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

Exam 1, phys, pate Flashcards

(69 cards)

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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
what mechanical factors affect airway Resistance
mucous, airway compression, lung volume
26
how does lung volume affect resistance
increase lung volume decreases Resistance
27
What factors affect airway compression
increase in R of peripheral airways elastic recoil of lung and chest wall force of contraction surface forces in alveoli
28
describe FVC, FRC, TLC, RV and FEV1 in obstructive lung diseases
dec FVC, FEV1 | inc FRC, RLC, RV
29
describe FVC, FRC, TLC, RV and FEV1 in restrictive diseases
dec FVC, FRC, TLC, RV, FEV1
30
describe what happens to pressure and blood flow in lungs during inspiration
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
describe what happens to pressure and blood flow in lungs during expiration
``` 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
What is difference of PAO2 and PaO2
A- alveolar | a- systemic arterial
33
DEscribe flow of CO2 and O2 in lungs
CO2 diffuses outwards faster from greater solubility | O2 diffuses inward
34
How do we calculate diffusing capacity of lung
measure CO uptake
35
how is diffusing capacity changed in emphysema and fibrosis
decreased
36
A Hb level of 10 is significatn for what?
anemia
37
Hb level of 20 is significant for what
polycythemia
38
O2 concentration calculation
(1.39xHbx (Sat/100) ) + 0.003Po2
39
What can cause a left shift in the Hb-O2 dissociation curve (more O2 bound to Hb)
decreased temp decrease PCO2 decreased 2,3-DPG decreased H
40
what can cause a right shift in the Hb-O2 dissociation curve (less O2 bound to Hb)
increase temp, increased PCO2 increased 2,3 DPG icnreased H+
41
2,3 DPG is produced in response to what conditions
ischemia
42
what occurs with deoxygenated Hb and CO2
form carbaminohemoglobin | so deoxy blood carries more CO2 for a given PCO2 than oxygenated
43
Which dissociation curve is more linear in physiologic conditions O2 or CO2
CO2
44
where does most of CO2 end up
in RBC as HCO3 and H ions
45
What are the central controllers of ventilation
pons, medulla, otehr parts of brain
46
what are the effectors of ventilation
respiratory muscles
47
what are the sensors of ventilation
chemo R | central peripheral, upper airway, pulmonary
48
What are the medullary centers for respiration and explain wach one
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
What are the pontine centers for respiration
apneustic center- keeps inspiration in the "on" position | penumotaxic- facilitaties inspiratory off switchign
50
What are vagal afferents
slowly adapting pulmonary stretch R rapidly adapting R lung and bronchial C fiber
51
what are the slow adapting pulmonary stretch R
increase activity with increased lung inflation, terminating inspiration
52
what are the rapidly adapting R
mechanoreceptors that respond to the rate of change of inflation, promoting inspiration
53
what are the lung and bronchial C fibers
chemoR that respond to histamine and PGs to influence heart rate, BP and RR
54
what are the muscle afferents for respiration
muscle spindles that provide info on length tendon organs taht provde muscle tension joint R that provide info to rib joint motion
55
What are the respiratory chemoR afferents
central- near ventral medulla | peripheral (carotid CN IX and aortic CN X bodies)
56
What do central chemoR sense
respond to changes in PCO2, pH of CSF | stimulation increases tidal volume
57
what is role of peripheral chemo R
respond to changes in PaO2, pH/PaCO2 very weak O2 response until PO2 falls below 60 mmHg respiration increases from increases F
58
central chemoR cannot detect what?
PO2 levels
59
what change in pH stimulates ventilation
a decrease
60
What is the alveolar to arterial O2 difference
difference between PAO2 and PaO2
61
``` What is the normal alveolar to arterial O2 difference based on ages: 1-30 40 50 70 ```
1-30 <25
62
A normal A-a O2 difference can rule out what on Ddx
problem with V/Q mismatch as a problem of hypoxemia
63
What can cause physiologic hypoxia
reduced PIO2 alveolar hypoventilation ventilation-perfusion mismatch shunt diffusion impairment
64
where in lungs is greatest perfusion
base
65
ventilation to perfusion ratio is greatest where in lungs
apex
66
how come a high V/Q branch of aveloi cannot make up for a deficienty oxygenation in a shunt
Hb is already near saturated
67
With a shunt in alveoli will supplemental O2 help
no
68
which physiological cause of hypoxia is not usually present at rest
diffusion abnormality
69
What can cause hypercapnia
- 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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