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Patho 2 > Physiology > Flashcards

Physiology Flashcards

1
Q

Cardio pulmonary physical therapy (CPPT) assesses what?

A

the functioning of a multi-system process effecting the human body

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2
Q

The purpose of CPPT?

A

prevent, mitigate or reverse CP dysfunction

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3
Q

Any insult to the O2 transport system will cause what

A

impairments, especially to exercise tolerance

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4
Q

how is the CP system related to movement?

A

we need to breath and oxygen to move

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5
Q

what will abnormalities of the cardiovascular and pulmonary system produce?

A

limitations in physical function

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6
Q

movement must be supported by what systems?

A

musculoskeletal, neuromuscular and cardiopulmonary

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7
Q

If you cannot breath, you can’t do what?

A

Move

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8
Q

The first step in O2 transport system

A

VE

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9
Q

What is VE

A

movement of air in and out of lungs in 1 min

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10
Q

VE occurs as a result of what?

A

respiratory muscle activity

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11
Q

what is the percent of the concentration of inspired O2

A

relatively constant at 21%

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12
Q

Step 2 of the O2 transport

A

Gas Exchange

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13
Q

where does gas exchange occur?

A

between the alveoli and pulmonary capillary blood

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14
Q

Blood must have sufficient transit time in the pulmonary capillary to allow what to happen?

A

time for diffusion of gases

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15
Q

Approximately what is the time needed for CO2 to move into the alveoli and for O2 to move into capillary blood

A

0.25 s

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16
Q

alveoli that are well ventilated must also be what?

A

well perfused

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17
Q

step 3 in the O2 transport

A

oxygenated blood enters the left side of the heart

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18
Q

What is diastole

A

when blood moves into the left ventricle

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19
Q

During diastole, the myocardium is what?

A

relaxed and compliant

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20
Q

A high degree of compliance is important for what?

A

to facilitate the movement of blood into the left ventricle

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21
Q

When can compliance decrease ?

A

with myocardial ischemia and LVH

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22
Q

With conditions of decreased compliance what symptoms may occur?

A

decreased Q, dyspnea

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23
Q

Step 4 in the O2 transport

A

Q to active muscles and the skin

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24
Q

the degree of vasodilation versus constriction is controlled by ? centrally and locally

A

Centrally: SNS and locally: cellular metabolites

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25
Q

as muscles become more active, there is an increase in the local concentration of what? (3) and causes what?

A

metabolites, CO2, H+

causes vasodilation

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26
Q

An increase in temp cans facilitate what?

A

vasodilatation

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27
Q

Step 5 of the O2 transport

A

O2 carrying capacity of blood

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28
Q

Factors that alter the oxyhemoglobin dissociation curve will affect what?

A

O2 delivery to skeletal muscles

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29
Q

A shift to the left impairs what

A

the amount of O2 extracted by the muscle (carboxyhemoglobin)

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30
Q

A shift to the right facilities what?

A

the unloading of O2 from hemoglobin (acidosis and increased body temperature)

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31
Q

90% saturation of O2 is what?

A

a red flag, stop exercising, need oxygen at home

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32
Q

What is the normal % of saturation O2

A

98 99

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33
Q

100 % of saturation of O2 means?

A

all RBC. Anemia

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34
Q

step 6 of the O2 transport

A

Homeostasis of blood gases

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35
Q

What needs to be prevented to not produce changes in the VE?

A

large fluctuations in ABGs and pH

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36
Q

what systems illustrate as interdigitating gears, forming a single gas transport system that supports cellular respiration

A

musculoskeletal, respiratory, cardiovascular

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37
Q

what two systems are functionally integrated as a single gas transport system for the support of cellular respiration?

A

cardiovascular and respiratory

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38
Q

the four O2 transport pathway and its component steps?

A
  1. the delivery of fully oxygenated blood to peripheral tissues
  2. the cellular uptake of O2 from the blood
  3. the utilization of O2 in the cells
  4. the Return of partially desaturated blood to the lungs
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39
Q

Flow of air into the lungs is a result of what?

A

pressure differences between the lungs and atmosphere

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40
Q

during inspiration, alveolar press is what compared to the atm (- thoracic pressure)

A

less

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41
Q

muscular contraction of the respiratory muscles lowers what and enlarges what?

A

lowers alveolar pressure

enlarges the thorax

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42
Q

pts. who cannot create negative pressure are what?

A

mechanically ventilated

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43
Q

when does exhalation occur?

A

alveolar pressure is greater than atm (+ thoracic pressure)

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44
Q

Compliance

A

ease with which the lungs are inflated during inspiration

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45
Q

how is distensibility measured

A

change in V / Change in P

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46
Q

What does an increase in P cause

A

a decrease in compliance and the alveolus will not inflate

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47
Q

A healthy lung resists what

A

enlargement during inspiration and tried to pull away from the chest wall

48
Q

The normal lung is very what?

A

compliant

49
Q

when does the lung become rigid

A

diseases that cause alveolar, interstitial, or pleural fibrosis and alveolar edema (decrease in compliance)

50
Q

what increases compliance?

A

Emphysema and age

51
Q

What is compliance dependent on?

A

surfactant

52
Q

What is surfactant

A

a lipoprotein fluid that lines the alveoli

53
Q

Restrictive

A

breathing in through a sip straw

54
Q

Obstructive

A

blowing up a balloon

55
Q

Surfactant increases compliance by

A

lowering the surface tension of the alveolus, reducing the muscular effort to ventilate the lungs

56
Q

A decrease in surfactant causes the alveolus to

A

collapse as in respiratory distress syndrome of the infant and ARDS

57
Q

Flow of air into the lungs depends on what

A

pressure differences and the resistance to flow by the A/w

58
Q

Upper AW are responsible for what percent of RAW

A

45%

59
Q

The Raw in the lower AW depends on what?

A

many factors and is difficult to predict

60
Q

Flow through the lower AW can be either?

A

Laminar or turbulent

61
Q

Laminar flow

A

Streamlined where resistance occurs between the sides of the tubes and the air molecules

62
Q

Laminar flow occurs at what rates

A

low flow

63
Q

When does Turbulent occur?

A

when there are frequent molecular collisions- high rates, irregularities

64
Q

What can cause turbulent irregularities ?

A

mucus, exudate, tumor, other obstructions

65
Q

A normal lung has turbulent or laminar

A

Mixture of both

66
Q

The elastic properties of the lung tend to collapse the lung if there is no what?

A

counterbalanced by external forces

67
Q

Elastic recoil of the lungs is pulling in what direction

A

inward

68
Q

Elastic recoil of the lungs is balanced by what?

A

the elastic recoil of the chest wall

69
Q

Elastic recoil of the chest wall is pulling in what direction

A

outward

70
Q

if the elastic recoil forces are interrupted what occurs?

A

(pneumothorax) lung collapses and the thoracic wall expands

71
Q

Explain the barrel chest of a pt with COPD

A

elastic tension of the chest wall being unopposed by the forces of the lungs.

72
Q

which direction does the chest move with increased compliance and why

A

outwards, decrease in elastic recoil of the lungs

73
Q

Which direction does the chest move with decrease compliance and why?

A

inward, increase in elastic recoil of the lungs

74
Q

What is ventilation

A

process by which air moves in to the lungs

75
Q

difference in ventilation throughout the lungs is due to the effect of what ?

A

POSITION or gravity on the lungs

76
Q

Where is ventilation favored regardless of body position

A

lower most lung

77
Q

Where must air cross (4)

A
  • Alveolar-capillary membrane
  • Surfactant lining
  • Alveolar epithelial membrane
  • Capillary endothelial membrane
78
Q

O2 travels more then air, where else does it go, where does it stop?

A
  • layer of plasma
  • erythtocyte membrane
  • intracellular fluid in erythrocyte
  • end hemoglobin molecule
79
Q

O2 molecule passes?

A

gas, tissue and liquid

80
Q

Diffusion in a healthy lung

A

very quick

81
Q

what separates the 2 membranes

A

fluid, edema, exudate

82
Q

O2 or CO2 diffusion slower through membrane ?

A

O2

83
Q

Patients with diffusion problems have

A

hypoxemia but normal PaCO2

84
Q

diffusion disorders?

A

disorders of Connective tissue, (sarcoidosis, scleroderma, pulmonary edema)

85
Q

What is perfusion?

A

Blood flow of the pulmonary circulation available for gas exchange

86
Q

Pulmonary circulation operates at what type of pressure unlike the systematic circulation

A

low pressure

87
Q

Walls in the pulmonary circulation are?

A

thinner

88
Q

PAP should be?

A

10-20 mmHg

89
Q

Hydrostatic pressure has a side effect on what?

A

lung perfusion, lower lobes

90
Q

Hydrostatic pressure reflects the effect of what?

A

gravity on the blood

91
Q

hydrostatic pressure favors perfusion on what portions of the lungs

A

lower lung/ dependent portions

92
Q

Pull blood vessels contract in response to what?

A

low arterial pressures of O2

93
Q

What is Hypoxic vasoconstriction ?

A

protective reflex diverting blood away from under ventilated or poorly oxygenated lung areas.

94
Q

Hypoxic vasoconstriction leads to what?

A

pull hypertension

95
Q

What causes Hypoxic vasoconstriction ?

A

a low pH

96
Q

what 3 factors are dependent on the distribution of blood within the pulmonary circulation

A
  1. gravity
  2. amount of blood ejected by the right ventricle
  3. pulmonary vascular resistance
97
Q

Ventilation-perfusion ratio V/Q

A

Ventilated area of the lung need to be in contact with perfused areas of the lung to effect normal gas exchange

98
Q

Where are the areas of optimal gas exchange occur?

A

where there is the greatest amount of perfusion and ventilation

99
Q

what will change the V/Q ratio?

A

changes in position

100
Q

What is the alveolar gas flow referred as?

A

alveolar ventilation (V)

101
Q

What is the pulmonary capillary blood flow referred as?

A

pulmonary perfusion (Q)

102
Q

How much V does the lungs receive

A

4 L/min

103
Q

how much Q does the lungs receive

A

5 L/min

104
Q

what section of the lung is optimal zone for ventilation and perfusion?

A

Middle/ zone II

105
Q

Most dependent section of the lung

A

Lowest/ Zone III

106
Q

What regions acts as a Shunt

A

low ratios/ perfusion in excess of vent

107
Q

What regions acts as dead space?

A

high ratios/ vent in excess of perfusion

108
Q

shunts

A

no vent but perfusion

109
Q

dead space

A

no perfusion but vent

110
Q

Test used to rule out pulmon embolism

A

V/Q scan

111
Q

Do you treat someone who is getting a V/Q scan

A

No

112
Q

Where is there increases in vent and perfusion?

A

down the upright lung

113
Q

where do optimal V/Q ratios occur?

A

mid-lung zones

114
Q

Why do uneven vents occur?

A

uneven RAW or uneven compliance in different parts of the lung

115
Q

What are problems that have adverse effects on O2 transport? (6)

A
  • respiratory muscle dysfunction and chest wall deformities
  • V/Q mismatching
  • Diffusion abnormalities
  • Inadequate cardiac output
  • Limitations in peripheral blood flow
  • Low O2 carrying capacity

Patho 2 (1 decks)

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