
HCO3-, H+
Co2 + H2O <--> H2CO3<--> ____ + ____
increase in H+ ( decrease in pH), lactic acid, from increased CO2
___ allows localized O2 distribution.
O2,CO2, Hb, localized
increasing the metabolism of a cell means they have an increased consumption of ____ and production of ____. Now raising the Co2 level will cause more O2 to be released from the ____. Does this occur in the whole body or is it localized to the area that is doing the work and needs the O2?
Bohr Effect
CO2 and pH alteration in Hb-O2 dissociation curve is called
H+, CO2
The Bohr effect is because the ___ and ____ bind to Hb ( at sites other than O2 binding site) to alter ( lower) Hb-O2 affinity.
CO2,H+
_____ bind to hemoglobin and lowers its affinity for O2.
reducing
The CO2 binds to Hb and its is this binding of Co2 to Hb that causes a change in the nature of Hb, thus______ the Hb affinity for O2.
T
T or F:The dissociation curve can be different in different parts of the body at the same time.
temperature
During strenuous exercise an increase in ____ (2-3degrees) in muscles shifts the curve to the right.
cooled,CO2
In the lung, blood is _____ and _____ is blown off to help maintain normal blood pH.
BPG ( 2,3-bisphosphoglycerate)
___ is made by RBC ( erythrocyte). It's a byproduct of anaerobic metabolism. Binds to deoxy-Hb and reduces Hb-O2 affinity.
BPG,DPG,GBP
Almost all of deoxyHb has ____ bound to it.
T,R,
BPG stabilizes the ___ state configuration of Hb (deoxy-Hb). Oxy Hb is the __ state.
T,O2
BY selectively binding to deoxyhemoglobin,BPG stabilizes the ___conformation, making it harder for ___to bind hemoglobin and more likely to be released to adjacent tissues.
hypoxia,more, increases, Bohr Effect
BPG is part of a feedback loop that can help prevent tissue ___ in conditions where it is most likely to occur. Conditions of low tissue oxygen concentration such as high altitude, airway obstruction, or congestive heart failure will tend to cause RBC to generate _____ BPG in their effort to generate energy by allowing more oxygen to be released in tissues deprived of oxygen. Ultimately this mechanism ___ oxygen release from RBCs under circumstances where it is needed most. This result is potentiated by the _____ for tissues with high energetic demands.
DPG, GBP
Some text refer to BPG as ___ or ____.
T
T or F: The main effect of BPG is in the non-lung tissue.
high
____ oxygen tension ( partial pressure) in the lungs favors the release of BPG from HB.
hypoxia,anaerobic,released
If you have localized tissue and its undergoing a shortage of O2 ( ________) your going to have ________ metabolism which will increase your BPG which will cause more O2 to be ________from Hb.
T
T or F: BPG levels will be higher in those acclimated to high altitudes
hypoxia
High altitude, airway obstruction, congestive heart failure are conditions of low tissue oxygen concentration called _____.
right
We all have a baseline level of BPG which keeps the curve shifted slightly to the ____.
right,10
The normal levels of BPG keep the curve slightly to the ____. BPG increases when Hb is chronically under saturated such as during hypoxic conditions, lasting more than a few hours. This causes oxygen to be released to the tissues at as much as _____ mmHg higher tissue oxygen pressure than would be the case without this increase.
O2
Without BPG it would be very difficult to get ___ off of Hb. So we need BPG. We are not made to not have BPG.
partial pressure
Oxygen tension is the same thing as
BPG
If we didn't have ____ we would have a difficult time breathing. It would cause the O2 to bind too tightly to the Hb.
CO,O2
CO and O2 have the same binding site on Hb, but ___ has a 240X greater affinity for it then ____.
carboxyhemoglobin
Hb and Co are coupled together
CO
tasteless,colorless,nonirritating
CO,50
____ will lock down the Hb making it nonavailabile for O2 binding. PCO2 of 0.5mmHg would yield ___% saturation.
O2
If not too severe, this poisoning of CO is treated with high pressure pure ____
dissolved,bound to Hb,bicarbonate
3 means of CO2 transport
CO
_____ poisoning does not alter arterial tension. It won't change the O2 tension in arterial blood.
100
If my Po2 in alveoli is still 100 mmHg, then my PO2 in arterial blood will be ____ mmHg even though the CO will lock down most of the Hb.
T
T or F: The amount of Hb in blood is irrelevant of the PO2 in arterial blood.
venous
suppose you diffuse the lungs with pure plasma, no RBC at all. The partial pressure of O2 coming out of the lungs will be the same even if 80% of Hb lock downed with CO. The Hb doesn't matter how much is functioning... for arterial blood but it will make a difference in _____ blood.
alveoli
The plasma coming out of the lungs will reflect what is in the_____ regardless of how many RBC or what the state of the Hb is.
10
___% of CO2 is dissolved
30
___% of CO2 is bound to Hb ( HbCO2).
carbamino CO2, globin
CO2 bound to Hemoglobin is called____ ( the CO2 binding site is on the ___ part of Hb)
60
____% of CO2 is in bicarbonate form.
bicarbonate ( HCO3-)
most of the CO2 in the body is transported in what form?
dissolved
The least amount of CO2 is transported in the body in this form
carbonic anhydrase
_____ is a erythrocyte enzyme that accelerates the reaction changing CO2 to bicarbonate
bicarbonate ( HCO3-)
CO2 combines with ___ to get a hydrogen (H+) and
HCO3-/Cl-
The HCO3- ( bicarbonate) is transported out of the RBC by a ______ countertransporter.
Cl-
The HCO3- is transported out of the RBC by a HCO3-/Cl- counter transporter. This movement of ___ maintains electrical neutrality across the cell membrane
Chloride shift
via HCO3-/Cl- countertransporter, in RBCs in non-lung tissue both ions go down their concentration gradients. In lung Cl- goes up its concentration gradient.
down,up
via HCO3-/Cl- countertransporter, in RBCs in non-lung tissue both ions go _____ their concentration gradients. In lung Cl- goes ____ its concentration gradient.
Hb
In the chloride shift, you have the movement of HCO3- and Cl-. H+ will bind to ___. This modulates the pH in the erythrocyte.
1/3
___(fraction) of CO2 is bound to Hb
no
Does CO cause low O2 content in arterial blood?
10^6
Carbonic anhydrase is an enzyme in the RBC ( erythrocyte) that accelerates the reaction of converting CO2--> HCO3- by how much?
CO2,Cl-,Hb
In non-lung tissue CO2 goes into RBC &combines with water and HCO3-. To get the reaction going you take a transporter that pulls the HCO3- out of the RBC. This allows more ____ to come in RBC. As HCO3- is leaving you move a negative charge across the membrane. To keep electrical neutrality, as you pull out a HCO3- you pull in a ____. This is called a chloride shift. To keep the pH from getting too low (acidic) in the RBC you have ____ which will bind the H+.
HCO3- ,Hb, O2
In non-lung tissue. As CO2 goes into the RBC, it becomes HCO3- and H+. _____is pulled off and put into the plasma and ___ takes the H+, allowing more CO2 to come in. as the H+ bind to the Hb, it causes more___ to come off the Hb to go into the tissue ( Bohr effect.)
O2
In non-lung tissue, what are you trying to get to come in ( CO2 or O2)?
Hemoglobin
_______ is a very important buffer in the RBC. It has a tremendous ability to take up H+.
CO2,into,O2,H+
In lung tissue the _____ is leaving the plasma into the alveoli so you can blow it off. HCO3- is transported ____ the RBC and Cl- will be kicked back out {lung}. As the HCO3- goes into the RBC and as you exhale CO2, now ___ in the alveoli binds to the Hb. This lowers the affinity of Hb with ___, freeing it and allowing it to bind HCO3- coming into the cell. This makes more CO2, driving it into the plasma & alveoli (down its cont. gradient) so you can exhale it.
Haldane Effect
deoxygenation of blood increases its ability to carry CO2
CO2,H+
Hb has a greater affinity for ____ and ___ than does HbO2 ( oxyhemoglobin). When O2 is bound to Hb is has less affinity for CO2 and H+. Works in your favor in lung
H+
O2 binding to hemoglobin causes _____ release from Hb leading to increase PCO2
H+,H20,CO2
100mmHg pressure in alveoli which is being driven in the blood and they very act of that is liberating H+ and CO2 from the Hb. CO2 is being blown off as the ___ binds to HCO3- making ___ and ____. Thus the CO2 can be blown off. This is the Haldane Effect.
1 mL/dL
1 volume percent =
blood
If you increase PCO2 ( partial pressure of CO2) you increase the amount of CO2 in the ____.
O2
The amount of CO2 that you can hold in blood is driven by how much ___ there is in the blood. This is the bases of the Haldane Effect.
?
If you have 40mmHg of CO2 and the PO2 is 100mmHg ( arterial blood) >>> if you raise PCO2 in blood to 45 mmHg your O2 tension has gone down...
T
T or F: When you increase the PCO2 you also decrease the PO2 enabling the blood to carry more CO2
CO2, Haldane
Because the PO2 level has gone down makes the blood more able to carry ____. This is known as the ___ Effect.
less
Now in the lungs, you have O2 driven into the blood in the alveoli, you increase the O2 tension.thus making the blood ____ able to carry CO2. This is beneficial because you want to get rid of ( blow off) the CO2.
CO2,CO2
Haldane effect approximatley increases ( doubles) the amount of ____ released from the blood in the lungs and approximalty increases (doubles) the pick up of ____ in the tissue.
linear
The graph between the PCO2 and CO2 content in blood as influenced by PO2 in blood ( Haldane Effect) is near _____ in nature
PCO2
(diffusion rate of CO2 from blood to alveoli/Alveolar ventilation rate) x k (863mmHg) =
increase PCO2 and decrease in PO2
What are the 2 variables in the increase the amount of CO2 in blood are
CO2
the relationship between PCO2 alveolar ventilation rate and the diffusion rate: this equation tells you that if you cut in half the alveolar ventilation rate then you double the partial pressure of _____ in the your arterial blood.
increases
If you cut the alveolar ventilation rate to nothing ( hold your breath). Your CO2 level in your blood ______.
decrease
If you double your alveolar ventilation rate ( hyperventilation) that will ____ in half your PCO2
alveolar
PCO2 in arterial blood = Partial pressure in _____ blood.
Cyanosis
Bluish color of tissue caused by presence of more than 5 gm deoxy Hb/dL in capillary bed.
5
Cyanosis is caused by presence of more than ___gm deoxyHb /dL in capillary bed
hypoxia
insufficient O2 at the cellular level
Hypoxic hypoxia (arterial hypoxia,hypoxemia)
decrease in O2 in blood ( hypoxia) usually caused by problem in lung function or too low of level of O2 in air
Anemic hypoxia
decrease in RBC ( hematocrit); decrease in Hb; CO poisoning ( but partial pressure in arterial O2 stays normal) ( hypoxia)
Circulating hypoxia (ischemia hypoxia)
too little oxygenated blood is delivered to the tissue. Vascular spasms (not letting adequate perfusion of capillary beds), blood clot, congestive heart failure( can't pump enough blood to meet the needs of the body) ( partial pressure in arterial blood is normal- there is proper amount of O2 in blood, just not enough blood!) (hypoxia)
Histotoxic hypoxia
cells are unable to utilize O2 i.e. cyanide poisoning ( hypoxia) ( O2 is there, you just can't use it)
Hyperoxia
above normal PO2
T
T or F: Oxygen toxicity can damage cells
Hypercapnia
too high CO2. Can be caused by hypoventilation. Results in respiratory acidosis. { not proper alveolar ventilation rate to blow off the CO2 level made by cells, you get build up of Co2 which combines with water, you get acid, decreasing pH all cause by respiratory problem)
Hypocapnia
below normal CO2. caused by hyperventilation. Results in respiratory alkalosis
Oxygen toxicity
Breathing too high of a concentration of oxygen for an extended period of time can be toxic
free radicals
The mechanism of deleterious effects of oxygen toxicity is thought to involve formation of ____ such as ".O2"
tissue
Increasing the PO2 will increase the amount of .O2 ( free radical) in _______.
free radicals,fatty acids,aging process
.O2 and other ______ occur at low levels naturally, but cells have enzymatic mechanisms to break down these molecules. Free radicals can cross link proteins and alter the composition of ___ in cell membranes. It is thought that free radicals are a factor in the normal _______. Some believe that taking antioxidants i.e. free radical scavengers ie.vitamin E may hinder the damage done by these molecules.
free radical
an unpaired electron
nonfunctional
If you cross link proteins ( enzymes) your making them ________.
Hyperbaric (CNS) O2 toxicity, Normobaric ( pulmonary) O2 toxicity
2 types of Oxygen toxicity
Hyperbaric (CNS) O2 toxicity
Exposed to a minimum of 1.5-2 atm of oxygen tension. Occurs in pressure chamber of during diving. Because of free radical formation, can lead to inactivation of key enzymes needed for neurological function. Can result in grand mal seizures.
Hyperbaric O2 toxicity
grandmal seizures can result from which type of O2 toxicity?
Hyperbaric O2 toxicity, ( inactivation of key enzymes needed for neurological function)grandmal seizures
Why is it illegal to fill scuba tanks with pure O2 for the general public?
pure
If you are exposed to 4 atm of _____O2 you will have a seizure and be in a coma within 1 hour.
Normobaric ( pulmonary) O2 toxicity
requires exposure to a minimum of 0.5 atm of O2 tension for 18-24 hours. Administration of 100% oxygen of long periods of time can cause pulmonary complications.Free radicals destroy type 2 alveolar cells that secrete surfactant. They can also cause pulmonary edema,atelectasis ( collapse of alveoli) and hemorrhaging( bleeding in lungs).
atelectasis
collapse of alveoli
Hyperbaric O2 toxicity
Means of death of neurological ( 1.5-2 atm Oxygen tension or partial pressure of O2)
lung
pure O2 for 12 hours or more will cause problems in the ___ because your not made to breath pure O2.