Functional organization of Respiratory system

1. How many types of bronchi in lungs?

Ans. primary, secondary and tertiary bronchi
2. What is the extension of conducting zone?
Ans. from nose to terminal bronchiole ( upto generation 16)
3. What is the extension of gas exchange area?
 From 17thgeneration to 23rd generation or or from respiratory bronchioles to alveolar
sacs.
4. Name the types and functions of alveolar epithelial cells?
 Type I alveolar epithelial cells(type 1 pneumocytes): where gas exchange occurs
 Type II alveolar cells (type 2 Pneumocytes):secrete alveolar surfactant
5. Name the layers of respiratory membrane.
• Ans. 6 Layers of membrane
1. layer of fluid and surfactant
2. alveolar epithelial wall of type I cells
3. alveolar epithelial basement membrane
4. interstitial space
5. capillary basement membrane
6. endothelial cells of capillary

Pulmonary ventilation
6. Define Alveolar pressure(also called intra-alveolar pressure).
 Pressure of air inside alveoli. It is -1 cm of H2O during inspiration and +1cm of H2O
during expiration.
7. Pleural pressure(also called Negative intrapleural pressure)
 Pressure in pleural cavity. It is -5 cm of H2O at the beginning of inspiration and becomes
upto -7.5 during inspiration
8. Transpulmonary( also called Transmural) pressure
 Difference between alveolar pressure and pulmonary pressure (require to expand lungs
9. Name the muscle of inspiration.
 Diaphragm (main muscle at resting condition), sternocleidomastoid, scalene, pectoralis
minor(accessary muscles when forceful inspiration is required).
10. Name the muscle of expiration.
 Elastic recoil of lung ( main factor during resting condition), muscles of anterior
abdominal wall(when forceful expiration is required).
COMPLIANCE AND SURFACTANT

11. Define Compliance of the Lungs

 Change in lung volume per unit change in transpulmonary pressure.
 Normal compliance 200 ml /cm H 2O
12. What is the composition of surfactant?
 Phospholipid, proteins and calcium
 Major phospholipid is Dipalmitoyl Phosphatidylcholine
 Proteins are SP-A, SP-B, SP-C and SP-D
 Proteins and calcium help to spread the surfactant

13. What are the functions of Surfactant?

 Lowers surface tension of alveoli
 Prevents collapse of lungs
 Prevents formation of pulmonary edema
 Prevents collapse of smaller alveoli
 Its deficiency causes Infant Respiratory Distress Syndrome
14. How lung collapse is prevented?

It is prevented by:

 Surfactant
 Residual volume
 Negative intra-pleural pressure
 Inter-dependence

15. Define Law of Laplace

PULMONARY VOLUMES AND CAPACITIES

16. Name 4 Lung volumes and 4 lung capacities

Lung Volumes
1. Tidal Volume(500ml)
2. Inspiratory Reserve volume(3300ml)
3. Expiratory Reserve Volume(1100ml)
4. Residual Volume(1200ml)
Lung Capacities
1. Inspiratory Capacity(TV+IRV)
2. Functional Residual Capacity(2300ml)(ERV+RV)
3. Vital Capacity(4600ml)(IRV+TV+ERV)
4. Total Lung Capacity(5800ml)(VC+RV)

17. Define Tidal volume

 volume of air inspired or expired in one breath during normal breathing.it is 500ml.
18. Define Vital capacity
 Amount of air maximally inspired and expired forcefully. Amount is 4600 ml
19. Define Residual volume.
 Amount of air that remains in the lungs after forceful expiration. Amount is 1200 ml
20. Define Total lung capacity
 Max volume of air to which lung can be expanded with the greatest possible inspiratory effort.
Value is 5800ml.
21. Define Functional Residual capacity.
 Amount of air remains in lungs after normal expiration.Value:2300ml

22. What is FEV1?

 FEV1: Forced Expiratory Volume in 1st sec. Normally 80 % of FVC
23. What is Alveolar Ventilation?
 Amount of air that enters alveoli per minute
 It is (Tidal volume – Dead Space air) X RR
 (500-150) X 12 = 4200 ml
24. What is the importance of Residual volume?
o Prevents lung collapse
o Prevents blood gas fluctuations and aerates blood during breaths
25. What is the importance of Vital capacity?
 It is used for prognosis of respiratory diseases
26. What is the importance of FEV1/FVC ratio?
 It is used to differentiate between Obstructive and Restrictive diseases.
 Usually ratio is decreased in obstructive diseases
TRANSPORT OF OXYGEN AND CO2

27. How oxygen is transported in blood?

 97% Combined with hemoglobin (Oxyhemoglobin)
 3% dissolved in plasma
28. Define Oxygen Hemoglobin dissociation curve.
 It shows relation between PO2 and % of hb saturated with o2.when po2 increases Hb
saturation also increases.
29. Enlist factors for rightward and leftward shift of oxygen Hemoglobin dissociation curve?
 Right shift curve (Dec affinity for O2) Factors are
 DEC PH
 inc. H ions
 inc co2
 inc. temp
 inc 2 3 diphosphoglycerate

 Left shift curve (inc affinity for O2) Factors are

 INC PH
 dec H ions
 dec co2
 dec temp
 dec 2 3 diphosphoglycerate
 fetal Hb
 Myoglobin
 CO

30. How carbon dioxide is transported in blood?

 7% dissolved in plasma
 23% as carbamino compounds(binds with amino gp of plasma proteins and amino gp of
Hb)
 70% as bicarbonate( HCO3-)

31. What is Bohr effect?

 Right ward shift of O2 –Hb Dissociation curve by changes in blood CO2 and H+
concentration is called Bohr effect(release of oxygen in tissues).
32. What is Haldane effect?
 Binding of O2 with hemoglobin displaces CO2 from the blood this is called Haldane
effect (release of CO2 in lung).
33. What is Chloride shift?
 Inside RBCs, when CO2+H2O form H2CO3, which dissociates into HCO3 and H+ ions. This
HCO3 leaves RBCs and Cl- ions enters inside RBCs to maintain electrical potential balance.
This is called Chloride shift.
REGULATION OF RESPIRATION

34. How the voluntary respiration is controlled?

 Voluntary is controlled by higher centers in cerebral cortex .
35. How the respiration is regulated?
 by Nervous regulation and by Chemical regulation
36. Where the respiratory centers are located?

In Pons
 Pneumotaxic centre
 Apneustic centre
In Medulla Oblongata :-
 Dorsal respiratory group
 Ventral respiratory group

37. What is the function of dorsal respiratory group?

 it causes inspiratory ramp signals
38. What is the function of ventral respiratory group?
 Takes part in active respiration and provides forceful expiration
39. What is the function of pnemotaxic center?
 turns off inspiratory ramp signal
40. what is the function of Apneustic center?
 stimulatory signals to inspiratory area to prolong inspiration (antagonist to pneumotaxic area)
41. what is chemical regulation of respiration?
 Controlled by central and peripheral chemoreceptors.

42. What are central chemoreceptors?

 These receptors are present in medulla and respond to changes in H+ or pCO2. Most sensitive to
H+ but as H+ can’t cross blood brain barrier so CO2 in ECF of brain forms H2CO3 which then forms
H+ and HCO3-
43. What are peripheral chemoreceptors?
 Located in aortic bodies and carotid bodies
 Signals from aortic bodies goes to dorsal respiratory group through vagus nerve
 Signals from carotid bodies goes to dorsal respiratory group through glossopharyngeal nerve
 respond to changes in H+, PaO2 or PaCO2
 Respond to PaO2 when it is less than 60 mm Hg
HYPOXIA AND ITS TYPES

44. Define hypoxia.

 Decrease oxygen in tissues
45. How many types of hypoxia?
 Hypoxic hypoxia--low pO2 in arterial blood (e.g at high altitude)
 Anemic hypoxia--too little functioning Hb (due to anemia)
 Stagnant hypoxia--blood flow is decreased(e.g congestive cardiac failure)
 Histotoxic hypoxia-- Inability to use O2 (e.g cyanide poisoning)
46. How much oxygen therapy is effective in different types of Hypoxia?
 Hypoxic hypoxia------100%
 Anemic hypoxia-------75%
 Stagnant hypoxia-----<50%
 Histotoxic hypoxia------0%

TYPES OF RESPIRATION
50. Define respiration and what are the types of respiration?
 Respiration is the process by which oxygen is taken in and carbon dioxide is given out.
 Respiration is classified into two types:
1. External respiration that involves exchange of respiratory gases, i.e. oxygen and carbon dioxide
between lungs and blood
2. Internal respiration, which involves exchange of gases between blood and tissues.
51. Describe dead space and its types.
 Dead space: the passage from nose to terminal bronchiole where gas exchange does not take
place is called Dead Space. The air present in this area is called Dead Space Air. The volume of
Dead space air is 150ml.
TYPES
 Anatomical dead space air: air in the conducting airways , never reaches the gas exchange area.
 Alveolar dead space air: air in alveoli which are destroyed and don’t take part in gas exchange.
 Physiological dead space air: combination of anatomical dead space air and alveolar dead space
air
52. What is Hering Breuer Reflex
 Expansion of lungs during inspiration stimulates the stretch receptors. Impulses from stretch
receptors reach the dorsal group neurons via vagal afferent fibers and inhibit them. So,
inspiration stops and expiration starts . Thus, the overstretching of lung tissues is prevented.
 However, HeringBreuer reflex does not operate during quiet breathing. It operates, only when
the tidal volume increases beyond 1,000 ml.
PULMONARY CIRCULATION AND ZONES OF LUNG

53. What is the systolic and diastolic pulmonary arterial pressure?

 25/8 mmHg
54. What is the Mean pulmonary capillary pressure?
 7 mm Hg
55. What is the effect of hypoxia on pulmonary vessels?
 Vasoconstriction
56. What is the effect of hydrostatic pressure of pulmonary capillary blood on blood flow?
 When a person is standing, blood flow is lowest at the apex (top) of the lungs and highest at the
base (bottom) of the lungs due to gravitational forces.
 When the person is supine (lying down), these gravitational effects disappear
57. At apices, how much arterial pressure is less from level of heart in upright position?
 15 mm Hg
58. At base, how much arterial pressure is more from level of heart in upright position?
 8mmHg
59. In how many zones, lungs are divided?
 Three( zone 1,2 and 3)
60. How many Zones are present in healthy persons?
 Two( zone 2 and 3)
61. Define all zones of lung?
 Zone 1: No blood flow during all portions of the cardiac cycle because the local alveolar
capillary pressure in that area of the lung never rises higher than the alveolar air
pressure during any part of the cardiac cycle
 Zone 2: Intermittent blood flow only during the peaks of pulmonary arterial pressure
because the systolic pressure is greater than the alveolar air pressure, but the diastolic
pressure is less than the alveolar air pressure
 Zone 3: Continuous blood flow because the alveolar capillary pressure remains greater
than alveolar air pressure during the entire cardiac cycle

62. What do you understand by ventilation perfusion ratio?

 Pulmonary capillary Blood flow should be normal to carry sufficient amount of oxygen
from alveoli. When there is imbalance between alveolar ventilation and alveolar blood
flow. This concept is called the ventilation perfusion ratio. It is expressed as VA /Q .
63. How can you calculate normal ventilation perfusion ratio?
 Normal ventilation is 4.2 L per minute. Normal perfusion is 5L of blood per minute.
 Normal V/Q = 4.2/5 or 0.84.
64. What is the value of V/Q in dead space?
 VA/0= ∞
65. What is the value of V/Q in physiological shunt?
 VA/0= 0
 66. What is physiological shunt?
 About 2% of the pulmonary blood flow by passes the alveoli (shunted blood).This is bronchial
blood flow that drains directly into the left ventricle.

67.
Which zone of lung behaves as physiological shunt?
 Zone 3
68.
Which zone of lung behaves as physiological dead space?
 Zone 1
69.
When coming from apex to base, what is the effect on ventilation?
 Ventilation increases
70.
Name a clinical condition in which VA/Q is increased?
 Emphysema
71.
Name a clinical condition in which VA/Q is decreased?
 Asthma
72.
In VA/Q diagram write down values of PO2 and PCO2 when VA/Q equals to 0, infinity and
normal?
 When VA /Q Equals Zero PO2 is 40 mm Hg and a PCO2 is 45 mm Hg.
 When VA /Q Equals Infinity PO2 is 149 and PCO2 is 0mmHg
 When VA /Q Is Normal PO2 is 104 and PCO2 is 40mmHg

PULMONARY DYNAMICS

73. Name the outward and inward starling forces which are acting on pulmonary capillaries and
their values.
 74. What is the net filtration pressure by which fluid is filtered from arterial end of capillary to
interstitium?
 +1 mmHg

75. How does pulmonary edema develop?

 Any factor that increases fluid filtration out of the pulmonary capillaries or that impedes
pulmonary lymphatic function causes pulmonary interstitial fluid pressure to rise from the
negative into the positive range
 This will lead to rapid filling of the pulmonary interstitial spaces and alveoli with large amounts
of free fluid.
76. What is pulmonary edema safety factor?
 Pulmonary capillary pressure normally must rise to a value at least equal to the colloid osmotic
pressure of the plasma inside the capillaries before significant pulmonary edema will occur.
 Therefore, in the human being, whose normal plasma colloid osmotic pressure is 28 mm Hg, one
can predict that the pulmonary capillary pressure must rise from the normal level of 7 mm Hg to
more than 28 mm Hg to cause pulmonary edema, giving an acute safety factor against
pulmonary edema of 21 mm Hg.

DIFFUSION of GASES

77. What are the values of partial pressure of O2 and N2 gas in atmosphere at sea level?
 partial pressure of nitrogen is 600 mm Hg, and the partial pressure of O2 is 160 mm Hg.
78. What is Fick’s principle?
 Vx=DA ∆P
X
Where
 Vx = Volume of gas transferred per unit time
 D = Diffusion coefficient of the gas
 A = Surface area
 P = Partial pressure difference of the gas
 X = Thickness of the membrane
79. What is Henry’s law?
 Concentration of dissolved gas in solution =Partial pressure x Solubility coefficient

80. What is the explanation of Henry’s law?

 The partial pressure of a gas in a solution is determined not only by its concentration but
also by the solubility coefficient of the gas. That is, some types of molecules, especially
CO2, are physically or chemically attracted to water molecules, whereas other types of
molecules are repelled. When molecules are attracted, more of them can be dissolved
without building up excess partial pressure within the solution. Conversely, in the case
of molecules that are repelled, high partial pressure will develop with fewer dissolved
molecules. These relations are expressed by Henry’s law.

81. What is vapor pressure of the water?

 The partial pressure that the water molecules exert to escape through the surface is
called the vapor pressure of the water. At normal body temperature, 37°C, this vapor
pressure is 47 mm Hg.

82. Define diffusion coefficient of a gas?

 The diffusion coefficient of a gas (D) is a combination of molecular weight and the
solubility of the gas. The diffusion coefficient for CO2 is approximately 20 times higher
than the diffusion coefficient for O2.

83. What are factors affecting the diffusion?

 (1) the thickness of the membrane,
 (2) the surface area of the membrane,
 (3) the diffusion coefficient of the gas in the substance of the membrane, and
 (4) the partial pressure difference of the gas between the two sides of the membrane.
Acclimatization & High altitude

84. What is acclimatization?

 People live at high altitude becomes adapted to low PO2 by increased pulmonary
ventilation, increase number of RBCs, increase vascularity of peripheral tissues.

85. What is acute mountain sickness?

 When low landers suddenly ascend at high altitude, they develop pulmonary edema

86. What is Caisson Disease?

 If a diver has been beneath the sea long enough that large amounts of nitrogen have
dissolved in his or her body and the diver then suddenly comes back to the surface of
the sea. Significant quantities of nitrogen bubbles can develop in the body fluids either
intracellularly or extracellularly and can cause minor or serious damage in almost any
area of the body, depending on the number and sizes of bubbles formed; this is called
decompression sickness or Caisson Disease

87. What is oxygen poisoning or toxicity?

 At high PO2 levels, the amounts of oxidizing free radicals are very high. One of the
principal effects of these free radicals is to oxidize the polyunsaturated fatty acids that
are essential components of many of the cell membranes.
 The nervous tissues are especially sensitive because of their high lipid content. brain
seizures followed by coma.