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phys exam 3 > Resp 1 > Flashcards

Resp 1 Flashcards

1
Q

tidal volume

A

volume inspired or expired with each normal breath

500

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2
Q

muscles of inspiration

A

diaphram
externam intercostals
SCM
scalene

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3
Q

muscles of expiration

A

abdominal

internal intercostals - ribs downward/inward

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4
Q

work of breathing

A

W = P x changeV

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5
Q

inspiratory reserve volume IRV

A

volume that can be inspired over and above tidal volume

used during exercise
3000ml

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6
Q

expiratory reserve volume ERV

A

volume that can be expired after the expiration of a tidal volume
1100ml

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7
Q

residual volume

A

volume that remains in lungs after maximal expiration
cannot be measured by spirometry
1200ml

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8
Q

volumes that cannot be measured by spirometry

A

total lung capacity
functional residual capacity
residual volume

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9
Q

minute ventilation

A

tidal vol x breaths/min

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10
Q

alveolar ventilation

A

(tidal vol - dead space) x breaths/min

5,250ml/min

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11
Q

inspiratory capacity IC

A

sum of tidal volume and Inspiratory reserve volume

3500ml

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12
Q

functional residual capacity FRC

A

sum of ERV and RV

amount of air that remains in lungs at the end of a normal expiration
2300ml

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13
Q

vital capacity VC

A

sum of tidal vol, IRV, ERV

volume of air that can be forcible expired after maximal inspiration

4600ml

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14
Q

total lung capacity TLC

A

sum of all 4 lung volumes
vol in lungs after a maximal inspiration
cannot be measured by spirometry

5800ml

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15
Q

pH

A

7.35 - 7.45

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16
Q

pCO2

A

38 - 42

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17
Q

bicarb

A

22-26

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18
Q

base excess

A

+1 - -1

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19
Q

OaO2

A

95 - 100

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20
Q

resp acidosis

A

decreased pH
increased pCO2
(increased bicarb)

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21
Q

resp alkalosis

A

increased pH
decreased pCO2
(decreased bicarb)

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22
Q

metabolic acidosis

A

decreased pH
decreased bicarb
(decreased pCO2)

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23
Q

metabolic alkalosis

A

increased pH
increased bicarb
(increased pCO2)

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24
Q

pO2 atm

A

.21 x 760 = 760

partial pressure of oxygen

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25
Q

pO2 lung

A

FiO2 (Patm - PH2O) = 150

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26
Q

PaO2

A

in alveoli

FiO2 (Patm - pH2O) - PaO2/.8 = 100

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27
Q

lung vol

A

4L

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28
Q

SA alveoli

A

85m^2 tennis court

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29
Q

conditions w increased compliance

A

aging

emphysema

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30
Q

conditions w decreased compliance

A 
pulmonary fibrosis
alveolar edema
altelectasis
hypoventilated lung
increased pulm venous pressure
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31
Q

Dorsal Resp Group

A 
located in medulla
INSPIRATION 
rhythm of breathing, determines when "ramp up" stops 
CN IX & X
phrenic nerve to diaphram
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32
Q

Ventral Resp Group

A

located in medulla
EXPIRATION (quiet during normal breathing)
increases drive for resp during exercise

33
Q

Hering Breuer Reflex

A

innspiratory inhibatory
prevent overinflation, stretch in smooth muscle of airway
affarant fivers in vafas,
stop inspiration early

34
Q

apneustic center

A

lower pons
sim inspiration
deep and prolonged gasp
[rolonged ramp

35
Q

pneumotaxic center

A

upper pons
inbibits inspiration by switching off ramp (limit filling time)
secondary increase RR

36
Q

Stretch receptors

A

slow adapting
activated by lung inflation
mylenated vagal afferent
COPT, increased vol, need more time to exhale, delay next inspiration

37
Q

irritant receptors

A

between epithelial cells in trachea, bronchi, bronchioles
rapid adapting
myelinated vagal afferent
cough, sneeze, bronchoconstrict (similar to asthma)
noxious stim (pollon, dust)

38
Q

J receptors

A

alveolar walls, close to capillaries
engorgement of pulm capillaries
cause rapid, shallow breathing
dyspnea, abnormal SOB, edema interstitioal lung disease

39
Q

ficks law

A

diffusion directly proportional to…

conc gradient
SA
diffusion coefficient (perm/MW)

inversely proportional to memb thickness

40
Q

inspired air

A

PO2: 159
PCO2: 0.3
PH2O: 3.7
PN2: 597

41
Q

expired air

A

PO2: 127
PCO2: 28
PH2O: 21
PN2: 584

42
Q

In alveoli

A

PO2: 104
PCO2: 40
PH2O: 47
PN2: 569

43
Q

Pulmonary Vein

A

(to system)

PO2: 100
PCO2: 40
PH2O: 47
PN2: 573

44
Q

Tissues

A

PO2: 40
PCO2: 46
PH2O: 47
PN2: 573

45
Q

Pulmonary Artery

A

(from system)

PO2: 40
PCo2: 46
PH2O: 47
PN2: 573

46
Q

Oxygen solubility coefficient

A

0.024

47
Q

carbon dioxide solubility coefficient

A

0.57

more attracted to water than O2

48
Q

henrys law

A

partial pressure = conc dissolved gas/solubility coefficient

49
Q

factors that affect the rate of diffusion

A 
solubility of gas
cross sectional area
distance which gas must diffuse
molecular weight of gas
temp of fluid
50
Q

2 things that change conc O2 in alveoli

A

1 - rate of absorption in blood

2 - rate of O2 into lungs via ventilation

51
Q

layers for diffusion - resp memo

A

1 - layer of fluid lining alveoli (surfactant)
2 - alveolar epithelial cells
3 - epithelial basement memo
4 - thin interstitial space between alveolar epithelial and cap memo
5 - capillary epithelial memb

thickness of memo is 0.6micrometers
total sa 70m2

52
Q

diffusion capacity O2

A

21 ml/min/mmHg at rest

53
Q

Left Shift O2-Hb Diss Curve

A

Increased affinity = less delivered to tissue

1 - decreased temp
2 - decreased PCo2
3 - Decreased 2, 3, DPG
4 - Increased pH (alkalosis - Bohr effect)

54
Q

Right Shift O2-Hb Diss Curve

A

decreased affinity = more delivered to tissue

1 - increased temp
2 - increased PCo2
3 - Increased 2, 3 DPG
4 - Decreased pH (acidosis)

55
Q

O2 delivery to tissue dependent on…

A

cardiac output
Hb content of blood
Ability of lung to oxygenate the blood

56
Q

zone 1

A

no blood flow

PA > Pa > Pv

capillaries pressed flad

57
Q

zone 2

A

intermittent blood flow during systole

Pa > PA > Pv

58
Q

zone 3

A

high, continuous flow bc cap pressure remains higher for full cycle

Pa > Pv > PA

59
Q

pulmonary circ

A

500ml

75ml in alveolar/cap memb

60
Q

2 protective mechanisms of lung blood flow

A

1 - recruit during stress/increased demand

2 - hypoxic vasoconstriction

61
Q

factors affecting pulmonary circulation

A

1 - blood flow during exercise
2 - hypoxic vasoconstriction
3 - nitric oxide
4 - acid/base;… alkalemia vasodilates

62
Q

alveolar ventilation rate V

A

4L/min

63
Q

pulmonary blood flow Q

A

5L/min

64
Q

4 causes of hypoxic state

A

1 - V/Q (most common) - will improve w increased FiO2
2 - hypoventilation
3 - diffusion limitation - fibrosis
4 - shunt - won’t improve w increased FiO2

65
Q

A-a gradient

A

over 15 bad
used to compare causes of hypoxemia

when normal - hypoventilation
above 15 - V/Q, shunt, diffusion defect

66
Q

alveolar gas exchange equation

A

PAO2 = FiO2 (Pb - Ph20) - (PACO2/R)

PAO2 = .21 (760 - 47) - (40/.8) = 100

67
Q

gases inhaled/exhaled

A

inhaled - O2, N2

exhaled - O2, CO2, H2O, N2

68
Q

end expiration

A

FRC - outward recoil of chest wall and inward force are equal

69
Q

inspiration

A

contraction of respiratory muscles begins to dominate, assisted by chest wall recoil out, overcomes tendency of lungs to recoil

70
Q

end inspiration

A

respiratory muscle contraction maintains lung expansion

71
Q

expiration

A

resp muscles relax, allowing elastic recoil of lungs to deflate lungs

72
Q

point of lowest intrapulmonary pressure

A

half way into inspiration

73
Q

point of highest intrapulmonary pressure

A

halfway into expiration

74
Q

3 goals of ventilation

A

1 - decrease work load
2 - maintain gas exchange
3 - regulate Co2 - acid/base

75
Q

co2

A

40 normal
45-75 = increase in vent
75+ curve flattens out

76
Q

V/Q = 0

A

no vent
PO2 = 40
PCO2 = 45

77
Q

V/Q = inf

A

no perfusion
PO2= 149
PCO2= 0

78
Q

V/Q = 0.8

A

normal
PO2= 104
PCO2 = 40

phys exam 3 (2 decks)

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