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Pulmonary > Physiology > Flashcards

Physiology Flashcards

1
Q

Tidal Volume

A

Amount of gas inspired and expired with each breath

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2
Q

Inspiratory Reserve Volume

A

Maximum amount of additional air that can be inspired from the end of a normal inspiration

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3
Q

Expiratory Reserve Volume

A

Maximum volume of additional air that can be inspired from the end of a normal expiration

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4
Q

Residual Volume

A

Volume of air remaining in the lung after a maximal expiration

(ONLY lung volume that cannot be measured w/ spirometry)

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5
Q

Total Lung Capacity

A

Volume of air contained in the lungs at the end of a maximal inspiration

TLC=RV+IRV+TV+ERV

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6
Q

Vital Capacity

A

Maximum volume of air that can be forcefully expelled from the lungs following a maximal inspiration

VC=IRV+TV+ERV

or

VC=TLC-RV

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7
Q

Functional Residual Capacity

A

Volume of air remaining in the lung at the end of a normal expiration

FRC=RV+ERV

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8
Q

Inspiratory Capacity

A

Maximum volume of air that can be inspired from end expiratory position

IC=TV+IRV

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9
Q

How can residual volume be measured?

A
  1. Gas Dilution Techniques
    1. Nitrogen Washout
      1. Poorly ventilated or non-ventilated areas not included in FRC
    2. Helium Dilution
      1. Poorly ventilated or non-ventilated areas not included in FRC
  2. Body Plethysmography
    1. Non-ventilated areas ARE included in FRC
  3. Radiographic Determination
    1. Non-ventilated areas ARE included in FRC
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10
Q

Obstructive Diseases

A
  • Emphysema
  • Chronic Bronchitis
  • Asthma

Decrease VC

Increase TLC, RV, FRC

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11
Q

Restrictive Diseases

A
  • Fibrosis
  • Sarcoidosis
  • Muscular Diseases
  • Chestwall Deformities

Decreased VC

Decreased TLC, RV, FRC

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12
Q

Pulmonary factors that can reduce vital capacity?

A
  • Absolute reduction in distensible lung tissue
    • Pneumonectomy
    • Atelectasis
  • Increase Stiffness of Lungs
    • Alveolar Edema
    • Respiratory Distress Syndrome
    • Infiltrative Interstitial Lung Disease
  • Increased Residual Volume
    • Emphysema
    • Asthma
    • Lung Cysts
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13
Q

Extrapulmonary factors that can reduce vital capacity?

A
  • Limited Thoracic Expansion
    • Kyphoscoliosis
    • Pleural Fibrosis
  • Limitations on Diaphragmatic Descent
    • Ascites
    • Pregnancy
  • Nerve or Muscle Dysfunction
    • Pain from surgery or rib fracture
    • Primary Neuromuscular Disease (Guillain-Barre Syndrome)
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14
Q

Minute Ventilation

A

= VT * f

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15
Q

Alveolar Ventilation

A
  • = VE - Vd = (VT - Vd)f = VTf - Vdf
  • If tidal volume increases alveolar ventilation increases but dead space ventilation is unchanged
  • Respiratory frequency increases both alveolar ventilation and dead space ventilation and thus is less effecient at increasing alveolar ventilation
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16
Q

Factors Determining Alveolar PCO2

A
  • Increased carbon dioxide production increases alveolar PCO2
  • Increased alveolar ventilation will dilute alveolar PCO2
  • PACO2 = (VCO2/VA) * 863 mmHg
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17
Q

Factors that Increase VCO2

A
  • Exercise
  • Fever
  • Hyperthyroidism
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18
Q

Factors Determining PO2

A
  • Increased metabolic activity increases oxygen uptake and decreases alveolar PO2
  • Increased alveolar ventilation increases flow of fresh air through alveoli and increases PO2
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19
Q

Alveolar Gas Equation

A

PAO2 = PIO2 - (PACO2/R)

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20
Q

A-a Difference

A
  • PAO2 is normally 5-20 mmHg greater than the PaO2
  • Increases w/ pulmonary disease
  • Normal range changes when breathing 100% O2
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21
Q

a/A PO2 Ratio

A
  • Normally averages just over 0.8
  • Ratio falls w/ pulmonary disease
  • Remains fairly constant w/ supplemental oxygen
22
Q

When calculating venous admixture, what can be used to estimate the end-capillary PcO2?

A

PAO2

23
Q

Bohr Equation for Physiological Dead Space

A

(Vd/VT) = (PaCO2 - PECO2)/PaCO2

24
Q

Right Atrial Pressure

A

Near 0 mmHg

25
Q

Right Ventricle

A

Systolic = 25 mmHg

Diastolic = 0 mmHg

26
Q

Pulmonary Artery

A

Mean = 15 mmHg

Systolic = 25 mmHg

Diastolic = 8 mmHg

27
Q

Site of Major Pressure Drop in Pulmonary Circulation

A

Capillaries

28
Q

Site of Major Pressure Drop in Systemic Circulation

A

Arterioles

29
Q

Site of Greatest Pulmonary Vascular Resistance

A

Pulmonary Capillaries

30
Q

What causes collapsing of of alveolar vessels?

A
  • Expansion of extra-alveolar vessels
  • Stretching of alveolar walls
31
Q

Hypoxic Vasoconstriction

A
  • Begins when PAO2 falls below 60
  • Beneficial in that blood flow goes to ventilated areas where gas exchange can occur
32
Q

Substances that contract pulmonary vascular smooth muscle?

A
  • Serotonin
  • Histamine
  • Norepinephrine
33
Q

Substances that relax pulmonary vascular smooth muscle?

A
  • Prostaglandins
  • Leukotrienes
  • Isoproterenol
  • Acetylcholine
34
Q

Fick Equation

A

Q = VO2/(CaO2 - CvO2)

  • Calculations will end up in dl/min
35
Q

Zone 1 of the lung?

A

PALV > PPA > PPV

NO Flow, Completely Collapsed

Not normally found in man, but may occur w/ hemorrhage or during positive pressure ventilation

36
Q

Zone 2 of the lung?

A

PPA > PALV > PPV

Partial Collapse

37
Q

Zone 3 of the lung?

A

PPA > PPV > PALV

Blood Vessels Fully Open

38
Q

L to R Shunt

A

Systemic arterial blood (oxygenated) which contaminates pulmonary arterial blood (deoxygenated)

39
Q

Venous Admixture

A
  • Physiological R to L Shunt
  • Occurs when deoxygenated blood contaminates normally oxygenated blood
  • Two factors that determine the effect of R to L Shunt
    • Amount of deoxygenated blood that is added
    • Saturation and thus the O2 content of the shunted blood
  • = (CcO2 - CaO2) / (CcO2 - CvO2)
    • PcO2 = PAO2
    • CcO2 = 1.36 * [Hb] * ScO2
40
Q

Physiological Functions of Pulmonary Circulation

A
  • Gas Exchange
  • Filter
  • Blood Reservoir for L Ventricle
  • Supply Nutrients to Lung Itself
  • Fluid Exchange
  • Angiotensin Converting Enzyme
41
Q

Where does the greatest fall in oxygen tension occur?

A

Across Systemic Capillaries

42
Q

Normal PvO2

A

40 mmHg

43
Q

Functions of Myoglobin

A
  • Buffer changes in tissue PO2 during changes in cellular metabolism
  • Facilitate O2 diffusion through the cytoplasm to the mitochondria where the O2 is used
44
Q

P50 of Myoglobin

A

2.7 mmHg

45
Q

What affects arterial PaO2?

A
  • Target alveolar PAO2
  • Condition of gas exchange surfaces
  • **Hb factors DO NOT alter PaO2**
46
Q

P50 of Hemoglobin

A

27 mmHg

47
Q

Blood PO2 of what corresponds with 50% O2 Saturation?

A

27 mmHg

48
Q

Blood PO2 of what corresponds with 90% O2 Saturation?

A

60 mmHg

49
Q

Blood PO2 of what corresponds with 75% O2 Saturation?

A

40 mmHg

50
Q

Blood PO2 of what corresponds with 97% O2 Saturation?

A

100 mmHg

51
Q

What direction does the oxygen dissociation curve shift w/ decreased hemoglobin affinity for O2?

A

Right

52
Q

What direction does the oxygen dissociation curve shift w/ increased hemoglobin affinity for O2?

A

Left

Pulmonary (5 decks)

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