Respiratory PHYSIology Flashcards
what structures are in the conducting zone?
larynx
trachea
primary bronchi
secondary bronchi
tertiary bronchi
small bronchi
bronchioles
terminal bronchioles
what structures are in the respiratory zone?
respiratory bronchioles
alveoli
T/F: the structures within the bronchial tree function independently of each other
T
which bronchi is straighter/more vertical & shorter and implicated more in diseases & choking
Right bronchi
at what division is bronchitis or other infections more likely to happen?
17-19 respiratory bronchiole
which zones are conducting zones? why are they called this?
zones 1-16
there is no gas exchange = dead space
the process of gas exchange occurs through ____
diffusion
is diffusion more sensitive to O2 or CO2
CO2!!!
what causes more of a trigger to breath?
high CO2 rather than low O2
CO2 diffusion occurs ____ times faster than O2
4 times
COPD patients are _____capnic
HYPER
Muscles produce pressure gradient in thoracic cage that is _____ than atmospheric
lower
the pressure in the interpleural space is ____ than the atmospheric pressure to keep the lung inflated
lower
which side of the diaphragm sits higher?
Right (d/t liver)
when a person inhales, the pressure in the lungs ____
increases
how does weakness in the ribs and/or diaphragm make it harder to breath?
can’t create negative pressure in pulmonic space –> work harder to breathe
what is minute ventilation?
Volume of air that is breathed in and out in 1 min
Tidal volume x RR
which is better to ventilate the alveoli:
a) higher tidal volume with lower RR
b) lower tidal volume with higher RR
a
where does blood go through vessels slower?
at the capillaries
how does the Valsalva maneuver decrease perfusion?
Causes decreased venous return and more blood pumped out
what is surfactant?
fluid to keep lungs open (prevent collapse)
decreased –> SIDS, burns, acute respiratory distress
intrapleural pressure should be
negative
if intra-alveolar pressure is decreased, the volume of air ____ (increases/decreases) and air goes _____ (closer/farther)
increases
farther
what creates the pressure gradient in the lungs?
muscle groups
when a person exhales, pressure ______ (increases/decreases)
increases
what can cause the diaphragm to migrate upwards?
supine position
obesity
decreased tone
after pulmonary surgery, is reduced which cause exhalation to be harder
Function Residual Capacity (FRC)
what is Function Residual Capacity (FRC)?
Ability to exhale beyond normal and still have air in the lungs
ER + RV = FRC
Exhalation is ____; inhalation is ____ (passive/active)
passive
active
increased compliance or a lung that is too stretch out leads to what type of disease?
obstructive (too much O2 left in lungs)
decreased compliance leads to what type of disease?
restrictive
there is a higher ____ pressure gradient in restrictive lung diseases
positive
what is expiratory reserve?
Amount of air can force out after normal exhale
what is residual volume?
Air left in lungs after maximal exhale
obstructive diseases have a/an _____ residual volume (increased/decreased)
increased
restrictive diseases have a/an _____ residual volume (increased/decreased)
decreased
which type of lung disease has a decreased tidal volume?
restrictive
what is vital capacity?
inspiratory capacity + expiratory reserve volume + tidal volume
how much can maximally inhale and exhale
total lung capacity _____ (increases/decreases) with COPD
increases
total lung capacity _____ (increases/decreases) with restrictive diseases
decreases
T/F: residual volume, functional residual capacity, and total lung capacity can be determined with basic spirometry
F (calculated mathematically)
what is a normal FEV 1?
80%
an FEV 1 of <80% indicates a ____ disease
obstructive
FEV 1 is estimated based on
Age, gender, race, height
what is a normal FEV1/FVC = forced vital capacity?
70%
(<70% = COPD)
should inhalation or exhalation be focused on with restrictive disorder patients?
inhalation
should inhalation or exhalation be focused on with obstructive disorder patients?
exhalation
why does exhalation take longer is obstructive diseases?
decreased elasticity
what is a normal ventilation-perfusion ratio?
0.8 (ideal = 1)
what occurs if there is more perfusion than ventilation?
shunting
(occurs in pneumonia, COPD, asthma)
what occurs if there is less perfusion than ventilation?
dead space
where is there more perfusion in an upright position?
bases
relatively, there is more perfusion in the ____ part of the lungs and more ventilation at the ______ parts
more perfusion - bases
more ventilation - upper & middle
what position is gravity reduced for the diaphragm?
prone
how does the ventilation/perfusion ratio change during exercise?
the upper lobes become more perfused and VPR is closer to 1
which type of diseases have diffusion issues?
restrictive (space between alveoli and capillaries are increased)
diffusion is maintained by
- slow blood at capillaries
- thin membrane b/w capillaries
and alveoli - capillaries are close to RBC size
what occurs in bronchopulmonary dysplasia?
Bronchial tree more fibrotic
Increased distance b/w alveoli and capillaries
there is mass vaso____ through pulmonary system with pulmonary HTN
vasoconstriction
how is pulmonary HTN monitored?
with a Swan Ganz catheter (R heart cath)
what pulmonary pressure is too high during exercise?
> 40 mm Hg
what pulmonary pressure is indicative of pulmonary HTN?
> 20 mm Hg at rest
what is the #1 reason for ventilation perfusion mismatch?
hypoxemia
what is the only situation in which supplemental O2 will not help?
large intrapulmonary shunt (large pulmonary embolism)
Most CO2 is transported as
bicarbonate
ways in which CO2 in transported in the blood
bicarbonate (mostly)
bound to Hb (5%)
in plasma (5%)
how does breathing change with metabolic acidosis?
Kussmaul’s respirations:
rapid and deep breaths
how is O2 mainly transported?
bound to Hb
what are the controls of respiration?
- chemoreceptors in medulla
- motor cortex, cerebellum, reticular formation
- carotid bodies
- skeletal muscles mechanoreceptors
- more air in the lungs causing stretch (increase RR)
- temperature (higher = inc RR)
how does a rebreather mask help with respiration?
the inspired CO2 stimulates inhales - increases RR
what is a normal blood pH?
7.4
when CO2 levels are high (hypercapnia), there is ____ventilation and an ____ environment
hyperventilation
acidic
what mm Hg of PaO2 is considered hypoxemia?
<80 mm
(note: COPD pts may be asymptomatic at <50)
how will the body compensate with high bicarbonate levels?
produce ketones
a right shift of the oxygen saturation curve indicates ___ SpO2 and more blood in the ____
low
plasma
during hypoventilation, CO2 is ____ and the environment is ____
increased
acidic
during hyperventilation, CO2 is ____ and the environment is ____
decreased
basic
what type of ventilation is seen during ketoacidosis?
hyperventilation
how long does it take the metabolic system to to control acid/base balance?
days
how long does it take the respiratory system to to control acid/base balance?
quick - minutes
what controls the acid/base balance in the metabolic system?
kidneys retain or release bicarbonate
components of vital capacity
tidal volume + inspiratory reserve volume + expiratory reserve volume
functional residual capacity components
expiratory reserve volume + residual volume
