Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Resiratory SCE > Physiology > Flashcards

Physiology Flashcards

(94 cards)

Start Studying
1
Q

Bronchial artery

A

Blood supply nose to bronchioles
Branch Aorta

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

Pulmonary artery

A

Blood supply to to the alveoli

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

Lung function categories

A

Spirometry
Lung volumes
Gas diffusion

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

Volume time curve

A

Tidal volume air moved normal breath

ERV exhalation past normal volume

IRV inhaled past normal volume

RV air left past max exhalation

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

Sum volumes

A

IC is TV + IRV
FRV Is ERV + RV so volume of air exhaled in total
VC= IRV+ TV + ERV
TLC = IRV+ TV + ERV+ RV

FEV1 is volume of air exhaled in 1s of forced expiration

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

Percentiles

A

Positive higher and negative lower
5th percentiles lowest or highest

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

Z score

A

SR +- 1.65 acceptable as 90% data in this range

5% split above and below abnormal
LLN decreases with age so over diagnose obstruction older men but under in young women

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

PEFR

A

PEFR maximum volume exhaled in L per sec

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

Obstructive vs restrictive

A

Fev1/fvc less than 0.7 is obstructive
More than 0.7 is restrictive

Volumes
Obstructive RV and TLC raised

Restrictive
All volumes reduced

Mixed
Obstructive
Low TLC

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

Measuring lung volumes

A

He dilution
N washout
Advantage simple and cheap
X doesn’t measure bullae

Body plesmography
Most accurate esp if bleb
X expensive

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

Variable extrathoracic obstruction

A

Inspiratory limb box so bottom
During inspirational obstruction sucked into trachea with partial obstruction

Vocal cord paralysis
Extrathoracic goitre
Laryngeal tumour

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

Variable intrathoracic

A

Expiratory limb top box
Trachea sucked out inspiration then expiration partial obstruction trachea

Tracheal stenosis
Tracheomalacia
Airway tumour

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

Fixed obstruction

A

Both Inspiratory and expiratory box

Tracheal stenosis eg GPA
Goitre
Airway tumour

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

TLCO

A

TLCO Co diffusion per min per pressure or gas exchange surface available
Kco when divided by total lung volume

= kco ( thickness alveolar membrane) x va (alveolar surface area )

Asthma
DLCO normal
KCO raised

Low both
Thickness membrane so reduced kco eg late Ild or pulm oedema or PH
VA low and kco low as alveoli gone in emphysema
Anaemia

Low Tlco and high KCO
Extrathoracic restriction eg muscle weakness or skeletal def or pleural disease - low Tlco and high kco
Pneumonectomy and consolidation - low Tlco and high kco

High TLCO and KCO
pulmonary haemorrhage Polycythaemia
obese or altitude or hyperthyroid
AVM so left to right shunt

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

Differentials

A

Restrictive
Low DLCO Ild
Normal or high DLCO due to kco — extrathoracic so chest wall or nmd
High TLCO obesity

Obstructive
Low DLCO in emphysema
Normal DLCO chronic bronchitis

Normal spiro
Low DLCO Normal lung function
Low DLCO pulmonary vascular disease or anaemia

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

PAo2

A

Is (barometric pressure x fio2) - paco2

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

Pressures lung

A

Trans pulmonary is 4
Intrapulmonary is -4
Intrapulmonary pressure is 0

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

Mechanism hypoxia

A

A-a = fio2 -(pco2x1.25)-po2
normal 1-2
Raised VQ and shunt
Normal alveolar hypoventilation

VQ mismatch
- plug so less ventilation so pneumonia or Atelectasis
- no perfusion eg PE or PH or shock

Shunt RtoL
- anatomical eg pda or pfo or asd or vsd/ lung/ hps - don’t respond to o2
- physiological eg ARDS or severe copd or Atelectasis or Pneumonectomy

Alveolar hypoventilation eg CNS or drugs or NM or ohs

Reduced fio2 eg altitude

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

Indication CPET

A

Fitness
Dx cause of limitation fitness in normal lung function
Disease severity
Pre procedure
Response to treatment

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

Stop cpet

A

Exhausted
Chest pain with ecg change
Arrhythmia
St depression more than 2mm with symptoms or 4mm no symptoms
Heart block
Hypotension or be over 250/120
hypoxia less than 80
Near syncope

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

V02

A

= CO x Cao2 x cvo2

Max uptake of oxygen by skeletal muscles in exercise

Limitation by SV/HR/ tissue extraction

Normal is more than 80% predicted

Cao2 lower
Lung disease
Anaemia
L to right shunt
PVD

Cvo2 low
Reduced consumption O2 eg myopathy or neuropathy

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

Cpet was it a maximal test

A

Vo2 above 15ml/kg or more than 80%
RER above 1.15 switch aerobic to anaerobic
Max HR 95% predicted so low HRR
Breathing reserve more than 20% gap
Rise in lactate
AT reached where vco2 rises faster than vo2

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

9 plot examples

A

Top right vo2
Top middle cardiac
All left vertical ventilation

Normal values
VO2 more than 80% predicted
Max HR should be more than 80% max (220-age)
VE should reach 80% so should have reserve
Desat more than 4% lung issue or PVD or RtL shunt
Oxygen pulse more than 10ml surrogate CO
AT should be more than 40% vo2

Vo2 max below reference 80% # cardiac or Resp
RER over 1.15 maximal
OHES oxygen uptake efficiency low then cardiac
Resp limit less than 20% between peak TV vs MVV (Fev1x40) then ventilatory limitation

Vo2 less than 80
Resp
low breathing reserve
Ve over vco2 increased dead space increased
Ve over 80%
Max hr not reached

CVS
O2 pulse reached first then cardiac
Early hr rise and low hr reserve

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

Contra indication cpet

A

Symptomatic aortic stenosis
Acute illness eg MI 5/7 or sbe or myocarditis or unstable angina or dissection
Severe pulmonary Hypertension
Acute Copd or asthma
Po2 less than 8
Recent DVT or acute PE
Heart failure
Syncope or pre syncope
Seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
OSA flow volume
Sawtooth
26
Volume pathology
Older increase RV Emphysema RV Fibrosis all volumes reduced Muscle weakness TLC low but RV high as cannot use expiratory muscle diaphragm Obesity increase FRC more elastic recoil
27
Pneumonectomy lung function
FEV1 and FVC both reduced Restrictive Reduced overall TLCO Raised kco as blood to smaller area VA reduced
28
Empey index
Fev1 (ml/s) times ten divided by Pefr L per min Fixed airway obstruction Fev1 x1000 divided by pefr times 60
29
Mid 25 or 75 low
Small airway narrowing
30
Not normally distributed
Pearson between two continuous variables Wilcoxon compare two groups pre and post Spearman rank association between ordinal or ranked data
31
Obese lung function
Fev1/fvc more than 70% FRC reduced as increased elastic recoil
32
Diaphragm weakness
Lying vc 20% drop Ddx bilateral diaphragm weakness as gravity not helping inspiration 10-20% fall vc suspicious diaphragm weakness Other MIP and SNIP fall esp lying down (insp muscle force and ER chest wall from residual volume) - men less than 70 - women less than 60
33
VQ
Better at base Perfusion increases higher rate than ventilation
34
PaO2
Fio2. 0.75
35
Pregnancy lung function
Reduced FRC and reduced ERV Spiro normal Increased o2 consumption O2 reserve reduced Minute ventilation increased Ph normal / reduced pco2/ increased bicarbonate excretion
36
Deconditioning cpet
Low vo2 max Low hrr High VE O2 pulse border of low/ normal AT 40-50% of vo2 max Sats ecg and bp normal
37
Cardiac disease cpet
Low vo2 max Early rise hr Low hrr O2 pulse below lln AT less than 40% Abnormal BP blunted high systolic
38
Lung disease cpet
Low vo2 max High hrr so ventilation limiting Low VE reserve so more than 80% predicted Desaturation High VEco2
39
Submaximal effort cpet
Vo2 less than 80 Max HR less than 80 VE max less than 80
40
Lung disease cpet
Vo2 max less than 80 Max hr less than 80 Ve max more than 80
41
Pulmonary vascular cpet
Vo2 max less than 80% Max hr more than 80% Low hrr and steep chronotropic profile Low AT Desat 4%
42
Cardiac disease cpet
Vo2 max less than 80% predicted Max hr more than 80% Less than 4% Desat
43
Dysfunctional breathing cpet
Normal vo2 max Normal AT High erratic RER more than aer to anaerobic High resting hr normal chronotropic profile
44
Muscle disease cpet
Low vo2 max Early AT less than 40% VO2 max Early lactate rise Steep chronotropic profile due to impaired peripheral o2 extraction Low o2 pulse
45
Peripheral vascular disease cpet
Low vo2 max High hrr High ve reserve Low at Heightened BP response
46
Bronch oxygen
More than 1m Desat less than 4% Sats less than 90%
47
Risks bronch
Arrhythmia sinus tachycardia Bleeding 0.2% Ptx 1/1000 so 0.1%
48
Sedation bronch
Fent or alfent Midas 2-5mg Local anaesthetic Max 9.6mg per kg
49
Bronch sample
Visible tumour 85% 5x samples brush and wash
50
Invasive Aspergillus bronch
Bal galactomanan and fungal culture
51
Clean bronch
Automated endoscopic reprocessor
52
Sedation bronch e+d
NBM 2 hours and clear fluids 4h Post for 24h No drive or heavy machinery No sign documents
53
CI spiro
Haemoptysis Ptx Cv disease Nausea or vomiting Recent chest or abdominal or eye sx
54
LLN
Age Gender Ethnicity Height
55
Respiratory muscle weak TLCO
TLCO normal Kco raised as lungs concentrated so co transfer better
56
Lung volume detect Ptx or bullae
PSG and helium dilution gas volume
57
Sensitivity
How likely test positive when has disease A/A+C (all those with disease)
58
Specificity
Test negative in healthy Negative healthy / all healthy
59
Ppv
Probability that positive test has disease Is a/ all positive
60
NPV
Test negative likelihood healthy Negative healthy / all negative
61
Likelihood ratio
Sensitivity ————— 1- specificity
62
Variables
Qualitative Binary vs ordinal Quantitative Discrete vs continuous
63
Normally distributed data sets
Z and T test eg bp pre and post Chi squared eg smoking vs non smoking Anova eg effect drug dosages 3 or more
64
Bronchoscopy death
1% serious 0.02% death
65
LTOT and Hypercapnia
Co2 increase 1 then not for LTOT
66
Restrictive Low TLCO but High KCO due to extrapulmonary restriction
Pneumonectomy/ chest wall disease and NMD as alveoli more concentrated smaller area
67
Low TLCO and low KCO
Emphysema ILD IPAH HPS
68
Hypoxaemia worse exercise
Reduced PvO2 and shortened capillary transit time as CO increases
69
Test types
Unpaired T for two independent groups Paired T test for repeated measurement same individual Small non SD then Mann Whitney Categorical Chi and fishers
70
Dead space increase ventilator
Increase peep Alveoli cause compression blood vessels so not perfusing air breathed in
71
TLC
Sum of all volumes Raised swimmers and emphysema Reduced Increased ER eg ILD or HF Chest wall stiff NMD or obesity Thoracic spine reduction effusion
72
Residual volume
Restrictive reduced as increased ER Obstructive increased due to premature airway closure/reduced ER and expiratory flow limitation ie air trapping
73
Indirect lung volume measured
TLC FRC RV
74
Anaerobic threshold
Highest vo2 at which at which lactate doesn’t rise Estimate exercise capacity VO2 at lactate rise is ventilator anaerobic threshold
75
RER
VCO2/Vo2 Increases in exercise due to buffered lactic acid and/or hyperventilation
76
Oxygen pulse
VO2/HR Low in ILD during peak exercise
77
HRR
Predicted 220-age Achieved Difference should be 0
78
Resp failure causes
Hypoxic Cardiac failure Ards Pneumonia Alveolar haemorrhage Atelectasis Hypercapnia Chest wall NMD or kyphosis CNS or PNS eg stroke vs GBS Muscle dystrophies Airway CoPD asthma ohas BrE
79
Lung function worked examples
PH Restrictive Spiro VA normal and KCO low Tlco low ILD Restrictive VA and KCO low so TLCO low Emphysema Obstructive VA reduced and KCO reduced so Tlco low Obesity Ratio normal or restrictive severe VA normal but KCO raised so TLCO high NM disease Restrictive as FVC low VA low but KCO increased so TLCO LOW
80
CPET values
Vo2 max effort and if 80% predicted no pathology HR should be 80% predicted (220-age) MV should NOT reach 80% predicted if so no Resp reserve Vco2 Sats more than 4% desat abnormal AT should be more than 40% VO2 max O2 pulse surrogate for CO and should be more than 10ml per beat at max RER more than 1.2 max effort
81
Algorithm CPET
Vo2 max more than 80% Yes normal No then Max HR more than 80% Yes — 4% drop in sats —- NO then decondition or cardiac. YES then PVD No VE max more than 80%? No then Su max effort. YES lung disease
82
PVD
Low VO2 High HRR High VE Low AT Exaggerated BP
83
Parametric
Interval data in normal distribution
84
Tests
Two groups P two sample t test Non P Mann Whitney or Wilcoxon Two or more groups difference P ANOVA Non P Kruskal- Wallis Strength association P correlation coefficient NP spearman Paired observation. P paired T test NP wilcoxon signed rank
85
Spirometry technique
Best of 3 with less than 100ml or 5% variability SABA 15 mins post for BDR Inhalers 4h Saba 8hrs laba 36hrs lama
86
Intrapulm shunt
Desat sit up Pulm circulation not affected by gravity Better perfusion upper and mid flatter
87
Oxygen diss left
Alkalosis Reduced temp Reduced 23dpg
88
Post op fev1
Pre op in ml x (remainder /19)
89
Compliance
Increased Copd Reduced Ild
90
Lung volumes by pathology
Elderly RV increased but normal TLC Raised TLC in emphysema with high RV Fibrosis Reduced TLC Proportionally RV higher Resp muscle weakness TLC reduced ERV tiny RV raised Obese Volumes reduced ERV reduced
91
Severe obstruction with v low Tlco/kco
Think CoPD with ILd
92
Cough reflex
Input C fibres etc thalamus/ upper airway trigeminal Vagus afferent To brainstem Inhibitory pathways
93
Commonest cause cough
Smoking Post infections flu myco pertussis ACEi Respiratory disease Rhinitis Reflux OSA/tonsil/earwax Treatable traits Asthma GORD Post nasal drip
94
Anti tussive
Codeine Morphine Pregabalin P2X receptor inhibitor block ion channels sensory vagus nerves Gefapixant SE taste disturbance

Resiratory SCE (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions