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DMU Respiratory > Resp_L02_Flashcards > Flashcards

Resp_L02_Flashcards

1
Q

What are the three key factors that control respiration? Which is most important?

A

PCO2 (most important), PO2, pH.

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2
Q

Describe the pathway by which PCO2, PO2, and pH influence respiration.

A

PCO2/PO2/pH –> peripheral chemoreceptors –> sensory integration in brain –> central pattern generators (CNS respiratory centers) –> spinal cord/CN VII, IX, X, XI, XII –> respiratory muscles.

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3
Q

What is the accessory pathway by which PCO2 can affect respiration?

A

PCO2 can directly influence central chemoreceptors which then influence central pattern generators (CNS respiratory centers).

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4
Q

True or false: respiration is directly influened by rate of metabolism.

A

TRUE

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5
Q

What are the components of the conducting airways?

A

Trachea, bronchi, and bronchioles up to generation 16 or 17.

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6
Q

What are the components of the respiratory airways/alveolar air spaces?

A

Bronchioles of generation 16 or 17 to alveoli.

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7
Q

Smooth muscle is a major target for drugs/treatments in the respiratory system. Where is smooth msucle primarily located in the respiratory tree?

A

Bronchioles

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8
Q

What is anatomic dead space? What does this term signify?

A

Anatomic dead space comprises of the respiratory tree outside the alveolar air spaces (trachea, bronchi, and up to 16th/17th generation of bronchioles). No gas exchange can occur here.

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9
Q

Where does resistance to airflow mainly come from in the respiratory tree?

A

Bronchi and bronchioles.

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10
Q

What is the largest contributing characteristic to airway resistance? How is it related to resistance?

A

Radius of the airway; inversely related.

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11
Q

What type of drugs should particularly be avoided in patients with asthma because they result in M3 activation and reduction of airway size?

A

Muscarinic agonists

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12
Q

How do sympathetic activators affect airway size? What are two examples of drugs that can be used for this affect?

A

Decrease resistance by increasing airway radius. Epinephrine & albuterol

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13
Q

What are the 6 components of the respiratory membrane?

A

Lumen of alveolus to lumen of capillary: fluid lining alveolus, alveolar epithelium, epithelial basement membrane, interstitial space, capillary basement membrane, and capillary endothelial membrane.

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14
Q

What is the function of fibroblasts in the lung interstitium?

A

Produce collagen and elastin (impart distensibility and elastic recoil of lungs).

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15
Q

What are 3 variable factors that influence gas diffusion across respiratory membrane?

A

Delta-P: difference in partial pressure of gas between alveoli and blood; A: surface area available for gas diffusion; d: membrane thickness.

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16
Q

What type of capillaries does parietal pleura contain? Do these capillaries produce pleural fluid under normal conditions?

A

Systemic capillaries; yes.

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17
Q

What type of capillaries does visceral pleura contain? Do these capillaries produce pleural fluid under normal conditions?

A

Pulmonary capillaries; no.

18
Q

How is pleural fluid drained from the interpleural space?

A

Through stoma (openings into lymphatic channels) located in parietal pleura.

19
Q

What happens when pulmonary capillaries start leaking fluid?

A

Pleural effusion

20
Q

What are the two most common reasons for pleural effusion?

A

Congestive heart failure (most common) and decreased microvascular oncotic pressure (leads to systemic edema).

21
Q

What is the problem with the lungs in restrictive pulmonary disorders?

A

Decreased expansion of lungs.

22
Q

What are the two main factors that determine lung compliance?

A

Elastic forces of lung tissue (elastin and collagen) and factors influencing surface tension (such as excess fluid accumulation).

23
Q

How compliant is pulmonary vasculature? Why is this significant?

A

Highly compliant; need to accommodate entire cardiac output.

24
Q

What is the physiological shunt of the pulmonary system?

A

Bronchial circulation (blood to lung tissue itself) does not get oxygenated before mixing with blood in pulmonary veins; this constitutes ~1 - 2% of CO and leads to a decrease in PO2 in pulmonary veins from 100 to ~98.

25
Q

What is hypoxic pulmonary vasoconstriction? Where in the body can this phenomenon occur?

A

Decreased oxygenation of tissue leads to vasoconstriction around that area. This happens only in lungs and facilitates redistribution of pulmonary blood flow to maximize ventilation-perfusion relationship.

26
Q

What is V/Q? What is the normal value for V/Q?

A

Ventilation-perfusion ratio (V = ventilation, Q = perfusion). Normal = 0.8

27
Q

Give examples of situations when V/Q ~ infinity. When V/Q is high. When V/Q = 0.

A

Infinity: dead space (ventilation without perfusion). High: right heart failure, vasoconstriction, PE (lots of ventilation, less perfusion). 0: physiological shunt, atrial septal defect (perfusion without ventilation).

28
Q

What lung volume cannot be measured by a spirometer?

A

Residual volume (and functional residual capacity).

29
Q

What is tidal volume?

A

Normal breathing volumes

30
Q

What is inspiratory reserve?

A

Amount one can forcefully inspire on top of normal inspiration.

31
Q

What is expiratory reserve?

A

Amount one can forcefully expire on top of normal expiration.

32
Q

What is inspiratory capacity?

A

Bottom of normal exhalation to top of force inhalation.

33
Q

What is vital capacity?

A

Everything minus residual volume.

34
Q

What is functional residual capacity?

A

Expiratory reserve volume + residual volume.

35
Q

What is total lung capacity?

A

Everything (including residual volume).

36
Q

When is most (75%) of air expelled from the lungs?

A

During first second of expiration.

37
Q

What does the sharp uptick of the expiratory portion of the flow-volume curve represent?

A

Air expelled from large airways.

38
Q

What does the downward slope of the expiratory portion of the flow volume curve represent?

A

Air expelled from small airways.

39
Q

What is the normal FEV1/FVC ratio?

A

~0.8

40
Q

What is the typical FEV1/FVC ratio for obstructive disease such as asthma?

A
41
Q

What is the typical FEV1/FVC ratio for restrictive disease such as fibrosis?

A

Normal or increased

DMU Respiratory (4 decks)

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