Mechanics of breathing Flashcards

1
Q

What are the accessory muscles for deep inhalation?

A

Sternocleidomastoid
Scalenes
Pectoralis minor

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2
Q

What are the muscles used during deep exhalation?

A

Abdominal muscles
Internal intercostals

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3
Q

What is Boyle’s law?

A

Pressure exerted by a gas in a closed container is inversely proportional to the volume of the container at a constant temperature

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4
Q

What is the normal range of the intrapleural pressure?

A

-3 to -5 cm of H20

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5
Q

What is transpulmonary pressure?

A

The difference between alveolar pressure and intrapleural pressure

Pt = Pa - Pi

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6
Q

What are the pressure changes during no breathing?

A

Intrapulmonary pressure is equal to atm
Intrapleural pressure is less than atm

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7
Q

What are the pressure changes during normal inhalation?

A

Intrapulmonary pressure decreases to -1
Intrapleural pressure drops to -6

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8
Q

What are the pressure changes during normal expiration?

A

Intrapulmonary pressure increases to +1
Intrapleural pressure increases to -4

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9
Q

What is the typical tidal volume?

A

~ 500 mL

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10
Q

What happens to transmural pressure during inspiration?

A

Difference increases, becoming more positive

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11
Q

What is positive pressure breathing?

A

Air can be forced into the lung by raising the pressure at the nose

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12
Q

What are the two methods for air to move into the lung?

A

Negative pressure breathing
Positive pressure breathing

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13
Q

What are indications for mechanical ventilation?

A

Poor oxygenation
Raised CO2 level
Increased work of breathing

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14
Q

What is the purpose of PEEP and what does it stand for?

A

Prevent alveolar collapse at the end of expiration

Positive end-expiratory pressure

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15
Q

What are factors contributing to the mechanics of respiration?

A

Lung compliance
Surface tension of alveolar fluid - surfactant
Airway resistance

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16
Q

What is the equation for compliance?

A

C = deltaV/deltaP

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17
Q

What is the normal compliance of both the isolated lungs?

A

200 mL of air/cm of H2O

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18
Q

What is represented by the slop of a pressure volume curve?

A

Compliance

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19
Q

What is the reciprocal of compliance?

A

Elastance

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20
Q

What are the two components of lung recoil?

A

Collagen and elastic fibers of the tissue
Surface tension forces

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21
Q

What factors cause the stability of the alveoli?

A

Surfactant
Alveolar interdependence

22
Q

What can be assessed by the L/S ratio in amniotic fluid?

A

Fetal lung maturity

23
Q

At what L/S ratio is the lung mature?

A

> 2

24
Q

What is the forced vital capacity?

A

Maximal volume attained on forced expiration beginning at TLC

25
Q

What is the FEV1?

A

Forced expiratory volume in the first second

26
Q

What is the FRC?

A

Functional residual capacity
Amount of air left in lungs after normal expiration

27
Q

What is the ERV?

A

Expiratory reserve volume
Amount that remains in lungs above the RV after quiet expiration

ERV = FRC - RV

28
Q

What is the IRV?

A

Inspiratory reserve volume
Amount of air that can be inspired above the tidal volume

29
Q

What is the IC?

A

Inspiratory capacity or inspiratory vital capacity
Maximal volume of air inhaled above FRC

30
Q

What is DLCO?

A

Diffusion capacity of CO
Measures the uptake of CO as surrogate for capillary beds

31
Q

What is the pressure relationship at FRC?

A

Balance between inward elastic recoil of lung and outward elastic recoil of chest wall

32
Q

What is the pressure relationship above FRC?

A

Overall pressure is positive

33
Q

What is the pressure relationship below FRC?

A

Overall pressure is negative

34
Q

What makes up non-elastic resistance?

A

Pulmonary tissue resistance
Airway resistance due to friction between gas molecules and airway walls

35
Q

What is the major site of airway resistance?

A

Medium-sized bronchi

36
Q

What is the general equation for airflow?

A

Flow(Q) = deltaP/R

37
Q

What is the equation for resistance using Poiseuille’s law?

A

R = (8 x eta x l)/(pi x r^4)

38
Q

What is the equation for airflow using Poiseuille’s law?

A

Flow = (deltaP x r^4 x pi)/(8 x eta x l)

39
Q

What is the equation for Reynold’s number?

A

Rn = (rho x Ve x D)/eta

rho = density
eta = viscosity

40
Q

At what value does airflow change from laminar to turbulent?

A

Rn > 2000

41
Q

What is the effect of SyNS stimulation on bronchial smooth muscle?

A

Bronchodilation

42
Q

What is the effect of PsNS stimulation on bronchial smooth muscle?

A

Bronchoconstriction

43
Q

What factors affect airway resistance?

A

Lung volume
Bronchial smooth muscle tone
Density and viscosity of inspired gas
Chemicals and other irritants

44
Q

What happens to the equal pressure point during expiration and why?

A

It moves deeper into the lung as expiration progresses because of increased resistance

45
Q

What is the pressure gradient for airflow during normal expiration?

A

Difference between alveolar pressure and atmospheric pressure

46
Q

What is the pressure gradient for airflow during forced expiration?

A

Between alveolar pressure and intrapleural pressure

47
Q

Why does alveolar elastic recoil pressure oppose dynamic compression?

A

Radial traction

48
Q

What is the equation for work?

A

W = Pt x deltaV

49
Q

What is airway resistance work?

A

Work required to overcome the resistance to airflow through the respiratory passage

50
Q

What is tissue resistance work?

A

Work required to overcome the resistance of the lungs and chest wall structures to change in shape because of molecular cohesion

51
Q

Why do patients with emphysema breath with pursed lips?

A

Moves site of main airway resistance closer to the mouth, keeping airways patent by extending time airway pressure remains high