Chapter 11: The Respiratory System (Part 2)

*Process of Inspiration* When the lungs expand, the intrapulmonary pressure decreases and is less than the atmospheric pressure. What does this cause?

A vacuum that draws air into the lungs - High pressure (atmosphere) goes to low pressure (lungs)

What is Inspiration?

Air flowing into the lungs

What is Expiration?

Air flowing out of the lungs

What is Functional Volume?

Air that actually reaches the respiratory zone and contributes to gas exchange

What is Dead Space Volume? What is a normal volume?

Air within the conducting respiratory passageways (inhaled air that does not reach areas for gas exchange and remains in the airways) - 150 ml

What is Apoxia?

An "absence of oxygen" to the tissues - Cells will die

*Process of Inspiration* Is the contraction of the diaphragm an active or passive process?

An active process (it takes energy to breathe in and contract the diaphragm)

What is a Spirometer?

An instrument that measures the volume of air moved with each breath (spirare means "to breathe" in latin)

Why is the Residual Volume necessary?

Because air always needs to be present in the lungs because it allows gas exchange to continue uninterrupted (impossible to completely breathe out)

*Process of Inspiration* The lungs move with the diaphragm and thoracic walls. Why?

Because they are connected by the pleural membrane (The visceral and parietal pleurae are normally flush against each other, so that the lungs are stuck to the chest wall in the same manner as two wet pieces of glass sticking to each other, creating resistance upon separation)

Why do kids breathe so fast?

Because they have a smaller lung volume and they metabolize nutrients at a very fast rate (which produces more CO2 that needs to be rid of and more oxygen to supply the cells)

What must happen in order for carbon dioxide to be released into the alveoli during external respiration?

Bicarbonate ions must first combine with hydrogen to form carbonic acid

What is Respiratory Gas Transport?

Blood carries the respiratory gases between the lungs and the tissues of the body

What is Pulmonary Ventilation?

Breathing - Air moving in and out of the lungs

*Process of Expiration* When expiration occurs, the diaphragm ______________.

Relaxes

What is Carbon Monoxide Poisoning?

When carbon monoxide (CO) binds to hemoglobin at the same site as oxygen usually does and competes vigorously for those binding sites

When does the pH of blood increase?

When less carbon dioxide is present, which is due to decreased levels of carbonic acid and subsequently hydrogen and bicarbonate ions

When do chemical factors modify our rate of respiration?

When there is a change in pH levels in the blood

When do emotional factors modify our rate of respiration?

When we are scared or frightened (increases breathing)

When do physical factors modify our rate of respiration?

When we have a demand for more oxygen or removal or carbon dioxide (exercising)

Which volume is expressed during a yawn?

Inspiratory Reserve Volume (additional air is inhaled)

How can Dead Space Volume be increased?

By breathing through a long tube, such as a snorkel, because it serves as an extension of respiratory passageways. Even though one end of the snorkel is open to the air, when the wearer breathes in, they inhale a significant quantity of air that remained in the snorkel from the previous exhalation.

How does the body respond to these abnormal pH levels?

By increasing or decreasing respiration rates by driving the equation towards: - The carbon dioxide (left) side to increase pH - The bicarbonate (right) side to decrease pH

Once carbon dioxide combines with water, what does it form?

Carbonic acid

*Process of Inspiration* When the diaphragm is contracting, what are the external intercostal muscles doing?

Contracting and lifting the rib cage

*Process of Inspiration* When Inspiration occurs, the diaphragm ______________.

Contracts

*Process of Expiration* What other situation may also make expiration an active process?

If they have a disease, singing, whistling, etc. - There are various diseases, like emphysema, that cause this

What does the carbon dioxide then proceed to do?

Diffuse into the alveoli from the blood stream

*Process of Expiration* How does exercise affect the process of expiration?

During exercise, we breathe more deeply and at a faster rate. At this time, expiration becomes an *active* process.

How does Carbon Monoxide Poisoning affect both internal respiration and external respiration?

External respiration does not occur which prevents internal respiration from occurring (oxygen won't enter the blood and cells won't receive nutrients and will die)

*Process of Expiration* During expiration, the intrapulmonary pressure is ____________ than the atmospheric pressure.

Greater

What does this Carbonic acid then split into?

Hydrogen ions and bicarbonate ions

What type of breathing will cause Alkalosis?

Hyperventilation - Fast, deep breathing

(overview) What is our need to breathe caused by?

*Our need to expel CO2*, not to inhale oxygen (when people have emphysema, then their need to breathe is caused by their need for oxygen since they have already have chronic acidosis)

What is the average lung capacity of a healthy adult?

- *6 liters* - 6000 mL

Air always flows from areas of _________ pressure to areas of __________ pressure.

- High - Low

How many respirations do adults have every minute?

12-15

What percent of the air we breathe is oxygen?

21%

How many respirations do 5 year olds have every minute?

25

How many respirations do infants have every minute?

30

How many respirations do newborns have every minute?

40-80

What is the 5 year survival rate of Small Cell Carcinoma/Oat Cell Carcinoma?

7% - The average person survives only 9 months after diagnosis

How is most carbon dioxide transported into the plasma?

70% is transported as a bicarbonate ion

What is the most common way in which oxygen is transported into the blood?

98.5% of oxygen attaches to hemoglobin in the RBC's to form oxyhemoglobin

What is Pneumonia?

A bacterial or viral infection in the lungs that causes the alveoli to become filled with fluid (bronchioles are affected too)

What is Asthma?

A chronic condition (allergic reaction) in which the smooth muscles of the airways spasm, narrow, and become inflamed.

*Process of Inspiration* During inspiration, the intrapulmonary pressure is ____________ than the atmospheric pressure.

Lower

What accounts for 1/3 of all cancer deaths in the U.S?

Lung cancer (90% are smokers)

If we didn't exhale any oxygen, what resuscitation method would not function?

Mouth-to-mouth resuscitation

*The Intrapleural Pressure should always be ______________.* Why?

Negative - It is always negative in order for the two membranes to stick together

What is our Volition on breathing?

One can only hold their breath for so long before the unconscious control takes over

*Process of Expiration* When the diaphragm is relaxing, what are the external intercostal muscles doing?

Relaxing and compressing the rib cage (lungs get compressed)

What does a low pH mean?

That a liquid is more acidic (less basic)

What does a high pH mean?

That a liquid is more basic (less acidic)

What is the Residual Volume? What is a normal volume?

The amount of air that "remains" after the ERV is exhaled (air that remains in a person's lungs after fully exhaling) - 1100 ml

What is Expiratory Reserve Volume (ERV)? What is a normal volume?

The amount of air that can be forcibly exhaled after a tidal expiration (additional air that can be exhaled) - 1000 ml

What is Inspiratory Reserve Volume (IRV)? What is a normal volume?

The amount of air that can be taken in forcibly over the tidal volume (additional air that can be inhaled) - 2100 - 3100 ml

What is Tidal Volume? What is a normal volume?

The amount of air transferred in one normal resting breath (air displaced between normal inhalation and exhalation when extra effort is not applied) - 500 ml or 1 pint

Where are the control centers for the phrenic and intercostal nerves located? (part in brain responsible for controlling breathing)

The medulla and pons

What is Atmospheric Pressure?

The pressure of the atmosphere around us - Only changes if you change your elevation

What is the Tidal Volume named after? Why?

The tides of the ocean - The tidal volume resembles the tides as the chest rises and falls during one normal resting breath

What are the lungs like in a fetus?

They are filled with fluid and all respiratory exchanges are made through the placenta

What is the relationship between volume and pressure?

They are inversely proportional - As volume increases, pressure decreases - As volume decreases, pressure increases

What is the relationship between pH and the amount of carbon dioxide in the blood?

They are inversely proportional - Increase in carbon dioxide, decrease in pH - Decrease in carbon dioxide, increase in pH

What happens to our respiration rates as we age? Why?

They increase - The lungs are less elastic, less efficient, and have a decreased capacity (more tired, can't breathe as deep)

What does carbonic acid further split into?

Water and carbon dioxide

When does the pH of blood decrease?

When more carbon dioxide is present, which is due to increased levels of carbonic acid and subsequently hydrogen and bicarbonate ions

What is Chronic Bronchitis?

When the mucosa of the lower respiratory passages (bronchi) become severely inflamed and produce excessive amounts of mucus

Because asthma narrows the airways, the ability to bring air in and out of the lung becomes ____________

difficult (creates wheezing and chest tightness. Asthma means "shortness of breath")

Which 2 volumes cannot be measured with a spirometer? Why?

- Dead space volume - Residual volume - They are always in our body and never released

*Process of Expiration* How does the relaxation of the diaphragm and intercostal muscles change the intrapulmonary volume and pressure?

- Intrapulmonary volume decreases (lungs get smaller) - Intrapulmonary pressure increases

*Process of Inspiration* How does the contraction of the diaphragm and intercostal muscles change the intrapulmonary volume and pressure?

- Intrapulmonary volume increases (lungs get bigger) - Intrapulmonary pressure decreases

What increases the risk of Hypoxia?

- Old age - Anxiety - Asthma - Other respiratory diseases

What are things that can modify our rate of respiration?

- Physical factors - Emotional factors - Chemical factors - Consciousness

What is the treatment of Small Cell Carcinoma/Oat Cell Carcinoma?

- Removal of diseased lung - Radiation - Chemotherapy

What are the 3 types of Lung Cancer?

- Squamos Cell Carcinoma - Adenocarcinoma - Small Cell Carcinoma/Oat Cell Carcinoma

What are the effects of the chemicals in cigarettes?

- The nasal hairs, mucous glands, and cilia (which protect the lungs) become overwhelmed and lose their function - Depressed activity of lung macrophages (WBC's)

Carbon Monoxide Poisoning occurs when carbon monoxide reaches what percent of the total air volume?

.1%

What are the 4 parts of Respiration?

1. Pulmonary Ventilation 2. External Respiration 3. Respiratory Gas Transport 4. Internal Respiration

What is Atelectasis?

A collapsed lung - When the pressure within the pleural space (which is always negative) becomes equal to the atmospheric pressure, resulting in an "incomplete expansion of the lungs"

What is Hypoxia?

A condition in which inadequate oxygen is available to tissue

What is Chronic Obstructive Pulmonary Disease (COPD)?

A series of diseases including *chronic bronchitis* and *emphysema* that prevents people from breathing effectively

How do the 15+ carcinogenic chemicals in cigarettes enter the lungs and translate into lung cancer?

By causing the mucosal cells to mutate and divide rapidly

What is Squamos Cell Carcinoma?

Cancer that arises in the epithelium of the larger bronchi and tends to form masses that hollow out and bleed - 20% - 40% of cases

What is Small Cell Carcinoma/Oat Cell Carcinoma?

Cancer that consists of lymphocyte-like epithelial cells that originate in the primary bronchi and grow aggressively in cords or small grape-like clusters within the mediastinum. - 10% - 20% of cases

What is Adenocarcinoma?

Cancer that originates in the peripheral areas of the lungs as solitary nodules that develop from bronchial mucous glands and alveolar epithelial cells - 25% - 35% of cases

How does Emphysema affect the expiration process?

Exhalation must become *active* instead of passive

What does the fluid in the alveoli interfere with the process of? Why?

External respiration is affected because the alveoli collapse and can't sufficiently supply the blood with oxygen

What type of breathing will cause Acidosis?

Hypoventilation - Slow or shallow breathing

*Process of Expiration* Which muscles are capable of lowering the ribs to aid in expiration? (when deeper expiration is needed)

Internal intercostal muscles - Various chest and abdominal muscles can help as well

What does Emphysema do to the surface area of the alveoli? What does this cause?

It decreases the surface area and makes it harder for gas exchange to occur (oxygen in, carbon dioxide out)

During internal respiration, where is carbon dioxide transported?

It diffuses into the blood from the tissues and combines with water

*Process of Expiration* When the lungs get compressed, the intrapulmonary pressure increases and exceeds the atmospheric pressure. What does this cause?

It forces the air within the lungs to flow out in order to equalize the pressure - High pressure (lungs) goes to low pressure (atmosphere)

What does this excessive amount of mucus do?

It impairs both ventilation and gas exchange and increases the likelihood of infection

How is 23% of the remaining carbon dioxide transmitted?

It is carried inside the RBC's attached to a different site than oxygen

How is the remaining 7% of the remaining carbon dioxide transmitted?

It is dissolved in the plasma

How is the remaining 1.5% of oxygen transmitted in the blood?

It is transported in the plasma (fluid of blood)

*Process of Inspiration* How does the diaphragm move when it contracts?

It moves inferiorly and flattens (when a muscle contracts, it shortens. Makes abdominal contents stick out more)

*Process of Expiration* How does the diaphragm move when it relaxes?

It moves superiorly and curves

How does breathing into a paper bag get rid of Alkalosis during Hyperventilation?

It reduces the amount of carbon dioxide you will be able to get rid of

What does the word, *reserve*, mean when referring to the expiratory or inspiratory reserve volumes?

It refers to the air "set aside" or "kept back" that can be inhaled or exhaled during certain times

What is External Respiration?

Oxygen enters the blood from the alveoli and carbon dioxide leaves the blood and enter the alveoli

What is Internal Respiration?

Oxygen enters the cells from the blood and the carbon dioxide leaves the cells and enters the blood in order to be transported back to the lungs

During internal respiration, where is oxygen transported?

Oxygen leaves the blood and diffuses in the tissues

*Process of Expiration* Is the relaxation of the diaphragm an active or passive process?

Passive (doesn't take energy to breathe out, unless you're breathing hard)

How does Emphysema affect the amount of oxygen in the blood?

Since large amounts of oxygen are always left in the lungs rather than going into the blood, it is results in a deficient oxygenation of the blood that causes blueness of the skin, a condition known as *cyanosis*

How does Emphysema affect the pH of blood?

Since there is more carbon dioxide remaining in the body, the blood pH decreases and *acidosis* is likely to occur

What is respiratory capacity regulated by?

Size, sex, age, and physical condition

Which type of Lung Cancer is the most deadly?

Small Cell Carcinoma/Oat Cell Carcinoma

What is COPD usually caused by? What does this lead to?

Smoking - Leads to coughing and frequent pulmonary infections and ultimately respiratory failure

What is the Vital Capacity? What is a normal volume?

TV + IRV + ERV - The total amount of exchangeable air (taking a big breath in and a big breath out) - 4500 ml

What is the diaphragm and intercostal muscles regulated by?

The phrenic and intercostal nerves

What is the Intrapulmonary Pressure?

The pressure inside the lungs

What is the Intrapleural Pressure?

The pressure inside the parietal and visceral pleurae (where the serous fluid is)

What is Emphysema?

When the alveoli enlarge as the walls of adjacent chambers break through and chronic inflammation promotes fibrosis (scarring) of the lungs - It's like turning a bunch of grapes into one big grape

*Process of Inspiration* Summarize the steps of Inhalation.

When the diaphragm and intercostal muscles contract, the intrapulmonary volume increases and the intrapulmonary pressure decreases. Because the intrapulmonary pressure is lower than the atmospheric pressure, air from the atmosphere is drawn into the lungs and creates inhalation.

*Process of Expiration* Summarize the steps of Expiration.

When the diaphragm and intercostal muscles relax, the intrapulmonary volume decreases and the intrapulmonary pressure increases. Because the intrapulmonary pressure is higher than the atmospheric pressure, air is drawn out lungs and into the atmosphere, creating expiration.

When does Acidosis of the blood occur?

When the pH of blood decreases from higher amounts of carbon dioxide (more carbonic acid, hydrogen and bicarbonate ions)

When does Alkalosis of the blood occur?

When the pH of blood increases from lower amounts of carbon dioxide (less carbonic acid, hydrogen and bicarbonate ions)

Is oxygen present in the air we exhale? Why?

Yes (about 14%) because our lungs are unable to absorb all the oxygen from the air in one breath