Exam 2 Flashcards
ventilation refers to
air moving in and out of the lungs
portion of tidal volume that remains in the conducting airways
anatomical deadspace (VD)2
list examples of deadspace
nose, mouth, pharynx, larynx, trachea, bronchi, and bronchioles
Dead air space does not participate in
gas exchange
Amt of anatomical dead space is usually equal to ones
weight
Tidal volume is usually 500 ml, but the amt that participates in gas exchange is usually
350 ml
Bc anatomical deadspace reflects the size of the conducting airways, what are some things that can effect this
decreased radius (smoking, mucus, or asthma) or length of airway (ex on a vent)
Refers to the anatomic dead space plus any other areas that don’t exchange gases (alveolar dead space).
physiological dead space
Physiological dead space is usually ___% of tv
30
having ventilation but no perfusion, or having perfusion but no ventilation could be an issue with what type of dead space
physiological
give an ex of when you can have vent without perfusion
when capillary is blocked, but air is still getting in
give an ex of when you can have perfusion without ventilation
asthma (air cant really get in/out, but perfusion capability still exists)
If you have more physiological dead space, you have to take in more air to compensate. You would do this by
increasing TV
More air goes into which side (which lung)
right
Which recieves more air, independent or dependent alveoli
dependent (eventhough they are smaller)
where does air “gather” when inspired
air will go where gravity takes it (sitting it goes inf or to the base of lungs, supine it goes posterior)
breathing at low volumes closes airways where (dependent or independent alveoli)
dependent
What must be present near alveoli for gas exchange to occur
capillary
Blood flow is ____ dependent
gravity
Where is blood flow greater, the apex or the base of the lungs
base
explain the 3 zone model in relation to blood flow in the pulm sx
Zone 1 is least gravity dependent and receives basically no blood flow, Zone 2 is the intermediate zone and receives intermittent blood flow (flow is based on difference between pulmonary arterial and alveolar pressures) Zone 3 is most gravity dependent and receives basically all blood flow
How can pulm blood flow help to aid in recovery when it comes to positioning our pts
we can alter position of our pts to increase or decrease blood flow
An increase in SV increases arterial pressure. This causes which zone to extend farther up the lung
3
What does V/Q mean
ventilation perfusion ratio
what is ventilation perfusion
Describes the relationship between factors that affect alveolar gas flow (V) and pulmonary capillary blood flow (Q)
What is the typical V/Q
4 = ventilation
5= blood flow
which is 4/5 = .8
amount of effort needed to inspire and expire is known as
work of breathing
normal WOB requires __% of O2 consumption
5
If elastic recoil is compromised, WOB increases or decreases
increases
What is elastic recoil
ability of lungs to return to original shape
What is compliance
ease with which lungs are inflated during inspiration
walls of the thorax are lined with ___ pleura
pariatel
the lungs are lined with ___ pleura
visceral
what is between both of the pleura
small amt of fluid
If compliance is low, what needs to occur to compensate in order to inflate the lungs (increase vol)
the lower the compliance, the greater the pressure change needed to change the size of the lung.
fibrosis or alveolar edema would do what to compliance
decrease
age or emphysema does what to compliance
increases it (expands too much)
with increased compliance, lungs can expand very easy, even when pressure changes are
very insignificant or low
with increased compliance, the lungs expand easy (even when pressure change is low) but this is bad why
bc getting air out is difficult
increased compliance, difficulty getting air out describes what disease
emphysema
Decreased compliance makes it more difficult to expand the lungs. Greater pressure changes are required to bring in the same amt of air (almost having to suck in air). This describes what disease
restrictive lung disease
Restrictive lung disease can lead to (increased or decreased) TV
deccreased
Surface tension exists where in the lungs
inside of the lining of the lungs (bc alveoli are covered by thin liquid)
explain how surface tension CAN exist in the lungs
water molecules become more attracted to one another (more than the air molecules)
The more fluid present, the (more or less) compliant the lung
less
What 2 things help lungs return to original shape
recoil, surface tension
What offsets surface tension (dt decreasing the attraction btwn water molecules)
surfactant
What cell type produces surfactant
type 2 alveolar cells
Surfactant increases or decreases the amt of muscle tension needed to expand the lungs
decreases
So essentially, surfactant makes the lungs more or less compliant
more
What is RDS
respiratory distress syndrome. premie babies before 26-28 weeks are born without surfactant
What does Q= changeP/R mean
air flow is equal to the change in pressure over resistance in the airways
biggest factor in controlling air flow is ___
resistance, which is determined by the radius of the airway
Parasympathetic system (via acetylcholine and muscarinic receptor) causes ___
bronchoconstriction
sympathetic system causes
bronchodilation
Losing TV does what to resp rate
increases
If a person gets fatigued or to exerted, what happens to TV
decreases
decreasing TV, as a result of increased WOB, does what to gas exchange
decreases the amt of O2 at level of alveoli/capillary level
If decreased TV can lead to decreased gas exchange, the person might have to go on supplemental O2, does this increase TV
no, just increases O2 sat
what is one way to have a very clear cut understanding as to a pts perfusion abilitiy
Ventilation/Perfusion Scan
pulmonary embolism would be an example of this on a ventilation/perfusion scan
ventilated but not perfused
COPD and pneumonia would be an example of this on a vent/perfusion scan
neither vent or perfused
Control center for respiration/HR is located where
medulla
peripheral chemoreceptors fire in response to
low O2 levels
min to min control mechanism for respiration is what
central chemoreceptors
central chemoreceptors are found where and respond to what
found in the medulla, respond directly to H and indirectly to CO2
What does exercise do to CO2 levels
increase them
Peripheral chemoreceptors normally don’t play a role in normal breathing processes, however, they will if a person is ill. If a person’s _____ gets very low they will inact.
PO2 (blood O2)
What does SaO2 mean
saturation of O2 on the hemoglobin
What is PaO2
how much O2 is in the blood
Think about the V/Q ratio, if something is ventilated and not perfused, what is the ratio, if something is perfused and not ventilated what is the ratio
V/Q
If there is vent but not perf = 4/0 infinity
if there is perf but no vent = 0/5
either way it’s bad
if PaO2 is 60 then SaO2 (sat) would be
90%
diabetic ketoacidosis leads to more acidic pH, what cascade of homeostasis follows
Decreased pH fires off the peripheral chemoreceptors increasing ventilation and blowing off the excess acid. Trying to decrease H by exhaling CO2
2 types of sleep apnea
central and obstructive
which type of sleep apnea Results from failure of the respiratory center, resulting from encephalistis, brainstem infarction, and bulbar poliomyelitis
central
idiopathic central sleep apena, results in a conscious effort to control ventilation
ondine’s curse
which type of sleep apnea may explain sids
central
this type of sleep apnea is related to relaxed or collapse of structures, or obesity
obstructive
obstructive apnea is aka
pickwickians syndrome
receptors Located in the smooth muscle that shut off inspiration to keep lungs from continuing to expand too much.
Hering-Breuer Reflex
for hering breuer reflex, Tidal volume has to reach about _____ before they fire.
1.5 liters