Respiratory Flashcards by Sam Skerritt

Acetyl cysteine, recombinant human DNAse are examples of what, and what is their action

Mucolytics

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What type of cells produce surfactant?

type two alveolar

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An FEV1/FVC ratio >0.7 indicates a

Restrictive

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An increase in pH with a decrease in temperature and a decrease in DPG concentration shifts the Hb-O2 dissociation curve to the

Left

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Anti IgE monoclonal antibody (omalizumab) inhibits

Binding of ige to mast cells

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Antimuscarinics are more effective than Beta-2 agonists in the treatment of

COPD

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d02 value?

1000ml/min

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V02 at rest?

250ml/min

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At rest work of breathing is what % of expenditure

2-5%

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Exercising breathing is what % of expenditure?

30%

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Increased blood pressure will lead to a what in ventilation?

Decrease

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Basic structure of haemoglobin (rule of 4)

4 x globin chains (141-146 AAs per chain)
4 x haem groups
4 x iron atoms
and binds
4 x O2 molecules

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Branching during development is associated with interaction of the

overlying visceral mesoderm

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Breath sounds generated

large airways

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cheyne stokes respiration is characterised by

progressively deeper and sometimes faster breathing, followed by a gradual decrease that results in a temporary stop in breathing called an apnea.

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CO is poisonous as

Extremely high affinity for haemoglobin

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CO2 is approximately how much more soluble in water than oxygen

24 times more soluble

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Compliance is defined as

the change in lung volume per unit of change in intrathoracic pressure

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Continued injury to infant lungs as a result of RDS may result in

Detachment of alveolar lining

Bronchopulmonary dysplasia

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Dalton’s law is defined as

The partial pressure of a gas in a gas mixture = total pressure x fractional concentration of the gas

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Increased compliance is seen in what disease?

Emphysema

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Diseases with decreased compliance

circumferential burns, kyphosocliosis, fibrosis

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Emphysema is the process of

widespread destruction and dilatation of distal airways due to chronic inflammation; leads to significant reduction in gas exchange

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Epithelial lining of bronchioles

Cuboidal

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trachea and bronchi lining

Columnar

Peak of V02

2-3years

Flow is affected most by what?

radius of lumen

FRC =

ERV+RV

FRC typical volume

2500ml

How much does work increase by from laminar to turbulent flow?

If the closing capacity exceeds FRC, the alveoli will be

Under perfused

Fully humidified air at 37c 02 has a value of what

19.95kpa

In restrictive condition how is work of breathing minimised?

quick shallow breathing

expiratory effort uses what muscles?

abdo, and internal intercostals

infant respiratory distress syndrome is due to what?

lack of surfactant

Inhaled corticosteroids, although 1st line regular asthma therapy, have what adverse effects

Iatrogenic Cushing's syndrome Hoarse throat Inhibition of hypothalamic pituitary axis

innervation to the diaphragm

C3,4,5

Which receptors lie close to capillary walls around alveolar triggered by trauma and increase what

J-receptors - increase ventilation

Lungs from which layer of the mesoderm

Endoderm

Mast cell stabilisers such as cromolyn, nedocromil, inhibit

no effect on smooth muscle inhibit mast cell contents

mean pulmonary capillary PO2 is very difficult to measure, what measurement is used in replacement?

CO diffusing capacity

What is minute volume?

Tidal volume X breathinf frequency

what is oxygen saturation?

Hb02 / HHB+Hb02

Partial pressure of O2 in the alveoli is lower than in air because

Inspired air is humidified in the upper airway In the alveoli oxygen is taken up while carbon dioxide is added The body consumes more O2 molecules than it produces CO2 molecules (typically 1.25 x)

Before what week is survival of a foetus unlikely due to lack of lung development?

week 26

pressure is proportional to

1/V

Restrictive lung diseases have what reduced volumes/capacities

RV, FRC, VC, TLC

Rapid distention of the abdomen could indicate what?

treacheoosophageal fistula

Small (0.5-3 μm) particles like Particulate pollution, stone dust, asbestos are deposited via sedimentation in the

BRONCHIOLES

Surfactant is made up of what?

90% phospholipid and 10% protein

Surfactant Protein B deficiency is

fatal, even with surfactant treatment

terminal bronchioles form by what week in development

Alveolar dead space defined as

Good ventilation but no perfusion

Apices of lungs are how much bigger than what base

BBB relies on what to inform its oxygenation status?

CO2

The dorsal respiratory group has neurones that

inspiration

The higher brain centres influence breathing via two methods:

cortical - voluntary hyperventilation/breath holding | hypothalamic - triggered by emotions or sensory reflexes to pain or cold

Hypoxic drive?

Uses low 02 to drive breathing

The influence of the pons on the medulla oblongata is by the action of two centres signalling to the dorsal respiratory group, what are they?

Apneustic- Stimulates | Pneumpotaxic- inhibit (toxic)

Law of laplace ?

Balloons! P= 2t/r, where t = surface tension

Week five of lung development =

secondary bronchi

which histogenesis period of the lungs has primitive alveoli, occurs from week 26 to birth, and has the development of a blood-air barrier beginning the production of surfactant

terminal sac

Which histogenesis period occurs 16-25 weeks, has respiratory bronchioles, vascularised mesodermal tissue

canilicular

What part of the respiratory system appears at week 4 of embryological development

Ventral bud of lung from foregut

haldane effect

deoxygenated can carry more co2

What is the cause and mechanism of Methaemoglobin

drug induced | metHb does not carry oxygen due to a defective Fe3+ mechanism

Plumonary agenisis

one or two sides fail of the lungs (both sides is fatal)

VC=

IRV ERV and TV

Tidal volume at rest?

350ml

typical irv

3000ml

typical erv

1500ml

typical VC

typical residual

1000ml

13.3kpa

partial pressur in alveoli

typical co2 partial pressur ein alveoli

5.3kpa

TLC =

TV + IRV + ERV + RV

3x co2 carriage in blood

Dissolved Carbamino compounds (bound to R-NH2 groups on protein) As carbonic acid/bicarbonate (mostly carried like this)

The ventral respiratory group has neurones which fire

inspiration and expiration

tense state of haemoglobin is

deoxygenated

Protons formed from bicarb are buffered by what

The partial pressure of a gas in solution is

inversely proprotional to its solubility

on inspiration the PA and PB are related how?

PB>PA air drawn in

on expiration the PA and PB are related how?

PA>PB air out

IgG is found where?

Small airways

IgA is found where?

Nose and large airways

What zone is alveolar dead space in?

Huffner constant

amount of 02 Hb can carry

An fev1/fvc ratio less than 0.7 indicates what?

obstructive condition