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Patho 1 > 3 - Pulmonary Ventilation and Flow > Flashcards

3 - Pulmonary Ventilation and Flow Flashcards

1
Q

What is the most important muscle that raises the rib cage?

A

External intercostals

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2
Q

List the four muscles that raise the ribcage

A

External intercostals

sternocleidomastoid

anterior serrati

Scaleni

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3
Q

Which two muscle groups pull the rib cage downward?

A

Abdominal Recti

Internal Intercostals

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4
Q

The external intercostals are _____ muscles

The internal intercostals are ______ muscles

A

Inspiratory

Expiratory

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5
Q

What maintains the suction between the visceral pleura and the parietal pleura?

A

Lymph suction!

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6
Q

What is normal/resting pleural pressure?

During inspiration?

A
  • 5 cmH20
  • 7.5 cm H20
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7
Q

What is resting alveolar pressure?

During inspiration?

During expiration?

A

0 cm H20

-1 cm H20

+1 cm H20

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8
Q

What is the transpulmonary pressure?

A

The difference between the alveolar pressure and the pleural pressure

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9
Q

What is lung compliance?

A

The extent to which the lungs will expand for each unit increase in transpulmonary pressure

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10
Q

What is normal lung compliance?

A

200ml of air for every 1 cm H2O change in transpulmonary pressure

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11
Q

What is the surface tension of alveoli without surfactant?

With surfactant?

A

50 dynes/cm

5-30 dynes/cm

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12
Q

What is the compliance of the lungs in the thorax?

Why is it different from the lungs alone?

A

110 ml/cm H2O

The thorax is heavier and much less elastic

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13
Q

Vital Capacity Definition

Calculation

A

maximum amount of air a person can expel from the lungs after filling the lungs to a maximum extent

Inspiratory reserve + expiratory reserve + tidal volume

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14
Q

Total Lung Capacity Definition

Calculation

A

Maximum volume to which the lungs can be expanded with the greatest possible effort

vital capacity + residual volume

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15
Q

Tidal Volume Definition

A

air inspired or expired with each normal breath

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16
Q

Inspiratory Reserve Volume

A

extra volume of air that can be inspired over and above the normal tidal volume

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17
Q

Expiratory Reserve Volume

A

max extra air that can be expired by forceful expiration

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18
Q

Residual Volume

A

Air remaining in the lungs after the most forceful expiration

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19
Q

Inspiratory Capacity Definition

Calculation

A

amount of air a person can breathe in after a normal exhalation

tidal volume + inspiratory reserve volume

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20
Q

Functional Residual Capacity Definition

Calculation

A

amount of air that remains in the lungs at the end of normal expiration

expiratory reserve volume + residual volume

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21
Q

What is phsyiologic dead space?

A

All dead space including alveolar dead space

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22
Q

What is the calculation for alveolar ventilation?

A

VA = RR x (VT - VD)

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23
Q

Bronchioles usually have a diameter less than _______

A

1.5 mm

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24
Q

What keeps bronchioles from collapsing?

A

NOT their rigidity, but rather the same transpulmonary pressure that keeps alveoli open

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25
Q

The trachea and bronchi are made up of ______ and ______

The bronchioles are made up of ________

A

Cartilage plates and smooth muscle

smooth muscle

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26
Q

What is the respiratory bronchiole?

What is it made of?

A

Most terminal bronchiole

made up mainly of pulmonary epithelium and underlying fibrous tissue

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27
Q

Where does the greatest resistance of airflow occur during normal breathing?

A

The larger bronchioles and bronchi near the trachea

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28
Q

In pathologic conditions, smaller bronchioles do have higher resistance than larger ones because of: (3)

A

muscle contraction in their walls

edema in the walls

mucus collecting in the lumens

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29
Q

How does sympathetic stimulation of the bronchioles occur: locally or hormonally?

A

Hormonally

Very few sympathetic nerve fibers penetrate into the central lung

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30
Q

Which causes more bronchodilation: norepinephrine or epinephrine?

Why?

A

Epinephrine

More beta adrenergic activity

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31
Q

In the bronchioles, sympathetic stimulation causes _____

parasympathetic causes

A

dilation

constriction

32
Q

What drug would attenuate parasympathetic constriction of bronchioles with underlying asthma?

A

Atropine

blocks the effects of acetylcholine

33
Q

Which two secrety factors cause bronchiolar constriction during allergic reactions?

A

Histamine

Slow reactive substance of anaphylaxis

34
Q

Cilia in the lungs beat ______

Cilia in the nose beat _______

A

upward

downward

35
Q

All mucous in the ciliary tract moves toward the ______

A

pharynx

is either coughed out or swallowed

36
Q

The ____ and ____ are especially sensitive to to light touch/irritation

A

larynx

carina

37
Q

What triggers the cough reflex?

A

Irritant -> Vagus Nerve -> Medulla -> Cough

38
Q

The sneeze reflex is the same as the cough reflex except _______

A

the uvula is depressed, allowing air to pass through the nose

39
Q

What are the three major organs of articulation?

A

lips

tongue

soft palate

40
Q

What are the four resonators?

A

Mouth

Nose/Nasal Sinus

Pharynx

Chest cavity

41
Q

The lung has two circulatory systems:

High Flow/_________

Low Flow/ _________

A

Low pressure

High Pressure

42
Q

Which pulmonary system supplies systemic arterial blood to the structures of the lung?

A

The high pressure/low flow

43
Q

Which pulmonary system provides blood to the alveoli and returns the blood to the heart?

A

Low pressure, high flow

44
Q

How thick is the pulmonary artery?

A

1/3 of the aorta

45
Q

Why does the pulmonary arterial tree have such large compliance?

A

Vessels have short branches and large diameters

46
Q

Where does de-oxygenated blood from lung structures go?

A

Into the LA and out to the circulation

This is the reason for the baseline physiologic shunt

47
Q

How are plasma proteins and particulates removed from the lung?

A

Lymph

48
Q

What is a normal RV SBP and DBP?

A

25/0

49
Q

What is the normal mean pulmonary capillary pressure?

A

7mmHg

50
Q

What is the blood volume of the lungs?

A

450ml

51
Q

The lungs are a blood resevoir. How much blood can they expel?

A

250ml with forced high pressure expiration (blowing a trumpet)

52
Q

Blood flow through the lungs is essentially equal to _______

A

cardiac output

53
Q

What happens to pulmonary alveolar arterioles when [O2] is low?

A

They constrict

The exact OPPOSITE of what systemic arterioles do

54
Q

In low O2 states, alveolar arterioles secrete ________

and inhibit _______

A

endothelin, ROS

nitric oxide release

55
Q

Describe zone 1 pattern of pulmonary blood flow

A

No blood flow during all portions of the cardiac cycle

Alveolar air pressure is always higher than pulmonary capillary pressure, so flow is cut off

56
Q

Describe Zone 2 Pattern of Pulmonary Blood Flow

A

Intermittent Blood Flow

systolic bp is higher than capillary prefusion pressure, but diastolic is not

So flow ceases during diastole

57
Q

Describe Zone 3 Pattern of Pulmonary Blood Flow

A

Continuous blood flow

Alveolar pressure is always lower than pulmonary capillary pressure, and flow occurs durng systole and diastole

58
Q

Zone 2 Flow is found in the ________

Zone 3 flow is found in the ________

A

Apices

Bases

59
Q

Where does zone 2 flow begin in normal lungs?

A

10cm above the midlevel of the heart to the top of the lungs

60
Q

Where does zone 3 flow occur in normal lungs?

A

everywhere below 10cm above the midlevel of the heart

61
Q

How do blood flow zones change when a person is lying down?

A

All areas receive zone 3 flow

62
Q

When does zone 1 flow occur in a normal lung?

A

It doesn’t

63
Q

What two factors cause zone 1 flow?

A

Abnormally low capillary perfusion pressure

Abnormally high alveolar pressure

64
Q

What happens to flow in the apices during exercise?

A

Receive zone 3 flow d/t increased capillary pressure

65
Q

How do the lungs increase perfusion during exercise?

A
  1. increases the number of open capillaries
  2. distends all the capillaries and increases rate of flow
  3. increases pulmonary arterial pressure
66
Q

How much does pulmonary arterial pressure increase during exercise?

A

hardly at all

capillary dilation and recruitment is usually sufficient

67
Q

What is a normal LA pressure?

A

1-5 mmHg

68
Q

What LA pressure is likely to cause pulmonary edema?

A

> 30

69
Q

Pulmonary capillary pressure is ________ than systemic capillary pressure

A

lower

7 vs 17

70
Q

Interstitial fluid pressure in the lungs is _______ than in the systemic system

A

more negative

71
Q

pulmonary capillary oncotic pressure is _______ than systemic capillary oncotic pressure

A

higher (14 v 7)

72
Q

Why don’t alveoli fill with fluid?

A

pulmonary capillaries and pulmonary interstitial fluid maintain slight negative pressure

sucks fluid out of the alveoli and into the interstitium or epithelium

73
Q

What are the most common causes of pulmonary edema?

A

L heart failure

Damage to pulmonary blood capillary membrane (infection, noxious substance)

74
Q

Pleural fluid has a _______ characteristic

A

mucoid

makes it nice and slippery

75
Q

The pleural space is really a _______ space

A

potential

76
Q
A

Patho 1 (17 decks)

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