anatomy ii presentation
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Discuss Hyperpnea of exercise
Describe the process and effects of
acclimatization to high altitude.
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Respiratory adjustments are geared to both the intensity and
duration of exercise
During vigorous exercise:
Muscles consume large amounts of O2 and produce large amounts of CO2
Ventilation can increase to 20 fold
Increase in ventilation in response to metabolic needs is called Hyperpnea
Exercise-enhanced ventilation is not prompted by rising PCO2 or
declining PO2 or pH in the blood.
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1. As exercise starts:
Ventilation increases abruptly, followed by gradual increase, and then a steady state
of ventilation is reached.
When exercise stops: Abrupt decline in ventilation, followed by gradual decline to the pre-exercise value.
2. Atrial PCO2 and PO2 levels remain surprisingly constant during
exercise.
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Increase in ventilation during exercise isdue to 3 neural factors: Psychological stimuli .
Cortical motor activation of skeletal muscles andrespiratory centers.
Excitatory impulses from proprioceptors in muscles,tendons, and joints.
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Gradual increase/decrease and plateauing ofrespiration reflect the rate of CO2 delivery to the lungs.
Abrupt decrease in ventilation after exercise reflects theshutting off of the 3 neural factors.
Gradual decline to baseline ventilation reflects adecline in CO2 flow as the oxygen deficit is beingrepaired. O2 deficit due to cardiac output limitations or inability of
skeletal muscles to increase their oxygen consumption.
Thus, practice of inhaling pure O2 by mask is uselessdue to oxygen deficit being in the muscles not thelungs.
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Most people live between sea level and an altitude of2400m (8000ft.). In this range, differences in atmospheric pressure are not great
enough to cause healthy people any problems when they spend
brief periods in the higher altitude areas. The body responds to quick movement to elevations
above 8000ft with acute mountain sickness. Symptoms such as headaches, shortness of breath, nausea and
dizziness. Common is travelers in ski resorts.
In severe cases of AMS, lethal pulmonary and cerebral edemamay occur.
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Acclimatization: respiratory and hematopoieticadjustments to altitude by: Chemoreceptors become more responsive to increases in PCO2 due to decrease in atrial PO2
substantial decrease in PO2, directly stimulates peripheralchemoreceptors.
Results in increase in ventilation
Due to brain attempting to restore gas exchange to previous levels.
Minute ventilation stabilizes at level of 2-3L/min higher than the
sea level rate.
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High-altitude conditions result in lower-than normalhemoglobin saturation levels due to: Less O2 being available to be loaded
Hemoglobins affinity to O2 is reduced due to increases in BPG
concentration
When blood O2 levels decline, kidneys accelerateproduction of erythropoietin Stimulates bone marrow production of red blood cells
This phase of acclimatization occurs slowly, providing long-term compensation for living at high altitudes.
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Compare the causes and consequences ofchronic bronchitis, emphysema, asthma,tuberculosis, and lung cancer.
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COPD, exemplified best by Emphysema and Chronicbronchitis.
Major cause of death and disability in North America.
Key physiological feature is an irreversible decrease in the
ability to force air out of the lungs. Patients share common features such as:
More than 80% of patients have a history of smoking
Dyspnea, labored breathing often referred as air hunger,occurs and progressively more severe.
Coughing and frequent pulmonary infections are common
Develop respiratory failure manifested as Hypoventilation,respiratory acidosis, and hypoxemia.
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Permanent enlargement of the alveoli, destruction of the alveolarwalls.
Lungs lose their elasticity
This has 3 important consequences
Accessory muscles must be enlisted to breathe Damage to the pulmonary capillaries as the alveolar walls disintegrate
Bronchioles open during inspiration but collapse during expiration
Traps high volumes of air in the alveoli.
This hyperventilation leads to permanently expended barrel
chest, flattening the diaphragm and reducing ventilationefficiency.
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Alveolar Changes in Emphysema
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Inhaled irritants lead to chronic excessivemucus production by the mucosa in the lowerrespiratory passageway and to inflammation
and fibrosis of that mucosa. These responses obstruct the airways and
severely impair lung ventilation and gasexchange
Pulmonary infections are frequent becausebacteria thrive in the stagnant pools of mucus.
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Categorized by: Dyspnea, wheezing, and chest tightness
Initially thought to be due to a consequence of bronchospasmtriggered by cold air, exercise, or allergens.
However, active inflammation of the airways was found to
precede bronchospasms. Air inflammation, is an immune response under the control of Th 2
cells, that secrete interleukins & stimulate the production of IgEand recruit inflammatory cells to the site.
Inflammation makes the airways hypersensitive to any irritant
Once airways thickened with inflammatory exudates, the effect ofbronchospasm is magnified.
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Infectious disease caused by the bacteriumMycobacterium tuberculosis
Spread by coughing, inhaled air
Treatment entails a 12-month course ofantibiotics
Potential concern are deadly strains of drug-resistantTB, when treatment incomplete or inadequate
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Leading cause of death, causing more deathsthan breast, prostate, and colorectal cancercombined.
Largely preventable Nearly 90% are a result of smoking
Cure rate is notoriously low, most victims die within1 year or diagnosis
Overall 5 year survival rate is about 17%
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Three most common types of cancer:
Squamous cell carcinoma (25-30% of cases) arises inthe epithelium of the bronchi
Adenocarcinoma (40% of cases) originates inperipheral lung areas
Small cell cacinoma (20% of cases) containslymphocyte like cells that originate in the main
bronchi and grow aggressively.
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Embryos develop in a head to tail direction Upper respiratory structures appear first
Olfactory placodes invaginate into olfactory
pits, which form the nasal cavity by the 4th
week.
Laryngotracheal buds are present by the 5thweek
Mucosae of the bronchi and lung alveoli arepresent by the 8th week.
By the 28th week, a baby born prematurely canbreathe on its own.
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During fetal life, the lungs are filled with fluidand all respiratory exchanges are made by theplacenta.
Vascular shunts cause blood to bypass thelungs
At birth, the fluid-filled pathway empties andthe respiratory passageways fill with air.
As PCO2rises in the babys blood, respiratorycenters are excited and the alveoli inflate, beginfunctioning in gas exchange.
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Respiratory rate is highest in newborns andslows until adulthood
Meanwhile, the lungs continue to mature and
more alveoli are formed until youngadulthood.
Respiratory efficiency decreases in old age dueto ciliary activity of the mucosa decreasing andthe macrophages in the lungs become sluggish.
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The chronic obstructive pulmonary disease isexemplified best by?
A) Asthma
B) Emphysema C) Tuberculosis
D) Lung Cancer
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