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Patho II > Respiraotry physiology - Exam 2 > Flashcards

Respiraotry physiology - Exam 2 Flashcards

1
Q

purpose of the respiratory system

A

to provide O₂ and remove CO₂

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2
Q

ventilation

A

exchange of air between atmosphere and alveoli by bulk flow

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2
Q

ventilation

A

exchange of air between atmosphere and alveoli by bulk flow

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3
Q

Exchange of CO₂ & O₂

A
  • between alveolar air and blood in lung capillaries by diffusion (external respiration)
  • between blood in tissue capillaries and cells in tissues by diffusion (internal respiration)
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4
Q

transport of O₂ and CO₂

A

through pulmonary and systemic circulation by bulk flow

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5
Q

cellular utilization of..

A

O₂ and production of CO₂

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6
Q

pleural membrane

A

pleura → serosa of the lung

visceral → attached to lung
parietal → attached to chest wall

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7
Q

serous fluid

A
  • fluid between the lung, pleura, and ribs
  • ** provides lubrication allows lung to move along the pleura and suction
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8
Q

Boyle’s law

A

PV = nRT

** Pressure is inversely proportional to the volume

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9
Q

understanding ventilation

A
  • laws of diffusion (gases moving from higher concentrations to lower concentrations)
  • Boyle’s law (P and V inversely related to each other)
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10
Q

** Quiet inspiration

A

active
- diaphragm contract
- external intercostals contract
- utilization of ATP through skeletal muscles

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11
Q

Forced inspiration

A

trying to create more additional space

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11
Q

** Quiet expiration

A

resting
- passive process “recoil”
- elastic properties of lung

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12
Q

forced expiration

A

active
- abdominals
- internal intercostals

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13
Q

alveolus

A

site of gas exchange

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14
Q

alveoli epithelial cells

A

type I: squamous epithelial cells, important for gas exchange
type II: make surfactant, help reduce surface tension

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15
Q

P suffix ip

A

intra pleural pressure

this needs to work in hand with changes that accommodate ventilation

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16
Q

transpulmonary pressure/transmural pressure

A

pressure differences holding lungs open (opposes inward elastic recoil of the lung)

  • typically Pip < Palv
  • Pip at rest = -4 mm Hg
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17
Q

** to accommodate inspiration Pip becomes

A

more negative

subatmospheric

then Ptp becomes more positive

Ptp = Palv - Pip

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18
Q

inspiration flow diagram

A
  • diaphragm and inspiratory intercostals contract
  • thorax: expands
  • Pip becomes more subatmospheric (negative)
  • ↑ transpulmonary pressure
  • lungs: expand
  • Palv becomes subatmospheric
  • air flow into alveoli
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19
Q

expiration flow diagram

A
  • diaphragm and inspiratory intercostals stop contracting
  • chest wall: recoils inward
  • Pip moves back toward preinspiration value
  • transpulmonary pressure moves back toward preinspiration value
  • lungs: recoil toward preinspiration size
  • air in alveoli becomes compressed
  • Palv becomes greater than Patm
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20
Q

airway resistance

A
  • flow = △P(3.144)r⁴ / (8ul)
  • resistance = 8ul/(3.144r⁴ ) ***
    depends on the length of the airway and the viscosity of the gas and is inversely proportional to the fourth power of the radius

l = length of airway
u = viscosity of the gas
r = radius of the airway

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21
Q

airway resistance can also be termed as

A

obstruction to the airflow

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21
Q

which causes more resistance, upper or lower airway?

A

upper

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22
Q

decrease in lung volume results in an __ in resistance

A

increase

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23
Q

compliance of lungs

A

determined by elastic forces

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24
Q

elastic forces

A
  • lung tissue
  • surface tension
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25
Q

surface tension

A
  • attraction of water molecules at the air-water interface
  • will result in collapse of alveoli
  • prevented by surfactant
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26
Q

*** vital capacity is the combination of

A

ERV = amount of air in excess of tidal expiration that can be exhaled with maximum effort

TV = amount of air inhaled and exhaled in one breath

IRV = amount of air in excess of tidal inspiration that can be inhaled with maximum effort

** amount of air that can be exhaled with max effort after max inspiration; used to assess the strength of thoracic muscles as well as pulmonary function

27
Q

RV

A

residual volume

amount of air remaining in the lungs after max expiration; keeps alveoli inflated between breaths and mixes with fresh air on next inspiration

28
Q

anatomical dead space

A
  • part of the respiratory system where gas exchange does no take place
  • 150 mL
  • conducting airways
29
Q

physiological dead space

A
  • depends on ventilation-perfusion ratio
30
Q

minute ventilation

A

total amount of air moves into and out of the respiratory system per minute

31
Q

alveolar frequency

A

how much air per minute enters parts of the respiratory system in which gas exchange takes place

32
Q

minute respiratory volume

A

TV x RR

33
Q

alveolar ventilation

A

(TV- dead space) x RR

34
Q

the bottom portion of the lung has a __ blood flow compared to the top of the lung at REST

A

higher

34
Q

*** pulmonary pressures

A

pulmonary artery pressures
- systolic 25 mmHg (quarter)
- diastolic 8 mmHg (almost a dime)
- mean 15 mmHg (dime + nickel)
- capillary 7 mmHg (dime + 2 pennies)

35
Q

Hypoxic vasoconstriction

A

less ventilated alveolus has a vasoconstricted pulm capillary

36
Q

inward forces

A

d/t plasma proteins causing plasma osmotic pressure that pulls the water into the pulmonary capillary

plasma osmotic pressure 28 mmHg

36
Q

outward forces

A

force of the fluid trying to go out of the capillary into the interstitial space

pulmonary capillary pressure 7 mmHg
interstitial osmotic pressure 14 mmHg
negative interstitial pressure 8 mmHg
total = 29 mmHg

37
Q

net filtration pressure

A

1 mmHg

38
Q

*** __ Interstitial pressure keeps alveoli dry

A

negative

38
Q

pulmonary edema

A

fluid accumulation in pulmonary interstitial space

39
Q

pulmonary edema causes:

A
  • increase in pulmonary venous and capillary pressure (left-sided HF, mitral valve stenosis); ↑ outward force
  • increased capillary membrane permeability (damage to associated with infections, noxious gases (chlorine, sulfur dioxide)
  • decrease in plasma oncotic pressure (liver failure); ↓ inward force
40
Q

*** pulmonary edema safety factor

A

protection against edema until pulmonary capillary pressure ( 7 mmHg) equals capillary osmotic pressure (28 mmHg)

41
Q

pleural effusion

A

excess fluid accumulation in the pleural space

42
Q

pleural effusion causes:

A
  • lymphatic obstruction (tumor)
  • HF
  • reduced plasma osmotic pressure
  • infection/inflammation of capillary membranes causing increased permeability
  • fluid production > drainage
43
Q

components of respiratory unit

A
  • terminal bronchiole
  • respiratory bronchiole
  • alveolar ducts
  • alveolar sacs
44
Q

alveolar walls - very __ walls to aid in gas exchange

A

thin

300 million alveoli in 2 lungs

45
Q

gas exchange occurs where?

A

alveolar sacs

46
Q

barriers for diffusion are:

A

surfactant/fluid
alveolar epithelium
epithelial basement membrane
interstitial space
capillary basement membrane
capillary endothelium

layers that create a barrier for diffusion of O2 and CO2

47
Q

diffusion in response to

A

concentration gradient

48
Q

pressure proportional to

A

concentration

49
Q

gas contributes to total pressure in direct __ proportion to concentration

A

direct

50
Q

CO₂ __ times as soluble as O₂

A

20

51
Q

diffusion depends on __ __ of gas

A

partial pressure

52
Q

air is humidifed yielding a vapor pressure of __ mmHg

A

47

53
Q

ventilation/perfusion

A
  • the relationship between adequate ventilation and adequate flow
  • defined as V/Q
  • V/Q (4L/min) / (5L /min) = 0.8
54
Q

alveolar PO₂ and PCO₂

A

determined by the ratio between ventilation and blood flow: V/Q

55
Q

PO₂ and PCO₂ are __ related through alveolar ventilation

A

inversely

56
Q

increasing V/Q produces

A

higher PAO₂ and lower PACO₂

hyperventilation defined as PACO₂ < 40

57
Q

decreasing V/Q produces

A

lower PAO₂ and higher PaCO₂

hypoventilation is defined as PACO₂ > 40

58
Q

V/Q if inadequate ventilation

A
  • less V ↓↓
  • 0/Q = 0
  • V/Q = 0
  • smaller value or nothing when there is inadequate ventilation
59
Q

V/Q if inadeqaute perfusion

A
  • block in the flow of blood so there can still be good ventilation but perfusion ↓
  • anything over 0 is infinity
  • V/Q = ∞
  • higher value when there is inadequate perfusion
60
Q

physiologic shunt

A
  • V/Q < normal
  • low ventilation
61
Q

physiologic dead space

A
  • V/Q > normal
  • wasted ventilation
62
Q

abnormalities with V/Q

A
  • upper lung V/Q 3 x normal
  • lower lung V/Q .5 x normal
63
Q
A
64
Q
A
65
Q
A
66
Q
A

Patho II (5 decks)

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