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Cardiorespiratory PBL > PBL 4 > Flashcards

PBL 4 Flashcards

1
Q

tidal volume

A

this is the lung volume representing the volume of air that is inhaled and exhaled in one breath measured at rest

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2
Q

inspiratory reserve volume

A

this is the maximal amount of additional air that can be drawn into the lungs by determine effort after normal inspiration

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3
Q

expiratory reserve volume

A

this is the maximal amount of addiiotnal air that can be expired from the lungs by determined effort after normal expiration

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4
Q

inspiratory capacity

A

this is the amount of air that can be inhaled after the end of a normal expiration

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5
Q

vital capacity

A

this is the maximum amount of air that can be inhaled or exhaled during a respiratory cycle, it is the sum of the expiratory reserve volume, tidal volume and inspiratory reserve volume

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6
Q

minute ventilation

A

this is the volume or air inhaled or exhaled from a persons lungs per minute

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7
Q

pneumatoachograph

A

technology that makes an accurate linear and reliable type of flow measurement spirometer

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8
Q

FEV1

A

this is how much air you can force from your lungs in one second, lower FEV-1 indicates more significant obstruction

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9
Q

FVC

A

this is the largest amount of air that you can forcefully exhale after breathing in as deeply as you can, a lower than normal FVC reading indicates restricted breathing

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10
Q

describe the anatomy of the lung

A

Right lung is split into 3 lobes, these are the superior, middle and inferior lobe
The left lung is split into 2 lobes this is because it has the heart near it
The right lung as an oblique fissure and a horizontal fissure whereas the left lung only has an oblique fissure
The left lung has a cardiac notch and T4 which goes over the heart and makes room for the heart
There is an apex and a base, apex begins 2cm above the clavicle
The lung as a pleura layer around it this is called the serous membrane , this divides into the parietal and the visceral layer, the parietal is the outer layer and is attached to the chest wall while the visceral inner layer is attached to the lungs itself
There is a gap between the parietal and visceral layer and this contains fluid that allows the lungs to expand
Pneumothorax can occur when air gets between these two layers
There are 3 zones in each lung, when looking at a clinical diagnosis you assess the function of each zone
- 23 bronchopulmonary zones

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11
Q

Describe mechanism of inspiration

A
  • Diaphragm contracts and flattens
  • The external intercostal muscles contract
  • Internal intercostal muscles relax
  • Pulls ribcage up and out
  • The volume of the thoracic cavity increases
  • Air pressure decreases in the thoracic cavity below the atmospheric pressure
  • Air moves down the pressure gradient from outside the body to the lungs via the nostrils
  • Alveolar sacs fill up with air and cause the inflation of lungs
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12
Q

Describe mechanism of expiration

A
  • Diaphragm relaxes and becomes dome shaped
  • The internal intercostal muscles contract
  • The external intercostal muscles relax
  • Ribcage moves in and down
  • This decreases the volume in thoracic cavity
  • The air pressure in the cavity is larger than outside the body
  • Air leaves the lungs down its pressure gradient into the atmosphere
  • The lungs deflate
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13
Q

what is spirometer and how is it used from a clinical perspective

A
  • Spirometry is a simple test used to diagnose and monitor lung conditions by measuring how much air you can breathe out and in in one forced breath
  • Main equipment used for basic pulmonary function tests
  • Used to find the cause of shortness of breath
  • Carried out on a spirometer which is a small machine that is attached by a cable to a mouthpiece
  • During the test – soft clip placed on nose to stop air escaping from it, inhale fully so lungs are completely filled with air, close lips tightly around the mouthpiece and then exhale quickly and forcefully making sure you empty lungs fully
  • Spirometry can be used to diagnose – asthma, COPD, cystic fibrosis, pulmonary fibrosis
  • It can detect abnormality in lung function even when there are no signs or symptoms present
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14
Q

what can spirometers be used to diagnose

A

asthma,
COPD,
cystic fibrosis,
pulmonary fibrosis

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15
Q

what does the result of spirometers tell us about

A
  • changes in lung volume
  • changes in airflow
  • Measures include the forced vital capacity (FVC) and forced expiratory volume (FEV)
  • FVC – this is the largest amount of air that you can forcefully exhale after breathing in as deeply as you can, a lower than normal FVC reading indicates restricted breathing
  • FEV – this is how much air you can force from your lungs in one second, lower FEV-1 indicates more significant obstruction
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16
Q

what are the effects of smoking

A
  • Makes your blood thicker and increases chance of clot formation
  • Increases blood pressure and heart rate making the heart work harder than normal
  • Narrows the arteries reducing the amount of oxygen rich blood circulating to the organs
  • Increase risk of heart attack or stroke
17
Q

what are the effects of smoking on the lungs

A
  • Lungs are affected badly by smoking
  • Coughs, colds, wheezing and asthma are just the start
  • Can cause fatal diseases such as pneumonia, emphysema and lung cancer
  • 84% of deaths of lung cancer are due to smoking
  • 83% if deaths of COPD is due to cancer
  • COPD – collection of lung diseases including chronic bronchitis and emphysema, people with COPD have difficulties breathing due to the narrowing of the airways and destruction of lung tissue
  • Symptoms of COPD include increasing breathlessness when active, phlegm and frequent chest infections
18
Q

what happens after you stop smoking

A

20 minutes - pulse rate is normal
8 hours - Nicotine and carbon monoxide levels in blood reduce by more than half and oxygen levels return to normal.
48 hours - Carbon monoxide is eliminated from the body
Lungs start to clear out mucus and other smoking debris
No nicotine in the body and the ability to taste and smell is improved

72 hours- Breathing becomes easier, bronchial tubes begin to relax and energy levels increase
2-12 weeks - circulation improves
3-9 months - Coughs, wheezing and breathing problems improve as lung function increases by up to 10%
1 year - Risk of heart disease is about half compared with a person who is still smoking
10 years - Risk of lung cancer falls to half that of a smoker
15 years - Risk of heart attack falls to the same as someone who has never smoked

19
Q

what does smoking do to the lungs

A

Promote goblet cell growth

Paralyzes the cilia lining the bronchi & bronchioles

Carcinogen cannot be removed from the lungs

This can lead to: Emphysema, Increased mucus,
Decreased flow rate, Obstructive lung disease,
Bronchospasm

20
Q

how does nictoine act as a stimulant

A

Dopamine release → addiction → craving to reach same dose of dopamine

21
Q

smoking an alveolar macrophages

A

smoking activates alveolar macrophages, and this leads to activation of neutrophils and protease (serine elastase) is released

22
Q

what is alpha 1 antityrpsin

A
  • this is a protease that inhibits the action of serine elastase
23
Q

what does alpha-1-antityrpsin do

A

Protective role acting to reduce the breakdown of
elastin by elastase in lung tissue

Deficiency (=similar effect to smoking): pulmonary
emphysema

24
Q

how do you work out minute ventilation

A

tidal volume and respiratory rate

25
Q

how do you work out vital capacity

A

tidal volume + inspiratory reserve volume + expiratory reserve volume

26
Q

where is the major site of airway resistance

A

small bronchi and bronchioles

27
Q

what are obstructive disorders

A
  • reduction in airflow
  • shortness of breath in exhaling lungs as the air remains inside the lungs after full expiration
  1. COPD
  2. ASTHMA
  3. BRONCHIECTASSI
28
Q

what are restrictive disorders

A
  • a reduction in lung volume
  • difficulty taking in air inside the lungs
  • due tot stiffness inside the lung tissue or chest wall cavity
  1. intestitial lung disease
  2. scoliosis
  3. neuromuscular cause
  4. marked obesity
29
Q

what is the FEV1 and FVC ratio in obstructive and restrictive disorder

A

obstructive - FEV1/FVC is reduced

restrictive - FEV1/FVC normal or increased

30
Q

what does peak flow measurement assess

A
  • airway resistance

- maximum flow rate during forced respiration

Cardiorespiratory PBL (5 decks)

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