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BB - Respiratory Review > 2 Mechanics of Breathing > Flashcards

2 Mechanics of Breathing Flashcards

1
Q

Goals of Respiration

A
  • distribute air & blood flow for gas exchange
  • provide oxygen to tissues
  • remove carbon dioxide from tissues
  • maintain homeostasis for metabolic needs
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2
Q

Functions of Respiration

A
  • mechanics of pulmonary circulation
  • diffusion of O2 and CO2 between alveoli and blood
  • transport of O2 & CO2 to and from tissues
  • regulation of ventilation & respiration
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3
Q

External Respiration

A
  • mechanics of breathing
  • movement of gases
  • gas transfer to lungs & tissues
  • maintain body & cellular homeostasis
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4
Q

Internal Respiration

A
  • intracellular oxygen metabolism
  • cellular transformation
  • Krebs cycle –> aerobic ATP generation
  • mitochondria - O2 utilization
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5
Q

Ventilation goal

A
  • to maintain an optimal composition of alveolar gas

- inspiration & expiration provide stable alveolar environment

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6
Q

Lung Physiology

A

~1.5% body weight

  • alveolar tissue makes up 60% of lung
  • 10% total blood volume resides in lungs
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7
Q

Alveoli Physiology

A
  • very large surface area

- 40 times external body surface area

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8
Q

What changes alveolar pressure?

A

change in pleural pressure

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9
Q

Inspiration

A
  • active phase
  • pressure in alveolar ducts decreases
  • it is negative pressure inhalation
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10
Q

Phrenic Nerve

A
  • inspiratory
  • innervated diaphragm
  • C3-5
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11
Q

Intercostal Nerves

A
  • T1-11

- innervate external intercostal muscles (EIM)

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12
Q

Diaphragm

A
  • 75% of inspiratory effort
  • contracts during inhalation –> abd contents forced down
  • avg. movement down 1 cm during inspiration, can go 10 cm during forced inspiration
  • paradoxical movement when denervated
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13
Q

Transdiaphragmatic Pressure

A

-effect of abdominal pressure on the chest wall mechanics is transmitted across the diaphragm

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14
Q

What physiological states can reduce FRC?

A

any state in which abdominal pressure is exerted on diaphragm

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15
Q

External Intercostals (EIM)

A
  • 25% of inspiratory effort
  • connect adjacent ribs
  • contraction pulls ribs upward and outward
  • paralysis/spinal - pt will feel as if they’re not breathing
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16
Q

Accessory Muscles

A

-assist with forced inspiration during periods of stress

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17
Q

Scalene Muscle

A
  • accessory muscle
  • attached cervical spine to apical rib
  • elevates first 2 ribs during forced
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18
Q

Sternocleidomastoid Muscle

A
  • accessory muscle
  • attached base of skull to top of sternum and clavicle
  • raises sternum during during inspiration
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19
Q

Expiration

A
  • passive phase of breathing cycle
  • chest muscles relax
  • elastic recoil
  • active during hyperventilation & exercise
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20
Q

Rectus Abdominus/abdominal obliques

A

-contraction raises diaphragm upward

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21
Q

Internal intercostal muscles

A
  • assists by pulling ribs downward and inward

- exhalation

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22
Q

Transpulmonary Pressure

A
  • pressure difference between alveolar pressure and pleural pressure
  • alveoli more likely to collapse in children
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23
Q

Recoil Pressure

A

elastic forces which tend to collapse the lung during respiration

24
Q

Pleural Space

A

visceral - thin serosal membrane that envelopes lungs

parietal - lines inner chest wall, diaphragm & lat mediastinum

25
Q

Pleural Fluid

A
  • lubrication between membranes
  • maintains surface tension
  • lymphatic draining maintains constant suction on pleura (-5 cmH20)
26
Q

Pleural Pressure

A
  • The pressure of the fluid in the space between the lung pleura (viscera) and the chest wall pleura (parietal)
  • NEGATIVE! - if not, you’ve got a problem
27
Q

TLC

A

total lung capacity
TLC = IRV + TV + ERV + RV
~ 5500 ml

28
Q

VC

A

vital capacity
VC = IRV + TV + ERV
~ 4500 ml

29
Q

IRV

A

inspiratory reserve volume

~2500 ml

30
Q

ERV

A

expiratory reserve volume

~1500 ml

31
Q

RV

A

residual volume

~ 1000 ml

32
Q

IC

A

inspiratory capacity
IC = TV + IRV
~ 3000 ml

33
Q

TV

A

tidal volume

avg 500 ml

34
Q

FRC

A

functional residual capacity
FRC = ERV + RV
~ 2500 ml

35
Q

Can spirometry measure RV?

A

No, FRC & TLC cannot be determined

36
Q

Lung Compliance

A
  • measure of lungs distensibility

- compliance = change in lung volume / change in lung pressure

37
Q

I:E ratio

A

inspiration : expiration

normal 1:2

38
Q

Elastic lung tissue…

A
  • elastin & collagen fibers of lung parenchyma
  • natural states is contracted coils
  • elastic force generated when returning to coiled state
39
Q

Surface air-fluid interface

A

2/3 of total elastic force in the lung

40
Q

Surfactant

A

-synthesized fatty-acid product of type II pnuemocytes

41
Q

DPPC

A
  • dipalmitoyl phsphatidyl choline
  • strongest surfactant molecule in surfactant mixture
  • hydrophobic & hydrophilic opposing ends
42
Q

Total Ventilation / Minute Ventilation

A

-total volume of air conducted into lungs per minute

43
Q

Alveolar Ventilation

A
  • volume of fresh air entering alveoli each minute

- steady state is achieved when supply matches demand

44
Q

Anatomical Dead Space

A

~30% of TV

45
Q

Wasted ventilation

A
  • deviation from ideal ventilation relative to blood flow
  • air available, blood not so much –> contributes to dead space
  • ventilation/blood mismatch –> V/Q mismatch
46
Q

Closing Volume & FRC

A

is the closing volume of the lung, at which small airways close, is greater than FRC, then small airways collapse –> atelectasis

47
Q

Bernouli Effect

A

explains airway collapse

48
Q

Laminar Flow

A
  • parallel streams of flow

- velocity at center is 2x as fast

49
Q

Poiseuille’s Law

A

describes resistance to flow through tube

  • reducing radius by 16% –>double resistance to flow
  • reduce radius by 50% –> increase resistance 16 fold
50
Q

Ohm’s Law

A

P = F x R

51
Q

Turbulent Flow

A
  • tends to occur at higher flow rates
  • pressure is no longer proportional to flow
  • increase in density, velocity or resistance –> turbulence is more probable
52
Q

Airway Resistance

A
  • chief site is medium sized bronchi

- factors: lung volume, bronchial smooth muscle, density & velocity of inspired gas

53
Q

Causes of bronchoconstriction

A

PSN, acetylcholine, low PCO2, direct stim, histamine, cold

54
Q

How does gas density effect airway flow resistance

A

higher density = increased resistance to flow

55
Q

What measures work of breathing

A

W = PxV

oxygen consumption - hyperventilation increases

BB - Respiratory Review (5 decks)

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