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Monica Respiratory > Respiratory Physiology > Flashcards

Respiratory Physiology Flashcards

1
Q

internal respiration consumes and produces what

A

consumes O2

produces CO2

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2
Q

list the four steps of external respiration

A

ventilation
gas exchange between alveoli and blood
gas transport in blood
gas exchange at tissue level

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3
Q

definine ventialtion

A

moving air between atmosphere and alveoli spaces

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4
Q

define Boyle’s law

A

at any constant temp the pressure exerted by a gas varies inversely with the volume of the gas
as volume of a gas increases = pressure by gas decreases

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5
Q

what must the intra-alevolar pressure become less than for air to flow into lungs

A

atmospheric pressure

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6
Q

2 forces holding thoracic wall and lungs

A

intrapleural fluid cohesiveness

negative intrapleural pressure

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7
Q

explain inspiration

A

active process
cause - contraction of inspiratory muscles
vl of throax increased vertically by contracting of diaphragm
phrenic nerve from cervical 3,4,5
external intercostal muscle contraction - lifts ribs + moves out sternum = bucket handle
increased lung size = intra-alveolar pressure fall air in larger volume (Boyle’s Law)
air enters down pressure gradient

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8
Q

name major inspiratory muscle

A

diaphragm

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9
Q

explain expiration

A 
passive process
relaxation of inspiratory muscles
recoil of lungs = intra-alveolar pressure rises
more molecules smaller volume (Boyle's)
air leaves down pressure gradient
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10
Q

explain pneumothorax

A

air in pleural space (abolishes transmural pressure gradient)

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11
Q

causes of pneumothorax

A

SPONTANEOUS
TRAUMATIC
IATROGENIC

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12
Q

pneumothorax can lead to

A

lung collapse

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13
Q

small pneumothorax can be

A

symptomatic

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14
Q

pneumothorax symptoms

A

SOB

chest pain

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15
Q

physical signs of pneumothorax

A

hyper resonant percussion ote

decreased/absent breath sounds

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16
Q

what causes lungs to recoli during expiration

A

elastic connective tissue

alveolar surface tension

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17
Q

explain alveolar surface tension

A

H2O molecules attraction at liquid air interface
produces force = resists lung stretching
alveoli lined H2O alone = tension too strong = alveoli collapse

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18
Q

what does surfactant reduce

A

alveolar surface tension

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19
Q

Law of LaPlace - alveolli

A

smaller alveoli = higher tendency to collapse

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20
Q

importance of surfactant

A

lowers surface tension of smaller alveoli more

prevents alveoli collapsing + emptying air contents into large alveoli

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21
Q

Laplace’s Law calculation

A

P=2T/r
P=inward directed collapsing pressures
T=surface tension
r=radius of bubble

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22
Q

Respiratory Distress Syndrome in New Born

A

fetal lungs unable synthesize lungs until late pregnancy
premature - lack of pulmonary surfactant
= respiratory distress syndrome of new born
= very strenuous inspiratory effects overcome high surface tension

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23
Q

explain alveolar interdependence

A

alveolus starts to collapse surrounding alveoli = stretched = recoil = expand forces in collapsing alveoli = open it

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24
Q

list forces keeping alveoli open

A

transmural pressure gradient
pulmonary surfactant
alveolar interdependence

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25
Q

forces promoting alveolar collapse

A

elasticity of stretched lung of connective tissue

alveolar surface tension

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26
Q

list the major inspiratory msucles

A

diaphragm and external intercostal muscles

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27
Q

list the accessory muscles of inspiration

A

sternocleidomastoid
scalenus
pectoral

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28
Q

list the muscles of active expiration

A

abdominal muscles

internal intercostal muscles

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29
Q

define tidal volume

A

vl air entering or leaving lungs single breath

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30
Q

define inspiratory reserve volume

A

extra vl of air that can be maximally inspired over and above typical resting tidal volume

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31
Q

define expiratory reserve volume

A

extra vl of air that can be actively expired by maximal contraction beyond normal vl of air after resting tidal volume

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32
Q

define residual volume

A

min vl of air remaining in lungs even after max expiration

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33
Q

define inspiratory capacity

A

max vl of air that can be inspired at end of normal quiet expriation

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34
Q

define functional residual volime

A

vl of air in lungs at end of normal passive expiration

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35
Q

define vital capacity

A

max vl of air moved out during a single breath following max inspiration

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36
Q

define total lung capacity

A

total vl air lungs can hold

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37
Q

explain total lung capacity

A 
max vl air lungs can hold
vital capacity + residual vl
residual cannot be measure by spirometry
hence TLC not measured by spirometry
loss of elastic recoli = residual vl increases
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38
Q

FVC =

A

max vl forcibly expelled from lungs following max insirtaion

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39
Q

FEV1 =

A

forced expiratory volume in 1 second

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40
Q

FEV1/FVC ratio =

A

proportion of FVX expired in 1st second
(FEV1/FVC) x100
Normally >70%
diagnosis of obstructive + restrictive lung disease

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41
Q

Obstructive Lung Disease FEV1/FVC =

A

<70%

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42
Q

Restrictive Lung Disease FEV1/FVC =

A

> 70%

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43
Q

Primary determinant of airway reiststance =

A

radius of conducting airway

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44
Q

parasympathetic =

A

bronchoconstriction

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45
Q

sympathetic =

A

bronchodilation

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46
Q

dynamic airway compression in normal people

A

no problem
increase in airway pressure
increases driving pressure between alveolus and airway

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47
Q

dynamic airway compression during active expiration in patients with airway obstruction

A

driving pressure
fall in airway pressure
airway compression by rising pleura pressure
diseased airway - more likely to collapse
worse - decreased elastic recoli of lungs

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48
Q

Peak Flow Meter

A 
peak flow rate estimate
assesses airway function
useful - obstructive lung disease
short sharp blow
best of 3 attempts
varies age and height
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49
Q

define pulmonary compliance

A

effort lungs has to go to stretching or distending lungs

less compliant = more work

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50
Q

causes of decreased pulmonary compliance

A 
pulmonary fibrosis
pulmonary oedema
lung collapse
pneumonia
absence of surfactant
51
Q

result of decreased pulmonary compliance

A

greater change in pressure required
SOC esp on exertion
restrictive pattern of lung vl

52
Q

cause of increased pulmonary compliance

A

elastic recoil of lungs = lost
emphysema
age
dynamic airway obstruction

53
Q

work of breathing increased when…

A

pulmonary compliance decreased
airway resistance increased
elastic recoil decreased
need for increased ventilation

54
Q

calculate pulmonary ventilation

A

tidal volume x respiratory rate

55
Q

why is alveolar ventilation less ham pulmonary ventilation

A

presence of anatomical dead space

56
Q

calculate alveolar ventilation

A

(tidal volume - dead space) x respiratory rate

57
Q

define pulmonary ventilation

A

vl air breathed in and out per minute

58
Q

define alveolar ventilation

A

vl air exchanged between atmosphere + alveoli per minute

59
Q

because of dead space it is more advantageous to

A

increase depth of breathing

60
Q

transfer of gases between body and atmosphere depend on

A

ventilation

perfusion

61
Q

define ventilation

A

rate at which gas is passing through lungs

62
Q

define perfusion

A

rate at which blood is passing through lungs

63
Q

ventilated alveoli which are not adequately perfused with blood are considered as

A

alveolar dead space

64
Q

alveolar dead space in health people

A

very small + little importance

65
Q

disease on alveolar dead space

A

increased significantly

66
Q

accumulation of CO2 in alveoli as a result of increased perfusion =

A

decreased airway resistance = increases airflow

67
Q

increased alveolar O2 concentration as a result of increased ventilation =

A

pulmonary vasodilation = increases blood flow

68
Q

areas in which perfusion = grater than ventilation

A 
CO2 increases in area
dilation of local airways
airflow increases
O2 decreases in area
constriction of local blood vessels
blood flow decreases
69
Q

areas in which ventilation = greater than perdusion

A 
CO2 decrease in area
constriction of local airways
airflow decreases
O2 increases in area
dilation of local blood vessels
blood flow increases
70
Q

effect of O2 on pulmonary arterioles

A 
decreased = vasoconstriction
increased = vasodilation
71
Q

effect of O2 on systemic arterioles

A 
decreased = vasodilation
increased = vasoconstriction
72
Q

factors influencing rate of gas exchnage

A

partial pressure gradient of O2 and CO2
diffusion coefficient for O2 and CO2
surface area of alveolar membrane
thickness of alveolar membrane

73
Q

explain Dalton’s Law of Partial Pressures

A

Total pressures exerted by a gaseous mixture = sum of partial pressures of each individual component in gas mixture

74
Q

partial pressure of gas =

A

pressure that 1 gas in a mixture of gases would exert if it were the only gas present in the whole volume occupied by the mix at a a given temp

75
Q

alveolar gas calculation =

A 
PAO2 = PiO2 - (PaCO2/0.8)
PAO2 = partial pressure of O2 in alveolar air
PiO2 = partial pressure of O2 in inspired air
PaCO2 = partial pressure of CO2 in arterial blood
0.8 = respiratory exchange ratio
76
Q

describe partial pressure gradient

A

gases move from higher to lower partial pressure

77
Q

define diffusion coefficient

A

solubility of gas in membrane

78
Q

compare diffusion coefficient for CO2 compared to O2

A

CO2 = x20 O2

79
Q

big gradient between PAO2 and PaO2 indicates

A

problems with gas exchange in lungs

right to eft heart shunt

80
Q

explain Fick’s Law of diffusion

A

amount of gas that moves across a sheet of tissue in unit time is proportional to the area of the sheet but inversely proportional to its thickness

81
Q

what does pulmonary circulation recieve

A

entire cardiac output

82
Q

respiratory tree pathway

A

trachea - bronchi - bronchioles - terminal bronchioles - respiratory bronchioles - alveolar ducts - alveolar sacs

83
Q

what are allveoli

A 
thin walled inflatable sacs
function in gas exchange
single layer of flattened type 1 alveolar cells
84
Q

what circles alveolus

A

pulmonary capillaries

85
Q

list 4 factors influencing rate of gas transfer across alveolar membrane

A

partial pressure gradient of O2 and O2
diffusion coefficient
surface area of alveolar membrane
thickness of alveolar membrane

86
Q

causes of decrease in surface area of alveolar membrane

A

emphysema
lung collapse
pneumonectomy

87
Q

O2 picked up by blood in lungs -

A

transported in blood to tissues for cellular use

88
Q

CO2 produced at tissues -

A

transported in blood to lungs for removal from body

89
Q

Henry’s Law

A

O2 amount dissolved in blood = proportional to partial pressure

90
Q

O2 is present in the blood in 2 forms

A

bound to haemoglobin

physically dissolved

91
Q

features of haemoglobin

A

Hb molecules contain 4 haem groups
each haem binds reversible to 1 O2 molecule
fully saturated when all Hb present = max load of O2

92
Q

primary factor determining percentage saturation of haem with O2

A

Po2

93
Q

calculate oxygen delivery index

A 
DO2l = CaO2 x Cl
VO2I = oxygen delivery index (ml/min/meter^2)
CaO2 = Oxygen content of arterial blood (ml/L)
Cl= cardiac index (L/min/meter^2)
94
Q

what is O2 delivery to the tissues a function of

A

O2 content of arterial blood

cardiac output

95
Q

calculate O2 content of arterial blood (Ca)2)

A 
CaO2 = 1.34 x (Hb) x SaO2
SaO2 = % saturated with O2 = determined by PO2
96
Q

causes of impaired O2 delivery to tissues

A 
respiratory distress (decrease arterial PO2 = decrease Hb saturation with O2 and O2 blood content)
heart failure (decreased cardiac output)
anaemia (decreased Hb conc = decreased )2 content in blood)
97
Q

what does partial pressure of inspired O2 depend on

A

total pressure

proportion of O2 in gas mic

98
Q

O2 binding of haem

A

binding O2 to Hb increases affinity
co-operativity
sigmoid
flattens = all sites occupied

99
Q

co-operativity

A

binding of 1 O2 to Hb increases affinity of Hb for O2

100
Q

Bohr Effect

shift to right

A

increase Pco2
increase H+
increase temp
increase 2,3 biphosphoglycerate

101
Q

features of foetal haemoglobin

A

HbF
2 alpha subunits
2 gamma subunits
interacts less with 2,3 biphosphoglycerate = higher affinity for 02 = shifted to left
allows O2 mother to baby even if PO2 = low

102
Q

features of myoglobin

A 
present in skeletal and cardia muscles
1 haem per myoglobin
no cooperative binding
dissociation curve = hyperbolic
presence in blood = muscle damage
103
Q

transporting CO2 in blood

A

solution
bicarbonate
carbamino compounds

104
Q

where does carbonic anhydrase occur

A

red blood cells

105
Q

describe carbamino compounds

A

CO2 + terminal amine groups
globulin of haemoglobin
rapid even without enzyme
reduced Hb = bind more CO2 than HbO2

106
Q

explain haldane effect

A

removing 02 from Hb = increases ability of Hb to pick up CO2 and CO2 generated H+

107
Q

what does the rhythm refer to

A

inspiration followed by expiration

108
Q

fairly normal ventilation if

A

section above medulla

109
Q

ventilation ceases if

A

section below medulla

110
Q

medulla is a

A

major rhythm generator

111
Q

explain Pre-Botzinger complex

A

network of nerves
pacemaker activity
upper end of medullary reps centre

112
Q

rise to inspiration

A 
rhythm generated = pre-botzinger complex
excites dorsal resp group neurones
fires in bursts
firing - contraction of inspiratory muscles
firing stops = passive expiration
113
Q

when does active expiration

A

during hyperventilation

114
Q

describe active expiration

A

increased firing of dorsal neurones= excited 2nd group
ventral respiratory group neurones
excite intercostal abdominals etc
forceful expiration

115
Q

rhythm generated in medulla can be modified by?

A

neurones in the pons

116
Q

what happens in absence of pneumotaxic centre

A

APNEUSIS

breathing = prolonged inspiratory gasps with expiration

117
Q

respiratory centres = influenced by stimuli received from

A 
higher brain centres
stretch receptors
Juxtapulmonary receptors
Joint receptors
Barorecptors
Central chemoreceptors
Peripheral chemoreceptors (high altitudues)
118
Q

causes of hypoxia at high altitudes

A

decreased partial pressure of inspired O2

119
Q

acute response of hypoxia

A

hyperventilation

increased cardiac output

120
Q

symptoms of acute mountain sickness

A 
headache
fatigue
nausea
tachycardia
dizziness
sleep disturbance
exhaustion
shortness of breath
unconsciousness
121
Q

chronic adaptation to high altitude hypoxia

A 
increased RBC
increased 2,3 BPG produced within RBC
increased capillary number
increased mitochondria number
kidneys conserve energy
122
Q

arterial Pco2 as chemical factor

A

weak stimulation - peripheral

strong stimulation - central

123
Q

arterial Po2 as chemical factor

A

important if Po2 < 8KPA - peripheral

severe hypoxia decreases resp centre - central

124
Q

arterial H+ as chemical factor

A

stimulation - peripheral

H+ cannot cross blood brain barrier - central

Monica Respiratory (21 decks)

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