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Physio > Physio Midterm > Flashcards

Physio Midterm Flashcards

1
Q

What are the 4 major aspects of respiration?

A

ventilation, gas exchange, blood transport of oxygen and carbon dioxide to and from the cells of the body, and the regulation of respiration.

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2
Q

Accessory muscles of forceful inspiration are?

A

External intercostals, Sternocleidomastoid, serratus anterior, Scalene.

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3
Q

Accessory muscles of forceful expiration?

A

internal intercostals and rectus abdominis

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4
Q

What is pleural pressure? Also, what happens to it during inspiration and expiration?

A

Pleural pressure is the space around the lungs. It drops from -5 to -7 during inspiration. During expiration, it goes from -7 to -5.

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5
Q

What happens to alveolar pressure during inspiration and expiration?

A

During inspiration, the pressure is 0 and goes to -1, and then goes back to 0. During expiration, it goes from 0 to 1, and then back to 0.

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6
Q

What is transpulmonary pressure?

A

The difference between pleural and alveolar pressure.

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7
Q

What creates constant negative pleural pressure?

A

The constant suctioning/pumping of the lymphatic system.

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8
Q

measure of lung volume increase per 1cm of water increase in transpulmonary pressure is called?

A

compliance

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9
Q

During inspiration, pleural pressure decreases from resting -5cm of water to -7.5 cm of water, which allows alveolar volume to increase enough to let _____ of air in

A

0.5 L

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10
Q

Total compliance of LUNGS ONLY in a healthy adult is _____ of air per 1cm of water increase in transpulmonary pressure.
About twice as low in vivo due to resistance of thoracic cage- ____ of air per 1cm of water. This only applies to mid-range of inspiratory movement

A

200 mL; 110 mL

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11
Q

At extreme inspiration or expiration, compliance drops to about ___ per 1cm of water increase in pressure.

A

20 mL

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12
Q

_______________are main contributors to decreased compliance

A

limitations of chest wall

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13
Q

Recoil forces of the lungs consist of two major components, which are:

A

elastic forces of alveolar walls (elastin and collagen fibers, and they represent about 1/3 of the total elastic recoil forces of the lungs) and surfactant (same forces that keep water liquid – polar molecules remain attracted to each other, water molecules on the surface of water are espessially strongly attracted to each other, represent about 2/3 of total elastic recoil force of the lungs.)

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14
Q

What is surfactant made out of?

A

phospholipids, calcium ions and proteins

Main constituent = dipalmitoylphosphatidylcholine

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15
Q

Note that the smaller the radius, the stronger the recoil forces
Clinical correlation – small babies have lungs more prone to recoil- What else is wrong with premature babies that causes lung collapse? (resp. distress syndrome of newborn)

A

Premature babies have little to no surfactant

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16
Q

What is tidal volume – Vt? What is the average amount in an average adult male?

A

volume that gets inspired and expired with each breath-(500mL in average adult male)

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17
Q

What is inspiratory reserve volume – IRV? What is it in average adult male?

A

Volume that can be inspired with full force and involvement of accessory muscles above normal tidal volume. Usually 3000mL in average adult male.

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18
Q

What is Inspiratory capacity – IC? What is it in average adult male?

A

maximum volume that can be inspired from neutral position = tidal volume + inspiratory reserve volume = 3500mL in average adult male (IC = Vt + IRV)

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19
Q

What is expiratory reserve volume – ERV? What is it i average adult male?

A

volume that can be forcefully expired with full force after the end of normal expiratory activity. Usually, 1100mL in average adult male.

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20
Q

What is residual volume – RV? Average amount?

A

e. volume of lungs at the end of complete forceful expiration = 1200mL

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21
Q

What is functional residual capacity – FRC?

A

volume of lungs at the end of normal expiration = expiratory reserve volume + residual volume = 2300mL (FRC = ERV + RV)

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22
Q

What is vital capacity?

A

maximum volume of air that can be expelled between full inspiration and full expiration = Inspiratory capacity + expiratory reserve volume = 4600mL (VC = IC + ERV = Vt +IRV+ERV)

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23
Q

What is total lung capacity?

A

maximum volume of lungs at the end of forceful inspiration = Vital capacity + residual volume = 5800mL. (TLC = VC + RV= IC + ERV + RV = IC + FRC)

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24
Q

What is dead space ? How many mL is it usually?

A

Vd - volume of the upper respiratory tract, starting with nasal cavity and ending in bronchioles. Names so due to no gas exchange in the area. Usually comprises 150 mL.

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25
Q

What is minute resp. volume?

A

for normal respiration is volume moving in and out of the lungs in one minute. MRV = VtXRR, where RR = respiratory rate. Vt~500mL,RR~ 12breaths/minute => MRV = 6000mL/min or 6L/min

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26
Q

What is alveolar ventilation rate?

A

volume participating in gas exchange in one minute Ů =(Vt-Vd)XRR = 450X12 = 4200mL/min

27
Q

What is the nose’s surface area and what is it’s function?

A

Surface area of 160cm2 and acts as a “climate control”.

28
Q

What else does the nose do?

A

Warms passing air (blood vessels are very close to the surface of the nasal mucosa). Humidifies passing air (nasal mucosa produces secretion moisturizing the passing air). Filters particles from the passing air (multiple conchae, turbinates, pharyngeal wall etc cause flowing air to change direction abruptly causing heavier than air particles to precipitate on the mucosal surfaces).

29
Q

Particles greater than ____ will not reach the trachea.

A

6 micrometers

30
Q

Particles between 1-5 micrometers will settle in the…..

A

terminal brochioles (coal minor disease)

31
Q

Particles between 0.5 and 1 micrometers will adhere to…..

A

Alveolar walls. The rest remain suspended in the air and are eventually exhaled.

32
Q

What prevents significant lung crusting and infections?

A

The nose; also, contribution of the nasal passages becomes obvious in situations when tracheostomy is necessary.

33
Q

What keeps the trachea open? What is the ring circumference extension?

A

cartilage rings, rings extend 5/6th of the total circumpherence of trachea

34
Q

What is responsible for most of the resistance to air flow during normal quiet respiration?

A

bronchi

35
Q

What are bronchi covered by curved cartilage plates that are spaced away from each other?

A

to allow for both openness and flexibility capable of accommodating lung movements.

36
Q

What muscle do bronchioles have and what is their diameter?

A

Small, diameter under 1.5 mm and no cartilaginous support, only smooth muscles.

37
Q

Over 65,000 parallel small bronchioles provide for low resistance to air flow under normal quiet respiration. True or False?

A

TRUE!

38
Q

What can obstruct the bronchioles?

A

mucus plugs

39
Q

What leads to constriction in the bronchiole smooth muscle?

A

Parasympathetic innervations via Vagus nerve is acetylcholine based and leads to constriction. Local factors of anaphylaxis and histamine bring about bronchiole constriction, too. Smoking, acidic components of the smog, sulfur dioxide and many other substances can facilitate non-nervous reaction of bronchiole constriction.

40
Q

Weak direct sympathetic stimulation can oppose parasympathetic constriction.
What neurotransmitter are bronchioles sensitive to in sympathetic NS?

A

Bronchioles are very sensitive to epinephrine produced by adrenal medulla via beta-adrenergic receptors – basis for epinephrine administration if anaphylaxis develops.

41
Q

Cough and Sneeze reflexes-In both cases, first rapid inhalation of ____ Liters of air happens

A

2.5 L; Then, epiglottis closes tightly and abdominal muscles constrict to bring pressure in the lungs to 100mmHg

42
Q

After epiglottis closes tightly during a cough reflex…

A

the vocal cords and epiglottis widely open suddenly and air explodes through trachea and mouth.

43
Q

After epiglottis closes tightly during a sneeze reflex…

A

similar to cough, but uvula gets depressed allowing for a larger portion of the air to escape through nasal passages

44
Q

What does the high pressure low flow systemic circulation supply from the bronchial arteries? What is the pressure almost level to?

A

It supplies the: trachea, bronchi down to

terminal bronchioles, and the outer coats of large pulmonary vessels. The pressure is almost level to the aorta.

45
Q

Low pressure, high flow circulation comes from the pulmonary arteries and brings…

A

blood to the alveoli for gas exchange

46
Q

How thin is the wall of the pulmonary artery?

A

thin- about 1/3 of aortic wall

47
Q

Where does the pulmonary artery go and what are the branches like?

A

Rises 5cm above the apex of right ventricle and branches off. Branches are
very short.

48
Q

Main pulmonary artery and all its branches have ______ diameter than systemic.
Distensible, with compliance of _________mL/1mmHg.
Pulmonary veins also short.

A

larger; 7mL/1mmHg

49
Q

What are the systolic and diastolic pressures of the right ventricle?

A

Systolic pressure up to 25mmHg, Diastolic – 0-1mmHg.

50
Q

What are the systolic and diastolic pressures of the pulmonary arteries?

A

Systolic up to 25mmHg. Diastolic about 8mmHg.

51
Q

What is the pressure in the pulmonary capillaries?

A

averages around 7mmHg

52
Q

What is the pressure in the pulmonary veins and left atrium?

A

averages at 2 mmHg

53
Q

What is the blood volume in the lungs?

A

450 mL- 10% of blood

54
Q

What volume of blood is in the capillaries?

A

70 mL

55
Q

The blood volume in the lungs can range between what? What pathologies go along with these extremes?

A

230 mL and 900 mL- you see this in left sided heart failure and more with mitral valve stenosis or regurgitation– dumping of blood in pulmonary circulation. Also, less with blowing very hard.

56
Q

What is the mediating substance that vasoconstricts the blood vessel through poorly oxygenated alveoli?

A

It is unknown!

57
Q

How long are the lungs? Also, what is the pressure in them above and below the heart?

A

Lungs are about 30 cm long. The lungs correspond to 23 mmHg. 15 mmHg above the heart, and 8 mmHg below. This creates a significant difference in flow.

58
Q

What is zone 1 of flow in the lungs?

A

No flow, alveoli pressure always higher. Zone 1 happens under special conditions.
Severe blood loss and upright position,
Breathing against positive pressure,
Right sided heart failure.

59
Q

What is zone 2 of flow in lungs?

A

Intermittent flow during cardiac cycle. Normally, apexes at Zone 2.
Systolic pressure of 25mmHg results in 10mmHg in apexes, while diastolic 8mmHg brings apical pressure to 0, no flow.

60
Q

What is zone 3 of flow in lungs?

A

Continuous flow!

61
Q

Blood flow to the lungs can increase 4 to 7 fold. By what three mechanisms can this be achieved?

A

Increased distensibility of capillaries. Increased number of capillaries. Increase in pulmonary artery pressure (not very dramatic).

62
Q

What is the pressure in the left atrium in a healthy person?

A

No more than 6 mmHg. Up to 8mmHg it does not increase pulmonary artery pressure. Above 8mmHg, increase in pulmonary capillary and pulmonary artery pressure is almost same as increase in left atrium pressure.

63
Q

When left atrial pressure is above 30 mmHg, what could happen? What about 40-50 mmHg?

A

pulmonary edema-30 mmHg and left side heart failure- 40-50 mmHg

Physio (11 decks)

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