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physiology 2 > respiratory 2 > Flashcards

respiratory 2 Flashcards

1
Q

to move gas into the lung, respiratory muscles overcome

A
  • elastic resistance

- resistance to air flow (non elastic resistance)

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2
Q

non-elastic resistance

A

airflow - 80%

viscous - 20%

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3
Q

the ability to inflate and deflate the lung depends on two properties

A

compliance and elastance

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4
Q

compliance

A

a highly compliant lung is easy to inflate
distensibility - stretchability - ease at which the lung will expand
lung is 100x more distensible than a balloon
pulmonary and/pr thoracic

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5
Q

elastance

A

tendency to recoil to initial size after the distention

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6
Q

elastance is created by

A

elastance proteins

- resist distension and cause recoil

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7
Q

a lung that is highly complaint will tend to have

A

low elastance

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8
Q

to be complaint we have to overcome

A

elastance

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9
Q

surface tension

A

important at low lung volumes

  • alveolar air-liquid interface
  • inwardly directed force 0 tends to reduce alveolar diameter
  • oppose alveolar expansion
  • lung collapse (particularly in small alveoli)
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10
Q

surfactant

A

lowers surface tension - reduces attractive forces of hydrogen bonding between H2O molecules

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11
Q

surfactant is produced by

A

alveolar type 2 pneumocytes

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12
Q

alveoli radius

A

small alveoli generate more surface tension

as alveolar radius decreases, surfactants ability to lower surface tension increases

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13
Q

why might we want smaller alveoli

A

to increase surface area

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14
Q

what do we do to reduce surface tension

A

line the alveoli with surfactant secreted by type 2 pneumocites

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15
Q

what happens when there is no surfactant

A

lack of surfactant creates huge surface tension requiring high expansion pressures

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16
Q

infant respiratory distress syndrome

A

premature birth

surfactant not produces at high levels until 34 weeks gestation so some very preterm babies don’t have enough surfactant

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17
Q

low compliance lung

A

stiff lung

extra work required for normal inspiration

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18
Q

low compliance lung may be caused by

A

fibrosis - decrease in pulmonary compliance

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19
Q

high compliance lung

A

floppy lung
extra work is required for expiration
elastic tissue is damaged

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20
Q

non-elastic resistance

A

35%

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21
Q

airway resistance

A

depends on the diameter

as airways get smaller this increases

22
Q

mucous resistance

A

depends how much mucous there is in the transmitting pathways
increased in response to histamine (histamine increases mucous secretions and viscosity)

23
Q

histamine receptors

A

HIR - volume

H2R - viscosity

24
Q

mucosal oedema

A

release of fluid from the blood into the lungs

caused by increase in permeability leading to transduction of fluid and macromolecules through wide intercellular gaps

25
Q

chronic bronchitis

A

too much mucous produced by the lungs

26
Q

cystic fibrosis

A

CFTR mutation
chloride channel
loss of ability too regulate chloride loss which changes osmotic gradient and affects mucous production

27
Q

bronchodilation

A

B2-adrenergic receptor activation

mostly endocrine but some nervous

28
Q

bronchoconstriction

A

muscarinic cholinergic re emptor activation

also histamine H1 receptor

29
Q

bronchomotor tone

A

parasympathetic tone controls bronchomotor tone

increase in parasympathetic tone increases acetyl choline produced and vice versa

30
Q

other local effects controlling acetylcholine reflex constriction

A

inhalation of smoke, dust, chemical irritants
arterial hypercapnia
cold
pulmonary emboli

31
Q

bronchodilator endocrine

A

adrenaline causes bronchodilator using b2 adrenergic receptor
beta agonists cause bronchodilation
beta antagonists cause bronchoconstriction

32
Q

measuring R

A

hard to measure resistance directly

measure its effects on function instead

33
Q

PEF

A

peak expiratory flow

34
Q

FEV1

A

forced expiratory volume in one second

35
Q

FEV1/FVC

A

FEV/forced vital capacity

36
Q

FVC

A

forced vital capacity

how much air can be taken out of fully inflated lung

37
Q

3 main things causing respiratory disease

A
  • respiratory muscles fail
  • restrictive disease decreases compliance
  • obstructive disease increases resistance
38
Q

restrictive lung disease

A

decreases compliance
decreases lung volume
limits expansion
decrease in flow and ventilation causing increase in work required

39
Q

obstructive lung disease

A

increase in resistance
flow rate is decreased
increase in work required to overcome resistance to flow
decreased ein airflow causes increase n respiratory times

40
Q

restrictive lung disorder stats

A

decreased vital capacity, residual volume, functional residual capacity

41
Q

obstructive lung disorders

A

decreased vital capacity, inspiratory and expiratory reserve volume

increased residual volume, functional residual capacity, RV/TLC,

42
Q

obstructive complications

A

increased resistance to airflow due to abnormalities within the airway lumen
changes in the wall of the airway
decrease in elastic recoil

43
Q

obstructive complications examples

A

asthma, chronic obstructive lung disease
bronchiectasis
cystic fibrosis
bronchiolitis

44
Q

restrictive defects are caused by

A
  • loss of lung volume
  • abnormalities of structure surrounding the lung
  • weakness of the inspiratory muscles of respiration
  • abnormalities of the lung parenchyma
45
Q

parenchymal

A 
sarcoidosis - fibrosis 
idiopathic pulmonary fibrosis 
pneumonia, pulmonary oedema 
drug or radiation induced 
interstitial lung disease
46
Q

extraparenchymal

A

myasthenia gravis - Guillain-barre syndrome, muscular dystrophies
diaphragmatic weakness/paralysis
chest wall, kyphoscoliosis

47
Q

normal FEV1/FVC

A

80%

48
Q

normal flow-volume loop

A

inspiratory is symmetric and convex

expiratory limb is linear

49
Q

obstructive flow volume loop

A

peak expiratory flow is reduced
increased residual volume
FEV1/FVC reduced

50
Q

restrictive flow volume loop

A

reduction in total lung capacity

FEV1/FVC reduced

physiology 2 (21 decks)

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