Flashcards in Mechanism of Breathing/Compliance Deck (26):
Name 3 pulmonary obstructive diseases
Name 1 pulmonary restrictive disease
What are the 4 steps of inspiration?
1. Contraction of inspiratory muscles
2. Inflation of Chest Cavity
3. Inflation of Lung
4. Inward Air-Flow
What are the main inspiratory muscles?
2. External intercostals
When the diaphragm contracts, does it move up or down?
What are the main expiratory muscles?
Expiration is primarily a passive process. During normal/quiet breathing, there are no muscles used for expiration.
During some activities/exercise or during forced expiration, some muscles do contract (e.g. muscles in abdominal wall, or internal intercostals which assist by pulling the ribs inward and downward to decrease the thoracic volume)
What is one of the effects of obstructive diseases in inspiratory muscles?
The inspiratory muscles are shorter. so they have a lower % maximal force.
E.g. the diaphragm is shorter and more flattened. As a result, the diaphragm is unable to produce as much force.
What is PIP?
Intraplural pressure. This helps the lung stay stuck to the chest wall.
What are typical values of PIP at the end of expiration and inspiration?
-5 cm-H2O at the end of expiration
-30 cm-H2O at the end of inspiration
The heightened (more negative) intrapleural pressure near the end of inspiration is mainly the result of the tendency of the lung to recoil towards its intrinsic equilibrium position and the resulting forces on the intrapleural space; these are their largest when the lung is maximally inflated
What is the elastic recoil pressure?
This is the positive pressure of the lung that is present during expiration. This pressure is what brings the lung back closer to its intrinsic equilibrium position.
What is a characteristic/factor of the lung that can affect the inflation of the lungs?
What is compliance?
Measure of how easily an applied pressure induces a volume change
What is the transpulmonary pressure?
It is the difference between the lung pressure and the intraplural pressure. This is the pressure that dictates how easily a lung inflates.
For example, if you're blowing up a balloon, it's not just the pressure that you apply inside a balloon that matters for how it blows up, it's actually the pressure difference between the inside and the outside of the balloon that is causing it to blow up.
PTP = Plung - PIP
Is the compliance curve of a lung linear?
No. It is curved. The compliance curve has Transpulmonary pressure (PTP) on the X axis and Lung Volume on the Y axis. As you increase PTP, you also increase Lung Volume, but the Lung Volume starts to plateau as you reach the maximum capacity of the lungs.
What does pulmonary fibrosis do to the compliance of lungs? Does this cause problems with inspiration or expiration?
Decreases compliance. Problems w/ Inspiration.
What does emphysema do to the compliance of lungs? Does this cause problems with inspiration or expiration?
Increases compliance (decreased elastin causes less elastic recoil pressure). Problems with expiration.
In emphysema, the lung is often called "floppy lung"
What is a characteristic/factor of the chest wall that can affect the inflation of the chest cavity?
Chest wall compliance
What are 3 things that cause a reduction in chest wall compliance?
1. Old age (more fibrotic)
2. Obesity (fat impedes)
3. Scar tissue
What is tidal volume?
The amount of air you take in with each breath
What happens to tidal volume when chest wall compliance goes down?
What are two accessory inspiratory muscles?
Sternomastoid and scalenes. These are generally silent during normal breathing but can be recruited when respiratory load is increased, such as during exercise. Their function is to elevate the rib cage.
The lung is more ____ than its intrinsic equilibrium position, and thus there is a force that tend to make the lung ____.
The chest wall is more ____ than its intrinsic equilibrium position, and thus there is a force for it to ____.
What creates the negative intrapleural pressure? (vacuum)
The two opposing forces of the lung wanting to return to its deflated position and the chest wall wanting to return to is expanded position creates the negative intrapleural pressure.
What is the main cause of PL achieving negative values during inspiration which result in lung inflation?
Increase in negativity in PIP