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Year 2 Respiratory > Exam 1, phys, pate > Flashcards

Exam 1, phys, pate Flashcards

1
Q

What is Vital lung volume

A

normal respiration amount

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2
Q

How can you calculate Vital capacity

A

total lung capacity minus the residual volume

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3
Q

What is forced residual capacity

A

about of air you can expire forcefully

end residual plus residual volume

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4
Q

What is inspiration capacity

A

amount of air you can inhale.

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5
Q

what is anatomic dead space

A

Volume of conducting airways

around 150 ml

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6
Q

What is alveolar dead space

A

alveoli containing air but no participating in gas exchange

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7
Q

what is physiologic dead space

A

total dead space for the system

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8
Q

what is alveolar ventilation

A

room air deliverd to the respiratory zone per minu(tidal volume- dead space)x RR

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9
Q

is inspiration active or passive movement for diaphragm? lungs?

A

active for diaphragm, passive for ribs

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10
Q

what mm do you use for inspiration

A

diaphragm, external intercostals, accessory mm like scalenes and SCM

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11
Q

what are the mm involved in expiration

A

passive

forced involves internal intercostals and abominal muscles

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12
Q

What is the intrapleural pressure before inspiration and at end

A

before is -5

at end is -8

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13
Q

What is the alveolar pressure during inspiration compared to before or after

A

during is -1

before or after is 0

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14
Q

What is alveolar pressure during expiration

A

+1

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15
Q

lung elastic recoil P is always equal and opp to what measurement

A

transpulmonary pressure

alveolar- intrapleural

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16
Q

What happens to lung pressures during a pneumothorax

A

alveolar P equals intramural so there is no P difference.. collapsed

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17
Q

What are the 2 major collapsing forces in the lung

A

surface tension and lung elastic recoil

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18
Q

how is surface tension reduced in lungs

A

surfactants

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19
Q

what determines the elastic recoil of the lung

A

elastin and collagen fibers

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20
Q

what are the 3 functions of surfactant

A

lowers Surface tension, increases alveolar stability

keeps alveoli dry

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21
Q

what type of lung disease category is emphysema? fibrosis?

A

emphysema is obstructive

fibrosis is restrictive

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22
Q

What part of lung has least Resistance

A

small airways in parallel

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23
Q

What stimulation can cause activation of SM bronchoconstrictors

A

PNS (Ach)
Histmaine
Irritants (cigarette smoke)

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24
Q

what stimulation can cause relaxation of SM, bronchodilators

A

SNS, NE via Beta adrenergics
agonists for beta 2
increase in CO2 pressure in bronchioles

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25
Q

what mechanical factors affect airway Resistance

A

mucous, airway compression, lung volume

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26
Q

how does lung volume affect resistance

A

increase lung volume decreases Resistance

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27
Q

What factors affect airway compression

A

increase in R of peripheral airways
elastic recoil of lung and chest wall
force of contraction
surface forces in alveoli

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28
Q

describe FVC, FRC, TLC, RV and FEV1 in obstructive lung diseases

A

dec FVC, FEV1

inc FRC, RLC, RV

29
Q

describe FVC, FRC, TLC, RV and FEV1 in restrictive diseases

A

dec FVC, FRC, TLC, RV, FEV1

30
Q

describe what happens to pressure and blood flow in lungs during inspiration

A

intrapleural pressure falls
VR and right ventricular output increases
pulmonary vessels expand, volume increases
VR to L heart and output decrease
systemic arterial arterial O decreases causing heart rate to increase

31
Q

describe what happens to pressure and blood flow in lungs during expiration

A 
intrapleural P increases (less negative)
VR and righ ventricle output decreases
pulmonary vessels constrict
return of blood and output increase
BP increases causing HR to dec
32
Q

What is difference of PAO2 and PaO2

A

A- alveolar

a- systemic arterial

33
Q

DEscribe flow of CO2 and O2 in lungs

A

CO2 diffuses outwards faster from greater solubility

O2 diffuses inward

34
Q

How do we calculate diffusing capacity of lung

A

measure CO uptake

35
Q

how is diffusing capacity changed in emphysema and fibrosis

A

decreased

36
Q

A Hb level of 10 is significatn for what?

A

anemia

37
Q

Hb level of 20 is significant for what

A

polycythemia

38
Q

O2 concentration calculation

A

(1.39xHbx (Sat/100) ) + 0.003Po2

39
Q

What can cause a left shift in the Hb-O2 dissociation curve (more O2 bound to Hb)

A

decreased temp
decrease PCO2
decreased 2,3-DPG
decreased H

40
Q

what can cause a right shift in the Hb-O2 dissociation curve (less O2 bound to Hb)

A

increase temp, increased PCO2
increased 2,3 DPG
icnreased H+

41
Q

2,3 DPG is produced in response to what conditions

A

ischemia

42
Q

what occurs with deoxygenated Hb and CO2

A

form carbaminohemoglobin

so deoxy blood carries more CO2 for a given PCO2 than oxygenated

43
Q

Which dissociation curve is more linear in physiologic conditions
O2 or CO2

A

CO2

44
Q

where does most of CO2 end up

A

in RBC as HCO3 and H ions

45
Q

What are the central controllers of ventilation

A

pons, medulla, otehr parts of brain

46
Q

what are the effectors of ventilation

A

respiratory muscles

47
Q

what are the sensors of ventilation

A

chemo R

central peripheral, upper airway, pulmonary

48
Q

What are the medullary centers for respiration and explain wach one

A

dorsal respiratory group: DRG is primarily inspiratory, provides rhythmic drive to contralateral phrenic motor neurons
Ventral respiratory group which is primarily expiratory drive to intercosals and abdominal muscles

49
Q

What are the pontine centers for respiration

A

apneustic center- keeps inspiration in the “on” position

penumotaxic- facilitaties inspiratory off switchign

50
Q

What are vagal afferents

A

slowly adapting pulmonary stretch R
rapidly adapting R
lung and bronchial C fiber

51
Q

what are the slow adapting pulmonary stretch R

A

increase activity with increased lung inflation, terminating inspiration

52
Q

what are the rapidly adapting R

A

mechanoreceptors that respond to the rate of change of inflation, promoting inspiration

53
Q

what are the lung and bronchial C fibers

A

chemoR that respond to histamine and PGs to influence heart rate, BP and RR

54
Q

what are the muscle afferents for respiration

A

muscle spindles that provide info on length
tendon organs taht provde muscle tension
joint R that provide info to rib joint motion

55
Q

What are the respiratory chemoR afferents

A

central- near ventral medulla

peripheral (carotid CN IX and aortic CN X bodies)

56
Q

What do central chemoR sense

A

respond to changes in PCO2, pH of CSF

stimulation increases tidal volume

57
Q

what is role of peripheral chemo R

A

respond to changes in PaO2, pH/PaCO2
very weak O2 response until PO2 falls below 60 mmHg
respiration increases from increases F

58
Q

central chemoR cannot detect what?

A

PO2 levels

59
Q

what change in pH stimulates ventilation

A

a decrease

60
Q

What is the alveolar to arterial O2 difference

A

difference between PAO2 and PaO2

61
Q 
What is the normal alveolar to arterial O2 difference based on ages:
1-30
40
50
70
A

1-30 <25

62
Q

A normal A-a O2 difference can rule out what on Ddx

A

problem with V/Q mismatch as a problem of hypoxemia

63
Q

What can cause physiologic hypoxia

A

reduced PIO2
alveolar hypoventilation
ventilation-perfusion mismatch shunt
diffusion impairment

64
Q

where in lungs is greatest perfusion

A

base

65
Q

ventilation to perfusion ratio is greatest where in lungs

A

apex

66
Q

how come a high V/Q branch of aveloi cannot make up for a deficienty oxygenation in a shunt

A

Hb is already near saturated

67
Q

With a shunt in alveoli will supplemental O2 help

A

no

68
Q

which physiological cause of hypoxia is not usually present at rest

A

diffusion abnormality

69
Q

What can cause hypercapnia

A
  • redulced alveolar ventialtion (increase in dead space)

- increase in CO2 without concomitant increase in ventilation (drug overdose or emphysema)

Year 2 Respiratory (5 decks)

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