Respiratory Flashcards
1
Q
the exchange between O2 and CO2 between tissues and the environment describes what
A
respiration
2
Q
what are the 5 steps to consider for respiration
A
- ventilation
- gas exchange
- gas transport
- gas exchange
- cellular respiration
3
Q
main two functions of the respiratory system
A
- provide O2
- remove CO2
4
Q
what happens to the diaphragm during inspiration
A
contraction
- active
5
Q
what causes expiration
A
lung elastic recoil pulling thorax and relaxed diaphragm
6
Q
is expiration a passive or active process at rest
A
no muscle contraction = passive
7
Q
what muscles are used in very deep, foreful breaths for inspiration
A
diaphragm and external intercostal muscle contraction and sternocleidomastoid and pectoralis minor
8
Q
what muscles are used in very deep, foreful breaths for expiration
A
lung elastic recoil and internal inter-coastal muscle + abdominal muscle
9
Q
what is the difference between partietal pleura and visceral pleura
A
partietal pleura - outer layer
visceral pleura - directly on lung
10
Q
what is the pleural cavity
A
sit-like potential space filled w/ fluid
allows pleural to slide
11
Q
what is the name for the exchange of air between the atmosphere and alveoli
A
ventilation
12
Q
in ventilation air moves by bulk from the region of ____ pressure to _____ pressure
A
high to low
13
Q
what is the equation for bulk flow
A
F=change in pressure / resistance
14
Q
all pressures in respiratory like in CVS are given relative to ________ pressure
A
atmospheric
15
Q
when there is no air flow what does this mean
A
pressure of alveoli = pressure of atmospheric
16
Q
what is boyles law
A
at constant temp, volume of gas varies inversely with absolute pressure
17
Q
during inspiration what happens to volume and pressure
A
volume = increased
pressure = decreased
18
Q
what are the 2 determinants for the changes in lung dimension - that determine lung volume
A
- difference in the pressure between inside and outside of lung (transpulmonary pressure)
- stretchability of lungs (compliance ) - how much lungs expand for a given chang in transpulmonary pressure
19
Q
what is the equation for transpulmonary pressure
A
Ptp = Palv - Pip
20
Q
transmural pressure resists the _____ ____ of the lung
A
elastic recoiling
21
Q
to increase volume lung requires positive of negative transpulmonary pressure
A
positive
22
Q
when does lung assume smallest size when transpulmonary pressure is
A
zero
23
Q
for transpulmonary pressure to be positive intrapleural fluid should be
A
negative
24
Q
during restful breathing, inspiration is caused by contraction of the diaphragm and what is expiration caused by
A
passive recoiling
25
if Patm = 0mmHg and Palv = 4mmHg then what does this mean
air is flowing out of the lung
26
what are the 2 reasons work is done for breathing
- overcome elastic properties
- overcome airway resistance
27
what is the equation for lung compliance
C= change in lung volume/ change in transpulmonary pressure
28
what are the 2 determines of lung compliance
1. stiffness
2. surface tension
29
those with emphysema have high compliance and floppy lungs what does this mean
- very stretch = no effect on inspiration
- low elastic recoil = requires more energy during expiration
30
those with fibrosis have low compliance and stiff lungs what does this mean
- more energy for inspiration
- high elastic recoil= no added energy required for expiration
31
why do you need to overcome force of surface tension to expand lungs
causes alveoli to collapse
32
reduces surfance tension in alveoli is called what
surfactant
33
what type of cells is surfactant produced by
alveolar type 2 cells
34
what is a major constituent of surfactant
phospholipids
35
in premature infants what is absent and what does this result in the development of
Surfactant
respiratory distress syndrome
36
what is the therapy of surfactant in premature infants
assisted ventilation and administration of natural or synthetic surfactant given through infants trachea
37
stabilizes the smaller alveoli, thereby preventing them from collapsing due to high pressure is known as what
surfactant
38
during quiet breathing what flow is air flow
mainly laminar
39
what is an important element to airway resistance
bronchoconstriction/ bronchodilation
40
what is the main area of airway resistance
Bronchi
41
why is resistance higher in larger airways
- depends on number of parallel pathways present
- generations exist in parallel rather than in series
42
what is radial traction
pulling adjacent alveoli - reduces airway resistance
43
in restrictive lung disease what happens to resistance and lung compliance and pressure volume curve
resistance - no change
lung compliance - decrease -
curve - shifted to right
44
lung compliance is increased in emphysema because chronic emphysema increases airway resistacne
both true - but not realted
45
what are two measurements of lunch function
1. spirometry
2. peak expiratory flow rates
46
what is the inspiratory capacity mad up of - and what is it
max beath in
tidal volum
IRV
47
what is vital capacity
max breath into out voulme of air can shift in/out of lungs
IRV + ERV
48
functional residual capacity
remaining volume at end of normal breath out
ERV + RV
49
total lung capacity
total volume in lungs when maximally full
VC + RV
50
lung volumes in restrictive diseases
breath mor shalloely and rapidly
- increased work - decrease lung compliance
- stiff lungs
decreases in all volumess and capacity- graph moves down
51
lung volumes in obstructive diseases
increasesed work due tor increase air way reisstnace
- narrow pipes
- breathe more slowly and deeply
most volume shift and increases on graph
52
is air way resistance inversly related to the 4th power of radius
true
53
in healthy individuals inspiration reduces the airway resistance due to an increase in the transpulmonary pressure
true
54
asthma increases airway resistance
true
55
does airflow velocity decrease as the size of the airway become smaller, hence the highest resistance is seen in the respiratory bronchioles
false
56
what doe force measurements give info about
flow rates
57
how long is forced expiratory volume
one second
58
what is a useful indicator of airway resistance and therefore lung disease
vital capacity
59
how much lung is expirated per 1 sec in normal healthy lung disease
80%
60
in obstructive lung disease what is % lung expirated
less than 70% - increases airway resistance
61
in restrictive lung disease is there a change in FEV/FVC ratio
no - no change in resistance
62
how much is normal tidal volume
500ml = 0.5L
63
what is the equation of total ventilation - how much we breath in and out
frequency x tidal volume
64
if single breath is 500ml and frequency 12mins
how much is total (mouth) ventialtion
6000ml/min
65
how can total (mouth) ventialtion change
to match metabolic demands - involuntarily (exercise)
voluntarily (changing breathing behaviour)
66
when some of the inhaled air never gets to the alveoli so gas exchange cant take place what is known as
dead space ventilation
67
what are the 2 types of dead space contributing to dead space ventilation
1. anatomical dead space
2. physiological dead space
68
what is the equation for dead space ventilation
anatomical + function dead space
69
in what dead space could exchange gas but not happening
function dead space
70
how much of inspired air is dead space
1/3rd
71
increasing dead space by transforming respiratory tissue into fibrotic tissue is know as what
pulmonary fibrosis
72
increases dead space by impairing pulmonary perfusion
pulmonary hypertension
73
what pattern of breathing decreases alveolar ventilation
fast shallow breathing
74
causing of hypoxia and hypercapnia and acidity is from shallow or deep breathing
shallow
75
FEV/FVC ratio doesn't decrease below 70% in restrictive lung disease BECAUSE restrictive lung disease doesn't affect the airway resistance
True - and realte
76
what does gas diffusion depend on and what is this law
partial pressure
daltons law
77
to work out partial pressure what must you know
% concentration of each gas and atmospheric pressure
78
what is barometric pressure at sea level at
760mmHG
79
in healthy lung what is the alveolar ventialtion and pulmonary blood flow
alveolar ventilation 4 L/min
Pulmonary 5L/min
80
what is normal V/Q ratio
0.8
81
if there is changes in the ventialtion to perfusion ration what does this impair
oxygen and carbon dioxide transfer
82
Atelectasis (fibrosis), emphysema, pulmonary oedema all lung disease that occur if what is imparied
ventialtion
83
vascular diseases such as pulmonary hypertension, heart failure and vascular diseases associsated with COPD what is impaired
perfusion
84
breathing pattern do not affect alveolar ventilation BECAUSE the change in breathing pattern will be compensated by the change in anatomical dead space to maintain constant
both statements are false
85
how does the gas move across the alveolar capillary membrane
diffusion
86
what is Diffusion constant depend on
gas solubility and molecular weight
87
what gas diffuses about 20z faster than the other
and why
CO2 diffuses faster than O2 because CO2 has higher solubility
88
a disease characterised by dilation of the alveolar space and destruction of the alveolar wall can be described as what
- meaning there is a decrease in surface area of the lung
emphysema
89
what does having less alveolar area mean for diffusion capacity
less
90
if something has more thickness does this reduce or increase diffusion takes place
reduces - therefore takes longer to supply nutrients
91
in pulmonary fibrosis there is an increase in thickening of the alveolar membrane what does this mean
diffusion distance increase
- reduced diffusion capacity
92
what is the main factor of ficks law
pressure difference
93
what 3 things does PaO2 depend on
P1O2 inspired air
alveolar ventialion
O2 consumption
94
the atmospheric PO2 is usually constant BECAUSE there is an imbalance between O2 consumption and alveolar ventilation
1st true
2nd false - there is a a balance - if this is true then 2nd would coerelate with the 1st
but for this they dont relate
95
what is alveolar partial pressure of CO2 kept constant at
40mmHG
96
what does PaCO2 depend on
alveolar ventilation
CO2 production
P1 CO2 inspired air
97
what is PaCO2 usually only determined by
WHY
balance between CO2 production and alveolar ventilation
because atmospheric PCOs is negligible
98
what are the 5 mechanisms that arterial hypoxemia can be caused by
1. reduced PB or F1O2
2. hypoventilation
3. impaired diffusion
4. shunt
5. ventialtion - perfuison mismatching
99
what is the RQ for fatty acid, CHO and normal diet
fat = 0.7
CHO= 1.0
normale = 0.8
100
the movement of oxygen by diffusion between the alveoli and the pulmonary capillary blood is
proportional to partial pressure gradient between air-blood barrier
101
what happens to ficks law with exercise
more capillaries perfuses = increase in capillary surface area and reduce diffusion for capillaries
102
what it the 2 forms that O2 is carried in the blood
1. dissolved O2
2. Combined w/ Hb
103
for each mmHg PO2 how much of O2 is dissolved
0.03ml
104
why is dissolved O2 very ineffective for O2 transport and how much do we need
3ml only dissolved
need about 250ml O2/min
105
because dissolves O2 is very ineffective what do we need to use
Haemoglobin to carry O2
106
oxyhemoglobin
O2 forms an easily reversible combination w/ Hb to give oxyhemoglobin
107
no oxygen is what colour
black
108
what is P50 on the Hb dissociation curve
where Hb is 50% saturated
25mmHg
109
what shape is the O2-Hb dissociation curve
sigmoidal
110
what does the steep part of the curve of Hb curve help with
loading of Hb and lungs and unloading of O2 to the tissues
111
what is the O2 carry capcaity and formular
how much O2 could blood carry
1.34 x 150(this number changes)
112
what is O2 content and what is the formular
how much O2 is the blood actually carring
1.34 x hb x sat/100 + 0.03 xPartial pressure in arteries
113
finding the artial and venous difference can relate to how many litres/min flow to tissues
Cardiac output
114
what does the right shift do
- release O2
- improves delivery of O2 by Hb
EXERCISE
- increase everything
115
2,3 diphosphooglycerate is a by-product of
glycolysis
116
what is problem with anamemia and Low Hb level with exercise of the bohr effect
dont have enough to match demands
117
what are the 3 transport of CO2
1. dissolved in plasma
2. bicarbonate
3. combined w/ proteins as carbamino compounds
118
what is majority of CO2 transport used as
Bicarbonate
HCO3
119
what is the Haldane effect
upward and downward shift of CO2
120
if Upward shift in Haldane effect what does this mean
CO2 and H+ bind more readily to globin when heme contains less O2
121
the Bohr effect is characterised by a right shift in the lungs BECAUSE Hb has a high affinity for Oxygen at low PCO2
both true
- not related
122
what are the 3 basic elements for the control of breathing
- central controller
- sensor
- effectors
123
what sets the pattern of breathing coordinates sensors and effectors to maintain respiratory homeostasis
central control system
124
what basic element with breathing adjust ventilation
respiratory muscles
125
what basic element of control of breathing receives a variety of neural and chemical inputs from cental and peripheral receptors
sensors
126
where does inspiratory center of dorasl respiratory group (DRG) send signals to
diaphrgam and external intercostal muscles
127
the ventral respiratory group send signals with what nerouns and which muscles
inspiratory neurons - to accessory inspiratory muscles
expiratory neurones - accessory expiratory muscles
128
what is the pre-Botzinger complex
respiratory rhythm generator
129
what does the Apnustic control and what does it do
VRG and DRG
- adjust ouput of respiratory rhythmicity
130
what is the pneuomotaxic center known as
pontine respiratory group
131
what are the 4 main chemicals in the respiratory system
CO2, O2, H+ and HCO3
132
what chemicals mainly act on respiratory centre
CO2 and H+ (due to CO2)
133
what main act through peripheral chemorecpetor
O2, H+ (not due to CO2)
134
centrral chemorecpetors - have specialized cells on the ____ ____ of the medulla
ventrolateral surface
135
central chemoreceptors sensitive to PCO2 not _____ of blood (because CO2 can easily diffuse)
PO2
136
what respiratory group neurons produce inspiratory and expiratory stimulus at rest
VRG
137
artrial PCO2 decreases during strenuous exercise BECAUSE strenuous exercise generates and releases lactic acid into the blood
both correct not related
138
what does endurance exercise require to work toegther (4 main physiological systems)
CVS
respiratory
nervous
musculoskeletal
139
softball or marathon running has high VO2
maratrhon - sports that are longer
140
what does pulse oximetry measure
oxygen saturation
141
what is the sex difference in % SaO2
males have stronger right shift
142
what is the sex difference in O2 dissociation curve
females - sig lower affinity
143
wha does sex difference in 2,3 bisphophoglycerate expression promotes
offloading of oxygen
144
how much O2 can be bound for each 100ml of blood
20ml
145
what metabolics is used for low to moderate intensities
lipids
146
what metabolic is used for during high intensities
CHO
147
if pulse oximeter was used on an athlete before exercise (at rest) and after moderate exericise, does % sa O2 level fall
148
