Lecture 1 - Intro To Resp Flashcards

1
Q

What is the equation for compliance?

A

Change in lung vol / change in lung pressure

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2
Q

What does it mean if the lungs are described as being highly compliant?

A

There a high change in lung volume when theres a small change in pressure

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3
Q

What is the pleural pressure at rest and what is the alveolar pressure at rest?

A

Plural pressure = negative at rest

Alveolar pressure = zero at rest

(The atmospheric pressure is zero)

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4
Q

How does air get drawn into the lungs during inspiration?

A

Diaphragm contracts decreasing alveolar pressure making it NEGATIVE this creates a pressure gradient drawing air into the alveoli

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5
Q

What happens to the pressures in expiration?

A

Its very passive

As muscles relax, the alveolar pressure becomes less negative, becomes positive then goes back to zero

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6
Q

What are the 2 components creating the elastic forces in the lungs?

A

Elastic creating elastic recoil

Fluid in alveoli creates surface tension between the air and fluid

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7
Q

How does the fluid in the alveoli contribute to the elastic forces drawing the lungs in?

A

Water molecules try and contract to make a smaller structure making alveoli more collapsible

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8
Q

What is Tidal volume?

What is the approximate tidal volume in most people?

A

The quiet breath

The amount of air drawn in and out when breathing normally

500ml

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9
Q

What is Inspiratory reserve volume?

What is the approximate IRV in a person?

A

Forceful inhalation of air after the normal inhalation of air (tidal volume)

2.5L

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10
Q

What is Expiratory Reserve Volume?

What is the average ERV?

A

The amount of air that can be forceful exhaled after the normal tidal volume is exhaled

1.5L

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11
Q

What is residual volume?

A

The air left in the lungs that cant be forcefully exhaled after the ERV

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12
Q

What is total lung capacity?

A

The total amount of air in the lungs

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13
Q

What is vital capacity?

A

The largest amount of air that can be moved in one breath

IRV + Tidal vol + ERV

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14
Q

What is inspiratory capacity?

A

TV + IRV

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15
Q

How do restrictive respiratory disorders affect lung compliancy and lung volumes?

A

Limits lung compliancy reducing all lung volumes

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16
Q

How are the airways affected in obstructive respiratory disorders?

How is compliancy affected?

A

Airways obstructed (mucus, narrowing)

Nothing happens to compliancy

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17
Q

How is inspiration and expiration affected in Obstructive Respiratory Disorders and why?

A

Inspiration not really affected since airways can expand

Expiration IS affected since as tube narrows the mucus blocks it trapping gases in lungs

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18
Q

How are the lung volumes affected in obstructive respiratory disorders?

A

IRV is normal ((airways expand)

ERV reduced leading to RV (Residual Volume) to increase since air able to be exhaled reduces

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19
Q

What is ventilation?

A

Process of inspiration and expiration

The physical action of breathing and moving air into and out of the lung

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20
Q

Why is the respiratory centre in the brain improtant for ventilation?

A

Neurones there generate impulses that get sent to the muscles of respiration making breathing rhythmic

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21
Q

What leads to the movement of gases?

A

Pressure gradients

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22
Q

What is respiration?

A

The exchange of oxygen and CO2 across a membrane either in the lungs or at the cellular level (between alveoli and capillaries)

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23
Q

What is the difference between respiration and ventilation?

A

Ventilation is the movement of air into and out of the lungs

Respiration is the exchange of gases

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24
Q

What are the 2 portions of the respiratory tract?

A

Conducting portion

Respiratory portion

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25
Q

What happens in the conducting portion of the respiratory tract?

A

Conducts air through

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26
Q

What happens in the respiratory portion of the respiratory tract?

A

Gas exchange

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27
Q

What is anatomical dead space?

A

The volume of air in the conducting AIRWAYS of the respiratory tract not involved in gas exchange

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28
Q

What is alveolar dead space?

A

The air in the alveoli that isn’t involved in gas exchange (these alveoli are not diseased or perfused)

29
Q

What is physiological dead space?

A

Its the combined anatomical dead space and alveolar dead space

All the air not involved in gas exchange

30
Q

What is tidal volume?

What is the equation for it?

A

Amount of air you move in and out with quiet breaths

TV = Anatomical Dead space + alveolar ventilation

31
Q

What is the equation for Total Pulmonary Ventilation?

A

TPV (minute volume) = Tidal vol x resp rate

32
Q

What is the equation for alveolar ventilation?

A

Alveolar ventilation = (tidal vol - dead space) x resp rate

33
Q

What is Intra pulmonary pressure?

A

Pressure inside the lungs/alveoli

34
Q

What happens in terms of muscle, volume of thoracic cavity and pressure when breathing in on a quiet breath?

A

Ribs move up and out (external intercostal muscle contracts)
Diaphragm contracts and flattens
Increases volume of thorax
Decreasing pressure in lungs drawing air in

35
Q

What happens in terms of muscle, volume of thoracic cavity and pressure when breathing out on a quiet breath?

A

Ribs fall
Diaphragm relaxes and moves up
Vol of chest decreases increasing pressure in lungs

36
Q

What is the mechanism of quiet expiration?

A

External intercostal and diaphragm relaxes
Vol of thoracic cavity reduces
Intra pulmonary pressure increases and lungs return to original vol

37
Q

What are the accessory muscles of forced inspiration?

A

Sternocleidomastoid
Scalene muscles
Serratus anterior
Pectoralis majo

38
Q

What are the accessory muscle of forced expiration?

A

Internal intercostals

Abdominal wall muscles

39
Q

Why is the pleural fluid important to the lungs?

A

Creates a surface tension coating the lungs in the thoracic cavity preventing the lungs from collapsing

40
Q

What are the pleural membranes?

What are the 2 parts to it?

A

Pair of serous membranes lining the thorax and enveloping the lungs

Parietal pleura (lines thorax)
Visceral pleura (lines lung

41
Q

What is the intrapleural space?

A

Pace between visceral and parietal pleura

42
Q

What is a pneumothorax?

A

When air gets into the pleural space

Leads to loss of contact of lungs with thorax leading to lung collapse

43
Q

What are the 2 forces exerted by the lungs and the chest wall?

A

Lungs have elastic recoil so want to go inwards

Chest wall has outward elastic recoil

44
Q

Why is important that the intrapleural pressure stays negative?

A

Keeps the alveoli and lungs from fully collapsing with each expiration

45
Q

How does intrapulmonary pressure change with inspiration and expiration?

A

Inspiration intrapulmonary pressure negative drawing air in

Expiration intrapulmonary pressure positive forcing air out

46
Q

What is trans pulmonary pressure?

A

Difference between intrapulmonary pressure minus intrapleural pressure

47
Q

What is Functional Residual Capacity? (FRC)

A

The volume of air at the resting expiratory level

So vol of air left after a normal breath out

48
Q

What is lung compliance?

A

A measure of distensibility (the change in volume relative to the change in pressure

Essentially how easily the volume of the lungs change

49
Q

What is the equation for compliance?

A

Change in vol / change in pressure

50
Q

What is Emphysema?

A

Abnormal permanent enlargement of the air spaces distal to the terminal bronchiole with destruction of the alveolar walls

51
Q

What happens in Emphysema?

A

Proteases like elastase breakdown the elastin in the alveoli reducing SA for gas exchange and increasing compliance

52
Q

What are the 2 main components contributing to the lungs elastic recoil?

A

The elastic fibres in the connective tissue

The surface tension of the water/fluid in the alveoli

53
Q

What is the space between an alveoli and a capillary called?

A

Interstitium

54
Q

What are interstitial lung diseases?

A

Diseases where dense fibrous tissue ends up getting deposited in the interstitium
(Pulmonary fibrosis)

55
Q

What happens to compliance in Pulmonary fibrosis and why?

A

Reduced compliance

Fibrous tissue has lots of elastin increasing the elastic recoil inwards of the lungs

This makes it harder for them to expand so more pressure changes is needed

56
Q

What type of ventilatory defect does pulmonary fibrosis make on spirometers?

A

Restrictive

57
Q

How does more surface tension of the watery fluid in the alveoli affect compliance?

A

More surface tension = less compliance making it harder for lungs to expand

58
Q

What is lung surfactant?

A

Has the opposite affect to the watery fluid creating surface tension

Is a lipoprotein

59
Q

What is the function of lung surfactant?

A

Keeps alveoli from collapsing when exhaling

60
Q

When do babies start producing surfactant and when do they have enough?

A

Start making at week 26

Enough after 35 weeks

61
Q

What is the condition called when babies dont produce enough lung surfactant?

A

Neonatal Repsiratory Distress syndrome

62
Q

How do you treat Neonatal respiratory distress syndrome?

A

Give exogenous surfactant via endotracheal tube
Give O2 /assisted ventilation

63
Q

How can you tell a baby has neonatal respiratory distress syndrome?

A

Grunting
Nasal flaring
Intercostal and subcostal retractions (abdominal muscles contract)
Tachypnoae (rapid resp rate)
Cyanosis

64
Q

What affects airway resistance?

A

Diameter of airway
(Mucus in airway, radial traction, pressure gradients)

Surface tension in airways

65
Q

Why is it useful that the airway tubes are connected in parallel?

A

Reduces airway resistance
Provides alternat routes

Highest resistance in upper airways

66
Q

Compare a bronchus to a bronchiole inn terms of cartilage and glands:

A

Bronchioles have no cartilage, bronchus does

Bronchioles have no glands, bronchus does

67
Q

What is radial traction?

A

When alveoli contract or are as small as possible and this pull the surrounding bronchioles open preventing their collapse

68
Q

How do bronchioles stay open when they have no cartilage?

A

Radial traction from alveoli getting smaller keeps bronchioles pulled open

69
Q

What is Bronchiectasis?

A

When lungs are widened leading to build up of mucus making prone to infection