3. Ventilation

Question 1

Minute ventilation =

Answer 1

Question 2

Normal respiration rate

Answer 2

12 breaths/min

Question 3

Normal Vt =

Answer 3

500 mL

Question 4

Normal minute ventilation =

Answer 4

500 mL x 12 breaths/min = 6000 mL/min

Question 5

What is more important alveolar or pulmonary ventilation?

Answer 5

Alveolar ventilation

Question 6

Is alveolar ventilation more or less than pulmonary ventilation and why?

Answer 6

Less than pulmonary ventilation due to anatomic dead space.

Question 7

Alveolar ventilation =

Answer 7

(tidal volume – dead space) x respiratory rate

Question 8

Airway resistant - generation vs resistance

Answer 8

Question 9

Airway resistance conductance, lung volume, resistance diagram

Answer 9

Question 9

Airway resistance conductance, lung volume, resistance diagram

Answer 9

Question 10

Local controls to match airflow to blood flow - blood flow > airflow diagram

Answer 10

Question 11

Local controls to match airflow to blood flow - airflow > blood flow diagram

Answer 11

Question 12

Regional ventilation and perfusion rates and ventilation-perfusion ratios in the lungs. Diagram

Answer 12

Question 13

Ventilation and perfusion rates and ventilation-perfusion ratios at top and bottom of lungs. Diagram

Answer 13

Question 14

Two main classifications of respiratory disease

Answer 14

• Obstuctive

- Restrictive

Question 15

X 4 points about obstructive

Answer 15

– Airway narrowing
– Increased airway resistance
– Reduced flow during expiration
– Examples: emphysema, chronic bronchitis, asthma.

Question 16

x 4 points about restrictive

Answer 16

– Reduced compliance
– Scar tissue formation
– Fibrosis
– Examples: pulmonary fibrosis

Question 17

Other respiratory conditions x 4

Answer 17

• Diseases impairing diffusion of O2 and CO2
• Neuromuscular disorders
• Inadequate perfusion
• Ventilation-perfusion imbalances

Question 18

FEV1.0 meaning

Answer 18

Force expired volume in 1 sec

Question 19

FVC meaning

Answer 19

Forced vital capacity

Question 20

FEV1.0/FVC is the…

Answer 20

disease index (i.e. <80%)

Question 21

Forced expired volumes in normal, obstructive and restrictive disease

Answer 21

Question 22

Obstructive I

Answer 22

• Airway hyper-reactivity
• Reversible airway narrowing
• Mucous thickening
• Smooth muscle constriction by spasms in small airways
• Most common childhood respiratory disease

Question 23

Obstructive I causes

Answer 23

• Allergens, pollens, animal fur, dusts
• Smoking, smog & airborne pollutants
• Changes in air temperature, humidity, pressure
• Exercise
• Emotional stress, anxiety

Question 24

Treatment for obstructive I

Answer 24

Bronchodilators, anti-inflammatory, O2

Question 25

Obstructive II (x 4)

Answer 25

* Inflammation of airway walls * Excessive mucous production * Airway narrowing and coughing (but cough cannot get rid of mucous) * Reversible

Question 26

Obstructive II causes

Answer 26

- Bacterial & viral infections - Smoking - Airborne pollutants - Chronic irritation (eg: miners)

Question 27

Is obstructive III reversible?

Answer 27

No irresversible

Question 28

What happens in obstructive III? x 3

Answer 28

* Destruction of alveolar walls (collapsing of small airways) * Enlargement of air spaces * Increased lung compliance

Question 29

Where does enlargement of air spaces occur in obstructive III?

Answer 29

Primarily distal to terminal bronchioles

Question 30

What does increased lung compliance occur via?

Answer 30

- Destruction of elastic fibres - Excessive release of enzymes: trypsin o Macrophages secrete α anti-trypsin to inhibit trypsin (but with chronic irritation, trypsin can break alveolar walls) - Reduced elastic recoil of the lung

Question 31

Causes of obstructive III x 4

Answer 31

- Smoking induced inflammation - Cilia destruction, tar accumulation - Airborne contaminants - Genetic: lack of α anti-trypsin production

Question 32

How many disorders does restrictive I result from ?

Answer 32

Over 130

Question 33

Causes of restrictive I x 4

Answer 33

- No known cause in 2/3 of all cases - Asbestos fibre breathing (can also cause lung cancer) - Inflammation - Scar tissue formation

Question 34

Patient type in restrictive I

Answer 34

Slim patient

Question 35

What occurs during restrictive I?

Answer 35

- Reduced elasticity - Reduced compliance of lung and chest wall - Increased work of breathing

Question 36

Restrictive I disease

Answer 36

Diffuse Interstitial Lung Disease (DILL)

Question 37

Disease characteristics chart

Answer 37

Question 38

Abnormal Spirograms Associated with Obstructive and Restrictive Lung Diseases

Answer 38

Question 39

Spirometry I

Answer 39

Question 40

Spirometry - II

Answer 40

Question 41

Flow-Volume Loop x 1

Answer 41

Question 42

Flow-Volume Loop x 3

Answer 42