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Respiratory Module > Physiology > Flashcards

Physiology Flashcards

1
Q

Ventilation

A

Exchange of gases between the lines and the environment outside

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2
Q

Gas exchange

A

Exchange of gas between the alveoli and the blood

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3
Q

Gas transport

A

Transport of oxygen to the tissues

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4
Q

Utilisation of gas

A

O2 is used in tissues to produce energy

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5
Q

External respiration

A

Ventilation

gas exchange

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6
Q

Internal respiration

A

Utilisation of oxygen

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7
Q

Primary function of respiration

A

Gas exchange

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8
Q

Normal arterial pressure of oxygen

A

Between 80 to 100 mm mercury

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9
Q

Normal arterial pressure of CO2

A

35-45mmHg

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10
Q

Normal PH

A

7.35 to 7.45

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11
Q

Secondary function of respiration

A

Regulation of body pH ( by changing CO2 level in blood )

Reservoir of blood (12% of total blood volume)

Immune defense function (muco ciliary escalator, IGA production , alveolar macrophages in alveoli)

Inactivation of biological substances like drugs ( Except epinephrine vasopressin angiotensin II)

Activates biological substances like angiotensin converting enzyme

Synthesis of biological substances like surfactant

Filtration of particulate matter like clots

Heat and water exchange
smell
speech
venous return

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12
Q

Saccular face of development of lung

A

Week 24 to birth where you have production of surfactants

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13
Q

alveolar stage of lung development

A

Maturation of alveoli post natal (90% of it)

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14
Q

Age at which maturation of alveolar is reached

A

6-8years old

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15
Q

Advantages of nasal breathing

A

Filtration of particulate matter

Humidification of inspired gas

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16
Q

What is the issue with endotracheal intubation

A

Bypass of nose so no humidification or filtration of air that gets into the lung

Requires additional System to humidify and filtrate the air that gets into the lung

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17
Q

Disadvantages of nasal breathing

A

Increased resistance to airflow so more chance of obstruction
Forced oral breathing ( common in children)

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18
Q

Why do you children tend to breathe a lot by mouth

A

Because they have narrower airways so increased airway resistance so more chances of congestion

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19
Q

Conducting zone in lower respiratory tract

A

From trachea to terminal bronchioles (first 16 generation)

Contain anatomical dead space (2ml/kg)

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20
Q

Main function of anatomical dead space

A

Conduction and humidification

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21
Q

transitional zone of lower respiratory tract

A

Respiratory bronchioles

alveolar ducts

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22
Q

respiratory zone

A

Alveoli

alveolar sac

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23
Q

Walls of bronchioles composed of

A

Smooth muscle

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24
Q

Characteristics of right main bronchus

A

Shorter
wider
more vertical

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25
Where do bronchial aspirates would more likely go
In the right main bronchus so right lung because it’s steeper
26
Number of segments in right lung
10 overall | 3-2-5
27
Number of segments in left lung
Nine overall | 5-4
28
Surfactant produced by
Pneumocytes type II
29
Type of cell for gas exchange
Pneumocyte type I with 90-85% of surface area
30
If pneumocyte type I gets damaged what happens
Pneumocyte type II différentiante and proliferate into type I
31
Role of surfactants
Reduce alveolar surface tension
32
Normal respiratory rate
12-20 breaths/min
33
Inspiration is an ... process | Expiration is a ... process
Active | Passive
34
Main muscle in inspiration
Diaphragm | external intercoastal
35
Accessory muscle for inspiration
Sternocleidomastoid | scalene muscle
36
When is expiration active
In respiratory disease or strenuous exercise
37
Muscle involved in active expiration
``` Internal intercoastal abdominal recti transversus abdominis external oblique internal oblique ```
38
Eupnea
Normal breathing rates
39
Tachypnea
Increased respiratory rate
40
Bradypnea
Decreased respiratory rate
41
Diaphragm innervated by
Phrenic nerve
42
Intercostal muscle innervated by
Intercostal nerves
43
In respiration meso that increase the vertical dimension of the thorax
Diaphragm ( bicycle pump handle)
44
Why is transaction of spinal cord above third cervical and segments fatal without artificial
Phrenic nerve arise from segment 3 to 5 | Will lose diaphragm innervation which can lead to respiratory difficulty
45
What happens if the abdomen becomes distended
Diaphragm is unable to move so breathing is decreased
46
External intercostal muscle contraction effect
Raise the ribs ( chest wall increases) rotation of ribs
47
Upper ribs effects and breathing
Increase the antero Posterior diameter ( water pump handle effect)
48
Lower ribs effects
Increase lateral diameter (water bucket handle effect)
49
Ventilation in neonate
More diaphragmatic
50
Negative intrapleural pressure function
Keep lungs open | presents chest wall from expanding
51
Lung recoil
Tension in wall of lungs to force it to collapse | Elastic recoil + surface tension ( major part of recoil)
52
Transpulnonary pressure equation
Alveolar pressure - intrapleural pressure
53
Relation between transpulmonary pressure and lung volume
The greater the TPP the greater the lung volume
54
Pneumothorax
Puncture in intrapleural space leading to intrapleura pressure equal atmospheric pressure No negative pressure (TPP becomes 0) so lung collapse and chest wall expend
55
Static lung volumes
Tidal volume Expiratory reserve volume Inspiratory reserve volume Residual volume
56
Lung capacities
Total lung capacity Vital capacity Inspiratory capacity Function residual capacity
57
Factors affecting lung volumes
``` Gender ( greater in males) Age ( lower in old) Height ( greater in taller people) Ethnicity ( lower in black) Altitude ( higher at higher altitude) Weight ( decrease in obesity) Posture Posture ( FRC reduced) Disease state ```
58
Measurement of lung volume
Spirometry except residual volume
59
ERV
Maximum of gas that can be forcefully expired after spontaneous expiration
60
IRV
Maximum amount of gas that can be in lahen after spontaneous inspiration
61
TV
Normal inspiration and expiration
62
RV
Volume of gas that remains in lung
63
Viral capicity
Max volume of gas exhaled after max inspiration TV + IRV + ERV
64
Change in restrictive lung disease
Reduced TLC , VC
65
Functional residual capacity
Volume of air remaining in lung after normal tidal expiration ERV + RV
66
Total lung capacity
Volume of air in lung after max inspiration | All 4 lung volumes
67
Inspiratory capacity
Maximum volume of air that can be inhaled | TV + IRV
68
FEV1 (forced expiratory volume )
Volume of air that can be expelled at 1s | FEV1/FVC <70% -> airway obstruction
69
FVC ( forced vital capacity)
Volume of air that can be expelled during max expiration
70
Lung recoil
Surface tension | Elastic forces
71
Lung compliance
Change in volume / change in pressure (TPP) Measure stretchability of the lung
72
High compliance means
Lungs are easily inflatable
73
Low compliance means
Stiff lung
74
Lung inflation curve characteristics
Does not start from 0 volume because of RV Non linear - difficult to inflate lung at start and end Inflation hysteresis - inspiratory limb different from expiratory one
75
Emphysema lung compliance
High because loss of elastic tissue for recoil
76
Lung compliance in restrictive lung diseas
Decreased because stiffness
77
Laplace law
Pressure proportional to tension | Inversely proportional to radius
78
To determine if fetal lung is mature
Lecithin: sphingomyelin ratio ( L/S) > 2:1 normal Surfactant / albumin if less than 35 it’s immature , if more than 55 mature
79
Flow relationship with radius
Flow varies as 4th power of radius
80
Pressure relationship with radius
Pressure inversely varies as 4th power of radius
81
Parasympathetic mediates
Bromchoconstriction by acetylcholine (M3 receptors )
82
Sympathetic mediated
Bronchodilaton | B2 receptors
83
Histamines mediates
H1 -> bronchoconstriction | H2-> bronchodilation
84
Characteristics of morphology of asthma
Smooth muscle hypertrophy Edema Mucus hyper secretion Epithelial damage
85
Drugs to treat asthma
``` Beta 2 agonist Anticholinergic Steroids Leukotriene receptor antagonist Cromoglicate Mucolytics ```
86
Why is Heliox given to patient with upper airflow obstruction
Lower gas density so lower resistance to air flow so better gas flow
87
Flow rate equation
Flow rate = cross sectional area x velocity of gas
88
Mixed flow pattern during inspiration and expiration
Laminar flow during inspiration ( goes from high velocity to low velocity) Turbulent flow during expiration ( goes from slow velocity to high velocity )
89
Disease with increase in anatomical dead space
Pneumonia Edema Pulmonary embolism
90
Minute ventilation
TV x respiratory rate
91
Alveolar minute volume
(TV - dead space) x RR Effective ventilation
92
Hypoventilation
Reduced alveolar minute vent. Low arterial pp of O2 High CO2 Acidosis Fast shallow breathing
93
Hyperventilation
Increased alveolar min vent High O2 Low CO2 Alkalemia Deep slow breathing
94
West three zone
Zone 1 -> no blood flow Zone 2-> medium blood flow Zone 3-> high blood flow
95
Normal ventilation perfusion ratio
0.8 | Best one is 1
96
Why tuberculosis mycobacterium stays in lung apex
Because zone of highest v/q | So higher pA O2
97
Air composition à
21% oxygen 0.03% CO2
98
Henry’s law
Gad dissolution into liquid proportional to gas partial pressure
99
How can you increase partial pressure of gas
Increase fractional concentration of gas
100
Gas diffusion goes from
Higher to lower partial pressure | b
101
Ficks law factors
Partial pressure gradient Thickness of membrane Solubility coefficient
102
Impaired diffusion interfere first with
Oxygen before CO2 because CO2 is twice more diffusible

Respiratory Module (5 decks)

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