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AP (2) > Exam 2 Lecture 9 (2-27-23) Pulmonary (Transpulmonary Pressure, Lung Volumes, Respiration Cycle Graph) > Flashcards

Exam 2 Lecture 9 (2-27-23) Pulmonary (Transpulmonary Pressure, Lung Volumes, Respiration Cycle Graph) Flashcards

1
Q

At sea level under perfect conditions, the pressure in the atmosphere should be _________ mmHg or _______ atm.

A

760 mmHg or 1 atm

If we go underground, atmospheric pressure will be higher. if we go to a higher altitude, atmospheric pressure will be lower.

(08:13) (09:23)

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2
Q

Why is atmospheric pressure important to the cardiopulmonary system?

A

Atmospheric pressure (760 mmHg) is what’s used to force gas into your lungs and into your blood vessels.

(8:41)

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3
Q

What is our normal alveolar pressure (PA) in between breaths?

A

0 cmH2O

(10:36)

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4
Q

What would an alveolar pressure (PA) of +1 cmH2O mean?

A

PA is higher than outside pressure. The pressure inside the alveoli is higher than the outside pressure, resulting in a delta P that will push air out of the alveoli.

(11:15)

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5
Q

When we expire, our PA is greater than or less than 0 cm H2O?

A

Greater than. PA will be +1 cmH20 and will push gas out of the lungs.

(11:15)

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6
Q

What would an alveolar pressure (PA) of -1 cmH2O mean?

A

If PA is -1 cmH2O, this will result in a Δp that would favor air movement into the lungs.

(12:00)

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7
Q

Under normal conditions, alveolar pressure (PA) oscillates between ________ and ________.

A

-1 cmH2O (inspiration) and +1 cmH2O (expiration)

(12:34)

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8
Q

When we inspire, our PA is greater than or less than 0 cm H2O?

A

Less than. PA will be -1 cmH20 and will pull gas into the lungs.

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9
Q

Define Elastic Recoil Pressure (PEL
or PER).

A

Refers to the tendency of a stretched out lung to want to recoil on itself.

(14:00)

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10
Q

What is the relationship between elastic recoil pressure and thoracic pressure?

If thoracic pressure is -5 cmH2O, what would PER be?

A

The elastic recoil pressure is typically equal and opposite to whatever the thoracic pressure is.

In this situation, as long as alveolar pressure is 0 cmH2O then PER = +5 cmH2O.

(15:30) (22:00)

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11
Q

Define Intra Pleural Pressure (PIP or PPL)?

A

Thoracic Pressure

PIP is -5 cmH2O under normal conditions in between breaths.

(17:12)

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12
Q

Define transmural pressure.

A

The difference in pressure between two sides of a ‘wall’.

So there’s a barrier, and we’re looking at what’s the pressure on one side of the barrier vs the pressure on the other side of the barrier.

18:00

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13
Q

Define transpulmonary pressure.

A

The difference in pressures between two different sides of a wall, or some kind of barrier.

Difference between the alveolar pressure and the intrapleural pressure in the pleural cavity. Amount of pressure to move air into the lungs.

(18:30)

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14
Q

What is the formula for transpulmonary pressure (PTP)?

A

PTP = PA - PIP

Transpulmonary Pressure = Alveolar Pressure - Intrapleural Pressure

(18:40)

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15
Q

What is the pressure between the chest wall and the outer border of the lung in between normal breaths?

A

-5 cmH2O (intrapleural pressure, intrathoracic pressure)

(20:00)

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16
Q

What is our transpulmonary pressure in between normal breaths?

A

+5 cmH2O

PTP = PA - PIP

PA = 0 cmH2O
PIP= -5 cmH20
0 - ( -5) = +5
PTP = 5 cmH2O

(21:00)

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17
Q

The formula for transpulmonary pressure is also equal to the equation of what other type of pressure?

A

Elastic Recoil Pressure (PER)

PER = PA - PIP

(21:30)

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18
Q

What is the PER in between normal breaths?

A

+5 cmH2O

Same formula as transpulmonary pressure (PTP)

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19
Q

In which direction do the chest wall and rib cage tend to recoil?

A

Chest wall and rib cage like to recoil outward.

(24:48)

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20
Q

Muscles in between the ribs are called _________.

A

Intercostal muscles.

Normal resting tone on intercostal muscles tends to want to pull the chest outward.

(25:30)

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21
Q

What are the two recoiling forces that we have in the pulmonary system?

A

Inward recoiling forces of the lung.
Outward recoiling forces of the chest wall, ribs, and intercostal muscles.

The opposing recoiling forces contribute to the negative intrapleural pressure in the thorax.

(26:00)

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22
Q

Why is transpulmonary pressure important to the lungs?

A

Transpulmonary pressure is the pressure that’s available to fill the lungs up with air.

(27:15)

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23
Q

What does positive transpulmonary pressure tell us?

A

A positive transpulmonary pressure indicates that we have something available to put air into the lungs, whether it’s coming from ourselves or some type of mechanical device.

(29:00)

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24
Q

How much is a normal tidal volume (VT)?

A

0.5 L

(30:30)

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25
Q

What is the amount of air that should be in the chest after a normal breath?

What is a term for this volume and what are the components?

A

3 L
(31:00)

Functional Residual Capacity (FRC)

FRC is comprised of Expiratory Reserve Volume (ERV) and Residual Volume (RV).

(32:00)

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26
Q

Define expiratory reserve volume (ERV).

A

The amount of air that can be exhaled out after a normal expiration.

ERV = 1.5 L

(34:00)

27
Q

What is the term that describes the amount of air in the lungs that can not be pushed out?

A

Residual Volume (RV)

RV = 1.5 L

(34:30)

28
Q

What is the function of the FRC?

A

Holds the lungs open by having a basal amount of air in them.

The FRC in our lungs also serves as a buffer/ safety factor if we forget to breathe or during induction. There will be 3 liters of air in the lungs for the blood to pass through the alveoli to be oxygenated in exchange for CO2.

(37:00)

29
Q

What is the term that describes the excess amount of air that a person can inspire past a normal tidal volume?

How much more can we inspire past our VT if we are young and healthy?

A

Inspiratory Reserve Volume

IRV = 2.5 L

30
Q

What is our inspiratory capacity (IC)?

How much is our inspiratory capacity (IC)?

A

Inspiratory Capacity (IC) = VT + IRV

IC = 3.0 L

(40:00)

31
Q

Name the four volumes of our lungs.

What is the term that describes the sum of all four lung volumes? How much will this be?

A

Inspiratory Reserve Volume (IRV) 2.5 L
Tidal Volume (VT) 0.5 L
Expiratory Reserve Volume (ERV) 1.5 L
Reserve Volume (RV) 1.5 L

Total Lung Capacity (TLC)

TLC = 6L total

(41:00)

32
Q

Which lung volumes are considered the “working” volumes?

What is the term that describes the sum of all three working volumes? How much is this?

A

Inspiratory Reserve Volume (IRV) 2.5 L
Tidal Volume (VT) 0.5L
Expiratory Reserve Volume (ERV) 1.5 L

Vital Capacity (VC) = 4.5 L

(41: 30)

33
Q

At what age do we reach our peak lung function?

A

Age 20 (Ideal lung performance age, all downhill from there.)

The lungs start to lose alveoli past this age :(

(43:30)

34
Q

According to this graph, what is intrapleural pressure (PIP) in between breaths?

A

-5cm H2O

(45:11)

35
Q

What graph depicts chest pressure over the course of a normal respiratory cycle?

A

B.

(45:23)

36
Q

What will be the new intrapleural pressure at the end of inspiration?

A

Look at graph B, new intrapleural pressure will be appx -7.5 cmH2O.

(45:40)

37
Q

According to this graph, how long is a normal respiratory cycle?
How long does inspiration take?
How long does expiration take?

A

4 seconds for a normal respiratory cycle.
2 seconds for inspiration.
2 seconds for expiration.

(46:15)

38
Q

During inspiration, as thoracic pressure decreases, what happens to alveolar pressure?

During what part of the inspiratory cycle will there be the fastest airflow into the lungs?

A

There will be a drop in alveolar pressure, which will cause air to move into the lungs. Most negative alveolar pressure will occur about halfway into the inspiratory cycle.

Halfway into the inspiratory cycle (1 second), there will be the fastest airflow into the lungs.

(48:30)

39
Q

What causes the tidal volume to increase from 0 to 0.5 L in graph A?

A

The drop in alveolar pressure will cause air to move into the lungs over the course of two seconds.

(51:50)

40
Q

At the end of normal inspiration, what will be the normal alveolar pressure?

A

0 cmH2O

No more air will be moving in, but the diaphragm will still be contracted and alveoli will be expanded due to the more negative thoracic pressure of 7.5 cmH2O.

(54:20)

41
Q

What will the Elastic Recoil Pressure (PER) be at the end of inspiration?

A

+7.5 cmH2O

PER is equal to and opposite of PIP.

(57:00)

42
Q

What does the lung do that is energy efficient during expiration?

A

Relaxation of the diaphragm and natural lung recoil should be sufficient enough to cause a positive alveolar pressure and push air out of the lungs.

(60:30)

43
Q

How does the ERV make its way out of the lungs?

A

Our 8-pack abdominal muscles will be used as an accessory muscle of expiration and push up on the diaphragm to cause the ERV out of the lungs.

(68:00)

44
Q

When FRC is at 3.0 L what two components are in balance?

A

Outward Recoil Pressure of the Chest wall
Inward Recoil Pressure on the Lung

(81:15)

45
Q

If the chest wall has a decreased recoil pressure, what will happen to the FRC?

A

There will be a decreased FRC.

(81:25)

46
Q

What happens to the FRC when there is a change from standing to a supine position? Why does this happen?

A

FRC decreases due to the decrease in ERV. The decrease in ERV is from the contents of the abdomen pushing upwards toward the base of the diaphragm when the body is supine.

(85:00)

47
Q

How does COPD affect alveoli elastic recoil?

A

We will lose some “springs” in the alveoli with COPD. There will be a decrease in alveoli elastic recoil.

(88:25)

48
Q

In older individuals with decreased alveoli elastic recoil, how will the respiratory cycle time be adjusted?

A

The Inspiration to Expiration ratio will be adjusted to 1:2 or 1:3 seconds.

(91:15)

49
Q

What is ventilation?

A

Ventilation means bringing air into the system or pushing air out of the system.

(92:00)

50
Q

With a normal VT. What percentage is involved with gas exchange?

A

70%

VT = 500 mL
350 mL is involved with gas exchange.

350/500 = 0.7

(93:00)

51
Q

With a normal VT. How much air is in the anatomical dead space?

A

150 mL

(93:30)

52
Q

What types of volumes make up the VT?

A

Volume of Alveolar gas (VA)
Volume of Dead Space (VD)

VT = VA + VD

(96:30)

53
Q

What does ‘n’ represent if we see it in an equation?

A

n= breaths/min

Normal n will be 12 breaths/min

(97:30)

54
Q

How much is our total minute ventilation (VE)?

A

6L/min = VE

This is the sum of alveolar minute ventilation and dead space minute ventilation.

Alveolar Minute Ventialtion
350 mL x 12 breaths/min = 4.2 L/min

Dead Space Minute Ventilation
150 mL x 12 breaths/min = 1.8 L/min

(98:24)

55
Q

VE is also equal to ________.

A

Minute Tidal Volume Ventilation

56
Q

What are two ways for the lungs to bring in more air?

Which way is more efficient?

A

Increase Respiratory Rate
Increase the Depth of Breathing (more efficient)

By increasing the depth of breathing, there will be an increase in alveolar ventilation for each breath without adding to dead space ventilation.

(104:00)

57
Q

What is this a picture of?

A

Alveolar capillaries

(107:00)

58
Q

If inspired air fills up the volume of the alveoli, what happens to the capillaries that are attached around the alveoli?

What happens to the vascular resistance of the capillaries?

A

The capillaries will increase in length and decrease in internal diameter.

Vascular resistance during inspiration will increase at the level of the alveoli.

(110:00)

59
Q

What are larger blood vessels in the lungs called?

A

Extra-alveolar Blood Vessels

These are your pulmonary arteries and veins.

(113:30)

60
Q

How do extra-alveolar blood vessels respond to inspiration?

A

During inspiration, the thoracic pressure will be more negative. This excess negative pressure will pull on the extra-alveolar wall (widens diameter) and decrease vascular resistance.

Expiration will decrease the diameter of extra-alveolar blood vessels and increase vascular resistance.

(115:00)

61
Q

During expiration, what will happen to alveolar capillary vascular resistance and extra-alveolar vascular resistance?

A

Alveolar Capillary Vascular Resistance will decrease with expiration.

Extra-alveolar Vascular Resistance will increase with expiration.

(116:00)

62
Q

Where will you have the lowest pulmonary vascular resistance?

How does this affect the right heart?

A

At FRC

At FRC, our right heart is happy because this is where PVR is the lowest. Going right or left from this point will increase PVR, which will cause the right heart to work harder.

(120:30)

63
Q

What causes the increased PVR from decrease lung volume?

What causes the increased PVR from increased lung volume?

A

Decrease lung volume will cause PVR to be elevated due to increased extra-alveolar vascular resistance.

Increase lung volume will cause PVR to be elevated due to increased alveolar-capillary vascular resistance.

(122:00)

AP (2) (5 decks)

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