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Physiology - Pulmonary > Pulmonary Ventilation > Flashcards

Pulmonary Ventilation Flashcards

1
Q

Purpose of nose, pharynx, larynx, trachea?

A

Conditioning of Inspired Air

Phonation

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2
Q

of divisions/branch points between trachea and alveoli?

A

23

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3
Q 
The first \_\_\_(#) branches do what activity?
Branches \_\_\_\_\_ (#) do what activity?
A

1-16 Only Move Air

17-23 have Absorptive Area

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4
Q

How do gasses move starting at the terminal and resp. bronchioles?

A

By Diffusion

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5
Q

What equation describes the cross sectional area of the alveoli and the volume of air?

A

(V1)(A1)=(V2)(A2)

*A refers to total area at this level

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6
Q

What comprises the conductive zone?

A

Bronchi, Bronchioles, Terminal Bronchioles

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7
Q

What is the conductive zone used for?

A

Bulk air movement

Defenses

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8
Q

Transitional/Respiratory Zones include:

A

Respiratory Bronchioles
Alveolar Ducts
Alveoli

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9
Q

Purpose of the transitional/respiratory zone?

A

Gas Exchange

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10
Q

Functional unit within the transitional/respiratory zone?

A

Acinus – terminal bronchiole, respiratory bronchiole, alveolar duct, alveoli, and their circulation

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11
Q

Effect of surface area on air velocity?

A

Each branch point leads to much greater surface area, causes the air velocity to drastically decrease.

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12
Q

How is air moved in the upper respiratory tract?

A

Bulk Flow

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13
Q

Three components of the circulation

A

Pulmonary Artery
Capillary Bed
Pulmonary Vein

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14
Q

Surfaces that oxygen must traverse

A 
Alveoli epithelium
Basement membrane
EC Fluid
Capillary Endothelium
Plasma
RBC
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15
Q

Region responsible for conditioning the air?

What does conditioning entail?

A

Nose-Pharynx

Humidification, Warming, Filtration

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16
Q

Value of humidification and warming?

A

Prevents desiccation of respiratory surface that could lead to infection

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17
Q

What filters particles over 10um?

A

Nosehairs

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18
Q

What filers particles from 5-10um?

A

Particles lodge in passageways due to turbulent airflow and inertia differences that cause them to collide with the surfaces.

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19
Q

What filters particles from 2-5um?

A

They settle out in bronchioles due to slow air velocity and gravity.

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20
Q

What filters particles less than 1 um?

A

Nothing. They land in the alveoli

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21
Q

Four players/actions involved in removal of debris?

A

Mucous
Cilia
Alveolar Macrophages
Sneexing/Coughing

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22
Q

Role of mucous?

A

Suspends debris, protects respiratory surfaces.

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23
Q

Where does mucous come from?

A

Secreted by submucosal glands and goblet cells.

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24
Q

Why is it difficult to suspend particles in the acini?

A

Mucous secreting cells only go as far as the terminal bronchioles.

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25
Q

Role of cilia in debris removal?

A

Propels mucous suspension toward pharynx from URT and LRT.

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26
Q

What is the intrapleural space?

A

Liquid-filled area between visceral pleura (outer covering of lung) and parietal pleura (inner covering of chest wall and diaphragm).

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27
Q

Role of intrapleural space?

A

Allows application of force from the chest wall/diaphragm to the lungs and viceversa.

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28
Q

Is the intrapleural pressure positive or negative?

A

Negative (enough to resist the lung’s desire to collapse)

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29
Q

What is it called when the chest cavity/intrapleural space is exposed to atmospheric pressure? What happens? Why?

A

Pneumothorax. Loss of slightly negative intrapleural pressure causes lungs to collapse.

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30
Q

Flow =

A

Pressure/Resistance

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31
Q

How does the diaphragm allow respiration? How much of the work of respiration does it account for?

A

Flattens out, changing cavity volume/pressure

75%

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32
Q

Other than the diaphragm, who else helps with inspiration?

A

External Intercostal muscles
Scalene
Sternomastoid Muscles

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33
Q

When are the non-diaphragm muscles especially important?

A

Forced Inspiration

ex. = exercise

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34
Q

Explain inspiration in the context of air flow/pressure.

A
  • Expiration lowers IP Pressure (Makes subatmospheric)
  • Pressure diff between Alv and URT causes air to flow toward alveoli
  • Large area makes small pressures sufficient to move lots of air
35
Q

How does expiration typically work?

A

Passive action of the recoil of the elastic elements in the lungs.

36
Q

What is different about active expiration?

A

Use of abdominal muscles

37
Q

Respiratory resistance equation.

A

(Airway Resistance) + (Tissue Resistance) + (Thoracic Resistance)

38
Q

What might increase pulmonary resistance?

A

Disease (Pulm. Fibrosis)

Increased Blood in Lungs

39
Q

What might increase thoracic resistance?

A

Diseases of the rib cage and diaphragm.

Increased intra-abdominal volume.

40
Q

What is surface tension?

A

Mutual attraction of water molecules at air-water interface

41
Q

Effect of surface tension on lung compliance?

Test that can show us this?

A

Surface tension alone would tend to decrease lung compliance, leading to collapse of the alveoli

Fill a lung with saline

42
Q

What is surfactant?

A

A phospholipid, made of dipalmitoyl phosphatidylcholine and 4 proteins

43
Q

What does surfactant do?

A

Dramatically lowers surface tension of the alveolar surface

Induces area-dependent effect on tension

44
Q

Why does area-dependent effect on tension happen?

A

Area-Dependent changes in packing of surfactant molecules

Resulting changes btw water molecules

45
Q

Pressure required maintain alveoli size is ________ related to its radius.

A

Inversely

46
Q

Describe the role of surfactant using the terms tension, pressure, and radius.

A

Surfactant decreases tension to compensate for increased pressure due to smaller radius.

47
Q

At ____ weeks gestation, surfactant production begins.

A

32

48
Q

Surfactant production is under the control of _____

A

Cortisol

49
Q

What does spirometry measure?

A

Volumes and capacities to assess lung function.

50
Q

Normal Tidal Volume?

A

0.5L

51
Q

Normal Inspiratory Capacity? IC Equation?

A

3L

TV+IRV

52
Q

What is Expiratory Reserve Volume? Normal Levels?

A

Maximum volume of forced exhale after normal exhale

1.5L

53
Q

Vital Capacity – Eq. and Normal level

A

TV+IRV+ERV

4.5L

54
Q

What is residual volume? Normal level?

A

Volume left after maximum Exhale

1.5 L

55
Q

Functional Residual Capacity. Equation and Normal level?

A

ERV+RV

3L

56
Q

What is described by Functional Residual Capacity?

A

Balance of force between lung collapse and chest wall recoil.

57
Q

How to measure functional residual capacity.

A
  • Measure using known concentration and volume of insoluble gas.
  • Gas will come to constant concentration after equilibrating with the lungs.
  • C1V1=C2(V1+FRC)
58
Q

What is total lung capacity?

A

Max volume the lungs can hold.

59
Q

What does forced expiratory volume measure?

What is forced vital capacity?

A

Volume exhaled in the first second of forced exhalation after inhale to TLC. FVC is the total air expelled forcibly

60
Q

Average value for FEV/FVC?

A

0.8 (rate of 8-10/min)

61
Q

Two types of work in breathing.

A

Elastic Work

Flow resistive work

62
Q

Cause of airway resistance?

A

Frictional loss of energy from airway walls

63
Q

Radius resistance relationship

A

resistance is proportional to 1/r^4

64
Q

Two types of pathological changes to the lungs.

A

Obstructive or Restrictive

65
Q

Explain Asthma and resistance.

A

Bronchoconstriction causes increased resistance

Increased mucous, edema, and inflammation may be less tractable)

66
Q

What is exercise induced asthma?

A

Coughing, wheezing, and chest tightness caused by bronchoconstriction.

Thought to be related to heat and water loss in rapid respiration.

67
Q

Explain the changes of resistance in emphysema.

A

FRC increase
Elastic Work Decreases
Airway resistance increases

68
Q

Name five restrictive diseases

A 
Atalectsis
Consolidation
Pleural Effusion
Pneumothorax
Respiratory Distress Syndrom
69
Q

What are restrictive diseases characterized by?

A

Reduction in total lung capacity

70
Q

What is atelectsis?

A

Lung collapse

71
Q

What is consolidation?

A

Filling of alveolar spaces with inflam. exudates

72
Q

What is pleural effusion?

A

Heart failure
Hypoporteinemia
Infection
Neoplasm

73
Q

Two kinds of RDS? Who gets them?

A

Idiopathic RDS – Infants, esp. premature

Acute RDS – Adults

74
Q

What is associated with onset of Acute RDS?

A

12-24 hours after trauma, near-drowning, acid aspiration, etc.

75
Q

How do restrictive diseases alter FEV/FVC? FRC?

A

Increased FEV/FVC

FRC decreases

76
Q

What is anatomic dead space?

A

The volume of conductive, non-respiratory passages.

77
Q

Tidal volume must be ______ than Dead Space

A

Greater

78
Q

What happens to dead space in ventilation?

A

Exhale forves old alveolar air into dead space
Inhale beings some of this air back with new air
Some new air stays in the dead space

79
Q

Tidal Volume =

A

Volume of Dead Space Air - Alveolar Air

80
Q

Alveolar Ventilation =

A

(TV-Vdead) X (#breaths/minute)

81
Q

Effect of dead space on effective ventilation?

A

Rapid, Shallow breathing ventilates less efficiently

Deep, Slow is better because of dead space contribution

82
Q

What is it? What do you do?

Small Puncture Wound
No Breath Sounds on Right
R=28

A

Collapsed R Lung

Close wound, put in chest tube and connect with neg. pressure system

83
Q

What happens when people breathe their vomit?

A

Aspirate HCl –> Kills Alveoli –> No Lung Tissue for Exchange

You die.

Physiology - Pulmonary (5 decks)

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