Respiratory Physiology Flashcards

week 3

1
Q

Steps of the oxygen cascade

A

Oxygen Cascade

Aspiration of air from lungs

O2 diffusion from air –> RBC

RBC circulation

O2 diffusion from RBCs –> mitochondria

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2
Q

Steps for CO2 movement

A

Diffusion of CO2 from mitochondria –> Blood

Circulation of blood

Diffusion of CO2 from blood into lung

Expiration of air from lungs

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3
Q

What is Pulmonary ventilation

A

Physical movement of air into and out of resp tract

Maintains alveolar ventilation

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4
Q

How is airway patency maintained?

A

Trachea – C-shaped cartlidge rings

Bronchi – Cartlidge plates

Bronchioles – positive transmural gradient and radial traction from surrounding tissue

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5
Q

What are the pressures involved in ventilation?

A

Transmural

Pleural/ interpleural/ intrathoracic

Pulmonary/ intrapulmonary / alveolar

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6
Q

Transmural pressure

A

Across airway wall or lung wall

Pi –P0

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7
Q

Pleural/ interpleural/ intrathoracic pressure:

A

Slight negative pressure ( to keep lungs patent and moving in chest wall)

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8
Q

Pulmonary/ intrapulmonary / alveolar

A

Total gas produced on alveoli

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9
Q

describe the pressure during inspiration.

A

Negative alveolar pressure (Pi < P0)

More negative pleural pressure

Airflows in to equalise pressure differnce

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10
Q

Describe the volume of thoracic during inspiration

A

diaphragm and ext intercostal muscles contract = ribs move superiolaterally and superiorly

= increased lung volume

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11
Q

Describe the volume of thoracic during expiration

A

Elastic recoil as muscles relax

= decreased lung volume

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12
Q

Describe the pressure of thoracic during expiration

A

Positive alveolar pressure (Pi > P0)

Less negative pleural pressure

Airflows out to equalise pressure difference

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13
Q

Eupnea features

A

Quiet breathing

Passive expiration (elastic recoil)

Inhalation involving D and Ext IC

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14
Q

Diaphragmatic breathing vs Costal breathing

A

D= diaphragm contraction creates Neg Alveolar pressure (DEEP)

Ext IC: ext IC create Neg Alvelor pressure (shallow)

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15
Q

Hyperpnoea vs hyperventilation

A

HP = increased breathing that MATCHES metabolic rate

HV = increased ventilation above that predicated by metabolic rate

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16
Q

Pathophysiology of OSA

A

Pharyngeal pressure > Patm –> pharnygeal narrowing (normally opposed by pharyngeal dilator muscle PDM)

Whilst sleep: PDM less active and tongue and spft palate fall bac causing partial occlude to airway

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17
Q

How does CPAP help OSA?

A

pushes air into the upper airways to maintain patency via positive pressure

also opposes the tongue and soft palate falling back

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18
Q

what is minute ventilation and what is its formula?

A

Amount of air moved each minute

VE= Vt x f

(VT = tidal volume)

19
Q

What is VD?

A

Dead Space

Amount of air NOT involved in gas exchange

20
Q

what is VA and what is its formula?

A

Alveolar ventilation

Amount of air reaching the alveoli each minute

Va = (VT-VD) x f

21
Q

what is tidal volume and its normal value?

A

Amount of air taken INTO the lungs at rest.

Normal value: 500ml

22
Q

What is inspiratory volume?

A

Amount of ADDITIONAL air that you inhale AFTER you have inhaled normally

23
Q

what is expiratory volume?\?

A

Expiratory Volume

Amount of ADDITIONAL air that you FORCE OUT after have expired normally

24
Q

What is Residual Volume?

A

Amount of air LEFT in the lungs after maximum expiration

25
What is the inspiratory capacity and what is its formula?
Amount of air can TAKE INTO lungs after normal inspiration is completed VT + IRV
26
what is the Functional residual capacity (FRC) and what is its formula?
The amount of air REMAINING IN lungs after expiration normally ERV + RV
27
what is the Vital Capcity and what is its formula?
MAX AMOUNT of air can move IN/OUT of lungs ERV + VT+ IRV
28
What is the TLC and what is its formula?
Total volume of lungs VC + RV
29
PVR
resistance to blood flow through the pulmonary circulation
30
how does PVR change at low lung volumes?
Decreased radial traction --> decreased pulmonary capillary diameter --> increased PVR (when there is decreased lung volume, lung tissue is less stretched and pulmonary vessels are compressed
31
how does PVR change at high lung volumes?
increased pulmonary pressure --> decreased pulmonary capilarry diameter --> increased PVR (increased lung volume from alveoli being filled with aire, compresses vessels)
32
What is lung compliance CL?
1. the ease of expansion of the lung
33
What is lung compliance affected by?
Pulmonary CT (loss of elastic fibres, increases compliance) Surfactant (reduces tension, decreases compliance) Thoracic cage mobility
34
Describe elastic resistance.
energy used to stretch lung When VT becomes costly --> adopt high f, low Vt breathing patten
35
describe airway resistance
Energy used to overcome friction in airways Associated with increased f (more air moving therefore, resistance is higher) When f becomes costly --> adopt high f, low Vt breating patterns
36
what is the Hugh VT and Low f pattern and when is it used?
Maximises alveolar ventilation (increased VA) but is energetically expensive In obstructive conditions when f becomes costly
37
Describe the Low VT and High f pattern
Energetically cheap but decreased VA m due to increased dead space ventilation (VD) In restrictive conditions Increased RR --> Decreased time for inhalation --> decreased air entry --> increased VD
38
What is the role of the conducting zone?
Clean - prevent lare particles via nasal hairs and mucous warm and humidify - nasal turbinates increase SA - nasal hair and mucous trap H2O - Capillaries - heat and H2O exchange
39
What are the 3 mechanisms that support airway patency?
Cartlidge - rings in the trachea and major bronchi - large airways only positive transmural P gradients - Pinside > P outside Radial Traction - tethered to surrounding elastic collagen - increased lung volume = increased airway radius
40
Name the 5 main pressure of the lungs and their mmHg value.
Intrapulmonary P = 760 or 0 intrapleural P= 746 or -4 Atmospheric P = 760 or 0
41
Explain how Intrapleural is a negative pressure and what this means
due to: lung elasticity (visceral away from pleural) Surface tension (tension from air and water molecules Vi away from Pa) Chest wall elasticity (expand chest wall, Pa away from V) effect: increase thoracic vacity volume = decreased pressure ive =deflate
42
describe the transthoracic pressire
from Intrapleural space --> outside TTP= (Pip - Patm) = (-4-0) = -4 as is negative = defalate
43
describe the Transpulmonary pressure
from Intrapulmonary space to intrepleural space TP = (Ppul-Pip) = +4 as is positive = inflate
44
explain the mechanism of radial traction
As the lung inflates, the expanding alveoli pull on the fibrous connections attached to neighboring airways, blood vessels, and other alveoli. = outward force that helps keep the airways open.