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Physiology > Respiratory pressures > Flashcards

Respiratory pressures Flashcards

1
Q

Type 1 pneumocyte

A

Simple squamous epithelium on the alveoli that contributes to gas exchange
Shares a BM with endothelial cells

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2
Q

Type 2 pneumocyte

A

Cuboidal epithelium with lamellar bodies
Produce surfactant

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3
Q

Surfactant

A

Reduces surface tension in alveoli and prevents collapsing during exhalation
Located in alveoli up to the respiratory bronchioles

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4
Q

What would happen without surfactant

A

Alveolar surface tension would be so high that they would collapse, making it difficult to re-expand during the lungs during the next inhalation

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5
Q

Why is surfactant crucial

A

Maintains lung compliance (ability of lungs to expand and recoil with ease

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6
Q

Law of LaPlace

A

If two circles have the same surface tension, the smaller bubble will have higher pressure (Decrease volume = increase pressure)

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7
Q

Law of LaPlace equation

A

Pressure = 2 times surface tension / radius of circle

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8
Q

What happens in different size alveoli without surfactant

A

With equal surface tension and a difference in volume (and pressure), the air is going to go towards the area with a decrease in pressure (goes down the pressure gradient)

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9
Q

Surfactant’s role in breathing

A

Inhalation, diaphragm and intercostal mm contract expanding the thoracic cavity
* This expansion lowers the intrapulmonary pressure, causing air to flow into the lungs.
* Surfactant ensures alveoli remain open, preventing collapse and facilitating the
entry of air.
* During exhalation, diaphragm and intercostal muscles relax, elastic recoil of the lungs naturally causes them to decrease in volume.
* Surfactant helps to reduce the work required to overcome surface tension during exhalation
and maintains the alveoli’s ability to stay open.
* This ensures that the lung tissue can efficiently and completely recoil to expel air

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10
Q

Alveolar macrophages

A

Dust cells
Phagocytize microbes and particulate matter
Derived from monocytes

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11
Q

Pulmonary capillary

A

Lined with endothelial cells (simple squamous)
Aid in gas exchange

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12
Q

Basement membrane in alveoli

A

Connects type I pneumocytes and simple squamous of the capillary (share the BM)

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13
Q

Perfusion

A

The blood that enters the lungs to be oxygenated

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14
Q

Transmural pressure

A

Difference in pressure between alveolar and pleural pressure
Transpulmonary pressure

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15
Q

Natural state of lungs with no outside forces

A

Collapse because of the elastic tissue

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16
Q

Natural state of the chest wall with no outside forces

A

Expanding out to its natural state that was formed during fetal development without any lung pressure

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17
Q

Contraction of the inspiratory muscles expands chest wall and _____ transmural pressure

A

increases

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18
Q

Contraction of expiratory muscles compresses chest wall _____ transmural pressure

A

decreases

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19
Q

Functional residual capacity

A

The volume remaining in the lungs after a normal, passive exhalation

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20
Q

At FRC

A

Diaphragm relaxed, elastic recoil of lungs is equal and opposite to the elastic recoil of the chest
Intrapleural pressure is -5
No airflow and no pressure gradient

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21
Q

What needs to happen to draw air into the lungs

A

A difference in the pressure in the alveoli and atmosphere needs to be created by contraction of the inspiratory muscles

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22
Q

Intrapleural pressure at rest

A

-5 cmH20

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23
Q

Elastic recoil of the lungs is ________ to the elastic recoil of the chest wall

A

equal in magnitude but opposite in direction

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24
Q

Parietal space impact on lung pressure system

A

When it changes in volume creates a suction that won’t allow the lungs to collapse any further

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25
Q

Step 1 of breathing

A

Lungs at FRC, glottis is open, alveolar pressure is equal to atmospheric pressure
No air flow

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26
Q

Step 2 of breathing

A

Diaphragm contracts, airways stretch, ribs move up and out
Increases volume of the lungs and alveoli increases
Alveolar pressure decreases below atmospheric pressure
Air flows in

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27
Q

Step 3 of breathing

A

Volume of the lungs and alveoli increased, alveolar pressure is equal to atmospheric pressure
No air is flowing

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28
Q

Step 4 of breathing

A

Diaphragm relaxes and airways recoil, ribs fall
Volume of lungs and alveoli decreases, alveolar pressure increases above atmospheric and air flows out

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29
Q

Step 5 of breathing

A

Repeat step 1

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30
Q

Pleural pressure

A

Less than atmospheric pressure
Negative pressure keeps lungs inflated

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31
Q

Pneumothorax

A

Air in pleural space that causes an equalization to atm pressure
Lung collapses

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32
Q

Spirometry

A

Shows air moving in and out/how much

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33
Q

Tidal volume

A

Amount of air that moves in and out the lungs during quiet breathing

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34
Q

Inspiratory reserve volume

A

Extra volume of air inspired with maximal effort at end of normal inspiration

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35
Q

Expiratory reserve volume

A

Extra volume of air expired with maximal effort beyond level reached at end of normal respiration

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36
Q

Residual volume

A

Amount of air that remains in lungs after fully exhaling

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37
Q

Total lung capacity

A

Sum of all lung volumes

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38
Q

Vital capactiy

A

Sum of IRV, TV, ERV

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39
Q

Functional residual capacity =

A

Expiratory reserve volume and residual volume

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40
Q

Arterial O2 Pressure (PaO2)

A

The amount of O2 gas molecules in the blood plasma

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41
Q

How oxygen is moved throughout the body

A

2% is dissolved in the plasma
98% is bound to HB in RBCs

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42
Q

Oxygen dissociation curve

A

Shows relationship between percentage saturation of hem. with O2 and partial pressure of oxygen

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43
Q

Sequential binding of O2 to Hb

A

Binding of first molecule is hard, but once one is bind, becomes easier to bind another (like this until all 4 subunits bound)
Because of confirmational change in structure once O2 binds

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44
Q

Cooperativity

A

O2 affinity of Hb increases with each progressive oxygen molecule binding
(same concept with loosing, hard to loose 1 but then easier as you loose more)

45
Q

Hemoglobin

A

Complex protein in RBCs that transports O2 from lungs to tissues
Contains 4 subunits with iron bound heme group that binds the O2

46
Q

Factors that impact Hb affinity for O2

A

Temp, pH, H+ ions, CO2

47
Q

Hb saturation with low PaO2 and location

A

Low
Small concentration of O2 so harder to bind with Hb
Tissues

48
Q

Hb saturation with high PaO2

A

High
High concentration of O2 so once bind easier to fill
Lungs

49
Q

PaO2 percentage in the lungs

A

100% or 100 mmHg - will be until it reaches systemic capillaries

50
Q

PaO2 percentage in the tissues

A

40% or 40mmHg

51
Q

O2 saturation % in the systemic veins

A

75%, don’t loose all the O2 at the tissues, only some is unloaded in the tissues

52
Q

How O2 moves to Hb or tissues

A

Wants to move down its concentration gradient
In lungs higher than in the blood
In blood higher than in tissues

53
Q

Hb saturation in the aorta

A

98%, remains until hits systemic capillaries

54
Q

P50

A

Partial pressure of O2 in the blood equals 50% saturation of Hb (~27mmHg)

55
Q

What causes shifting O2-Hb dissociation curve to the right

A

Increase in temp (exercise)
Increase in CO2 amount
Decrease in pH
Increase in H+ ions

56
Q

Result of shifting O2-Hb dissociation curve to the right

A

Decrease O2 affinity, results in increase O2 unloading
The p50 has a higher PO2 to get to the same amount of O2 saturation in Hb

57
Q

Why exercise shits O2 Hb curve

A

Your muscles need more O2, so want to decrease affinity so more O2 is sent to the tissues

58
Q

What causes shifting O2-Hb dissociation curve to the left

A

Decrease in temperature
Decrease in H+ ions
Increase in pH

59
Q

Bohr effect

A

Excess H+ bind to hemoglobin which creates confirmational change that decreases affinity of Hb for O2

60
Q

Result of increase in H+ ions

A

Changes Hb formation so decrease affinity for O2 and results in O2 unloading (shift to the right)

61
Q

Haldane effect

A

Affinity of Hb for CO2 decreases in high O2 environment
So increase in O2 kicks of the H+, confirmational change so CO2 loses affinity and O2 can bind

62
Q

Ways to transport CO2

A

Hb transports to lungs
CO2 dissolves in plasma
CO2 diffuses in RBC and turned to bicarb

63
Q

CO2 to bicarb

A

In RBC, carbonic anhydrase turns CO2 and water into carbonic acid, which is a weak acid so it dissociates into bicarb and H+, so more acidic

64
Q

Equilibrium for increase in CO2

A

With an increase in CO2, convert with H20 to create bicarb and H+

65
Q

Equilibrium for increase in H+ ions

A

When H+ ions get kicked off hemoglobin bicarb combines with the H+ to form CO2 and H20

66
Q

A-a gradient

A

Difference between O2 concentration in alveoli and arterial system
PAO2 - PaO2

67
Q

Measuring PaO2

A

Via blood gas

68
Q

Measuring PAO2

A

Calculation is used

69
Q

How is the A-a equation helpful

A

Shows how well Hb can grab and let go of O2
Want a low gradient

70
Q

Respiration

A

Entire breathing process that includes ventilation and oxygenation

71
Q

Ventilation

A

Exchange of gases in the lungs on a molecular level
O2 in and CO2 out

72
Q

Oxygenation

A

Diffusion of oxygen from the air into the RBCs where it is then delivered to the tissues
O2 from lungs to the tissues via RBCs

73
Q

Perfusion

A

Delivery aspect of tissue oxygenation

74
Q

Increase in CO2 down chain equation

A

Combines with what
To carbonic acid
Dissociates into H+ and bicarbonate ion

75
Q

Chemoreceptors

A

Monitor levels of CO2 which then can increase or decrease ventilation

76
Q

Ventilation CO2 impact

A

Increases CO2 (decreases pH)
Primary stimuli to initiate breathing

77
Q

Primary stimuli to breathing

A

CO2

78
Q

Increasing minute ventilation can change _____

A

pH rapidy

79
Q

Minute ventilation =

A

Respiratory rate x tidal volume

80
Q

Normal range of pH

A

7.35- 7.45

81
Q

Increase in minute ventilation causes an increase in CO2 elimination. Would this increase or decrease pH?

A

Increase
Less conversion to bicarb and H+
So more basic

82
Q

Decreases in minute ventilation cause a/an ______ in CO2 elimination and results in _____ CO2 and ______ pH

A

decrease
increased retention of
decreased (conversion to bicarb and H+)

83
Q

Hypercapnia (hypercarbia)

A

CO2 retention
PaCO2 over 45 mmHg

84
Q

Hypocapnia

A

Decrease in PaCO2
Below 35 mmHg

85
Q

CO2 and bicarb equation controls

A

Left side is controlled by respiratory system
By changing RR and TV can change the amount of CO2 in the system
Can take seconds to minutes
Right side is controlled by the kidneys by retaining or secreting bicarb and H+ into the urine
Days to weeks

86
Q

Chronic CO2 elevelation

A

Down regulates chemoreceptors response to a reduced pH
So much CO2 that is bombarding the chemoreceptors that it now takes even more of a change to activate them
Creates a new baseline

87
Q

Stimulus for breathing with hypoventilation

A

With chronic hypercapnia, hypoxia becomes the primary stimulus for ventilation

88
Q

A-a gradient in hypoventilation

A

Normal
Decrease in PAO2 which means that the PaO2 is also decreased, so both is smaller but gradient is the same

89
Q

Hypoxemia

A

When the partial pressure of oxygen in blood is low (under 75 mmHg)

90
Q

How to measure hypoxemia

A

Blood gas (ABG)

91
Q

Oxygen saturation

A

How much oxygen is currently bound to hemoglobin

92
Q

How to measure oxygen saturation

A

Pulse oximetry

93
Q

Hypoxia

A

When tissue oxygen level is impaired

94
Q

Anoxic

A

No oxygen delivery to a tissue
Infarction
Tissue death

95
Q

Causes of hypoxemia without hypoxia

A

Without hypoxia: Increase in O2 delivery to compensate for low PaO2, more O2 in tissues, less in the blood
CO increased to maintain perfusion or a decrease in O2 consumption (hypothermia)

96
Q

Causes of hypoxemia with hypoxia

A

Low arterial O2 content

97
Q

Most common cause of hypoxia

A

Low oxygen available in the blood

98
Q

Causes of hypoxia without hypoxemia

A

Tissues unable to use O2 effectively or delivery system is impaired
No perfusion, poisoning, shunting

99
Q

Causes of hypoxia with hypoxemia

A

Low arterial O2 content

100
Q

V/Q mismatch

A

During hypoxemia events, looking at the amount of air entering the alveoli and the blood flow passing by the alveoli
Can see where the problem is

101
Q

V = (mismatch)

A

Alveolar ventilation
Air entering the lungs into the alveoli

102
Q

Q= (mismatch)

A

Perfusion
Blood flow in capillary past alveolus
Access to blood flow

103
Q

Goal of normal pulmonary ventilation

A

Match blood flow to areas of gas exchange

104
Q

Hypoxic pulmonary vasoconstriction

A

If there is an area that is damage lungs will cut off that section so oxygen goes to somewhere that will use it
Vasoconstrict pulmonary blood flow to poorly functioning areas

105
Q

Common causes of V/Q mismatch

A

Asthma
COPD
Pulmonary embolism
Cystic fibrosis
Interstitial lung disease

106
Q

Right to left shunt (V/Q mismatch)

A

Blood travels from RV to LA without ever being oxygenated
No air flow into the lungs so blood can’t pick up O2

107
Q

Diffusion impairment

A

Getting oxygen from the alveolus to the capillary
Can be due to scaring or fibrosis of the membrane or to reduction in surface area

108
Q

Carbon monoxide

A

Has much stronger binding ability for Hb, competitive antagonism
Also changes shape of Hb making it harder to unload O2 into tissues

Physiology (5 decks)

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