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FOUNDATIONS > RESPIRATORY > Flashcards

RESPIRATORY Flashcards

1
Q

FUNCTIONS OF RESPIRATORY CENTRE (6)

A
  • Gas exchange
  • Regular blood pH
  • Smell
  • Filter warm and moisten air
  • Produce sound
  • Excretes water and heat
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2
Q

Name conducting zone vs respiratory zone

A

Conducting zone
* nose, pharynx, larynx, trachea, bronchi, bronchioles, terminal bronchioles
Respiratory zone (external respiration or gas exchange occurs)
* respiratory bronchioles. Alveolar ducts, alveolar sacs, alveoli

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3
Q

Describe the pharynx + functions

A
  • skeletal muscles with mucous membranes
  • comprised of naso/oro/laryngopharynx
  • part of conducting airways
    Functions
  • passage for food and air
  • resonating chamber for speech sounds
  • houses the tonsils
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4
Q

describe larynx structure and position

A
  • Short tube of cartilage
  • Lined by mucous membrane
  • Connects pharynx to trachea
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5
Q

function of thyroid cartilage

A

forms anterior wall of the larynx

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6
Q

epiglottis, made from what, does what

A
  • Elastic cartilage
  • Partial section is free to move up and down with swallowing to protect larynx
  • Food diverts down into oesophagus
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7
Q

Cricoid cartilage, made from what, does what

A
  • Ring of hyaline cartilage
  • Forms inferior wall of larynx
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8
Q

Trachea structure and function

A
  • Passageway for air anterior to oesophagus
  • Divides into left and right bronchi
  • Lined with mucous membrane (cilia and goblet cells)
  • Supported by cartilage
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9
Q

Describe bronchioles structure

A

progressively become smaller
cartilage decreases and then dissapears
smooth muscle cells are no longer present past the bronchioles
decrease of cilia
decrease of goblet cells = decrease mucous

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10
Q

parietal vs visceral pleura

A
  • Parietal pleura- outer layer, attached to wall of thoracic cavity and diaphragm
  • Visceral pleura- inner payer, attached to the lungs
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11
Q

lobes of lungs

A

right - 3 lobes
left 2 lobes

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12
Q

how much fluid in intrapleural space

A

18mls

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13
Q

alveoli structure and function

A

lined with epithelium
covered with surfactant

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14
Q

respiratory pattern medulla vs pons

A

Medulla
* Controls rhythm
* Both inspiratory and expiratory areas
Apneustic
* Area in lower pons
* Increases time of inhalation
Pneumotaxic
* Area in upper pons
* Help turn off inspiration to…decrease time of inhalation, increase respiratory rate

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15
Q

What stimulates our medulla for respiratory drive

A

Cortical influences
* Impulses from hypothalamus and limbic system stimulate respiratory centre
Chemoreceptor regulation
* Located in medulla
* Responds to H+ and PCO2 levels in CSF
this is a negative feedback system

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16
Q

Pulmonary ventilation, describe inhalation and exhalations relationship to atmospheric pressure

A

Inhalation occurs when pressure in lungs is LESS than the atmospheric pressure
Exhalation occurs when the pressure in the lungs is GREATER than the atmospheric pressure

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17
Q

Muscles of ventilation, inspiratory vs expiratory

A

Quite unforced inhalation
* Diaphragm and external intercostals
* Diaphragm = decreased pressure so air can flow in

Quiet exhalation is a passive process
* Begins when diaphragm and intercostals relax
* Due to elastic recoil of chest wall and lungs
* Volume decreases which forces air out

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18
Q

Ventilation pressure changes
At rest, inhalation, exhalation
comparing atmospheric pressure and alveolar pressure

A

At rest
* Atmospheric pressure = 760mmhg
* Alveolar pressure = 760mmhg
Inhalation
* Atmospheric pressure = 760mmhg
* Alveolar pressure = 756 mmhg
Exhalation
* Atmospheric pressure = 760mmhg
* Alveolar pressure = 762mmhg

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19
Q

Boyles Law define and relate to ventilation

A

relationship between pressure and volume
decrease volume = increase pressure and vice versa
* This happens when the muscles of inhalation cause the chest and lungs to expand on the command of the medulla oblongata (intrapulmonary pressure then falls to 758mmHg)

20
Q

Daltons Law define and relate to gas exchange

A

The total pressure exerted by a mixture of gases is the sum of the pressures exerted by each gas in the mixture
* The partial pressure is proportional to the percentage of that gas in the mixture
* This is important in determining the movement of oxygen and co2 between the atmosphere and the alveoli, alveoli and blood and blood and cells.
* Each gas operates independently and diffuses from a higher PP to an area of lower PP

21
Q

Henrys Law

A

The amount of gas that is dissolved in a liquid is directly proportional to the partial pressure of that gas above the liquid when the temperature is kept constant.
Increased temp = decreased solubility
O2 and nitrogen solubility is less than CO2 meaning very little can enter circulation at normal pressures

22
Q

% of gases inspired at atmospheric pressure

A
  • Nitrogen = 78.6%
  • Oxygen = 20.0%
  • Carbon dioxide =0.04%
  • Water vapour = 0.46%
23
Q

External respiration vs internal respiration brief description

A

aka pulmonary gas exchange

  • Diffusion of O2 from air in alveoli to blood in pulmonary capillaries
  • Diffusion of CO2 from pulm caps back to alveoli and then exhaled

internal = systemic gas exchange
= exchange of O2 and CO2 between systemic capillaries and tissues

24
Q

Tidal volume vs minute volume

A

TV= volume of one breath
MV= rr x tidal volume

25
Q

% of VT that participates in gas exchange vs what remains in conducting airways

A

70% for gas exchange at bronchioles and alveoli
30% remains in conducting airways

26
Q

IRV vs ERV vs RV

A

IRV- forced inhalation/deliberate deep breath, how much can we breath under forced inspiration
ERV- how much can we breath out under forced expiration
RV - air that remains in the lungs following expiration (ie the amount that is in the conducting airways/anatomical deadspace)

27
Q

Average RV for males and females

A
  • 1200mls males
  • 1100mls females
28
Q

IC vs FRC vs VC vs TLC

A

IC = VT+IRV
FRC= RV+ERV
VC= IRV+VT+ERV
TLC= VC + RV

29
Q

hypoxia vs hypoxemia

A

Hypoxemia = low oxygen levels in your blood
hypoxia = low oxygen levels in your tissues.
Hypoxemia can lead to hypoxia and they often both appear together, but not always.

30
Q

Oxygen transport

A
  • 1.5% dissolved in plasma
  • 98.5% bound to Hb in RBC
  • When oxygen is bound it cannot participate in gas exchange it must be dissolved
31
Q

L shift OHDC

A

Incressed affinity
decreased temp
decrease PCO2
decrease 2-3 DBG
increased Ph

32
Q

R shift OHDC

A

Decreased affinity
increased temp
increased PCO2
increased 2-3DPG
decresased ph

33
Q

CO2 transport

A
  • Dissolved (7% in plasma)
  • Bound to amino acids 23%
  • (mostly to Hb)
  • Bicarbonate ions (transported in blood approx. 70%)
34
Q

normal V/Q ratio

A

Normal V/Q = 0.4 (4L O2/5L blood)

35
Q

decreased V = shunting
provide examples
what is occurring in lungs

A

asthma, COPD, APO
ventilation has gone down but perfusion is normal

  • Body compensates and will vasoconstrict pulmonary circulation causing increased pressure = pulmonary hypertension = right sided heart failure eventually
  • You may not be able to get your SPO2 to normal levels and you need to accept a lower limit
  • Treat the respiratory issue to improve
  • Here our V/Q ratio is decreasing
36
Q

decreased P = deadspace

A

this is a phsyiological issues as opposed to anatomical
there is an obstruction in pulmonary circulation
Reduction in PAO2 and SPO2
Need to fix the perfusion to fix the oxygenation
here our ratio is increasing

37
Q

compare obstructive lung vs restrictive lung and their respective volumes

A

Obstructive lung
the overall size has increased so we see an increase in ERV AND RV (not helpful, we need an increase in IRV and TV)
increased compliance but decreased recoil
asthma and COPD- able to get the air in, unable to get it out

Restrictive Lung
smaller lung volumes
decreased compliance but increased recoil
pneumonia, fibrosis, ARDS

38
Q

SPO2 % to PaO2 correlation

A

97%- 95mmhg
92%- 60mmhg
89%- 50mmhg
75% - 40mmhg
40%- 27mmhg

39
Q

Normal wave form capnography phases

A

1 baseline
2 start of exhlation
3 exhalation (movement of air through conducting airways)
end of 3 is end tidal co2 value
4 inspiration

40
Q

rounded capnography waveform

A

osephageal in nature
will decrease to nothing

41
Q

increasing in size capno waveform

A

hypoventilation
rosc pt with increased perfusion
hypermetabolic state
increase in temp (producing more co2)

42
Q

shark fin capno

A

bronchospastic, occlusion of circuit

43
Q

decreasing in size capno

A

hyperventilation, decreasing perfusion, decrease metabolic state, PE

44
Q

reversible causes 5 H’s and 4 T’s

A
  • Hypoxia
  • Hypovolemia (low etco2)
  • Hypothermia (low)
  • Hyperkalaemia
  • H+ (acidosis, high etco2)
    T’s
  • TpT (low etco2)
  • Tamponade (decrease perfusion)
  • Toxins (metabolic state)
  • Thrombosis
45
Q

compare asthma vs COPD

A

asthma
reactive
bronchodilator +corticosteroid response
mast cells, eosinophils and macrophages
all airways involved

COPD
no reactivity
poor broncho and corticosteriod response
neutrophil and macrophage response ++
peripheral airways
mucous secretion +++

FOUNDATIONS (10 decks)

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