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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
Q

Where do bronchial aspirates would more likely go

A

In the right main bronchus so right lung because it’s steeper

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26
Q

Number of segments in right lung

A

10 overall

3-2-5

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27
Q

Number of segments in left lung

A

Nine overall

5-4

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28
Q

Surfactant produced by

A

Pneumocytes type II

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29
Q

Type of cell for gas exchange

A

Pneumocyte type I with 90-85% of surface area

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30
Q

If pneumocyte type I gets damaged what happens

A

Pneumocyte type II différentiante and proliferate into type I

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31
Q

Role of surfactants

A

Reduce alveolar surface tension

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32
Q

Normal respiratory rate

A

12-20 breaths/min

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33
Q

Inspiration is an … process

Expiration is a … process

A

Active

Passive

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34
Q

Main muscle in inspiration

A

Diaphragm

external intercoastal

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35
Q

Accessory muscle for inspiration

A

Sternocleidomastoid

scalene muscle

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36
Q

When is expiration active

A

In respiratory disease or strenuous exercise

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37
Q

Muscle involved in active expiration

A 
Internal intercoastal 
abdominal recti
 transversus abdominis 
external oblique 
internal oblique
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38
Q

Eupnea

A

Normal breathing rates

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39
Q

Tachypnea

A

Increased respiratory rate

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40
Q

Bradypnea

A

Decreased respiratory rate

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41
Q

Diaphragm innervated by

A

Phrenic nerve

42
Q

Intercostal muscle innervated by

A

Intercostal nerves

43
Q

In respiration meso that increase the vertical dimension of the thorax

A

Diaphragm ( bicycle pump handle)

44
Q

Why is transaction of spinal cord above third cervical and segments fatal without artificial

A

Phrenic nerve arise from segment 3 to 5

Will lose diaphragm innervation which can lead to respiratory difficulty

45
Q

What happens if the abdomen becomes distended

A

Diaphragm is unable to move so breathing is decreased

46
Q

External intercostal muscle contraction effect

A

Raise the ribs ( chest wall increases)

rotation of ribs

47
Q

Upper ribs effects and breathing

A

Increase the antero Posterior diameter ( water pump handle effect)

48
Q

Lower ribs effects

A

Increase lateral diameter (water bucket handle effect)

49
Q

Ventilation in neonate

A

More diaphragmatic

50
Q

Negative intrapleural pressure function

A

Keep lungs open

presents chest wall from expanding

51
Q

Lung recoil

A

Tension in wall of lungs to force it to collapse

Elastic recoil + surface tension ( major part of recoil)

52
Q

Transpulnonary pressure equation

A

Alveolar pressure - intrapleural pressure

53
Q

Relation between transpulmonary pressure and lung volume

A

The greater the TPP the greater the lung volume

54
Q

Pneumothorax

A

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
Q

Static lung volumes

A

Tidal volume
Expiratory reserve volume
Inspiratory reserve volume
Residual volume

56
Q

Lung capacities

A

Total lung capacity
Vital capacity
Inspiratory capacity
Function residual capacity

57
Q

Factors affecting lung volumes

A 
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
Q

Measurement of lung volume

A

Spirometry except residual volume

59
Q

ERV

A

Maximum of gas that can be forcefully expired after spontaneous expiration

60
Q

IRV

A

Maximum amount of gas that can be in lahen after spontaneous inspiration

61
Q

TV

A

Normal inspiration and expiration

62
Q

RV

A

Volume of gas that remains in lung

63
Q

Viral capicity

A

Max volume of gas exhaled after max inspiration

TV + IRV + ERV

64
Q

Change in restrictive lung disease

A

Reduced TLC , VC

65
Q

Functional residual capacity

A

Volume of air remaining in lung after normal tidal expiration
ERV + RV

66
Q

Total lung capacity

A

Volume of air in lung after max inspiration

All 4 lung volumes

67
Q

Inspiratory capacity

A

Maximum volume of air that can be inhaled

TV + IRV

68
Q

FEV1 (forced expiratory volume )

A

Volume of air that can be expelled at 1s

FEV1/FVC <70% -> airway obstruction

69
Q

FVC ( forced vital capacity)

A

Volume of air that can be expelled during max expiration

70
Q

Lung recoil

A

Surface tension

Elastic forces

71
Q

Lung compliance

A

Change in volume / change in pressure (TPP)

Measure stretchability of the lung

72
Q

High compliance means

A

Lungs are easily inflatable

73
Q

Low compliance means

A

Stiff lung

74
Q

Lung inflation curve characteristics

A

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
Q

Emphysema lung compliance

A

High because loss of elastic tissue for recoil

76
Q

Lung compliance in restrictive lung diseas

A

Decreased because stiffness

77
Q

Laplace law

A

Pressure proportional to tension

Inversely proportional to radius

78
Q

To determine if fetal lung is mature

A

Lecithin: sphingomyelin ratio ( L/S) > 2:1 normal

Surfactant / albumin if less than 35 it’s immature , if more than 55 mature

79
Q

Flow relationship with radius

A

Flow varies as 4th power of radius

80
Q

Pressure relationship with radius

A

Pressure inversely varies as 4th power of radius

81
Q

Parasympathetic mediates

A

Bromchoconstriction by acetylcholine (M3 receptors )

82
Q

Sympathetic mediated

A

Bronchodilaton

B2 receptors

83
Q

Histamines mediates

A

H1 -> bronchoconstriction

H2-> bronchodilation

84
Q

Characteristics of morphology of asthma

A

Smooth muscle hypertrophy
Edema
Mucus hyper secretion
Epithelial damage

85
Q

Drugs to treat asthma

A 
Beta 2 agonist 
Anticholinergic 
Steroids
Leukotriene receptor antagonist 
Cromoglicate 
Mucolytics
86
Q

Why is Heliox given to patient with upper airflow obstruction

A

Lower gas density so lower resistance to air flow so better gas flow

87
Q

Flow rate equation

A

Flow rate = cross sectional area x velocity of gas

88
Q

Mixed flow pattern during inspiration and expiration

A

Laminar flow during inspiration ( goes from high velocity to low velocity)

Turbulent flow during expiration ( goes from slow velocity to high velocity )

89
Q

Disease with increase in anatomical dead space

A

Pneumonia
Edema
Pulmonary embolism

90
Q

Minute ventilation

A

TV x respiratory rate

91
Q

Alveolar minute volume

A

(TV - dead space) x RR

Effective ventilation

92
Q

Hypoventilation

A

Reduced alveolar minute vent.
Low arterial pp of O2
High CO2
Acidosis

Fast shallow breathing

93
Q

Hyperventilation

A

Increased alveolar min vent

High O2
Low CO2
Alkalemia

Deep slow breathing

94
Q

West three zone

A

Zone 1 -> no blood flow

Zone 2-> medium blood flow

Zone 3-> high blood flow

95
Q

Normal ventilation perfusion ratio

A

0.8

Best one is 1

96
Q

Why tuberculosis mycobacterium stays in lung apex

A

Because zone of highest v/q

So higher pA O2

97
Q

Air composition à

A

21% oxygen

0.03% CO2

98
Q

Henry’s law

A

Gad dissolution into liquid proportional to gas partial pressure

99
Q

How can you increase partial pressure of gas

A

Increase fractional concentration of gas

100
Q

Gas diffusion goes from

A

Higher to lower partial pressure

b

101
Q

Ficks law factors

A

Partial pressure gradient
Thickness of membrane
Solubility coefficient

102
Q

Impaired diffusion interfere first with

A

Oxygen before CO2 because CO2 is twice more diffusible

Respiratory Module (5 decks)

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