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Physiology and Pharmacology > Respiration 3+4 > Flashcards

Respiration 3+4 Flashcards

1
Q

What is the shape of a flow-volume loop?

A 
Exhalation- curve increases rapidly 
Reaches peak expiratory flow 
Slowly decreases
Decrease is effort independant 
Inhalation is negative
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2
Q

What is the shape of a volume-time curve?

A

Most air expired at the start (rapid rise)
About 80% expired in the first 1
Curve extends horizontally (no more air can be expired)

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3
Q

What is FEV1%?

A

FEV1/VC

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4
Q

What is it a sign of if the FEV1% decreases below 80%

A

Obstructive lung disease

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5
Q

What is obstructive lung disease?

A

Narrowing of the airways causing a restriction of flow

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6
Q

What are 4 types of obstructive lung disease?

A

Chronic bronchitis - persistant cough and excess mucus (3 consecutive months in 2 years)
Asthma - Hypersensitivity of the bronchial smooth muscle
COPD - swelling in the LOWER airways
Emphysema - loss of elasticity in alveoli

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7
Q

Change in spirometry in obstructive lung disease?

A

VC is normal
FEV1 is less than 80%

Flow-volume:
Sharper decrease but similar initial raise

Volume-time:
Endpoint volume is the same

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8
Q

What is the atopic causes of asthma and what does this cause?

A

Allergies
Increases IgE
Increases inflammation

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9
Q

What are the non-atopic causes of asthma?

A 
Respiratory infections
Cold air 
Stress 
Exercise 
Ibuprofen

NO IgE increase involved

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10
Q

What is the response to triggers of asthma?

A

Inflammatory cells move into the airways
Release of inflammatory mediators (histamine)
BRONCHOCONSTRICTION

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11
Q

How does salbutamol treat asthma?

A

SHORT-ACTING B2 adrenoreceptor agonist
Acts through Gs pathway

Blue inhaler

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12
Q

How does glucocorticoids treat asthma?

A

LONG-ACTING B2 adrenoreceptor agonist

Brown inhaler

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13
Q

What are the 2 causes of restrictive lung disease?

A

1) Loss of compliance (fibrosis - increase in collagen)

2) Reduced chest expansion due to chest wall abnormalities or muscle contraction deficiency

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14
Q

What is vital capacity based upon?

A

Age, height, gender, weight

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15
Q

What happens to the spirometry in restrictive lung disease?

A

Flow-volume
Shape is normal
Reduction in volume (look smaller)
MAY be decrease in peak flow

Volume-time
VC decreases
FEV1% remains unaltered or even increase

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16
Q

Where is the basic rhythm generated and where is the pattern of breathing modified?

A

Generated in the medulla

Modified in the pons

17
Q

If cut above medulla what happens to breathing?

If cut below medulla what happens?

A

BASIC rhythm maintained

Breathing is ceased

18
Q

What are the two centres in the medulla which lead to relaxation and contraction of the brochi muscles and how?

A

1) Dorsal respiratory group
- Basic INSPIRATION pattern (not expiration)
- Sends signals to inspiratory muscles

  • Spontaneously active
  • Periods of activity during INSPIRATION
  • Increase in firing
  • Contraction
  • Shut down signalling when expire

2) Ventral respiratory group
- Linked to FORCED inspiration and expiration
- Inactive during quiet inspiration

  • (Hering-Breur reflex) - negative feedback loop
  • Stretch receptors in the lung send signals back to the medulla via the Vagus nerve
  • INHIBITS respiratory system
19
Q

What two centres in the pons adjust respiratory patterning?

A

1) Pneuomtaxic centre
- INHIBITORY EFFECT on INSPIRATORY centre
- increases respiration RATE by REDUCING FIRING
- Shorter inspirations

2) Apneustic centre
- STIMULATES inspiratory centre
- Increases respiration DEPTH by INCREASING FIRING
- Prolonging inspirations

20
Q

What do central chemoreceptors do?

A

Monitor conditions of the CSF

Sense changes in pH and CO2

21
Q

What do the peripheral chemoreceptors respond to and where are they located?

A

Located in the carotid sinus and aortic arch

Respond to pH and CO2 and decrease O2

22
Q

What 5 things is CO2 carried as in the blood?

A 
Dissolved CO2 gas 
Carbonic acid 
Bicarbonate acid 
Carbonate 
Carbamino compounds
23
Q

What are the fates of CO2 in the capillary?

A

Dissolved in plasma by binding to carbamino compounds or as bicarbonate
- Most enters the RBC by the ‘Rhesus pathway’ or by the ‘protein pathway’

24
Q

What are the fates of CO2 in the RBC?

A
  • Dissolves into cytoplasm
  • Combines with Hb but not at the Fe binding site
  • Majority is converted into H+ and HCO3- by CARBONIC ANHYDRASE 2
  • In respiring tissues HCO3- goes out of the RBC via band3 and Cl- comes in
25
Q

What causes O2 to dissociate from the RBC?

A

Local acidification due to CO2

26
Q

Difference between lung ventilation at the apex and the base of the lungs?

A

Apex:

  • Larger starting volume of alveoli
  • Gas exchange greater

Base:

  • Smaller starting volume of alveoli
  • Higher ventilation (more room for expansion)
  • Greater lung perfusion
27
Q

What is lung perfusion?

A

The passage of fluid from the circulatory system to the organ
Linked to posture and gravity

28
Q

What is the Ventillation/perfusion ratio?

A

Ventilation/Perfusion
Use to get an idea of gas exchange
If miss-matched it can highlight a problem with ventilation or circulation

29
Q

What is Dalton’s law?

A

The total pressure of a MIXTURE of gases is the SUM of all of their individual pressures

  • Adding water to air (in the lungs) increases the partial pressure of water and decreases the pp of the other gases
  • But overall the total pressure remains the same
30
Q

What is Henry’s law and what does it calculate?

A

Calculate the amount of gas dissolved in solution using partial pressures

[gas]dis = s x Pgas
s is the solubility coefficient which changes with gases

31
Q

What is the structure of heamoglobin?

A
  • Tetramer
  • Each subunit has: Heam unit and globin chain
  • Globin chains differ depending upon Hb type.
32
Q

Structure of the Haem unit in Hb?

A

Porphorin ring- containing a single Fe2+ (must be +2 to bind)

33
Q

2 states of haemoglobin?

What causes the switch from the two states?

A

Tense- low affinity for O2
Relaxed - high affinity for O2

Binding of one O2 to one heam group switches all four subunits to the relaxed state

34
Q

What happens to the O2 carrying capacity of haemoglobin when the dissociation curve shifts to the:
Right?
Left?

A

To the right: carry LESS oxygen (more dissociation)

To the left: carry MORE oxygen (less dissociation)

35
Q

What causes the dissociation curve to shift to the right?

A

Increase pp Co2
Increase of temperature
Increase in 2,3-diphosphoglycerate
Decrease in pH

36
Q

What does 2,3-diphosphoglycerate do to Hb?

A

Binds to B chain. Binds better in a deoxygenated state

37
Q

How is the structure of Hb different in the fetal to in the adult?

A

Adult:
2 alpha chains
2 beta chains

Fetal:
Left shifted (higher afinity for )2)
2 beta chains replaced gamma chains
Lose affinity for 2,3-diphosphoglycerate

Physiology and Pharmacology (15 decks)

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