Mechanics of Breathing, Pressures and Work Flashcards

1
Q

What is ventilation?

A

Ventilation refers to the movement of air in and out of the lungs, which is also known as breathing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is respiration?

A

Respiration refers to the process of gas exchange in the alveoli, involving the exchange of oxygen (O2) and carbon dioxide (CO2).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is cellular respiration?

A

Cellular respiration refers to the metabolic process that occurs in cells, specifically in the Krebs cycle, where nutrients are metabolized and energy is produced. It involves the consumption of oxygen (O2) and the release of carbon dioxide (CO2).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the intrapleural space?

A

The intrapleural space is the space between the visceral and parietal pleura.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is tidal volume (VT)?

A

Tidal volume is the volume of air inhaled or exhaled during each breath. It is typically around 500 mL at rest.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the normal respiratory rate (RR)?

A

The normal respiratory rate is approximately 15 breaths per minute, with a range of 12-18 breaths per minute.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is minute ventilation (V)?

A

Minute ventilation is the volume of air that enters the lungs per minute. It is calculated by multiplying tidal volume (VT) by the respiratory rate (RR). For example, if VT is 500 mL and RR is 15 breaths per minute, then the minute ventilation would be 7500 mL/minute.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is alveolar ventilation (VA)?

A

Alveolar ventilation refers to the volume of air that takes part in gas exchange per minute. It is slightly lower than minute ventilation due to the presence of dead space.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What happens during inspiration?

A

Intercostal muscles elevate and evert the ribs.
The diaphragm moves downward.
Scalene muscles, inserted into the first two ribs, raise the upper ribs and push the sternum forward (pump action), increasing the anterior-posterior diameter of the thoracic cavity.
The sloping lower ribs rise and move out, creating the bucket handle action and increasing the transverse diameter of the chest wall.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What happens when the diaphragm contracts during inspiration?

A

When the diaphragm contracts, there is a 75% increase in volume in the thoracic cavity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What happens during inspiration with the intercostal muscles?

A

The intercostal muscles contract, resulting in the bucket-handle movement of the ribs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What muscles are involved in the contraction during inspiration?

A

The scalene muscles contract, causing the sternum to rise.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What effect does the contraction of the scalene muscles have?

A

The contraction of the scalene muscles leads to the expansion of the anterior-posterior diameter of the thoracic cavity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which muscles are considered accessory muscles during forced inspiration?

A

The accessory muscles involved in forced inspiration are the sternomastoid (located in the upper neck), serratus anterior, and pectoralis major muscles.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What type of ventilation is predominant in adults at rest?

A

In adults at rest, ventilation is largely diaphragmatic, meaning the diaphragm is primarily responsible for the movement of air during breathing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What happens when the inspiratory muscles (diaphragm and intercostals) contract during inspiration?

A

Contraction of the inspiratory muscles expands the thoracic cavity, resulting in an increase in thoracic volumes and a decrease in intrapleural and alveolar pressures (according to Boyle’s Law).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the effect of the pressure gradient created during inspiration?

A

The pressure gradient between the alveoli and the mouth allows air to enter the lungs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When does the pressure in the alveoli equalize with the pressure in the mouth during inspiration?

A

At the end of inspiration, the pressures in the alveoli and the mouth are equal.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What happens after inspiration?

A

Following inspiration, the lungs and chest wall undergo recoil, returning to their original positions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What type of process is expiration?

A

Expiration is a passive process.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What causes expiration?

A

Expiration occurs due to the elastic recoil of the lungs and the chest wall.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What happens to the intrapleural and alveolar pressures during expiration?

A

During expiration, both intrapleural pressure and alveolar pressures rise.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is required for forced expiration, such as during coughing or sneezing?

A

Forced expiration requires the contraction of the abdominal walls, which push the diaphragm upward.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How high can intrapleural pressures rise during forced expiration?

A

Intrapleural pressures may rise to +8 kPa (60 mmHg) during forced expiration.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the atmospheric pressure at sea level?

A

The atmospheric pressure at sea level is 760 mmHg.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How does intra-alveolar (intrapulmonary) pressure determine the movement of air in and out of the lungs?

A

Intra-alveolar (intrapulmonary) pressure determines whether air will enter or leave the lungs.
During inspiration, the intra-alveolar pressure is lower than atmospheric pressure (<760 mmHg), allowing air to enter the lungs.
During expiration, the intra-alveolar pressure is higher than atmospheric pressure (>760 mmHg), causing air to leave the lungs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the intrapleural pressure (Ppl) and its relationship with atmospheric pressure?

A

The intrapleural pressure (Ppl) does not equilibrate with the atmosphere because the pleural space is closed and fluid-filled. It is slightly sub-atmospheric, meaning it is lower than atmospheric pressure. This sub-atmospheric pressure is maintained due to the recoil of the chest and lungs away from each other. The negative intrapleural pressure helps prevent the lungs from collapsing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the role of the chest wall in generating airflow during breathing?

A

The chest wall exerts a distending pressure on the pleural space, which is transmitted to the alveoli, increasing their volume, lowering the pressure, and generating airflow inwards.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the transmural pulmonary pressure (Ptp)?

A

The transmural pulmonary pressure (Ptp) is the distending pressure exerted on the alveoli by the chest wall. It is always positive under physiological conditions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are the pressure conditions in the respiratory system during quiet breathing?

A

The transmural pulmonary pressure (Ptp) is always positive.
The intrapleural pressure (Ppl) is always negative.
The intra-pulmonary/alveolar pressure (Palv) moves from slightly negative to slightly positive as we breathe. It is always higher than the intrapleural pressure due to the recoil of the lungs. At the end of inspiration and expiration, it reaches 0, resulting in no air flow.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How does the transmural pulmonary pressure (Ptp) prevent the collapse of the lungs?

A

For a given lung volume, the transmural pulmonary pressure is equal and opposite to the elastic recoil pressure of the lung. This pressure differential ensures that the lungs don’t collapse. It “sucks” the lungs out during inspiration and “sucks” them back in during expiration.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What does FRC stand for and what does it represent?

A

FRC stands for Functional Residual Capacity, which is the volume of air left in the lungs at the end of a normal breath.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What happens to the respiratory muscles, lungs, and chest wall at FRC?

A

At FRC, the respiratory muscles are relaxed, and the lungs and chest wall recoil in opposite directions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

How is the balance between the outward recoil of the chest wall and the inward recoil of the lungs achieved at FRC?

A

At FRC, the outward recoil of the chest wall exactly balances the inward recoil of the lungs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What determines the volume of air at FRC?

A

The volume of air at FRC is determined by the elastic properties of the lungs and the chest wall.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

How does lung disease affect FRC?

A

FRC is decreased in pulmonary fibrosis, where the lungs are stiff and small with increased elastic recoil. FRC is increased in emphysema, which involves the loss of alveolar tissue and decreased elastic recoil.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is the impedance in lung mechanics?

A

Impedance in lung mechanics refers to the combined effect of frictional airway resistance and elastic resistance to stretching of the lungs and chest wall. It is the resistance encountered by the inspiratory muscles during breathing in.

38
Q

What is compliance in lung mechanics?

A

Compliance refers to the ability of the lungs to stretch and recoil, similar to a spring, during ventilation. Lung compliance (CL) is defined as the change in lung volume per unit change in distending pressure.

39
Q

How is the distending pressure (P) calculated in lung mechanics?

A

The distending pressure, P, is the pressure difference across the lung, which is the alveolar-intrapleural pressure.

40
Q

What happens during quiet expiration regarding elastic recoil?

A

During quiet expiration, there is elastic recoil of the lungs, which is balanced by the tendency of the chest wall to recoil in the opposite direction. At the end of quiet expiration, the pressures within the lungs and chest wall balance each other.

41
Q

What is observed in the static pressure-volume loop as lung volume approaches TLC (Total Lung Capacity)?

A

As lung volume approaches TLC, the curve on the static pressure-volume loop flattens.

42
Q

What is hysteresis in the context of the static pressure-volume loop?

A

Hysteresis refers to the slight difference between the inspiratory and expiratory curves on the static pressure-volume loop. It is a common property of elastic bodies.

43
Q

How is static lung compliance defined?

A

Static lung compliance is defined as the slope of the steepest part of the static pressure-volume loop, which is just above FRC (Functional Residual Capacity).

44
Q

How is a dynamic pressure-volume loop obtained?

A

A dynamic pressure-volume loop is obtained by continuously measuring intrapleural pressure and volume during a normal breathing cycle.

45
Q

What are the conditions at the end of inspiration and expiration in a dynamic pressure-volume loop?

A

At the end of inspiration and expiration, airflow and alveolar pressures are zero.

46
Q

What does the slope of the line joining the end points of inspiration and expiration represent in a dynamic pressure-volume loop?

A

The slope of the line joining the end points of inspiration and expiration represents dynamic compliance.

47
Q

What does the area of the dynamic pressure-volume loop indicate?

A

The area of the dynamic pressure-volume loop is a measure of the work done against airway resistance.

48
Q

How does dynamic compliance compare to static compliance in health?

A

In health, dynamic compliance is similar to static compliance.

49
Q

How does dynamic compliance differ in lung diseases characterized by stiff lungs?

A

In lung diseases characterized by stiff lungs, dynamic compliance will be different from static compliance.

50
Q

What does lung compliance depend on?

A

Lung compliance depends on how inflated or deflated the lungs are.

51
Q

What is hysteresis in the context of lung compliance?

A

Hysteresis differs between the compliance curves for inspiration and exhalation. It is caused by changes in frictional resistance.

52
Q

How does lung compliance change with lung volume?

A

The lung is less compliant at higher volumes, requiring more pressure to achieve the same volume change than at lower volumes.

53
Q

How does lung compliance change in interstitial fibrosis?

A

In interstitial fibrosis, lung compliance is decreased due to the stiffening of alveolar walls from scarring, resulting in reduced elasticity.

54
Q

How does lung compliance change in emphysema?

A

In emphysema, lung compliance is normal. The compliance is just right, allowing for low work of inhalation and effective exhalation while retaining the elasticity of alveolar units.

55
Q

How does lung compliance change in normal lung?

A

Compliance is typically within a normal range in a normal lung.

56
Q

What type of airflow occurs during quiet breathing?

A

During quiet breathing, there is laminar airflow in the airways, where gas particles move parallel to the walls of the bronchi.

57
Q

What happens during laminar airflow?

A

During laminar airflow, the center layers of gas particles move faster than the outer layers, creating a cone-shaped front.

58
Q

When does turbulent airflow occur?

A

Turbulent airflow occurs at higher linear velocities in wide airways and near branch points.

59
Q

When does turbulent airflow occur in the trachea?

A

Turbulent airflow occurs in the trachea during exercise, resulting in harsh breath sounds.

60
Q

What causes airway resistance (RAW)?

A

Airway resistance (RAW) originates from the friction between air and the mucosa lining the airways.

61
Q

How does airway resistance affect ventilation?

A

Airway resistance (RAW) needs to be overcome with elastic recoil to inflate the lungs and facilitate ventilation.

62
Q

How is airway resistance (RAW) calculated?

A

Airway resistance (RAW) is calculated as the pressure difference between the alveoli and the mouth divided by the flow rate.

63
Q

What is the relationship between airway resistance (RAW) and the radius of the airways?

A

Airway resistance (RAW) is inversely proportional to the 4th power of the radius of the airways.

64
Q

How is airflow related to the viscosity of the fluid?

A

Airflow is inversely proportional to the viscosity of the fluid.

65
Q

How can airway resistance (RAW) be assessed indirectly?

A

Forced expiratory measures such as FEV1 (forced expiratory volume in 1 second), FVC (forced vital capacity), and FEV1/FVC ratio can provide indirect information about airway resistance (RAW).

66
Q

What factors affect laminar flow and airway resistance?

A

Factors affecting laminar flow and airway resistance include the radius of the conducting airways, the presence of diseases in the peripheral airways, and the tone of bronchial smooth muscle and epithelium.

67
Q

How does the radius of the airways affect airway resistance?

A

According to Poiseuille’s equation, reducing the radius of an airway by half increases the airway resistance by 16 times.

68
Q

Which anatomical structures offer the most resistance in the airways?

A

The nose, pharynx, and trachea are the anatomical structures that offer the most resistance to airflow.

69
Q

How does mouth breathing affect airway resistance?

A

Breathing through the mouth, such as during exercise, decreases airway resistance compared to breathing through the nose.

70
Q

How does bronchial smooth muscle and epithelium tone affect airway resistance?

A

The tone of bronchial smooth muscle and epithelium can influence airway resistance. Parasympathetic nerve supply and acetylcholine acting on M3 receptors can increase bronchomotor tone and airway resistance, while β-adrenergic receptor activation by substances like adrenaline and salbutamol promotes relaxation and decreases airway resistance.

71
Q

What is the role of nitric oxide in airway resistance?

A

Nitric oxide causes bronchodilation, resulting in a decrease in airway resistance.

72
Q

What is the effect of resting bronchomotor tone on airway resistance?

A

Resting bronchomotor tone can influence airway resistance. Increased bronchomotor tone can cause bronchoconstriction, leading to a decrease in airway radius, increased resistance, and decreased airflow.

73
Q

How does bronchoconstriction affect airway resistance?

A

Bronchoconstriction, characterized by a decrease in airway radius, increases airway resistance and reduces airflow.

74
Q

What is the effect of bronchodilation on airway resistance?

A

Bronchodilation, which increases the radius of the airways, decreases airway resistance and promotes increased airflow.

75
Q

How does acute asthma affect airway resistance?

A

Acute asthma is associated with increased airway resistance. It is characterized by bronchoconstriction, mucosal edema (swelling of the airway lining), mucus hypersecretion, and mucus plugging, all of which contribute to increased airway resistance.

76
Q

How does chronic obstructive pulmonary disease (COPD) affect airway resistance?

A

COPD is associated with increased airway resistance. It involves both bronchoconstriction and chronic mucosal hypertrophy (thickening of the airway lining), leading to increased airway resistance and reduced airflow.

77
Q

What causes surface tension forces in the alveoli?

A

Surface tension forces in the alveoli are caused by the air-fluid interface. Cohesive forces between molecules at the surface of the alveolar bubble create tension, which tends to shrink the bubble.

78
Q

Why are alveoli and small airways inherently unstable?

A

Alveoli and small airways are inherently unstable because they tend to collapse during expiration, leading to a condition called atelectasis.

79
Q

How do surface tension forces affect inspiration?

A

During inspiration, the surface tension forces in the alveoli must be overcome to expand the alveolar bubbles and allow for air entry into the lungs.

80
Q

How does surface tension change with age and lung disease?

A

Surface tension can be affected by age and lung disease. Changes in surfactant production or composition can alter surface tension, leading to increased lung stiffness and decreased compliance. These changes contribute to respiratory difficulties seen in certain lung diseases.

81
Q

What is pulmonary surfactant?

A

Pulmonary surfactant is a mixture of phospholipids, primarily phosphatidylcholine, and proteins. It is produced by Type II pneumocytes and floats on the surface of the alveolar fluid.

82
Q

How does pulmonary surfactant reduce surface tension?

A

Pulmonary surfactant reduces surface tension by interfering with the attractive forces between liquid molecules at the air-fluid interface. The hydrophilic and hydrophobic ends of the surfactant molecules repel each other, creating a film that lowers the surface tension in the alveoli.

83
Q

What is the role of surfactant in the lungs?

A

Surfactant plays a crucial role in the lungs by reducing surface tension. This prevents the collapse of alveoli during expiration, promotes lung compliance, and facilitates the expansion of the alveoli during inspiration.

84
Q

What happens when there is a deficiency or dysfunction of pulmonary surfactant?

A

Deficiency or dysfunction of pulmonary surfactant can lead to increased surface tension, resulting in decreased lung compliance and the development of respiratory distress syndrome, particularly in premature infants.

85
Q

How does surfactant production change with fetal lung development?

A

Surfactant production increases as the fetal lungs develop, particularly in the third trimester. This is essential for lung function after birth and the prevention of respiratory complications.

86
Q

How does pulmonary surfactant affect lung compliance?

A

Pulmonary surfactant reduces surface tension, which increases lung compliance by reducing the forces that tend to shrink the alveoli. This allows for easier expansion of the lungs during inspiration.

87
Q

What is the role of pulmonary surfactant in maintaining alveolar stability?

A

Pulmonary surfactant prevents alveolar collapse by reducing surface tension. It keeps small alveoli from collapsing completely during expiration and prevents large alveoli from becoming overly distended during inspiration.

88
Q

How does pulmonary surfactant prevent fluid accumulation in the lungs?

A

Pulmonary surfactant reduces surface tension, which helps prevent the accumulation of fluid in the lungs. By reducing the hydrostatic pressure in the tissue outside the capillaries, it helps to keep the lungs dry and prevents fluid from being drawn from the capillaries into the alveoli.

89
Q

What is the role of pulmonary surfactant in defense against infection?

A

Pulmonary surfactant plays a role in the defense against infection by enhancing the clearance of pathogens from the lungs. It contains antimicrobial proteins that help to neutralize and eliminate microorganisms, contributing to lung health.

90
Q

What is Neonatal Respiratory Distress Syndrome (NRDS)?

A

Neonatal Respiratory Distress Syndrome is a condition that occurs in premature babies who have a lack of surfactant. Without sufficient surfactant, the alveoli cannot remain open, leading to difficulty in breathing and inadequate oxygenation. NRDS is a significant cause of morbidity and mortality in premature infants.