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LSS: respiratory > lecture 2: ventilation > Flashcards

lecture 2: ventilation Flashcards

1
Q

what are the two main components to the chest wall?

A
  • bone and muscle and fibrous tissue
  • the lungs
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2
Q

ribcage and lungs

what are the natural tendencies of both the rib cage and the lungs?

A
  • the ribcage recoils outwards
  • the lungs recoil inwards
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3
Q

what is the volume and pressure of the pleural cavity?

A
  • fixed volume
  • and contains protein-rich negative fluid
  • there is negative pressure
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4
Q

what is the functional residual capacity?

A
  • when we are at the end of tidal expiration
  • at the end we are at FRC when both the lungs and the ribcage are in equilibrium
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5
Q

what is the importance of the pleural cavity?

A
  • it is the link between the lungs and the chest wall
  • if we do a full inspiration we are expanding the chest wall as well as pulling the diaphragm down
  • so the chest wall needs to pull the lung with it
  • the negative pressure of the pleural cavity allows the chest wall to pull the lungs with it
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6
Q

what happens to the pleural cavity with a punctured lung?

A
  • if you have a puncture in the chest wall
  • the fixed volume pleural cavity is compromised
  • air will fill the pleural cavity the elastic recoil will take over and the lung will collapse
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7
Q

what is the difference with a haemothorax?

A
  • this occurs much slower
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8
Q

what is hyperventilation?

A

excessive ventilation of the lungs atop of metabolic demand

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9
Q

what is hypoventilation?

A

Deficient ventilation of the lungs; unable to meet metabolic demand

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10
Q

*show a diagram of a labelled lung volume and capacity graph :

A

*

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11
Q

what is the tidal volume?

A

normal breathing volume - it can increase during exercise

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12
Q

what is inspiratory reserve volume?

A

how much extra air you can draw in after a breath in

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13
Q

what is expiratory Reserve volume?

A

how much extra air you can breathe out after a normal breath in

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14
Q

residual volume?

A

the volume left in the lungs after normal expiration

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15
Q

what factors affect the lung volume and capacity?

A
  • body size - sex (men are bigger) - fitness - disease - age
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16
Q

what is dead space?

A

these are areas on the airway that do not participate in gas exhange

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17
Q

what are the two types of dead space?

A

anatomical dead space -

alveolar dead space -

non perfused parenchyma (alveoli without a blood supply)

the conducting zone is dead space

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18
Q

what are the two distinct parts of the lungs?

A
  • conducting zone - anatomical dead space - respiratory zone - split into 7 generations
19
Q

*show a diagram of dead space:

A

*

20
Q

how to increase dead space ?

A
  • use a ventilator
21
Q

how to decrease the dead space?

A
  • tracheostomy
22
Q

what is

transmural pressure

transpulmonary pressure

transrespiratory pressure

A

transmural = across several tissues

transpulmonary = difference between alveolar and intrapleural pressure

transrespiratory pressure = tells us if there is airflow into or out of the lung

23
Q

what is the snorkel analogy saying?

A

a longer snorkel means more dead space which means the lungs may not be able to shift - poiseuilles law: a decrease in diameter by a half increases resistance by x16

24
Q

how does the alveolar volume and pressure in alveolar change ?

A
  • at the start there is no transpulmonary pressure - there is no pressure change - the chest wall expands and creates the negative pressure - the pressure gradient is established - the pressure gradient equalises
25
Q

how to work out the orientation of the gradient?

A

inside - outisde

26
Q

how do we normally inspire?

in terms of pressure

A
  • we inspire when there is a lower pressure inside the lungs
  • it is possible to ventilate using positive pressure breathing

this is when we increase the pressure outside by using a ventilatory or CPR

27
Q

what is the chest wall relationship?

A
  • the elastic recoil of the lungs inwards and the outward recoil of the rib cage are in equilibrium - the lungs are surrounded by a visceral pleural membrane whilst the inner surface in covered in a parietal membrane
28
Q

what does breaching in the pleural cavity result in?

A
  • haemothorax - bleeding in chest cavity - pneumothorax - perforated chest wall
29
Q

how is air flow generated?

A
  • goes from high pressure - to low pressure *****
30
Q

what is negative pressure breathing?

A

this is inspiration with a lower pressure in the lungs (NORMAL)

31
Q

what is positive pressure breathing?

A
  • this is pressure increased abnormally in situations like CPR and ventilation
32
Q

what is transmural pressure?

A

pressure inside - pressure outside this is the pressure across the tissues a positive transmural pressure leads to expiration

33
Q

what is transpulmonary pressure?

A
  • this is a difference between the alveolar and interpleual pressure this pressure dictates the airflow
34
Q

what is the chest wall relationship graph?

A

*** will go over in later lecture

35
Q

how are lung function tests carried out?

A
  • patient wears nose clip and inhales to total lung capacity - the patient exhales as hard and fast as they can until 6 seconds have passed - inspect the graph and look for -slow starts - early stops or - intramanouver variability
36
Q

how to calculate the FEV1/ FVC ratio? (forced vital capacity)

A

volume of air forced out in 1 second / volume of air at max inhalation

37
Q

what does obstructive lung disease do to the lung function tests?

A

FEV1 and FVC is much lower while FET is much higher (takes longer to expel). - forced expiratory time

38
Q

what do restrictive lung diseases do to the lung function tests?

A

FVC is lower while FEV1 is relatively high as the airway conduction pathway is clear (not like in COPD).

39
Q

what does the volume time graph look like?

A

**

40
Q

what peak flow test?

A

this measures the force of exhalation instead of the volume or time taken

41
Q

how to measure the peak flow?

A

look at the graph which is peak expiratory flow rate / age and look at the max point

42
Q

how to calculate alveolar ventilation

A

**

43
Q

how to calculate alveolar ventilation

A

**

LSS: respiratory (17 decks)

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