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Respiratory > Respiratory Phys Review > Flashcards

Respiratory Phys Review Flashcards

1
Q

Describe the chemical control of respiration

A

metabolic change –> peripheral chemoreceptors–>respiratory center–>spontaneous rhythmic discharge to motor neurons–>respiratory muscles

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2
Q

what is the key cellular layer that adds to resistance to air flow?

A

smooth muscle layer

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3
Q

what is the most influential factor of the Reynold’s formula in resistance to airflow?

A

radius to the 4th

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4
Q

please list 4 changes to the respiratory passageways in obstructive disease

A
  1. inflammation of bronchial epithelium - bronchitis
  2. secretion from epithelium - asthma, infection
  3. constriction of smooth muscle - asthma
  4. physical blockade - tumors, aspiration FB
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5
Q

what are the 3 main factors of air resistance that can change through either disease state or medications?

A

bronchiolar size, PNS, SNS

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6
Q

What are the diseases/medications associated with each change?

A
  1. bronchiolar size: asthma, bronchitis
  2. PNS: M3 increased - asthma, muscarinic agonists
  3. SNS: B2 decreased - epinephrine and albuterol
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7
Q

list 3 types of obstructive lung disease

A

obstruction of the…

  1. airway wall
  2. lung parenchyma
  3. airway lumen
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8
Q

what consists of the respiratory unit

A
  1. respiratory bronchiole
  2. alveolar ducts
  3. atria
  4. alveoli
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9
Q

what makes up the respiratory membrane

A
  1. surfactant
  2. alveolar epi
  3. epithelial basement membrane
  4. interstitial space
  5. capillary basement membrane
  6. capillary endothelial membrane
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10
Q

what is in the lung interstitium

A
  1. connective tissue
  2. smooth muscle
  3. lymphatics
  4. capillaries
  5. cells - fibroblasts (collagen and elastin)
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11
Q

what is the function of collagen

A

limits lung distensability

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12
Q

what is the function of elastin

A

major contributor to elastic recoil of the lung

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13
Q

What factors influence diffusion across the respiratory membrane?

A

Directly related to…

  1. partial pressure btwn alveoli and blood
  2. surface area for gas exchange (atelectasis/tumor)
  3. solubility

Indirectly related to…

  1. distance btwn the 2 sides of the membrane
  2. molecular weight of the molecules
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14
Q

What are some unique features of the visceral pleura?

A
  • microvessels are further away from the surface
  • supplied by the bronchial circulation
  • no drainage for pleural fluid
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15
Q

what are some unique features of the parietal pleura

A
  • microvessela are closer to the surface
  • supplied by the intercostal arteries
  • have somata - exit points for pleural fluid, proteins, cells
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16
Q

please list the ways in which you can have increased rate of formation of pleural fluid

A
  • increased pulmonary venous pressure (most common - CHF)
  • decrease in microvascular oncotic pressure
  • decrease in pressure in the pleural space (atelectasis)
  • increase in microvascular permeability
  • fluid from the parietal cavity (diaphragm lymph)
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17
Q

please list ways in which you can have decreased rate of clearance of pleural fluid

A
  • systemic venous hypertension

- blockage of clearance

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18
Q

compliance is the inverse of elasticity or recoil

A

true

19
Q

lung compliance reflects distensability of the lungs

A

true

20
Q

what are the 2 things compliance is determined by

A
  1. elastin and collagen

2. elastic forces of surface tension

21
Q

what are the 4 categories of restrictive lung disease

A
  1. lung parenchyma
  2. pleural space
  3. neuromuscular, chest wall, obesity
  4. infection of inflammation of the lungs
22
Q

list 2 examples of lung parenchymal disorders

A
  • fibrotic interstitial disease

- atelectasis

23
Q

list 2 examples of pleural space disorders

A
  • pneumothorax

- pleural effusion

24
Q

list 2 examples of neuromuscular, cw, obesity disorders

A

neuro: polio, MS, MG, Guillain Barre Syndrome
CW: kyphosis, ankylosing spondylitis, flail chest

25
Q

which circulation is the largest vascular bed in the entire body?

A

-pulmonary circulation

26
Q

what is the function of the bronchial circulation

A
  • 1-2% of CO going to the lungs
  • some of it goes to the LA = phys shunt
  • majority goes back into the RA for oxygenation
27
Q

what are some conditions that cause hypoxic vasoconstriction

A
  1. airway obstruction
  2. failure of ventilation
  3. acute lung damage
  4. high altitude
28
Q

What is the alveolar PO2 that would cause hypoxic vasoconstriction

A
29
Q

what the normal value of V/Q

A

0.8

30
Q

what is dead space and give an example of a disease state that has this

A
  • dead space is ventilation of lungs that are not perfused

- an example is pulmonary embolism

31
Q

what are the main symptoms of a PE

A
  1. hypoxemia 2. CP 3. hypotension (RV failure)
32
Q

what is a shunt

A

portion of the CO or blood flow tha tis diverted or rerouted - V/Q = 0

33
Q

please list 3 types of shunt

A
  1. physiologic
  2. L–>R
  3. R–>L
34
Q

describe R –> L shunts

A
  • always hypoxic

- cannot be corrected by increasing O2

35
Q

describe L–>R shunts

A
  • do not cause hypoxemia

- some causes: PDA, traumatic injury

36
Q

what is the residual volume

A
  • volume of gas left in the lungs after maximal forced expiration
  • determined by muscles of expiration and the inward elastic recoil of the lungs
  • cannot be measured by spirometry
37
Q

where does expiratory reserve volume begin

A
  • at the END of TV

- therefore ERV = FRC - RV

38
Q

define FRC

A
  • ERV + RV
  • this is because you do not typically use your expiratory reserve volume
  • represents the balance point btwn inward elastic recoil of the lungs and outward elastic recoil of the cw
39
Q

what values cannot be measured by spirometry

A

RV, FRC, TLC

40
Q

what is TLC determined by?

A

strength of contraction of the inspiratory muscles and inward recoil of the lungs

41
Q

What is a normal FEV1/FVC?

A

0.8

42
Q

what are the changes to FEV1 and FVC in obstructive disease

A

Ex: asthma

-both decrease but FEV1 decreases more, therefore ratio is

43
Q

what are the changes to FEV1 and FVC in restrictive disease

A

Ex: alveolar fibrosis

  • both decrease but FVC decreases more so that ratio either stays the same or increases
  • same or more than 0.8

Respiratory (11 decks)

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