Discuss Hyperpnea of exercise Describe the process and effects of acclimatization to high altitude.

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.

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.

Increase in ventilation during exercise is due to 3 neural factors:

Psychological stimuli . Cortical motor activation of skeletal muscles and respiratory centers. Excitatory impulses from proprioceptors in muscles, tendons, and joints.

Gradual increase/decrease and plateauing of respiration reflect the rate of CO2 delivery to the lungs. Abrupt decrease in ventilation after exercise reflects the shutting off of the 3 neural factors. Gradual decline to baseline ventilation reflects a decline in CO2 flow as the oxygen deficit is being repaired.

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 useless due to oxygen deficit being in the muscles not the lungs.

Most people live between sea level and an altitude of 2400m (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 edema may occur.

Acclimatization: respiratory and hematopoietic adjustments to altitude by:

Chemoreceptors become more responsive to increases in PCO2

due to decrease in atrial PO2 substantial decrease in PO2, directly stimulates peripheral chemoreceptors.

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.

High-altitude conditions result in lower-than normal hemoglobin 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 accelerate production of erythropoietin

Stimulates bone marrow production of red blood cells This phase of acclimatization occurs slowly, providing longterm compensation for living at high altitudes.

Compare the causes and consequences of chronic bronchitis, emphysema, asthma, tuberculosis, and lung cancer.

COPD, exemplified best by Emphysema and Chronic bronchitis.

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. 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.

Patients share common features such as:

Permanent enlargement of the alveoli, destruction of the alveolar walls. 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 ventilation efficiency.

Alveolar Changes in Emphysema

Inhaled irritants lead to chronic excessive mucus production by the mucosa in the lower respiratory passageway and to inflammation and fibrosis of that mucosa. These responses obstruct the airways and severely impair lung ventilation and gas exchange Pulmonary infections are frequent because bacteria thrive in the stagnant pools of mucus.

Categorized by:

Dyspnea, wheezing, and chest tightness

Initially thought to be due to a consequence of bronchospasm triggered 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 IgE and recruit inflammatory cells to the site. Inflammation makes the airways hypersensitive to any irritant Once airways thickened with inflammatory exudates, the effect of bronchospasm is magnified.

http://www.youtube.com/watch?v=vqr78Wj4xM&feature=BFa&list=PL871AFE0DE3A978C2&lf= results_main

Infectious disease caused by the bacterium Mycobacterium tuberculosis Spread by coughing, inhaled air Treatment entails a 12-month course of antibiotics

Potential concern are deadly strains of drug-resistant TB, when treatment incomplete or inadequate

Leading cause of death, causing more deaths than breast, prostate, and colorectal cancer combined. Largely preventable
Nearly 90% are a result of smoking Cure rate is notoriously low, most victims die within 1 year or diagnosis Overall 5 year survival rate is about 17%

Three most common types of cancer:

Squamous cell carcinoma (25-30% of cases) arises in the epithelium of the bronchi Adenocarcinoma (40% of cases) originates in peripheral lung areas Small cell cacinoma (20% of cases) contains lymphocyte like cells that originate in the main bronchi and grow aggressively.

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 5th week Mucosae of the bronchi and lung alveoli are present by the 8th week. By the 28th week, a baby born prematurely can breathe on its own.

During fetal life, the lungs are filled with fluid and all respiratory exchanges are made by the placenta. Vascular shunts cause blood to bypass the lungs At birth, the fluid-filled pathway empties and the respiratory passageways fill with air. As PCO2 rises in the babys blood, respiratory centers are excited and the alveoli inflate, begin functioning in gas exchange.

Respiratory rate is highest in newborns and slows until adulthood Meanwhile, the lungs continue to mature and more alveoli are formed until young adulthood. Respiratory efficiency decreases in old age due to ciliary activity of the mucosa decreasing and the macrophages in the lungs become sluggish.

The chronic obstructive pulmonary disease is exemplified best by? A) Asthma B) Emphysema C) Tuberculosis D) Lung Cancer