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Case 1 Flashcards

too hug yaffa (96 cards)

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1
Q

How is normal breathing achieved ( inspiration)

A

Internal intercostal relax
external intercostal contract
Diaphragm contracts inferiorly

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2
Q

How is normal breathing achieved ( expiration )

A

Internal intercostal contract
external intercostal relax
Diaphragm relaxes
elastic recoil of lungs

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3
Q

How is forced expiration achieved

A

accessory muscles force diaphragm up
internal and external obliques
transversus abdominas and rectus abdominas

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4
Q

How is forced inhalation achieved

A

accessory muscles
scalene , sternocleidomastoid, serratus anterior and pec minor increase thoracic cavity volume

Diaphragm contracts and external intercostal muscles contract

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5
Q

what do young children have to rely on for breathing

A

the descent of the diaphragm

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6
Q

Where are the group’s neurons located that control breathing

A

Medulla oblongata

pons

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7
Q

what are the 3 major collections of neurones

A

dorsal respiratory group
ventral respiratory group
pneumotaxic centre

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8
Q

what provides the basic rhythm of respiration

A

dorsal respiratory group of neurones

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9
Q

what signal neurones to the diaphragm

A

RAMP

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10
Q

what is the advantage of neurones ramp

A

causes a steady increase in the volume of the lungs during respiration rather than gasps

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11
Q

what initiates RAMP signal

A

apneustic centre

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12
Q

what calms down RAMP

A

pneumotoxic centre

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13
Q

what part controls the filling phase of the lung

A

pneumotoxic centre

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14
Q

what can a strong pneumotoxic signal do

A

Inspiration is short.

Breathing rate increases

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15
Q

what does the apneustic area do

A

coordinates transition between inhalation and exhalation

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16
Q

what can override apneustic area

A

pneumotoxic signal

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17
Q

what respiratory group controls normal quiet respiration

A

dorsal respiratory group

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18
Q

What lies next to the dorsal respiratory group

A

ventral respiratory group

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19
Q

what can cause the dorsal respiratory signals to spill over into the ventral respiratory neurones

A

when you are breathing rapidly

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20
Q

what is the ventral respiratory group used for

A

very heavy exercise and thus this is an overdrive system. It can stimulate both inspiration and expiration

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21
Q

What is the Hering Breuer inflation reflex

A

stretch receptors that activate when the lungs become overstretched. when they do become overstretched they activate a feedback loop that switches off the inspiration ramp

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22
Q

what chemoreceptors does oxygen act on

A

peripheral chemoreceptors

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23
Q

Excess carbon dioxide what does that act on

A

access carbon dioxide acts directly on the respiratory centre itself thus increasing respiration

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24
Q

Where is Alpha 1 antitrypsin made and what is it for

A

The liver and it protects the lungs

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25
What is Tidal Volume
The volume of air exchanged during normal inspiration or expiration
26
What is IRV (inspiratory reserve volume)
The maximum volume that can be inspired in addition to a tidal inspiration
27
What is ERV ( Expiratory reserve volume)
The maximum volume that can be expired in addition to a tidal expiration
28
What is RV ( residual volume )
The volume remaining in the lungs at the end of a maximum expiration.
29
Which Lung volume can’t be measured during a test
Residual Volume
30
``` What do these stand for FVC/VC TLC RV TV IRV ERV IC FRC ```
``` Forced/vital capacity Total lung capacity Reserve volume Tidal volume Inspiratory reserve volume Expiratory reserve volume Inspiratory capacity Functional reserve capacity ```
31
What kind of process is Inspiration
Active process
32
What kind of process is Forced inspiration
Active process
33
What kind of process is expiration
Passive process
34
What kind of process is Forced expiration
Active process
35
What muscles are used in Forced inspiration
Accessory muscles - sternocleidomastoid, scalene muscles, serrated anterior and pec minor
36
What prevents lungs collapsing in expiration
Surfactant and inter-pleural pressure
37
What muscles are used in inspiration
Diaphragm and external intercostal
38
What muscles are used in Forced expiration
Internal ones - innermost and internal intercostal and transversals thoracis Abdominal - external and internal obliques and Transversus abdominis and rectus abdominis
39
What are the layers of muscles on the belly deep to superficial
Transverse abdominis then rectus abdominis
40
What does the apneustic center do
Adjusts output of the DRG by continually stimulating it to build up the ramp signal from the DRG
41
What does DRG stand for
Dorsal respiratory group
42
What happens when respiratory drive increases for ventilation
DGR spills to the VGR and the inspiratory center of the VGR becomes activated
43
What nerves do the Dorsal respiratory group
Phrenic nerve Intercostal nerves Nerves for the accessory respiratory shite
44
What does the phrenic nerve innervate
Diaphragm
45
What nerves send nerve shite to the PONS
Vagus | Glossopharyngeal
46
What does Oxygen act on in terms of respiration group
Peripheral chemoreceptors
47
Where are peripheral chemoreceptors located
Carotid and aortic bodies
48
What do hydrogen ions do in terms of stimulation respiration
The have a direct effect in stimulating the neurones as CO2 reacts with water to form carbonic acid which dissociates into hydrogen and bicarbonate ions
49
What is the Hering Breuer Reflex
When the lungs are over inflated the stretch receptors activate
50
What does the hering breuer reflex do to the rate of respiration
Increase it
51
What does rising Pco2 do on smooth muscle in walls of arteries and capillaries
Vasodilation and increases blood flow
52
What does hypoxia mean bitch
Lack of o2 motherfucker
53
What is cyanosis caused by
Hypoxia
54
Where is the lung suspended from
It’s hilum from the mediastinum
55
What is the pressure normally of the fluid in the pleural cavity
Slightly negative
56
What does hypoxia mean
Lack of oxygen
57
What does pleural pressure mean
Pressure of “fluid” between visceral and parietal pleurae
58
When the Diaphragm is relaxed what are the relative pressures in Plural pressure , alveolus and atmospheric
Ppl>Palv | Palv=Patm
59
In inspiration what are the pressure differences in Ppl, Palv and Patm
Ppl<
60
In terms of long/short and narrow and wide what would cause greater airways resistance
Longer the airway and the narrower the airway the greater the airways resistance
61
What is compliance
An indication of a lungs expandability / how easily the lungs expand and contract
62
What type of alveolar epithelial cells secretes surfactant
Type II alveolar epithelial
63
What is surfactant a mixture of
Phospholipids, proteins and ions
64
What is a pneumothorax
Collection of air between the visceral and parietal pleura causing a real rather than potential pleural space.
65
What are the types of Pneumothoraxes
Primary Spontaneous Secondary spontaneous Traumatic Tension
66
Explain the following pneumothorax PRIMARY and SECONDARY spontaneous
Primary = most common and caused by a rupture of a small subpleural emphysematous bulla . Secondary = More deadly and caused by COPD or asthma (underlying Lung disease)
67
What is the difference in traumatic pneumothorax and tension
Traumatic = blunt trauma or penetrating, can also be associated with a haemothorax. Tension = Most commmon during mechanical ventilation/ following a traumatic pneumothorax. Air flow is ONE WAY, LUNG INTO PNEUMOTHORAX . Air cant escape
68
What would the treatment for a tension pneumothorax be
Needle aspiration and chest drain
69
What is Dysponea
Laboured breathing
70
What would the percussion note be of a pneumothorax
Resonant
71
What is the most consistent finding in the clinical features of the pneumothorax
Reduction in breath sounds on the affected side
72
On an x ray what would the lung look like on the side with a pneumothorax
Extra black space
73
In a tension pneumothorax what can happen and be observed in an x ray
Trachea displacement and lung shrivels up away from the affected side
74
To confirm diagnosis what can be seen on the x ray in relations to the pleura
Clear line of visceral pleura with absence of peripheral lung markings beyond it
75
What will the arterial blood gases be in a pneumothorax
Hypoxia
76
What is a needle aspiration
Needle in 2nd intercostal space used as diagnostic tool for pneumothorax and to relieve pressure before a chest drain
77
What is a chest drain
Long tube that enters through the 5th intercostal space and goes down to a container with water that acts as a one way valve
78
What is the ATLS protocol for
Standard method for the initial management of severely injured patients
79
In the ATLS protocol what does ABCDE stand for
``` A = airways B = breathing and ventilation C= circulation with haemorrhage control D= disability and Neurological status E = exposure and environment ```
80
What are the two divisions of the Autonomic nervous system
Sympathetic and parasympathetic
81
What do the SNS and PNS secrete
Acetylcholine | Norepinephrine
82
What are the majority of the sympathetic in terms of adrenergic and cholinergic
Sympathetic are adrenergic
83
What are the fibres of Ach and Norepinephrine said to be
``` Ach = cholinergic N = adrenergic ```
84
What do the acetylcholine receptors activate
Nicotine receptors and muscarinic receptors
85
Where are the Ach nicotinic receptors found
Autonomic ganglia at the synapses between the preganglionic and postgangionic neurons - both SNS and PNS
86
Where are Ach muscarinic receptors found
All effector cells that are stimulated by the postganglionic cholinergic neurons of the PNS
87
What are all preganglionic neurons
Cholinergic
88
In the postganglionic system what are most of the sympathetic and parasympathetic
``` SNS = adrenergic PNS = cholinergic ```
89
What are the two major types of adrenergic receptors
Alpha and Beta
90
Where are alpha 1 found
Alpha 1 = found in the walls of blood vessels
91
What do Alpha 1 and Alpha 2 receptors do
Alpha 1 = smooth muscle dilation of walls of blood vessels | Alpha 2 = decreases cAMP formation. By inhibiting addenylate cyclase
92
What controls the Vasoconstriction and vasodilation of Alpha 1
SNS - stimulation of SNS causes vasoconstriction and less stimulation of SNS causes vasodilation
93
What do all beta receptors of adrenergic receptors stimulate
Adenylate cyclase
94
Where do Beta 1,2,3 live
Beta 1 = heart Beta 2 = lungs Beta 3 = fat cells
95
What do Beta 1,2,3 do to the Heart, Lungs and Fat cells
Increase cardiac output Bronchodilation Lipolysis of Adipose tissue
96
What receptors are G-protein couple receptors
Alpha and Beta

Sem 2 Case 1 (6 decks)

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