2. Ventilation Flashcards

1
Q

Define minute ventilation

A

The volume of air expired in one minute or per minute

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2
Q

Define respiratory rate

A

The frequency of breathing per minute

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3
Q

Define alveolar ventilation

A

The volume of air reaching the respiratory zone. The number of breath take per minute multiplied by the volume of breath reaching the alveoli with each breath.

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4
Q

Define respiration

A

The process of generating ATP either with an excess of oxygen (aerobic) and a short fall (anaerobic)

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5
Q

Define anatomical dead space

A

The capacity of the airways incapable of undertaking gas exchange

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6
Q

Define alveolar dead space

A

Capacity of the airways that should be able to undertake gas exchange but cannot (hypoperfused alveoli)

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7
Q

Define physiological dead space

A

Equivalent to the sum of alveolar and anatomical dead space

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8
Q

Define hypoventilation

A

Deficient ventilation of the lungs

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9
Q

Define hyperventilation

A

Excessive ventilation of the lungs

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10
Q

Define Hyperpnoea

A

Increased depth of breathing (to meet metabolic demand)

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11
Q

Define Hypopnoea

A

Decreased depth of breathing (inadequate to meed metabolic demand)

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12
Q

Define Apnoea

A

Cessation of breathing

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13
Q

Define Bradypnoea

A

Abnormally slow breathing rate

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14
Q

Define Tachypnoea

A

Abnormally fast breathing rate

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15
Q

Define Orthopnoea

A

Positional difficulty in breathing (When lying down)

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16
Q

What are the two components to the chest wall?

A

1) Lungs

2) Bone + Muscle + Fibrous tissue

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17
Q

What is FRC?

A

Functional residual capacity

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18
Q

When the ribcage and lungs are in equilibrium what is required to push the equilibrium?

A

Muscular effort

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19
Q

What is the pleural cavity?

A

The space between the parietal and visceral pleura

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20
Q

What does the pleural cavity contain?

A

A fixed volume of protein rich pleural fluid. The pleural cavity is at negative pressure

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21
Q

How does the lung and chest wall expand and recoil together as one?

A

It is held together by the negative pressure of the pleural cavity

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22
Q

What happens when the chest wall or lung is compromised?

A

The fixed volume of the pleural cavity is compromised so air will fill the pleural cavity causing lung collapse

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23
Q

Define haemothorax

A

Collection of blood in the pleural cavity due to intrapleural bleeding

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24
Q

Define tidal breathing

A

The amount of inspiration and expiration that meets metabolic demand. Usually nasal

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25
Q

When happens to tidal breathing when you exercise?

A

The tidal volume increases

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26
Q

What does the end of a tidal breath mark?

A

FRC

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27
Q

Why can you not empty the lungs fully?

A

Due to the surfactant in the alveoli - prevents the alveoli from sticking together and not reopening

28
Q

Define residual volume

A

The volume in the lungs which cannot be emptied

29
Q

Define functional residual capacity

A

The volume of air in the lungs when the outwards recoil of the rib cage and the inwards recoil of the lungs are in equilibrium. At the end of tidal expiration.

30
Q

Define total lung capacity

A

When you inspire all the way and fill your lungs as much as possible, the volume of air in the lungs in the TLC

31
Q

Define vital capacity

A

How much air is within the confines of what we are inspire and expire
TLC - RV

32
Q

Define inspiratory capacity

A

How much extra air you can take on top of the FRC

33
Q

What are the four main volumes?

A

Inspiratory reserve volume
Expiratory reserve volume
Tidal volume
Reserve volume

34
Q

When talking about lung volumes what is the unit?

A

cm H20

35
Q

What are transmural pressures?

A

Pressure cross a tissue or several tissues

P inside - P outside

36
Q

Define transpulmonary pressure

A

Difference between alveolar and intrapleural pressure

37
Q

What pressure results in expiration?

A

Positive transmural pressures

38
Q

What is transrespiratory pressure?

A

This is the pressure that says whether there will be airflow into or out of the lung

39
Q

What is the pressure in the lung when you inspire?

A

The pressure is lower inside of the lung - negative pressure breathing

40
Q

In terms of transpulmonary pressure, when there is no volume change there is…

A

No transpulmonary pressure

41
Q

What does the expansion of the chest wall create?

A

It creates negative pressure so more air flows in

42
Q

What type of gradient does airflow move down?

A

Pressure gradient

43
Q

What are the two zones in the lungs?

A

Conducting Zone

Respiratory Zone

44
Q

What zone is dead space?

A

Conducting Zone

45
Q

What is the alveolar dead space like in healthy individuals?

A

There should be zero alveolar dead space - physiological dead space about equal to anatomical dead space

46
Q

What is the normal physiological dead space?

A

150 mL

47
Q

What varies the anatomical dead space?

A

The size of the conducting zone

48
Q

What is a clinical procedures which can reduce a patients dead space?

A

Tracheostomy - cutting off the upper part of the airway so it is no longer dead space

49
Q

What is shape of an intact lungs volume-pressure graph?

A

Sigmoid shape

50
Q

Why is the volume pressure graph a lung sigmoid?

A

It takes relatively little pressure to get the chest wall to expand to 6L, because the chest wall wants to expand. However to get the elastic lung to expand the bigger the volume the more pressure needed.

51
Q

In a healthy person how much air is expelled in the first second from TLC?

A

75%

52
Q

Define forced vital capacity

A

The amount of air which can be forcibly exhaled from the lungs after TLC

53
Q

Define FET

A

Forced expiratory time - The time taken to expel all the air from the lungs

54
Q

What is FEV1

A

The amount (volume) of air expelled from the lungs in 1 second

55
Q

In obstructive lung disease (COPD) what would the FEV1, FET and FVC be?

A

FEV1 would be much lower
FET would be much higher
FVC would be much lower

56
Q

In restrictive lung disease what would be what would the FVC and FEV1 be?

A

Restrictive lung disease limits the expansion of the thorax

FVC is lower
FEV1, is relatively high because their conducting airways are quite clear they can expel air relatively easily

57
Q

What are the FEV1/FVC of normal, restrictive and obstructive patients?

A
Normal = 73
Restrictive = 87
Obstructive = 53
58
Q

How can you assess lung function in the GP?

A

Wright peak flow meter

59
Q

Describe the shape of flow-volume loop in a patient with obstructive disease

A

The last bit of expiration is usually a straight line however people with obstructive disease have an indentation (coving). The size of indentation depends on the severity of the disease.
The flow-volume loop is also shifted to the left due to an increase in the volume of the lungs and the expansion of residual volume

60
Q

Why would the residual volume expand in obstructive lung disease?

A

Because there is air trapped in the alveoli as small airways connecting these alveoli may have collapsed

61
Q

Why would there be in increase in the volume of the lungs

A

Emphysema can degrade the alveolar resulting in one large alveolus.

62
Q

Describe the shape of flow-volume loop in a patient with restrictive disease

A

Narrower flow-volume loop

The loop moves to the right

63
Q

Why would there be a narrower flow-volume loop in restrictive disease?

A

This is because getting to a high TLC is difficult because of the restriction to expansion of the lung

64
Q

Describe the flow volume loop of a patient with variable extrathoracic obstruction

A

Flattened inspiratory curve

65
Q

Describe the flow volume loop of a patient with variable intrathoracic obstruction

A

Flattened expiratory curve

66
Q

Describe the flow volume loop of a patient with fixed airway obstruction

A

Both the inspiratory and expiratory curves are flattened

67
Q

Why when we exercise do we not use the whole of our VC?

A

It is inefficient to use the whole of our vital capacity because a lot of energy and effort is required to utilise the inspiratory and expiratory muscles to the maximum