Physiology: Ventilation/Alveolar Gases Flashcards

1
Q

What effect does dynamic compression of airways have on normal subjects?

A

Limits airflow during a forced expiration

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2
Q

What diseases exaggerate Dynamic Compression of Airways?

A

Some lung diseases which have reduced elastic recoil and loss of radial traction on airways e.g. emphysema

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3
Q

How do people counteract dynamic compression of airways?

A

Purse-lipped breathing - maintain airway pressure which splints airway open & limits the flow rate.
Slows the flow of air and maintains a filling pressure in airways so they cannot collapse.
Avoids dynamic compression.

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4
Q

Why is the work of breathing performed?

A

Done to overcome the elastic properties/stiffness of the lung system = compliance and surfactant.
Overcome airways resistance (friction) = bronchoconstriction and dynamic collapse

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5
Q

Why is the work of breathing increased in restrictive lung diseases?

A

Increased work due to decreased lung compliance (stiff lungs) - work harder to change the lung volume

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6
Q

Why is the work of breathing increased in obstructive lung diseases?

A

Increased work due to increase in airway resistance (narrow pipes)

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7
Q

Why is the work of breathing increased in pulmonary oedema?

A

Increased work due to decreased lung compliance (stiff lungs) - functional restrictive disease

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8
Q

GO over graph of work of breathing!!

A

xx

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9
Q

What is the equation for the work of breathing?

A

Work of breathing = P x change in volume

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10
Q

How do we know if a patient is Hypoventilating?

A

Carbon dioxide is greater than 40

Ventilation is the only thing that affects carbon dioxide

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11
Q

What causes a work of breathing too high?

A

Decreased compliance, increased airways resistance (asthma, COPD)

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12
Q

What could be reasons as to why a patient cannot do the work of breathing?

A

Fatigue
Muscle Weakness
Depressed central control e.g. opiates

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13
Q

Why might a patient not do enough work of breathing?

A

Behavioural (sleep), panic attack

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14
Q

What happens to carbon dioxide when someone hyperventilates?

A

Carbon dioxide goes down.

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15
Q

What is the respiratory exchange ratio?

A

VCO2/VO2

Should be about 0.8

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16
Q

Where does gas exchange occur?

A

Diffusion across the alveolar membrane - large SA

17
Q

What drives gas exchange?

A

Pressure gradients - alveolar pressures are important e.g. PAO2, PACO2

18
Q

What else is gas exchange dependent on?

A

Alveolar perfusion - need the right balance of ventilation and perfusion (V/Q)

19
Q

What determines the partial pressures?

A

Composition of inspired air
Alveolar ventilation
O2 consumption or CO2 production
Matching of alveolar ventilation to pulmonary capillary blood flow

20
Q

What is R/RER and what is it dependent on?

A

Respiratory Quotient/Resp Exchange Ratio

Depends on diet - mixed diet is about 0.8

21
Q

What is the A-a gradient?

A

Difference between PAO2 and PaO2 = indicates a problem with gas exchange.
Normally <10mmHg
Increased A-a = decreased gas exchange

22
Q

Go over examples in lecture slides.

A

xxx