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Cardiopulmonary > Exam III: 5A Cardiopulmonary System > Flashcards

Exam III: 5A Cardiopulmonary System Flashcards

0
Q

What is the Transpulmonary pressure?

A

The difference in pressure between intraalveolar pressure & intrapleural pressure

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1
Q

What are the pressures involved with breathing?

A

1) Atmospheric pressure
2) Intra-Alveolar Pressure
3) Intraplueral pressure
4) Transpulmonary Pressure

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2
Q

How is the negative intrapleural pressure established?

A

2 Forces act to pull the lungs (visceral pleura) away from the chest wall (parietal pleura) and cause lung collapse

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3
Q

What are the 2 forces that exist within the thoracic cavity (negative intrapleural pressure)?

A

1) “The lungs’ “ natural tendency to recoil. Because of their elasticity, lungs always assume the smallest size possible.
2) “The surface tension “of the alveolar fluid. The surface tension of the alveolar fluid constantly acts to draw the alveoli to their smallest possible dimension.

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4
Q

Which of these forces, a) lung-collapsing force or b) natural elasticity of the chest wall (force that tens to pull the thorax & to enlarge the lungs) which will win?

A

Neither, because of the strong adhesive forces between the parietal and visceral pleura.

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5
Q

How does Pleural fluid secure the pleurae together?

A

-Same way a drop of water holds two glass slides together.

  • The Pleurae slide from side to side easily, but remain closely apposed, and separating them requires extreme force.
  • The net result of the dynamic interplay between these forces is a negative P ip.
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6
Q

What causes immediate lung collapse?

A

Any condition that equalizes P ip with the intrapulmonary (or atmospheric) pressure causes immediate lung collapse.

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7
Q

What keeps the the air spaces of the lungs open (keeps the lungs from collapsing) ?

A

It is the Transpulmonary pressure (or transmural pressure) -the differences between the intrapulmonary and intrapleural pressures (P pul - P ip)

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8
Q

What determines the size of the lungs at any time ?

A

The size of the Transpulmonary pressure that determines the size of the lungs and the greater the transpulmonary pressure, the larger the lungs.

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9
Q

What is Boyle’s Law?

What is the formula?

A
  • The volume changes lead to pressure changes, and pressure changes lead to the flow of gases to equalize the pressure.
  • P1 V1= P2 V2
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10
Q

Do we do positive pressure breathing or negative?

A

Negative

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11
Q

At rest (before inspiration begins) what 3 things happen?

A

1) Alveolar pressure equals atmospheric pressure
2) Intrapleural pressure is negative
3) Lung volume is the FRC

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12
Q

At rest why is alveolar pressure said to be zero?

A

Because lung pressures are expressed relative to atmospheric pressure

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13
Q

What creates a negative pressure in the intrapleural space between the lungs and chest wall?

A

The opposing forces of the lungs trying to collapse and the chest wall trying to expand create a negative pressure.

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14
Q

During inspiration what occurs?

A

1) The inspiratory muscles contract and cause the volume of the thorax to increase
2) Intrapleural pressure becomes more negative
3) Lung volume increases by one TV

\

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15
Q

What happens when lung volume increases?

A

Alveolar pressure decreases to less than atmospheric pressure (becomes negative)

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16
Q

What does the pressure gradient between the atmospheric and the alveoli cause?

A

Causes air to flow into the lungs; airflow will continue until the pressure gradient dissipates

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17
Q

When the lung volume increases during inspiration, what happens to the elastic recoil strength of the lungs?

A

It increases

As a result: Intrapleural pressure becomes even more negative then it was at rest.

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18
Q

What happens to the alveolar pressure when alveolar gas is compressed by elastic forces of the lung??

A

Becomes greater

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19
Q

When causes air to flow out of the lungs?

A

When alveolar pressure is higher than atmospheric pressure, the pressure gradient is reversed, and air flows out of the lungs.

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20
Q

What occurs during expiration?

A

1) Alveolar pressure becomes great than atmospheric pressure
2) Intrapleural pressure return to its resting value during a normal (passive) expiration.
3) lung volume return to FRC

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21
Q

What happens during a forced expiration?

A

Intrapleural pressure actually becomes Positive.

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22
Q

How does positive Intrapleural pressure affect the airways?

A

Compresses the airways making expiration more difficult.

23
Q

What are physical factors that influence ventilation?

A

1) Airway resistance
2) alveolar surface tension
3) Lung compliance

24
Q

Other than using energy to enlarge the thorax during inspiration, what else uses energy?

A

Energy is used to overcome various factors that hinder air passage and pulmonary ventilation.

25
Q

How does the contraction and relaxation of bronchial smooth muscle affect airways?

A

Changes airway resistance by altering the radius of the airways.

26
Q

What constricts the airways, decreases the radius, and increases the resistance to airflow?

A

Parasympathetic stimulates, muscarinic agonists, irritants and slow-reacting substance of anaphylaxis (asthma)

27
Q

How does sympathetic stimulation and sympathetic agonists dilate the airways? And what are the affects on the radius, and airflow?

A

Dilate airways via Beta-2 receptors, increases radius, and decreases the resistance to airflow.

28
Q

What does Alveolar surface tension result from?

A

The attractive forces between liquid molecules lining the alveoli.

29
Q

What does these attractive forces create ?

A

A collapsing pressure that is directly proportional to surface tension and inversely proportional to surface tension and inversely proportional to alveolar radius.

30
Q

What is Laplace’s Law?

A

P= 2 T/ R
Collapsing pressure in directly proportional to surface tension and inversely proportional to alveolar radius.

-Collapsing pressure on alveolus or pressure required to keep alveolus open.

31
Q

What is Pulmonary Surfactant ?

A

To prevent collapse of alveoli within the lung, pulmonary surfactant is made by Type 2 alveolar cells & coats the inside of each alveolus.

32
Q

What does surfactant consist of ?

A

phospholipids DPPC, other lipids, proteins, and carbohydrate.

***phospholipid is the major component due to its amphipathic properties.

33
Q

What is the function of surfactant?

A

To lower surface surface tension & subsequently reduce the tendency of the alveoli to collapse completely.

34
Q

What properties do Large alveoli (large radii) have?

A
  • Increased radius
  • decreased pressure
  • decreased tendency to collapse (low tendency)

*** EASY to KEEP OPEN

35
Q

What are the characteristics of Small alveoli (small radii)

A
  • Decreased resistance
  • Increased pressure
  • increased tendency to collapse

**** MORE DIFFICULT to KEEP OPEN **

36
Q

In the absence of surfactant what happens to the small alveoli?

A

The small alveoli have a tendency to collapse (atelectasis)

37
Q

What is compliance?

A

Describes the distensibility of the lungs and is inversely related to “stiffness”

-The change in volume for a given change in pressure or C= V/P

38
Q

How is compliance affected by middle and high ranges

A
  • In middle range of pressures, compliance is GREATEST & the lungs are most distensible.
  • At high expanding pressures, compliance is LOWEST, the lungs are least distensible & curves flatten.
39
Q

The stiffer the lungs, the ___________ the compliance, the more energy it takes to breath.

A

LESS

40
Q

When does Asthma begin?

A

When an allergen is inhaled. The allergen bind to IgE antibodies on MAST CELLS in the lungs.

41
Q

In asthma binding triggers exocytosis of the mast cells w/ the release what?

A

Histamines and Leukotrienes

42
Q

What are potential triggers for asthma?

A

House dust mites, Cockroach allergens, Animal allergens, pollen allergens, mold allergens, nonallergic airborne irritants

43
Q

What do Histamine & Leukotrienes do?

A

Cause the smooth muscle cells of the bronchi to contract narrowing the lumen of the bronchi.
**This is the early phase or reaction occurs within 1 hour or exposure to the allergen.

44
Q

What occurs in the late phase or reaction? What cells are attracted?

A

Attract an accumulation of inflammatory cell, EOSINOPHILS and production of mucus.

  • Occurs within 4-5 hours after exposure to the allergen.
  • **with repeated attacks the lining of the bronchi often becomes damaged.
45
Q

What causes Asthma?

A
  • Predisposition to respond to antigens or genetic component.
  • Can be triggered by non-specific factors, like cold air, exercise, and tobacco smoke.
46
Q

What is Asthma characterized by?

A

1) Increased responsiveness of the trachea & bronchi to various stimuli/triggers
2) Bronchoconstriction ( contraction of airway smooth muscle)
3) Inflammation (Mucosal thickening from edema /cellular Inflammtion)
4) Collection of abnormally thick plugs of mucus in the airways.

47
Q

What is Obstructive Lung disease?

A

-Shortness of breath or difficultly exhaling all the air from their lungs because of damage or increased airway resistance.

  • Exhaled air come out more slowly than normal.
  • At the end of a full expiration, an abnormally high amount of air may still linger in the lungs.
48
Q

What are the most common causes of Obstructive Lung disease?

A

1) Chronic obstruc. pulmonary disease (COPD), includes emphysema & chronic bronchitis
2) Asthma

Note: makes it harder to breathe, during increased acitivity or exertion.

49
Q

What is Restrictive Lung Disease?

A

People that cant fully fill their lungs with air. Lungs are “restricted” from fully expanding

50
Q

Why does restrictive lung disease occur?

A

1) Interstitial lung disease, idiopathic pulmonary fibrosis
2) Obesity
3) Neuromuscular disease, muscular dystrophy or amyotrophic lateral sclerosis.

51
Q

How are the lungs affected during Restrictive lung disease?

A

Stiffness to lungs, or stiffness of the chest wall, weak muscles, or damaged nerves may cause the restriction in lung expansion.

52
Q

What is the Forced Expiratory Volume 1.0 (FEV 1.0)

A

FEV= Forced expiratory volume
The measurement of respiratory volumes & capacities is important in assessing severity of disease and monitoring pulmonary function.

53
Q

How is FEV measured?

A

Measured by the vital capacity that can be exhaled in a given time interval.

  • A healthy adult should expel 75-85% of the vital capacity in 1.0 second (FEV 1.0)
54
Q

How is the FEV 1.0 affected in Obstructive diseases?

A

FEV 1.0 is reduced much more than the FVC, giving a LOW FEV 1.0/FVC %

FEV = 1.3 (normal is 4L)
FVC= 3.1 (normal is 5L)
%= 42 (normal is 80)
55
Q

How is the FEV 1.0 affected in Restrictive diseases?

A

In like pulmonary fibrosis, both FEV & FVC (forced vital capacity- total volume exhaled) are reduced, but characteristically the FEV 1.0/FVC% is normal or increased.

FEV = 2.8 (normal is 4L)
FVC= 3.1 (normal is 5L)
%=90 (normal is 80)

Cardiopulmonary (19 decks)

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