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Pathophys > Pulmonary Module 2: Ventilation > Flashcards

Pulmonary Module 2: Ventilation Flashcards

1
Q

Define Ventilation

A

Mechanical process by which anent air is brought into and exchanged with air in the lungs

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2
Q

Define Respiration

A

Gas Exchange that occurs in lungs and throughout the body

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3
Q

Ventilation Rate

A
  1. beats per min

2. at rest: approximately 12 per min

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4
Q

Minute ventilation

A
  1. volume of air inspired/expired per min
  2. at rest: 6L/min
  3. minute ventilation = (alveolar ventilation + dead space ventilation)*RR
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5
Q

Alveolar ventilation

A

Volume of air that reaches the alveoli per minute

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6
Q

Dead space ventilation

A

volume of air that DOES NOT reach the alveoli per min

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7
Q

Resting Ventilation Rate = ____ breaths/min

A
  1. Inspiration =2 s. Expiration =3s
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8
Q

Respiratory center in brainstem (medulla and pons) controls what.

A

contraction and relaxation of respiratory muscles

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9
Q

Respiratory center in brainstem (medulla and pons) consists of:

A

multiple clusters of neurons in medulla and pons

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10
Q

Dorsal respiratory group in medulla (DRG)
Action:
Function:

A

Action: primary inspiration
Function: sets automatic rhythm of breathing

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11
Q

What influences rate of ventilation?

A

blood CO2 and O2 levels

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12
Q

Ventral respiratory group in medulla (VRG)
Action:
Function:

A

Action: both inspiratory and expiratory actions
Function:
1. quiet at rest
2. active when increased ventilation is required

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13
Q

Pneumotaxic & apneustic centers in pons

Function:

A

To modify the depth and rate of inspiration that has been set by the medullary centers (DRG and VRG)

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14
Q

Function of lung receptors

A

sends impulses to DRG to influence rate of ventilation

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15
Q

Irritant receptors (rapidly adapting lung receptors)
Location:
Stimulus:
Action:

A

located in epithelia on Conducting Airways

stimulus: noxious gas, particles
action: cough reflex, gasping (hyperpnea)

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16
Q

Stretch receptors (slowly adapting lung receptors)
Location:
Stimulus:
Action:

A

located in smooth muscle of Conducting Airways
Stimulus: stretch. takes a lot to activate
Action: sends signals to CN10 (vagus) to brainstem INHIBIT INSPIRATION. Also prolongs time for expiration and DECREASES volume of ventilation

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17
Q

J-receptors (Capillary lung receptors)
Location:
Stimulus:
Action:

A

located near/in alveolar septum of capillaries
Stimulus: elevated pulmonary capillary pressure
Action: STIMULATES INSPIRATION. rapid, shallow breathing, decreases HR and BP. Extreme situations can cause “opposite” effect: apnea

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18
Q

What do Chemoreceptors monitor

A

pH, PaCO2, and PaO2

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19
Q

Location of central chemoreceptors

A

Brainstem

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20
Q

Stimulus of central chemoreceptors

A

detect changes in pH levels in CSF. CO2 easily diffuses across BBB into CSF. H+ ions DO NOT cross BBB. If CO2 rises in CSF the H+ levels increase (pH decreases), which signals INCREASE in ventilation

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21
Q

Action of Central Chemoreceptors

A

If PaCO2 increases then central chemoreceptors will stimulate respiratory centers to INCREASE VENTILATION. Also plays a role in acid- base compensation

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22
Q

Location of Peripheral chemoreceptors

A

in carotid(bifurcation) and aortic bodies (arch of aorta)

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23
Q

Stimulus of Peripheral chemoreceptors

A

Sensitive to changes in PaO2. Responsible for ventilation in response to hypoxic conditions (PaO2<60mmHg)

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24
Q

Action of Peripheral chemoreceptors

A

increase ventilation via DRG. Plays important role in chronic hypoxemia

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25
Q

Describe the relationship between central and peripheral chemoreceptors in health conditions.

A

CO2 and pH levels are primary influence on ventilation. Central receptors MORE sensitive than peripheral receptors. (O2 levels need to drop ALOT for peripheral receptor to influence ventilation)

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26
Q

Hypoventilation creates:

A

decrease PaO2, increased PaCO2, decreased pH

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27
Q

Describe the relationship between central and peripheral chemoreceptors in unhealth conditions.

A

chronic hypoventilation the central chemoreceptors may become less sensitive and the peripheral chemoreceptors “take over” role of regulating ventilation

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28
Q

Mechanisms of Inspiration
At rest:
Exercise/disease:

A

Rest: diaphragm and external intercostal muscles
Exercise: accessory muscles (SCM and scalenes)

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29
Q

Mechanisms of Expiration
At rest:
Exercise/disease:

A

Rest: no major muscles
Exercise: accessory muscles (abdominal and internal intercostal muscles)

30
Q

Surfactant ________ the surface tension to allow alveoli to expand

A

lowers

31
Q

If the radius of alveoli decreases then the surfactant makes it _____ to distend the alveoli

A

EASIER

32
Q

As radius of alveoli increases then it becomes more ______ to distend the alveoli

A

Difficult

33
Q

At low lung volumes it is ____ to inflate the lungs than it is at high lung volumes (after inspiration)

A

Easier

34
Q

Inadequate surfactant causes:

A

increase surface tension and alveoli will collapse. Decrease lung expansion and Increase work of breathing, poor exchange

35
Q

Example of Inadequate surfactant is IRDS. What is IRDS

A

Infant respiratory distress syndrome (hyaline membrane disease) - premature infants born before 28-32 wks

36
Q

Work of Breath (WOB) in a health individual is high or low?

A

Very LOW

37
Q

Atmospheric pressure at sea level =

A

760 mmHG - decrease with elevation

38
Q

Define partial pressure

A

pressure of individual gases within total air pressure

39
Q

Equation to find Partial Pressure

A

% concentration X total pressure of gas (air) = PP

40
Q

Partial pressure of O2 =

A

20.9%

41
Q

Partial pressure of Nitrogen =

A

78.1%

42
Q

Partial pressure of CO2 =

A

0.03%

43
Q

If total air pressure = 760 mmHg, then what is the partial pressure of O2

A

PO2 159 mm HG = 760 mmHG x 20.9%

44
Q

If total air pressure = 760 mmHg, then what is the partial pressure of CO2

A

PCO2 0.23 mm HG = 760 mmHG x 0.03%

45
Q

Is O2 partial pressure high in alveoli or in pulmonary capillaries?

A

Alveoli - promotes O2 to diffuse into blood

46
Q

Is blood stream CO2 partial pressures high in pulmonary capillaries or in alveoli

A

Pulmonary capillaries - promotes CO2 to diffuse into alveoli

47
Q

Air pressure within respiratory system is ____(> or<) atmospheric pressure?

A

Less than

48
Q

Respiratory tract warms and humidifies air, which ____(increases or decreases) total air pressure?

A

decreases

49
Q

Water vapor of respiratory tract =

A

47 mmHg

50
Q

How do you calculate total pressure in respiratory tract? What does it equal?

A

water vapor - atmospheric air

760 mmHG - 47 mmHG = 713 mmHg

51
Q 
Trachea:
Total air pressure = 713 mmHG
20.9 % of air = O2
0.03% of air = CO2
PO2 =
PCO2 =
A 
PO2 = 149 mmHg
PCO2 = 0.21 mmHg
52
Q 
Alveoli:
Total air pressure = 713 mmHG
14.5 % of air = O2
5.5% of air = CO2
PO2 =
PCO2 =
A 
PO2 = 103 mmHg
PCO2 = 39 mmHg
53
Q

TV (tidal Volume) = ___ml

Define TV

A

500 ml

Volume of air inspired or expired with each NORMAL breath

54
Q

IRV (Inspiratory reserve volume) = _____ml

Define IRV

A

3000-3300 ml

Volumn of air that can be inspired over and above the TV (used with EXERCISE)

55
Q

ERV (expiratory reserve volumn) = _____ ml

Define ERV

A

1000-1200 ml

Volume of air that can be expired after the expiration at TV

56
Q

RV (reserve volume or residual lung volume) = _____ml

Define RV

A

1200ml

Volume of air that remains in the lungs after maximal expiration. CAN NOT be measured by spirometry

57
Q

FVC (forced vital capacity) = _______ml

Define FVC

A

4500-5000ml

Volume of air that can be forcibly expired after max inspiration. TV + IRV + ERV = VC

58
Q

TLC (total lung capacity) = ______ml

Define TLC

A

5700-6200 ml
Sum of all four lung volumes.
VC+RV = TLC
CAN NOT be measured by spirometry (bc RV)

59
Q

FEV1 =

A

Forced Expiratory Volume (volume of air that measured during the first seconds of expiration)

60
Q

FEV1 to FVC ration =

A

% of FVC that can be expired in one second.

61
Q

Normal FEV1/FVC =

A

70-90%

62
Q

Average FEV1/FVC =

A

85%

63
Q

Abnormal FEV1/FVC =

A

90% = Restrictive disease

64
Q

Define Minute Ventilation (Ve)

A

Volume of air expired in one minute. Ve=RR*TV

65
Q

Define Maximum minute ventilation (Max Ve)

A

Max volume of air moved in/out of lungs during maximal exercise (stress test)

66
Q

Health adult Max minute Ventilation will only be:

A

60-70% of MVV

67
Q

Maximum voluntary ventilation (MVV) =

A

maximum volume of air that can be moved in and out of lungs in 60 sec.

68
Q

Maximum voluntary ventilation (MVV) in females:

in males:

A

females: 80-120 L/min
Males: 140-180 L/min
elite athlete = 230-240 L/min

69
Q

Forced Expiratory Flow Rate (FEF25%-75%) aka MMEFR is what portion of FEV

A

middle portion

70
Q

What are measurements of lung volumes/capacities useful for?

A

predicting disease/dysfunciton

Pathophys (3 decks)

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