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phsl232 > Respiratory > Flashcards

Respiratory Flashcards

1
Q

the exchange between O2 and CO2 between tissues and the environment describes what

A

respiration

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2
Q

what are the 5 steps to consider for respiration

A
  1. ventilation
  2. gas exchange
  3. gas transport
  4. gas exchange
  5. cellular respiration
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3
Q

main two functions of the respiratory system

A
  1. provide O2
  2. remove CO2
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4
Q

what happens to the diaphragm during inspiration

A

contraction
- active

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5
Q

what causes expiration

A

lung elastic recoil pulling thorax and relaxed diaphragm

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6
Q

is expiration a passive or active process at rest

A

no muscle contraction = passive

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7
Q

what muscles are used in very deep, foreful breaths for inspiration

A

diaphragm and external intercostal muscle contraction and sternocleidomastoid and pectoralis minor

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8
Q

what muscles are used in very deep, foreful breaths for expiration

A

lung elastic recoil and internal inter-coastal muscle + abdominal muscle

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9
Q

what is the difference between partietal pleura and visceral pleura

A

partietal pleura - outer layer
visceral pleura - directly on lung

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10
Q

what is the pleural cavity

A

sit-like potential space filled w/ fluid
allows pleural to slide

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11
Q

what is the name for the exchange of air between the atmosphere and alveoli

A

ventilation

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12
Q

in ventilation air moves by bulk from the region of ____ pressure to _____ pressure

A

high to low

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13
Q

what is the equation for bulk flow

A

F=change in pressure / resistance

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14
Q

all pressures in respiratory like in CVS are given relative to ________ pressure

A

atmospheric

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15
Q

when there is no air flow what does this mean

A

pressure of alveoli = pressure of atmospheric

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16
Q

what is boyles law

A

at constant temp, volume of gas varies inversely with absolute pressure

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17
Q

during inspiration what happens to volume and pressure

A

volume = increased
pressure = decreased

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18
Q

what are the 2 determinants for the changes in lung dimension - that determine lung volume

A
  • difference in the pressure between inside and outside of lung (transpulmonary pressure)
  • stretchability of lungs (compliance ) - how much lungs expand for a given chang in transpulmonary pressure
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19
Q

what is the equation for transpulmonary pressure

A

Ptp = Palv - Pip

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20
Q

transmural pressure resists the _____ ____ of the lung

A

elastic recoiling

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21
Q

to increase volume lung requires positive of negative transpulmonary pressure

A

positive

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22
Q

when does lung assume smallest size when transpulmonary pressure is

A

zero

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23
Q

for transpulmonary pressure to be positive intrapleural fluid should be

A

negative

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24
Q

during restful breathing, inspiration is caused by contraction of the diaphragm and what is expiration caused by

A

passive recoiling

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25
Q

if Patm = 0mmHg and Palv = 4mmHg then what does this mean

A

air is flowing out of the lung

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26
Q

what are the 2 reasons work is done for breathing

A
  • overcome elastic properties
  • overcome airway resistance
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27
Q

what is the equation for lung compliance

A

C= change in lung volume/ change in transpulmonary pressure

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28
Q

what are the 2 determines of lung compliance

A
  1. stiffness
  2. surface tension
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29
Q

those with emphysema have high compliance and floppy lungs what does this mean

A
  • very stretch = no effect on inspiration
  • low elastic recoil = requires more energy during expiration
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30
Q

those with fibrosis have low compliance and stiff lungs what does this mean

A
  • more energy for inspiration
  • high elastic recoil= no added energy required for expiration
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31
Q

why do you need to overcome force of surface tension to expand lungs

A

causes alveoli to collapse

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32
Q

reduces surfance tension in alveoli is called what

A

surfactant

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33
Q

what type of cells is surfactant produced by

A

alveolar type 2 cells

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34
Q

what is a major constituent of surfactant

A

phospholipids

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35
Q

in premature infants what is absent and what does this result in the development of

A

Surfactant
respiratory distress syndrome

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36
Q

what is the therapy of surfactant in premature infants

A

assisted ventilation and administration of natural or synthetic surfactant given through infants trachea

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37
Q

stabilizes the smaller alveoli, thereby preventing them from collapsing due to high pressure is known as what

A

surfactant

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38
Q

during quiet breathing what flow is air flow

A

mainly laminar

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39
Q

what is an important element to airway resistance

A

bronchoconstriction/ bronchodilation

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40
Q

what is the main area of airway resistance

A

Bronchi

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41
Q

why is resistance higher in larger airways

A
  • depends on number of parallel pathways present
  • generations exist in parallel rather than in series
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42
Q

what is radial traction

A

pulling adjacent alveoli - reduces airway resistance

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43
Q

in restrictive lung disease what happens to resistance and lung compliance and pressure volume curve

A

resistance - no change
lung compliance - decrease -
curve - shifted to right

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44
Q

lung compliance is increased in emphysema because chronic emphysema increases airway resistacne

A

both true - but not realted

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45
Q

what are two measurements of lunch function

A
  1. spirometry
  2. peak expiratory flow rates
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46
Q

what is the inspiratory capacity mad up of - and what is it

A

max beath in
tidal volum
IRV

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47
Q

what is vital capacity

A

max breath into out voulme of air can shift in/out of lungs
IRV + ERV

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48
Q

functional residual capacity

A

remaining volume at end of normal breath out
ERV + RV

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49
Q

total lung capacity

A

total volume in lungs when maximally full
VC + RV

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50
Q

lung volumes in restrictive diseases

A

breath mor shalloely and rapidly
- increased work - decrease lung compliance
- stiff lungs
decreases in all volumess and capacity- graph moves down

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51
Q

lung volumes in obstructive diseases

A

increasesed work due tor increase air way reisstnace
- narrow pipes
- breathe more slowly and deeply
most volume shift and increases on graph

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52
Q

is air way resistance inversly related to the 4th power of radius

A

true

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53
Q

in healthy individuals inspiration reduces the airway resistance due to an increase in the transpulmonary pressure

A

true

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54
Q

asthma increases airway resistance

A

true

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55
Q

does airflow velocity decrease as the size of the airway become smaller, hence the highest resistance is seen in the respiratory bronchioles

A

false

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56
Q

what doe force measurements give info about

A

flow rates

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57
Q

how long is forced expiratory volume

A

one second

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58
Q

what is a useful indicator of airway resistance and therefore lung disease

A

vital capacity

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59
Q

how much lung is expirated per 1 sec in normal healthy lung disease

A

80%

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60
Q

in obstructive lung disease what is % lung expirated

A

less than 70% - increases airway resistance

61
Q

in restrictive lung disease is there a change in FEV/FVC ratio

A

no - no change in resistance

62
Q

how much is normal tidal volume

A

500ml = 0.5L

63
Q

what is the equation of total ventilation - how much we breath in and out

A

frequency x tidal volume

64
Q

if single breath is 500ml and frequency 12mins
how much is total (mouth) ventialtion

A

6000ml/min

65
Q

how can total (mouth) ventialtion change

A

to match metabolic demands - involuntarily (exercise)
voluntarily (changing breathing behaviour)

66
Q

when some of the inhaled air never gets to the alveoli so gas exchange cant take place what is known as

A

dead space ventilation

67
Q

what are the 2 types of dead space contributing to dead space ventilation

A
  1. anatomical dead space
  2. physiological dead space
68
Q

what is the equation for dead space ventilation

A

anatomical + function dead space

69
Q

in what dead space could exchange gas but not happening

A

function dead space

70
Q

how much of inspired air is dead space

A

1/3rd

71
Q

increasing dead space by transforming respiratory tissue into fibrotic tissue is know as what

A

pulmonary fibrosis

72
Q

increases dead space by impairing pulmonary perfusion

A

pulmonary hypertension

73
Q

what pattern of breathing decreases alveolar ventilation

A

fast shallow breathing

74
Q

causing of hypoxia and hypercapnia and acidity is from shallow or deep breathing

A

shallow

75
Q

FEV/FVC ratio doesn’t decrease below 70% in restrictive lung disease BECAUSE restrictive lung disease doesn’t affect the airway resistance

A

True - and realte

76
Q

what does gas diffusion depend on and what is this law

A

partial pressure
daltons law

77
Q

to work out partial pressure what must you know

A

% concentration of each gas and atmospheric pressure

78
Q

what is barometric pressure at sea level at

A

760mmHG

79
Q

in healthy lung what is the alveolar ventialtion and pulmonary blood flow

A

alveolar ventilation 4 L/min
Pulmonary 5L/min

80
Q

what is normal V/Q ratio

A

0.8

81
Q

if there is changes in the ventialtion to perfusion ration what does this impair

A

oxygen and carbon dioxide transfer

82
Q

Atelectasis (fibrosis), emphysema, pulmonary oedema all lung disease that occur if what is imparied

A

ventialtion

83
Q

vascular diseases such as pulmonary hypertension, heart failure and vascular diseases associsated with COPD what is impaired

A

perfusion

84
Q

breathing pattern do not affect alveolar ventilation BECAUSE the change in breathing pattern will be compensated by the change in anatomical dead space to maintain constant

A

both statements are false

85
Q

how does the gas move across the alveolar capillary membrane

A

diffusion

86
Q

what is Diffusion constant depend on

A

gas solubility and molecular weight

87
Q

what gas diffuses about 20z faster than the other
and why

A

CO2 diffuses faster than O2 because CO2 has higher solubility

88
Q

a disease characterised by dilation of the alveolar space and destruction of the alveolar wall can be described as what
- meaning there is a decrease in surface area of the lung

A

emphysema

89
Q

what does having less alveolar area mean for diffusion capacity

A

less

90
Q

if something has more thickness does this reduce or increase diffusion takes place

A

reduces - therefore takes longer to supply nutrients

91
Q

in pulmonary fibrosis there is an increase in thickening of the alveolar membrane what does this mean

A

diffusion distance increase
- reduced diffusion capacity

92
Q

what is the main factor of ficks law

A

pressure difference

93
Q

what 3 things does PaO2 depend on

A

P1O2 inspired air
alveolar ventialion
O2 consumption

94
Q

the atmospheric PO2 is usually constant BECAUSE there is an imbalance between O2 consumption and alveolar ventilation

A

1st true
2nd false - there is a a balance - if this is true then 2nd would coerelate with the 1st

but for this they dont relate

95
Q

what is alveolar partial pressure of CO2 kept constant at

A

40mmHG

96
Q

what does PaCO2 depend on

A

alveolar ventilation
CO2 production
P1 CO2 inspired air

97
Q

what is PaCO2 usually only determined by
WHY

A

balance between CO2 production and alveolar ventilation
because atmospheric PCOs is negligible

98
Q

what are the 5 mechanisms that arterial hypoxemia can be caused by

A
  1. reduced PB or F1O2
  2. hypoventilation
  3. impaired diffusion
  4. shunt
  5. ventialtion - perfuison mismatching
99
Q

what is the RQ for fatty acid, CHO and normal diet

A

fat = 0.7
CHO= 1.0
normale = 0.8

100
Q

the movement of oxygen by diffusion between the alveoli and the pulmonary capillary blood is

A

proportional to partial pressure gradient between air-blood barrier

101
Q

what happens to ficks law with exercise

A

more capillaries perfuses = increase in capillary surface area and reduce diffusion for capillaries

102
Q

what it the 2 forms that O2 is carried in the blood

A
  1. dissolved O2
  2. Combined w/ Hb
103
Q

for each mmHg PO2 how much of O2 is dissolved

A

0.03ml

104
Q

why is dissolved O2 very ineffective for O2 transport and how much do we need

A

3ml only dissolved
need about 250ml O2/min

105
Q

because dissolves O2 is very ineffective what do we need to use

A

Haemoglobin to carry O2

106
Q

oxyhemoglobin

A

O2 forms an easily reversible combination w/ Hb to give oxyhemoglobin

107
Q

no oxygen is what colour

A

black

108
Q

what is P50 on the Hb dissociation curve

A

where Hb is 50% saturated
25mmHg

109
Q

what shape is the O2-Hb dissociation curve

A

sigmoidal

110
Q

what does the steep part of the curve of Hb curve help with

A

loading of Hb and lungs and unloading of O2 to the tissues

111
Q

what is the O2 carry capcaity and formular

A

how much O2 could blood carry
1.34 x 150(this number changes)

112
Q

what is O2 content and what is the formular

A

how much O2 is the blood actually carring

1.34 x hb x sat/100 + 0.03 xPartial pressure in arteries

113
Q

finding the artial and venous difference can relate to how many litres/min flow to tissues

A

Cardiac output

114
Q

what does the right shift do

A
  • release O2
  • improves delivery of O2 by Hb
    EXERCISE
  • increase everything
115
Q

2,3 diphosphooglycerate is a by-product of

A

glycolysis

116
Q

what is problem with anamemia and Low Hb level with exercise of the bohr effect

A

dont have enough to match demands

117
Q

what are the 3 transport of CO2

A
  1. dissolved in plasma
  2. bicarbonate
  3. combined w/ proteins as carbamino compounds
118
Q

what is majority of CO2 transport used as

A

Bicarbonate
HCO3

119
Q

what is the Haldane effect

A

upward and downward shift of CO2

120
Q

if Upward shift in Haldane effect what does this mean

A

CO2 and H+ bind more readily to globin when heme contains less O2

121
Q

the Bohr effect is characterised by a right shift in the lungs BECAUSE Hb has a high affinity for Oxygen at low PCO2

A

both true
- not related

122
Q

what are the 3 basic elements for the control of breathing

A
  • central controller
  • sensor
  • effectors
123
Q

what sets the pattern of breathing coordinates sensors and effectors to maintain respiratory homeostasis

A

central control system

124
Q

what basic element with breathing adjust ventilation

A

respiratory muscles

125
Q

what basic element of control of breathing receives a variety of neural and chemical inputs from cental and peripheral receptors

A

sensors

126
Q

where does inspiratory center of dorasl respiratory group (DRG) send signals to

A

diaphrgam and external intercostal muscles

127
Q

the ventral respiratory group send signals with what nerouns and which muscles

A

inspiratory neurons - to accessory inspiratory muscles
expiratory neurones - accessory expiratory muscles

128
Q

what is the pre-Botzinger complex

A

respiratory rhythm generator

129
Q

what does the Apnustic control and what does it do

A

VRG and DRG
- adjust ouput of respiratory rhythmicity

130
Q

what is the pneuomotaxic center known as

A

pontine respiratory group

131
Q

what are the 4 main chemicals in the respiratory system

A

CO2, O2, H+ and HCO3

132
Q

what chemicals mainly act on respiratory centre

A

CO2 and H+ (due to CO2)

133
Q

what main act through peripheral chemorecpetor

A

O2, H+ (not due to CO2)

134
Q

centrral chemorecpetors - have specialized cells on the ____ ____ of the medulla

A

ventrolateral surface

135
Q

central chemoreceptors sensitive to PCO2 not _____ of blood (because CO2 can easily diffuse)

A

PO2

136
Q

what respiratory group neurons produce inspiratory and expiratory stimulus at rest

A

VRG

137
Q

artrial PCO2 decreases during strenuous exercise BECAUSE strenuous exercise generates and releases lactic acid into the blood

A

both correct not related

138
Q

what does endurance exercise require to work toegther (4 main physiological systems)

A

CVS
respiratory
nervous
musculoskeletal

139
Q

softball or marathon running has high VO2

A

maratrhon - sports that are longer

140
Q

what does pulse oximetry measure

A

oxygen saturation

141
Q

what is the sex difference in % SaO2

A

males have stronger right shift

142
Q

what is the sex difference in O2 dissociation curve

A

females - sig lower affinity

143
Q

wha does sex difference in 2,3 bisphophoglycerate expression promotes

A

offloading of oxygen

144
Q

how much O2 can be bound for each 100ml of blood

A

20ml

145
Q

what metabolics is used for low to moderate intensities

A

lipids

146
Q

what metabolic is used for during high intensities

A

CHO

147
Q

if pulse oximeter was used on an athlete before exercise (at rest) and after moderate exericise, does % sa O2 level fall

A
148
Q
A

phsl232 (6 decks)

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