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Respiration > Respiration Quizlet by luca (STUDY THIS ONE FIRST) > Flashcards

Respiration Quizlet by luca (STUDY THIS ONE FIRST) Flashcards

1
Q

Ventilation

A

Movement of gas from the environment to gas exchange space (the lung)
- The product of breathing freq. X tidal volume

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2
Q

Law of partial pressures

A

he total pressure of a gas is the sum of partial pressures of the gases present

Ptot = P1 + P2 + … + Pn

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3
Q

Dalton’s Law

A

The partial pressure of a gas can be found by knowing the total pressure and the fractional concentration of the individual gas species

Px = Ptot * Fx

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4
Q

Atmospheric pressure at sea level

A

760 mmHg = 1 atm

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5
Q

Partial pressure of O2 at sea level

A

Fractional content inspired O2 gas

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6
Q

Normal arterial O2

A

100 mmHg

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7
Q

The 3 functions of the nose

A
  • Filters air
  • Warms air
  • Saturates air with water
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8
Q

Water vapor correction

A

Air in lung is completely saturated with H2O
- P(H2O) at 37 C = 47 mmHg

So Px = (Pb - 47) * Fx

Pb=barometric pressure

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9
Q

Partial pressure of O2 in the lung

A

P(O2) = (760-47)*0.209 = 149 mmHg

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10
Q

Henry’s Law

A

The volume of gas dissolved in liquid is proportional to the partial pressure

Cx = k * Px

k=solubility

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11
Q

Fick’s Law of Diffusion

A

J = DAalpha(C1-C2)/X

J = rate of diffusion
D = permeability constant
A = area
Alpha = solubility (K in Henry's Law)
X = thickness
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12
Q

Sternocleidomastoids

A

Insert on 1st rib or sternum - stabilize rib 1 when you breathe

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13
Q

Internal intercostals

A

Primarily expiratory

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14
Q

External intercostals

A

Primarily inspiratory

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15
Q

Minute ventilation

A

VdotE = Vt * f
= tidal volume times breathing frequency

Volume of air moving in an out of the lung every minute

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16
Q

Ti

A

Inspiratory time

Ti > 50% of Ttot is a classic indication of respiratory failure

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17
Q

Te

A

Expiratory time

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18
Q

Ttot

A

Total breath time

= Ti + Te

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19
Q

Breathing frequency

A

=1/Ttot * 60

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20
Q

Vt

A

Tidal volume

Total amount of air going in and out with each normal breath

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21
Q

Pulse oximeter

A

Measures percent oxygenation of Hb

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22
Q

Fluid filled pleural space

A

Lung tissue can slide around easily but it is difficult to separate it from the chest wall (hydrostatic forces)

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23
Q

Ppl

A

Intrapleural pressure

Inward pulling force of lung is balanced by outward pulling force of chest wall - creates negative pleural pressure

  • About -5 cm water at rest
  • Can be divided into two parts: compliance and resistance
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24
Q

P(A)

A

Alveolar pressure

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25
Q

P(TP)

A

Transpulmonary pressure

= P(A) - Ppl

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26
Q

Palv

A

Alveolar pressure

= 0 (atmospheric) at rest

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27
Q

Pneumothorax

A

Air introduced into pleural space through a hole in either the visceral or parietal pleura ~> lung collapse, chest springs outwards
- No lung movement when you breathe

External - pretty easy to fix (usually hit by car, etc.)
Internal - ventilating pneumothorax instead of alveoli (more difficult to fix - debride)

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28
Q

Esophageal pressure

A

Nearly the same as the pleural pressure

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29
Q

Transdiaphragmatic pressure

A

A measure of the strength of the diaphragm

Can be measured by putting a probe in the esophagus and a second down in the stomach

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30
Q

P(B)

A

Barometric pressure

= Patm

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31
Q

Asthma

A

Resistance problem

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32
Q

Emphysema

A

Compliance problem
Also decreases surface area because it destroys alveoli and makes them into one big one
- Increased compliance, decreased surface area
- Patients may look barrel chested
- Some treatment available

  • FRC increases
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33
Q

Compliance

A

= deltaV / deltaP

Energy lost overcoming compliance is recovered during expiration

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34
Q

Fibrosis

A

Compliance problem

  • Scar tissue forms, decreased compliance
  • No treatment
  • FRC decreases
  • Ppl goes more negative during inspiration
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35
Q

Lung collapsing forces

A

Surface tension

Lung elastic recoil

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36
Q

Laplace Law

A

P = 2tau / r

P = the pressure necessary to keep the air bubble open
Tau = surface tension
r = radius

So the greater the radius, the lower the pressure required
In lung have lots of small alveoli (necessary for gas exchange) ~> wouldn’t be able to expand lung without surfactant to reduce surface tension

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37
Q

Atelectasis

A

Alveolar collapse

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38
Q

Surfactant

A

Phospholipid layer - creates air-oil interface (instead of air-water)

  • Produced by alveolar type II cells late in the 3rd trimester
  • 2 main functions: reduce surface tension (prevent airway collapse) and prevent transudation of the lung (water will not cross)
  • Without surfactant you die
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39
Q

Total lung capacity (TLC)

A

Maximum volume of air you can fill the respiratory system with

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40
Q

Residual volume

A

Air still left in lung after you’ve exhaled as much as you can (varies by species)

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41
Q

Work of breathing

A

How much work the muscles have to do to ventilate the lungs

  • Animals try to breathe to the minimum work of breathing
  • If increased, you increase energy lost

W = {P dV

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42
Q

Total system compliance

A

Sum of lung compliance and chest wall compliance

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43
Q

Functional residual capacity (FRC)

A

Volume of air in respiratory system at rest position
The point at which the expanding force of the chest wall balances the collapsing force of the lung
- We breathe above FRC (where compliance is high)
- FRC decreases if you decrease lung compliance
- = expiratory reserve volume + residual volume
- Difficult to measure (inhale He)

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44
Q

Volume regulators

A

Newborns, cats, dogs

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45
Q

Ventilation regulators

A

Adult humans

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46
Q

Expiratory reserve volume

A

Volume between FRC and residual volume

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47
Q

Vital capacity

A

= inspiratory capacity + expiratory reserve

The max. amount of air we can move in and out of the respiratory system

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48
Q

Horses

A

Breathe around FRC at rest, instead of above it

- Active and passive inhalation, AND active and passive exhalation phases

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49
Q

Lung sounds

A

Increase because of increased resistance

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50
Q

Total ventilation

A

= alveolar ventilation + dead space ventilation

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51
Q

Resistance

A

You LOSE energy as heat to overcome resistance

  • If you bronchodilate an animal and they get better then you have a resistance problem
  • Resistance is affected by: driving pressure, diameter of tube, length of tube, viscosity of the gas
  • Total area increases deeper in the lung, so total resistance goes down
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52
Q

Poiseuille’s Law

A

Vdot = pi(P1-P2)r^4 / 8nu(l)

R = (P1-P2) / Vdot = 8nu(l) / pi(r^4)

  • Area = pi(r^2)
  • nu = viscosity
  • R = resistance
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53
Q

Stint

A

A hard tube inserted to hold a tube open

Doesn’t work well in respiratory because the tubes keep expanding and contracting

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54
Q

Conductance

A

The inverse of resistance

- Linear over varying lung volumes

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55
Q

Resistance over varying lung volumes

A

Hyperbolic relationship
Inhalation: airways expand, decreasing resistance
Exhalation: airways collapsing back down, increasing resistance

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56
Q

Air flow patterns

A

Laminar - straight, high velocity in center, lower at edges
Turbulent - increases with higher velocity (decreasing resistance increases velocity)
- Turbulence highest in the largest tubes
- Flow is very laminar in the small airways
- Turbulence can increase resistance

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57
Q

Pleural pressure during breathing

A

Resistance or compliance issues increase pleural pressure during breathing

  • If big dip but comes back to specific point (compliance point) it’s a resistance problem
  • If big dip and stays low then it’s a compliance issue

**When there’s no airflow (between inhalation and exhalation) all the pleural pressure is due to compliance (because there is no resistance)

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58
Q

Respiratory assist on venous blood return to the heart

A

From negative pressure created for inhalation

- Don’t get this on mechanical ventilation

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59
Q

Barotrauma

A

Some of the smaller airways may pop from high pressures during mechanical ventilation

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60
Q

Peak expiratory flow rate (PEFR)

A

A measure of total airway resistance

Limited by effort independent region

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61
Q

Effort independent region

A

For a given lung volume, there is an expiratory flow rate that cannot be exceeded no matter how hard you try due to increasing resistance (airways collapsing as you exhale)

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62
Q

Chronic obstructive pulmonary disease (COPD)

A

A resistance problem

With a resistance problem you get exercise intolerance because the work of breathing gets too high

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63
Q

Net expiratory pressure

A

= active pressure + recoil pressure

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64
Q

Equal pressure point (EPP)

A

In active exhalation, you put positive pressure on the whole respiratory system, not just the alveoli
As you go towards the mouth, pressure reduces to 0 (atmospheric)
So there is a point where pressure inside the tube equals pressure applied to the outside of the tube (squeeze pressure)

  • Only happens with active exhalation, no EPP for passive exhalation
  • Past EPP collapsing pressure decreases the radius and increases the resistance of the airway
  • Why animals have trouble breathing with emphysema or asthma
  • Increased expiratory effort ~> increased dynamic airway collapse
  • There’s a point where you can’t increase velocity any more because resistance counteracts it
65
Q

EPP with increased compliance

A
  • With increased compliance, you lose some elastic recoil (have to compensate with active) so the EPP moves closer to the lungs
  • Breathing through pursed lips moves EPP further up again by increasing resistance at the end of the system, so pressure backs up
66
Q

Trapped gas

A

With high compliance EPP moves closer to the lung, where there’s less cartilage, so you can get small airway collapse
This traps gas and leads to hyperinflation (because you can still get air in, just not out)
- Problem in emphysema, etc. - regional issue

67
Q

EPP with increased peripheral resistance

A

Stenosis (narrowing) from asthma, etc.
Increased resistance causes dissipation of energy
So EPP moves deeper into the lung ~> small airway collapse ~> gas trapping
Treat with bronchodilator

68
Q

Dead space ventilation

A

The last gas in and the first gas back out

At the end of exhalation, the dead space is filled with gas that was in the alveoli

69
Q

Terminal bronchioles

A

Just before alveoli start budding off

70
Q

Respiratory bronchioles

A

Have alveoli coming off the sides

71
Q

Division between conducting zone (dead space) and respiratory zone (alveoli)

A

Transition point between terminal and respiratory bronchioles

72
Q

VdotO2

A

Rate of oxygen absorption into the blood

- Depends on blood flow and alveolar ventilation

73
Q

VdotCO2

A

Rate of carbon dioxide release into the alveoli

74
Q

Alveolar ventilation

A

VdotA = (VT - VD) * f

Can only be changed in 2 ways: volume and frequency changes

  • Increasing tidal volume - greater effect on VA
  • Increasing frequency - less work
75
Q

Alveolar CO2

A

PACO2 = (VdotCO2 / VdotA) * k

PACO2 ~= PaCO2
PACO2 = rate you get rid of it over rate you’re bringing it to the alveoli, times the concentration

76
Q

Alveolar O2

A

PAO2 = PIO2 - [(VdotO2 / VdotA) * k]

  • Max is 149
  • More complex than PACO2 because you have to account for atmospheric conc.
  • Changing PIO2, VdotO2, or VdotA can change alveolar O2
  • Can also express this using respiratory quotient and exhaled CO2
77
Q

Hyperventilation

A

PCO2 is low

78
Q

Hypoventilation

A

PCO2 is high

79
Q

Breathing strategies

A
  • Horse at rest breathes around FRC (stiff chested)
  • Exercising quadruped gait limited, uses 1:1 gait-to-f
  • Neonate active FRC
80
Q

Lung diffusion constant

A

D(L) = DAalpha / X

D(L) = VdotO2 / deltaP(O2)

81
Q

CO lung diffusion constant (DLCO)

A

D(L)CO = J(CO) / P(ACO)

Decreased in any condition that affects effective alveolar surface area and/or thickness

82
Q

Gravity dependent alveolar ventilation

A

Easier to ventilate lower lung (in biped)
During diastole, poor perfusion to apical lung
So apical lung tends to be underperfused and underventilated - regional diffusion in the human
- Not as big a deal in quadrupeds (except in large, laterally recumbent animals - can shut off airflow to bottom lung)

83
Q

Capillary transit time

A

Time the RBC is in contact with the alveolus
Normal is about 3/4 of a second

Can get problems with gas exchange if transit time is too short or if time required for gas exchange is increased (e.g. edema)

84
Q

Pulmonary embolism

A

Clot in lung vasculature ~> shunt

85
Q

Anatomical dead space

A

Incapable of gas exchange, doesn’t change

86
Q

Physiologic dead space

A

lveolar regions that aren’t perfused + anatomical dead space

87
Q

O2 transport methods

A
  1. Dissolved in plasma

2. Bound to Hb

88
Q

C(O2)

A

Oxygen content

89
Q

Oxygen solubility

A

= 0.003 ml O2/dL/mmHgO2

90
Q

C(aO2)

A

= solubility * P(O2)

91
Q

Hb-bound O2 content

A

= 1.39 [Hb] %saturation

92
Q

P50

A

Partial pressure at which 50% of Hb is bound - a measure of O2 affinity of Hb

93
Q

Factors affecting Hb affinity for O2

A
  • pH (direct)
  • CO2 (inverse)
  • Temperature (inverse)
94
Q

Total blood oxygen content

A

Sum of Hb bound and dissolved contents

= (1.39 X [Hb] X %saturation) + (0.003 X PO2)

95
Q

Oxygen toxicity

A

FiO2 too high ~> production of radicals and oxidative damage to the airways

96
Q

Volume of O2 extracted by the tissues

A

= CaO2 - CvO2

97
Q

CO2 transport methods

A
  1. Dissolved
  2. Protein bound - carbamino compounds
  3. Bicarbonate
98
Q

Carbonic anhydrase reaction

A

CO2 + H20 H2CO3 HCO3- + H+

99
Q

Haldane effect

A

Affinity of Hb for CO2 changes depending on how much O2 is in the blood (and vice versa)

100
Q

Ventilation-perfusion relationship

A

VdotA / Qdot

= 1 in normal ventilation

101
Q

Hypoxemia

A

Below normal PaO2

102
Q

5 causes of hypoxemia

A
  1. Hypoxic hypoxemia
  2. Alveolar hypoventilation
  3. Diffusion limitation
  4. Shunt
  5. VA/Q mismatch
103
Q
  1. Hypoxic hypoxemia

causes of hypoxemia

A

Low PaO2, low PaCO2, low PIO2

  • Low PaCO2 b/c low PIO2 makes you want to breathe more
  • High altitude or O2 tank runs out

Tx: increase PIO2

104
Q
  1. Alveolar hypoventilation

causes of hypoxemia

A

Low PaO2, high PaCO2
- Strong analgesics (barbituates - shut off CO2 response)

Tx: increase alveolar ventilation (just increasing PIO2 will shut off the last signal to keep breathing!!!)

105
Q
  1. Diffusion limitation

causes of hypoxemia

A

Low PaO2, normal PaCO2

  • Diffusion problem, insufficient capillary transit time
  • PaCO2 normal to slightly low because it diffuses much faster and breathing will be stimulated
106
Q
  1. Shunt

causes of hypoxemia

A

Low PaO2, slightly high PaCO2

  • A/a gradient is a measure of shunt
  • Thebecian veins - natural shunt
  • Lateral recumbent horse

Tx: increasing PIO2 has no effect

107
Q
  1. VA/Q mismatch

causes of hypoxemia

A

Low PaO2, high PaCO2

  • VA/Q does not equal 1
  • Partial airway or bloodflow restriction (much more common than complete)
  • Smaller changes in CO2 because more soluble

Tx: increase PIO2

108
Q

VdotA/Qdot extremes

A

Shunt extreme: perfusion, no ventilation

  • VA/Q very low
  • PAO2 approaches venous (40)
  • PACO2 approaches venous (45)

Physiologic dead space extreme: ventilation, no perfusion

  • VA/Q very high
  • PAO2 approaches atmospheric (150)
  • PACO2 approaches atmospheric (0)
109
Q

When mixing blood

A

O2 content equilibrates (average)

Find PO2 from saturation curve

110
Q

Pulmonary vessel constriction

A 
Constricted region:
- Lower blood volume going through
- PAO2/CO2 approach atmospheric
- So blood is doing lots of gas exchange, but low volume
Normal region: 2 complications
1. Decreased transit time
2. Increased volume of Hb passing exchange surface
3. Increased oxygen extraction
4. Decreased CaO2/dL
5. Decreased PaO2
6. Hypoxemia
111
Q

Respiratory quotient

A

R = VdotCO2 / VdotO2

Rate at which CO2 is released over rate at which oxygen is extracted

112
Q

Alveolar gas equation prediction of PAO2

A

PAO2 = PIO2 - PACO2/R

PAO2 ~ PaO2
- PAO2 = 100 mmHg
- PaO2 = 95 mmHg
Normal shunt

113
Q

Extracellular pH

A

7.35 - 7.45

114
Q

Mechanisms for H+ regulation

A
  1. Extracellular buffering
  2. Adjustments to blood PCO2 by altering the ventilatory capacity of the lungs
  3. Adjustments to renal acid excretion or base resorption
115
Q

Alkalemia

A

pH > 7.45

116
Q

Acidemia

A

pH < 7.35

117
Q

Acid

A

Proton donor

118
Q

Base

A

Proton acceptor

119
Q

Buffer

A

Reduces changes in pH resulting from addition of strong acids or bases

120
Q

Dissociation constant (Henderson-Hasselbach equation)

A

HA H+ + A-
K = [H+][A-] / [HA]
pH = pKa + log ([A-]/[HA])

Strong acid: large K
Weak acid: small K

121
Q

Buffers in the body

A

Bicarbonate
Phosphates
Proteins (Hb, etc.)

122
Q

Buffer value

A

= delta[HCO3-] / deltapH

123
Q

Respiratory acid

A

CO2

124
Q

Metabolic acid

A

Any acid other than CO2

125
Q

Respiratory acidemia

A

pH: low
PaCO2: high
HCO3-: normal

Compensation: kidney retains HCO3-

e.g. hypoventilation

126
Q

Respiratory alkalemia

A

pH: high
PaCO2: low
HCO3-: normal

Compensation: kidney loses HCO3-

e.g. hyperventilation

127
Q

Metabolic acidemia

A

pH: low
PaCO2: normal
HCO3-: low

Compensation: decrease CO2 (hyperventilation)

Lots of disease states (e.g. diabetes, heart failure, renal failure, diarrhea)

128
Q

Metabolic alkalemia

A

pH: high
PaCO2: normal
HCO3-: high

Compensation: increase CO2 (hypoventilation)

e.g. loss of H+ through vomiting

129
Q

3 components of the respiratory control system

A
  1. Central neural activity
  2. Peripheral sensory neural feedback
  3. Chemical status of blood and CSF
130
Q

Medulla

A

Both essential and sufficient for generating the pumping actions of the respiratory system
- Irregular with no other higher centers

131
Q

Apneustic center

A

In caudal pons
Without higher centers this generates long sustained inspiration with short expiration
Produces the on signal

132
Q

Pneumotaxic center

A

In rostral pons
Without higher centers, this provides a regular rhythm to the respiratory cycle
Produces the off signal

133
Q

Phrenic nerve

A

Innervates diaphragm (inspiratory)
Rat/human: 3,4,5, to stay alive
Dog/cat: 5,6,7 to keep you from heaven

134
Q

Medullary oscillator

A

= brainstem oscillator = respiratory control neural network
Interneurons and inspiratory and expiratory neurons in the medulla
The central control - everything else is modifying this system

135
Q

Slowly adapting pulmonary stretch receptors (PSRs)

A

Endings in epithelium of the airway
Myelinated (fast conducting)
When lung expands, you get APs

Gives information about how much you are inflating the lung

136
Q

Rapidly adapting pulmonary stretch receptors (PSRs)

A

Inspiratory inhibitory/protectory - prevents animal from breathing on top of hyperinflation
Burst of APs during inflation that falls off quickly (rapidly adapting)
- Also respond to certain chemicals (e.g. smoke)

Gives information about the rate of inflation

137
Q

Vagus nerve

A

Primary sensory pathway from the lung to the brain

- PSRs travel in it

138
Q

Pulmonary C-fibers

A

Unmyelinated (slow conducting)
Alveoli surface - sit between alveolus and capillary
Chemoreceptors

Give information on the status of the respiratory surface/diffusion barrier (e.g. edema)

139
Q

Bronchiole C-fibers

A

Unmyelinated
Bronchiole surfaces
Chemoreceptors

Give information on irritants, chemicals, particles, etc. in the epithelium of the conducting airways

140
Q

Respiratory muscle afferents

A
  1. Muscle spindles
  2. Tendon organs
  3. Joint receptors

Also need to know if the pump is providing the right force (monitor work of breathing)
Tell us whether the pump is pumping or not

141
Q

Muscle spindles

A

Monitor muscle length

142
Q

Tendon organs

A

Monitor muscle tension (a function of muscle length)

143
Q

Joint receptors

A

Measure the rotation of the ribs at the costovertebral joints

144
Q

Aortic bodies

A

Measure PO2 in aorta (NOT content)

  • Low oxygen ~> higher AP frequency
  • Low O2 sensed by PNS only

Also monitors H+ (~CO2)
- High H+ ~> higher AP freq.

145
Q

Carotid bodies

A

Measure PO2 in carotid (NOT content)

  • Low oxygen ~> higher AP frequency
  • Low O2 sensed by PNS only

Also monitors H+ (~CO2)
- High H+ ~> higher AP freq.

146
Q

Low O2 response

A

Increase breathing frequency

147
Q

High CO2 response

A

Increase tidal volume

148
Q

Hypoxic response index

A

deltaV(E40) = isocapnic increase in V(E) when P(ACO2) is reduced to 40 mmHg

149
Q

CO2 sensing

A

Sensed in both peripheral blood (carotid and aortic bodies) and CSF
About 60% are central - sensitive to H+ and to a lesser extent

150
Q

Dysphagia

A

Disordered swallow

- Some therapy available

151
Q

Dystussia

A

Disordered cough

- No therapy exists

152
Q

Reflex pathway for cough

A

Larynx (?) + lungs/airways (RARs, SARs, C-fibers) ~> superior laryngeal n. (larynx) + vagus n. (lung) ~> brainstem cough generator ~> respiratory muscles

153
Q

Diving response

A

Nasal/facial receptors ~> trigeminal n.

~> sympathetic nerves ~> vasoconstriction
~> vagus n. ~> bradycardia
~> apnea

154
Q

Laryngeal chemoreflex

A

Larynx ~> superior laryngeal n. ~> swallowing + laryngospasm + apnea + (~> vagus n. ~>) bradycardia

Primarily a neonatal response - prevents aspiration of fluids

155
Q

Bronchomotor tone

A

Baseline contractile activity

156
Q

Epiphase

A

Viscous mucus

157
Q

Hypophase

A

Layer of serous fluid that the mucus floats on

158
Q

Hering-Breuer reflex

A

Mediated by slowly adapting PSRs

Hyperinflation of the lungs leads to apnea

Respiration (2 decks)

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