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Anatomy exam 3 > limbiks_Exam 3 Lecture 1 > Flashcards

limbiks_Exam 3 Lecture 1 Flashcards

1
Q

What is a 100% O2 source?

A

Eliminates other gases from entering the patient

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2
Q

What is the purpose of most pulmonary function tests?

A

Analyze expired gas

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3
Q

What does expired gas indicate?

A

Status of the respiratory system

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4
Q

What percentage of oxygen is the person inspired from?

A

100%

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5
Q

Where should the first 350cc of the inspired air make it down in the lungs?

A

Deep parts for gas exchange

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6
Q

Where is the last 150cc of the inspired air found in the respiratory tree?

A

Conducting areas

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7
Q

Do conducting areas of the respiratory tree undergo gas exchange directly?

A

No

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8
Q

How much anatomical dead space does a normally sized average adult have?

A

150cc

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9
Q

Where in the respiratory tree is there no gas exchange happening?

A

Conducting zones

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10
Q

What is the first 150cc of air that a person exhales?

A

Anatomical dead space

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11
Q

What is the composition of the last 150cc of air expired by a patient?

A

100% oxygen with a little bit of water vapor

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12
Q

What is the purpose of a nitrogen meter in this apparatus?

A

Measures nitrogen in expired air

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13
Q

What would the nitrogen meter show in the first 100cc of expired air?

A

No nitrogen

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14
Q

Why is there no nitrogen in the first 100cc of expired air?

A

No nitrogen in inspired gas

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15
Q

Percentage of nitrogen in atmospheric air

A

80%

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16
Q

Percentage of nitrogen in alveolar air

A

75%

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17
Q

First 100 CC’s of volume expired

A

Nitrogen composition expected

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18
Q

What do we expect to see in the first 100cc of expired air?

A

No nitrogen

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19
Q

What happens to nitrogen levels in expired air after 100cc?

A

Nitrogen appears

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20
Q

What does nitrogen in expired air indicate?

A

Alveolar gas

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21
Q

Where is the Alveolar Plateau phase located?

A

100CC mark

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22
Q

What technique is used to determine anatomical dead space?

A

Adds 100CC of expired air with no nitrogen to transitional phase volume

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23
Q

What characterizes the transitional phase?

A

Rapidly increasing nitrogen

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24
Q

Halfway mark to plateau phase

A

Where nitrogen is coming off the patient

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25
Q

Anatomical Deadspace measurement

A

150 CC’s

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26
Q

Location of 100 CC’s with no nitrogen

A

Upper airways

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27
Q

PN2 of alveoli

A

75%

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28
Q

Where does alveolar gas mix with dead space gas in expired air?

A

First portion

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29
Q

Why is the nitrogen content low in the first portion of expired air?

A

Close to large airways

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30
Q

Importance of measuring anatomical dead space volume

A

To estimate volume of nitrogen-free area

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31
Q

Composition of anatomical dead space

A

Nitrogen-rich near beginning, nitrogen-poor closer to large airways

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32
Q

Definition of anatomical dead space

A

Area of gas exchange in airways

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33
Q

How do we calculate anatomical dead space?

A

Volume at midway point + 100 CCs

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34
Q

What is the total anatomical dead space in the example provided?

A

About 150 CCs

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35
Q

What does the fowler test measure?

A

Nitrogen deficiency in expired air

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36
Q

-24:30 Slide 2: What is Fowler’s test used for?

A

To determine anatomical dead space volume

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37
Q

-24:30 Slide 2: What is added to the volume of air expired to determine anatomical dead space?

A

Midway point at transitional area

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38
Q

What can expired gas help us visualize?

A

Inner workings of the lungs

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39
Q

What does expired gas measurement allow us to determine?

A

Anatomical dead space

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40
Q

What type of gas is typically used for the measurement?

A

100% Oxygen

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41
Q

Can we measure physiological dead space with this method?

A

Questioned if physio dead space can be measured

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42
Q

Can we measure alveolar dead space?

A

No

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43
Q

What is anatomical dead space?

A

Combination of Anatomical factors

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44
Q

What is alveolar dead space?

A

Wasted ventilation

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45
Q

What is the maximum rate of inspiration?

A

10 liters per second

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46
Q

What is the maximum expiratory flow rate for an average person?

A

10 liters per second

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47
Q

What is the point at which the lung is entirely filled up with air?

A

TLC

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48
Q

What is the start point for flow volume flow volumes?

A

RV

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49
Q

How fast can air go into the lungs during maximal effort?

A

10 Liters per second

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50
Q

What is the maximum flow rate?

A

10 liters per second

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51
Q

When does the maximum flow rate occur?

A

Early expiration

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52
Q

What is the relationship between expiration and flow rate?

A

Flow rate increases quickly at the start of expiration

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53
Q

What happens after the high point in lung volume?

A

Tapers off in a straight line

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54
Q

What are the start points on the horizontal axis in terms of lung volume?

A

Always RV

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55
Q

How is the horizontal axis represented in lung volume?

A

With numbers

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56
Q

What is the normal vital capacity?

A

4.5 liters

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57
Q

What units are pulmonary function lab results typically given in?

A

liters

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58
Q

Is there a standardized way to display numbers in pulmonary function labs?

A

No

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59
Q

What is the difference between the start point and another point mentioned?

A

Four and a half liters

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60
Q

Can the start point on the axis be arbitrary?

A

Yes

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61
Q

What could be a possible value for the start point on the graph?

A

Two or zero

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62
Q

What is important in determining volume on a graduated cylinder?

A

Distance between bars

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63
Q

Does the start or end point matter on a graduated cylinder?

A

No

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64
Q

Maximal effort inspiration and expiration flow rates

A

10 L/sec

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65
Q

During maximal effort, which curve represents the flow rate?

A

Smaller curves between top/bottom curves

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66
Q

How is the duration of inspiration/expiration indicated on the graph?

A

Airflow is in units of L/sec

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67
Q

What is the typical shape of the curve during inspiration?

A

Half circle

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68
Q

What is observed in the inspiratory curve?

A

Symmetry during inspiration

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69
Q

What occurs during expiration based on the curve?

A

Front-loaded and tapers off

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70
Q

What is the general shape of an expiratory flow curve?

A

Upside-down ice cream cone

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71
Q

Where does the expiratory flow curve show higher flow?

A

Left side

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72
Q

How does the expiratory flow change as air continues to come out of the lung?

A

Starts fast then tapers off

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73
Q

What is usually the focus when conducting pulmonary function tests?

A

Expiratory side

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74
Q

Why do we have a high peak expiratory flow rate at the beginning of the maneuver?

A

Big airways at total lung capacity

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75
Q

What happens as we get towards lower and lower lung volumes?

A

Effort independence

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76
Q

What is the period when expiratory flow rate becomes effort independence?

A

Towards lower lung volumes

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77
Q

At what lung volume does max expiratory flow rate become independent of effort?

A

Around FRC

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78
Q

What contributes to small airway collapse?

A

Pressure generated

79
Q

Where are small airways more likely to collapse?

A

Bottom part of the lung

80
Q

When does expiratory flow rate become effort independent?

A

37:30-42:30 Slide 8

81
Q

What happens to alveoli at the top and bottom as lung volume decreases?

A

Top alveoli are full, bottom alveoli empty first

82
Q

Why do the alveoli at the bottom empty out first as lung volume decreases?

A

Reduced traction and airway diameter

83
Q

What happens to airway diameter as we reach lower lung volumes?

A

Airway diameter reduces

84
Q

Why does applying pressure at lower lung volumes shut the airway?

A

Airway diameter is reduced

85
Q

What factors influence the shape of the normal curve?

A

Airway width, elastic recoil, traction

86
Q

Why does airway collapse become more likely with reduced traction or elastic recoil?

A

Higher probability of airway collapse

87
Q

How are the curves typically plotted?

A

Expiratory part only

88
Q

What does the blue curve on the right in an expiratory flow volume loop indicate?

A

Restrictive lung disease

89
Q

What does the blue curve on the left in an expiratory flow volume loop indicate?

A

Obstructive disease

90
Q

What is the typical expiratory and inspiratory flow rate a typical person can generate under maximal effort?

A

About 10 liters per minute

91
Q

Typical expiratory flow rate for an average 34 year old person

A

10 L/min

92
Q

Max expiratory flow rate for a large football player

A

Faster than 10 L/min

93
Q

Why do restrictive lung diseases lead to a reduction in max expiratory flow rate?

A

Airways are more narrow and more likely to collapse

94
Q

What effect does having less full alveoli have on the airways in restrictive lung disease?

A

Makes airways more narrow

95
Q

Why are the airways in restrictive lung diseases more likely to collapse?

A

Because they are narrower than in a normal lung

96
Q

What happens to the peak expiratory flow rate in obstructive lung disease?

A

Reduced

97
Q

Why does the expiratory flow rate taper off in obstructive lung disease?

A

Loss of traction springs

98
Q

What happens to airways with reduced alveolar support during exhalation?

A

Airways collapse, limiting end expiratory flow rate.

99
Q

What would we expect to see with both obstructive and restrictive lung diseases?

A

Reduction in peak flow rate for different reasons

100
Q

What might we see as obstructive lung disease worsens?

A

Crazy patterns

101
Q

What is the average vital capacity?

A

1.5 liters

102
Q

How is vital capacity measured?

A

Helium dilution technique

103
Q

What is FRC?

A

Functional residual capacity

104
Q

Where is FRC located?

A

Around the vital capacity

105
Q

What does the drawing on the left indicate?

A

Passive expiration

106
Q

What does the drawing on the right represent?

A

Forced expiration

107
Q

What happens during passive expiration?

A

Diaphragm drops, pleural pressure drops, generates negative alveolar pressure

108
Q

How did pleural pressure change?

A

-8

109
Q

What was the recoil pressure of the alveolus?

A

10

110
Q

What is alveolar pressure when pleural pressure is -8 and recoil pressure is +10?

A

2

111
Q

What is the reference pressure at the entrance to the respiratory system?

A

Zero atmospheric pressure

112
Q

What delta p is required to move volume out of the lungs?

A

Two centimeters of water

113
Q

What happens to the alveolus during exhalation?

A

It gets smaller

114
Q

What happens to the recoil pressure to the alveolus during exhalation?

A

It is being reduced

115
Q

What alveolar pressure allows air to be in balance again?

A

Positive eight

116
Q

How does air move during passive expiration?

A

Air moves out of the lungs.

117
Q

What do we know about pressure gradients?

A

Not static

118
Q

Where is the pressure highest in relation to the source (alveolar elastic recoil)?

A

Closest

119
Q

What would we expect to see at a point between alveolar and mouth pressure?

A

Lower pressure gradient

120
Q

What changes in the pressure gradient might be observed in different parts of the system?

A

Illustrated changes

121
Q

Where is the beginning of the small airway located?

A

Next to the alveolus

122
Q

Why is the pressure in the small airway lower than in the alveolus?

A

Not as close to the source

123
Q

How does the pressure change as you move farther away from the alveolus in the small airway?

A

Pressure decreases

124
Q

Why is there no risk for airway collapse as we move down the respiratory tree?

A

Higher internal Airway Pressure than pleural pressure

125
Q

What is the relationship between pleural pressure and internal pressure in the airway?

A

Negative pleural pressure, positive internal pressure

126
Q

What provides support at the very beginning of the small airway?

A

Traction springs

127
Q

What keeps the airway open when internal pressure is higher than the surrounding pressure?

A

Pressure difference

128
Q

What do conducting bronchioles typically have for structural reinforcement?

A

Cartilage

129
Q

What provides structural reinforcement to resist collapse in the conducting branches of the respiratory tree?

A

Cartilage

130
Q

Why do the walls of airways become thicker as we move further up the respiratory tree?

A

To resist collapse

131
Q

What helps keep the airway open in the presence of positive external pressure?

A

Cartilage

132
Q

What is the airway structure in the small airways?

A

Soft tissue, no cartilage.

133
Q

What happens during forced expiration?

A

Strong abdominal contraction, high pleural pressure, high alveolar pressure

134
Q

How is a high alveolar pressure achieved during forced expiration?

A

Positive pleural pressure combined with positive recoil pressure

135
Q

What is the significance of an alveolar pressure of positive 35?

A

Pushes air out quickly

136
Q

What contributes to the quick air expulsion at positive 35 pressure?

A

Pleural pressure and elastic recoil

137
Q

What pressure is present at the mouthpiece in the given scenario?

A

Zero

138
Q

What is the alveolar pressure?

A

Positive 35

139
Q

What is the pressure in the small airway?

A

Positive 30

140
Q

What is the internal pressure at the edge where cartilage starts?

A

Positive 25

141
Q

Why shouldn’t the airway collapse in this scenario?

A

Pressures are the same

142
Q

What makes an airway prone to collapse?

A

Higher pleural pressure

143
Q

What happens when internal airway pressure is equal to surrounding tissue pressure?

A

No collapse

144
Q

What happens to pressures as we go up in the drawing?

A

Numbers get smaller

145
Q

What is the alveolar pressure in this scenario?

A

33

146
Q

What is the pressure in the airway when moving farther from the alveolus?

A

28

147
Q

Approximately, what is the next pressure point labeled on the graph?

A

23

148
Q

What is the pressure a little bit further away from the alveolus?

A

23

149
Q

What is the pressure before entering the reinforced cartilaginous airways?

A

23

150
Q

What happens if the pleural pressure is +25 but the internal airway pressure is +23?

A

Small airway collapse

151
Q

What results from high pleural pressure causing small airway collapse?

A

Limitation in the rate at which air can leave the lungs

152
Q

Why does the lung’s elastic recoil pressure decrease?

A

As the lung empties (reduction in lung volume)

153
Q

What is the consequence of decreased recoil pressure in the lungs?

A

Lower alveolar pressure, affecting small airway support

154
Q

What happens when there is a reduction in lung volume?

A

Decrease in elastic recoil and force expiration rate

155
Q

How does a decrease in lung volume affect tissue springiness?

A

Decrease in tissue springiness and recoil pressure

156
Q

What is prone to dynamic compression?

A

Small airway

157
Q

When does dynamic compression occur?

A

Forced expiration

158
Q

What conditions increase the likelihood of dynamic compression?

A

Lack of springs or traction, already narrow airway

159
Q

What do pulmonary function tests measure?

A

Air flow speed

160
Q

What do healthy lungs show in a pulmonary function test?

A

Fast air exit

161
Q

What does slow air exit in a pulmonary function test indicate?

A

Obstructive lung disease

162
Q

Common obstructive lung diseases seen clinically are?

A

Asthma, emphysema

163
Q

What happens to the resistance in a parallel circuit as more pathways are added?

A

The resistance decreases.

164
Q

What are the two basic setups for electrical resistances in circuits?

A

Parallel and series circuits.

165
Q

How does current flow in a parallel circuit?

A

Through one of two or more pathways.

166
Q

What are the two pathways that could lead to lower overall resistance?

A

R1 and R2

167
Q

What is the impact of setting up resistances in a series?

A

More difficult to get through

168
Q

What is the formula for total resistance in a series setup?

A

R1 + R2 = total resistance

169
Q

What is the total resistance of a series circuit with two resistors of 2 ohms each?

A

4 ohms

170
Q

What formula is used to calculate the total resistance of resistors in parallel?

A

1/R_total = 1/R1 + 1/R2

171
Q

How do we express the formula for resistors in parallel?

A

1/R_total = 1/R1 + 1/R2

172
Q

What does conductance describe?

A

How easy it is to get current through a setup

173
Q

What would happen if resistance was replaced by conductance in a mathematical formula?

A

Math would have to be flipped

174
Q

How do you calculate the total conductance of a system with parallel conductances?

A

Conductance 1 + Conductance 2 = Conductance total

175
Q

What is the relationship between conductance and resistance?

A

Conductance is the inverse of resistance.

176
Q

How do you calculate total system resistance for resistances in series?

A

Sum of individual resistances

177
Q

What happens if two items are arranged in a series back to back?

A

Harder to get current through

178
Q

How is the total system conductance calculated for items in series?

A

Using a specific expression

179
Q

What formula is used for individual resistances in a parallel pathway?

A

Reciprocal formula

180
Q

What is the relationship between conductance in a series?

A

Overall conductance lower

181
Q

How to calculate conductance of a system with two conductors in series?

A

1/Conductance total = 1/Conductor 1 + 1/Conductor 2

182
Q

What is the function of the lungs?

A

Get air into the lungs

183
Q

What force must be overcome to get air into the lungs?

A

Elastic recoil

184
Q

What can become an impediment to filling the lung with air?

A

Chest wall

185
Q

What is an obstacle when chest wall BMI is high?

A

Filling lung with air

186
Q

What are the two impediments to filling the lungs?

A

Chest wall and elastic recoil of the lung

187
Q

What is compliance a measure of?

A

How easy it is to get air into the system

188
Q

What does lung compliance refer to?

A

Ease of putting air into the lungs

189
Q

Why would the compliance of a system with two impediments be lower than each part individually?

A

Arranged in series

190
Q

What are the two components that contribute to the compliance of the overall respiratory system?

A

Chest wall compliance and lung compliance

191
Q

How is the total system compliance calculated?

A

1 over the total system compliance equals the sum of 1 over the compliance of the lung plus 1 over the compliance of the chest wall.

192
Q

What is the compliance of the lung and chest wall individually?

A

0.2

193
Q

What is the total compliance when considering both the lung and chest wall?

A

10

Anatomy exam 3 (2 decks)

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