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My Cardiopulmonary > Lecture 5A > Flashcards

Lecture 5A Flashcards

1
Q

Define the following:

  • Atmospheric Pressure

- Intra-alveolar Pressure (Intrapulmonary pressure)

A

Atmospheric pressure - Outside

Intra-Alveolar Pressure (intrapulmonary) - In lungs

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2
Q

What is Intrapleural pressure

A

Pressure inside the pleural space

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3
Q

What is Transpulmonary pressure?

A

Difference in pressure across the lung wall

The difference of Intrapulmonary and Intrapleural pressure

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4
Q

How is the negative intrapleural pressure established? (2)

A

Two forces that exist in the thoracic cavity:

  1. The lungs’ natural tendency to recoil. Their elasticity causes the lungs to always assume the smallest size possible
  2. The surface tension of the alveolar fluid (surfactant). This tension constantly acts to draw the alveoli to their smallest possible dimension
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5
Q

What are the lung-collapsing forces main action?

A

There are two forces that act to pull the lungs (visceral pleura) away from the chest wall (parietal pleura) and cause lung collapse

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6
Q

If there are (2) lung-collapsing forces as well as outward chest elasticity forces, which force wins?

A

Neither in a healthy individual. The strong adhesive force between the parietal and visceral pleura is the reason. The pleural fluid secures the pleurae together just like a drop of water holds two glass slides together. Net result is a negative Pip (intrapleural pressure).

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7
Q

A condition that equalizes the Pip with the intrapulmonary (or atmospheric) pressure causes what?

A

Immediate lung collapse. There must be a megative pressure in the intrapleural space and tight coupling of the lungs to the thorax wall.

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8
Q

What is the purpose of the transpulmonary pressure?

A

This difference between Intrapulmonary Pressure and Intrapleural Pressure keeps the air spaces of the lungs open. In other words, keeps the lungs from collapsing

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9
Q

What determines the size of the lungs at any time?

A

The size of the transpulmonary pressure. The greater the transpulmonary pressure, the larger the lungs

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10
Q

What is Boyle’s Law?

A

Volume changes lead to pressure changes. Pressure changes lead to the flow of gases to equalize the pressure.
P1V1=P2V2

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11
Q

Respiratory Cycle: What three things are occurring AT REST? or before inspiration begins

A
  1. Alveolar Pressure equals atmospheric pressure
  2. Intrapleural pressure is negative
  3. Lung volume is the FRC (functional residual capacity)
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12
Q

What creates the intrapleural negative pressure while at rest?

A

The opposing forces of the lungs trying to collapse and the chest wall trying to expand create a negative pressure in the intrapleural space between them

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13
Q

Respiratory Cycle: What three things are occurring DURING INSPIRATION?

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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14
Q

Respiratory Cycle: What three things are occurring DURING EXPIRATION?

A
  1. Alveolar pressure becomes greater than atmospheric pressure
  2. Intrapleural pressure returns to is resting value during a normal (passive) expiration
  3. Lung volume returns to FRC
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15
Q

What are the three factors that hinder air passage and pulmonary ventilation

A

Airway Resistance
Alveolar Surface Tension
Lung Compliance

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16
Q

What is the main target in overcoming Airway Resistance

A

Contraction and Relaxation of Bronchial Smooth Muscle

- Changes airway resistance by altering the radius of the airways

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17
Q

What 4 things constrict the airways, decrease the radius, and increase the resistance to airflow?

A
  1. PNS stimulation
  2. Muscarinic agonists
  3. Irritants
  4. Slow-reacting substances of anaphylaxis (Asthma)
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18
Q

What two things increase the radius and decrease the resistance to airflow?

A

Sympathetic stimulation and sympathetic agonists

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19
Q

What is an example of a sympathetic agonist and how does it work?

A

Albuterol

Via B2 receptors, increases the radius and decreases the resistance to airflow

20
Q

What is Laplace’s Law?

A

P=2T/R,

21
Q

What does Pulmonary Surfactant do?

A

It is made by Type 2 alveolar cells that coats the inside of each alveolus
It prevents the collapse of alveoli within the lung

22
Q

What is the main component of Pulmonary surfactant

A

DPPC (Dipalmitoylphosphatidylcholine)

In other words, phospholipid is the major component due to its amphipathic properties

23
Q

How does Pulmonary surfactant work?

A

Its function is to lower surface tension and subsequently reduce the tendency of the alveoli to collapse completely

24
Q

What is the air composition within alveoli?

A

78% Nitrogen
21% Oxygen
Traces of Co2
Traces of H2O

25
Q

What size of alveoli have low collapsing pressures and are easy to keep open?

A

Large alveoli,

Small alveoli have high collapsing pressures and are more difficult to keep open.

26
Q

In the absence of pulmonary surfactant, the small alveoli have a tendency to do what?

A

Collapse (Atelectasis)

27
Q

What is lung compliance

A

Describes the distensibility of the lungs and is inversely related to “stiffness”
Mathematically –> C=V/P

28
Q

When is compliance the greatest and lungs are most distensible?

A

In the middle range of pressures

29
Q

What occurs with compliance and distensibility at high expanding pressures?

A

Compliance is lowest

Lungs are least distensible and the curves flatten

30
Q

What happens to compliance and breathing when the lungs are stiff?

A

The stiffer the lungs, the less the compliance, the more energy it takes to breathe.

31
Q

Breifly describe the pathophysiology of asthma

A

An attack beings when an allergen is inhaled.
The allergen binds to IgE antibodies on mast cells in the lungs.
Binding triggers exocytosis of the mast cells with the release of histamine and leukotrienes.

32
Q

What two things are released in the pathophysiology of Asthma?

A

Histamine and leukotrienes

33
Q

What do Histamine and Leukotrienes do in the early phase or reaction of an attack?

A

Cause the smooth muscle cells of the bronchi to contract narrowing the lumen of the bronchi. Occurs within 1 hour of exposure to the allergen

34
Q

What do Histamine and Leukotrienes do in the late phase or reaction of an attack?

A

They attract an accumulation of inflammatory cells - especially eosinophils - and the production of mucus. Occurs 4-5 hours after exposure
- When repeated, lining of bronchi often becomes damaged

35
Q

In asthma, people have a predisposition to do what?

A 
Respond to antigens by making antibodies of the IgE class
This trait tends to run in families so there is probably a genetic component associated.
36
Q

T or F, Can asthma also be triggered in time by non-specific factors like cold air, exercise, and tobacco smoke?

A

True

37
Q

Asthma is physiologically and pathologically characterized by what 4 things

A
  1. Increased responsiveness of the trachea and bronchi to various stimuli/triggers
  2. Contraction of airway smooth muscle (bronchoconstriction)
  3. Mucosal thickening from edema and cellular infiltration (inflammation)
  4. Collection of abnormally thick plugs of mucus in the airways.
38
Q

Most common causes of obstructive lung disease

A
  1. Chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis
  2. Asthma
39
Q

Describe Obstructive Lung Disease

A
  1. Shortness of breath due to difficulty exhaling all the air from their lungs
  2. Exhaled air comes out slowly due to lung damage or increased airway resistance
  3. At the end of a full expiration, an abnormally high amount of air may still linger in the lungs
40
Q

Conditions causing restrictive lung disease

A
  1. Interstitial lung disease such as idiopathic pulmonary fibrosis
  2. Obesity
  3. Neuromuscular disease, such as muscular dystrophy or amyotrophic lateral sclerosis
41
Q

Describe Restrictive lung disease

A
  1. Cannot fully fill lungs with air. Their lungs are restricted from fully expanding.
  2. Results from a condition causing stiffness in the lungs themselves.
42
Q

What two ways can one clinically asses pulmonary function

A
  1. Measurement of respiratory volumes and capacities

2. Analyzing airflow

43
Q

What is Forced Expiratory Volume

A

The percentage of the vital capacity that can be exhaled in a give time interval. Used to measure airflow by having a subject exhale as rapidly as possible into a spirometer and measuring the FEV

44
Q

What healthy adult should be able to expel what percentage of vital capacity in what amount of time?

A

75-85% of vital capacity in 1 second. Called FEV1.0

45
Q

In obstructive diseases, what is the comparison of FEV1.0 and FVC?

A

FEV1.o is reduced more than the FVC –> Low FEV1.0/FVC%

46
Q

In restrictive diseases such as pulmonary fibrosis, what is the comparison of FEV1.0 and FVC?

A

Both are reduced but the FEV1.0/FVC% is normal or increased.

My Cardiopulmonary (17 decks)

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