What is the significance of the large
compliance of the pulmonary arteries?
allows the pulmonary arteries to
accommodate the stroke volume output of
the right ventricle
Lymph from the lungs primarily drains
through what?
right thoracic lymph duct
When the concentration of oxygen in the
alveoli decreases, what occurs, resulting in
automatic regulation of pulmonary blood
flow distribution?
If some alveoli are poorly ventilated so that
their oxygen concentration becomes low,
the local vessels constrict. This causes the
blood to flow through other areas of the
lungs that are better aerated, thus providing
an automatic control system for distributing
blood flow to the pulmonary areas in
proportion to their alveolar oxygen
pressures.
Left heart failure will likely result in what
clinically?
pulmonary edema
Why would the flow into the left atrium and
the left ventricular output be about 1 to 2
per cent greater than the right ventricular
output?
Blood also flows to the lungs through small
bronchial arteries that originate from the
systemic circulation, amounting to about 1
to 2 per cent of the total cardiac output (this
blood supplies the lungs).
Normal pulmonary pressures.
Systolic - 25 mmHg
Diastolic - 8 mmHg
Mean - 15 mmHg
Capillary - 7 mmHg
How do the lungs accommodate increased
cardiac output during exercise (increased
blood flow)?
by increasing the number of open
capillaries; and by distending all the
capillaries and increasing the rate of flow
through each capillary (pulmonary arterial
pressure does not have to rise as much)
What is the mechanism for keeping the
alveoli "dry" or from collapsing?
negative pressure in the interstitial spaces
What is the acute safety factor in the body Pleural effusion
that prevents pulmonary edema?
collection of large amounts of free fluid in
pulmonary capillary pressure elevates to the pleural space
compensate left atrial pressure rise (once it
rises above 25-30 mmHg death from
pulmonary edema can occur within hours)

What is the potential space? What causes the negative pressure in the
pleural space?
space between the visceral and parietal
pleura; thin layer of fluid (pressure within pumping of fluid from the space by
the space is -7 mmHg to keep the lungs lymphatics
from collapsing)

CHAPTER 39 PULMONARY CIRCULATION, PULMONARY EDEMA, PLEURAL FLUID

The pressure is directly proportional to the How is the alveolar air composition
____________ of the gas molecules. different from atmospheric air?

concentration it is humidified, higher carbon dioxide,

lower oxygen

What two factors control oxygen As alveolar ventilation increases, what

concentration in the alveoli? occurs to alveolar PCo2 and PO2?

the rate of absorption of oxygen into the PCo2 - decreases; PO2 - increases
blood and rate of entry of new oxygen into
the lungs by the ventilatory process

Respiratory unit Because of the extensiveness of the

_______ ______, the flow of blood in the
respiratory bronchiole, alveolar ducts, atria, alveolar wall has been described as a
and alveoli “sheet” of flowing blood.

capillary plexus

Factors that affect the rate of gas diffusion. What is the physiologic shunt?

thickness of the membrane, surface area of venous blood passing through the
the membrane, diffusion coefficient of the pulmonary capillaries that does not become
gas in the substance of the membrane, and oxygenated
partial pressure difference of the gas
between the two sides of the membrane

What is the ventilation-perfusion ratio?
ratio of alveolar ventilation to alveolar
blood flow (Va/Q)
Under normal conditions, the alveolar air
Po2 averages ___ mm Hg and the Pco2
averages __ mm Hg.
104; 40

What creates physiologic dead space?

ventilation is high but blood flow is

inadequate (ventilation of these alveoli is
wasted)

What results from abnormalities in

ventilation-perfusion ratio in the upper and
lower lung?

at the top of the lung, there is a moderate

amount of physiologic dead space (more
ventilation, less blood flow) while at the
bottom of the lung, there is physiologic
shunt (less ventilation, more blood flow)

CHAPTER 40 PRINCIPLES OF GAS EXCHANGE; DIFFUSION OF OXYGEN ABD CARBON DIOIDE

THROUGH RESPIRATORY MEMBRANE
The transport of oxygen and carbon dioxide
is dependent on what two factors?
diffusion (partial pressure difference) and
blood flow
How can blood still be oxygenated during
strenuous exercise, when the time it remains
in the pulmonary capillaries may be reduced
by up to one half normal?
increased capillary surface area, more ideal
ventilation-perfusion ratio in the upper lung,
blood is normally oxygenated in the first 1/3
of the pulmonary capillary so even when the
time is reduced it will still cause full
oxygenation

If cell metabolism of oxygen increases, how If blood flow increases, how is interstitial
is interstitial Po2 affected? Po2 affected?
decreases
What is the primary difference between the
diffusion of oxygen and carbon dioxide?
carbon dioxide can diffuse about 20 times as increases
rapidly as oxygen
How would increased tissue metabolism
affect interstitial Pco2?
increases
Usual oxygen saturation of systemic arterial
blood averages?
97
What can cause up to a 20-fold increase in
oxygen transport to the tissues in well
trained athletes?
3-fold increase in oxygen delivery to tissues
(oxygen dissociates from hemoglobin), 6-7
times increase in cardiac output
What is the "oxygen buffer" function of
blood hemoglobin?
the level of alveolar oxygen may vary
greatly—from 60 to more than 500 mm Hg
Po2—and still the Po2 in the peripheral
tissues does not vary more than a few
millimeters from normal
Bohr effect
increases
How would decreased blood flow affect
interstitial Pco2?
What is depicted on the oxygen-hemoglobin
dissociation curve?
progressive increase in the percentage of
hemoglobin bound with oxygen as blood
Po2
increases, which is called the per cent
saturation of hemoglobin
Under normal conditions, about __ mL of
oxygen are transported from the lungs to the
tissues by each ___ mL of blood flow.
5; 100 (97% to 75% hemoglobin saturation
on passing through the tissue capillaries)
The percentage of the blood that gives up its
oxygen as it passes through the tissue
capillaries is called the __________
___________.
utilization coefficient
Shifts the oxygen-hemoglobin dissociation
curve to the right.
increased hydrogen ions (pH), increased
CO2, increased temperature, increased 2,3
biphosphoglycerate (BPG)
binding of carbon dioxide with hemoglobin
tends to displace oxygen
CHAPTER 41 TRANSPORT OF OXYGEN AND CARBON DIOXIDE IN BLOOD AND TISSUE
FLUIDS
Respiratory center in the medulla (3
groups).
dorsal respiratory group - inspiration
ventral respiratory group - expiration
pneumotaxic center - located dorsally in the
superior portion of the pons, which mainly
controls rate and depth of breathing
Increased signal from the pneumotaxic
center causes what?
decreased depth and increased rate of
breathing
Nuclei associated with the ventral
respiratory group.
nucleus ambiguus (rostrally) and nucleus
retroambiguus (caudally)
Hering-Breuer inflation reflex
stretch receptors located in the walls of the
bronchi and bronchioles of the lungs
transmit signals through the vagi into the
dorsal respiratory group of neurons when
the lungs become overstretched (switch off
inspiration)
Chemoreceptors (respond to blood oxygen
changes)
Important nucleus associated with the dorsal
respiratory group.
solitary nucleus (CN IX and X)
Nucleus associated with the pneumotaxic
center.
nucleus parabrachialis
Nuclei associated with the ventral
respiratory group.
nucleus ambiguus (rostrally) and nucleus
retroambiguus (caudally)
Main function of the ventral respiratory
group.
function to increase forceful inspiration and
expiration with increased pulmonary
ventilation such as with heavy exercise
(does not function during normal, quiet
breathing)
The chemoreceptive area of the respiratory
center responds to changes in?
blood carbon dioxide or hydrogen
concentration
Their afferent nerve fibers pass through
Hering’s nerves to the glossopharyngeal
carotid bodies and aortic bodies nerves and then to the dorsal respiratory
area of the medulla.

carotid bodies

Their afferent nerve fibers pass through the

vagi, also to the dorsal medullary
respiratory area.

aortic bodies

Which is stimulated more rapidly, What occurs during acclimatization?

peripheral chemoreceptors or central
stimulation? sensitivity to CO2 decreases and low
oxygen is able to stimulate increased
peripheral chemoreceptors (however, central alveolar ventilation
stimulation is more powerful; peripheral
may play a key role in increase of CO2 at
onset of exercise

Why does increased breathing rate occur What is the difference between obstructive
almost simultaneous to the start of exercise? and central sleep apnea?

collateral impulses excite the respiratory obstructive - overweight, fat may be

center from the vasomotor center of the compressing the pharynx, enlarged tonsils,
brain stem nasal obstruction
central - central nervous system drive to the
ventilatory muscles transiently ceases

CHAPTER 42 REGULATION OF RESPIRATION

Methods to assess pulmonary performance. Maximum expiratory flow

blood Po2, CO2, pH When a person expires with great force, the
expiratory airflow reaches a maximum flow
beyond which the flow cannot be increased
any more even
with greatly increased additional force.
Forced expiratory vital capacity (FVC)

maximum inspiration followed by

maximum expiration into a spirometer used
as a clinical pulmonary test
Forced expiratory vital capacity (FVC)
maximum inspiration followed by
maximum expiration into a spirometer used
as a clinical pulmonary test
Effects of pulmonary emphysema.
increases airway resistance, decreased
diffusing capacity in alveolar walls due to
destruction, abnormal ventilation-perfusion
ratios (physiologic shunt in some parts and
physiologic dead space in others),
pulmonary hypertension (right sided heart
failure)
Collapse of the alveoli.
Atelectasis (caused by total obstruction of
the airway or lack of surfactant in the fluids
lining the alveoli)
When the asthmatic person breathes in
pollen to which he or she is sensitive (that
is, to which the person has developed IgE
antibodies), the pollen reacts with the mast
cell–attached antibodies and causes the mast
cells to release?
histamine, leukotrienes, eosinophilic
chemotactic factor, bradykinin
Tuberculosis is marked by decreased what?
Causes of pulmonary emphysema.
chronic infection, chronic obstruction,
entrapment of air in the alveoli causing
destruction
Any inflammatory condition of the lung in
which some or all of the alveoli are filled
with fluid and blood cells.
pneumonia
With one lung entirely collapsed, mean
oxygen saturation is not greatly affected
(versus in pneumonia when it may be
greatly reduced if only 1 lung is affected),
why?
the collapsed lung does not receive much
blood flow so all the blood must pass
through the remaining lung, in pneumonia
the mean oxygen saturation will be an
average of the unaffected and affected lung
so it will be greatly reduced
The functional residual capacity and
residual volume of the lung become
especially ________ during the acute
asthmatic attack because of the difficulty in
expiring air from the lungs.
increased
Oxygen therapy is 100% effective in which
type of hypoxia?
vital capacity and breathing capacity; total
respiratory membrane surface area;
pulmonary diffusing capacity; and abnormal
ventilation-perfusion ratio
In which types of hypoxia is oxygen
therapy not effective?
anemia, abnormal hemoglobin transport of
oxygen, circulatory deficiency, or
physiologic shunt, inadequate tissue use of
oxygen
Hypercapnia usually occurs in association
with hypoxia only when the hypoxia is
caused by _____________ or __________
____________.
hypoventilation; circulatory deficiency
CHAPTER 43 PULMONARY INSUFFFICIENCY- PATHOPHYSIOLOGY, DIAGNOSIS, OXYGEN
THERAPY
Decrease in _________ _________ is the
basic cause of all the hypoxia problems in
high-altitude physiology.
barometric pressure
Acute effects of hypoxia.
drowsiness, lassitude, mental and muscle
fatigue, headache, nausea, and sometimes
euphoria
atmospheric (also can be effective for
hypoventilation hypoxia but does nothing
for increased CO2 caused by
hypoventilation; also impaired alveolar
membrane diffusion by increasing oxygen
pressure gradient)
Excess carbon dioxide in the body fluids.
hypercapnia
Mental anguish associated with inability to
ventilate enough to satisfy the demand for
air.
dyspnea
Sea Level PCO2 = __ mm Hg
40
Acclimatization
(1) great increase in pulmonary ventilation
due to decreased PO2 - increase slowed by
decreased PCO2
(2) increased number of red blood cells
(hematocrit content)
(3) increased diffusing capacity of lungs
(4) increased vascularity of peripheral
tissues (increased capillarity)
(5) increased ability of the tissue cells to use
oxygen despite low PO2
Increased Pulmonary ventilation - Role of Acute cerebral edema
arterial chemoreceptors
- results from local vasodilation of cerebral
- Immediate exposure to low PO2 stimulates blood vessels caused by hypoxia
arterial chemoreceptors, which increase - can lead to severe disorientation and other
alveolar ventilation to 1.65x normal effects of cerebral dysfunction
- Remaining at altitude for several days can
increase ventilation by 5x normal
- Increase in pulmonary ventilation reduces
PCO2 and increases pH of body fluids

Acute pulmonary edema Effects of a prolonged stay in space:

- local edema can result from constriction of
pulmonary arterioles and increased capillary
pressure in these areas
- typically breathing pure oxygen can
reverse this process in hours
(1) decrease in blood volume
(2) decrease in RBC mass
(3) decrease in muscle strength and work
capacity
(4) decrease in maximum cardiac output
(5) loss of calcium and phosphate from
bones

CHAPTER 44 AVIATION, SPACE, AND DEEP SEA DIVING PHYSIOLOGY

CHAPTER 45 PHYSIOLOGY OF DEEP-SEA DIVING AND OTHER HYPERBARIC CONDITIONS

UNIT 5 EXAM BREAKDOWN
MECHANICS OF VENTIATION =8
RESPIRATORY SYSTEM, ANATOMY = 10
RESPIRATORY SYSTEM HISTOLOGY = 10
BIOENERGETICS, TCA CYCLE, BIOLOGICAL OXIDATION, RESPIRATORY CHAIN = 10
GLYCOLYSIS AND GLUCONEOGENESIS = 8
FA OXIDATION, SYNTHESIS, KETOGENESIS = 8
ADIPOSE TISSUE METABOLISM = 6
AMINO ACID METABOLISM = 4
HEXOSE MONOPHOSPHATE PATHWAY = 7
ALVEOLAR VENTILATION, GAS EXCHANGE, TRANSPORT OF O2 & CO2, REGULATION OF
RESPIRATION = 24
AVAIATION, HIGH ALTITUDE, SPACE, DEEP SEA DIVING =12
POM= 5