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Physiology > Respiratory I Ventilation > Flashcards

Respiratory I Ventilation Flashcards

1
Q

what are the functions of the respiratory system

A

-exchange of gases between the atmosphere and the blood
- regulation of pH
- protection from inhaled pathogens and irritants
-vocalization
-route for water and heat loss

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2
Q

what is ventilation

A

air moves in and out of lungs

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3
Q

what do gases diffuse between

A

alveoli and blood
-blood and tissues

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4
Q

what is the visceral pleura

A

attaches to the surface of the lung

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5
Q

what is the parietal pleura

A

covers the surface of the chest wall, diaphragm, and mediastinum

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6
Q

what does the pleural space contain

A

a thin layer of pleural fluid under negative pressure

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7
Q

what is the negative pressure in the pleural space referred to as

A

the intrapleural pressure

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8
Q

is intrapleural pressure higher or lower than atmospheric pressure

A

subatmospheric - lower

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9
Q

what is a pleural effusion

A

excess fluid in the pleural space which makes lung expansion difficult so the person will breathe shallow and fast

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10
Q

how many lobes are in the right and left lobe

A

right-3
left-2

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11
Q

what zone is the best site for gas exchange and why

A

zone 3 because it gets more air and blood due to gravity

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12
Q

what zone are the alveoli largest

A

zone 1

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13
Q

normally most of the lungs are zones _____

A

3 and 2

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14
Q

what two functional zones is the respiratory system divided into

A

conducting zone and the respiratory zone

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15
Q

what does the conducting zone consist of

A

trachea, bronchi, bronchioles, and terminal bronchioles

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16
Q

what does the respiratory zone consist of

A

respiratory bronchioles, alveolar ducts, and alveolar sacs

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17
Q

how much air is in the conducting zone and what is it called

A

150 mL called the anatomic dead space

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18
Q

what happens to the diameter and number of the airways as you move down

A

the diameter decreases and the number of each increases

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19
Q

what happens to the amount of cartilage and smooth muscle of the airways as you move down

A

decrease in cartilage and increase in smooth muscle

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20
Q

what happens to surface area of the airways as you move down

A

increases

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21
Q

what happens to air in the conducting zone

A

it is warmed, humidified and filtered

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22
Q

what is the function of cartilage and smooth muscle

A

cartilage: prevents airway collapse
smooth muscle: alters resistance to airflow

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23
Q

what is the formula for velocity of air

A

V = flow/cross sectional area

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24
Q

what are the cell types in alveoli

A

-type I cells (simple squamous epithelial cells)
- type II alveolar (produce surfactant)
-macrophages

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25
Q

what cells make up wall of alveoli

A

type I

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26
Q

what is the basement membrane fused of

A

the endothelium and the alveolar epithelium

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27
Q

what is the typical transit time at rest for an erythrocyte through an alveolar capillary

A

0.75 seconds

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28
Q

how long does gas exchange take

A

0.25 seconds

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29
Q

what are the numbers for diffusion equilibrium for O2 and CO2

A

PAO2 and PaO2 = 100
PACO2 and PaCO2 = 40

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30
Q

what are the partial pressure for O2 and CO2 in arteries

A

PaO2: 40 mmHg
PaCO2: 45 mmHg

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31
Q

what are the partial pressures for O2 and CO2 in alveoli

A

PAO2: 100mmHg
PACO2: 40 mmHg

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32
Q

what type of muscles are respiratory muscles

A

skeletal muscles

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33
Q

what controls the alpha motor neurons in the respiratory muscles

A

neurons in the medulla and pons

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34
Q

what are the inspiratory muscles and what does contraction do

A

-mainly diaphragm and external intercostals but also sternocleidomastoid and scalenes
- increases the size of the thorax and lungs and decreases Palv

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35
Q

what are the expiratory muscles and what does contraction do

A

-mostly internal intercostals, external oblique, internal oblique, transversus abdominus, and rectus abdominus
-contraction decreases the size of the thorax and the lungs causing increase in Palv

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36
Q

when do expiratory muscles contract

A

only with active expiration

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37
Q

what do the internal intercostals do in expiration

A

depress the ribs

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38
Q

what do the abdominal muscles do in expiration

A

push abdominal contents against the diaphragm compressing the lungs

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39
Q

what is the primary inspiratory muscle

A

the diaphragm

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40
Q

what is boyles law

A

P1V1=P2V2

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41
Q

what changes first: changes in volume or changes in pressure

A

changes in volume

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42
Q

for air to enter the lungs the pressure in the alveoli must be_____

A

lower than the atmospheric pressure

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43
Q

for air to leave the lungs the pressure in the alveoli must be ____

A

higher than atmospheric pressure

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44
Q

which way do the chest and lung recoil

A

chest recoils outward, lungs recoil inward

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45
Q

what does the elastic recoil of the lungs favor

A

a decrease in lung volume or compression

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46
Q

what does the elastic recoil of the chest wall favor

A

an increase in lung volume or expansion

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47
Q

how is the intrapleural fluid related to recoil

A

it overcomes recoil and keeps the chest wall and lungs attached together so when the chest moves the lungs move with it

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48
Q

what is the formula for transmural or transpulmonary pressure

A

Ptp = Palv - Pip

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49
Q

what must happen to the transmural pressure to produce inspiration vs expiration

A

-must increase to produce inspiration
-must decrease to produce expiration

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50
Q

what pressure value equals zero in a pneumothorax

A

Ptp is 0 because Pip = Patm

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51
Q

where is half of the energy expended for inspiration stored and when is it released

A

stored in elastic recoil and released during expiration to overcome airway resistance

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52
Q

at what pressure does inspiration begin

A

at rest when Patm = Palv

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53
Q

what happens to the pressures during inspiration

A

decrease in Pip from -5 to -7.5mmHg causes Ptp to increase to 7.5 mmHg which causes the lung volume to increase

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54
Q

what happens to Palv as air enters the lungs

A

it increases again

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55
Q

when does air flow stop in inspiration

A

when Palv = Patm again

56
Q

what volume of air does normal inspiration move

A

500mL - tidal volume

57
Q

why is expiration a passive process in relaxed breathing

A

relaxation of inspiratory muscles

58
Q

what happens to the pressures during expiration

A

increase in Pip from -7.5 to -5 mmHg which causes Ptp to decrease from 7.5 to 5 mmHg

59
Q

what 2 factors affect pulmonary ventilation

A

lung compliance and airway resistance

60
Q

what is the formula for compliance

A

change in volume/ change in pressure

61
Q

what does high compliance vs low compliance mean

A

high: lung stretches easily
low: difficult for lung to stretch

62
Q

where are alveoli more compliant

A

in the base of the lungs

63
Q

what is the opposite of compliance

A

elasticity

64
Q

what is elasticity

A

lungs ability to return to its normal resting position

65
Q

what does high elasticity mean

A

easy recoil

66
Q

lungs with lower compliance require a ___ Ptp to increase volume

A

larger

67
Q

what happens in obstructive lung disease and what happens to compliance

A

-elastic fibers destroyed
- increase in compliance: will breathe deep and slowly to reduce the work of breathing

68
Q

what happens in restrictive lung disease to compliance

A

decreased compliance
-will breathe shallow and fast to reduce the work of breathing

69
Q

what is an example of obstructive lung disease

A

emphysema

70
Q

what is an example of restrictive lung disease

A

pulmonary fibrosis

71
Q

how much of pulmonary elasticity does surface tension account for

A

two thirds

72
Q

what is surface tension

A

force that occurs at any gas liquid interface due to the cohesive forces between liquid molecules

73
Q

what force does the fluid covering alveoli exert

A

a constant force favoring contraction

74
Q

what does the law of laplace describe

A

the relationship between surface tension and radius of an alveolus

75
Q

what is the formula for the law of laplace

A

P = 2T/r

76
Q

if two alveoli are connected and the surface tension is equal, in which of the alveoli is the pressure greater? because of this where will the air flow

A

pressure is greater in the small alveolus and air will flwo into the larger alveoli

77
Q

what does surfactant do and what is it secreted by

A

reduces surface tension (and thus elasticity) and equalizes pressure between alveoli of different sizes
-secreted by type II alveolar cells

78
Q

what is surfactant made of

A

phospholipids

79
Q

some components of surfactant are components of ____ immunity

A

innate

80
Q

surfactant is particularly important for reducing surface tension where and what does this do

A

in small alveoli which decreases the likelihood of alveolar collapse

81
Q

surfactant decreases the work of ____

A

inspiration

82
Q

when is surfactant production increased

A

with hyperinflation of the lungs, exercise and beta adrenergic agonists

83
Q

what pathologies are associated with decreases in surfactant production

A

infant respiratory distress syndrome, acute respiratory distress syndrome, chronic smoking

84
Q

what is the formula for air flow in the lungs

A

(Patm- Palv)/ resistance

85
Q

what are the determinants of resistance

A

-radius of bronchi/bronchioles
-viscosity of substance
-length of tube

86
Q

what determines the radius of bronchi/bronchioles

A

-bronchodilation
-bronchoconstriction
-mucus accumulation

87
Q

what causes bronchodilation

A

EPI on B2, decreased O2and increased CO2

88
Q

what causes bronchoconstriction

A

ACH on M3, increased O2, decreased CO2, and histamine

89
Q

the airways with the smallest radius have the ____individual resistance and the ____ total resistance

A

highest individual and smallest total

90
Q

what are the pathologies that increase airway resistance

A

obstructive diseases such as asthma, emphysema and bronchitis

91
Q

what is the resting normal tidal volume

A

500mL

92
Q

what is IRV

A

deepest breath possible

93
Q

what is expiratory reserve volume

A

deepest breath out possible

94
Q

what is the normal anatomic dead space

A

1 mL per pound of idea body weight which is the conducting zone of the respiratory system

95
Q

what is the formula for the physiologic dead space

A

anatomic DS + alveolar DS

96
Q

describe the alveolar dead space of a healthy young person

A

little or no alveolar dead space

97
Q

describe the alveolar dead space of someone with low cardiac output and why

A

a lot of alveolar dead space due to low perfusion and thus a higher V/Q ratio

98
Q

what is included in vital capacity

A

IRV + ERV + TV

99
Q

what is included in total lung capacity

A

VC + RV

100
Q

what is included in inspiratory capacity

A

TV + IRV

101
Q

what is included in functional residual capacity

A

ERV + RV

102
Q

what is the formula for minute, pulmonary or total ventilation

A

tidal volume x respiration rate

103
Q

what is the formula for alveolar ventilation

A

(tidal volume - dead space volume) x respiration rate

104
Q

which pulmonary function test is a better indicator of gas exchange: total ventilation or alveolar ventilation

A

alveolar ventilation

105
Q

what is the normal respiratory rate

A

between 12-20 breaths/minute at rest

106
Q

is it better to breath deeper or faster and why

A

deeper to get more air into the respiratory zone for gas exchange

107
Q

what do measurements of expiratory flow reflect

A

air flow within large airways. used to test for increased airway resistance

108
Q

what are the measurements of expiratory flow

A

-forced vital capacity
- forced expiration volume

109
Q

what is the forced vital capacity

A

volume of air forcibly expired after maximal inhalation ~5L

110
Q

what is the forced expiration volume

A

fraction of FVC expired during the first second

111
Q

what is the normal forced expiration volume

A

.8 or 80%

112
Q

what is FEV1 in obstructive lung diseases

A

less than 80%

113
Q

what does FEV1 reflect

A

flow in large airways

114
Q

what is eupnea

A

normal quiet breathing

115
Q

what is hyperpnea and when does it occur

A

increased rate or volume due to higher metabolism
-during exercise

116
Q

what is hyperventilation and when does it occur

A

increased rate or volume without increased metabolism
- during emotions,blowing up a ballon

117
Q

what is hypoventilation and when does it occur

A
  • decreased alveolar ventilation
  • shallow breathing, asthma, restrictive lung disease
118
Q

what is tachypnea and when does it occur

A

rapid breathing usually with decreased depth
-panting

119
Q

what is dyspnea and when does it occur

A

-difficulty breathing, air hunger
- various pathologies or hard exercise

120
Q

what percentage of total body energy does normal quiet breathing take

A

3-5%

121
Q

what are obstructive diseases due to and examples

A

-due to increased airway resistance
- ex: asthma, emphysema, bronchitis, cystic fibrosis

122
Q

what do obstructive diseases primarily impact and describe the breathing pattern

A

impacts expiration
- breathe slow and deep

123
Q

what are restrictive diseases due to and example

A

decreased lung compliance
-ex: pulmonary fibrosis

124
Q

what do restrictive diseases primarily impact and describe the breathing patttern

A

-impacts inspiration
-breathe fast and shallow

125
Q

what is atopic asthma

A

-IgE mediated- type 1 hypersensitivity reaction
-an allergen leads to an inflammatory response that causes bronchospasms that obstruct airflow

126
Q

what can chronic inflammation in atopic asthma lead to

A

imparied mucociliary response, edema and increased airway responsiveness

127
Q

what are the quick relief and long term treatment options for atopic asthma

A

-quick: B2 agonists, anticholinergic agents
- long: inhaled corticosteroids, long acting bronchodilators

128
Q

what can nonatopic asthma occur with

A

respiratory infections, exercise, hyperventilation, cold air, inhaled irritants, aspirin and other NSAIDS

129
Q

what happens in the early phase response and late phase responses of atopic asthma

A

early: increased mucus production and mast cells release cytokines upon IgE binding
late: increased vascular permeability and edema

130
Q

what type of lung disease is cystic fibrosis and what happens in it

A
  • obstructive disease
    -autosomal recessive disorder resulting in defective CTFR ion channel that results in abnormally thick mucus that obstructs airways
    -defective Cl- secretion and excessive Na+ and H2O absorption
131
Q

what are the treatments for cystic fibrosis

A

-antibiotics
-chest physical therapy (percussion and postural drainage)
- mucolytic agents
-pancreatic enzyme replacement

132
Q

what chromosome is defective in cystic fibrosis

A

7

133
Q

what is the pathway in cystic fibrosis

A

abnormal thick and viscid secretions
-development of a microenvironment that is protective of microbial agents and defective mucociliary clearance
- chronic airway obstruction and bacterial infection
- neutrophil influx and release of elastase and inflammatory mediators
- development of chronic bronchitis and respiratory failure

134
Q

what happens in emphysema

A

destruction of elastic fibers and enlargement of airspaces due to destruction of airspace walls

135
Q

what does emphysema lead to

A
  • airway collapse which increases resistance and decreases flow
  • damage to alveolar membrane so decreased gas exchange
  • decreased elasticity and increased compliance
136
Q

what happens in restrictive respiratory diseases

A

-chronic inflammation and the normal lung tissue is replaced with scar tissue/fibrosis (collagen fibers decrease lung compliance)
- low compliance - more difficult to inhale
- work of breathing increases (pt breathes shallow and fast decreases alveolar ventilation and decreases gas exchange

137
Q

what are signs and symptoms of restrictive pulmonary diseases

A

-increased respiratory rate
-chronic cough - dry, non productive
-polycythemia due to hypoxia (decreased PaO2 and increased # RBCs)

Physiology (41 decks)

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