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YR 1 Respiratory > Respiratory Physiology > Flashcards

Respiratory Physiology Flashcards

1
Q

Functions of Respiratory System X4

A
  • Gas exchange –Oxygen added to the blood from the air, carbon dioxide removed from the blood into the air.
  • Acid base balance –regulation of body pH
  • Protection from infection
  • Communication via speech
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2
Q

Cellular/Internal respiration

A

A biochemical process that releases energy from glucose either via Glycolysis or Oxidative Phosphorylation. Latter requires oxygen and depends on EXTERNAL RESPIRATION

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3
Q

External Respiration

A

movement of gases between the air and the body’s cells, via both the respiratory and cardiovascular systems.

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4
Q

systemic vs pulmonary ventilation

A

pulmonary delivers CO2(to the lungs) and collects O2(from the lungs)

while the systemic circulation delivers O2 to peripheral tissues and collects CO2.

The pulmonary artery carries deoxygenated blood away from heart

while the pulmonary vein carries oxygenated blood.

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5
Q

net volume of gas exchanged in the lungs per unit time

A

250ml/min O2; 200ml/min CO2

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6
Q

URT

A

nose

pharynx - throat

larynx- voice box

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7
Q

LRT

A

trachea

bronchi

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8
Q

alveoli cell structures

A

type 1- gas exchange

type 2- surfactant production

macrophages

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9
Q

alveoli type 1 cells are always next to

A

cappilaries

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10
Q

tidal volume

A

500-600ml

(5-6L)

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11
Q

residual lung volume

A

1200ml

prevents alveolar collapse and allows gas exchange outside inspiration

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12
Q

vital capacity

A

full volume of air that can be forced in and out
4600ml

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13
Q

functional residual capacity

A

volume of air left in lungs after relaxed expiration

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14
Q

all muscles used in breathing x6

A

DIAPHRAGM

internal intercostals

external intercostals

abdominal muscles

scalenes

sternocleidomastoids

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15
Q

internal intercostal rib movement

A

down and in

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16
Q

external intercostal rib movement

A

up and out

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17
Q

accessory muscles of expiration

A

abdominal

internal intercostals
inter inter cancels out si makes expiration

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18
Q

accessory muscles of inspiration

A

external intercostals

scalenes and
sternocleidomastoids

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19
Q

lung contraction is controlled by

A

phrenic nerve

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20
Q

Intra-thoracic (Alveolar) Pressure (PA):

A

pressure inside the thoracic cavity, (essentially pressure inside the lungs). May be negative or positive compared to atmospheric pressure.

always negative to pleural

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21
Q

Intra-pleural Pressure (Pip):

A

pressure inside the pleural cavity, typically negative compared to atmospheric pressure (in healthy lungs at least!)

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22
Q

Transpulmonary pressure (PT):

A

difference between alveolar pressure and intra-pleural pressure. Almost always positive because Pip is negative (in health).

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23
Q

PT=

A

Palv–Pip

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24
Q

Between breaths at the end of an unforced expiration Patm =

A

alveolar pressure- no air movement

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25
Q

what does surfactant do

A
  • Reduces surface tension on alveolar surface membrane thus reducing tendency for alveoli to collapse
  • Increases lung compliance (distensibilty)
  • Reduces lung’s tendency to recoil
  • Makes work of breathing easier
  • Is more effective in small alveoli than large alveoli because surfactant molecules come closer together and are therefore more concentrated
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26
Q

law of laplace

A

when surfactant is low, the smaller alveoli collapse and push air into the bigger ones which makes them bigger

decreasing SA ratio making them less effective and harder to keep open- requires more pressure

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27
Q

compliance definition

A

change in volume relative to change in pressure i.e. how much does volume change for any given change in pressureI t represents

the stretchability of the lungs - how easy it is to get the air in

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28
Q

HIGH COMPLIANCE

A

large increase in lung volume for small decrease in ip pressure- less efort

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29
Q

LOW COMPLIANCE =

A

small increase in lung volume for large decrease in ip pressure

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30
Q

Anatomical dead space volume is

A

150 mL

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31
Q

Pulmonary (Minute) ventilation=

A

total air movement into/out of lungs (relatively insignificant in functional terms)

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32
Q

Alveolar ventilation=

A

fresh air getting to alveoli and therefore available for gas exchange (functionally much more significant!)

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33
Q

pulmonary and alveolar ventilation is measured in

A

L/min

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34
Q

pumonary ventilation =

A

resp rate X air coming in- tidal volume

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35
Q

alveolar volume =

A

tidal volume minus dead space

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36
Q

why is dead space important

A

it wont change

but amount of air getting in and out can - tidal volume and resp rate

so it can take up a different proportion of that, leading to hypo / hyper ventilation

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37
Q

hypo ventilation

A

shallow fast breathing

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38
Q

hyperventilation

A

deep slow breathing

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39
Q

PP of O2 in lungs

A

100mmHg

13kPa

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40
Q

PP CO2 in lungs

A

40mmHg

5.3kPa

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41
Q

Alveolar ventilation declines

A

with height from base to apex of an upright lung due to changes in compliance

42
Q

PP of arterial blood =

A

PP of alveolar

100mmHg O2 40mmHg CO2

43
Q

PP of venous blood =

A

PP of peripheral tissues

40mmHg/ 5.3 kPa O2
46mmHg/ 6.3kPa CO2

44
Q

diffusion in lungs

A

CO2 diffuses more rapidly because of its greater solubility.

Nevertheless the overall rates of equilibrium between O2& CO2 are similar because of the greater pressure gradient for O2

45
Q

diseases causing diffusion problems

A

emphysema
pulmonary edema

46
Q

diseases causing ventilation problems

A

fibrotic lung disease
asthma

47
Q

emphysema

A

normal alveolar O2

low artery O2

reduced alveolar SA due to damage
less elastic recoil- harder to breath out
Increased compliance

48
Q

pulmonary edema

A

normal alveolar O2

low artery O2

increased ISF distance
CO2 normal- dissolves more easily

49
Q

fibrotic lung disease

A

normal alveolar O2
low arterial O2

thick alveoli walls slows gas exchange
decreased compliance
too much connective tissue

50
Q

asthma

A

low alveoli O2
low arterial O2

increased CO2

constricted bronchioles

51
Q

obstructive vs restrictive lung disease

A

obstructive: obstruction of air flow
effects exhalation

Restrictive: Restriction of lung expansion
effects inhalation

52
Q

obstructive lung diseases

A

asthma

COPD

53
Q

restrictive lung diseases

A

Fibrosis

Infant Respiratory Distress Syndrome

Oedema

Pneumothorax

54
Q

loss of compliance causes

A

difficulty inhaling

can’t expand to let in

55
Q

increase of compliance causes

A

difficulty exhaling

can’t squeeze out

56
Q

types of spirometry

A

Static–where the only consideration made is the volume exhaled

Dynamic–where the time taken to exhale a certain volume is what is being measured

57
Q

volumes not measured by spirometery

A

anything that uses residual volume

inc. total lung capacity and expiratory reserve volume

58
Q

FEV1

A

Forced expiratory volume in 1 second

59
Q

FVC

A

Forced vital capacity

60
Q

FVC volume

A

5l

61
Q

FEV1/FVC normal ratio

A

80%

62
Q

obstructive lung disease and FEV1/FVC

A

decreases ratio

63
Q

restrictive lung disease and FEV1/FVC

A

stays same - both FEV and FVC decrease
less can get in less can get out

64
Q

perfusion means

A

blood distribution

65
Q

distribution of ventilation and blood flow in lungs

A

Both blood flow and ventilation decrease with height across the lung- apex lower

66
Q

apex blood flow/ventilation ratio

A

both lower than base

but more ventilation than blood flow

67
Q

base blood flow/ventilation ratio

A

both more than apex

more blood flow than ventilation

68
Q

what happens when blood flow > ventilation

A

shunt

happens at base

69
Q

shunt

A

deoxygentaed blood that didn’t get oxygenated by faulty alveoli gets shunted into oxygenated blood diluting it

increases CO2 in alveoli and decreases O2 in both

70
Q

how shunt is fixed

A

vasoconstricting blood vessels- diverts passed faulty alveoli

71
Q

when ventilation > blood flow

A

alveolar dead space

happens at apex

gets O2 fine but can’t perfuse it well

72
Q

how alveolar dead space is fixed

A

vasodilation

73
Q

what does RSA do

A

keep perfusion-ventilation match during breathing by changing heart beat

through vagus nerve

74
Q

how O2 and CO2 is distributed

A

3ml O2 dissolved per litre plasma

197ml per L in haemoglobin in red blood cells

Bulk (77%) of CO2is transported in solution in plasma, 23% is stored within haemoglobin

75
Q

what is The major determinant of the degree to which haemoglobin binds (is saturated with) oxygen

A

partial pressure of oxygen in the blood.

76
Q

PP of O2 only refers to

A

O2 dissolves in plasma

77
Q

What would happen to PO2in anaemia?

A

nothing- Po2 is only the stuff dissolved in plasma- not heamoglobin

78
Q

what causes decreased haemoglobin affinity for O2

A

decrease in pH
an increase in PCO2
increase in temperature

binding 2,3-diphosphoglycerate (2,3-DPG)
found in areas of low O2 like heart disease to max O2

79
Q

what causes increased haemoglobin affinity for O2

A

a rise in pH or a fall in PCO2, or temperature

will take up lots of O2 but wont give away to tissues

80
Q

oxygen disassociation in different types of Hb

A

HbF and myoglobin have a higher affinity for O2

81
Q

where is myoglobin found

A

cardiac and skeletal muscle

82
Q

5 types of hypoxia

A
  1. Hypoxaemic Hypoxia: most common. Reduction in O2diffusion at lungs either due to decreased PO2atmos or tissue pathology.
  2. Anaemic Hypoxia: Reduction in O2 carrying capacity of blood due to anaemia (red blood cell loss/iron deficiency).
  3. Stagnant Hypoxia: Heart disease results in inefficient pumping of blood to lungs/around the body
  4. Histotoxic Hypoxia: poisoning prevents cells utilising oxygen delivered to them e.g. carbon monoxide/cyanide
  5. Metabolic Hypoxia: oxygen delivery to the tissues does not meet increased oxygen demand by cells
83
Q

respiratory centre has its rhythm controlled by

A
  1. Emotion (via limbic system in the brain)
  2. Voluntary over-ride (via higher centres in the brain)
  3. Mechano-sensory input from the thorax (e.g. stretch reflex).
  4. Chemical composition of the blood (PCO2, PO2and pH) –detected by chemoreceptors
84
Q

where are central chemoreceptors found

A

medulla

85
Q

where are peripheral chemoreceptors found

A

carotid and aortic bodies

86
Q

cental chemoreceptors function

A
  • Detect changes in [H+] in CSF around brain
  • Cause reflex stimulation of ventilation following rise in [H+]
87
Q

peripheral chemoreceptor function

A

Detect changes in arterial PO2and [H+]

•Cause reflex stimulation of ventilation following significant fall in arterial PO2

(not O2 content- doesnt take Hb into account)

88
Q

hypoxic drive

A

Individuals become desensitised to PCO2and instead rely on changes in PaO2to stimulate ventilation

89
Q

if plasma pH falls ([H+] increases) ventilation will be

A

stimulated (acidosis)

90
Q

if plasma pH increases ([H+] falls) e.g.vomiting (alkalosis), ventilation

A

will be inhibited

91
Q

Hypoventilation leads to

A

causing CO2 retention, leads to increased [H+] bringing about respiratory acidosis.

92
Q

Hyperventilation leads to

A

blowing off more CO2, lead to decreased [H+] bringing about respiratory alkalosis

93
Q

how to calculate alveolar volume

A

(tidal volume - dead space) X resp rate

94
Q

PAO2 is

A

alveolar

95
Q

PaO2 is

A

arterial

96
Q

how to calculate pack years

A

(number of cigarettes a day/ 20)

X

years of smoking

97
Q

Hb affinity for O2 is decreased by

A

decrease in pH

increase in PCO2

Increase in temp

binding of 2,3- DPG

means Hb gives oxygen to tissues more regularly- like during exercise

98
Q

what makes Hb curve move right

A

decrease in pH

increase in PCO2

Increase in temp

e.g in asthma attack

99
Q

what increases Hb affinity for O2

A

rise in Ph

fall in PCO2

fall in temp

oxygen unloading is more difficult but keep oxygen up in pulmonary circulation

100
Q

what makes Hb curve move left

A

rise in Ph

fall in PCO2

fall in temp

caused by alkalosis

101
Q

foetal haemoglobin is shifted to the ____ on the Hb curve

A

left

102
Q

when is 2,3-DPG found

A

when O2 supply isn’t enough:

heart/lung disease

living at high altitude

YR 1 Respiratory (15 decks)

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