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AP + Phys > Mechanics Breathing > Flashcards

Mechanics Breathing Flashcards

1
Q

Functions of respiration

A
  1. Pulmonary ventilation
  2. Diffusion of O2 and CO2
  3. Transport of O2 and CO2
  4. Regulation of ventilation and respiration
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2
Q

External respiration

A

Mechanics of breathing
Moving gas in and out of the body
Gas transfer from lungs to tissues
Maintains body and cellular homeostasis

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3
Q

Internal respiration

A

Intracellular oxygen metabolism
Cellular transformation
Krebs cycle
Mitochondria and O2 utilization

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4
Q

Main purpose of ventilation

A

Maintain and optimal composition of alveolar gas

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5
Q

Alveolar gas

A

Acts as a stabilizing buffer between environment and pulmonary capillary blood
O2 and CO2 are constantly being diffused

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6
Q

Physiological lung structure

A

Lung weighs 1.5% of body weight
Large surface area- 70m^2, 40x the body surface area
Short diffusion pathway for gases permits rapid and efficient gas exchange, 500ml blood in lungs

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7
Q

Factors required to alter lung volumes

A

Respiratory muscles inflate and deflate
Tissue elasticity and resistance impede
Distribution of air in the lung, resistance in airway
Overcoming surface tension in alveoli

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8
Q

How are changes in alveolar pressure generated?

A

By changes in pleural pressure

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9
Q

Diaphragm & nerve innervation

A

75% of inspiratory effort
Pulls down 1cm - 10cm when forced
Pulls abdominal contents downward and forward
Prenic nerve C 3,4,5
Paradoxical movement when paralyzed- when diaphragm is enervated- causes upward movement with inspiratory drop of intrathoracic pressures

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10
Q

External intercostal & nerve innervation

A

25% of inspiratory effort
Pulls ribs upward and forward on inspiration
Intercostal nerves ventral rami T1-T11

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11
Q

Alterations to FRC

A

Increase: upright position, reverse trendelenburg, prone
Decrease: pregnancy, obesity, bowel obstruction, laparoscopic surgery, ascites, abdominal mass, trendelenburg, valsalva maneuver

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12
Q

Inspiratory accessory muscles

A

Scalene- attach cervical spine to apical rib, raise first to ribs during forced expiration
Sternocleidomastoid- attach base of skull to top of sternum, raise sternum during forced expiration

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13
Q

Expiratory accessory muscles

A

Rectus abdominus/ abdominal obliques- move diaphragm upward, intra thoracic pressure rises and forces air out
Internal intercostals- pull ribs downward and inward, decrease thoracic volume
These muscles are also used in coughing, vomiting, and defecation

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14
Q

TPP

A

Difference between alveolar pressure and pleural pressure
Alveoli collapse together when pleural pressure pulls outward
Elastic forces that collapse the lung during respiration is recoil pressure

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15
Q

Two parts of pleural membrane

A

Visceral pleura- thin serous lining of lungs
Parietal pleura- lines inner surface of chest
Pleura cavity is made of serous fluid
Pleura fluid maintains -5cmH2o pressure via lymphatic drainage, acts as a lubricant, and adherence

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16
Q

What happens if pleural pressure become positive

A

Pneumothorax
Hemothorax
Chylothorax

17
Q

FRC

A

ERV + RV
2.5L

18
Q

TLC

A

RV+ERV+TV+IRV
5.5L

19
Q

VC

A

IRV+TV+ERV
4.5L

20
Q

IC

A

TV+IRV
3L

21
Q

How can FRC and TLC be determined?

A

CANNOT be measured by spirometry

Helium dilution, nitrogen washout, or body plethysmography

22
Q

Compliance
What does it measure?

A

Change in volume / change in pressure
Measures distensibility of lungs

23
Q

Normal static compliance

A

70-100cm H2O

24
Q

Alterations in compliance

A

Increased with ages, emphysema
Decreased with with lower lung volumes, higher lung volumes, higher expansion pressure, venous congestion, alveolar edema, atelectasis, fibrosis

25
Q

Surfactant

A

A synthesized fatty acid
Lowers surface tension of alveoli
DPPC Dipalmitoyl phosphatidyl choline- hydrophobic and hydrophilic ends , alignment of intermolecular forces, opposed water self attractant elastic force, reduce surface tension greater when film compressed

26
Q

Elastic lung tissue

A

-Elastin and collagen fibers of lung parenchyma
Natural state if these fibers is contracted coils
-surface air fluid interface- 2/3 of total elastic force in lung, surface tension of h2o,

27
Q

Functions of surfactant

A

Lowers surface tension
Promotes stability of alveoli
Prevents transudation of fluid in alveoli

28
Q

Alveolar ventilation

A

70% of total ventilation
Always less than total ventilation
Alveolar O2 concentration steady state achieved when supply matches demand

29
Q

Dead space

A

Vt = Va + Vd
30%
2ml/kg

30
Q

Wasted ventilation

A

Deviation from the ideal ventilation relative to blood flow
Includes anatomical dead space PLUS any part of alveolar ventilation that is not working properly
Clot or emboli
Vt= Vt + Vd + Vad

31
Q

Airway closure

A

The base of lung during exhalation does not have all of gas compressed out
Dependent regions only intermittently ventilating leading to defective gas exchange
Closing volume= volume when small airways collapse

32
Q

Poiseulle law

A

R= 8Ln / pir4
Describes resistance to flow thru a tube (laminar flow)
Pressure increases proportional to flow rate and gas viscosity
Smaller airway radius and longer distance increase resistance
Reduce radius by 16% will double R

33
Q

Ohm’s law

A

P=FR
P pressure
F flow
R resistance

34
Q

Chief site of airway resistance

A

Major resistance is at medium sized bronchi
7th division most pressure drop
Very little resistance at small bronchioles

35
Q

Factors determining airway resistance

A

Lung volume
Bronchial smooth muscle - low co2, acetylcholine, direct stimulation, histamine, cold
Density & viscount of inspired gas - density is a bigger factor

36
Q

Work of breathing

A

W=PV
Illustrated by pressure volume curve
Oxygen consumption can be used to measure WOB
Quiet breathing - 5%
hyperventilation - 30%
High O2 cost in OLD

AP + Phys (38 decks)

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