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Principles III > Resp Physiology > Flashcards

Resp Physiology Flashcards

1
Q

How many rib pairs do we have?

A

12

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2
Q

How many are true ribs and how many are false?

A

7 true ribs

5 false (2 floaters)

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3
Q

Name the bones of the sternum

A

Manubrium, Body, Xiphoid process

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4
Q

What 2 bones create the shoulder girdle?

A

clavicle and scapula

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5
Q

During inspiration, what moves passively?

A

the diaphragm: 75-80%

The external Intercostals

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6
Q

During inspiration, what moves actively?

A

the diaphragm, external intercostals, scalene, sternocleidomastoid

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7
Q

During expiration, what moves passively?

A

the Diaphragm

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8
Q

During expiration, what moves actively?

A

diaphragm, internal intercostals, rectus abdominus, internal/external obliques, transverse abs

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9
Q

Name 7 things located in the mediastinum.

A

Heart, great vessels, trachea, esophagus, thymus, thoracic duct, phrenic nerve

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10
Q

Name 4 structures located in the plueral cavity

A

lungs, visceral pleural, pareital pleura, pleural fluid

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11
Q

There are \__*a__ generations of the bronchi. #_b_-_c*_ are conduction.

_d__-_e__ are transition and ___f____ become present.

And #__g_-_h__ are respiratory and the ____i__ generation ends in alveolar sacs

A

a. 23
b. 1
c. 16
d. 17
e. 19
f. Alveoli
g. 20
h. 23
i. 23rd

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12
Q

Im not reviewing the airway…. you should know this

A
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13
Q

The lungs have an ________ elastic recoil to their makeup.

Approx ______ is elastic fiber

Approx _____ is the fluid lining the surface of the lungs.

A

inward

1/3

2/3

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14
Q

The thoracic cage has an _______ and _______ recoil or tendency.

A

outward and upward

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15
Q

What is the pressure in the intra-plueral pressure?

A

-5 cmH2O

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16
Q

The intra-pleural pressure is made more negative upon _______ to approx _____ cmH2O

A

inspiration, -7

this causes the lungs to expand and create a subatmospheric environment

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17
Q

Under normal respirations is the intra-pleural pressure ever positive?

A

No

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18
Q

Discuss normal ventilation: inhalation

A

muscular force causes contraction of the diaphragm, contraction of the external intercostal muscles (pale handle effect).

This increases the negativity of the intra-pleural space, thereby drawing the surface of the lungs outward.

Creates a negative environment within the lungs, drawing air into the thoracic space.

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19
Q

Discuss normal ventilation: ventilation

A

Muscular interaction (exhalation) passive relaxation of diaphragm and passive relaxation of the external intercostals.

Increases pressure within thoracic cavity along with elastic recoil of lungs, forcing air to be expired by the body.

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20
Q
A
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21
Q

Which airways are lined with cartilage and smooth muscle tissue?

A

larger airways

22
Q

Which airways are lined with smooth muscle tissue- but lack cartilage?

A

smaller airways

They are also attatched to lung paranchyma

23
Q

Physiologic Control

Bronchial airways have what type of innervation?

And what are the receptors?

A

Sympathetic and Parasympathetic

Sympathetic is Beta 2and some Alpha 1

Parasympathetic is roughly 80% M2 and 20% M3

(FUN FACT: M2 are parasympatholytic in the pulm system)

24
Q

Humoral Control

What are 3 parts of the humoral system that control the airways?

A

circulating catecholamines

inflammatory mediators

Neural peptides (vasoactive intestinal peptides)

25
Q

The alveolus

“____ __ ______ ___ _____ _________!!”

A

This is where the magic happens!!!

26
Q

Alveoli are how thick?

Surrounded by what?

What occurs at this point?

A

ONE cell layer thick

vascular bundle/ network

Gas exchange

27
Q

What do type 1 alveolar cells do?

A

create a tight junction

28
Q

What do type 2 alveolar cells do?

A

Surfactant production

29
Q

3 other important cells in the airways?

A

Macrophages

Mast

Lymphocytes

30
Q

Under NORMAL conditions alveoli in the apex are more/less distended and at a higher/lower resting pressure?

A

more

lower

(alveoli are at near MAXIMAL expansion)

31
Q

Under normal conditions the alveoli in the base of the lungs are more/less distended and are at a higher/lower resting pressure.

A

less

higher

32
Q

the pressures in the apex and bases are related to gravity. When averaged, the normal ressure of the alveoli at end expiration is approximately ______

A

Zero

33
Q

How many zones of West are there?

A

4

34
Q

The zones of West were devised by the nature of the alveoli and their interaction with the vascular system.

What do these mean?

PA

Pa

PV

A

Partial pressure of the alveolus= PA

Partial pressure of the artery= Pa

Partial pressure of the vein= PV

35
Q

In zone 1 put the PA Pa and PV in order of pressures

A

PA > Pa > PV

36
Q

In zone 2 put the PA Pa and PV in order of pressures

A

Pa > PA > PV

37
Q

In zone 3 put the PA Pa and PV in order of pressures

A

Pa > PV > PA

38
Q
A
39
Q

Just another pic of the zones of West

A
40
Q

In Zone 1 is there what?

A

NO respiration. No exchange of gases or wastes!

41
Q

In Zone 2 how is the respiration?

A

marginal/ intermittent

42
Q

In Zone 3 how is the respiration?

A

BEST!!!!!

43
Q

What is the normal ventilation?

A

4 L/min

44
Q

What is normal perfusion?

A

5 L/min

45
Q

In case you forgot…. How do you calc MV?

A

VT x Respirations

46
Q

Average MV for an adult?

Average Alveolar vent for an adult?

A

5l/min

4l/min

47
Q

What are some causes of V/Q mismatch?

A

position changes, anesthesia (PPV,NMB), Heart disease (failure, MI), Lung disease (dead space, shunting, atelectasis)

48
Q
A

A- Normally functioning unit

B- Shunt (asthma, atelectasis, ONLV)

C- Dead Space (PE, COPD- sorta Lo)

D- Dead unit

49
Q

Tell me a bit about HPV

A

Pulmonary vasculature sensitive to hypoxia

Increased mediators such as leukotrienes compared to vasodilatory prostaglandins

Hypercarbia in lungs = vasoconstriction

50
Q

How long does it take atelectasis to form during anesthesia?

A

5 min

51
Q

How does the law of lapace relate to vent/perfusion during mechanical ventilation?

A

2T = PR
T= Wall tension (surface tension)
P= Distending pressures within the alveolus
R= Radius of the alveolus
Rearranged P= 2T/R
Surface tension proportional
Radius inversely proportional

Therefor: Alveoli in apex r/t size require a lower pressure to increase in air/gas uptake

Alveoli in bases will require a higher pressure for distensibility

52
Q
A

Principles III (24 decks)

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