resp

Homeostatic Imbalances

  1. Tonsillitis

    1. Pharyngeal tonsil inflamed from a bacterial infection, obstructs nasopharynx (can no longer breathe through nose)

    2. Have to breath through mouth - air does not properly get moistened, warmed, or filtered before the lungs → infection in the palatine tonsils in the oropharynx

  2. Laryngitis

    1. Inflamed & swollen vocal folds → voice gets hoarse or inability to speak above a whisper

    2. Caused by overuse of voice, very dry air, bacterial infection, tumors on vocal folds, inhalation of irritating chemicals

  3. Heimlich maneuver

    1. Used to stop people from suffocating after choking on food during tracheal obstruction

    2. Emergency tracheostomy may be needed

  4. Smoking

    1. Destroys the cilia → coughing is the only method of preventing mucus from accumulating in the lungs

  5. Pleurisy

    1. Inflammation of the pleura from decreased secretion of pleural fluid → pleural surfaces become dry + rough → friction + stabbing pain with each breath

  6. Pleural effusion

    1. Pleurae produce excessive fluid + exert pressure on the lungs → hinders breathing movements but is less painful than pleurisy

  7. Atelectasis

    1. Bronchiole plugged → collapse of part or all of a lung, making it useless for ventilation

    2. Happens when air enters pleural space through a wound, rupture of the visceral pleura → air enters pleural space from respiratory tract, blockage of air passages (from pneumonia, foreign object, tumor, or mucus plug), or pressure on lung

  8. Pneumothorax

    1. Presence of air in the intrapleural space

    2. Reversed by drawing air out with chest tubes, which allows the lung to inflate + function

  9. Hypoxia

    1. Inadequate oxygen delivery to body tissues

    2. Fair-skinned people become cyanotic, dark-skinned people’s mucosae & nailbeds change

    3. Result of anemia (anemic hypoxia), pulmonary disease (hypoxemic hypoxia), impaired or blocked blood circulation (ischemic hypoxia), or inability to use O2 due to poisons like cyanide (histotonic hypoxia)

  10. Carbon monoxide poisoning

    1. Unique type of hypoxemic hypoxia

    2. CO competes with oxygen for the binding sites on hemoglobin, and it usually wins cuz it crowds out or displaces oxygen

    3. Patients are given 100% oxygen until the CO is gone

    4. Confusion & throbbing headache, possible cherry-redness of the skin (color of hemoglobin-CO complex) – not cyanosis or respiratory distress

  11. Suppressed medullary centers

    1. Overdose of sleeping pills, morphine, or alcohol → respiration stops completely → death

  12. Emphysema

    1. Alveoli enlarge as adjacent chambers break through → fewer & larger air sacs

    2. Chronic inflammation promotes lung fibrosis → airways collapse during expiration & obstruct outflow of air

    3. A lot of energy to exhale, overinflation of lungs (permanent barrel chest), damage to capillaries increases resistance in pulmonary circuit (right ventricle overowrks & enlarges), late cyanosis

  13. Chronic bronchitis

    1. Mucosa of lower respiratory passages becomes inflamed → mucus production increases → impairs ventilation & gas exchange → risk of lung infection increases, pneumonia is common, hypoxia & cyanosis occur early

  14. Hyperventilation

    1. Overbreathing - state of breathing faster/deeper than necessary

    2. Carbon dioxide & other sources of acids accumulate in blood → blood pH starts to drop → hyperventilation → blows off more carbon dioxide & decreases the amount of carbonic acid → blood pH returns to normal range

    3. Leads to hypocapnia, apnea, cyanosis, dizzying & fainting from alkalosis causing blood vessels to constrict

  15. Hypoventilation

    1. Respiratory depression - when ventilation is inadequate to perform the needed gas exchange

    2. Blood somehow becomes more basic → breathing slows → carbon dioxide & carbonic acid accumulates in the blood and brings blood pH back to normal range

    3. Possible alkalosis

  16. Chronic Obstructive Pulmonary Disease (COPD)

    1. Usually have a history of smoking, dyspnea becomes more severe, coughing & pulmonary infections are common

    2. Most victims retain CO2, are hypoxic, & have respiratory acidosis

  17. Infant Respiratory Distress Syndrome (IRDS)

    1. From being born prematurely or inadequate surfactant production

    2. Have dyspnea within hours after birth, taking energy to reinflate alveloli after each breath

    3. Treat by spraying surfactant on the airway until it can make its own, or devices that maintain postitive pressure & keep alveoli open & working in gas exchange until the lungs can make their own surfactant

  18. Cystic fibrosis

    1. Caused by a faulty gene for the CFTR protein (chloride Cl– channel controlling its flow in and out of cells)

    2. CFTR gets stuck in the endoplasmic reticulum & cannot reach the plasma membrane to perform its normal function

    3. Oversecretion of thick mucus → impairs food digestion by clogging ducts delivering pancreatic enzymes & bile to the small intestine

  19. Cleft palate

    1. The two plates making the hard palate are not joined (also soft palate cleft & cleft lip) → uvula is usually split

    2. Hole in roof of mouth connects mouth to nasal cavity → air leaks into nasal cavity resulting in a hypernasal voice & nasal emissions

    3. Treat with speech therapy, prosthetics, or surgery

  20. Sudden Infant Death Syndrome (SIDS)

    1. Seemingly healthy infant stops breathing and dies during sleep

    2. Thought to be a problem of the neural respiratory control, viral infection, or heart rhythm abnormalities

  21. Asthma

    1. Chronic inflamed hypersensitive bronchial passages that respond to many irritants (dust mite & cockroach droppings, dog dander, fungi)

    2. Dyspnea, coughing, and wheezing in response to irritants

    3. Treatment by use of inhalers with bronchodialatory chemicals (inhaled corticosteroids treat the underlying condition) or antileukotrienes and antibodies against the IgE class to limit airway inflammation

  22. Aging

    1. Decreased elasticity of lungs, vital capacity, and blood oxygen levels

    2. Sleep apnea from sleeping flat and CO2 levels decreasing

    3. Less efficient protective respiratory system mechanisms

    4. Ciliary activity of mucosa decreases, phagocytes in lungs become sluggish

    5. More risk of respiratory tract infection

  23. Lung Cancer

    1. Squamous cell carcinoma – originates in bronchial epithelium

    2. Adenocarcinoma – originates in glandular tissue

    3. Small cell carcinoma – originates in neuroendocrine cells in the main bronchi and may abnormally secrete ACTH or ADH hormones


All of the pnea’s

  1. Eupnea - normal (12-15/min)

  2. Hyperpnea - increased (exercise)

  3. Apnea - stop (sleep in old people)

  4. Dyspnea - labored (COPD, IRDS, Asthma)


Volumes & Capacities

  1. Tidal volume TV = amount of air moved with each normal breath (500 ml)

  2. Inspiratory reserve volume IRV = amount of air that can be taken in forcibly over the TV

  3. Expiratory reserve volume ERV = amount of air that can be exhaled forcibly

  4. Residual volume RV = air remaining in lung after exhaling all the way

  5. Inspiratory capacity IC = TV + IRV = max amount of air that can be inhaled after a TV expiration

  6. Functional residual capacity FRC = ERV + RV = volume remaining in lungs after TV expiration

  7. Vital capacity VC = TV + IRV + ERV = total amount of exchangeable air

  8. Total lung capacity TLC = TV + IRV + ERV + RV = sum of all lung volumes 

  9. Dead space volume = air that remains in conducting and never reaches alveoli

  10. Functional volume = air that actually reaches the respiratory zone


Events of Respiration

  1. Pulmonary ventilation - plain ol’ breathing - air in n out of lungs

    1. Volume changes in thoracic cavity → pressure changes → flow of gases to equalize pressure

  2. External respiration - gas exchange between pulmonary blood and alveoli - gas exchanges are being made between blood and body exterior

    1. Oxygen movement into the blood: alveoli have more O2 than blood, oxygen moves towards lower concentration aka pulmonary capillaries

    2. Carbon dioxide movement out of blood: blood has higher CO2 levels than alveoli, alveoli gets CO2 from pulmonary capillaries

  3. Respiratory gas transport - oxygen and carbon dioxide transported to and from the lungs and tissue cells via the bloodstream

    1. Oxygen: attaches to hemoglobin

    2. Carbon dioxide: small amount on hemoglobin, most in plasma as bicarbonate ion, an important blood buffer

  4. Internal respiration - gas exchanges between blood and cells inside the body

    1. Oxygen: diffuses from blood to tissue

    2. Carbon dioxide: diffuses to blood from tissue


Laws

  1. Boyle’s law: at constant temp, pressure of gas (P) varies inversely with its volume (V)

  2. Dalton’s law: total pressure exerted by a mixture of gases = sum of the pressures exerted independently by each gas in the mixture. Directly proportional to the percentage of that gas in the mixture

  3. Henry’s law: gas + liquid = gas dissolves in liquid in proportion to its partial pressure. > concentration of the gas, faster it will dissolve