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Physiology Pulmonary > Pulmonary ventilation > Flashcards

Pulmonary ventilation Flashcards

1
Q

conditioning of inspiring air and phonation

A

nose, pharynx, larynx, and trachea

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2
Q

conduction zone

A

bronchi, bronchioles, temrinal bronchioles. Bulk ari movement. NO respiratory function. Defensive roles

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3
Q

transitional respiratory zones

A

respiratory bronchioles, alveolar ducts and alveoli. Gas exchange site.

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4
Q

functional unit acinus

A

terminal bronchiole, respiratory bronchioles, alveolar duct and alveoli (alveolar sac) and their circulation

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5
Q

surface area

A

increase surface area at each branch point leads to drastic decrease in air velocity between the upper respiratory tract and acini.

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6
Q

closed system equation

A

closed system (air velocity x total airway)/time must be equal at all points

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7
Q

Acini air velocity

A

air velocity drops to zero, gas movement is primarily diffusion at the terminal and respiratory bronchioles

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8
Q

air movement in upper respiratory tract

A

bulk flow

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9
Q

circulation

A

provided by pulmonary artery, capillary bed and pulmonary vein

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10
Q

total diffusion distance

A

alveolus to capillary lumen-> .5 mum. In adult, very large diffusional area. approx: 300 x 10^6 alveoli

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11
Q

defensive function of respiratory system

A

conditioning of inspired air: humidification, filtration, removal of debris: mucous, cilia, alveolar macrophages, sneezing and coughing

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12
Q

humidification and warming

A

prevents desiccation of respiratory surface that could lead to infection

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13
Q

filtration

A

particles greater and than 10 micrometers are removed by hairs in the nose. 5-10 mm particles lodge in passageways of nose and pharynx due to turbulent air flow and difference in inertia between air and particles. High inertia particles causes them to collide with and stick to surfaces of nose and pharynx. 205mm particles settle out the bronchioles due to slow air velocity and gravity. particles less than 1 mm settle out in alveoli. Many particulates in industrial pollutants and cigarette smoke are less than 1mm

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14
Q

mucous

A

suspends debris, protects respiratory surfaces. Secrete by submucosal glands and goblet cells, but only as far as terminal bronchioles. makes suspension of very fine particles in acini very troublesome

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15
Q

cilia

A

beat of cilia propels mucous suspension toward pharynx from either lower or upper respiratory tract

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16
Q

alveolar macrophages

A

phagocytic destruction of debris, microbes etc.

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17
Q

mechanics of ventilation

A

intrapleural space, intrapleural and intrapulmonary pressures, inspiration, expiration, respiration, respiratory resistance, alveolar surface tension

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18
Q

intrapleural space

A

liquid filled are between visceral pleura (outer lung covering) and parietal pleura (outer covering of chest and diaphragm) that provides fluid coupling between the two surfaces. Application of force from the chest wall and diaphragm to lungs and vice versa. help rub against either other but resist being pulled apart

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19
Q

intrapleural and intrapulmonary pressures

A

pressures are given relative to atmosphere. Recoil force of chest wall and diaphragm just balances lung tendency to collapse-> gives a slightly negative intrapleural pressure and 0 intrapulmonary pressure.

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20
Q

how to lungs collapse

A

exposing chest cavity to atmospheric pressure and or introducing air into the thorax intrapleural space will cause lungs to collapse

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21
Q

inspiration: diaphragm

A

striatal muscle which separates pleural and abdominal cavities-> evokes inspiration by flatting out from a dome shape. accounts for 75% of change in chest cavity volume change during quiet ventilation. Much of remaining volume change is provided by external intercostal muscles that lift and expand rib cage. Scalene and sternomastoid muscle elevate ribs on rear pivot, expanding the chest-> are important during forced inspiration

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22
Q

inspiration: diaphragm->expansion of chest

A

lowers intrapleural pressure-> makes intrapulmonary pressure substmospheric. Pressure differential between alveoli and upper respiratory tract causes air to flow towards the alveoli. Due to large cross-sectional area of lower respiratory structures (low very low total resistance to flow) very small pressures suffice to move large amounts of air.

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23
Q

expiration

A

at rest, expiration is passive-> due solely to recoil of elastic elements in lungs. Lungs recoil until their force is balance by outward force of chest wall. Active expiration-> may involve abdominal muscles. inadequate expiration will limit useful lung capacity

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24
Q

respiratory resistance

A

R(total)=R(airway)+R(tissue)+R(thoracic)
airway and pulmonary tissue resistance are collectively called pulmonary resistance
R(total)=R(pulmonary)+ R(thoracic)

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25
Q

pulmonary resistance

A

increases with diseases, such as pulmonary fibrosis, as well as when there is increased blood in lungs. Higher when recumbent

26
Q

thoracic resistance

A

increases with disease of rib cage and diaphragm as well as with increased intra-abdominal volume. Also high when recumbent

27
Q

Alveolar surface tension

A

mutual attraction of water molecule at an air-water interface that tends to minimize the area of the surface-> seen in skinning at the surface of an over-filled water glass

28
Q

alveolar surface tension: effect on lung compliance

A

compliance represents the change in volume for a given change in pressure (deltaV/deltaP). surface tension at the alveolar air-water interface favors collapse of the alveoli-> tends to decrease lung compliance. Air filled lung versus a saline filled lung-> saline abolishes surface tension giving much greater compliance

29
Q

pulmonary surfactant

A

phospholipid consisting mainly of dipalmitoyl phosphatidlycholine and 4 proteins. Surfactant induces an area-dependent effect on tension-> due to area-dependent changes in packing of surfactant molecules and resulting changes in interactions between water molecules

30
Q

experiment to measure surface tension as a function of area

A

used water, water and detergent, water and surfactant. Water has high surface tension and there is no effect on change in surface area. Detergent lowers tension but no change in area. Surfactant dramatically lowers tension relative to water.

31
Q

physical action of surfactant

A

decrease overall tension of extracellular fluid coating the lumenal alveolar surface. Makes tension decrease with decreasing area and vice versa.

32
Q

physiological importance of surfactant

A

pressure required to maintain the size of an alveolus is inversely related to its radius->surfactants reduce the work required to expand lung-> increases compliance. Prevents collapse of smaller alveoli with otherwise would occur due to pressure differences between them and their larger neighbors. Causes decreased tension (T), to compensate for increased pressure (P) due to smaller radius (r)

33
Q

surfactant production

A

starts at 32 weeks gestation under the control of cortisol. Premature birth is often characterized by surfactant deficiency and attendant ventilation difficulties

34
Q

Pulmonary gas volumes: Spirometry

A

measure volumes and capacities to asses lung function

35
Q

Tidal volume (TV)

A

Volume of normal breath-> .5L

36
Q

inspiration capacity (IC)

A

maximum volume inhaled after normal exhale (TV +IRV)->.3L

37
Q

expiratory reserve volume (ERV)

A

maximum volume of forced exhale after normal exhale-> 1.5L

38
Q

vita capacity (VC)

A

maximum volume inhaled and exhaled (TV+ IRV+ERV)-> 4.5L Measures muscle effectiveness

39
Q

residual volume (RV)

A

volume of air in lungs after maximal exhale-> 1.5L (25% TLC)

40
Q

functional residual capacity (FRC)

A

volume of air in lungs after normal exhale (ERV+RV)-> 3L (50% of TLC). Describes the balance of force between lung collapse and chest wall recoil

41
Q

functional residual capacity (FRC):measuring FRC- equilibration technique

A

start with unknown concentration C1 and volume V1 of insoluble gas in spirometer. Allow breathing while O2 and removing CO2. Insoluble gas comes to constant concentration C2 in spirometer after equilibrating with lungs. Measure C2 after exhale (equation in notes)

42
Q

total lung capacity (TLC)

A

maximum volume of air lungs can hold.

43
Q

dynamic measure

A

above volumes are static-> measured at end of held breath. Measurement of rate at which air is moved (dynamic measure) is a better indication of work involved in breathing, and also the status of airways

44
Q

forced expiratory volume (FEV1.0) and forced vital capacity (FVC)

A

FEV1.0=volume exhaled in first second of forced exhalation after inhale to TLC.
TLC
FVC=total air expelled forcibly after inhale to TLC
FEV/FVC is usually about .8 at a rate of 8-10 1/min
changes in FEV/FVC can be ascribed to specific pathological states

45
Q

work of breathing

A

elastic work of breathing: work is required to expand the chest wall and to expand the elastic tissue of the lungs

46
Q

work of breathing

A

flow resistive work of breathing: airway resistance: resistance to airflow due to frictional loss of energy from walls airways (equation in notes)

47
Q

pathological changes in lungs compliance/resistance/volume assessed by FEV1.0

A

lung diseases are generally distributed to two groups-> obstructive and restrictive

48
Q

obstructive diseases

A

characterized by increased airway resistance and CO2 retention

49
Q

obstructive diseases: asthma

A

example bronchospastic or “reversible” obstructive condition, so called because the increase in resistance due to bronchoconstriction can be pharmacologically reversed. Aspects of the condition-> increased mucus, edema, inflammation-> not be as tractable.

50
Q

exercised induced asthma

A

cough, wheezing, and chest tightness-> result of bronchocconstriction thought to be related to heat and water loss during rapid respiration

51
Q

obstructive disease: emphysema

A

irreversible obstructive condition, FRC increases and elastic work actually decreases but airway resistance increases. Tendency for CO2 retention

52
Q

obstructive condition

A

asthma and emphysema (COPD), have decreased FEV/FVC. as a result of the increased airway resistance combined in some cases with loss of lung elasticity/recoil action

53
Q

restrictive disease

A

characterized by a reduction in total lung capacity. Atelectsis, consolidation, pleural effusion, pneumothorax, respiratory distress syndrome

54
Q

atelectsis

A

collapse of part or entire lung

55
Q

consolidation

A

filling of alveolar spaces with inflammatory exudates

56
Q

pleural effusion

A

heart failure, hypoproteinemia, infection and neoplasma

57
Q

respiratory distress syndrome (RDS)

A

most common example of restrictive disease most often observed in infants as idiopathic RDS, and inadults as acute RDS. Former is typical of premature births. cause of latter is not clear but it develops 12-24 hours after trauma, near-drowning, acid aspiration, etc. Although FEV/FVC increases in restrictive disease, the absolute volume of air that moves is decreased due to the reduction in FRC.

58
Q

alveolar ventilation

A

measurement of ventilatory efficiency is best done by assessing amount of fresh air delivered to respiratory surface, alveoli.

59
Q

anatomic dead space

A

the volume of conductive, non-respiratory passages

60
Q

effect dead space on alveolar ventilation

A

during a breath: exhale forces old alveolar air into dead space, inhale brings some of this old air back along with fresh air-> some of fresh air never moves beyond the dead space so it cannot participate in gas exchange. Rapid shallow breathing ventilates alveoli less efficiently than does deeper, slower breathing because of constant contribution of dead space.

Physiology Pulmonary (4 decks)

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