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Transition Block > Physiology Khogali prep > Flashcards

Physiology Khogali prep Flashcards

1
Q

Respiratory causes of SOB

A

asthma
COPD
pneumonia
lung cancer
pulmonary fibrosis
pleural effusion
pneumothorax

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2
Q

cardiovascular causes of SOB

A

heart failure: IHD, hypertension, valvular heart disease, cardiomyopathy, arrhythmias
pulmonary embolism

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3
Q

other causes of SOB (not resp or cardio causes)

A

anaemia
acidosis e.g. lactic acidosis, diabetic ketoacidosis
panic attacks
exercise
obesity
pregnancy

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4
Q

what/where are the respiratory centres in the brainstem?

A

pons and medulla

(respiration modified by inputs from pons, respiratory rhythm generated in medulla)

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5
Q

-

A

central chemoreceptors
peripheral chemoreceptors

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6
Q

where are stretch receptors found in resp

A

in the walls of bronchi and bronchioles

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7
Q

which receptors are stimulated by pulmonary capillary congestion and pulmonary oedema; also pulmonary emboli —-> rapid shallow breathing

A

juxtapulmonary receptors

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8
Q

which receptors lead to increased ventilatory rate in response to decrease BP

A

baroreceptors

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9
Q

where are central chemoreceptors situated

A

near the surface of the medulla of the brainstem

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10
Q

central chemoreceptors respond to the __________ concentration of the ____

A

hydrogen
CSF

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11
Q

does CSF contain more or less protein than blood

A

less

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12
Q

what separates the CSF from the blood

A

blood brain barrier

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13
Q

the blood brain barrier is relatively impermeable to ____ and _______.
____ diffuses readily.

A

impermeable to H+ and HCO3-

CO2 diffuses readily

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14
Q

what is hypercapnia

A

too much carbon dioxide (CO2) in your blood

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15
Q

the hypoxic drive of respiration effect is all via the ___________ chemoreceptors

A

peripheral

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16
Q

when might the hypoxic drive of respiration become important?

A
  • patients with chronic CO2 retention (e.g. COPD)
  • high altitudes
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17
Q

does H+ readily cross the blood brain barrier

A

no

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18
Q

peripheral chemoreceptor stimulation by hydrogen causes hyperventilation and increases elimination of ____ from the body

A

CO2

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19
Q

what is the effect of increased PCO2 in the arterial blood on the central chemoreceptors?

A

strongly stimulates the central chemoreceptors; is the dominant control of ventilation

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20
Q

in inspiration, the volume of the thorax is increased vertically by contraction of the ___________

A

diaphragm

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21
Q

the ___________ ___________ muscle contraction lifts the ribs and moves out the sternum

A

external intercostal

22
Q

what is the “bucket handle” mechanism?

A

the external intercostal muscle contraction lifts the ribs and moves out the sternum

23
Q

what are the major muscles of inspiration?

A

The diaphragm and the external intercostals

24
Q

what are the accessory muscles of respiration?

A

The accessory inspiratory muscles are the sternocleidomastoid, the scalenus anterior, medius, and posterior, the pectoralis major and minor, the inferior fibres of serratus anterior and latissimus dorsi, the serratus posterior superior may help in inspiration also the iliocostalis cervicis

The accessory expiratory muscles are the abdominal muscles: rectus abdominis, external oblique, internal oblique, and transversus abdominis.

25
Q

what are the three important pressures in ventilation

A

atmospheric pressure
intra-alveolar pressure
intrapleural pressure

26
Q

forces keeping the alveoli open

A
  • transmural pressure gradient
  • pulmonary surfactant
  • alveolar interdependence
27
Q

forces promoting alveolar collapse

A
  • elasticity of stretched pulmonary connective tissue fibres
  • alveolar surface tension
28
Q

primary determinant of airway resistance is the ________ of the conducting airway

A

radius

29
Q

airway resistance:
parasympathetic stimulation causes _______________________

A

bronchoconstriction

30
Q

airway resistance:
sympathetic stimulation causes _______________________

A

bronchodilatation

31
Q

what happens to intrapleural pressure during inspiration

A

it falls.

32
Q

what happens to intrapleural pressure during expiration

A

it rises

33
Q

what is dynamic airway compression

A

occurs when the pressure surrounding the airway exceeds the pressure within the airway lumen.

34
Q

what is lung compliance

A

compliance is a measure of the effort that has to go into stretching or distending the lungs.

the less compliant the lungs are, the more work is required to produce a give degree of inflation

35
Q

give an example of a factor that could decrease lung compliance

A

pulmonary fibrosis

36
Q

situations when work of breathing is increased (5 points)

A
  • when pulmonary compliance is decreased
  • when chest expansion is restricted
  • when airway resistance is increased
  • when elastic recoil is decreased
  • when there is a need for increased ventilation
37
Q

what do alveoli walls consist of

A

a single layer of flattened Type I alveolar cells

38
Q

what encircle each alveolus

A

pulmonary capillaries

39
Q

four factors that influence the rate of gas transfer across the alveolar membrane

A
  • partial pressure gradients of O2 and CO2
  • surface area of the alveolar membrane
  • thickness of the barrier separating the air and blood across the alveolar membrane
  • diffusion coefficient
40
Q

gas exchange abnormalities

A

hypoxia and hypercapnia

41
Q

what is functional residual capacity

A

the volume remaining in the lungs after a normal, passive exhalation

42
Q

what is cardiac output

A

the volume of blood pumped by each ventricle per minute

43
Q

cardiac output equation

A

CO = SV x HR

44
Q

what is stroke volume

A

the volume of blood ejected by each ventricle per heart beat

45
Q

stroke volume equation

A

SV = EDV - ESV

46
Q

What is the end diastolic volume determined by

A

the venous return to the heart

47
Q

what does the frank-starling curve state

A

the more the ventricle is filled with blood during diastole (EDV), the greater the volume of ejected blood will be during the resulting systolic contraction (stroke volume)

48
Q

what is chronic heart failure

A

a complex syndrome that can result from any structural or functional cardiac disorder that impairs the pumping ability of the heart

49
Q

what is the leading cause of heart failure

A

coronary artery disease

50
Q

in anaemia, would the arterial PO2 be low, normal or high?

A

normal

Transition Block (5 decks)

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