Respiratory Physiology II Flashcards by Matt Stanton

increased VR

with inspiration - to right heart

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decreased VR

with inspiration - to left heart

pulmonary vessel expansion

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inspiration

systemic arterial pressure decrease

-heart rate increases

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expiration

increased BP and decreased HR

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alveolar gas equation**

PAO2 = (Patm - PH2O) FIO2 - PACO2/R

FIO2 - fraction of inspired oxygen - should be 0.21

R - normally 0.8

normally around 100mmHg

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PACO2

typically 40mmHg

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venous O2 and CO2

PVO2 - 40mmHg

PVCO2 - 47mmHg

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air PO2

150

drops to 100 in alveoli

drops to 40 in tissues

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CO2

diffuses faster than O2

-greater solubility

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diffusion of gas

Vgas ~ A/T x D x deltaP

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perfusion limited gases

N2O

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measure uptake of CO

diffusion capacity of lung

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diffusion limited

O2 - in fibrosis, emphysema

CO**

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O2 content of blood

(1.39 x Hb x Sat/100) + 0.0003PO2 dissolved

** know this equation

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normal Hg

15 g/dL

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2,3 DPG

increased in response to hypoxemia

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promoted offloading of O2 from Hg

increased T
increased pCO2
increased 2,3, DPG
increased H+
decreased pH

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shift of Hb-O2 curve to left

decreased T
decreased pCO2
decreased 2,3 BPG
decreased H

increased affinity

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deoxygenated Hb

carries more CO2 than oygenated blood

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CO2 transport

majority - bicarb
dissolved
complexed to proteins

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dorsal respiratory group

medulla

inspiration

to phrenic

ventral respiratory group

medulla

expiratory

to intercostals and abdominal muscles

phrenic nerve

diaphragm

pontine centers

modify medullary oscillation

gives better timing

apneustic center

pontine | -stimulate inspiration

pneumotaxic center

pontine | -inhibit inspiration

vagal afferents

pulmonary stretch receptors -terminate inspiration rapid adapting receptors -promote inspiration C fibers - chemoreceptors - histamine and prostaglandin response - change HR, BP, RR

RAR

rapid adapting receptors -rate of change receptors promote inspiration

muscle afferents

muscle spindle - length tendon organs - tension info joint receptors - rib joint motion

central chemoreceptors

ventral surface of medulla sense pH changes in CSF NO O2 sensor -stimulation increases tidal volume**

peripheral chemoreceptors

carotid and aortic bodies glossopharyngeal and vagal nerve -respond to PaO2 and PaCO2 (pH) weak O2 response til falls below 60mmHg** then respiration increased

blood brain barrier

permeable to CO2 central chemoreceptors - sense changes in H+

CO2

more important for respiratory drive than O2

metabolic acidosis/alkalosis

immediate resp compensation

acute and chronic resp acidosis/alkalosis

acute - no renal compensation chronic - with renal compensation

normal alveolar to arterial oxygen difference

around 5 mmHg older - increased

first cause of hypoxemia

decreased PIO2 -ex. at elevation decreased Patm normal alveolar to arterial O2**

alveolar hypoventilation

increased CO2 and decreased O2 in alveolar normal alveolar to arterial O2** second cause of hypoxemia

barbituates

decreased resp drive not responsive to CO2 changes sole drive is hypoxemia - low O2 giving O2 - this gets rid of this drive to breath = BAD

shunt

ventilation/perfusion mismatch = shunt blood bypasses alveoli increased alveolar-arterial O2**

V/Q matching

gas exchange worse with increased V/Q mismatch greatest ration at apex low ration at base - but ventilation and perfusion are increased

partial pressure of O2

higher at apex

partial pressure of CO2

higher at base

decreased ventilation

more significant than decreased perfusion

fluid filled alveoli

causes shunted blood

individual with hypoxemia

nothing happens | -likely a shunt

diffusion impairment

cause 4 of hypoxemia alveolar-arterial PO2 increased** thicker membrane for diffusion - decreased O2 to blood

V-Q mismatch

may respond to supplement O2

shunt**

no response to supplemental O2**

diffusion abnormality

will respond to supplemental O2 more present during exertion**