PGY 300 5th Edition Exam # 3 Study Guide Lectures: 1 - 7Lecture 1: Organization of Respiratory System – Gas LawsOverview of Respiration: Ventilation: inspiration, expiration Exchange I: between atmosphere and lungs Exchange II O2 and CO2 between lungs and blood Transport of O2 and CO2 in blood Exchange III of O2 and CO2 between blood and cellsMuscles of Inspiration & Expiration: Passive Inspiration: External Intercostals & Diaphragm  Active Inspiration (exercising): Sternocleidomastoids and & Scalenes o Additional m. used for opening ribcage a little more Passive Expiration: Internal Intercostals & Abdominal m. Active Expiration: forces CO2 out and pulls ribcage inwardsLungs: Right lung: 3 lobes: Superior, Middle, Inferior Lobe; 60% of total lung Left lung: 2 lobes: Superior, Inferior Lobe; 40% of total lungo Smaller than right lung b/c the heart sits towards the left Pleural fluid: 25-30mL, holds lungs against thoracic wallFunctions of Airway:- Warming air to body temp; 37 C- Adding water vapor; 100% humidity- Filters out viruses, bacteria, inorganic particlesConducting airway: starts from larynx -> trachea -> left primary bronchus -> secondary bronchus-> bronchiole -> alveoli - Increase diameter = decrease cross-sectional area = increase air flow Terminal bronchiole: starts from left primary bronchus down to bronchioleCollapsible Airway: bronchioles, respiratory bronchioles, alveoli; b/c no cartilageCilia: conducting airway, moves mucus out to pharynx- Water saline allows cilia to push mucusGoblet cells: secrets mucusCigarette smoking paralyzes cilia in airway & increases mucus -> coughingSodium/Potassium Chloride Pump: down at basil side- NKCC brings Cl- from ECF - Anion channel lets Cl- pass into lumen- Na+ from ECF goes to lumen b/c of electrochemical gradient - NaCl in lumen creates concentration gradient so H2O follows into lumen Cystic Fibrosis: -genetic disease, poor Cl- transport in epithelial cells -> decrease of Na+ & H2O-anion channel becomes defective-no Cl- ->no saline layer -> mucus sticks to ciliaStructure of Lung lobules:- each clusters of alveoli is surrounded by elastic fibers and network of capillaries- Elastic fibers: recoil of lungs - Capillary beds cover 80-90% of alveolar surface- Lymphatic Vessel: keeps liquid, extra fluid in interstitial space - If fluid in space cause edema -> decrease in diffusion of O2 & CO2- Low fluid level- Alveoli: Surface area of tennis court; SA beneficial for gas diffusion Alveolar Structure:- 300 million alveoli - Type I alveolar cells for gas exchangeo Cover 96% SA- Type II alveolar cells (surfactant cells) synthesizes surfactant o Cuboidal cells , cover 4-6% SAo Replace or replenishes injured/loss Type I epithelial cells - Alveolar macrophage ingests foreign materialsEmphysema: - loss of SA & elsastic tissue; large alveolar - use expiratory m. to breathe while sitting Gas exchange between alveolar air space and plasmaPulmonary Blood Flow: low pressure system- Pulmonary blood volume = 0.5L (10% total)- Pulmonary capillary volume = 75 mL (contact alveolar space)- Pulmonary BP = 25/8 mmHgGas Laws:- Dalton’s law: total pressure of a mixture of gases is the sum of pressures of individual gaseso Barometric pressure – pressure associated w/ air, humidity o Partial pressure of a gas = Patm X % of gas in atmosphere o Altitude and humidity can change Atmospheric pressure o Temperature can alter Partial Pressure of composition - Gas Diffusion: gases move from areas of higher pressure to lower pressure- Boyle’s law: P1V1 = P2V2 ; inverse mannero Decreasing volume increases collisions & increases pressureLecture 2: Respiratory Mechanics At rest: diaphragm is relaxed - Air flow determined by pressure gradient - PATM = 0 , PA = 0, PPL = -3Inhalation: diaphragm contracts, thoracic volume increases- PATM = 0, PA = -1, PPL = -6- Diaphragm of volume = 60-75% ; inspiratory volume - Muscle disease : Myasthenia Gravis, Polioo Affects skeletal m. -> results in less force of volumeExpiration: diaphragm relaxes, thoracic volume decreases- PATM = 0, PA = 1 , PPL = -3Pneumothorax: leakage in the lung- Treatment: stop air leak, remove air from pleural space, use pleural vac to create neg. pressure -> lung expandsCompliance and Elastance- Compliance: ability of the lung to stretch o Restrictive lung disease reduces complianceo Fibrotic Lung Disease: inelastic scar-tissue in lung -> doesn’t stretch well o Respiratory Distress Syndrome (RDS): lack of surfactant (decrease in SA)- Elastance: ability of the lung to recoil back to resting volumeo Emphysema : low elastance, high complianceLaw of LaPlace: P = 2T/r- 2 bubbles having the same surface tension (T), the smaller bubble will have higher pressure- Surfactant reduces T ; pressure is equalized in the large and small bubbleLecture 3: Lung Volumes and Ventilation Spirometer: measures lung volumeTidal Volume: amt of air moving in/out of lungs4 Lung Volumes:- RV= residual volume, amt of gas left- ERV= expiratory reserve volume, - VT = tidal volume- IRV = inspiratory reserve volume Vital capacity: total amt of air we can move in/out of lungsFunctional residual capacity (FRC): end of expiration Pulmonary and Alveolar Ventilation:- Total pulmonary ventilation (minute volume)o Minute volume = vent rate X tidal volume o Anatomic dead space = 150Ml- Alveolar ventilation = vent rate X (TV – dead space)o Amt of air in/out of alveolar Types and Patterns of Ventilation:- Hyperventilation: increase respiratory rate, increase alveolar ventilation- Hypoventilation: decrease alveolar ventilation- Tachypnea: rapid breathing, increase respiratory rate w/ decreased depth Total pulmonary ventilation = 6 L/minTotal alveolar ventilation = 4.2 L/minMaximum voluntary ventilation = 125-170 L/minRespiration rate = 12-20 br/minLocal Control of Arterioles and Bronchioles by O2 and CO2 :- PCO2 increases : Bronchioles dilate - PCO2 decreases: Bronchioles constrict - PO2 increase : pulmonary arterioles dilate- PO2 decreases: pulmonary arterioles constrict- Direct relationship; good w/ good, bad w/ badLecture 4: Gas Exchange in Alveoli and TissueFick’s Law – DiffusionDiffusion rate = surface area X concentration gradient X membrane permeability Solubility: amt of gas that will dissolve in the solutionPartial pressure: at equilibrium between a gas and a liquid Increase in temp = increase in solubility Concentration: dependent upon partial pressure and solubility O2 low