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- Bloc B - Respiration > Normal Physiology 4 - Ventilation > Flashcards

Normal Physiology 4 - Ventilation Flashcards

1
Q

to what can we compare the diaphragm

A

To a piston : Descends and flattens when it contracts leading to an increase in lung volume

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2
Q

What kind of movement of the ribs do we see with the lifting of the lower chest wall created by the contraction of the diaphragm?

A

the bucket handle motion of the ribs

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3
Q

3 accessory muscles for respiration

A

scalenes, sternocleidomastoids and trapezius

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4
Q

What does the sternocleidomastoid

A

elevates sternum and clavicle

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5
Q

What does the trapezius

A

stabilizes and moves the scapula

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6
Q

What does the scalene muscles

A

elevate upper ribs

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7
Q

What is the role of the accessory muscles?

A

its a backup system for the primary respiratory muscles

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8
Q

During exercise, what helps the inspiration

A

abdominal muscles: rectus abdominis, transverse abdominis, internal/external oblique muscles

thoracic muscles: internal/innermost intercostal muscles

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9
Q

how many generations of airways in the respiratory system

A

23 generations
- first 16 act as conduits only
- after 16 generation start to have alveoli

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10
Q

what is the tidal volume, and what is the volume

A

the volume of gas inspired and expired during each normal breath, typically around 500ml at rest

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11
Q

what is the minute ventilation

A

the total volume of fresh gas drawn into the lungs each minute

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12
Q

formula for minute ventilation

A

f= normal respiratory rate environ 12-20 /minute
Vt = normal tidal volume, 350-500ml

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13
Q

what is the anatomic dead space

A

The amount of gas that never makes it past the conducting zone (about 150ml)

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14
Q

What happens if Vt is lower than Vd (dead space)

A

no exchange of air. Vt must be greater than Vd

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15
Q

What is the anatomic dead space ventilation

A

the volume of fresh gas reaching the anatomic dead space each minute

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16
Q

What is the alveolar ventilation

A

The volume of fresh gas reaching the respiratory zone each minute

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17
Q

The minute ventilation is the sum of?

A

the sum of alveolar ventilation plus dead space ventilation

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18
Q

Why is there a physiological dead space (versus anatomic dead space)

A

sometines increases in minute ventilation are not matched by increases in alveolar ventilation, so dead space appear to be increased.

The total dead space, also referred to as physiological dead space, is the volume of inspired gas that does not exchange CO2

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19
Q

2 components of physiological dead space

A

VD Physiological = VD Anatomic + VD Alveolar

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20
Q

what is partial pressure

A

the relative amounts of each gas in a mixture is reflected in its partial pressure.

Partial pressure are exerted in proportion to the number of molecules present in the mixture

21
Q

what is the water vapor pressure for body temperature (37 C)

A

47 torr or 47 mm Hg

22
Q

How can we calculate the volume of Co2 eliminated from the lungs each minute?

A

The alveolar CO2 equation, where FACO2 is the fraction of CO2:

23
Q

What is the partial pressure in the alveoli (PA) of N2? O2? Co2? H2O?

A

N2: 573
O2: 100
Co2: 40
H2O: 47

24
Q

Total atmospheric pressure at sea level

A

760 mmHg

25
Q

how are related fraction concentration of CO2 and alveolar CO2 partial pressure ?

A

They are proportionally related.

26
Q

What is a fractional concentration ?

A

the volume of CO2 eliminated from the lung each minute - VCO2

27
Q

Important formula for PACO2

A
28
Q

explain

A

The CO2 fraction pressure is proportianately related to the amount of CO2 excreted by the alveoli, and inversely related to the minute ventilation.

If you stop breathin (minute ventilation decreased drastically) the PACO2 will increased.

If you exercise and produce more CO2 (VCO2), the partial pressure will also increase (but will be readjusted by increasing the minute ventilation to make sure that the PACO2 stays within limit)

29
Q

What is the check and balance system to keep PACO2 within normal limit

A

minute ventilation is adjusted to keep PCO2 within tight limits by ensuring adequate alveolar ventilation

30
Q

So what happens if Alveolar ventilation is too low

A
  • Increased PACO2
  • Respiratory acidosis - Increased [H+] and low pH in the blood
31
Q

Why is PACO2 so related to the blood concentration of CO2

A

Because CO2 is a highly soluble gas, so basically if PACO2 increases in the alveolar, it will also increase in the blood. in fact, PACO2 = PaCO2 (arterial partial pressure)

32
Q

What happens in alveolar ventilation is too high

A
  • Decreased PACO2
  • REspiratory alkalosis : decreased [H+] and high blood pH
33
Q

What is the metabolic regulation of acid-base balance?

A

the other way the body can regulate alkalosis or acidosis (appart from the lungs)

34
Q

What is the major metabolic buffering system

A

HCO3-

35
Q

What regulates the level og HCO3- ?

A

The kidneys

36
Q

Which system can act the fastest to deal with acidosis or alkalosis?

A

The lungs - Changes in blood CO2 with ventilation is faster than the kidney

37
Q

What results in an increased of [HCO3-] ?

A

Metabolic alkalosis - increased in blood pH

38
Q

What results in a decrease of [HCO3-] ?

A

Metabolic acidosis, decreased blood pH

39
Q

difference between osis and emia

A

osis is a process and emia is blood value

40
Q

important formula for acid-base balance

A

[H+][HCO3-] = 24 x PaCO2

41
Q

what determines the pH

A

The ratio of HCO3- / PaCO2

42
Q

So how do the kidneys react with an increase of PCo2 ?

A

respiratory acidosis, kidney compensates by increasing HCO3- (to increase pH)

43
Q

And how do the lungs react to a metabolic acidosis?

A

So metabolic acidosis = a decreased of HCO3- = acidosis, so lungs want to increase pH, so decreases the partial pressure of Co2, by ventilating more

44
Q

what happens to the respiratory muscles if the tissue is non compliant?

A

they will be more solicitated

45
Q

what region of the lungs experience a bigger change in volume with the inspiration?

A

the lower region of the lung - more compliant

46
Q

2 types of respiratory failures

A

type 1: Decreased PaO2
Type 2: Increased PaCO2

47
Q

what is respiratory failure?

A

When the respiratory system is unable to keep up and cannot accomplish its job of exchanging O2 and CO2

48
Q

major categories of respiratory failures (5)

A
  1. abnormal lungs with impared gas exchange
  2. stiff lungs or stiff chest wall (low compliance)
  3. obstructed airways (high resistance)
  4. impaired muscle function
  5. suppression of respiratory drive
49
Q

how is the hyperinflation of lungs leads to inspiratory muscle dysfunction?

A

if lung volume is greatly increased, the diaphragm is flattened/shortened all the time. Muscles that are shortened do not contract efficiently

- Bloc B - Respiration (9 decks)

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