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BMS 615 Cardiovascular > Test 3: Wk11: 2.2 Mechanisms of Ventilation - Dasgupta > Flashcards

Test 3: Wk11: 2.2 Mechanisms of Ventilation - Dasgupta Flashcards

1
Q

Specific Compliance =

A

Compliance / FRC

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2
Q

FRC adult

FRC Child

A
  1. 5 L

0. 7 L

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3
Q

Specific Compliance Adult

Specific Compliance Child

A

Adult 0.125 / 2.5 = 0.05

Child 0.035 / 0.7 = 0.05

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4
Q

Compliance adult

Compliance child

A

adult .125

child .035

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5
Q

compliance =

A

delta V / delta P

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6
Q

Compliance is measure by a

A

spirometer

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7
Q

spirometer measures

A

lung and chest wall Compliance

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8
Q

lung and chest wall are in

A

series

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9
Q

total Compliance equation

A

1 / total Compliance = 1 / lung Compliance + 1 / Chest Wall Compliance

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10
Q

Compliance is the inverse of

A

resistance

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11
Q

safe to assume that chest wall compliance is

A

normal

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12
Q

the lung is made of connective proteins like

A

collagen and elastin

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13
Q

— is prominent polymeric protein in lung tissue

A

elastin

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14
Q

— degrades elastin

A

elastase

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15
Q

elastase is regulated by

A

alpha-1-antitrypsin

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16
Q

deficiency in alpha-1 antitrypsin or a mutation in alpha-1 antitrypsin synthesis results in

A

widespread lung tissue destruction

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17
Q

smoking is a major risk in emphysema because

A

it inhibits alpha-1 antitrypsin

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18
Q

Alveolar simplification

A

tissue destruction seen in
emphysema

Increased breakdown of structural proteins means that elements of the
alveoli, and ultimately whole alveoli, are lost

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19
Q

emphysema makes the FRC

A

much larger than normal

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20
Q

emphysema also causes

A

destruction of vasculature

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21
Q

most common morphological subtype of emphysema

A

Centrilobular emphysema

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22
Q

Centrilobular emphysema affects

A

the central portion of secondary pulmonary lobules, around the central respiratory bronchioles

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23
Q

— involves the superior part of the lung

A

Centrilobular emphysema

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24
Q

Centrilobular emphysema begins in the

A

respiratory bronchioles and spreads peripherally

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25
Q

Centrilobular emphysema caused by

A

long-standing cigarette smoking, occupational exposure to chemicals, dust etc.

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26
Q

Panacinar emphysema

A

destroys the entire alveolus uniformly

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27
Q

Panacinar emphysema is primarily in

A

the lower half of the lungs

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28
Q

— emphysema observed in patients with homozygous alpha1-antitrypsin (AAT) deficiency or Ritalin-induced lung emphysema

A

Panacinar emphysema

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29
Q

how does Ritalin abuse cause emphysema

A

Ritalin pills contain fillers which are insoluble. These fillers block fine blood vessels in the lung and cause pulmonary hypertension and damage lung tissue

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30
Q

In people who smoke, — at the lung bases may accompany centrilobular emphysema.

A

focal panacinar emphysema

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31
Q

reasons for decrease in compliance

A

interstitial lung dz

loss of surfactant

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32
Q

PV curve shifts — in decrease compliance

A

to the right

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33
Q

Total lung capacity in decreased compliance

A

lowered

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34
Q

reasons for increase in compliance

A

emphysema, loss of elastic fibers

old age

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35
Q

PV curve shifts — in increase compliance

A

to the left

36
Q

Total lung capacity in increased compliance

A

increased

37
Q

increased compliance means the lung is

A

softer

38
Q

decreased compliance means the lung is

A

stiffer

39
Q

slope of PV curve =

A

compliance

40
Q

PV curve shift — with decreased pulmonary surfactant

A

right, decreased compliance

lungs have more surface tension and are stiffer

41
Q

PV curve shift — with removal of one lobe

A

right, decreased compliance

lobes of the lung are in parallel and compliance is in parallel

42
Q

PV curve shift — with obesity

A

right, decreased compliance

fat layers compress thoracic cage

43
Q

PV curve shift — with pulmonary vascular congestion

A

right, decreased compliance

vascular congestion causes edema which floods alveoli washing away surfactant and increasing surface tension

44
Q

laminar flow

A

all molecules of air are flowing parallel to each other

45
Q

airway resistance is inversely proportional to

A

airway radius

46
Q

airway resistance is inversely proportional to the

A

airway radius

47
Q

laminar flow follows the — equation

A

Poisueille

48
Q

airways are arranged in

A

parallel

49
Q

the greatest resistance is in

A

largest airways

50
Q

the region of the lung containing small airways is often referred to as the — because

A

silent zone

low airway flow velocity and resistance

51
Q

the greatest airway resistance AND flow velocity is in the

A

largest airways

52
Q

is turbulent flow or laminar flow faster

A

turbulent is always faster

53
Q

forced exhalation makes the interpleural pressure

A

positve

54
Q

forced exhalation is primarily mediated by

A

internal intercostal muscles and abdominal muscles

55
Q

why is forced exhalation not a problem in normal lungs

A

airways are reinforced with rings of cartilage

56
Q

why is forced exhalation bad in emphysema

A

lung elastic recoil is decreased. this causes the airway to collapse

57
Q

the more effort put into a forced exhalation

A

the more airways collapse and resistance is higher

58
Q

the faster the airflow, the smaller

A

the force holding open the airway - greater tendency to collapse

59
Q

what happens to the airway in emphysema

A

loss of radial traction

loss of tissue

60
Q

what happens to airways in asthma

A

edema of wall during flare

mucus further narrows the airway

61
Q

Radial traction

A

the action of lung tissue on airway walls, tending to hold

them open.

62
Q

“Tethering” of airways or alveoli refers

A

to them being attached to their neighbors

63
Q

Tidal Volume

A

volume of inspired or expired air with each breath

64
Q

Normal tidal vol mL

A

500mL

65
Q

Dead Space Vol

A

air not used for gas exchange

66
Q

Dead Space Vol mL

A

150 mL

67
Q

Residual volume

A

amount of air remaining in lungs

68
Q

Residual Vol amount

A

1-2 L

69
Q

Total Lung Capacity

A

Volume of air in the lungs after a maximal inspiratory effort

70
Q

Total Lung Capacity amount TLC

A

6000 mL

71
Q

Forced Vital Capacity (FVC)

A

amount of air that can be exhaled as quickly during forced exhalation

72
Q

Forced Vital Capacity (FVC) amount

A

4600 mL

73
Q

Forced expiratory volume in 1 second (FEV1)

A

amount exhaled in the first second

74
Q

Forced expiratory volume in 1 second (FEV1) amount

A

3800 mL

75
Q

FEV1 should be

A

80% FVC

76
Q

Functional Residual Capacity (FRC)

A

volume of air in the lung when the lung and chest wall have recoil force

77
Q

Functional Residual Capacity (FRC) amount

A

2300 mL

78
Q

Lung capacity is the sum of

A

2 or more lung volumes

79
Q

Spirometer direct measurement (4)

A

TV
FVC
FEV1
FEF

80
Q

Cannot be measured with Spirometer

A

RV
FRC
TLC

81
Q

limitation of Helium dilution technique

A

cannot be used in emphysema and COPD

82
Q

what does Helium dilution measure

A

FRC

83
Q

How does body position effect FRC - Supine position

A

lower

84
Q

What happens to FRC with age

A

increases - lung becomes softer

85
Q

Pregnancy does what to FRC

A

decreases

86
Q

Lung resection does what to FRC

A

reduce vol of lung to reduce FRC

87
Q

chest wall deformity affect on FRC

A

decrease FRC

BMS 615 Cardiovascular (49 decks)

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