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S&F III: Exam Two > Respiratory Mechanics > Flashcards

Respiratory Mechanics Flashcards

0
Q

FRC

A

“Functional Residual Capacity”

-Amount of air in the lungs with the mouth is held open; elastic recoil of the lungs and thoracic wall are equal and opposite

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1
Q

Most common cause of pleurisy

A

Viral infection

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2
Q

2 Forces of Lung Elastic Recoil

A
  1. Collagen and elastin fibers

2. Surface tension from the water lining the alveoli

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3
Q

Laplace’s Law (Surface Tension)

A

P=T/ r/2

*Pressure is inversely proportional to radius

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4
Q

Shunt

A

Vascular pathway in the lung which has no gas exchange

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5
Q

Dipalmitoyl phosphatidyl choline

A

“SURFACTANT”

-Surfactant inserts itself b/w water molecules lining the alveoli to decrease the cohesive forces b/w them

Net Result= Decreased surface tension

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6
Q

Tripod Position

A

Assumed by COPD pts. in an effort to force expiration of air

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7
Q

Pressures in Inspiration

A

Start: Transmural Pressure = -5 cm H2O; lung elastic recoil = 5 cm H2O
=>No air-flow

Begin inhalation: Pleural volume increases; decrease in Ppl
=> Lungs begin to expand

During Inhalation: Increased lung volume increases the volume of alveoli; Patm> Pa
=>Air flows in

End Inhalation: Elastic recoil is stretched to limits and it balances forces around the lung
=>Airflow stops

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8
Q

Flail Chest

A

Damage thorax causes chest cavity to move inward during inspiration

-Ppl is not sufficiently negative causing no air to flow in

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9
Q

Tension Pneumothorax

A

Air accumulates in pleural cavity after collapse of lung

*Mediastinum will shift to opposite side of lung

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10
Q

Transmural Pressure

A

Ptm= Palv- Ppl

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11
Q

Compliance in emphysema and fibrosis

A

Emphysema= INCREASED

Fibrosis= DECREASED

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12
Q

Specific Compliance

A

A measure of compliance as a function of size

C= P/V

Specific Compliance= C/volume of lungs

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13
Q

Total pulmonary compliance

A

1/total compliance= 1/lung compliance + 1/ chest wall compliance

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14
Q

Alveolar Simplification

A

Breakdown of structural proteins due to increased levels of trypsin in the lungs

=>Decreased # of alveoli

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15
Q

Centrilobar emphysema

A

Most common subtype of emphysema that affects the central region around the secondary pulmonary lobules; (Upper lobe)

  • Spreads peripherally
  • Assoc. w/ long-term smoking; inhalation of chemicals
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16
Q

Panacinar Emphysema

A

Uniform destruction of alveoli predominantly in the lower lungs

-Assoc. w/ AAT deficiencies of Ritalin abuse

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17
Q

Predict compliance in the following situations:

Decreased pulmonary surfactant

Removal of lobe

Obesity

Pulmonary Vascular Congestion

A

Decreased in all

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18
Q

Areas of greatest airway resistance

A

Large airways

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19
Q

Passive Exhalation

A

Elastic recoil forces in alveoli move air out of the airway; airway is held open by expansile forces since Ppl is negative

20
Q

Forced Exhalation

A

When the rib cage pushes in and abdominal muscles push upwards, Ppl increases

Alveolar pressure becomes more positive pushing air out faster

21
Q

Dynamic Compression

A

Increased Ppl during forced exhalation can cause collapse of the alveolar airways => Decreased air release

*Common in emphysema; decreased elastic recoil means air must be forced out of alveoli

22
Q

Greatest flow rate in lungs

A

Large Airways

*Must have cartilaginous rings because fast air flow=decreased pressure; airway could collapse

23
Q

Tethering

A

The attachment of alveoli to neighboring alveoli

=>Decreases the tendency for vessels to collapse

*Decreased in emphysema

24
Q

Dead Space Volume

A

Volume of air person breathes but is not used for gas exchange

-Fills nose, pharynx, trachea (respiratory passages); part of first 17 divisions of respiratory system

25
Q

FVC

A

“Forced Vital Capacity”

Amount of air that can be quickly expired

26
Q

Cannot be measured w/ spirometry

A

RV, TLC, and FRC

-All include the RV

27
Q

FRC measuremetn

A

Pbag X Vbag= PHe X (Vbag + FRC)

PHe=new pressure of helium in the lungs after mixing

28
Q

Body Box Plethysmogrophy

A

Used to measure FRC in pts. w/ emphsyema because it takes them a long time to expire into the bag

29
Q

Predict FRC in the following conditions:

Emphysema

Age

Laying Down

Obesity/Pregnancy

Kyphoscoliosis

A

Increased

Increased

Decreased

Decreased

Decreased

30
Q

Barrel chest symptom

A

Residual pockets of air in emphysema pts. can lead to “barrel chest”

31
Q

Bronchitis

A

Inflammation of the mucous membranes of the bronchi; affects the upper pathways of the respiratory system

32
Q

COPD

A

Co-existence of emphysema and chronic bronchitis; assoc. w/ chronic narrowing of the pathways and shortness of breath

33
Q

Sarcoidosis

A

The formulation of granulomas in the lungs due to the accumulation of chronic inflammatory cells; cause unknown

34
Q

Flow Volume Loops of Emphysema

A

Expiration is low and prolonged due to high compliance and dynamic collapse; graph is shifted to the right

-Top part of graph has significant scooping

35
Q

Flow Volume Loops of Restrictive Disease

A

Lungs are stiffer=> only small volume is inhaled and exhaled

*Top part of graph looks like a witch-hat

36
Q

Diagnosis of Lung Diseases

A

Examine FEV1/FVC ratio

Examine the shape of the PV-loop

Perform methacholine and DLco test

37
Q

Variable Intrathoracic Legions

A

Cause dynamic compression during forced expiration; legions will further compress airways along with increased Ppl

38
Q

Variable Extrathoracic Legion

A

Cause dynamic compression during forced inhalation; negative Ppl causes the region near the trachea to collapse

*Vocal chord paralysis; fat deposits

39
Q

Fixed Obstructions

A

Affect both inspiration and exhalation; caused by fibrosis or scarring

40
Q

Methacholine Challenge Test

A

Give the pt. successively increased dosages of methacholine
(.0625-16mg/mL)

  • 20% reduction in FEV before 16mg/mL => airway hyperreactivity
  • Not all pts. may have asthma, pts. who do may test negative if they are on drugs or it has not been triggered
41
Q

DLco

A

Diffusing Capacity of the Lung

DLco is directly related to surface area; indirectly rated to membrane thickness

*Emphysema=decrease A; Fibrosis=thickened membrane

42
Q

Hypoxia stimulates what receptors?

A

Peripheral; during lung disease, patients respiration is being maintained by hypoxic stimulus of these receptors so they should NOT be placed on a ventilator

43
Q

Causes a great increase in anatomical dead space

A

Mechanical ventilation

  • This is due to P1V1=P2V2; use Va1/Va2=PaCO2/PaCO1 w/ before and after PaCO2s
  • Equation possible due to inverse nature of the two
44
Q

FEV1

A

Measurement of airway resistance; big FEV/small resistance

45
Q

FEF25-75%

A

Slope of FEV1; directly related to FEV1

46
Q

Fixed intra/extra thoracic legion

A

Causes compression on inspiration and expiration; caused by scarring and inflammation

47
Q

O2 delivery

A

CO x O2 content

S&F III: Exam Two (22 decks)

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