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Phys > Test 4 Lungs > Flashcards

Test 4 Lungs Flashcards

1
Q

Non-respiratory Lung Fx

A 
filters
reservoir for drugs
metab vasoactive substance
    ACE
Metab bronchoactive substance 
   leukotrienes - bronchospasm
Metab drugs
Immunoglobulin production
Mast cells produce heparin
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2
Q

Anemia

< O2 binding capacity

A

hgb deficiency so oxyhemoglobin stay low

can’t tx w/ O2 administration

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3
Q

Pulmonary

Hypoxic Vasoconstriction

A

Low PAO2
shunt blood to other well ventilated portions

Hypoxia in all lung ->
Pum HTN
Acidemia –> pulm vasoconstriction

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4
Q

Pulm Circulation Resistance

@ low lung Vol

A

> resistance
Extra alveolar vessel
< Resistance
Alveolar/Capillary Vessel

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5
Q

Pulm Circulation Resistance

@ High lung Vol

A 
> Resistance
     Alveolar/Capillary Vessel
       squashed 
< Resistance 
       Extra alveolar vessel 
         dilate
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6
Q

Central Chemoreceptors

A

Located: Medulla
Sense: change in CSF pH d/t change in CO2
make H+ locally

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7
Q

Rate of Airflow

A

(PA - P-ATM) / R-AW

Flow = P diff / resistance

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8
Q

Major muscles of inspiration

accessory muscles?

A

diaphragm
external intercostal

sternocleidomastoid
scalenes

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9
Q

Accessory muscles of expiration

A

internal intercostals

abdominal muscles

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10
Q

Elastic Recoil of Lung

A

lung elasticity

surface tension

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11
Q

Compliance

A

how easy to stretch open
volume change / pressure change

Low Compliance if:
small vol change per large P change

Higher @ lower lung volumes
highest @ RV

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12
Q

Inspiration

A

PA (intrapulmonary P) fall below P-ATM
Lowest PA 1/2 way through inspiration

Start w/ insp muscle contraction and chest recoil overcome lung recoil

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13
Q

Expiration

A

Recoil of lung = > PA (intrapulmonary P) above P-ATM = air out of lungs

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14
Q

Intrapleural (Pleural) Pressure

A

always - compared to atmosphere
space b/w lung and thorax
Exert expanding effect on lungs
^compliance

Less - @ bottom of Lung

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15
Q

Transpulmonary Pressure

A

pulling pressure of pleurae
~ 4mmHg

PA -pleural P

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16
Q

Elastic Recoil Pressure of system compared to FRC

A

@FRC:
system in equilibrium

Above FRC:
Net recoil P: +
relaxation -> expiration

Below FRC:
Net recoil P -
relaxation —> inspiration

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17
Q

Chest wall recoil @ 0

A

at 70% TLC

@ TLC lung and chest wall want to recoil

18
Q

Lung Apex

A

big resting Vol = < compliance
less change in alveolar vol in inspiration
higher intrapleural P

19
Q

Lung Base

A

Less - intrapleural P

Expand alveoli more w/ inspiration

20
Q

LaPlace’s Law

A

P = 4T / r
will expand if P in alveoli > 4T/r

small alveoli need > P to pen

21
Q

Absence of surfactant –>

A

< lung compliance
alveolar atelectasis
pulm edema

22
Q

Turbulent airflow
vs
Laminar Flow

A 
Turbulent: 
  in larger airways
  depend on gas density
Laminar Flow
  smaller airways 
   lower flows
  viscosity
  Poiseulle's Law: resistance inversely proportional to r^4 and directly proportional to tube length
   V = [P (pi) r^4]/[8nL]
23
Q

Ohms Law

Airway Resistance

A

Airflow = P change / resistance

Site of greatest airways resistance in medium size bronchi

> lung vol = < airway resistance

24
Q

Obstructive Disease

A

difficult to get air out
> airway resistance = > work of breathing to overcome flow-resistance
compliance unchanged
no change in elastic work of breathing

COPD, asthma, emphysema
have trouble coughing

25
Q

Restrictive Disease

A

difficult to get air in
low compliance
> elastic work of breathing
flow resistance normal

ARDS, interstitial lung D
need > PEEP

26
Q

Effort-independence of maximal expiratory flow rate

A

With more expiratory force you will reach higher peak expiratory flow rate but flow rate will equal out

rate of airflow doesn’t change with > force of expiratory muscles

27
Q

Obstructive Lung D

Pulmonary Function

A 
< elastic recoil
> Lung volumes (TLC, >>RF, FRC)
< FEV1, <  FEV1/FVC
start w/ more vol in lung and have very large RV
< max expiratory flow
28
Q

Restrictive Lung D

Pulmonary Function

A

lung compliance <
< lung volumes (TLC, VC, FRC)
< in FEV1 and FVC
< max expiratory flow

29
Q

Oxygen Transportation in Blood

Total blood O2 content?

A

1) dissolved
0.003 ml O2/ 100ml plasma / mmHg PO2
PaO2 x .003 = mlO2/dL
Henry’s Law
2) on Hb (~98%)
1.34 ml O2 / g Hb
1.34 x Hbg x O2 Sat = mL O2/dL

both added together

30
Q

Hemoglobin Coposition

A

heme = Fe+porphyrin compound
globulin = protein w 2 alpha and 2 beta peptide chains
^each have a heme
carry 4 Oxygens

31
Q

R shift

Oxyhemoglobin Dissociation Curve

A

> PCO2, H+, Temp, 2,3DPG
O2 dissociation from Hgb
larger O2 gradient

32
Q

L Shift

Oxyhemoglobin Dissociation Curve

A

Increase affinity of Hgb for O2
Alkalosis, carboxyhemoglobin, methemoglobin
< CO2/ Temp/ 2,3 DPG

33
Q

Oxyhemoglobin Dissociation Curve

A

partial P of O2 to oxygen saturation of Hgb
PO2 100mmHg = SaO2 98%
sigmoidal shape
PaO2 < 60 lead to rapid < in SaO2 % with further

34
Q

CO2 Transport

A

1) dissolved in blood 7%
CO2 20x soluble then O2
2) as bicarb 70%
3) carbaminohemoglobin 23%

35
Q

CO2 binding to Hgb lead to affinity change

pH of venous blood?

A

< affinity for O2 when CO2 bind to Hgb

Venous blood acidic, has more CO2

36
Q

Haldane Effect

A

Oxygenated Hgb in Lung = > unload of CO2

Deoxygenated Hgb (tissues) = > CO2 go onto Hgb

37
Q

CO2 Equilibrium Curve

A

steep and linear
small diff b/w PaCO2 (40) and PvCO2 (45)
Venous line L shift- Haldane

38
Q

volatile acid

A

CO2

39
Q

Peripheral Chemoreceptors

Respond to:

A

PaO2 (and PaCO2 / pH)
Carotid Body (CN 9)
Aortic Body (CN 10)
Send signal to Respiratory Center in Medulla
Resp Center send out signals on Phrenic and intercostal nerves

40
Q

Lung Receptors

(Vagus Nerve)

A 
Irritant receptors 
--> bronchoconstriction/ hyperpnea
Stretch Receptors
 --> < RR
J Receptors
--> rapid shallow breathing
41
Q

Exercise responses

A

> CO2 production and O2 consumption
mean PaO2 PaCO2 don’t change!!
CO and RR >
curve shift to R

42
Q

CO Poisoning

A 
CO 240x O2 affinity for Hgb
displace O2 = carboxyhemoglobin
< O2 carrying capacity
L shift of curve, hold onto O2
false high SpO2 %
venous PO2 <<<<

Phys (3 decks)

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