Chapter 20: Respiratory System

A person has a Hb concentration of 10 g/dL and a venous Hb saturation of 30 mmHg. What is this person's approximate venous content of oxygen?

7.4 mL/dL

Neurological injury can result in a variety of abnormal breathing patterns. Predict which structures, when injured, might lead to altered breathing. For each, discuss the type of breathing pattern that might result from the injury.

Damage to the brainstem can dramatically change breathing patterns depending on which areas are affect.

Administering high levels of oxygen to a person with chronically high P CO2 levels would likely lead to:

Decrease in ventilation

Which of the below describes external and internal respiration?

Gas exchange in the lungs and gas exchange in the systemic tissues of the body respectively

The structure most responsible for producing sound is the?

Glottis

An increase in altitude leads to a:

-Decrease in atmospheric pressure -Decrease in inhaled P O2

Sort these lung structures/segments in order from largest to smallest:

1. Lobe 2. Bronchopulmonary segment 3. Lobule

Sort the following structures from superior to inferior:

1. Nasopharynx 2. Oropharynx 3. Laryngopharynx

Sort these segments of the pulmonary circulation from proximal to distal:

1. Pulmonary trunk 2. Right pulmonary artery 3. Lobar artery 4. Pulmonary capillaries

Match the definition with the term: 1. Amount of air left in the lung after a complete exhale 2. Amount of air inhaled and exhaled during normal breathing 3. Amount of air that can be inhaled "on top of" a normal inhale 4. The total amount of air that a person can move into, or out of, their lungs

1. Residual volume 2. Tidal volume 3. Inspiratory reserve volume 4. Vital capacity

Sort these structures in the order that air would pass through them during inhalation.

1. Respiratory bronchiole 2. Alveolar duct 3. Alveolar sac 4. Alveoi

Match each of the following structures with their anatomical classification: 1. Nose 2. Trachea 3. Bronchi 4. Pharynx

1. Upper respiratory tract 2. Lower respiratory 3. Lower respiratory 4. Upper respiratory tract

Approximately how many hemoglobin molecules are in red blood cell?

250 million

At a partial pressure of oxygen of 60 mm Hg, hemoglobin is ___ percent saturated.

90

Diffusion results from:

A difference in concentration

Dead space air is best describe as:

Air that does not participate in gas exchange

The respiratory center is located in the:

Brainstem

Coughing and sneezing both attempt to:

Clear irritants from the airways

Which structure is responsible for the large surface area of the nasal cavity?

Conchae

As blood moves along the length of the pulmonary capillary, the partial pressure gradient of oxygen:

Decreases

Atmospheric pressure is:

Determined as the mathematical sum of all the partial gas pressures that make it up

Input from the chemoreceptors (aortic and carotid bodies) enters the respiratory center via the:

Dorsal respiratory group

A 7-year-old boy was brought to the clinic by his mother because she has noticed that he seemed to have trouble breathing. She said that it was not constant, but she really noticed it earlier in the spring, and it seems to come back up whenever he plays with his friends. She is concerned that he has anxiety and tried to limit the amount of time he spends around groups of children. She noted that while he played, he would seem to have difficulty breathing, would take frequent breaks from running, and would have coughing spells. During a medical history, the boy stated that he enjoyed being around his friends, but he got winded easily making it difficult to keep up with others. He also noted that he would cough something up when he started feeling like he couldn't breathe. When I questioned what he was coughing up, he described a clear sputum with white dots. On physical examination, the physician detected wheezing in both basilar lung fields on auscultation, but no rales or stridor. The heart and abdominal sounds were normal. There was no fever and no lymphadenopathy. What is the likely problem the patient is suffering from?

Exercise-induced asthma * This is a classic case of exercise-induced asthma in a young patient. Lung cancers are very rare in someone this age, and he didn't present with a bloody sputum. There was no evidence of infection. The little white dots are called Curschmann's spirals, microscopic mucus plugs that come from the bronchioles, and are usually diagnostic for asthma.

A 4-year-old male was brought to the emergency department just before one in the morning because of violent coughing after eating peanuts. On physical examination, his lips looked cyanotic (blue) and he continued to cough. After a talking to him for a short time, the attending physician was able to determine that at some point, the young boy began to wonder how many peanuts would fit in his nose. What is the likely problem the patient is suffering from?

Foreign material in his lung. * The peanuts have moved through his nasopharynx into his lungs, which is responsible for the violent coughing and the peripheral hypoxia - causing the cyanosis in his lips. An acute allergy to peanuts would cause a systemic response akin to anaphylactic shock. Foreign material in his throat would be loosened by his coughing.

Carbaminohemoglobin is:

Hemoglobin with carbon dioxide bound to it

There are a number of professional athletes that sleep in either hypo- or hyper-baric chambers. Discuss the pros and cons of using such devices.

Hyperbaric chambers have been shown to reduce swelling, promote wound healing, fight infections and increase blood O2 levels. Hypobaric chambers have been shown to increase capillary density within muscle, and to increase the efficiency of mitochondria in O2 usage.

If a greater pressure difference is generated between the atmosphere and the lungs, and the airways maintain their diameter, the flow rate of air entering the lungs will?

Increase

If the volume occupied by a gas decreases by 1/3 (i.e. to 2/3 of original volume), what will happen to the pressure of the gas?

Increase by 50%

During the process of internal respiration, oxygen diffuses ___ systemic cels and carbon dioxide diffuses ___ systemic cells.

Into, out of

Which of the following pressures are less than atmospheric pressure (760 mm Hg)?

Intrapleural pressure

During expiration, how does intrapulmonary pressure compare to atmospheric pressure?

Intrapulmonary pressure is higher

Without chloride shift:

Less carbon dioxide would be transformed to bicarbonate

The partial pressure gradient for carbon dioxide across the respiratory membrane is ___ than that for oxygen. The rate of diffusion of carbon dioxide across the respiratory membrane is ___ than that of oxygen.

Less, more

The number of primary bronchi match the number of ___ that we have.

Lungs

If a mixture of gas is composed of 50% O2 and 50% CO2, and a beaker of water is placed in the mixture:

More CO2 than O2 will dissolve in the beaker of water

The ability of a gas to dissolve in water is dependent on which of the following:

Partial gas pressure, chemical solubility and temperature

When the airways constrict, the most likely value to be affected is the:

Peak expiratory flow

The region of the brainstem though to be most responsible for generating a basic pattern of breathing is the:

Pre- Bötzinger area

A benefit of humidifying air prior to its arrivial in the respiratory division:

Prevents dryness of the lung tissue

Surfactant is necessary for:

Reducing surface tension in the alveoli

Is ventilation controlled by the autonomic nervous system? Which aspects of ventilation seem to argue for, and which against, being autonomically controlled?

Respiration can be controlled by changes in CSF pH, Po2 in arterial blood and mechanoreceptors in the airways and lungs, all at an autonomic level. The control of respiration by the medulla is also at an autonomic level, which can be over-ridden by inputs from the cortex.

Populations that live at altitude (such as the Sherpas of Tibet) are better adapted to the low oxygen levels than those that travel from lower climates and acclimatize for several months at higher elevation. Predict possible reasons, including physiological benefits, that might explain how these high-altitude dwellers can thrive in their native environment.

Sherpas of Tibet have the following changes: more efficient mitochondria, producing more energy with less O2; vascular changes to small blood vessels keeping them open during low O2 levels and a lot-shifted hemoglobin:O2 binding curve.

Zones of blood flow through the lungs are most directly determine by :

The relationship between alveolar pressure and capillary pressure

Transpulmonary pressure is the pressure measured across:

The visceral pleura

If you have two chambers of different volumes, but the same partial pressure of oxygen in each chamber, this would mean:

The volume of oxygen would be greater in the larger chamber

If a person has one lung lobe removed (due to lung cancer, for example), to what extent would you expect this to impact gas exchange and ventilatory volumes? What types of respiratory compensation would you expect after the surgery?

This would decrease the ability of the lungs to supply oxygen and remove carbon dioxide. This would be most notable when exercising or walking up stairs. It would generally decrease all ventilatory volumes. Compensation would likely be an increase rate of breathing - hypercapnia.

A normal resting breath is also called the:

Tidal volume

If a beaker of water with an initial P O2 of 0 mmHg is placed into a gas mixture with a P O2 of 100 mmHg, what is the resulting P O2 in the water (after equilibrium)?

Undetermined with the given parameters * Volumes and solubility coefficients are unknown

Fetal hemoglobin binds oxygen ___ than adult hemoglobin.

With greater affinity