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respiratory strand test questions Flashcards

1
Q

what is the role of surfactant

A

surfactant is a phospholipid which decreases the surface tension in alveolar cells

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2
Q

do the lungs act as a reservoir of blood

A

yes

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3
Q

how do lungs stop blood clots entering systemic circulation

A

filter them out

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4
Q

which metabolites play an important role in defence agains inflammation and homestasis

A

synthesis of a arachidonic acid metabolites such as eicosanoids

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5
Q

what is acute bronchitis

A

usually self limiting which is acute inflammation of the trachea and bronchi

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6
Q

what is pleurisy

A

inflammation of the pleura

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7
Q

what is pulmonary fibrosis

A

inflammation of the airways producing lung scarring and cyst formation

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8
Q

what are the energy uses in breathing

A

about half is dissipated during inspiration as heat to overcome resistance to airflow
the rest is stored as potential energy in elastic structures of the lung which drives normal expiration

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9
Q

what do flow volume loops measure

A

velocity of air flowing through the airways in relation to the volume of air moved during inspiration and expiration

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10
Q

how does the rib cage aid inspiration

A

increase diameter of the chest making the negative pressure in the lungs more negative

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11
Q

how do the joints in the ribs aid inspiration

A

joints between posterior ends of the ribs and the transverse vertebrae enable the lower ribs to swivel upwards and outwards
aids 25%
diaphrgam 75%

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12
Q

what specifically are restrictive lung diseases

A

reduced total lung capacity but airflow and airway resistance is normal

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13
Q

what are examples of intrinsic lung diseases

A

restrictive
lung tissue is destroyed which reduces lung volume
air spaces may be filled with inflammatory exudates
chronic inflammation or scarring

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14
Q

what are examples of extrinsic lung disorders

A

affect the muscles of respiration which impair movement

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15
Q

what are some examples of restrictive lung disease

A

pneumothorax
pulmonary embolism
ARDS
pulmonary fibrosis

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16
Q

what do the external intercostals do

A

move ribcage upwards and outwards to increase lateral and anterograde-posterior diameter of the thorax

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17
Q

how do the neck muscles aid in respiration with examples

A

pull rib cage up
sternocleidomastoids elevate the sternum
scalenus major elevate the first two ribs and the sternum

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18
Q

how do abdominal muscles aid respiration

A

the oblique, transverses and rectus abdomens pull the ribcage downwards

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19
Q

which muscles fix the shoulder girdle in respiration

A

pec major
lat dorsi
pull ribcage outwards

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20
Q

what does the position of the diaphragm

A

posture

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21
Q

how does being the upright posture affect the diaphragm

A

sinks and flattens out under gravity therefore movement required to reach expansion is smaller

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22
Q

how does effort of breathing change while in supine position

A

diaphragm is more dome shaped so more effort required on inspiration

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23
Q

describe the nervous supply to the diaphragm and the intercostal muscles

A

phrenic from c3-5 left and right

branches peripherally to the intercostal muscles

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24
Q

how much does the diaphragm move in eupnoea and heavy breathing

A

1.5cm to 7 cm

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25
what would spinal injuries above C3/4 result in
apnoea and death
26
how does vaporisation of liquids contribute to total pressure
pressure of water vapour is independent of barometric pressure but dependant on temperature therefore partial pressure of gas in humidified air must be reduced so that the total will be equal to barometric pressure
27
when you ventilate how does the intrapulmonary pressure change
falls and rise about 3 mmHg below and above atmospheric pressure
28
why is the intrapleural pressure usually sub atmospheric
elastic recoil of the lungs trying to separate the two layers
29
what happens to intrapleural pressures during deep inspiration
pressure drops 40 mmHg below atmospheric
30
what is used to measure intrapleural pressure
manometer
31
what is atelectasis and what is it caused by
failure of the lungs to expand acutely by foreign bodies chronically by tumour
32
what happens to the lungs and alveoli in atelectasis
collapse of lung and alveoli
33
what causes compression in atelectasis
pleural effusion or pneumothorax opposing inflation
34
what is bronchiectasis
permanently dilated bronchi with chronic infection
35
flow related collapse is common in which diseases
asthma and emphysema
36
airway collapse over time can lead to what
hyperinflation of the chest as air gets trapped
37
what is the closing capacity of the lungs
The closing capacity (CC) is the volume in the lungs at which its smallest airways, the respiratory bronchioles, collapse
38
what happens when closing capacity exceed FRC
compromise gas exchange
39
what happens to lung compliance in pulmonary fibrosis
reduces as the lungs become less elastic
40
how is compliance in a new born different and old age
low compliance so lungs are not easy to inflate | decreases in old age
41
which diseases cause decrease in lung compliance
emphysema pulmonary fibrosis pulmonary congestion
42
what is lung capacity
the amount of gas that an be accommodated will depend on the size of the lungs and the thorax related to age, sex and ethnicity
43
what is lung volume
the amount of gas that can be moved with respiration and depends on inspiratory and expiratory effort
44
what is a typical breathing rate at rest
12 - 15 breaths per minute
45
what is the average tidal volume
500 ml
46
who have larger FEV1 and FVC
swimmers divers and brass players
47
how could you measure airway obstruction
FEV1/FVC or FEV1 expressed as a percentage of FVC
48
at what age does FEV1 usually start to decline
30 but it is accelerated in COPD
49
which drugs can be used to decrease the rate of FEV1 normally and in COPD
no drug has yet been shown
50
how can you distinguish between COPD and asthma
measure FEV1 and PEFR after use of a b adrenreceptor agonist such as salbuatamol asthma should be reversed
51
what is the max improvement in FEV1 or PEFR after use of salbutamol
no greater than 15% or max 200 ml/s
52
what type of flow increases resistance
turbulent flow
53
what happens if workload to breathing becomes too much
respiratory fatigue
54
what by definition is airway resistance
result of frictional forces opposing the flow of air
55
airflow in the centre of tubes in analogous to what
blood
56
which equations describes the resistance of laminar flow of air
poiseullies law which indicates that resistance increases to the power of 4 as the airways narrow
57
what usually creates the most resistance to airflow in the lung
large airways, trachea and bronchi larger than 2 mm diameter this is due to having a much smaller cross sectional area
58
what can increase resistance to airflow outside of the conducting airways
tumour mediastinal masses hilar lymph nodes
59
during anaesthetics what happens which can cause increased resistance to airflow
tongue falls back and causes block
60
what objects outside the body can cause airway resistance
aspirated objects such as peanuts or pretzels
61
inflammation in asthma can lead to what
oedema and mucus plugging
62
during asthma what cells enter the airways and cause damage
eosinophils and lymphocytes
63
which three things must you consider when determining treatment for lung obstruction
bronchospasm inflammation secretion
64
what are mast cells activated during allergy
attachment of Fc portion of immunoglobulin IgE and other complement factors
65
what happens when mast cells become activated by IgE
rise in intracellular Ca and release of chemical mediators - mainly histamine which is stored inside granules
66
activation of mast cells leads to the synthesis of what
arachidonic acid derivatives such as leukotriene C4 that cause a slow but sustained contraction of bronchial smooth muscle
67
during inspiration there is a small change in pressure until pressure reaches what amount
at 5-6 mmHg inflation becomes much faster and volume is changed rapidly
68
what shape of inflation is there during inspiration and until what mmHg
non linear expansion until past 5-6 mmHg then reaches max around 15 mmHg
69
what happens to the graph of expiration during deflation
the curve is displaced to the left so that the pressure at any volume is less on expiration than inspiration
70
what is hysteresis
the presence of surfactant allows easier expiration and lower pressure than that of inspiration Lung hysteresis is evident when observing the compliance of a lung on inspiration versus expiration. ... Lung volume at any given pressure during inhalation is less than the lung volume at any given pressure during exhalation. check diagram on homepage
71
what do the elastic properties of the lungs mean for intrapleural pressure
tend to pull them away from the elastic wall giving rise to negative intrapleural pressure
72
what happens to intrapleural pressure when you inhale
intrapleural pressure becomes from negative
73
rate of simple diffusion is dependant on what | pulmonary diffusing capacity
thickness of the membrane (0.5 - 0.2) microns | gas concentration gradient in solution
74
what is the law of diffusion across the membrane
Ficks law
75
what test is more usually a test of pulmonary diffusing capacity
the single breath CO diffusion test
76
what is the average oxygen diffusing capacity
15 - 35 | around 20 ml/min/mmHg
77
what affects the oxygen diffusing capacity
exercise increases it due to dilation of capillaries and opening of closed capillaries in the apex of the lung it is decreased due to thickening of the membrane such as in scleroderma, pulmonary fibrosis, asbestosis also decreased due to reduction of area such as in emphysema
78
what does the concept of partial pressures apply to
both gases and liquids
79
when does a gas enter a liquid
gas molecules enter a liquid until the partial pressure in the liquid matches that of the surrounding air - even between air and liquid
80
the rate at which a gas equilibrates in a liquid depends on what
the gas solubility and on chemical binding in the liquid
81
what happens if there is CO2 retention in the alveoli
less O2 enters the blood
82
which lung volume cannot be measured by spirometry
residual volume or any volumes left in the lung after a full exhale
83
during expiration which pressure is greatest
expiration the PA (pressure in the alveoli) is greater than PB (pressure in the atmosphere)
84
how is turbulence created and what is the difference in sound to laminar flow
laminar flow is silent turbulent flow is noisy turbulence results from high air flow and common near the edges of airways
85
beyond which zone in the lung is there no cartilage and therefore rely on elastic recoil to prevent collapse
generation 11
86
which diseases are common to have flow related collapse
emphysema and asthma
87
what happens to FEV1 in obstructive disease
decreased
88
what happens during alveolar fibrosis
there is increased thickness of the alveoli membrane
89
what is alveolar consolidation
result of replacement of air with transudate, pus, blood or other cells
90
what are adenoids
small bumps as the back of the nasal passage above the mouth - glands that produce antibodies or white blood cells
91
which cells are present under cilia in the trachea lining
columnar epithelium | with pericillary layer and mucus layer on top
92
what is the difference between adult and foetal Hb
adult = 2 alpha and 2 beta | foetal has 2 alpha and 2 gamma
93
describe the 4 structures of Hb levels
primary - 141 ish amino acids per chain secondary - globular structure tertiary crevice for haemolytic and O2 binding quaternary 4 chains
94
``` describe how these factors affect the O2 dissociation curve increase temp increase 2-3DPG increase CO2 increased pH increase CO ```
``` moves to right moves to right moves to right moves to left down ```
95
during gases exchange what is the kPa range of PaO2 and PaCO2 in oxygenated red blood cells
PaO2 - 10-13 kPa | PaCO2 - 4.5 - 6 kPa
96
what is the difference in alveolar pressure, PA, pulmonary arterial pressure Pa and Pulmonary venous pressure Pv in each of the zones of the lungs
zone 1: blood flow collapses PA > Pa > Pv zone 2: Pa increases with respect to PA - vascular waterfall Pa > PA > Pv zone 3: blood flow depends on Pa and Pv Pa > Pv > PA
97
what are the two factors that effect ventilation perfusion mismatch
dead space near apex where there is not blood flow due to collapse and no gas exchange but high ventilation shunt vessels - hypoxia - no ventilation but good perfusion of blood
98
what is the difference in peripheral vs central chemoreception
peripheral - O2 decrease, CO2 increase, H+ increase | central - increase in CO2 and increase in H+
99
what are the steps of the oxygen cascade
``` dry air humidified air alveolar gas pulmonary capillary arterial blood mean capillary bed cytoplasm mitochondria ```
100
what are the responses of high altitude
hyperventilation cerebral oedema pulmonary oedema alkalosis
101
``` what do these drugs molecules have on bronchi muscarinic antagonists ACh cAMP Adrenaline Adenosine Theophylline ```
Theophylline – reduces bronchoconstriction by stopping PDE converting cAMP to AMP as cAMP causes bronchodilation Muscarinic antagonists – reduce bronchoconstriction Beta agonists – increases cAMP causing bronchodilation ACH – increases bronchoconstriction Adenosine – increases bronchoconstriction Adrenaline – increases bronchodilation
102
what are treatments for allergy induced asthma
``` mast cell stabilisation glucocorticoids desensitisation to allergens leukotriene antagonists B2 agonists ```

Body Systems (77 decks)

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