Mechanisms of Gas exchange Flashcards

(41 cards)

1
Q

the most important muscle in inspiration is? What happens when it contracts

A

diaphragm

  • contraction:
    • pushes abdominal contents downward
    • increase intrathoracic volume
    • decrease in intrathoracic pressure
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2
Q

function of sternocleidomastoid and scalenes in inspiration

A
  • sternocleidomastoid: elevates sternum
  • scalenes: elevates upper ribs
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3
Q

air is driven out of the lungs by what between the lungs and atmosphere

A

reverse pressure gradient

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4
Q

what are the expiratory muscles. Which is most important

A
  • abdominal muscles: most important
  • internal intercostals: pull ribs inward and downward
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5
Q

What nerves are responsible for the diaphragm descending and the external intercostal muscles enlarging the thoracic cavity during inspiration

A
  • phrenic nerve
  • intercostal nerves
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6
Q

is expiration a passive or active process? Why?

A
  • passive
  • accomplished by elastic property of lungs (stretched lungs recoil) and relaxation of the inspiratory muscles
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7
Q

What are the pressures involved in ventilation

A
  • atmospheric
  • intra-alveolar
  • intra-pleural

**when intra-alveolar < atmospheric; flow of air into lungs

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8
Q

relationship between intra-alveolar pressure and intrapleural pressure throughout the cycle? This creates what type of pressure gradient?

A
  • intra-alveolar pressure > intrapleural pressure
  • transmural pressure gradient
    • lung is always stretched
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9
Q

transmural pressure

A

= alveolar pressure - intrapleural pressure

  • lung is always stretched to some degree, even during expiration
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10
Q

lung elastic recoil is due to

A
  • collagen and elastic fibers
  • **favors collapse
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11
Q

why are changes in thoracic dimensions accompanied by changes in lung dimensions?

A
  • antagonist action of lung elastic recoil and chest wall elastic forces generates negative intrapleural pressure
    • intrapleural pressure and fluid cohesiveness counteract the elastic forces
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12
Q

lung compliance

A

change in lung volume for a given pressure change

C= change in V/change in P

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13
Q

relationship between lung compliance and lung elasticity

A

lung compliance is inversely correlated with the lungs elastic properties

  • more elastic tissue = decreased compliance
  • **if lungs have high compliance, inflation is easier but elastic tissue is less
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14
Q

relate volume of lung with negative pressure outside the lung

A
  • lung is inflated with negative pressure outside
  • lung is deflated by decreasing negative pressure outside
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15
Q

Slope of lung volume vs negative pressure outside of lung gives

A

lung compliance

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16
Q

relate compliance between inspiration and expiration

A

compliance is different for inspiration and expiration

  • for a given pressure, expiratory volume > inspiratory volume
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17
Q

What is pneumothorax? what is the consequence?

A
  • object punctures intrapleural space
    • air is introduced
    • intrapleural P = atmospheric P
  • consequence
    • lungs collapse bc no negative intrapleural pressure to keep lungs open
    • chest wall springs out bc no negative IPP to prevent chest wall from springing out
18
Q

what happens to lung compliance in emphysema (obstructive disease)? consequence?

A
  • emphysema: less of elastic fibers in lungs
  • compliance increases
    • compliance increases with lower lung volumes
  • therefore, at a given volume the elastic recoil (collapsing) force on the lungs decreases
    • chest becomes barrel shaped
19
Q

what happens to lung compliance in fibrosis (restrictive disease)?

A
  • stiffning of lung tissues
  • compliance decreases
  • **lung compliance decreases with high lung volumes
20
Q

Law of Laplace

A
  • pressure generated by each sphere (alveolus)
  • P = 2T/r
    • P= collapsing pressure on alveolus
    • T: surface tension
    • r: radius
21
Q

role of surfactant in alveolus

A

surfactant reduces the collapsing pressure

  • disrupts intermolecular forces in the fluid lining the alveoli
22
Q

collapsed alveoli are called

23
Q

synthesis of surfactant begins at week what in a fetus?

A
  • week 24
  • always present by week 35
24
Q

equation relating flow of air to resistance

A
  • Q = change of pressure/R
    • Q= airflow rate
25
what is the primary determinant of resistance
airway radius R= 8nl/π(r^4)
26
what is the major site of airway resistance
medium sized bronchi
27
what ANS system is responsible for relaxation of bronchial smooth muscle
* SNS adrenergic * via activation of B2 receptors * i.e. epinephrine/albuterol
28
what ANS system is responsible for constriction of bronchial smooth muscle
* PNS cholinergic * activation of muscarinic agonists
29
presentation * airway resistance increased * thickening of walls from inflammation and histamine induced edema * plugging of airway by secretion of mucus * airway hyperresponsiveness, constricting spasms
asthma
30
treatment of asthma
* B adrenergic agonist -\> relax SM * corticosteroids -\> decrease inflammation
31
lungs are protected by a1-antitrypsin. What happens in emphysema?
* collapse of airways and destruction of alveolar walls * **macrophages release trypsin** * overrides the protective ability of a1-antitrypsin
32
type A emphysema
* **pink puffers** * mild hypoxemia * normal PCO2
33
type B emphysema
* Blue bloaters * hypoxemia * hypercapnia: Increased PCO2
34
elastic forces of the chest wall favor
expansion
35
Fick's law
volume of gas transferred/unit time (Vx) = (D x A x change in P) / change in X * D: diffusion coeff * A: surface area * P: partial pressure difference of gas * X: membrane thickness
36
the driving force for the diffusion of a gas comes from
partial pressure difference of gas
37
diffusion coefficient of a gas (D) depends on
* molecular weight * solubility
38
diffusion for CO2 is what compared to diffusion of O2
D for CO2 is **20x higher** than for O2
39
how does lung diffusing capacity vary in emphysema? In fibrosis? In anemia? In exercise?
* **emphysema: DL decreases** * destruction of alveoli -\> decreased surface area * **Fibrosis: DL decreases** * diffusion distance increases * **Anemia: DL decreases** * decreased Hb in RBC * **Exercise: DL increases** * additional capillaries perfused-\> increased surface area
40
Henry's law of dissolved gas
Cx = Px x solubility
41
in solutions (blood), gas is carried in what three forms? give ex
* **dissolved** * nitrogen: only in dissolved form * **bound** * O2, CO2 bind to proteins in blood * **chemically modified** * conversion of CO2 to HCO3-