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CRAAB II > Trachte Respiratory Physiology > Flashcards

Trachte Respiratory Physiology Flashcards

1
Q

What are the four key processes in respiration?

A
  1. Ventilationv (air into lungs)
  2. Diffusion (O2 to blood)
  3. Perfusion (blood flow)
  4. Gas transport (via hemaglobin)
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2
Q

Define ventilation

A

Getting air into the lungs

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3
Q

Define diffusion

A

getting oxygen into the blood

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4
Q

Define perfusion

A

blood flow

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5
Q

How do gases more across the blood gas interface?

A

via diffusion - high to low pressure

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6
Q

Partial pressure of O2 in the alveoli?

A

150 mmHg

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7
Q

Partial pressure of O2 in the venous blood?

A

40 mmHg

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8
Q

Gases move across a barrier depending on these four things -

A
  1. Cross sectional area of the barrier
  2. Permeability of the barrier
  3. Thickness of barrier
  4. Pressure gradients
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9
Q

Pulmonary fibrosis destroys this part of the gas/barrier interface

A

Permeability of barrier

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10
Q

Emphysema destroys this part of the gas/barrier interface

A

Cross sectional area of the barrier

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11
Q

How the the parts of the airway descend?

A

Trachea - L and R bronchi - Lobular bronchi - segmented bronchi - terminal bronchioles - respiratory bronchioles

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12
Q

Conducting airway is composed of these parts of the airway

A

Trachea all the way through the terminal bronchioles. Movement of air occurs here.

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13
Q

Is there gas exchange at the conducting airway?

A

No, just conduction of air.

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14
Q

Where is the anatomic dead space?

A

The conducting airway

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15
Q

What is one way we see increased anatomic dead space in humans?

A

When someone is on a respirator

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16
Q

Muscle contraction during inspiration?

A

Diaphragm contracts by moving down

Intercostals contract and raise ribs

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17
Q

Where does dust settle if you have an inhalation?

A

in the terminal bronchioles (NOT the alveoli)

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18
Q

Blood flow in lungs?

A

Pulmonary artery to capillaries to pulmonary veins

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19
Q

What damages the vascular walls in the lungs?

A

Increased capillary pressure (HTN, hypoxia) or increasing alveolar pressure (respirator)

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20
Q

Are we as good as birds?

A

Nope. Humans aren’t as good as birds.

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21
Q

______ reduce surface tension and prevent alveolar collpase

A

Surfactants

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22
Q

Ventilation is defined as

A

the amount of air entering and leaving the lungs per minute

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23
Q

Tidal volume is defined as

A

the amount of air inspired and expired in routine breathing

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24
Q

What is a normal tidal volume? Alveoli volume?

A

500 mL

350 mL

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25
Q

Vital capacity is defined as

A

The maximum volume of air that can be exhaled after a maximum inspiration

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26
Q

Residual volume is defined as

A

the amount remaining in the lung after a maximal expiration

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27
Q

Functional residual capacity is defined as

A

the amount remaining in the lungs after a typical exhalation

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28
Q

How do you measure FRC?

A

You cannot directly, use helium/gas dilution test to calculate

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29
Q

Regarding a gas dilution test - the more dilute the helium the _______ the lungs

A

Larger, have greater volume

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30
Q

How do you calculate alveolar ventilation?

A

Va = VCO2/PCO2 (x K)

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31
Q

How do you measure anatomic dead space?

A

breath O2, plot N and find midpoint (half maximal) concentration - transition from deadspace to alveolar ventilation

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32
Q

Vd/Vt (volume dead space/tidal volume) =

A

(PaCO2 - PeCO2)/PaCO2

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33
Q

Which portions of the lungs are best ventilated?

A

The lower portions

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34
Q

What is the difference between anatomic and physiological dead space?

A

anatomic dead space is the amount of ventilation confined to the conducting airway
Physiologic dead space is the amount of ventilation not exchanging with the blood

35
Q

Total lung volume =

A

vital capacity + residual volume

36
Q

What two ventilatory measures can you measure directly?

A

Tidal volume

vital capacity

37
Q

The process by which O2 (or other gases) move from higher to lower pressure

A

Diffusion

38
Q

Diffusion is _____ to surface area

A

proportional

39
Q

Diffusion is _____ ________ to barrier thickness

A

inversely proportional

40
Q

Example of less diffusion via less surface area?

A

Pneumothorax

41
Q

Example of less diffusion because of barrier thickness?

A

Some sort of interstitial disease

42
Q

What is the driving force for diffusion?

A

Pressure differences

43
Q

Carbon Monoxide and blood

A

So soluble that it is diffusion limited

44
Q

When is O2 diffusion limited?

A

Certain pulmonary diseases - not the norm

45
Q

What do you do if you need more O2 diffusion?

A

Increase CO. It is a perfusion/low limited process

46
Q

When does O2 reach equilibrium during diffusion?

A

1/3 through capillaries

47
Q

High altitude and diffusion?

A

Harder, because PaO2 is lower

48
Q

How do you measure diffusion capacity?

A

Carbon monoxide test

Diffusion capacity = Vco/(P1-P2)

49
Q

When do you do a diffusion capacity test?

A

To test for interstitial diseases

50
Q

Diffusion of gas through a tissue is proportional to

A 
Area
1/thickness
1/molecular weight
solubility
pressure differential
51
Q

Diffusion limited gases

A

CO and O2 (in some disease states)

52
Q

Perfusion limited gases

A

O2, N2O and CO2

53
Q

What is a normal PO2

A

40 mmHg

54
Q

What is a normal PCO2

A

45/46 mmHg

55
Q

What is normal pulmonary pressure

A

25/8

56
Q

Why does pulmonary artery resistance decrease when there is an increase in pulmonary artery pressure?

A

Recruitment of additional capillaries to conduct BF

Distention of capillaries to allow more blood flow

57
Q

Radius and length in pulmonary capillaries

A

Radius is larger, Length is shorter

We want low pressure to keep lungs dry

58
Q

3 drugs that contract vessels and result in an increase in resistance

A

NE
5HT
Histamine

59
Q

3 drugs that relax vessels and reduce resistance

A

Ach
Iso
Prostacyclin

60
Q

Fick Equation/Principle

A

O2 consumed = CO (CaO2 - CvO2)

61
Q

Pulmonary blood flow equation

A

VO2 / (CaO2 - CvO2)

62
Q

Why is there more flow to the base of the lung than the apex?

A

Gravity

63
Q

Zone 1 Characteristics

A

Palveoli > Parteriole > Pvenous
NO FLOW
Does not happen naturally, hemorrhage or positive pressure breathing typically

64
Q

Zone 2 Characteristics

A

Part > P alveoli > Pvenous
Determined by pressure differences of artery and alveoli
Apical region

65
Q

Zone 3 Characteristics

A

P art > Pvenous > Palveoli
Flow dependent on arterial venous pressure differences (normal situation in the circulatory system)
Midregions and base of lung

66
Q

P art > P alveoli > P venous

A

Zone 2

67
Q

P alveoli > P art > p venous

A

Zone 1

68
Q

P art > P venous > P alveoli

A

Zone 3

69
Q

How does alveolar hypoxia constrict blood vessels perfusing the hypoxic region of the lung?

A

Inhibiting voltage gated K channels = hypopolarize

Causes an increase in [Ca] leading to vasoconstriction

70
Q

What controls fluid movement in the lungs?

A

Starling forces

71
Q

Other functions for pulmonary circulation?

A

Reservoir for blood

Filter of blood (thrombi in legs can’t get to brain) – thats helpful

72
Q

Metabolic functions of the lungs

A
  1. AGI to AGII via ACE
  2. Inactivates bradykinin
  3. 5HT removal from circulation
  4. prostaglandin metabolism
  5. PG and Leu synthesis
73
Q

Is pressure lower or higher than systemic in the pulmonary system?

A

Lower

74
Q

Resistance is extremely low and falls further upon increases in CO in the pulmonary system – why?

A

recruitment and distension

75
Q

Causes of hypoxemia

A

Hypoventilation
Diffusion limitation
Shunt (R to L)
Ventilation-perfusion mismatch

76
Q

Oxygen levels in air vs. blood

A

150 mmHg in humidified air
100 mmHg is alveoli
1-100 mmHg in tissues

77
Q

Why does the PCO2 increase when we hypoventilate?

A

Stimulates breathing, respiratory exchange

78
Q

PCO2 =

A

(VCO2/Va) x K

79
Q

PAO2 =

A

PIO2 - ([PACO2/R])

80
Q

What is a shunt?

A

Mixing of O2 depleted blood from the bronchial circulation and a small amount of blood from the thebesian veins of the heart

81
Q

Can O2 correct a shunt?

A

No.. Doesn’t matter how much you oxygenate, still will be some mixture and will not maintain 100% O2 sats.

82
Q

If there is no perfusion but the alveoli are still ventilated…

A

PO2 and PCO2 approach that of the inspired gas

83
Q

If there is perfusion but no ventilation (obstruction to airflow)

A

the PO2 and PCO2 approach that of venous blood

84
Q

Does the apex or base of the lung have a higher ventilation to perfusion ratio?

A

Apex

CRAAB II (7 decks)

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