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respiratory physiology Flashcards

1
Q

pulmonary ventilation

A

breathing

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2
Q

inspiration

A

air flowing into the lungs

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3
Q

expiration

A

air flowing out of the lungs

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4
Q

atmospheric pressure (Patm)

A

the pressure exerted by the gases/air surrounding the body

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5
Q

Negative respiratory pressure

A

pressure that is lower than atmospheric pressure

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6
Q

positive respiratory pressure

A

pressure that is higher than atmospheric pressure

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7
Q

zero respiratory pressure

A

pressure that is equal to atmospheric pressure

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8
Q

intrapulmonary pressure (Ppul)

A

the pressure within the alveoli
- rises/falls with the phases of breathing – always equalizes with atmospheric pressure

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9
Q

intrapleural pressure (Pip)

A

the pressure in the pleural cavity
- rises/falls with the phases of breathing - always about 4mmHg less than Ppul
- Pip is always negative relative to Ppul

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10
Q

forces causing the lungs to collapse

A
  • lungs natural elasticity/tendency to recoil
  • surface tension of the fluid lining the alveoli
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11
Q

force causing the lungs to expand

A

natural elasticity of the chest wall

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12
Q

negative intrapleural pressure

A
  • secondary to the presence of pleural fluid, there is a strong adhesive force between the parietal and visceral pleurae
  • the amount of pleural fluid is closely regulated and drained by the lymphatics
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13
Q

net result

A

a negative Pip

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14
Q

transpulmonary pressure

A

the difference between Ppul and Pip
- the pressure that keeps the air spaces of the lungs open and prevents lung collapse

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15
Q

what does a greater transpulmonary pressure mean

A

lungs are larger in size

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16
Q

what will cause lungs to collapse

A

any condition that equalizes Pip with Ppul or atmospheric pressure

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17
Q

atelectasis

A

“lung collapse”
- occurs when a bronchiole becomes plugged
- the associated alveoli will collapse
- often an extension of pneumonia

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18
Q

pneumothorax

A

“air thorax”
- presence of air in the pleural cavity
- reversed by drawing the air out via a chest tube
- lung will reinflate

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19
Q

pulmonary ventilation (extra explanation)

A
  • the mechanical process of breathing – inspiration and expiration
  • it is entirely dependent on volume changes in the thoracic cavity
  • volume changes –> pressure changes –> flow of gases to equalize pressure
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20
Q

Boyle’s Law

A
  • gives the relationship between pressure and volume of a gas
  • at a constant temperature, pressure varies with volume
  • P1V1 = P2V2
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21
Q

inspiration (longer explanation)

A
  • diaphragm + external intercostal muscles contract
  • height + diameter of the thorax increase
  • volume of the thoracic cavity increases - 500 mL
  • lungs are stretched, intrapulmonary volume increases
  • Ppul decreases
  • air rushes into the lungs
  • Ppul equalizes to Patm
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22
Q

expiration (longer explanation)

A
  • quiet expiration is a passive process
  • dependent on lung elasticity
  • inspiratory muscles relax, rib cage descends, lungs recoil
  • thoracic + intrapulmonary volumes decrease
  • Ppul rises
  • when Ppul > Patm air flows out
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23
Q

forced expiration

A
  • an active process
  • intra abdominal pressure rises, and the abdominal organs press against the diaphragm
  • internal intercostal muscles depress the rib cage and decrease thoracic volume
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24
Q

2 muscles used for forces expiration

A

transverse abdomonis and obliques

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25
Q

deep/forced inspiration

A
  • utilizes accessory muscles – the scalenes, SCM, and pectoralis minor further increase thoracic volume
  • spinal extension flattens the thoracic curve
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26
Q

precise expiration

A
  • requires the fine control and coordination of the accessory muscles
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27
Q

non-respiratory air movements

A
  • coughing, sneezing, crying, laughing, hicupping, and yawning – all after the normal respiratory rhythm
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28
Q

what are three factors influencing the ease of air passage and the amount of energy required for ventilation

A
  • airway resistance
  • alveolar surface tension
  • lung compliance
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29
Q

airway resistance (R)

A

friction or drag encountered in the respiratory passageways

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30
Q

which branch of the autonomic nervous system is responsible for bronchiconstriction

A

sympathetic nervous system

  • epinephrine is the antidote
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31
Q

Is epinephrine a bronchodilator or a bronchoconstrictor

A

bronchodilator

32
Q

surface tension

A

attracts liquid molecules to each other, resists any force that attempts to increase the liquid’s surface area

33
Q

Water vs. surface tensions

A
  • water is composed of highly polar molecules, so it has a high surface tension
  • water is always working to keep alveoli at their smallest possible size
34
Q

surfactant

A

detergent-like complex of lipids and proteins produced by type II alveolar cells

  • surfactant reduces surface tensiona nd discourages alveolar collapse – less energy is required to expand the lungs
35
Q

infant respiratory distress syndrome

A
  • when surfactant levels aren’t adequate
  • alveoli will collapse, and it takes significant energy to reinflate them
  • treatwe with artificial surfactant, devices that maintain positive airway pressure, ventilators
36
Q

bronchopulmonary dysplasia

A
  • potential complication of IRDS
  • often caused by prolonged ventilation and O2 therapy
37
Q

lung compliance

A

measure of the change in lung volume that occurs with a given in transpulmonary pressure

higher compliance = lungs that are easier to expand

  • reduced by fibrosis, reduced amounts of surfactant, and decreased flexibility of thoracic cage
38
Q

2 determining factors

A
  1. distensibility of lung tissue
  2. alveolar surface tension
39
Q

total respiratory compliance

A

total compliance of the respiratory system is influenced by lung compliance and compliance of the thoracic wall

40
Q

compliance of the thoracic wall is reduced by

A
  • thoracic deformity
  • ossification of the costal cartilage
  • paralysis of the intercostal muscles
41
Q

tidal volume (TV)

A

air inspired/expired with normal, quiet breathing

42
Q

inspiratory reserve volume (IRV)

A

air inspired beyond TV

43
Q

expiratory reserve volume (ERV)

A

air expired beyond TV

44
Q

residual volume (RV)

A

air that remains in the lungs after ERV

45
Q

minimal volume (MV)

A

small amount of air that remains in the lungs – even if chest is opened

46
Q

inspiratory capacity (IC)

A

TV + IRV

47
Q

functional residual capacity (FRC)

A

RV + ERV

48
Q

vital capacity (VC)

A

IRV + TV + ERV

total amount of exchangeable air in the lungs

49
Q

total lung capacity (TLC)

A

sum of all lung volumes

50
Q

vital capacity (VC)

A

the total amount of exchangeable air in the lungs

51
Q

residual volume (RV)

A

-total amount of non-exchangeable air
- air that remains in the lungs after ERV

52
Q

anatomical dead space

A

air that remains in the passageways and does not contribute to gas exchange - 150mL

53
Q

alveolar (physiologic) dead speace

A

air is non-functional alveoli

54
Q

total dead space

A

the sum of non-useful volumes – anatomical + alveolar dead space

55
Q
A
56
Q

obstructive pulmonary diseases

A

diseases of increased airway resistance
- TLC, FRC, RV may increase

57
Q

restrictive disorders

A

diseases of reduced lung capacity due to fibrosis/disease
- VC, TLC, FRC, RV may decline

58
Q

forced vital capacity (FVC)

A

the amount of gas expelled when a subject takes a deep breath and then forcefully exhales as maximally and rapidly as possible

59
Q

forced expiratory volume (FEV)

A

determines the amount of air expelled during specific time intervals of the FVC test

60
Q

FEV 1

A

the amount of air exhaled during the 1st second - typically about 80%

61
Q

minute venitlation

A

the amount of air flowing in/out of the respiratory tract in 1 minute
- provides a rough estimate of respiratory efficiency

62
Q

normal (resting)

A

500 mL x 12 breaths per minutes = 6L/min

63
Q

normal (exercising)

A

up to 200L/min

64
Q

alveolar ventilation

A

amount of air flowing in/out of the alveoli per unit of time
- a more effective measurement
- dead space is typically constant
- rapid, shallow breathing decrease AVR

65
Q

AVR (mL/min)

A

frequency (breaths/min) x TV - dead space (mL/breath)

66
Q

external repsiration

A

exchange of gases in the lungs
- O2 diffuses into the blood
- CO2 diffuses out of the blood

67
Q

internal respiration

A

exchange of gases in the body’s tissues
- O2 diffuses out of the blood
- CO2 diffuses into the blood

68
Q

what happens at high altitude

A

atmospheric pressure declines, so partial pressures also decline

69
Q

what happens at low altitude

A

atmospheric pressure increases, so partial pressures also increase

70
Q

the exchange of O2 and CO2 is influenced by

A
  • thickness and surface area of the respiratory membrane
  • partial pressure gradients and gas solubilities
  • ventilation perfusion coupling
71
Q

the respiratory membrane

A
  • has a large surface area for exchange
  • membranes thicken with edema and gas exchange becomes inadequate
  • surface area is reduced with emphysema, tumors, inflammation, and mucus
72
Q

what is diffusion driven by

A

the partial pressure gradients of O2 and CO2

73
Q

perfusion

A

amount of blood reaching the alveoli

74
Q

ventilation

A

amount of gas reaching the alveoli

75
Q

Henry’s Law

A
  • how gases move in and out of solutions
  • gas will dissolve into liquid in proportion to its partial pressure
    greater concentration = more and faster the gas goes into the solution
  • direction and movement of gas is determined by its partial pressure in the 2 phases
76
Q

2 additional factors for henry’s law

A
  1. soubility - CO2 is 20x more soluble in H2O than O2
  2. temperature - as a liquid’s temperature rises, solubility decreases
77
Q

Dalton’s Law

A
  • explains how gas behaves when it is part of a mixture of gases
  • total pressure exerted by a mixture of gases equals the sums of the pressures exerted by each gas individually
  • partial pressure of each gas is proportional to its percentage in the mixture

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