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Renal/Resp > Control of Respiration > Flashcards

Control of Respiration Flashcards

1
Q

What is diffusing capacity?

A

Diffusion=(Change in PressureAreaSurface)/(distance*sqrt(MW))

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2
Q

What is the equation for DLco?

A

DLco=(Va60)/((Pb-47)T)*Ln(FACOi/FACOe)

Va=alveolar volume
Pb=barometric pressure
47=water pressure at 37 degrees celsius
T=breath hold time
FACOi=fractional conccnetration of alveolar CO at start of breath hold
FACOe= fractional concentration of alveolar CO expired at the end of breath hold

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3
Q

What is the equation fro Va?

A

Va=Vi/(FECH4/FiCH4)

FiCH4=fractional concentration of inspired CH4
FECH4=fractional concentration of expired CH4
VI=inspired volume at STPD

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4
Q

What is the equation for Dl?

A

D/change in pressure

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5
Q

What are type I cells in the aortic and carotid bodies?

A

type I cells are glomus

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6
Q

What are type II cells in aortic and carotid bodies?

A

type II cells are sheath cells

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7
Q

where are the central chemoceptors located?

A

located in brainstem, including the ventral medullary surface, near the nucleus tractus solilatrus and near the locus ceruleus

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8
Q

In respiratory distress, sternocleidomastoid muscles are contracting what ishappening ot the abdomen?

A

sternocleidomastoid muscles contracting; abdomen move inwards. Keep rib cage elevated and allow for ventilation

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9
Q

What is the diaphragm used for?

A

quite tidal breathing

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10
Q

What senses high PaCO2?

A

both central and peripheral chemoreceptors

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11
Q

What senses a low PaO2?

A

sensed by peripheral chemoreceptors

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12
Q

Low PaO2 plus high PaCO2?

A

increases ventilation by increasing the depth and frequency of breathign. Effectively, acessory muscles are recruited.

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13
Q

What are the accessory breathing muscles?

A

sternocleidomastoids, scalenes, and the abdominus recti

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14
Q

What are the inputs to the brainstem, other than peripheral and central chemoreceptors?

A

focus on input to the brainstem. Mechanoreceptors in the nose, in the lungs, feedback from hypothalamus and important voluntary control

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15
Q

Small airways collapse leading to incomplete aveolar emptying in what?

A

COPD or other obstructive lng disease

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16
Q

What is the consequence of chronically elevated PaCO2?

A

PaCO2 rises leads to compensatory HCO3. Increase pH
consequentially respiratory drive decreases
chronic hypercapnia such as occurs in COPD, respiratory drive is not maintained by CO2 anymore but rather b PaO2

17
Q

In a pt with chronic hypercapnia what is respiratory drive maintained by?

A

bc of chronic hypercapnia

respiratory drive not maintained by CO2 but rather by PaO2

18
Q

What is the 2nd reason why too much O2 bad for severe COPD other than PaO2 repressing respiratory drive?

A

pt with alveolar damage from COPD blod gets diverted away from bad portion of lung, when you give thm lots of O2 blood flow was diverted away is now vasodilated. V/q mismatch and has worsened hypercapnia

19
Q

In COPD when blood is divereted away from bad portion fo lung what is this called?

A

hypoxic vasoconstriction

20
Q

What is a thrid mechanism that makes O2 bad for COPD?

A

hemoglobin normally acts as a buffer for carbon dioxide

but in COPD pts with 100% oxygen because binding sites are all taken up
haldane effect CO2 cant be bufered leads to an increase of PaCO2

21
Q

What is the haldane effect?

A

buffering of CO2 by hemoglobin during gas exchange

22
Q

What happens to abdomen when diaphragm is fatigued or not working?

A

paradoxical abdominal breathingg

23
Q

What is maximum expiratory pressure less than 60 cm H20 predicts what?

A

weak cough

24
Q

What is maximum inspiratory pressure less than 30 % predict?

A

respiratory failure

25
Q

What is vital capacity less than 55% predict?

A

respiratory failure

26
Q

In brainstem you should be aware of 2 large groups of neurons

A

first located in medulla are the dorsal and ventral respiratory group of neurons.

27
Q

What group is responsible for quite breathing?

A

dorsal group

28
Q

What group of neurons has 6 divisions and are ultimately responsible for breathing during exercise and responible for not so quite breathin, responsible for both inspiration and expiratory changes?

A

medulla is the ventral respiratory group

29
Q

What does the pontine group inhibit what?

A

central pattern generator

30
Q

What is the function of the pontine group?

A

function is to limit inspiration. created using a ramped signal and this group of neurons act to shut off inspiration.

31
Q

What nervous group is used to limit inspiration

A

pontine group

32
Q

If the central pattern generator is damaged in a medullary stroke what hapens to breathing?

A

becomes ataxic; amplitude and frequency are both altered

33
Q

What is the result of a pontine stroke it results in what sorta breathing?

A

apneustic breathing, long period of inspiration followed by a burst of expiration

34
Q

What is lastly medication such as opiates and barbs have on central pattern generator?

A

inhibitory effect, on central pattern generator

central pattern generator function is inhibited by morphine and so the effectors do not receive the signal to increase ventilation

35
Q

What is primary alveolar hypoventilation?

A

ondine’s curse; all autonomic functions leading to a respiratory drive are gone. pt has to Remember to breathe

36
Q

What is polysomnography used for?

A

useful for OSA and periodic limb movment disorder determination

37
Q

What can we learn from a sleep study?

A

sleep disordered breathing
-evaluation and treatment
movement disorder of sleep
parasomnias

38
Q

What is sleep diary used for?

A

quantifying sleep and assessing patterns of sleep

Renal/Resp (22 decks)

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