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Pulmonary > PHYS: Ventilation and Lung Volumes > Flashcards

PHYS: Ventilation and Lung Volumes Flashcards

1
Q

What is the term for the volume of air moving into or out of the lungs in a given time?

A

ventilation

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2
Q

What is the equation for flow?

A

Flow= Change in Pressure/Resistance to Flow

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3
Q

What values cannot be measured by spirometry?

A
  • Residual Volume
  • Functional residual capacity
  • Total Lung Capacity
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4
Q

What is TLC?

A

Total Lung Capacity = VC + RV

around 6 to 7 L

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5
Q

What is TV?

A

Tidal Volume= volume of a normal breath

around 500 mL

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6
Q

What is FRC?

A

Functional Residual Capacity= ERV + RV
(volume of air int he lungs after a normal expiration)
around 2.5 L

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7
Q

What are 2 ways to measure FRC?

A 
Helium Dilution
Body Plethysmograph (Boyle's Law Box)
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8
Q

What is FVC?

A

Forced Vital Capacity= TV + IRV + ERV
(volume of air exhaled during a forceful expiration)
around 5 L

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9
Q

What is IRV?

A

Inspiratory Reserve Volume is the additional amount that can enter during forced inspiration
around 3L

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10
Q

What is ERV?

A

Expiratory Reserve Volume is the difference between tidal end volume and forceful expiration end volume
around 1L

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11
Q

What is FEV1?

A

Forced expiratory volume in 1 second

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12
Q

What is a normal value for FEV1?

A

80% of the FVC

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13
Q

How can you use the FEV1/FVC ratio clinically?

A

To distinguish whether your patient has an obstructive or restrictive lung disease

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14
Q

What is the FEV1/FVC ratio for an obstructive lung disease?

A

Less than .7

both numbers are lowered, because it is difficult to expire through a narrowed airway, but FEV1 is lowered more!

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15
Q

What is the FEV1/FVC ratio for an restrictive lung disease?

A

.8 or higher

FVC is reduced due to reduced expansion causing problems getting air into the lungs

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16
Q

List 3 examples of an obstructive lung disease.

A

Asthma
Emphysema
Chronic Bronchitis

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17
Q

List 2 examples of a restrictive lung disease.

A

Obestiy

Pulmonary Fibrosis

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18
Q

What is the volume of the conducting airways not available for gas exchange? What is this called?

A

Anatomic dead space ~ 150 mL

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19
Q

What is the volume of alveolar space not available for gas exchange due to limitations in blood supply (e.g. embolis)?

A

Alveolar dead space= volume of non-perfused alveoli

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20
Q

What is the sum of anatomic dead space and alveolar dead space?

A

physiologic dead space

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21
Q

What is the equation for minute ventilation?

A

Vmv= TV X f

minute ventilation = tidal volume X respiratory rate

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22
Q

What is the difference between minute ventilation and alveolar ventilation?

A

Minute ventilation does not account for the fact that no gas exchange occurs in the dead space

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23
Q

What is the equation for alveolar ventilation?

A

Valv= (TV - Dead Space) X f

24
Q

Why is their a greater ratio of exercise/rest for alveolar ventilation versus minute ventilation?

A

Dead space ventilation decreases as a percentage of minute volume

25
Q

Which is more effective for alveolar ventilation: increasing depth of breath or increasing breathing rate?

A

Increasing the depth of breathing!

26
Q

What is atmospheric pressure in mmHg?

A

760

27
Q

What is the driving force for flow into and out of the lungs?

A

the pressure difference from the alveoli to the mouth

28
Q

What is transpulmonary (transmural) pressure?

A

the difference between the alveolar pressure and the intrapleural pressure (outside the lungs)

29
Q

How do we estimate the intrapleural pressure?

A

Inserting a balloon catheter into the esophagus for an estimate

30
Q

List the muscles that aid in inspiration.

A 
Diaphragm
External intercostals
accessory muscles (scalene, SCM)
31
Q

List the muscles involved in expiration.

A 
None normally (passive), but during exercise:
Internal intercostals 
Abdominal muscles
32
Q

When is the alveolar pressure most negative in the breathing cycle?

A

Mid-inspiration

33
Q

When is the intrapleural pressure most negative in the breathing cycle?

A

End of inspiration

34
Q

When is the alveolar pressure most positive in the breathing cycle?

A

Mid-expiration

35
Q

When is the intrapleural pressure most positive in the breathing cycle?

A

End of expiration

36
Q

How do you treat a pneumothorax?

A

intrapleural pressure equalizes with atmosphere, so you place a chest tube, hook it up to suction, and create a negative pressure

37
Q

What is another word for the “stretchability” of the lung?

A

compliance

38
Q

Compliance is the inverse of what value?

A

elastance

39
Q

How do you calculate compliance from a pressure-volume curve?

A

it is the slope of the pressure volume curve, or:

change in volume/change in pressure

40
Q

What word is used to describe the pressure-volume curve of the lung?

A

hysteresis

41
Q

What causes the hysteresis seen in the pressure-volume curve of the lung?

A

surface tension

42
Q

Decreased compliance is caused by diseases like what? What do they do to the lungs?

A

Restrictive diseases: fibrosis, edema

make the lungs stiffer where you cannot get air IN

43
Q

Do people with decreased compliance have a higher or lower FRC?

A

lower

44
Q

Increased compliance is caused by diseases like what? What do they do to the lungs?

A

Obstructive ventilatory defects: emphysema

Makes the lungs more stretchy and prone to collapse where you cannot get air OUT

45
Q

Do people with increased compliance have a higher or lower FRC?

A

Higher (must breathe in larger volumes to fill lungs–barrel-shaped chests)

46
Q

True or false: intrapleural pressure is always a negative value.

A

FALSE: forced expiration will change intrapleural pressure to a positive value which can be problematic (cause collapsed airways) for people with COPD or people with reduced elastic recoil (increased compliance)

47
Q

A flow-volume loop of an obstructive ventilatory defect will show what?

A

inability to expire at a normal rate

48
Q

A flow-volume loop of a restrictive ventilatory defect will show what?

A

reduced volume of air in lungs (can’t get as much in

49
Q

What are the two major factors that determine lung compliance?

A

1) Tissue properties (1/3 is dependent on collagen, elastin, and interdependence)
2) Surface tension (molecular attractive force between lipid molecules

50
Q

What is surfactant?

A

a mixture of phospholipids (ex. DPPC), cholesterol, and proteins produces by type II pneumocytes and stored in lamellar bodies

51
Q

What stimulates surfactant production?

A

deep breaths

52
Q

What is the major role of surfactant?

A

Increases lung compliance
Reduces the work needed to expand lungs
Reduces the tendency for pulmonary edema

53
Q

In neonatal RDS, the lack of surfactant does what to the lung compliance?

A

decreases compliance

54
Q

Which has a greater pressure, a large or small alveoli?

A

small (decreased radius, increased pressure)

55
Q

What is the most important factor in resistance of airflow through the lungs?

A

radius of airway!

56
Q

List the 4 factors affecting airway resistance.

A

1) Lateral traction (elastic tissue holding airway open from outside)
2) Lung volume (means increased airway diameter)
3) Relaxation/contraction of bronchial smooth muscle
4) Density and viscosity of inhaled gas

Pulmonary (34 decks)

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