B: Gas Laws and Dead Space Flashcards

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A: Boyle’s Law = (pressure:volume) = [V1•P1 = V2•P2] OR
[V = 1/P] as long as temp & mass are constant

B: Charle’s Law = ([Kelvin Temperature]:volume) = [V = T] at constant pressures

C: [GayLussac’s Law] = ([Kelvin Temperature]:pressure) =
[P = T] at constant volume

D: [COMBINED GAS LAW] = [V = (T/P)]

E: Avogadro’s law (volume:amount law) states that if amount of gas in a container INC, Volume INC

F: Ideal gas law: PV = nRT (R is universal gas constant)

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2
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A: Dalton’s Law of Partial Pressures : Total Pressure = Sum of all individual non-reacting partial pressures

B: [Amagat’s Law of Partial Volumes] = same as Dalton’s but with Volume

C: [Henry’s Law of Gas Solubility] = Concentration of gas in a solution is DIRECTLY proportional to its partial pressure ABOVE the liquid solution

D: 
ºAtmospheric/barometric pressure @sea level = 760 mm Hg  
Ambient Air :
-79% N2 = 563 mm Hg
-21% O2 = 150 mm Hg
-1% water vapor 
-0.04% CO2

E: When air enters respiratory SYSTEM it is filtered, warmed to body temp (37º C) and then humidified 100%. [Water Vapor pressure is 47 mmHg at 37ºC] so this “dilutes” the other gases being inhaled

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3
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A: When tracheal air reaches Alveoli gas composition DRASTICALLY CHANGES—> since O2 is flowing into pulm blood and CO2 is flowing OUT pulm blood. BUT on average:

ºPaNitrogen = 563 mm Hg/constant because our body doesn’t produce nor consume it

ºPaO2 in alveoli “PAO2” = 102 mm Hg

*ALVEOLAR O2 GAS EQUATION
B: How do you calculate [Alveolar PaO2] from using [Alveolar PaCO2= 45 mm Hg] if you breath 100% O2??

1st. [Barometric - (water vapor p.)] x (% O2) = A
1st. [713] x (1) = (A)

2nd. (A) - [Alveolar PaCo2] / 0.8 = [Alveolar PaO2]
2nd: [(A) - 45] / 0.8 = [Alveolar PaO2]

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4
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  • Alveolar Co2 gas equation*

B: Normally [CO2 production] is about 250 mL/min and [alveolar ventilation] = 5L/min in order to keep [PACO2 at 40-45 mm Hg]. HYPERventilation : (10L/min) will DEC PACO2 to 20 mm Hg.

C: Distribution of inspired air into vertical lung is NOT UNIFORM and shunts MORE to LUNG BASE (near diaphragm). This is because:

  1. there are MORE alveoli at Lung bases to receive MORE air
  2. at FRC Lung base is more compliant-> so receives better volume changes during ventilation

D: [Intrapleural Pressure] & [TransPulmLung pressure] are Greater at APEX and this EFFECT is Amplified at RV, but disappears at TLC

E: [TransPulmLung pressure] at RV = low for both parts of lung but Apex is HIgher..and there is a GREATER DIFFERENCE between Apex & base

F: [TransPulmLung pressure] at TLC = HIGHER for both parts of lung and Apex is still HIgher..but here there is smaller difference between the two

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5
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A: Rate at which Alveolar fills with depends on
ºResistance (INC Resistance = INC TC)
ºCompliance (DEC Compliance = DEC TC)
[R x C = (time constant) ] **HIGH (time constant) means alveoli are filling up & emptying out SLOWLY! **

C: [Single-Breath Nitrogen Washout Test] assess uniformity of ventilation and determine [ANATOMICAL dead space] = when we breathe in atmospheric air lung is 78% N2. If we were to exhale everything out and then inhale 100% O2 this would dilute the N2. (LUNG BASES SHOULD HAVE MORE DILUTION since they receive MORE VENTILATION) Once pt breaths out into a N2 meter at constant flow from TLC –>RV the N2 concentration is plotted and 4 parts results

Part 1) N2 remains fixed at zero as dead space filled with O2 empties first
Part 2) rapid Upswing in %N2 concentration as alveolar regions empty

Part 3) [Alveolar plateau] occurs as a result of equal emptying of ALL lung zones from base to apex

C2: This test determines [ANATOMICAL dead space (using Fowler’s method)] by looking at [Part 2 first Upswing]. The Volume up to the Vertical meeting point between A and B is dead space. A and B are markings of when the curve starts to shift into different part

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6
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A: [Ventilation = (Freq. of breathing) x TV] = 7500 mL/min]
A2: [Tidal Volume] fills Dead Space FIRST and then alveolar space smh —> Ventilation consist of dead space and “life space” ventilation

B: dead space Ventilation = (Freq. of breathing) x (Ventilation of dead space only)

C: ALVEOLAR VENTILATION =[ (Freq. of breathing) x (TV - (Dead Space VOLUME) ]

D: [Physiological Dead Space] is Total Volume that does NOT participate in gas eXchange =( [Anatomical Dead Space] + [Ventilated Alveoli but not perfused] ). It is identical to [alveolar PCO2]

D2: Normal ratio [Dead Space]/[Tital Volume] ratio is 0.2-0.35 and Anatomical & Physiological Dead Space are usually the same

D3: Lung Dz pt have a HIGHER Physiological Dead Space #

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7
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A: alveolar ventilation is less than [Pulmonary Tidal Ventilation]. INC TV is MORE EFFECTIVE at increasing [Alveolar ventilation] (and DEC Dead space ratio) than increasing respiratory rate

B: INC [Pulmonary tidal volume]—-> DEC [dead space ventilation

C: [Pulmonary Tidal VENtilation] is comprised of air going to [Dead Space] AND air going to [actual alveolar ventilation]

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8
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A: 3 Factors facilitate gas diffusion

1) LARGE Alveolar Surface Area
2) Short Distances for gas to travel
3) Use of gases w/advantageous diffusion properties

B: [Capillary diameter = less than 10 µm] vs. [Erythrocyte= 7µm diameter]. Erythrocytes pass thru capillaries in SINGLE FILE in less than 1 sec.

C: Fick’s Law states [amount of gas transferred] is ººproportional to area / Diffusion constant / [∆ partial pressure]
ºººINVERSE to THICKNESS
————————————————————————————–
————————————————————————————–
D: [Graham’s Law] –> {Gas DIFFUSION RATE = [Solubility coefficient] / [√molecular weight] }
D2: CO2 Diffuses across alveolar membrane 20x FASTER than O2 due to its Higher [Solubility coefficient]

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9
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A: N20 / O2 / CO2 are all [PERFUSION LIMITED] = their partial pressures end up having enough time to equilibrate with alveolar pressure first BEFORE leaving the Capillary. This is because they are less soluble and don’t combine chemically w/proteins.

A2: O2 can be converted into [diffusion limited] uptake in 3 ways: at low alveolar PO2 (i.e. high altitudes) and during Exercise becuz it’ll start being taken up by Hgb/perfusing much more rapidly and then only need to worry about [diffusion rate].
•(This convert also occurs from a [Thickened Blood-Gas Barrier]**
••*RBC that spend less than 0.25 sec in capillary bed will induce [diffusion limited] conversion
————————————————————————————–

vs.
- ————————————————————————————-

B: CO which is [diffusion limited] = it NEVER has the time to reach equilibrium with alveolar pressure once in capillaries becuz it’s taken up RAPIDLY by Hgb AS SOON as it diffuses over = [perfusion UNlimited]

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10
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A: driving Pressure in the pulmonary circuit is 6 mm Hg vs. in the Body 87 mm Hg. Resistance to flow in lungs is less than 10% of Resistance to flow in the Body!

B: [pulmonary arteries] have thin walls with minimal smooth muscle. They are easily distended and 7 x MORE COMPLIANT than Systemic Arteries with low pressure circulations

C: [Pulm Vascular Resistance] = [∆ Pressure] / [Blood Flow (Q)] . [PVR] INC at very low OR VERY HIGH lung volumes.

D: [LUNG PERFUSION] is influenced by

  • [Pulm Vascular Resistance]
  • Gravity
  • Alveolar pressure
  • [Arterial-venous pressure gradient]

E: In the lungs, INC [Arterial or venous Pressure]/[Cardiac Output]—->DEC [Pulmonary Vascular Resistance] . This is due to [Alveolar CAPILLARY RECRUITMENT] which involve opening up normally UNavailable capillaries AND distending already-perfused capillaries

F: changes in [Pulm vascular resistance] during INhalation form a U-shaped curve with [nadir trough] at FRC. This is becuz during INhalation extra-alveolar vessels DEC resistance but [alveolar vessels INC resistance]

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11
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A: There are 2 reasons blood flow is HIGHER in LUNG BASES
1. Bases have More [Lung tissue & capillaries] due to triangular shape of vertical lung

  1. Blood is more massive than air so GRAVITY pulls blood into Base more easily

B: [R Ventricle] and Gravity work together to overcome [Pulmonary Vascular resistance] and push blood “up hill”. There are 3 Zones Blood Flows thru in Lungs

Zone 1 =
º “NO FLOW ZONE” . Blood can nOT reach this part because R Vt is not that strong :-( AND [Atmospheric ALVEOLAR] pressures are greater than BOTH arterial and venous in this zone.

ºThis is a pathological zone due to low R Vt [Cardiac Output], hypOtension or [Mechanical Positive Pressure Ventilation].

ºDue to [pulmonary arterial pressures] this zone exist only above the shoulders normally and does not exist in regular lungs!

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12
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[R Ventricle] and Gravity work together to overcome [Pulmonary Vascular resistance] and push blood “up hill”. There are 3 Zones Blood Flows thru in Lungs:

Zone 2 = “COMPRESSIVE WATERFALL ZONE” = top/mid lung. [Pulmonary ARTERIAL pressure] is HIGHER than [Atmospheric Alveolar] pressure but since venous pressure is still lower than [Atmospheric Alveolar pressure] blood tends to “FALL DOWN” thru the capillaries to zones where venous is higher and UNobstructed

ºWorks like a Starling resistor where [Atmospheric Alveolar pressure] controls flow! (not pressure gradient between [Pulmonary ARTERIAL] and vein)

º[Atmospheric Alveolar] pressure COMPRESSES the vessels and INC their [Vascular Resistance] during inhalation

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13
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[R Ventricle] and Gravity work together to overcome [Pulmonary Vascular resistance] and push blood “up hill”. There are 3 Zones Blood Flows thru in Lungs:

Zone 3 = “Normal Zone” = Lung Base. [Pulmonary Arterial Pressure] AND [Venous Pressure] are GREATER than [atmospheric alveolar] pressures here —->[atmospheric alveolar pressure] has NO EFFECT ON VASCULAR RESISTANCE here

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14
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A: [Hypoxic Vasoconstriction] is determined by [Alveolar PO2 gas only]. It shifts blood AWAY from hypoxic areas to well-perfused areas. (Local vasoconstrictors/vasoDilators also help but are short-lived and only important in pathological conditions) [Hypoxic Vasoconstriction] is important at birth!

B: Water Balance inside & Outside Lung vessels depends on [Starling forces = Hydrostatic vs. oncotic pressures]. Normally there is a net OUTWARD force pushing fluids into interstitium and then collected by lympathics.. In the lungs…

  1. Plasma water is filtered from PULMONARY capillaries into alveolar walls and then picked up by lymphatics. Excessive Filtration–>[Alveolar wall Engorgement] AND [Alveolar flooding/internal drowning].
  2. Plasma water filtered from systemic capillaries goes into pleural space and is eventually picked up by lymphatics. Excessive Filtration here–> [Pleural space Engorgement]—-> [Pleural Effusions] which DEC lung volume and FRC

C: When [Interstitial Drainage rates] EXCEED [Maximal Lymphatic Flow]—> interstitial AND then Alveolar Lung EDEMA Develop

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15
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A: Alveolus and its capillary blood flow are the functional unit of Lung. [V/Q ratios] dictate amount of O2 put IN and amount of CO2 taken out from [pulmonary capillary blood]

B: [alveolar Pulmonary capillary blood] goes from [40 mm Hg/DEoxygenated] to [100 mm Hg/ONCE OXYGENATED] and CO2 levels in capillary blood DECREASES from
45—>40 once it passes the Alveolus

C: Although [alveolar Pulmonary capillary blood] ONCE OXYGENATED STARTS AT 100 mm Hg it DEC by 5 in the ARTERIES due to 3 things:

  • mixing with Bronchiolar venous blood
  • mixing with [thebesian veins tht drain myocardium]
  • [V/Q] inequalities between Lung apex and BASE

D: The difference between [pulmonary capillary blood] PaO2 of ARTERIES and [pulmonary capillary blood] PaO2 of alveoli should be LESS THAN 15 but will INC with dz

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16
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A1: [V/Q ratio] at the level of 1 alveoli compares [alveolar ventilation: capillary blood flow]

B1: [V/Q ratio] GREATER THAN 1 = VENTILATION IS GREATER THAN PERFUSION. THIS OCCURS AT LUNG APEX & WITH [DEAD SPACE ALVEOLUS] WHICH ARE VENTILATED BUT NOT PERFUSED {physiological dead space/OVER-VENTILATED}. ALVEOLAR PARTIAL PRESSURES HERE EQUAL ATMOSPHERIC PARTIAL PRESSURES BECAUSE NOTHING IS MOVING: PaO2(150MMHG) and PaCO2(0 MMHG)

C: Normal [V/Q ratio] = 0.8
————————————————————————————–
D: [v/q ratio] less than 1 = perfusion is GREATEr than ventilation and this occurs more commonly at lung bases & with [shunt alveolus] where [v/q ratio] = 0.
D2: In [shunt alveolus] alveolar pressures equal mixed venous blood pressures: PCO2(45mmHg) and PO2(40mmHg) and no gas exchange occurs

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A: LUNG BASE receives LARGEST % of VENTILATION ANND PERFUSION and apex the least.

A2: PERFUSION INCREASES more Vastly from apex–>BASE than ventilation does –> this is because gravity has STRONGER effects on [HIGH DENSITY BLOOD] than [low density air]

B: The [middle Lung] is the ONLY part where [Perfusion/Blood Flow] and ventilation are ideally matched LUNG BASE has MORE BLOOD FLOW than Ventilation–> DEC [V/Q ratio}

C: Lung BASE has turnover of alveolar gas with fresh air that is less frequent—> “over-perfusion” –>gives even more time for O2 to leave and CO2 to enter

D: Due to V/Q inequality between apex and BASE, MOST of Oxygenated Blood comes from BASE.
[apex alveolar PaO2 of 132 mm Hg] + [BASE ALVEOLAR PaO2 of 89] —> [Arterial PaO2 of 97 mm Hg]

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A: Difference between PaO2 INSIDE ALVEOLI and actually inside Arteries should be less than 15 mmHg but INC by 4 every 10 years = [AaDO2] = used to determine causes of [Hypoxemia]

B: There is a Difference of PaO2 between these two places because:

1) [V/Q] inequalities between Lung apex and BASE
2) [Anatomical Shunts (Thebesian vessels / [bronchial venous dumping into pulm veins] )

C:[AaDO2] can be determined by finding [alveolar PaO2] with the [Alveolar Gas equation].
C2: And then find [ARTERIAL PaO2] with Blood Gas Analysis

C3: = (150 mm Hg - 40 mm Hg / 0.8) - 95 = 5 mm Hg Difference! 
150 = room air
40= PaCO2 from [Blood Gas Analysis] 
95= Arterial PaO2 from [Blood Gas Analysis] 

0.8 = [respiratory quotient] = constant = [excreted CO2/O2 taken up]

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A: [Tissue hypoxia] is usually due to to low of vascular routes and too high of tissue demands. [Tissue hypoxia] can become [TISSUE ANOXIA/NO O2 AT ALL] during clot formation.

A1: [Hypoxemia] occurs when O2 CONCENTRATION IN ARTERIAL BLOOD ITSELF is too low. It’s defined as [ARTERIAL PaO2 of less than 80 mm Hg] at sea level.

  • 4 things cause Hypoxemia at room air*:
    1. [hypOventilation]
    2. [Diffusion limitation]
    3. SHUNT [Anatomical vs. Physiological]
    4. [V/Q inequality] = MOST FREQUENT CAUSE

B2: When hypOventilation causes [Hypoxemia] [AaDO2] is likely still normal because BOTH alveoli AND Arteries will be receiving less O2 due to LESS VENTILATION–> INC Arterial PaCO2

B3: {[Hypoxemia] 2º to hypOventilation} can be caused by [morphine/heroin/barbiturates/Anesthesia] which centrally depress breathing drives AND

B4: can be corrected by giving Additional O2

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A1: [Hypoxemia] occurs when O2 CONCENTRATION IN ARTERIAL BLOOD ITSELF is too low. It’s defined as [ARTERIAL PaO2 of less than 80 mm Hg] at sea level.

  • 4 things cause Hypoxemia at room air*:
    1. [hypOventilation]
    2. [Diffusion limitation]
    3. SHUNT [Anatomical vs. Physiological]
    4. [V/Q inequality] = MOST FREQUENT CAUSE

A2: {[Hypoxemia] 2º to [Diffusion limitation]} will cause [AaDO2] to INC because there’ll be more O2 in alveoli and LESS O2 IN ARTERIES BECAUSE LESS DIFFUSED ACROSS “Fick’s Law” .

A3: {[Hypoxemia] 2º to [Diffusion limitation]} can be caused by [Lung Edema] / Fibrosis / [Alveolar capillary Block]

A4: {[Hypoxemia] 2º to [Diffusion limitation]} can be CORRECTED by giving Additional O2

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A1: [Hypoxemia] occurs when O2 CONCENTRATION IN ARTERIAL BLOOD ITSELF is too low. It’s defined as [ARTERIAL PaO2 of less than 80 mm Hg] at sea level.

  • 4 things cause Hypoxemia at room air*:
    1. [hypOventilation]
    2. [Diffusion limitation]
    3. SHUNT [Anatomical vs. Physiological]
    4. [V/Q inequality] = MOST FREQUENT CAUSE

A2: {[Hypoxemia] 2º to SHUNT [Anatomical vs. Physiological]} will cause [AaDO2] to INC.

ºAnatomical Shunt shits [DEoxygenated Venous Blood] from [pulmonary artery], BYPASSES Alveoli ,and directly to [Pulmonary Veins] where it mixes with Oxygenated blood.

ººº Physiological Shunts are mostly caused by Atelectasis (collapse & closure of Lung —> DEC or NO gas exchange! )

A3: SHUNT [Anatomical AND Physiological] IS THE ONLY CAUSE IN WHICH Giving Additional O2 WILL NOT HELP!

22
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A1: [Hypoxemia] occurs when O2 CONCENTRATION IN ARTERIAL BLOOD ITSELF is too low. It’s defined as [ARTERIAL PaO2 of less than 80 mm Hg] at sea level.

  • 4 things cause Hypoxemia at room air*:
    1. [hypOventilation]
    2. [Diffusion limitation]
    3. SHUNT [Anatomical vs. Physiological]
    4. [V/Q inequality] = MOST FREQUENT CAUSE

A2: {[Hypoxemia] 2º to [V/Q inequality] IS THE MOST COMMON HYPOXEMIA IN PT WITH RESPIRATORY DZ! [AaDO2] is INC in this situation.

A3: This Condition CAN be improved by giving Additional O2

B: [V/Q inequality] DEC gas exchange efficacy for all gases!

C: Even though CO2 elimination is still impaired by [V/Q inequality] you can improve this by INC [alveolar ventilation] due to its dissociation abilities.

C2: [V/Q inequality] causes Hypoxemia which (DURING [V/Q inequality]) CAN NOT BE FIXED BY INC [alveolar ventilation]

23
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A: [Carbon MONOxide] has 200x STRONGER AFFINITY for Hgb than O2 and only needs partial pressure of [1 mm Hg] b4 FULLY SATURATING Hgb/preventing O2 from hopping on. It forms [Carboxyhemoglobin] which is EVEN MORE RED IN COLOR!

B: [Pulse Oximeter] of 97% Hgb Saturation = Normal. Pulse Ox of 90% corresponds to PaO2 of [60 mm Hg] which is DANGEROUS but normal for pt with COPD.

C: Hgb SATURATION is INDEPENDENT of Hgb Concentration

D: 1 gram of Hgb binds to 1.34 mL of O2 = [O2 capacity]. Normal blood has 15g Hgb/100 mL = [20.1 mL O2 bound/100 mL = SO2 100%]

E: There is [4.4 mL O2 / 100 mL] EXTRACTED from blood during “drop off” to tissues

E2: Anemic Pts only have 7.5g Hgb/100 mL = [10.1 mL O2 bound / 100 mL = SO2 100%]. This means in order for THEM to extract 4.4 mL of O2 they’ll have to go down to a SO2 of 54% from 97% (vs. the normal of 75% post drop-off)

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A: Breathing has 3 phases

1) Inspiratory airflow
2) expiratory airflow
3) expiratory APnea (DEC during exercise)

C: Breathing is BOTH Automatic and Voluntary. [Medullary Respiratory Centers] AUTOMATICALLY GENERATE nerve impulses to [Spinal Cord]—> [Respiratory Muscles] for control. These muscles expand lung and chest wall which
1. via [mechanoreceptors] feed back to [Medullary Respiratory Centers] AND

  1. via changes in Blood pH after diffusion feed back to [Medullary Respiratory Centers] as well via [Central&Peripheral Chemoreceptors]

D: The Cerebral Cortex allows VOLUNTARY respiratory control using [Corticospinal tracts]

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A: [Medullary Respiratory Centers] consist of
1. [Dorsal Respiratory Group-NST] = generates inspiratory m.

  1. ## [ventral respiratory group -Nc. paraambiguus]B: [Medullary Respiratory Centers] are “controlled” by [PONTINE Respiratory Groups] which are the
    -[Apneustic Center] = EXCITES DRG by blocking Pneumotaxic –> generates inspiratory m.
    and

-[Pneumotaxic center] = STOPS DRG from stimulating inspiratory m. & controls breathing pattern = BLOCKS INSPIRATION from occur

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A: [CENTRAL CHEMORECEPTORS] that feedback to [Medullary Respiratory Centers] are found on the ventrolateral surface of the Medulla and are sensitive to changes in CSF pH! THESE ARE THE MAIN [CHEMORECEPTOR VENTOREGULATORS]

B: [Blood Brain Barrier] is normally impermeable to [H+ and HCO3], soo…PCO2 is the only factor that stimulates [CENTRAL CHEMORECEPTORS] and this occurs WITHIN MINUTES of PaCO2 changes. THEY DO NOT RESPOND TO PO2 CHANGES!

C: [Blood Brain Barrier] can BECOME partly permeable to H+ when Arterial pH is realllly low smh

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A: [peripheral chemoreceptors] in the [aortic arch] and [Carotid Bodies] also feedback to [Medullary Respiratory Centers] and are the ONLY chemoreceptors that respond to [High PCO2] AND [low PO2 dude]! They’re responsible for 20-40% of ventilatory responses to CO2.

••[Carotid Body peripheral chemoreceptors] respond to low pH THAT MAY COME FROM RENAL OR METABOLIC ACIDOSIS. ••

C: [Hering-Breuer Reflex] = DEEP inflation activates [Pulmonary Stretch receptors] found in [Visceral pleura] & [large airway smooth m.] & INHIBITS FURTHER INSPIRATION by sending inhibitory signals to the DRG via Vagus nerve (AND VICE VERSA FOR DEFLATION–>INITIATES inspiratory m. and blocks vagus n. )
————————————————————————————–
D: [Irritant receptors] lie between epithelial cells of our airway and are stimulated by [noxious gases], [cigarette smoke], dust & [COLD AIR]. They send impulses thru the Vagus Nerve and play a role in ASTHMA!
————————————————————————————–
E: [Juxtacapillary receptors & bronchial-c fibers] respond to chemical injected into PULMONARY (J RECEPTORS) and bronchial (c fibers) circulation

F: Other receptors involved in breathing control include

1) Nose/Upper airway irritant receptors
2) Joint/Muscle receptors
3) Pain/Temp Receptors
4) Arterial Baroreceptors

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A: At normal PaO2, ventilation INC 3 L/min for each 1 mmHg INC in PaCO2. IF PaO2 is LOWERED under [100 mmHg] DURING HIGH PaCO2—> This response becomes MORE STEEP and ventilation INCREASES MORE RAPIDLY from PaCO2 Increase!

**PaO2 HAS to be LOWER than 60 mmHg in order to get LARGE COMPENSATORY RESPONSE **

A2: At low or normal PaCO2, PaO2 can be decreased to
[50-70 mmHg] WITHOUT ANY CHANGE in Ventilation

B: HIGH PaCO2 will make you want to breathe MORE FREQUENTLY/HYPERVENTILATE (and vice versa). A lowered PaO2 will make this response more sensitive

C: [PaCO2 Ventilatory Response] is LESS sensitive (doesn’t respond as quickly to PaCO2 increase) during…
*sleep
*aging
*[Athletes or Divers]
*[Morphine/ BARBITURATES / (ELEVATED WOB FROM COPD) ]
*[Anesthetics] = [RESPONSE BARELY WORKS AT ALL]
————————————————————————————–
D: [Metabolic Acidosis] makes [PaCO2 Ventilatory Response] MORE SENSITIVE to Increases in PaCO2

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B: [Metabolic Acidosis] from [uncontrolled DM] and [Renal Failure] INC ventilation despite low PaCO2. This occurs because [Carotid Body peripheral chemoreceptors] sense low pH.

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A:During exercise, TV is able to INC by accessing IRV and ERV. Ventilation INC 15x the resting level with O2 consumption of 4L/min and Ventilation of 120L/min

B: During “moderate” Exercise PaO2, PCO2 and pH do NOT change that much …so it is NOT understood why ventilation actually Increases during “moderate” exercise lol

C: SEVERE Exercise causes [lactic acid] release which DEC pH and eventually stimulates [anaerobic threshold] –> which is the point variables like [O2 consumption] and [Ventilation rate] change

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A: 30% of normal people have brief episodes of apnea or hypOventilation during sleep and this does NOT effect blood gas levels

B: MOST CLINICALY IMPORTANT breathing syndrome is Sleep Apnea { [Obstructive/OSA] vs. [Central Alveolar hypOventilation/Ondine’s Curse] }

  1. [Kussmaul breathing] = INCREASED DEPTH of breathing and HYPERventilation characteristic of [Diabetic KetoAcidosis]
    - ————————————————————————————-
  2. [Biot’s respiration] = Are SUPER DEEP inhalations and exhalations followed by long pauses inbetween. Pt exhibit this near death from neuronal damage.
32
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[Apneustic respiration] = Sustained periods of INhalation followed by brief exhalation. Is caused by NO input from the [PONTINE pneumotaxic center] and Vagus n. to inhibit inspiratory m. Usually is associated with brain damage or intoxication

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[Cheyne-Stokes Ventilation] comes from brain injury with INC [intracranial pressure] from tumors & encephalopathy. It is fast inhalation and exhalation with long pauses inbetween.