Respiratory Flashcards
1
Q
What is entropy
A
Disorder
2
Q
Where does glycolysis take place
A
in the cytosol of cells
3
Q
What is the net gain of glycolysis
A
two ATPs and two NADHs per glucose
4
Q
What pathway does NADH participate in
A
catabolic pathways
5
Q
What pathway does NADPH participate in
A
anabolic pathways
6
Q
What is blood lactate levels normally at
A
~1mM
7
Q
Where is lactate converted into glucose in the body
A
in the liver
8
Q
What organ can use lactate directly
A
the heart
9
Q
After a meal what is the bloodstream high in
A
sugars and fatty acids
10
Q
What forms are sugars and fats stored in
A
glycogen
11
Q
What are fatty acids stored as and where
A
as triglycerides in adipocytes
12
Q
How does glucose enter cells
A
through transport proteins embedded in the cell membrane
13
Q
Where are GLUT1s
A
in red blood cells and other tissues (Km of 3mM)
14
Q
Where are GLUT2s
A
In the liver and pancreas (Km of 17mM)
15
Q
Where are GLUT3s
A
in the brain (Km of 1.4mM)
16
Q
Where are GLUT4s
A
in muscle and adipose tissue (Km of 5mM)
17
Q
What does a high Km mean
A
better at responding to an increase in glucose than other tissues
18
Q
How many grams of sugar does the brain consume daily
A
around 120g
19
Q
At what point does the brain become starved of food
A
when blood-glucose levels are less than 2mM
20
Q
In resting muscle, what is their main source of food
A
fatty acids
21
Q
Where is the major site of fatty acid synthesis
A
the liver
22
Q
What is the main source of food for the heart
A
fatty acids
23
Q
Where do fats get broken down into fatty acids and glycerol
A
In the mouth and gut (start of digestion)
24
Q
What does low glucose level trigger
A
the breakdown of fats stored in adipose tissue
25
How many mitochondria do liver and heart cells roughly contain
around 2000
26
What is pyruvate converted into?, where? and how?
into acetyl CoA and CO2 in the mitochondrial matrix by pyruvate dehydrogenase complex
27
Net gain from citric acid cycle for 1 molecule of glucose
2ATP, 10NADH, 2 GTP, 2 FADH2
28
What is Alveolar gas and its symbol
(A) the gas in the alveoli of the lungs where gaseous exchange with capillary blood takes place (AKA alveolar air)
29
What is arterial blood and its symbol
(a) blood found in the systemic arteries
30
What is blood flows symbol
Q
31
What is cardiac outputs symbol
Q
32
What is expired gas and its symbol
(E) any gas expelled from lungs
33
What is fractional concentration and its symbol
(F) convert percentage composition of a gas to a fraction for use in Dalton's Law
34
What is gas content and its symbol
(C) total volume of gas per unit volume of blood
35
What is gas flow and its symbol
(V with a dot on top) indicates alveolar ventilation
36
What is inspired gas and its symbol
(I) any gas that has been inhaled
37
What is mixed venous blood and its symbol
(V with a line on top) sampled from the pulmonary or the right ventricle
38
What is partial pressure and its symbol
(P) mixture of ideal gasses, each gas has a partial pressure which is the pressure which the gas would exert if it occupied the space alone
39
What is saturation and its symbol
(S) measure of the percentage of binding sites of haemoglobin that occupied oxygen
40
What is the amount of oxygen delivered to tissue the product of
cardiac output
41
What is hypoxia
abnormally low oxygen content in organs/tissues
42
What is hypoxic hypoxia (hypoxaemia)
insufficient oxygen is available to the lungs and so saturation of haemoglobin is reduced (pneumonia or high altitude)
43
What is ischaemic hypoxia
cardiac output (Q) is reduced (heart failure)
44
What is anaemic hypoxia
concentration of functioning haemoglobin is decreased (iron deficiency anaemia)
45
What is histotoxic anaemia
inability to utilise available oxygen (cyanide poisoning)
46
define tidal volume and its symbol
(Vt) volume of air inhaled/exhaled during a single quiet breath
47
Define inspiratory reserve volume and its symbol
(IRV) following a maximal inspiration, the volume of air inhaled in excess of tidal volume
48
Define expiratory reserve volume and its symbol
(ERV) volume of air that remains in the lungs after a normal expiration
49
Define residual volume and its symbol
(RV) volume of air that remains in the lungs and cannot be exhaled
50
Define physiological dead space
volume of gas that does not participate in gas exchange
51
Equation for physiological dead space
physiological dead space=alveolar dead space + anatomical dead space
52
How do you calculate anatomical dead space
= 2.2ml/kg x body weight (kg)
53
Another way of saying respiratory minute volume and what it is
pulmonary ventilation rate
| volume of air we breathe out of our lungs every minute
54
What is the respiratory exchange ratio (RQ)
ratio of carbon dioxide produced divided by rate of oxygen consumed per unit time
55
What is calorimetry
measurement of energy expenditure
56
What is direct calorimetry
measuring the heat exerted by a subject whilst they are in an experimental chamber
57
What is indirect calorimetry
simpler technique, relies upon principle that all energy releasing processes in the body depend upon the utilisation of oxygen
58
What is the metabolic rate
energy released/or generated per second
59
What does soda lime crystals do in a spirometer
acts to remove carbon dioxide
60
What is acidaemia
decrease in blood pH
61
What is hypercapnia
build-up of carbon dioxide in the blood
62
What are some receptors in the respiratory system
central and peripheral chemoreceptors
63
Where is the control centre for the respiratory system
located in the brainstem, medulla oblongata
64
What is the clinical name for a panic attack
voluntary hyperventilation (leads to hypercapnia)
65
What is academia and what does it cause
causes respiratory acidosis, decrease in pH
66
What is alkaemia and what does it cause
causes respiratory alkalosis, increase in pH
67
What do central chemoreceptors respond to
to an increase in hydrogen ion concentration
(They cannot pass the blood brain barrier)
carbon dioxide diffuses accrocs bbb and convert into hydrogen ions
Over time there is an increase in bicarbonate in the CSF
68
What are peripheral chemoreceptors stimulated by
acidaemia, hypoxia, hypercapnia and hypotension
69
Influence of pH equation
pH∝ [HCO3-]/PaCO2
70
What is pathological decrease of bicarbonate termed as
metabolic acidosis and causes acidaemia
71
When is metabolic acidosis often seen
in type 1 diabetes mellitus (known as diabetic ketoacidosis)
72
What is Kussmaul breathing
pattern of deep sighing breathing
73
What is the influence of opioids on the respiratory system
bind to MOP receptors and depresses alveolar ventilation
| causes respiratory acidosis
74
What do negative pressure ventilators do
lower alveolar pressure below atmospheric and suck air in
75
What do positive pressure ventilators do
generate higher pressures than atmospheric and blow air out
76
What are the effects of an increase in pulmonary arterial pressure
increase pulmonary blood flow
increases perfusion of the lung apices
reduced physiological dead space
77
Fick equation
CO (cardiac output) = VO2 (o2 consumed in ml) / (Ca (oxygen content in arterial blood) - Cv (oxygen content of mixed venous blood)
78
What is the effects of training on the heart
increased myocardial capillaries
increased size of ventricular chamber due to hypertrophy of the chamber wall
increased vagal tone results in bradycardia
79
What is material hypoxia defined as
arterial PO2 of less than 60mmHg
80
Range that defines hypercapnia
above 42mmHg
81
Range that defines hypocapnia
below 35mmHg
82
What is P
partial pressure
83
what is S
saturation
84
What is V
volume of gas
85
What is F
fractional concentration of gas
86
What is a
material blood
87
what is v
venous blood
88
Equation for respiratory minute volume
respiratory minute volume = tidal volume x respiratory rate
89
Equation for the alveolar ventilation
alveolar ventilation = (tidal volume - dead space) x respiratory rate
90
Equation for PACO2 (partial pressure of co2 in alveolar gas)
PACO2 = rate of production of CO2 / alveolar ventilation
91
What does emergency assessment ABCDEF mean
```
airway
breathing
circulation
disability
exposure
don't Forget to measure blood glucose
```
92
Normal respiratory rate
10-15 per minute
93
What is rapid breathing called
tachypnoea
94
What is respiratory arrest known as
apnoea
95
What is Cheyne-stokes breathing
occurs at end of life, gradually decreases to a complete stop
96
What does Kussmaul breathing indicate
acidity of arterial blood (Acidosis)
97
What is vesicular breathing
normal breathing
98
What is a stridor
an abnormal inspiratory noise due to obstructed upper airway
99
What is bronchiole breathing
localised fluid within alveoli associated with things like pneumonia
100
What does perfusion mean
flow of blood
101
What is the Laplace equation
transmural pressure = 2 x pressure tension radius
102
What is FRC
functional residual capacity
103
What happens in a traumatic pneumothorax
intra pleural pressure becomes equal to the atmospheric pressure and the lungs collapse
104
What is surface tension reduced by
surfactant (produced by type II alveolar cells)
105
When does the ability to produce surfactant develop
between24-35 weeks
106
What is meant by compliance (in terms of the respiratory system)
the distensibility of the lungs and chest wall
107
What is hysteresis
the difference between the inspiratory and expiratory limbs
108
What do fibrotic (restrictive) diseases lead to
scarring of the lungs
reduction in compliance
reduction in FRC (functional residual capacity)
109
What does emphysema or obstructive diseases lead to
loss of elastin fibres
increase in compliance
increase in FRC
clinical description of a barrel-shaped chest
110
What determines FRC
elastic properties of lungs give them a tendency to collapse, chest wall has a tendency to expand and spring outwards
point at which these forces are equal and opposite produces the FRC
111
Where is the pressure generated by in the pulmonary circuit and systemic circuit
```
pulmonary = right ventricle
systemic = left ventricle
```
112
what is the normal systolic/diastolic pressure in the pulmonary circuit and systemic circuit
```
pulmonary = 25/8
systemic = 120/80
```
113
What is the resistance like in the pulmonary circuit and systemic circuit
```
pulmonary = lower (pulmonary vascular resistance)
systemic = higher (total peripheral resistance)
```
114
What is the blood flow (perfusion) like in the pulmonary circuit and systemic circuit
```
pulmonary = little less than 5L/min
systemic = 5L/min
```
115
What is the response of arterioles/small arteries to hypoxia in the pulmonary circuit and systemic circuit
```
pulmonary = vasoconstriction
Systemic = vasodilation
```
116
What is an advantage of hypoxic vasoconstriction
diverts blood away from poorly ventilated alveoli
117
What is cor pulmonae
right-sided heart failure due to hypoxic lung disease
118
What are signs of cor pulmonae
cyanosis
pitting oedema
raised internal JVP
hepatomegaly (abnormal enlargement of liver)
119
Why does the oxygen dissociation curve shift to the right
```
facilitates unloading
decreased affinity
rise in PCO2
decrease in pH
increase in temperature
increase in 2,3-DPG
```
120
Why does the oxygen dissociation curve shift to the left
```
increased affinity
facilitates loading
fall in PCO2
increase in pH
decrease in temperature
decrease in 2,3-DPG
```
121
What is the Bohr effect
changes in affinity due to changes in PCO2 and pH
122
What does 2,3-DPG do
facilitates unloading of oxygen at peripheral tissues
123
Describe carbon dioxide transport in blood
dissolved in plasma
bound to HbA forming carbaminohaemoglobin
converted to bicarbonate (HCO3-)
