Resp Physiology Flashcards
How many rib pairs do we have?
12
How many are true ribs and how many are false?
7 true ribs
5 false (2 floaters)
Name the bones of the sternum
Manubrium, Body, Xiphoid process
What 2 bones create the shoulder girdle?
clavicle and scapula
During inspiration, what moves passively?
the diaphragm: 75-80%
The external Intercostals
During inspiration, what moves actively?
the diaphragm, external intercostals, scalene, sternocleidomastoid
During expiration, what moves passively?
the Diaphragm
During expiration, what moves actively?
diaphragm, internal intercostals, rectus abdominus, internal/external obliques, transverse abs
Name 7 things located in the mediastinum.
Heart, great vessels, trachea, esophagus, thymus, thoracic duct, phrenic nerve
Name 4 structures located in the plueral cavity
lungs, visceral pleural, pareital pleura, pleural fluid
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. 23
b. 1
c. 16
d. 17
e. 19
f. Alveoli
g. 20
h. 23
i. 23rd
Im not reviewing the airway…. you should know this
The lungs have an ________ elastic recoil to their makeup.
Approx ______ is elastic fiber
Approx _____ is the fluid lining the surface of the lungs.
inward
1/3
2/3
The thoracic cage has an _______ and _______ recoil or tendency.
outward and upward
What is the pressure in the intra-plueral pressure?
-5 cmH2O
The intra-pleural pressure is made more negative upon _______ to approx _____ cmH2O
inspiration, -7
this causes the lungs to expand and create a subatmospheric environment
Under normal respirations is the intra-pleural pressure ever positive?
No
Discuss normal ventilation: inhalation
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.
Discuss normal ventilation: ventilation
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.
Which airways are lined with cartilage and smooth muscle tissue?
larger airways
Which airways are lined with smooth muscle tissue- but lack cartilage?
smaller airways
They are also attatched to lung paranchyma
Physiologic Control
Bronchial airways have what type of innervation?
And what are the receptors?
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)
Humoral Control
What are 3 parts of the humoral system that control the airways?
circulating catecholamines
inflammatory mediators
Neural peptides (vasoactive intestinal peptides)
The alveolus
“____ __ ______ ___ _____ _________!!”
This is where the magic happens!!!
Alveoli are how thick?
Surrounded by what?
What occurs at this point?
ONE cell layer thick
vascular bundle/ network
Gas exchange
What do type 1 alveolar cells do?
create a tight junction
What do type 2 alveolar cells do?
Surfactant production
3 other important cells in the airways?
Macrophages
Mast
Lymphocytes
Under NORMAL conditions alveoli in the apex are more/less distended and at a higher/lower resting pressure?
more
lower
(alveoli are at near MAXIMAL expansion)
Under normal conditions the alveoli in the base of the lungs are more/less distended and are at a higher/lower resting pressure.
less
higher
the pressures in the apex and bases are related to gravity. When averaged, the normal ressure of the alveoli at end expiration is approximately ______
Zero
How many zones of West are there?
4
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
Partial pressure of the alveolus= PA
Partial pressure of the artery= Pa
Partial pressure of the vein= PV
In zone 1 put the PA Pa and PV in order of pressures
PA > Pa > PV
In zone 2 put the PA Pa and PV in order of pressures
Pa > PA > PV
In zone 3 put the PA Pa and PV in order of pressures
Pa > PV > PA
Just another pic of the zones of West
In Zone 1 is there what?
NO respiration. No exchange of gases or wastes!
In Zone 2 how is the respiration?
marginal/ intermittent
In Zone 3 how is the respiration?
BEST!!!!!
What is the normal ventilation?
4 L/min
What is normal perfusion?
5 L/min
In case you forgot…. How do you calc MV?
VT x Respirations
Average MV for an adult?
Average Alveolar vent for an adult?
5l/min
4l/min
What are some causes of V/Q mismatch?
position changes, anesthesia (PPV,NMB), Heart disease (failure, MI), Lung disease (dead space, shunting, atelectasis)
A- Normally functioning unit
B- Shunt (asthma, atelectasis, ONLV)
C- Dead Space (PE, COPD- sorta Lo)
D- Dead unit
Tell me a bit about HPV
Pulmonary vasculature sensitive to hypoxia
Increased mediators such as leukotrienes compared to vasodilatory prostaglandins
Hypercarbia in lungs = vasoconstriction
How long does it take atelectasis to form during anesthesia?
5 min
How does the law of lapace relate to vent/perfusion during mechanical ventilation?
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
