physiology Flashcards
what is internal respiration?
intracellular mechanism of which consumes oxygen and produces co2
food + oxygen = energy + carbon dioxide (+ water)
what is external respiration?
the 4 sequence of events that lead to the exchange of O2 and co2 between the external environment and the cells of the body
what are the steps of external respiration?
- ventilation- air in and out of lungs
- gas exchange between alveoli and blood
- exchange of o2 in alveoli - gas transport in the blood- binding of o2 and co2 to blood
- gas exchange at tissue level
what 4 systems are involved in external respiration?
- respiratory system
- cardiovascular system
- haematology
- nervous system
what is boyle’s law?
at a constant temp- as the volume of the gas increases the pressure of the gas decreases.
what must happen to intra-alveolar pressure in order for air to flow into the lungs during inspiration?
intra-alveolar pressure must be lower than atmospheric pressure.
how does air flowing into the lungs occur?
inspiration
Rib cage expands and moves upwards
caused by contraction of the diaphragm - increases volume of thorax
and external intercostal muscles- contracts and lifts ribs and sternum
what are the two forces which hold the thoracic wall and the lungs in close opposition?
- intrapleural fluid cohesiveness- water molecules in the intrapleural fluid are attracted to each other and resist being pulled apart. Keeps pleural membrane together
- negative intrapleural pressure- sub atmospheric intrapleural pressure creates a transmullar pressure gradient across the lung wall and also the chest wall.
What are the main pressures involved in pulmonary ventilation?
- Atmospheric pressure at sea level
- intra-alveolar pressure- pressure within the lung alveoli
- intrapleural pressure- pressure exerted outside the lungs but within the pleural cavity
What are the usual pressure values of these pressures
- atmospheric pressure- 760 mm Hg
- intra-alveolar- when equal to atmospheric pressure it is 760 mm Hg
- Intra pleural- 756 mm Hg
what is the name of the mechanism describing the movement of external intercostal muscles during inspiration?
bucket handle mechanism
what nerves supply the diaphragm?
phrenic nerve from C3,4,5
what does inspiration do the intra alveolar pressure?
makes it decrease due to increase size of lungs= more volume
what is the difference between inspiration and expiration in regards to the process?
inspiration is active- requires contraction of muscles
(normal) expiration is passive- relies on relaxation of inspiratory muscles
when the diaphragm relaxes what causes the lungs decrease in size during expiration?
its elastic recoil properties from the elastic connective tissue
alveolar surface tension( most important factor)
what happens to the intra alveolar pressure during expiration?
increase due to decrease in volume. Pressure rises above atmospheric pressure allowing for expiration
what is transmural/transpulmonary pressure?
It is the difference in pressure between the alveolar and pleural pressures.
what is alveolar surface tension?
The characteristic of water particles on the surface to have a strong attraction to water particles on the inner surface due to cohesion.
what reduces alveolar surface tension?
surfactant
what is a surfactant
A mixture of Phospholipids, proteins, and ions. It is a surface-active agent of water.
where is pulmonary surfactant secreted from?
Type ii alveolar epithelial cells. These cells are granular.
What is la place’s law?
P= 2T/r where: P = inward directed collapsing pressure T = surface tension r = radius of the alveoli
what does la place’s law suggest?
smaller the alveoli the bigger the risk of it collapsing
why are surfactants so important?
prevents smaller alveoli collapsing and emptying contents into larger alveoli
besides from transmural pressure and pulmonary surfactant what other major force tries to keep alveoli open?
alveolar interdependence
what is alveolar interdependence?
When a collapsing alveolus stretches the ones around it.
This in turn causes the alveoli surrounding it to recoil and pull it open.
what are the accessory muscles of inspiration?
sternocleidomastoid - lifts the sternum
pectoral
scalenus
when are accessory muscles used for inspiration
during forceful inspiration
what are the muscles of active expiration?
- Abdominal muscles 2. Internal intercostal muscles
What is the tidal volume? (TV)
ii. what is its average value ( in a young adult male)
volume of air entering or leaving lungs during a single breath
ii. 0.5 L
what is the inspiratory reserve volume?
ii. average value?
extra volume of air that can be maximally inspired over and above the typical resting tidal volume
ii. 3.0 L
what is the expiratory reserve volume?
ii. average value?
extra volume of air that can be maximally actively expired over and above the typical resting tidal volume
ii. 1.0 L
what is the residual volume?
ii. average value?
minimum volume of air remaining in the lungs even after a maximal expiration
ii. 1.2 L
What is the definition of inspiratory capacity?
ii. average value?
maximum volume of air that can be inspired at the end of a normal expiration.
ii. 3.5 L
how do you calculate the inspiratory capacity?
Tidal volume plus the inspiratory reserve volume
what is the Functional residual capacity?
ii. average value?
volume of air in lungs at end of normal passive expiration.
ii. 2.2 L
how do you calculate the FRC?
expiratory reserve volume plus the residual volume.
what is the vital capacity?
ii. average value?
maximum volume of air that can be moved out during a single breath following a maximal inspiration
ii. 4.5 L
How do you calculate the VC?
inspiratory reserve volume plus the tidal volume plus the expiratory reserve volume.
What is the total lung capacity?
ii. average value?
Total volume of air in the lungs
ii. 5.7 L
How do you calculate TLC?
you can’t their effect on the pop scene is unquantifiable
Vital capacity+ residual volume
when does the residual volume increase?
when elastic recoil of the lung is decreased
why can’t TLC be measured by a spirometry?
because the residual volume cannot be recored by a spirometry. you need the RV to calculate the spirometry
What is the function of a volume time curve?
allows you to calculate Forced vital capacity (FVC) and forced expiratory volume in one second ( FEV1)
what is FEV1?
volume of air that can be expired during the first second of expiration in an FVC determination
What is the FEV1/FVC ratio?
proportion of the FVC that can be expired in the first second
What equipment is used to calculate volume time curve?
spirometry
What is the normal % of a FEV1/FVC ratio?
ii. what does it suggest if this value is below this number?
> 70%
ii. obstructive lung disease
what is the main role of parasympathetic stimulation on the airways?
bronchoconstriction
what is the main role of sympathetic stimulation on the airways?
bronchodilation
How do you calculate airway resistance
Flow= change in pressure/resistance
why is there only a small pressure gradient in the airway for air movement?
as resistance to flow is very low
what happens to intrapleural pressure in:
- inspiration
- expiration
- decrease
2. increase- causes dynamic compression
what is the effect of dynamic airway compression?
not effective on normal people
only effects patients with obstructive lung disease by making it harder to actively expire
what does dynamic airway compression effect? ( anatomically speaking)
compresses alveoli and airway
compressing alveoli- helps push air out
compressing airway- a nuisance!
why does obstructive lung disease not benefit from dynamic compression?
the driving pressure between the alveolus and airway is lost over the obstructive segment.
causes fall in airway pressure resulting in airway compression from the pleural pressure
what is a peak flow meter?
records peak flow rate-measures the maximum speed at which a patient can move air out of lungs
what is the peak flow rate?
assesses the airway function
useful for obstructive lung disease
what is lung compliance?
The ability for the lungs to expand/stretch and how much effort is required.
i.e. less compliance= more effort required for the lungs to stretch
what factors decrease lung compliance?
Pulmonary fibrosis
Pulmonary oedema
Lung collapse
Pneumonia
lack of surfactant
Decreased pulmonary compliance has what effect on pressure difference in the lungs?
Greater pressure difference needed to change volume of lungs
what effect has lung compliance have on a volume time curve?
shows patient to have restrictive patterns
why might abnormal increase of lung compliance occur?
ii. what is this common in?
loss of elastic recoil of the lungs
ii. emphysema- hyperinflation of lungs
compliance increases with age true or false?
true
when does work of breathing increase?
decrease in lung compliance
decrease in elastic recoil
increase in airway resistance
when lungs are required to increase ventilation
what is Anatomical dead space?
the non exchange areas where air may remain in the respiratory system
what is pulmonary ventilation?
volume of air breathed in and our per minute
what is alveolar ventilation?
volume of air exchange between the atmosphere and alveoli per minute
represents new air available of gas exchange with blood
How do you calculate pulmonary ventilation?
Tidal volume x Respiratory rate= PV (L/min)
What is the normal respiratory rate?
12-20 breaths per minute
How do you calculate alveolar ventilation?
(Tidal volume-dead space)x respiratory rate
why does alveolar ventilation have a lower value than pulmonary ventilation?
As it takes into consideration anatomical dead space
Because of anatomical dead space what should you do to increase pulmonary ventilation?
increase the depth of breathing (Increase Tidal volume)
what is the difference between ventilation and perfusion?
Ventilation: rate at which gas is passing through the lungs (rate of airflow)
perfusion: rate at which blood is passing through the lungs (rate of blood flow)
what is alveolar dead space?
refers to alveoli with poor ventilation or perfusion
Accumulation of CO2 in alveoli due to increase perfusion causes what?
decreased airway resistance= increased airflow
Increase in alveolar O2 concentration as a result of increased ventilation causes what?
pulmonary vasodilation
increased blood flow
What factors occur when Perfusion is greater than ventilation?
CO2 increases in area
O2 decrease in area
dilation of local airways
Constriction of local blood vessels
Airflow increase
Blood flow decrease
What factors occur when ventilation is greater than perfusion?
Co2 decreases in area
O2 increase in area
constriction of local airways
dilation of local blood vessels
airflow decrease
blood flow increase
what is the difference between Physiological and anatomical dead space?
ii. is there a difference in value?
Physiological dead space includes alveolar dead space. (Anatomical dead space + alveolar dead space)
Anatomical dead space does not
ii.In healthy individuals the values are equal. However, Unhealthy individuals can have physiological dead space being 1 to 2 litres greater.
What happens to pulmonary and systemic arterioles during:
- Decreased O2
- Increased O2
- Pulmonary: vasoconstriction
Systemic: Vasodilation - Pulmonary: Vasodilation
Systemic: vasoconstriction
What are the four factors which effect the rate of Gas exchange across the alveolar membrane?
- Partial Pressure gradient of O2 and CO2
- Diffusion coefficient of O2 and Co2
- Surface area of alveolar membrane
- thickness of alveolar membrane