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S2 MAP II > Pulmonary Ventilation and Circulation > Flashcards

Pulmonary Ventilation and Circulation Flashcards

1
Q

pleurae

  • what are they
  • potential pathology
  • involves which step of the O2 transport system
  • what would you hear with auscultation
A 
outside coverings of lungs
potential pathology
-pleurisy/pleuritis
O2 system
-step 3?
friction rub sound with auscultation
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2
Q

what are aventitious breaths?

-types

A

abnormal sounds that are heard over a patient’s lungs and airways

  • crackles (rales)
  • wheezes
  • pleural rubs and stridor
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3
Q

lung tissue

  • made of
  • benefit of this composition
A

primarily elastic connective tissue

elasticity of healthy lungs helps reduce the work of breathing

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4
Q

bronchopulmonary segments

  • _____ vs. _____
  • separated by…
  • served by own _____
  • receives air from an individual _____
A 
R vs. L
separated by connective tissue septa
served by own artery and vein
receives air from an individual bronchus
clinical relevance
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5
Q

R bronchopulmonary segments

A 
upper
-apical
-anterior
-posterior
middle
-lateral
-medial
lower (base)
-anterior
-superior
-lateral
-posterior
-medial
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6
Q

L bronchopulmonary segments

A 
upper
-apical posterior
-anterior
-superior (lingula)
-inferior (lingula)
lower (base)
-anterior
-superior
-lateral
-posterior
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7
Q

upper respiratory tract

  • location
  • components
A

from nasal and oral orifices to the false vocal cords in the larynx

  • nose
  • nasal cavity
  • pharynx (naso-, oro-, laryngo-)
  • larynx
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8
Q

lower respiratory tract

  • location
  • components
A 
from level of true vocal cords to the alveoli
components
-trachea
-R and L primary bronchi
-second, tertiary, etc. bronchi
-bronchioles
-terminal bronchioles
-respiratory bronchioles
-alveolar duct --> alveolar sacs --> alveoli
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9
Q

lower respiratory tract

-divided into what 2 regions

A

conducting and respiratory zones

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10
Q

conducting zone

-location

A

trachea through terminal bronchioles

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11
Q

conducting zone

  • trachea bifurcates at about…
  • bifurcates into…
  • these divide into…
A

trachea bifurcates at about T7
bifurcates into R and L main bronchi
main bronchi divide into lobar bronchi

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12
Q

conducting zone: lobar bronchi

  • how many
  • divides into…
A

3 on R, 2 on L

divides into segmental bronchi (tertiary)

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13
Q

conducting zone

-about how many order of branching air passageways

A

about 23

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14
Q

conducting zone: bronchioles

-size

A

< 1 mm diameter

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15
Q

conducting zone: terminal bronchioles

-size

A

< 0.5 mm in diameter

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16
Q

where and what is the anatomic dead space?

A

conducting zone + upper airway
space in respiratory passage where gas exchange does not occur
about 150 ml’s

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17
Q

transition into respiratory zone

-begins…

A

begins where terminal bronchioles feed into respiratory bronchioles

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18
Q

respiratory zone

  • contains ____ air at rest
  • holds up to _____ with max inspiration
A

2.5 L air at rest

up to 4-6 L with max inspiration

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19
Q

alveoli

  • walls composed of…
  • external surface covered by…
A

walls composed of a single layer of Type I cells - squamous epithelial - surrounded by basement membrane
external surface covered by a “web” of capillaries

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20
Q

respiratory membrane

-composed of

A

composed of

  • alveolar epithelial cells
  • capillary walls
  • fused basement membrane
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21
Q

how much O2 and CO2 leaves and enters the alveoli per minute, respectively

A

250 ml O2 leaves alveoli to blood

200 ml CO2 diffuse from blood to gas in alveoli per minute

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22
Q

alveoli type II cells

-function

A

secrete surfactant

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23
Q

what is a pathology that can affect the efficiency of the alveoli

A

pulmonary edema

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24
Q

anatomical dead space

-definition

A

volume of all the space of the respiratory system other than alveoli and their closely related gas exchange areas

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25
Q

physiological dead space

-what is it

A

alveolar dead space ( usually due to diseased state) + anatomical dead space

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26
Q

how different should normal and pathological dead space be from each other in a healthy individual

A

should be similar

27
Q

blood supply to lung tissue

  • comes from
  • this blood is drained through…
A

comes from bronchial arteries
-off of thoracic aorta
drains into pulmonary veins
-this will decrease the partial pressure of O2 in the pulmonary veins, since it is deoxygenated

28
Q

PSNS effect on airways

A

constricts air tubes

  • ACh released - smooth muscle contraction
  • increases airway resistance
  • slows and reduces volume of airflow
29
Q

SNS effect on airways

A

dilates air tubes

  • weak direct control by sympathetic nerve fibers
  • EPI and NE - smooth muscle relaxation
  • -stronger affect by epi and ne released in blood: released by adrenal medulla following SNS stimulation
  • reduces airway resistance, enhances flow
30
Q

five major functional events of respiraton

A 
pulmonary ventilation
external respiration
transport of respiratory gases
internal respiration
regulation of respiration/ventilation
31
Q

five major functional events of respiraton

A 
pulmonary ventilation
external respiration
transport of respiratory gases
internal respiration (at the muscle)
regulation of respiration/ventilation
32
Q

pulmonary ventilation

-what is it

A

movement of air into and out of lungs

33
Q

pulmonary ventilation

-mechanisms of expansion/contraction of lungs

A

contraction of diaphragm: lengthens or shortens the chest cavity
elevation/depression of ribs

34
Q

diaphragm function

A

primarily responsible for quiet inspiration
contracts: dome shape “flattens”
increases thoracic volume
relaxes back to dome shape during quiet expiration
decreases thoracic volume

35
Q

additional inspiration muscles

A 
elevation of ribs
-external intercostals
other muscles
-SCM
-scalenes
-serratus anterior
-pectoralis minor
-erector spinae muscles
36
Q

expiration muscles

A

recruited with increased respiratory demands/forced expiration

  • internal intercostals
  • rectus abdominis
37
Q

respiratory pressures are always described relative to…

A

atmospheric pressure (760 mmHg)

38
Q

intrapulmonary pressure

  • where is this pressure
  • wants to…
A

alveolar pressure

wants to equalize with atmospheric pressure

39
Q

intrapleural pressure

  • where is this pressure
  • what is the pressure?
A

pressure in pleural cavity

about -4 mmHg (lower than atmospheric pressure by 4 mmHg)

40
Q

Boyle’s Law

-what does it say

A

at constant temperature, the pressure of a gas varies inversely with its volume

41
Q

alveolar pressure

  • what is it?
  • during inspiration…
  • during expiration…
A

pressure inside lung alveoli
during inspiration
-alveolar pressure drops slightly to -1 cm H2O
-enough change to allow 500 mL air to be pulled into lungs in about 2 seconds
expiration
-alveolar pressure rises to 1 cmH2O
-drives air out of alveoli in 2-3 seconds

42
Q

transpulmonary pressure

  • what is it
  • function
A

alveolar pressure minus intrapleural pressure
function
-keeps air spaces of lungs open
-difference between the alveolar pressure and the pleural pressure

43
Q

atelectasis

-what is it?

A

lung collapse (or part of lung collapses)

44
Q

pneumothorax

-what is it

A

presence of air in intrapleural space

45
Q

alveolar ventilation per minute

  • what is it
  • major factor in…
A

total volume of new air enterior the alveoli and their adjacent gas exchange areas each minute
major factor in determining the concentration of O2 and CO2 in the alveoli

46
Q

resistance to airflow in bronchial tree during

  • normal respiratory conditions
  • diesease conditions
A

normal
-larger bronchioles and bronchi near trachea provide greatest amount of resistance to airflow
disease
-smaller bronchioles provide greater resistance to airflow

47
Q

lung compliance

  • what is it?
  • a normal lung is _____
  • determined by…
A

measure of the change in lung volume that occurs with a given change in transpulmonary pressure
a normal lung is distensible
determines by
-distensibility (elastic forces) of lung tissue
-alveolar surface tension
–surfactant

48
Q

idiopathic pulmonary fibrosis is an example of a _____ lung disease

A

restrictive

49
Q

surfactant

-surface tension principle

A

“raindrop”
alveoli without surfactant
the smaller the alveolus, the greater the alveolar pressure causes by the surface tension

50
Q

surfactant

  • composition
  • functions
A

phospholipids, proteins, and ions
functions
-greatly reduces surface tension
-reduces effort required by respiratory muscle to expand the lungs

51
Q

why is the intrapleural pressure negative

A

2 forces act to pull lungs from the thorax wall (parietal pleura) which would cause lung collapse
-lungs natural tendency to recoil
-surface tension of alveolar fluid
opposed by natural elasticity of chest wall
maintaining pleural fluid adhesive force
combination of all forces

52
Q

when is surfactant first secreted into the alveoli

A

7 months gestation

53
Q

what would happen if a baby is born prematurely without surfactant being produced?

A

lungs would want to collapse

54
Q

work of breathing

  • 3 components during quiet breathing
  • energy expenditure
A 
components
-compliance work or elastic work
-tissue resistance work
-airway resistance work
energy expenditure
-3-5% total body energy expenditure required for pulmonary ventilation
55
Q

relationship of flow, velocity, cross-sectional area

A

flow = change in pressure / resistance

flow will decrease with increased resistance

56
Q

pulmonary function measurements

A 
inhaled minute volume (Vi)
exhaled minute volume (Ve)
FVC
FEV1
Minute respiratory volume
57
Q

Vi

-what is it

A

volume of gas inhaled per minute

58
Q

Ve

-what is it

A

volume of gas exhaled per minute

59
Q

FVC

A

total volume of air that can be exhaled during a forced exhalation

60
Q

FEV1

-what is it

A

amount of vital capacity that can be exhaled in 1 second

61
Q

minute respiratory volume

-equation

A

RR x tidal volume

62
Q

pulmonary circulation - heart to lungs

A

pulmonary artery –> R and L main branches –> continual branching
-thin walled
-short
-larger diameters than systemic counterparts
-much more compliant: can accommodate stroke volume output of R ventricle
pulmonary vein

63
Q

blood volume and distribution

  • blood gets distributed to alveoli with…
  • low O2 in alveoli causes…
  • -this reaction is opposite to…
A

blood gets distributed to alveoli with best oxygenation

low O2 pressure in alveoli causes capillary constriction - opposite to systemic capillary reaction to low O2 pressure

64
Q

if alveolar pressure is greater than capillary? pressure..

A

capillaries close and no blood flow

S2 MAP II (17 decks)

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