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Physio > Exam 3 - Pulmonary Ventilation > Flashcards

Exam 3 - Pulmonary Ventilation Flashcards

1
Q

what parts of the respiratory tract are included in the conductive zone?

A
  • bronchi
  • bronchioles
  • terminal bronchioles
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2
Q

fxn of the conductive zone

A
  • bulk movement of air
  • defensive role

(NO respiratory fxn)

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3
Q

what parts of the respiratory tract are included in the transitional/respiratory zone?

A
  • respiratory bronchioles
  • alveolar ducts
  • alveoli
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4
Q

fxn of the transitional/respiratory zone

A

-sites for gas exchange

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5
Q

what is the functional unit of the lung?

A

acinus: terminal bronchiole, respiratory bronchioles, alveolar duct, and alveoli, and their circulation

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6
Q

describe how air velocity changes at each branch point, where there is an increase in surface area? what does this mean in terms of where diffusive gas movement begins?

A

Increase in SA leads to drastic decrease in velocity b/c in a closed system, (air velocity)(total airway area)/time must be equal at all points -> air velocity drops to almost zero in the acini

(for this reason, gas movement is primarily diffusive beginning at the terminal and respiratory bronchioles, whereas in the URT gas is moved by bulk flow)

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7
Q

what is total diffusion distance from alveolus to capillary lumen?

A

less than 0.5 um

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8
Q

what are the two main defensive functions of the respiratory tract?

A
  1. conditioning of inspired air

2. removal of debris

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9
Q

why do we need conditioning of inspired air?

A
  • humidification and warming to prevent dessication of resp surface that could lead to infection
  • filtration
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10
Q

how do we remove debris?

A
  • mucous: suspends debris, protecting resp surfaces (only as far as terminal bronchioles)
  • cilia: propel mucous suspension toward pharynx
  • alveolar macrophages: phagocytic destruction of debris
  • sneezing and coughing
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11
Q

what is the intrapleural space and its fxn?

A

liquid-filled area b/w visceral and parietal pleura - provides fluid coupling b/w the surfaces (slide easily against one another but resist being pulled apart)

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12
Q

why is the intrapleural pressure slightly negative and the intrapulmonary pressure zero?

A

recoil force of chest wall and diaphragm just balance the lung’s tendency to collapse, leading to these pressures

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13
Q

what does air in the intrapleural space cause?

A

pneumothorax

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14
Q

what structures are responsible for inspiration?

A

quiet: diaphragm (75%), external intercostals
forced: same + scalenes and SCM

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15
Q

how do the actions of the inspiratory structures cause inspiration?

A

expansion of chest lowers intrapleural pressure, making intrapulmonary pressure sub-atmospheric -> pressure differentials cause air to flow toward alveoli

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16
Q

why do very small pressures suffice to move large amounts of air?

A

b/c of the large cross-sectional area of the LRT, and therefore the very low total resistance to flow

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17
Q

what structures are responsible for expiration?

A

quiet: passive - due to recoil of elastic elements of lung
forced: abdominal muscles

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18
Q

equation for respiratory resistance

A

Rtotal = Rpulmonary + Rthoracic

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19
Q

what pathology can cause an increase in respiratory resistance?

A
  • increased blood/fluid in lungs/pulm fibrosis -> increase in pulmonary resistance
  • diseases of rib cage and diaphragm/ increased intra-abdominal volume -> increased thoracic resistance
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20
Q

what is surface tension?

A

mutual attraction of water molecules at an air-water interface that tends to minimize the area of the interface

21
Q

what is lung compliance?

A

the change in lung volume for a given change in pressure (deltaV/deltaP)

22
Q

relationship between surface tension and compliance in the lung

A

surface tension at the alveolar air-water interface favors collapse of alveoli (aka it decreases lung compliance)

23
Q

how does the body compensate for the fact that surface tension/compliance favor collapse of alveoli?

A

surfactant (phospholipid of dipalmitoyl phosphatidylcholine + 4 proteins) - dramatically lowers tension relative to water + induces an area-dependent effect on tension

(increase in film area = increase in tension and vice versa -> compliance is never compromised - actually increases compliance by reducing work required to expand lung - causes decreased tension to compensate for increased pressure of a smaller radius)

24
Q

describe surfactant production

A
  • starts at 32 weeks gestation
  • under influence of cortisol

premies often have surfactant deficiency and need to be put on positive pressure ventilators

25
Q

tidal volume (TV)

A

volume of normal breath - 0.5L

26
Q

inspiratory capacity (IC)

A

maximum volume inhaled after normal exhale (TV + IRV) = 3L

27
Q

expiratory reserve volume (ERV)

A

maximum volume of forced exhale after normal exhale = 1.5L

28
Q

vital capacity (VC)

A

maximum volume inhaled and exhaled (TV+IRV+ERV) = 4.5L

-measure of muscle effectiveness

29
Q

residual volume (RV)

A

volume of air in lungs after maximal exhale = 1.5L (25% TLC)

30
Q

functional residual capacity (FRC)

A

volume of air in lungs after normal exhale (ERV+RV) = 3L (50% TLC)
-describes the balance of force b/w lung collapse and chest wall recoil

31
Q

how do you measure FRC?

A 
FRC = (C1V1)/C2 - V1 
FRC = RV + ERV
32
Q

total lung capacity (TLC)

A

maximum volume of air lungs can hold

33
Q

what is the advantage of measuring dynamic rather than static values?

A

measurement of rate at which air is moved is a better indication of work involved in breathing and also the status of the airways

34
Q

forced expiratory volume (FEV)

A

volume exhaled in the first second of forced exhalation after inhale to TLC

35
Q

forced vital capacity (FVC)

A

total air expelled forcibly after inhale to TLC

36
Q

normal value of FEV/FCV ratio and significance

A

~0.8 at a rate of 8-10/min

  • measures dynamic properties of the lung
  • changes can reflect specific pathology
37
Q

what is the elastic work of breathing?

A

work required to expand the chest wall and to expand the elastic tissue of the lungs

38
Q

obstructive vs. restrictive diseases

A
  • obstructive: characterized by increased airway resistance and CO2 retention
  • restrictive: characterized by a reduction in TLC
39
Q

asthma

A

-bronchospastic or reversible obstructive condition

exercised-induced due to bronchoconstriction related to heat and water loss during rapid respiration

40
Q

emphysema

A
  • irreversible obstructive condition
  • FRC increases, elastic work decreases, airway resistance increases
  • tendency for CO2 retention
  • decreased FEV/FVC
41
Q

atelectasis

A

collapse of part or entire lung - restrictive

pneumothorax also restrictive

42
Q

consolidation

A

filling of alveolar spaces with inflammatory exudates - restrictive

43
Q

pleural effusion

A

due to heart failure, hypoproteinemia, infection, neoplasm - restrictive
-treat with thoracentesis

44
Q

respiratory distress syndrome (RDS)

A
  • adults: acute RDS
  • infants: idiopathis RDS (hyaline membrane disease similar)
  • decrease in absolute volume of air that moves due to decreased FRC
45
Q

what is the best measure of ventilatory efficiency?

A

measure amount of fresh air delivered to the respiratory surface (aka alveoli)

46
Q

what is anatomic dead space?

A

volume of conductive, non-respiratory passages

47
Q

what is the effect of dead space on alveolar ventilation?

A
  • exhale forces ole alveolar air into dead space
  • inhale brings some of this old air back along with fresh air, but some fresh air never moves beyond the dead space so it cannot participate in gas exchange

(TV must exceed volume of dead space)

48
Q

equation for alveolar ventilation

A

(TV-Vdeadspace) x N # of breaths/min

49
Q

which is more efficient: rapid, shallow breathing or deeper, slower breathing? why?

A

deeper, slower breathing b/c less contribution of dead space

Physio (12 decks)

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