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JKC Med Phys Spring '24 > Respiration Part 1 > Flashcards

Respiration Part 1 Flashcards

1
Q

What is the magic number for Carbon dioxide?

A

40

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2
Q

What is the magic number for Oxygen?

A

100

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3
Q

What muscles are used for expiration?

A

Abdominal muscles and internal intercostals

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4
Q

What additional muscles are used for inspiration?

A

External intercostals
SCM
Anterior Serratous
Scaleni

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5
Q

What two ways can the lungs be contracted?

A
  1. Elevation and depression of the ribs to increase/decrease the anteroposterior diameter of the chest cavity
  2. Downward and upward movement of the diaphragm to lengthen or shorten the chest cavity. (normal quiet breathing)
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6
Q

What is the outside membrane of the lungs called ?

A

Visceral plueral membrane

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7
Q

What is the membrane on the thoracic cavity?

A

Parietal pleural surface

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8
Q

How can you increase the volume in the chest?

A

by increasing the diaphragm space

OR

pulling the diaphragm down

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9
Q

What is pleuracy?

A

The inflammation of the fluid between the 2 layers

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10
Q

What keeps the lungs from collapsing?

A

Because the fluid between the 2 membranes

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11
Q

There is _____ pressure in the thoracic cavity at rest

A

low

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12
Q

When the pressure is higher in the atmosphere than in your lungs, how does the air get in your lungs?

A

through bulk flow, naturally will flow to where there is less pressure by creating more volume aka decreasing the pressure inside your lungs

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13
Q

Muscles that aid inspiration are attached to ?

A

attached to the ribs

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14
Q

at rest, exhale is ____

A

passive, very little work needs to be done

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15
Q

During ______ alveolar pressure falls about 1cm of water

A

inspiration

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16
Q

During ______ the alveolar pressure increased by about 1cm of water

A

expiration

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17
Q

Recoil pressure is the difference between the ______ pressure and the _____ pressure

A

alveolar and pleural

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18
Q

_______ is a measure of the elastic forces in the lungs that tend to collapse the lungs at each instant of respiration

A

recoil pressure

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19
Q

Elastin fibers at rest look like _____, when they expand they look like _____

A

a zig zag, a straight line

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20
Q

What is ventilation?

A

When you increase the pressure in your lungs by decreasing the volume, so the pressure is higher than the atmospheric pressure and the air flows out of your lungs

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21
Q

What is keeping the lungs from collapsing?

A

because the fluid between the parietal and visceral membranes has a negative pressure keeping them from collapsing

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22
Q

The tendency for the lungs to want to collapse is described as?

A

Trans-pulmonary pressure/ recoil pressure

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23
Q

One type of lung disease that is caused by permanent scaring of the alveolar, causes them to get stiff

A
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24
Q

What is surface tension?

A

When water forms a surface with air, the water molecules on the surface of the water have a strong attraction for one another

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25
Q

_____ are interwoven among the lung parenchyma

A

collagen

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26
Q

As the lungs expand, _____ fibers become stretched and unkinked exerting more force

A

collagen

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27
Q

Elastic forces caused by _____ of the fluid that lines the inside walls of the alveoli

A

surface tension

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28
Q

What is surfactant? What type of cell is it produced by?

A

surface active agent in water that reduces surface tension

Type II alveolar epithelial cells - 6-7 months of gestation

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29
Q

inside of the alveoli, water causes _____ which causes the alveoli to want to shrink up

A

surface tension

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30
Q

Why at the end of inspiration, is it so much harder?

A

because the rib cage is already expanded, the more you pull it apart the harder it is to pull apart

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31
Q

Obstructive lung disease, traps air inside the lungs

A

Emphysema

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32
Q

Which one has a greater affect on breathing. surface tension or elastic recoil? why?

A

Surface tension- 2/3
Elastic forces -1/3

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33
Q

A _________ is one that occurs without an apparent cause and in the absence of significant lung disease

A

primary pneumothorax

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34
Q

a ________ occurs in the presence of existing lung pathology.

A

secondary pneumothorax

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35
Q

Very tall and thin people are more prone to ? What syndrome is associated with it?

A

Primary pneumothorax

Marfarn syndrome

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36
Q

What is tidal volume?

A

Volume inspired or expired per breath

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37
Q

What is the magic number for tidal volume?

A

500mL

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38
Q

How much air does a normal human breathe in one minute?

A

6 Liters of air

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39
Q

What is minute ventilation? How is it expressed?

A

total amount of air you breath in 1 minute,

VE (there is a dot above the V)

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40
Q

What is total lung capacity? What is the magic number associated with it?

A

the max amount of air you can take your lungs

4000mL- 4200mL

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41
Q

Describe boxes 1 and 2

A

1: TV: Tidal Volume- Volume inspired or expired per breath

2: IRV: Inspiratory Reserve Volume- Max inspiration at end of tidal inspiration

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42
Q

Describe boxes 3 and 4

A

3: ERV: Expiratory Reserve Volume: Max expiration at end of tidal inspiration

4: FRC: Functional Residual Capacity- Volume in lungs after tidal expiration

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43
Q

Describe box 5

A

5: RLV: Residual Lung Volume- Volume in lungs after max expiration

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44
Q

Describe box 6 and 7

A

6: FVC: Forced Vital Capacity- Max volume expired after max inspiration

7: TLC: Total Lung Capacity- Volume in lungs after max inspiration

45
Q

What percent of of air can you NOT exhale from your lungs no matter how hard you try? What is this called?

A

25%, Residual lung volume

46
Q

*** What are the limiting factors when a person is exercising heavily?

A

The heart and muscle metabolism, it is NOT breathing/lungs (unless they have lung disease)

47
Q

What is minute ventilation?

A

The volume of air breathed each minute

Breathing rate (12bpm) * tidal volume (0.5 L)

48
Q

How can minute ventilation be increased?

A

increase in the rate or depth of breathing (or both)

49
Q

Breathing deeply uses (more/less) energy?

A

more energy, not as efficient

49
Q

At max exercise the oxygen is ____ and CO2 is _____. Why?

A

110

30

The lungs are better than the heart

50
Q

About _____ of the air does not participate in the gas exchange process. **How many mL is it (magic number)

A

1/3- 150ml of the 500ml taken in

51
Q

What is considered the anatomical dead space?

A

Trachea, bronchial tubes, bronchi and smaller airways

52
Q

What is another name for the anatomical dead space?

A

Conduction zone

53
Q

What is the physiologic dead space?

A

Space not currently being perfused with blood

54
Q

Breathing deeply causes ____ in the muscles

A

fatigue

55
Q

Why is shallow breathing not ideal?

A

because the air just goes into the anatomical dead space, not the alveoli

56
Q

_____ multiple cartilage rings for most of the diameter to prevent collapse

A

Trachea

57
Q

_____ are less extensive cartilages but have more ability to expand and contract

A

Bronchi

58
Q

______ have diameters less than 1.5 mm, are NOT prevented from collapsing by the rigidity of their walls, kept expanded by the transpulmonary pressures that expand the alveoli

A

Bronchioles

59
Q

_____ walls are almost entirely smooth muscle

A

bronchioles

60
Q

Many _____ of the lung result from narrowing of the smaller bronchi and larger bronchioles, often because of excessive contraction of the smooth muscle itself.

A

obstructive diseases

61
Q

As you breath in, the diameter of the airway _____, and the pressure ______

A

Increases, decreases

62
Q

The harder you breath out, what happens to the airway?

A

the airway diameter decreases because the pressure increases

63
Q

Direct control of the bronchioles by sympathetic NS is _____

A

weak

64
Q

Why is the direct control of the bronchioles by sympathetic NS weak?

A

because few Syn. Neurons penetrate to the central portions of the lung

65
Q

Epinephrine caused _____ because of its greater stimulation of _____

A

Dilation of the bronchial tree

beta-adrenergic receptors

66
Q

Parasympathetic control on the bronchioles causes ____

A

bronchiconstriction

67
Q

Some Parasympathetic nerve fibers penetrate the lung parenchyma. These nerves secrete _____ and, when activated, causes ????

A

acetylcholine

mild to moderate contraction of the bronchioles

68
Q

_____ sometimes relax the respiratory passages enough to relieve the obstruction.
What does it block?

A

Atropine

Blocks Ach

69
Q

What two things cause the mast cells to degranulate?

A

Drying or cooling of airways

70
Q

Mast cells deganulate (quickly/slowly)? Fatigue (quickly/slowly)?

A

Very quickly

They fatigue very quickly

71
Q

Name the 2 circulations in the lungs?

A

High pressure/Low Flow

Low pressure/High Flow

72
Q

The high pressure/low flow circulation supplies what things?

A

bronchial arteries
tissues of the lung
Trachae, bronchial tree and terminal bronchioles

73
Q

Which circulation originates from the systemic circulation?

A

High Pressure/Low flow

74
Q

Which circulation is responsible for 1-2% of total cardiac output?

A

High Pressure/Low flow

75
Q

Which circulation empties into the pulmonary veins and enters the Left atrium?

A

High Pressure/Low flow

76
Q

What is the “correct” definition of an artery?

A

vessel that takes blood away from the heart

77
Q

High pressure/Low flow circulation is a pressure of ? What side does it dump into?

A

120/80

Left

78
Q

Low pressure/High flow has a pressure of ? What side does it dump into?

A

25/8

79
Q

Give two reasons why the pulse ox is never at 100?

A
  1. High pressure/Low flow that supplies the lungs with nutrients and oxygen will be extracted and go to the left side of the heart
  2. Normal V/Q mismatch with the lungs
80
Q

What is pulmonary hypertension? What is it due to?

A

When the low pressure/high flow circulation is higher than 25/8

Weak left ventricle/ left side heart failure

81
Q

What is another reason for pulmonary hypertension?

A

Fluid build up in the alveoli

82
Q

In the Low pressure/High flow system, it supplies ?

Where does it dump into?

A

venous blood from all parts of the body to the alveolar capillaries where oxygen is added and CO2 is removed

Left atrium

83
Q

Describe the Pulmonary Capillary Wedge Pressure

A

Test used to determine pulmonary pressure by inflating a balloon inside the pulmonary artery

84
Q

When people are dying of high altitude what is really going on?

A

Pulmonary hypertension due to release of unknown vasoconstrictor substance in the alveoli causing your body to redistribute air to better ventilated areas but at high altitude there are no better ventilated areas

85
Q

What is ventilation?

A

How much air are you taking in and out of your lungs

86
Q

What is perfusion?

A

How much blood is coming out of your heart going to your lungs

87
Q

What is normal VE/CO?

A

4200mL/5000mL= 0.8

88
Q

Do all areas of the lung when standing upright have the same V/Q?

A

No, the top of the lung has more air and the bottom has more blood

89
Q

The bottom of the lung has a (high/low) V/Q ratio?

A

Low ration

90
Q

The top of the lung has a (high/low) V/Q ratio?

A

High

91
Q

True/False: There is plenty of time during peak exercise and at rest for the oxygen to become saturated

A

True, have about .5 second of buffer

Our blood CANNOT be pumped fast enough to exceed the lungs ability for gas exchange

92
Q

Pulmonary capillary walls are distended by the ______ inside them

A

blood pressure

93
Q

Pulmonary capillary walls are compressed by the _____ on their outsides

A

alveolar air pressure

94
Q

If ______ becomes greater than ______ the capillaries close and there is no blood flow

A

alveolar air pressure

capillary blood pressure,

95
Q

3 zones of blood distribution

Zone 1:

A

No blood flow during all portions of the cardiac cycle

96
Q

3 zones of blood distribution

Zone 2:

A

Intermittent blood flow only during the peaks of pulmonary arterial pressure (systolic)

97
Q

3 zones of blood distribution

Zone 3:

A

Continuous flow because capillary pressure remains greater than alveolar air pressure during the entire cardiac cycle.

98
Q

During exercise what happens to the zone 2 pattern of flow?

A

Zone 2 becomes continuous flow because capillary pressure remains greater than alveolar air pressure during the entire cardiac cycle

99
Q

How does scar tissue affect diffusion?

A

Decreases diffusion by increasing the distance oxygen has to go to get to the alveoli

100
Q

What increases distance during diffusion?

A

Build up of fluid

101
Q

Why is pneumonia dangerous?

A

because they are wet and full of fluid

102
Q

What causes the distance between the capillary and the alveolus to remain dry?

A
103
Q

What pressure causes fluid to leak from the capillaries?

A

-Hydrostatic (+7) and Cardiac output (forces plasma out into the interstitial space)
- Interstitial Colloid Osmotic Pressure (-14)
- Negative Interstitial fluid pressure (-8)

104
Q

What causes the fluid to want to stay inside the capillaries?

A

Plasma colloid osmotic pressure (-28)

105
Q

Net of +1 between the capillary and alveolus pressure causes what ???

A

Fluid to leak outside the capillary and causes the lung to be wet

106
Q

How does the body respond to the +1 pressure?

A

The lymphatic system drains the +1 pressure keeping the lungs dry

107
Q

What can cause there to be an increase in the fluid leaking from the capillaries?

A

Pulmonary hypertension causing more fluid to leak that the lymphatic system cannot drain fast enough

Blood clots

Pneumonia

Breathing noxious substances

108
Q

How can you help to reduce fluid on the lungs?

A

give a diuretic to help the patient pee out the excess

JKC Med Phys Spring '24 (18 decks)

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