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Hard Core Physiology > Respiratory > Flashcards

Respiratory Flashcards

1
Q

primary muscle of respiration

A

diaphragm –> 75% of change in chest volume

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2
Q

Tracheobronchial tree

A

conduit for ventilation & clearance of secretions

- C-shaped cartilage rings

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3
Q

Narrowest part of the airway?

A

cricoid cartilage in adults

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4
Q

Main stem bronchi orientation?

A

R-main stem is more vertical –> aspiration

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5
Q

Type I pneumocyte

A

prevent passage of fluid/material into lungs

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6
Q

Type II pneumocyte

A

prominent cytoplasm

  • produce surfactant –> can divide
  • resistant to O2 toxicity
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7
Q

Pulmonary Circulation

A
  1. Bronchial circulation –> from left side (sustains metabolic requirements of lungs)
  2. Pulmonary capillaries –> incorporated into walls of alveoli, large junctions allow passage of albumin
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8
Q

Innervation of lungs

A
  • diaphragm is phrenic (C3-5)
  • intercostal muscles –> thoracic nerve roots
  • vagus –> sensory innervation of tracheobronchial tree
  • sympathetics –> bronchodilation
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9
Q

Spontaneous respirations

A
  1. Diaphragm and intercostals activate –> chest expansion
  2. Drop in intrapleural pressure –> (-) pressure gradient for air into lungs
  3. Diaphragm relaxation and chest recoil –> passive expiration
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10
Q

Transplumonary pressure?

A

P(alveolar) - P(intrapleural)

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11
Q

Compliance?

A

deltaV/deltaP

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12
Q

Dynamic compliance

A

measure of overall resistance

- peak pressures (bronchospasm)

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13
Q

Static compliance

A

measure of overall lung stiffness

- plateau pressure (measured at fixed lung volume)

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14
Q

Surface tension forces?

A

LaPlace’s Law

Pressure = 2*surface tension / radius

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15
Q

What does pulmonary surfactant do to surface tension?

A

it decreases alveolar surface tension, to reduce pressure

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16
Q

What happens to chest wall compliance in supine position?

A

Chest wall compliance is reduced in supine position compared to upright

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17
Q

Functional Reserve Capacity

A

lung volume @ end expiration

- at FRC, inward lung elastic recoil is opposed by outward chest recoil –> equals out

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18
Q

What makes FRC decrease?

A
  1. Supine vs Sitting
  2. Obese
  3. Short stature
  4. Lung Disease (fibrosis)
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19
Q

Closing capacity

A

volume at which volume in the airways begin to close (below FRC)
- small airways w/o cartilage depend of radial traction to keep them open

20
Q

What makes FRC increase?

A
  1. Height
  2. Old age –> loss of elastic recoil
  3. Obstructive lung disease
21
Q

Gas flow in lungs equation?

A

Flow = Pressure gradient / Resistance

22
Q

Resistance equation

A

R = 8Lviscosity / (pi)R^4

23
Q

Reynolds Number

A

Rey = diameter * velocity * density / viscosity

24
Q

Reynolds >1500

A

Turbulent Flow

25
Q

Reynolds <1000

A

Laminar flow

26
Q

Volume related airway collapse

A

at low lung volumes –> lose that radial traction –> airway collapse due to increased resistance
- use PEEP to decrease resistance and keep airways open

27
Q

Breathing pattern of patients with reduced compliance

A

rapid, shallow breaths

28
Q

Breathing pattern of patients with increased resistance

A

slow, deep breaths

29
Q

Effects of anesthesia on pulmonary mechanics

A
  1. Sitting –> supine: decrease FRC, reduced diaphragm excursion
  2. Inducing GA –> further reduces FRC and causes atelectasis
  3. Steep Trendelenburg –> further reduces FRC and diaphragm excursion
30
Q

Ventilation

A

~ 5 L/min

MV = RR * Tv

31
Q

Alveolar ventilation

A

actual gas taking part in gas exchange

32
Q

Dead space ventilation

A

portion of Tv that fills airway but does not exchange gas

33
Q

Bohr Equation

A

Vd/Vt = PaCO2 - EtCO2 / PaCO2

34
Q

Which lung receives more ventilation?

A

R > L

  • lower lungs receive more ventilation
  • upper lungs under more negative pressure
35
Q

Pulmonary Perfusion

A

~5 L/min

  • only 70-100 cc actually participate in gas exchange at any one time
  • low pressure system –> can accommodate fluid
36
Q

5 mechanisms of hypoxia

A
  1. Hypoventilation
  2. Low FiO2 (altitude)
  3. diffusion limitation
  4. V/Q mismatch
  5. Shunt
37
Q

What hypoxia causes A-a gradient

A
  1. V/Q mismatch
  2. Shunt
  3. diffusion limitation
38
Q

Wide A-a gradient that responds to O2

A
  1. V/Q mismatch

2. diffusion limitation

39
Q

Wide A-a gradient that doesn’t respond to O2

A

Shunt!!!!

40
Q

Calculate A-a gradient

A

PAO2 = PiO2 - PaCO2/Rq

41
Q

Central center of respiration

A

MEDULLA

  • dorsal = inspiration
  • ventral = expiration
42
Q

Central sensors of respiration

A

chemoreceptors respond to changes in [H+] in the CSF

  • CO2 crosses BBB and is converted to H+
  • HCO3 CANNOT cross BBB
43
Q

Peripheral sensors of respiration

A

GLOSSOPHARYNGEAL NERVE

  1. Carotid body = primary sensor
    • most sensitive to PaO2
  2. Aortic body - secondary sensor
44
Q

Depressants of response to hypoxia and respiration?

A

Acidosis, hypoxia, and anesthetic agents

45
Q

Hering-Bruer Reflex

A

lung stretch receptors inhibit inspiration when stretched by too much volume

Hard Core Physiology (7 decks)

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