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Physiology Flashcards

1
Q

What is external respiration?

A

Exchange of 02 and CO2 between the external environment and the cells

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2
Q

Describe ventilation

A

Gas exchange between the atmosphere and alveoli

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3
Q

What is the second step of respiration?

A

Gas exchange between alveoli and pulmonary circulation

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4
Q

What is the third step of respiration?

A

Transport of O2 and CO2 from the lungs to tissue

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5
Q

What is final step of respiration?

A

Gas exchange between the blood and tissue

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6
Q

What is Boyle’s Law?

A

At any constant temperature, the pressure exerted by a gas varies inversely with the volume of the gas

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7
Q

Which two forces hold the thoracic wall and the lungs in close opposition?

A

Intrapleural fluid cohesiveness

Transmural pressure gradient

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8
Q

Describe intra-pleural fluid cohesiveness

A

Water molecules in intrapleural fluid are attracted to each other and resist being pulled apart

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9
Q

Which pressures combine to create the transmural pressure gradient?

A

Negative intrapleural

Sub-atmospheric

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10
Q

What is the intrapleural pressure (approx.) ?

A

756mmHg

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11
Q

Approx what is the intra-alveolar pressure?

A

760mmHg

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12
Q

Which nerve supplies the diaphragm?

A

Phrenic

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13
Q

Which muscle lifts the ribs and moves out the sternum?

A

External intercostal

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14
Q

Describe inspiration

A

Active process
Increase in size of lungs, decreases pressure
Pulls air in down the pressure gradient until the pressures are equal

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15
Q

Describe normal (quiet) expiration

A

Passive
Relaxation of inspiratory muscles and recoil of lungs increases intra-alveolar pressure
Air pushed out of lungs

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16
Q

What is a pneumothorax?

A

Air in the pleural space

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17
Q

Outline the pathophysiology of a pneumothorax

A

Air enters pleural space
Abolishes transmural pressure gradient
Lung collapse (as no longer held in opposition with thoracic wall)

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18
Q

How does pneumothorax present?

A

Chest pain

Dyspnoea

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19
Q

What causes the lungs to recoil during expiration?

A

Elastin

Alveolar surface tension

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20
Q

What is the alveolar surface tension?

A

Attraction between water molecules at a liquid-air interface

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21
Q

What is the Law of LaPlace?

A

Smaller alveoli have a higher tendency to collapse

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22
Q

What is pulmonary surfactant?

A

Mixture of lipids and proteins secreted by type II alveoli

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23
Q

How does surfactant affect surface tension?

A

Intersperses the water lining the alveoli and lowers surface tension

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24
Q

What causes respiratory distress of the newborn?

A

Surfactant deficiency

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25
What is alveolar interdependence?
When alveolus starts to collapse the surrounding alveoli are stretched Exert expanding forces in the collapsing alveolus to open it
26
What are the major inspiratory muscles?
Diaphragm and external intercostals
27
What are the accessory muscles of inspiration?
SCM Scalenus Pecs
28
What are the muscles of active expiration?
Abdo muscles | Internal intercostals
29
What is the tidal volume?
Volume of air in a single breath
30
What is the inspiratory reserve volume?
Air which can be inspired on top of the TV
31
What is the expiratory reserve volume?
Air expired through active expiration | After normal tidal volume breath
32
What is the residual volume?
Minimum volume of air in lungs after maximal expiration
33
What is the average tidal volume?
500ml
34
What is the average inspiratory reserve volume?
3000ml
35
What is the average expiratory reserve volume?
1000ml
36
What is the average residual volume?
1200ml
37
What is the inspiratory capacity?
Maximum volume of air inspired | After normal expiration
38
What is the functional residual capacity?
Volume of air in lungs after normal expiration
39
What is the vital capacity?
Maximum volume of air moved out | After a maximum inspiration
40
What is the total lung capacity?
Total volume the lungs can hold
41
What is the average inspiratory capacity?
3500ml
42
What is the average functional residual capacity?
2200ml
43
What is the average vital capacity?
4500ml
44
What is the average total lung capacity?
5700ml
45
What is the FVC?
Max volume forcibly expelled from the lungs after a maximum inspiration
46
What is the FEV1?
Volume of air forcibly expired in 1 second
47
What should the FEV1/FVC ratio be?
>70%
48
Describe spirometry finings in obstructive lung disease
Decreased FEV1/FVC ratio | Because FEV1 decreased but FVC stays the same
49
Describe the spirometry findings in restrictive lung disease
FVC normal | FEV1 and FVC decreased
50
What does parasympathetic stimulation cause in the lungs?
Bronchoconstriction
51
What does sympathetic stimulation cause in the lungs?
Bronchodilation
52
What is the primary determinant of airway resistance?
Radius of airway
53
Dynamic airway compression is pathological and causes disease on young, non-smokers true/false
False | Dynamic airway compression is a physiological process which causes no problems in health airways
54
What is compliance measured as?
The work involved in stretching the lungs on inspiration
55
In which conditions would pulmonary compliance be decreased?
``` Pul fibrosis Pul oedema Pneumonia Long collapse Surfactant def ```
56
In which conditions would pulmonary compliance be increased?
Emphysema | COPD
57
Which pattern does decreased pul compliance show on spirometry?
Restrictive
58
How is the pulmonary ventilation in litres calculated?
Tidal volume (L/breath) * RR
59
Approx what is the volume in litres of pulmonary ventilation under resting conditions?
6L/min
60
What is anatomical dead space?
Space in the airway which is not available for gas exchange
61
What is pulmonary ventilation?
Volume of air breathed in and out per minute
62
What is alveolar ventilation?
Volume of air exchanged between the atmosphere and the alveoli per minute
63
What is the perfusion rate?
Rate at which the blood is passing through the lungs
64
Which factor most effects the pulmonary ventilation?
Depth of breathing
65
What is Dalton's Law of Partial Pressures?
Sum of all the partial pressures = the total pressure exerted by the gas
66
What is the partial pressure of a gas in a mixture?
The pressure that the one gas would exert if it was the whole volume of the mixture
67
CO2 diffuses more readily than O2 | true/false
True
68
What is Fick's Law of Diffusion?
Amount of gas which diffuses is: proportional to the area of the membrane disproportional to the thickness
69
What are alveoli?
Thin-walled inflatable sacs which function in gas exchange
70
Type II alveolar cells make up the wall of the alveoli | true/false
False | It is type I
71
What is Henry's Law?
Amount of gas which dissolves in a constant type and volume | Is proportional to the partial pressure of gas in equilibrium with the liquid
72
How does resp disease impair O2 delivery to tissues?
Decreased arterial PO2
73
How does anaemia impair O2 delivery to tissues?
Decreased Hb concentration
74
How does heart failure impair O2 delivery to tissues?
Decreased CO
75
Describe the co-operativity of Hb?
When O2 binds to one globin chain, the affinity for O2 in the other chains goes up
76
What is the Bohr effect?
When the O2 binding curve shifts to the right
77
Describe the structure of myoglobin
One haem group per molecule
78
Where is myoglobin present?
In skeletal and cardiac muscle
79
What is the role of myoglobin?
Provides short-term storage for anaerobic conditions
80
What are gap junctions?
Protein channels which form low resistance electrical communication pathways between myocytes
81
What is the role of the desmosomes?
Mechanical adhesions between adjacent cardiac cells
82
What is the contractile unit of the heart?
Myofibrils
83
Which filaments are found in myofibrils?
Actin | Myocin
84
How are actin and myocin arranged in a myofibril?
Into sarcomeres
85
Actin is the thick filament | true/false
False | Actin is thin
86
What is required to form links between actin and myosin?
Ca2+ | ADP
87
What is the role of calcium in actin-myocin cross bridging?
Moves troponin out the way of the binding site on actin
88
Where is Ca2+ released from in the myocyte?
Sarcoplasmic reticulum
89
What is Ca2+ release dependent on in the myocyte?
Extra-cellular Ca2+
90
What occurs during the plateau phase of muscle contraction?
Ca2+ influx through L-type Ca2+ channels
91
What enzyme is responsible for re-sequestering Ca2++ in the endoplasmic reticulum?
Calcium-ATP-ase
92
What is the refractory period of muscle contraction?
Period following an action potential where there can't be another action potential
93
How is the muscle prevented from contracting again in the refractory period?
Na channels closed in plateau phase K+ channels open in descending phase Therefore muscles cannot be depolarised
94
What is the stroke volume?
Volume of blood ejected by each ventricle per beat
95
What is the end diastolic volume?
Volume of blood in each ventricle at the end of diastole
96
What is the end diastolic volume determined by?
Venous return to the heart
97
What does the end diastolic volume determine?
Cardiac preload
98
What does the Frank-Starling curve state in regards to stroke volume?
Bigger then end diastolic volume, bigger the stroke volume
99
What is the optimal length of a skeletal muscle?
Resting length
100
What is the optimum fibre length of cardiac muscle?
Stretched
101
What does the afterload indicate?
The resistance into which the heart is pumping
102
What is the physiological response to increased afterload?
LVH
103
Which nerve fibres supply the ventricular muscle?
Sympathetic
104
What is the effect of sympathetic stimulation on the heart?
Positive inotropic and chronotropic
105
Increase in heart contractility shifts the Frank-Starling curve to the....
Left
106
What is the cardiac output?
Volume of blood pumped by each ventricle per minute
107
What is the equation for CO?
CO = SV x HR
108
Roughly what is the resting CO of a healthy adult?
5 litres
109
What is paroxysmal AF?
<48 hours | Often recurrent
110
What is persistent AF?
>48 hours | Unlikely to revert to normal sinus rhythm
111
What is permanent AF?
Unable to restore normal sinus rhythm
112
How does AF present?
``` Palps Pre-syncope Syncope Chest pain Dyspnoea Sweaty ```
113
Describe ECG changes in AF?
>300bpm Rhythm irregularly irregular Absence of P waves
114
What is atrial flutter?
Rapid and regular form of atrial tachycardia | Paroxysmal
115
What is the first line treatment of atrial flutter?
radiofrequency abalation

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