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Physiology I F2015 > 8. Pulmonary Lung Vol > Flashcards

8. Pulmonary Lung Vol Flashcards

1
Q

What is diff b/w vol + capacities?

A

Vol = directly measured; capacities = inferred from lung vol

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2
Q

What is normal TV?

A

6-8ml/kg

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3
Q

What is normal vital capacity (VC)?

A

60ml/kg +/- 20% (~10x TV)

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4
Q

What is normal RR?

A

12-20bpm for adults

30-60bpm at birth

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5
Q

To cough effectively VC has to be how much greater than TV?

A

VC > 3 x TV

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6
Q

What is TV?

A

Normal volume of air breathed in during baseline state

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7
Q

What is expiratory reserve vol (ERV)?

A

Add. vol of air forcefully expired past norm. expiration

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8
Q

What is residual volume (RV)?

A

Vol remaining after max. expiration –> vol to keep alveoli open, RV=FRC-ERV

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9
Q

What is inspiratory reserve volume (IRV)?

A

Add. vol of air that can be forcefully inhaled past norm. inspiration

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10
Q

What is vital capacity (VC)?

A

Max vol of air that can be forcibly expired after max inspiration

VC=TV+IRV+ERV

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11
Q

What is inspiratory capacity?

A

If at end of tidal vol expiration, vol of max inspiration

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12
Q

What is total lung capacity (TLC)?

A

Vol air at end of max. inspiration

TLC=FRC+TV+IRV=VC+RV

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13
Q

What is functional residual capacity (FRC)?

A

Vol air remaining after norm. passive exhalation

FRC=RV+ERV

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14
Q

What is minute ventilation?

A

Vol air exhaled per min

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15
Q

What is normal TV?

A

500ml

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16
Q

What is normal IRV?

A

3000ml

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17
Q

What is normal ERV?

A

1100ml

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18
Q

What is normal RV?

A

1200ml

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19
Q

What is normal FRC?

A

2300ml

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20
Q

What is normal TLC?

A

5800ml

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21
Q

How does pt positioning affect alveolar size?

A

Size of alveoli diff at top than bottom (upright) –> weight of lungs compressing alveoli at base. W less weight pushing against upper alveoli, expanded out more (alveolar interdependence). Top alveoli has decr. compliance b/c closer to TLC –> lesser ventilation.

22
Q

(T/F) Gravity doesn’t affect perfusion.

A

False, greater perfusion near base of lungs. HOWEVER, perfusion and ventilation have diff slopes resulting in V/Q mismatches at both extremes of apex + base.

23
Q

Describe a flow-volume loop.

A 
Full expiration near 0 on Lhand side
TLC/total inhalation on Rhand
Lower curve inhalation
Upper curve exhalation
BUT typically move only small range w/in flow-vol loop (from FRC to TLC), typically w/ most compliance
24
Q

What happens to elasticity + compliance in a sick lung?

A

Lower compliance (easier to distend) + elasticity (ability of lungs to recoil) worsens –> greater V/Q mismatches, alveoli are hyperextended

25
What is FVC/FEV1
Forced VC is when pt asked to take biggest breath as can + as quick + hard as can blow out --> vol measured. Forced expiratory volume at 1s measured over 1s (norm=~4L)
26
What is Max. Voluntary Vent (MVV)?
MVV (aka Maximal breathing capacity) is max vol air that can be exhaled by voluntary effort in 15s interval, then multiplied by 4 --> L/min
27
What is closing capacity?
Vol in lungs at which airway + alveoli start to collapse. Want to stay above this or else cause atelectasis. FRC + alveolar interdependence helps compete against this. CC typically well below FRC. HOWEVER, CC sig. increases with age while FRC barely if any. FURTHERMORE, FRC decr. based on position + esp. w anes., smoking history, and lung disease --> encourage coughing + deep breathing after GA.
28
What happens as alveoli remain collapsed for longer + longer periods of time?
More V/Q mismatch, gas exchange prob, hypoxemia + other post-op pulm. complications
29
(T/F) In young, healthy pt, a few coughs + deep breaths is not sufficient to re-expand alveoli.
False
30
What variables affect FRC?
1. Sex 2. Body habitus (obesity adds extra weight --> blunts outward recoil of chest wall --> decrease FRC) 3. Posture/positioning 4. Age 5. Lung disease 6. Diaphragmatic tone
31
Where is the dependent part of lung?
Lower portion of lung
32
What happens when you lose diaphragmatic tone?
(almost imm w induction of anes even before MR) abd contents push up on lungs --> compress to smaller size --> sig. drop FRC
33
What % of all pt have atelectasis under GA as result of loss of diaphragmatic tone
85-95%
34
When pt transitions from upright to supine position, how much does FRC drop?
0.5-1L
35
What is the relationship between FRC + age
FRC decreases w increasing age
36
How does induction of anesthesia affect muscle tone?
GA causes diaphragm + chest wall muscle tone to decrease
37
By what % does FRC decrease w GA?
10-20% drop
38
How long does it take for FRC to return back to normal after GA?
Hours
39
(T/F) Elderly pt can't generate enough P to overcome atelectasis after GA.
True
40
What are different types of ventilation that you can use on pts + how do they affect atelectasis?
Standard TV ventilation (10-20cmH2O) - ineffective Sigh breaths (20cmH2O) - ineffective 40cmH2O - typically effective
41
How does size + number change as progress down pulm. airway?
The size of airways decrease but number increases sig --> sig. increase in sum cross-sectional airway (many terminal bronchioles vs. trachea)
42
Describe the tracheobronchial tree and how it affects ventilation.
Terminal bronchi have smooth muscle surrounding them --> contract + dilate. However, are very small --> greater resistance in bronchus than in trachea
43
Which flow system has lowest resistance to flow?
Laminar flow as opposed to turbulent flow
44
Which type of airway has the greatest resistance to flow?
Small airways, esp. those lined w secretions --> increased work of breathing. Larger airways = easier to maintain laminar flow
45
What is Poiseuille's Law?
Resistance is inversely related to r^4 --> small increase in radius decreases resistance sig!
46
How does lung volume affect airway resistance?
As lung vol increase, resistance decreases sig (exponential drop). Alveolar expansion helps extend term. bronchioles
47
How does airway resistance change as pt changes from upright to supine position?
Resistance increases, R in upright pt is close to its lowest
48
Where is the greatest resistance found in pulm. airway + why?
Greatest R in bronchi because of smaller size compared to trachea. However, R decreases sig. as branch from bronchus to bronchioles to term. bronchioles --> sig. increase in total surface area (make up sig. portion of airflow)
49
How does secretions or bronchospasm affect airway resistance?
Change in diameter --> sig increase in R --> increased work of breathing
50
What is alveolar interdependence?
Tethering of alveoli to each other --> helps stent open alveoli + airway --> drops R. HOWEVER, tethering decreases w disease + destruction of alveoli

Physiology I F2015 (13 decks)

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