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AEMCA Studying > Respiratory System Physiology > Flashcards

Respiratory System Physiology Flashcards

(65 cards)

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1
Q

What gradient does air follow, and what happens without it

A

High to low, no air movement

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2
Q

What does inspiration require within the body

A

A lower alveolar pressure than atmospheric pressure

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3
Q

Describe normal inspiration

A

Contraction of respiratory muscles = enlargement of the thoracic cage & lung expansion = decrease in pressure inside lungs = air moves in

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4
Q

What is the principle muscle of inspiration

A

The diaphragm

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5
Q

Describe the diaphragm

A

Large, dome-shaped sheet

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6
Q

What muscle may be the only one used during quiet breathing

A

The diaphragm

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7
Q

When the diaphragm contracts, what happens

A

There is a downwards pull enlarging the thoracic cavity

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8
Q

During max ventilation the diaphragm can move as much as __ cm

A

10 cm

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9
Q

What controls the diaphragm

A

The phrenic nerve, innervated through the 3rd-5th cervical vertebrae

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10
Q

What can be a complication with a cervical spine injury at or below C3

A

Paralysis of the ventilatory muscles

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11
Q

What do the intercostal muscles do

A

Increase the anterior-posterior diameter of the thorax by moving the anterior end of ribs up & out

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12
Q

What does contraction of the intercostal muscles do

A

Tenses the intercostal spaces so they aren’t sucked in during inspiration

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13
Q

Where are the nerves that control the intercostal muscles

A

C1-11

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14
Q

What are the accessory muscles of inspiration

A

Scalenes & sternocleidomastoids

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15
Q

What do the accessory muscles do

A

Contraction raises the 1st rib, manubrium & sternum, while helping to stabilize the thoracic cage so the intercostal muscles can function accordingly

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16
Q

Max contraction of the inspiratory muscles can decrease intrapleural pressure by how much

A

60-100mmHg

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17
Q

Expiration is usually __

A

Passive

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18
Q

How is potential energy stored in the inspiratory muscles, and why is it important for expiration

A

Through contraction causing the elastic tissues of the lungs & thorax to stretch, which recoil & release the stored energy producing expiration

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19
Q

When do expiratory muscles actively contract

A

At high respirates or with partial/moderate airway obstructions (ie asthma/emphysema)

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20
Q

What abd muscles are pertinent for expiratory

A

External & internal obliques, rectus abdominus, transverse abdominus

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21
Q

How do the abdominal muscles contribute to expiration

A

Contraction increases intra-abd pressure therefore pushes the diaphragm up & depresses the lower ribs which decreases the thorax circumference

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22
Q

How do the internal intercostal muscles assist with expiration

A

The depress the ribs down & in, while stiffening the intercostal spaces so they dont bludge during expiratory efforts

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23
Q

What are the respiratory reflexes

A

Sneeze & cough

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24
Q

What are the mechanics of a cough

A

Violent expiratory blast against a partially closed glottis

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25
What induces a cough
Irritation/stimulant of a sensory nerve endings in either the larynx, trachea, or larger bronchi which transmits impulses to the cough center in the medulla
26
What are some examples of irritant/stimulus that may cause a cough
— Infection/Inflammation — Mechanical (dust/smoke) — Chemical (noxious gas) — Thermal (cold air)
27
Describe the process of a cough
Deep inspiration —> tight closing of glottis (accumulates pressure in the air passages) —> expiration against the glottis —> glottis partially opens to expel the material (partial opens causes rapid expiratory flow to rid obstruction)
28
How does a sneeze work
The sensory nerve endings of the nasal mucous membranes are irritated causing deep inspiration & violent expiration
29
Healthy lungs are made of __ tissue
Elastic
30
Describe the definition of elastance
The property of matter which allows it to return to its original shape after having been deformed by some exertional force
31
Describe the definition of compliance
The amount of pressure that must be generated to expand the lungs wth a given volume (decrease in compliance = increase in disease)
32
What are two examples of conditions that can cause ‘stiff lungs’ through decreasing compliance
Worsening interstitial pneumonia Increasing pulmonary fibrosis
33
If you had to describe how surface tension works, what example/equivalent would you use
If cells in the alveolar wall have iron in the nucleus & a magnet is in the middle, the pull creates tension
34
What is produced by the alveoli and what does it do
Decreases surface tension & the workload for muscles to expand the alveoli
35
What is IRDS (and what is that acronym)
Infant respiratory distress syndrome — most commonly in premature infants (where there is a physical immaturity of surfactant producing cells) tons of effort is required to inspire and open the alveolar walls (this pt NEEDS PPV!!)
36
How much O2 is required by the respiratory muscles, and how much is that of the body’s O2 consumption
3-14mL, <5% of the body’s consumption
37
How much O2 consumption can be utilized by the respiratory muscles during a cardiac/respiratory pathological state
Up to 25% of the body’s consumption
38
To get enough O2 through consumption during a cardiac/respiratory pathological state, what would the body do
Increase ventilation
39
What is the tidal volume
(Tv or Vt) Volume of air inspired & expired each breath at rest, in a healthy adult usually 400-500mL
40
What is the residual volume
Air remaining at end of expiration, even with max effort
41
What is the functional residual capacity
(FRC) Volume of gas remaining at end of normal tidal exhalation. PEEP devices decrease exhalation & increase FRC
42
What is the total lung capacity
(TLC) maximum amount of air the lungs can contain
43
What is the forced vital capacity
Max air that can be exhaled post-max inspiration
44
What the forced expiratory volume for one second
(FeVt) measure of amount of air that can be exhaled in the first second of a maximal forced exhalation
45
What is spirometry
The process of measuring volumes of air moving in and out of lungs
46
How may a ‘restrictive’ disease be found on spirometry
A reduction of lung volumes
47
What may cause a restrictive disease as indicated on a spirometry test
— Decrease distensibility of lungs (pulmonary fibrosis) — Decrease distensibility of the chest wall (kyphoscoliosis & certain neurological diseases)
48
What would an increase in lung volumes indicate
The lungs are hyper inflated
49
What can cause a hyperinflation of the lungs
— Obstruction of AWs (asthma) — Loss of lung elasticity (emphysema)
50
Why is a decrease in lung elasticity bad for a pt
It decreases the ability to rapidly exhale inspired air therefore decreasing flow rates
51
Where is ventilation controlled from
The respiratory center in the brainstem
52
How does the control of ventilation change when a pt has chronically marked high CO2
The respiratory center may be inactive as it typically responds to increased CO2 to change the ventilatory effort, therefore the hypoxic drive may take over
53
What is the hypoxic drive
Hypoxia sensed through the carotid & aortic arch chemoreceptors, and when stimulated they increase the rate &/or volume of respiration
54
How can various drugs impact the respiratory drive
— Stimulate it (ie ASA) — Depress it (ie narcotics or sedatives)
55
Define ventilation
(V) the volume of air which moves into/out of the mouth
56
Define minute ventilation/volume
Number of breaths q min x volume of each breath
57
Calculate the minute ventilation/volume if the RR is 12 and Tv is 500cc
12 x 500cc = 6000cc/min
58
Define perfusion
(Q) the flow of blood through tissues
59
What is often a normal perfusion value at rest (CO)
~6L/min
60
How can you show ventilation to perfusion
V=Q, V:Q, V/Q
61
If functional V/Q is 1, when would it be <1, or even 0
<1 during bronchospasm 0 during full occlusion
62
What is a good example of decreasing V/Q ratio
An asthmatic pt who is declining from alveolar obstruction through both bronchospasm & further mucous plugging
63
When does an intrapulmonary shunt occur
Any time the disease permits blood through the lungs without saturating the Hb, causing a decreasing arterial O2 consumption
64
How can CO affect the oxygen saturation
(In a case of cardiogenic shock) there is a decrease in CO, therefore decrease in blood to the functional alveoli, decreasing gas exchange (for example if normal is 6L and it drops to 4L, the body is only getting 2/3 of required blood to used for exchange)
65
Considering V/Q mismatch results in a decreased SpO2, why can oxygen not really fix the saturation
Because the shunting that takes place cannot be impacted by the added O2, therefore the O2 is only going to the already functional units

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