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kin 435 > Chapter 7 > Flashcards

Chapter 7 Flashcards

1
Q

Is inspiration passive or active?

A
  • Active always
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2
Q

Is Expiration Passive or Active?

A
  • Passive during rest
  • Active during exercise
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3
Q

What is the most important muscle for inspiration? What is it innervated by?

A

Muscle
- Diaphragm
Innervation
- Phrenic Nerves that originate from cervical segments 3,4,5

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4
Q

What plays a key role in active expiration?

A
  • contraction of the abdominal muscles
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5
Q

What are the Primary Muscles of Inspiration? What are they innervated by?

A
  • Diaphragm: Phrenic, C3-C5
  • Scalenes: C2-C7
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6
Q

What are the Accessory Muscles of Inspiration and Muscles of Expiration? What are they innervated by?

A
  • Sternomastoid: Accessory Nerve & C2-C3
  • Intercostal: T1-T11
  • Abdominal Muscles (especially Transversus Abdominus): T7-L1
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7
Q

What is the shape of the Pressure-Volume curve of the lung? why is it that shape?

A
  • Linear: because the lung gets stiffer at higher volumes
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8
Q

What is Hysteresis?

A

the amount of energy/work needed to surpass the airways resistance during inspiration, and expiration.

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9
Q

What is Compliance of the lung?

A

The slope of Change in Volume/ Change in Pressure

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10
Q

What is responsible for the compliance behaviour of the lung?

A
  • Structural proteins: Collagen and Elastin
  • Surface Tension
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11
Q

What can cause a reduction in compliance?

A
  • Pulmonary Fibrosis
  • Alveolar Edema
  • Increased Venous Pressure
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12
Q

What causes an increase in Compliance?

A
  • Emphysema
  • Normal Aging
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13
Q

What balances the tendency of the lung to recoil to its deflated volume?

A
  • The tendency of the chest cage to bow out
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14
Q

What is a similarity about the lungs and the thoracic cage?

A
  • they are both elastic
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15
Q

What is the intra-pleural pressure compared to atomospheric pressure? Why?

A

Sub-atmoshperic: Because the tendency of the lung to recoil to its deflated volume is balanced by the tendency of the chest cage to bow out

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16
Q

What determines the Pressure-Volume Curve?

A
  • Elastic properties of both the lung and chest wall determine the combined volume
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17
Q

What happens at FRC? (functional reserve capacity)

A
  • The inward pull of the lung is balanced by the outward spring of the chest wall
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18
Q

At what volumes does the Lung retract?

A
  • All volumes above minimal volume
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19
Q

At what volumes does the chest wall expand?

A
  • Volumes up to 75% of vital capacity
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20
Q

What does Pulmonary Surfactant do?

A
  • Reduces the surface tension of the alveolar lining layer
21
Q

What is Pulmonary Surfactant Produced by?

A
  • Type II alveolar Epithelial cells
22
Q

What does Pulmonary Surfactant Contain?

A
  • DPPC
23
Q

What results from the absence of Pulmonary Surfactant?

A
  • Reduced Lung compliance
  • Alveolar Atelectasis (complete or partial collapse)
  • Pulmonary Edema
24
Q

What are some regional differences in lung Ventilation?

A
  • Weight of the upright lung causes a higher (less negative) intrapleural pressure around the base compared with apex
  • Because pressure-volume curve is non-linear, alveoli at the base expand more than do those at the apex
  • If a small inspiration is made from residual volume (RV), the extreme base of the lung is unventilated
25
Q

What is Laminar Flow Governed by?

A

Poiseuille’s Law: V. = P(pi)r^4 / (8nl)
or
R = 8nl / (pi)r^4
R (resistance)
n (viscosity)
l (length)
r (radius)
P (driving pressure)

26
Q

What happens if the radius is halved for laminar flow?

A

Resistance is Increase 16-fold. r^4.

27
Q

What is Reynolds Number?

A

Re = 2rvd/n
d (density)
v (average velocity)
r (radius)
n (viscosity)

28
Q

What is resistance inversely proportional to in Laminar Flow?

A
  • the fourth power of the radius
29
Q

What does the velocity profile show for laminar flow?

A

A central spike of fast gas

30
Q

When is turbulent flow most likely to occur?

A
  • At a high Reynolds number: when inertial forces dominate over viscous forces
31
Q

Where is airway resistance the highest?

A
  • Medium-sized Bronchi
32
Q

Where is Airway Resistance Low?

A
  • Very small airways
33
Q

What happens to airway resistance when lung volume increases?

A

It decrease: because airways are pulled open

34
Q

What is the Bronchial smooth muscle controlled by?

A
  • Autonomic Nervous system
35
Q

What causes Bronchodilation?

A
  • Stimulation of the B2-Adrenergic Receptors
36
Q

What happens when you breath in a dense gas?

A
  • Increase in airway resistance
37
Q

When is flow effort independent? Why?

A
  • Low to Mid Volumes: Because the flow rate reaches a plateau and cannot be increased with further increase in intra-pleural pressure
38
Q

When is flow effort dependent? Why?

A
  • High Volumes: Because the expiratory flow rate continues to increase with effort (passive at low-mid volume)
39
Q

What does Dynamic Compression of the airways do in normal subjects during a forced expiration?

A
  • Limits air flow
40
Q

When might dynamic compression occur during low expiratory flow rates? what might be the consequence?

A
  • In a diseased lung: Reduces exercise ability
41
Q

What is flow determined by during Dynamic Compression?

A
  • Alveolar pressure minus pleural pressure (not mouth pressure)
42
Q

When might Dynamic Compression be exaggerated?

A
  • In some lung diseases, due to reduced lung elastic recoil and a loss of radial traction on airways
43
Q

What does an increase in resistance of peripheral airways do? Why?

A

Exaggerates flow-limiting mechanisms:
- magnifies the pressure drop
- decreases the intrabronchial pressure during expiration

44
Q

What does low lung volumes do?

A

Exaggerates flow-limiting mechanisms: because it reduces the driving pressure (alveolar-intrapleural)

45
Q

What can emphysema do to flow?

A

Reduces Flow by:
- Reduces Recoil Pressure: reduces driving pressure
- Reduces Radial Traction on Airways: they compress more readily

46
Q

What is the difference between flow limitation in healthy subjects vs subjects with severe obstructive lung disease?

A

Healthy subject: only seen during forced expiration
Lung Disease: seen during normal breathing

47
Q

How does a forced expiration test help diagnosis?

A
  • used to evaluate patients with chronic dyspnea
  • Distinguishes between obstructive and restrictive disease
48
Q

Where might you see a lack of surfactant? what can it lead to?

A
  • in premature infants: leads to low compliance and respiratory failure

kin 435 (14 decks)

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