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PHYSICAL THERAPY > Respiratory Physiology > Flashcards

Respiratory Physiology Flashcards

1
Q

Pulmonary Function

A

Bring air + blood together with equal flow rates for gas exchange

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2
Q

UAW

A 
(Upper Airway)
Nose
Mouth
Pharynx
Larynx
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3
Q

Nose

A

Nares - ultradian
Septum - creates 2 cavities
Turbinates/Conchae - ciliated and increase SA

Function:

  1. FIltration
  2. Heating
  3. Humidification
  4. Phonation
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4
Q

Sinuses

A

Air-filled cavities within skull

  • lighten head
  • voice resonance
  • lined with cilia and goblet cells
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5
Q

Oral Cavity

A

Assess “W” for tissue inflammation

  • Uvula
  • Palatine tonsils on either side
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6
Q

Pharynx

A

Nasal cavity down to epiglottis / larynx and trachea

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7
Q

OSA

A

(Obstructive Sleep Apnea)

Tongue or body deformations obstruct UAW

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8
Q

Epiglottis

A

Disc that covers larynx to prevent aspiration

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9
Q

Larynx

A

Narrowest and most inferior part of UAW

  • Series of cartilage U’s
  • Cricoid Cartilage - full ring used during intubation
  • vocal cords here

*AIRFLOW

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10
Q

Larynx: Ventilation

A

In: vocal cords ABD
Out: vocal cords ADD slightly

*Valsalva’s Maneuver

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11
Q

Valsalva’s Maneuver

A

ADDuction of vocal cords to seal off larynx and prevent air escape

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12
Q

Lungs

A 
Right:
  -2 fissures / 3 lobes
  -shorter for liver
  -wider, more vertical bronchus
Left:
  -1 fissure / 2 lobes

Sit in pleural cavity on either side of mediastinum
-Visceral / pleural space / parietal pleura

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13
Q

Pneumothorax

A

Air in pleural space

  • causes separation of pleura
    • ->pressure builds and collapses lungs
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14
Q

Blep

A

Large, weakened alveoli

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15
Q

LAW

A 
(Lower Airway)
Conducting Zone:
   -Trachea
   -Mainstem bronchi (1*)
   -Carina
   -Lobar bronchi (2*)
   -Segmental bronchi (3*)
   -Bronchioles (no cartilage)
   -Terminal bronchioles (no cartilage)
Respiratory Zone:
   -Respiratory bronchioles
   -alveoli
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16
Q

Conducting Zone

A

Portion of LAW where air simply passes through, no gas exchange:
-Trachea to terminal bronchioles

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17
Q

Respiratory Zone

A

Portion of LAW where gas exchange occurs:

  • Respiratory bronchioles
  • Alveoli
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18
Q

Mucous Blanket

A

Two ciliated layers in lungs that help move fluid and secretions moving up and out of lungs

  1. Sol (aqueous)
  2. Gel
  • Disease breaks up blanket
    • ->fluid and bacteria remain
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19
Q

Respiratory Bronchioles

A

Functional pulmonary units in respiratory zone of LAW

-lead into alveoli where gas exchange occurs

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20
Q

Acinus

A

Basic pulmonary unit

21
Q

Pneumocytes

A

Cells in walls of alveoli
Type I - create lining
Type II - produce surfactant

22
Q

Surfactant

A

Substance formed by Type II Pneumocyte:

  • reduces surface tension
    • ->keeps lungs open and prevents collapse
23
Q

Alveoli

A

Air sacs at end of respiratory bronchioles
-collateral ventilation (air moves alveoli-alveoli) through
pores of Kohn

24
Q

Pulmonary Circulation

A

2 flows to lung:
1. Pulmonary arteries deliver venous blood to
nourish
2. Pulmonary veins remove oxygenated blood to
take to heart

25
Q

Respiratory Membrane

A

Three layered membrane between capillaries and alveoli:

  • alveolar wall
  • interstitial CT
  • capillary endothelium
  • GAS EXCHANGE!!
    • if enlarged with disease, diffusion more difficult
26
Q

Respiratory Natural Defenses

A
  1. Turbinates
  2. Tonsils (adenoids)
  3. Epiglottis
27
Q

AW Reflexes

A
  1. Cough (debris out)
  2. Gag (prevents aspiration)
  3. Sneeze
  4. Swallow

*Lost during anesthesia

28
Q

O2 Transport

A
  1. Bound to Hgb
    O2 affinity INC in pulmonary cap
    O2 affinity DEC in systemic cap
  2. Dissolved in plasma (<2%)

Amt pumped out of heart per minute:
[O2 Transport = CO x CaO2 x 10]
(Norm ~1000mL/min)

29
Q

O2 Affinity

A

Hgb’s attraction to O2
–>enables saturation for transport and release at
arrival

30
Q

Oxyhemoglobin DIssociation Curve

A

Relationship b/w PaO2 in alveoli and O2 saturation on Hgb

PaO2 > 60 –> High affinity, pick up
PaO2 < 60 –> Low affinity, drop off

Norm P02 in alveoli: 40-100mmHg
Norm Hgb Sat: 70-97%

31
Q

Factors that Affect O2 Affinity for Hgb

A
  1. Body temp (INVERSE)
  2. 2,3 dpg (INVERSE)
  3. pH (DIRECT)
32
Q

O2 Consumption

A

Total O2 consumed by body per minute

Norm ~ 200-290mL/min

33
Q

Factors that Precipitate Hypoxic Injury

A
  1. DEC CO
  2. DEC Hgb saturation
  3. Anemia
  4. INC tissue O2 requirements
  5. Inability of cells to use O2 (cyanide poisoning)
34
Q

Hypoxic Compensatory Mechanisms

A
  1. INC CO

2. INC Hgb

35
Q

CO2

A

Fundamental trigger of inspiration

Detected by chemoreceptors
INC CO2 = INC Bicarb = INC H+ = INC RR

*Unless chronic lung disease where CO2 is always high, then O2 stimulates inspiration

36
Q

Herring Breuer Reflex

A

Pulmonary stretch receptors protect lungs from over-distending during inspiration

37
Q

Ventilation

A

Movement of air in and out of lungs

38
Q

Oxygenation

A

Movement of O2 into blood and tissues

39
Q

CO2 Transport

A

Crosses respiratory membrane faster than O2

  1. Dissolved in plasma
  2. HCO3- (Bicarbonate)
  3. Combined with proteins and Hgb
40
Q

Diaphragm

A

Muscle of inspiration

  • Contraction causes pressure drop in lungs
    • ->pulls air in

Innervated by Phrenic N (C345)

41
Q

Accessory Muscles of Inspiration

A
  1. Scalenes
  2. Sternocleidomastoid
  3. Pectoralis major
  4. Trap
  5. External intercostals
42
Q

Accessory Muscles of Expiration

A

When RAW elevated, these muscles contract and increase intrathoracic pressure to push air OUT:

  1. Rectus abdominis
  2. Ext abdominis
  3. Int abdominis
  4. Transverse abdominis
  5. Int intercostals
43
Q

RAW

A

(Airway Resistance)
Restricts movement of air out of lungs and increases use of accessory muscles of expirations

Factors:

  1. Diameter of AW
  2. Smooth muscle contraxn
  3. Vascular engorgement
  4. Excessive secretions
44
Q

V/Q Ratio

A 
(Ventilation / Blood Flow)
  -Gravity
  -Shunting
  -Deadspace
Normal: 0.8 - 1.2 (4:5)
45
Q

Shunt

A

(Perfusion without ventilation)
Block of air getting into alveoli
–>Hypoventilation

Causes:

  • pleural effusion in alveoli
  • bronchitis, emphysema, asthma (rel shunt)
46
Q

Deadspace Ventilation

A

Ventilation with too little or no perfusion

Cause:
-PE –> blocks blood flow to alveoli

47
Q

APGAR Score

A 
Appearance - Color
Pulse - HR
Grimace - Reflex
Activity - Muscle tone
Respirations - Effort
48
Q

CPAP

A

(Continuous Positive AW Pressure)

Machine that keeps lungs open by creating positive pressure

PHYSICAL THERAPY (13 decks)

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