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
What happens in the conducting portion of the respiratory tract?
Conducts air through
26
What happens in the respiratory portion of the respiratory tract?
Gas exchange
27
What is anatomical dead space?
The volume of air in the conducting AIRWAYS of the respiratory tract not involved in gas exchange
28
What is alveolar dead space?
The air in the alveoli that isn’t involved in gas exchange (these alveoli are not diseased or perfused)
29
What is physiological dead space?
Its the combined anatomical dead space and alveolar dead space All the air not involved in gas exchange
30
What is tidal volume? What is the equation for it?
Amount of air you move in and out with quiet breaths TV = Anatomical Dead space + alveolar ventilation
31
What is the equation for Total Pulmonary Ventilation?
TPV (minute volume) = Tidal vol x resp rate
32
What is the equation for alveolar ventilation?
Alveolar ventilation = (tidal vol - dead space) x resp rate
33
What is Intra pulmonary pressure?
Pressure inside the lungs/alveoli
34
What happens in terms of muscle, volume of thoracic cavity and pressure when breathing in on a quiet breath?
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
What happens in terms of muscle, volume of thoracic cavity and pressure when breathing out on a quiet breath?
Ribs fall Diaphragm relaxes and moves up Vol of chest decreases increasing pressure in lungs
36
What is the mechanism of quiet expiration?
External intercostal and diaphragm relaxes Vol of thoracic cavity reduces Intra pulmonary pressure increases and lungs return to original vol
37
What are the accessory muscles of forced inspiration?
Sternocleidomastoid Scalene muscles Serratus anterior Pectoralis majo
38
What are the accessory muscle of forced expiration?
Internal intercostals Abdominal wall muscles
39
Why is the pleural fluid important to the lungs?
Creates a surface tension coating the lungs in the thoracic cavity preventing the lungs from collapsing
40
What are the pleural membranes? What are the 2 parts to it?
Pair of serous membranes lining the thorax and enveloping the lungs Parietal pleura (lines thorax) Visceral pleura (lines lung
41
What is the intrapleural space?
Pace between visceral and parietal pleura
42
What is a pneumothorax?
When air gets into the pleural space Leads to loss of contact of lungs with thorax leading to lung collapse
43
What are the 2 forces exerted by the lungs and the chest wall?
Lungs have elastic recoil so want to go inwards Chest wall has outward elastic recoil
44
Why is important that the intrapleural pressure stays negative?
Keeps the alveoli and lungs from fully collapsing with each expiration
45
How does intrapulmonary pressure change with inspiration and expiration?
Inspiration intrapulmonary pressure negative drawing air in Expiration intrapulmonary pressure positive forcing air out
46
What is trans pulmonary pressure?
Difference between intrapulmonary pressure minus intrapleural pressure
47
What is Functional Residual Capacity? (FRC)
The volume of air at the resting expiratory level So vol of air left after a normal breath out
48
What is lung compliance?
A measure of distensibility (the change in volume relative to the change in pressure Essentially how easily the volume of the lungs change
49
What is the equation for compliance?
Change in vol / change in pressure
50
What is Emphysema?
Abnormal permanent enlargement of the air spaces distal to the terminal bronchiole with destruction of the alveolar walls
51
What happens in Emphysema?
Proteases like elastase breakdown the elastin in the alveoli reducing SA for gas exchange and increasing compliance
52
What are the 2 main components contributing to the lungs elastic recoil?
The elastic fibres in the connective tissue The surface tension of the water/fluid in the alveoli
53
What is the space between an alveoli and a capillary called?
Interstitium
54
What are interstitial lung diseases?
Diseases where dense fibrous tissue ends up getting deposited in the interstitium (Pulmonary fibrosis)
55
What happens to compliance in Pulmonary fibrosis and why?
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
What type of ventilatory defect does pulmonary fibrosis make on spirometers?
Restrictive
57
How does more surface tension of the watery fluid in the alveoli affect compliance?
More surface tension = less compliance making it harder for lungs to expand
58
What is lung surfactant?
Has the opposite affect to the watery fluid creating surface tension Is a lipoprotein
59
What is the function of lung surfactant?
Keeps alveoli from collapsing when exhaling
60
When do babies start producing surfactant and when do they have enough?
Start making at week 26 Enough after 35 weeks
61
What is the condition called when babies dont produce enough lung surfactant?
Neonatal Repsiratory Distress syndrome
62
How do you treat Neonatal respiratory distress syndrome?
Give exogenous surfactant via endotracheal tube Give O2 /assisted ventilation
63
How can you tell a baby has neonatal respiratory distress syndrome?
Grunting Nasal flaring Intercostal and subcostal retractions (abdominal muscles contract) Tachypnoae (rapid resp rate) Cyanosis
64
What affects airway resistance?
Diameter of airway (Mucus in airway, radial traction, pressure gradients) Surface tension in airways
65
Why is it useful that the airway tubes are connected in parallel?
Reduces airway resistance Provides alternat routes Highest resistance in upper airways
66
Compare a bronchus to a bronchiole inn terms of cartilage and glands:
Bronchioles have no cartilage, bronchus does Bronchioles have no glands, bronchus does
67
What is radial traction?
When alveoli contract or are as small as possible and this pull the surrounding bronchioles open preventing their collapse
68
How do bronchioles stay open when they have no cartilage?
Radial traction from alveoli getting smaller keeps bronchioles pulled open
69
What is Bronchiectasis?
When lungs are widened leading to build up of mucus making prone to infection