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20005 > airway passages and ventilation > Flashcards

airway passages and ventilation Flashcards

1
Q

what are the sections of the airway

A
  1. trachea
  2. bronchi
  3. bronchioles
  4. alveolar ducts
  5. alveolar sacs
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2
Q

what is the role of the condicting airway

A
  • movement of air by bulk flow
  • warming
  • humidification
  • immune defence
  • filtration
  • sound production
  • assist olfaction
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3
Q

what are the main factors affecting airflow

A
  • ability to establish/ maintain a sufficient pressure gradient
  • resistance to airflow
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4
Q

what is darcy’s law

A

flow is proportional to the pressure over the radius

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5
Q

how does air move into the lungs

A
  1. contraction of diaphragm and intercostals
  2. increase intrathoracic volume
  3. transient increase in pleural cavity volume decreases Pip
  4. increase Ptp, overcomes lung elastic recoil force
  5. increase lung volume, decrease Pa
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6
Q

what happens to lung function is diaphragmatic dysfunction

A
  • contraction can’t happen
  • pressure gradient for inspiration has stopped
  • nerves wont send a message
  • pradoxial breathing
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7
Q

what are the causes of pneumothorax

A
  • open injury
  • damage tissue allowing airflow into pleura
  • spontaneous
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8
Q

what effect does pneumothorax have on breathing

A
  • intrapleural pressure increases to atmospheric pressure
  • transpulmonary pressure decreases
  • can’t overcome elastic recoil
  • lung collapses
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9
Q

what is flail chest

A
  • loss of anatomical integrity of the rib cage
  • affects ability to change thorax volume
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10
Q

what is compliance of respiratory system

A

property of a material undergoing elastic deformation when subject to an applied force

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11
Q

what is the function of compliance in the respiratory system

A
  • compliance of the alveoli and lung tissue
  • compliance of thoracic wall
  • needed for pressure maintenance
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12
Q

what is infant respiratory distress syndrome

A
  • unable to produce surfactant so reduced surface tension and collapse
  • poor lung compliance
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13
Q

what lung factors can alter compliance

A
  • interstitial lung disease
  • pulmonary hypertension
  • aspiration
  • pleural disease
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14
Q

what chest wall factors can alter compliance

A
  • extensive scarring
  • sever scoliosis
  • ossification of coastal cartilage
  • obesity
  • position
  • neuromuscular changes to intercostal muscles
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15
Q

what affects does increased airway resistance have

A
  • reduced rate of inflation
  • decreased tidal volume
  • increased PaCO2 and decreased PaO2
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16
Q

what affect does patency have on airways

A
  • needed for sufficient airflow
  • lack of patency increases resistance to airflow
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17
Q

what are changes in children’s airways in chocking management

A
  • narrower airways
  • larger tongue and adenoids
  • larger occiput
  • high metabolic rate and small FRC = fast hypoxia
18
Q

how do abdominal thrust work

A
  1. rapid decrease in volume of the thoracic cavity and lungs
  2. sharp increase in pressure in the lungs
  3. increase speed of airflow, turbulent airflow
  4. increase partial pressure helps dislodge
19
Q

what is laryngospasm

A

sustain colures of the larynx by contraction of the intrinsic laryngeal muscles resulting in complete or partial obstruction

20
Q

what mediates larngospasm

A

peri-glottic stimulus by mechanoreceptors

21
Q

how does sleeping affect airway patency

A
  1. intraluminal pressure in upper airway decreases
  2. risk of collapse and obstructive sleep apnea
22
Q

how does autonomic signalling affect resistance

A
  1. ach binds to M3 ach receptors on bronchial smooth muscle so bronchoconstriction
  2. slow and sustained bronchorelaxation
  3. afferent fibres - constrict
23
Q

how does inflammation affect airway patency

A

obstruction from hyperactivity and hypersensitivity reduces expiratory flow

24
Q

what are additional factors that increase airflow resistance

A
  • increased mucus production
  • inflammation and oedema in airways
  • head and neck masses
  • neck trauma
  • obesity
25
Q

how is airway resistance inversely correlated to lung volume

A
  • reduction in lung volume causes a reduction in the radius of airways increasing resistance
  • increase lung volume increases airway radius which reduces resistance
26
Q

what is the result of alveolar walls being destroyed

A
  • prone to collapse and small diameter and total resistance is higher
27
Q

how to calculate transmural pressure

A

PTM = airway pressure - intracranial pressure

28
Q

what is the spirometry results in restrictive disorders

A
  • FVC reduced
  • FEV reduced
  • FEV/FVC ratio is within normal range
29
Q

what are the effects of a supine position for ventilation

A
  • reduced functional residual capacity
  • diaphragm elongated so more ability to contract
  • increased resistance to airflow
30
Q

what does the ventral respiratory group do

A
  • activation of accessory inspiration and expiratory motor neurones
  • upper airway dilator function
31
Q

what does dorsal respiratory group

A
  • activation of inspiratory motor neurones
  • close to nucleus tractus solitarius
  • regulates timing of respiratory cycle
32
Q

what is the pons function in respiration

A
  • influences the medulla to fine tune respiratory cycle
33
Q

what are the excitatory neurones of the central pattern generator

A

glutamate

34
Q

what are the inhibitory neurones of the central pattern generator

A

glycine and GABA

35
Q

what is the purpose of ventilatory support

A

alveolar ventilation is too low to maintain adequate PAO2 and PACO2

36
Q

what does negative pressure do in ventilation

A

helps the body to increase the alveoli

37
Q

what does positive pressure do in ventilation

A

increase the amount of air that enters

38
Q

examples of non-invasive positive pressure ventilation

A
  • BVM
  • CPAP
  • other ventilators
39
Q

how does CPAP work

A
  • air supplied at continuous pressure
  • positive end expiratory flow
  • prevents airway collapse
40
Q

how does mechanical ventilation increase dead space

A

increased lung volume > increases radial traction on airways > enhances anatomical deadspace

41
Q

what are the spirometry results in obstructive disorders

A
  • FVC in expected range
  • FEV is reduced
  • FEV/FVC is reduced

20005 (29 decks)

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