Respiratory physiology 1 Flashcards

1
Q

Anatomic dead space begins at the mouth and ends in the:
a. small airways
b. terminal bronchioles
c. respiratory bronchioles
d. alveolar ducts

A

b. terminal bronchioles

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2
Q

The airway is functionally divided into 3 zones:

A

conducting
respiratory
transitional

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3
Q

Ventilation is the process of

A

exchanging gas (O2 & Co2) between the atmosphere and the lungs

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4
Q

A coordinated effort between the brain and the respiratory muscles is required to produce

A

cyclic pressure changes that allow air to move into and out of the lungs

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5
Q

___________ & ________________ during inspiration

A

The diaphragm and external intercostals contract

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6
Q

Exhalation is usually

A

passive

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7
Q

Accessory muscles for inspiration include

A

the sternocleidomastoid and scalene muscles

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8
Q

Accessory muscles for active expiration include

A

the rectus abdominis, transverse abdominis, internal obliques, and external obliques

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9
Q

A vital capacity of _________ is required for an effective cough

A

at least 15 mL/kg

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10
Q

What is the action of the conducting zone?

A

does not participate in gas exchange
function: bulk gas movement

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11
Q

What is the transitional zone?

A

serves a dual function of air conduit and gas exchange

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12
Q

What is the respiratory zone?

A

participates in gas exchange

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13
Q

The transpulmonary pressure is

A

the difference between alveolar pressure and pleural pressure

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14
Q

Alveolar pressure is the

A

pressure inside an airway

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15
Q

Pleural pressure is the

A

pressure outside of the airway

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16
Q

An airway stays open if transpulmonary pressure is

A

positive

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17
Q

An airway collapses when transpulmonary pressure is

A

negative

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18
Q

The _____________ increases the superior-inferior dimension of the chest

A

diaphragm

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19
Q

The ________ increase the anterior-posterior diameter

A

external intercostals

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20
Q

What is the mnemonic for active exhalation?

A

I let the air out of my TIREs
transverse abdominis, internal oblique, rectus abdominis, external oblique

21
Q

Exhalation becomes an active process when

A

minute ventilation increases or in patients with lung disease such as COPD

22
Q

What anatomical structures are included in the conducting zone

A

trachea
bronchi
bronchioles

23
Q

What anatomical structures make up the transitional zone?

A

respiratory bronchioles

24
Q

What anatomic structures make up the respiratory zone?

A

alveolar ducts
alveolar sacs

25
To prevent airway collapse, the pressure inside the airway must be
greater than the pressure outside the airway
26
During tidal breathing, transpulmonary pressure
is always positive (keeps tha airway open)
27
During tidal breathing, intrapleural pressure is always
negative (keeps the lungs inflated)
28
Aside from pathologic states, such as pneumothorax, the only time that intrapleural pressure becomes positive is during
forced expiration
29
What is the primary determinant of carbon dioxide elimination? a. minute ventilation b. tidal volume c. alveolar ventilation d. respiratory rate
C. alveolar ventilation
30
A tidal volume is
the amount of gas that is inhaled and exhaled during the breath (6-8 mL/kg)
31
What is minute ventilation?
tidal volume x respiratory rate
32
What is alveolar ventilation?
(tidal volume- dead space) x respiratory rate
33
When you take a breath, only part of the Vt is delivered to the _________ while the remainder sits in the ____________
respiratory zone; conducting zone (dead space)
34
When you exhale, ______________ gas is removed first.
conducting zone
35
Any condition that increases the volume of the conducting zone (Vd) makes it more
difficult to eliminate expiratory gases from the lungs -if alveolar ventilation is not increased, then the patient will retain CO2
36
In a healthy, 70 kg adult, the normal dead space is
~2 mL/kg or 150 mL
37
Alveolar ventilation removes _________ from the minute ventilation equation.
dead space
38
Alveolar ventilation is directly proportional to
Carbon dioxide production (a higher CO2 production stimulates the body to breathe deeper and faster so it can eliminate more CO2)
39
Alveolar ventilation is inversely proportional to
PaCO2 (faster & deeper breathing reduces PaCO2)
40
Which conditions will MOST likely increase the PaCO2 to EtCO2 gradient? (select 3). a. positive pressure ventilation b. laryngeal mask airway c. hypotension d. endotracheal tube e. neck flexion f. atropine
a. positive pressure ventilation c. hypotension f. atropine
41
Why does hypotension increase dead space?
hypotension reduces pulmonary blood flow, which increases alveolar dead space
42
Why does atropine increase dead space?
atropine is a bronchodilator, so it increases anatomic dead space by increasing the volume of the conducting zone
43
Why does positive pressure ventilation increase dead space?
increases alveolar pressure, which increases ventilation relative to perfusion.
44
Dead space is reduced by anything that
reduces the volume of the conducting zone or increases pulmonary blood flow
45
What are the four types of dead space?
anatomic alveolar physiologic apparatus
46
What is anatomic dead space?
air confined to the conducting airways
47
What is alveolar deadspace?
alveoli that are ventilated but not perfused
48
What is physiologic dead space?
anatomic Vd + alveolar Vd
49
What is apparatus dead space?
Vd added by equipment