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Physiology > Section 5 Lecture 4 > Flashcards

Section 5 Lecture 4 Flashcards

1
Q

alveolar pressure increases between ___ and decreases between ____:

A

middle of inspiration to middle of expiration, middle of expiration to middle of inspiration

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2
Q

When is alveolar pressure negative?

A

inspiration

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3
Q

When is intracellular pressure increasing?

A

expiration

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4
Q

Range of intracellular pressure:

A

-6 to -3 mm Hg

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5
Q

When is intrapleural pressure decreasing?

A

inspiration

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6
Q

How to measure pleural pressure:

A

esophageal balloon

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7
Q

Average volume of air exchanged in and out of lungs per breath:

A

500 mL

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8
Q

What is the flow limitation in inspiration?

A

None

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9
Q

distending pressure =

A

arterial pressure - pleural pressure

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10
Q

Arterial pressure =

A

pressure tending to collapse lung + pleural pressure

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11
Q

distending pressure =

A

pressure tending to collapse lung

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12
Q

These are equal at FRC:

A

Barometric and atmospheric pressures

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13
Q

Average pleural pressure:

A

-3 cm H2O

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14
Q

P(el) is equals and opposite to:

A

P(cw) P(el) = pressure tending to collapse lung, P(cw) = chest wall pressure

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15
Q

Sequence of events leading to inspiration:

A

inspiratory muscles contraction, chest wall expansion, P(pl) becomes more subatmospheric, lung expands, P(A) becomes sub-atmospheric, air flows into alveoli

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16
Q

No pull on lung to expand, lung collapses:

A

peumothorax

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17
Q

When can a pneumothorax occur from the inside?

A

if the P(pleural) is very positive, tumor, infection, or over expansion

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18
Q

True or False? Increasing surface tension makes it easier to reinstall a collapsed lung.

A

F. decreasing surface tension

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19
Q

True or False? Intracellular pressure matches atmospheric when the normal lung is at rest.

A

F. sub-atmospheric

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20
Q

How is the rib cage affected if there is a pneumothorax?

A

rib cage expands slightly (air flows in and lung collapses)

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21
Q

When does the lung volume plateau?

A

maximum vital capacity

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22
Q

True or False? The lung is always trying to collapse so it always has a positive pressure.

A

T.

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23
Q

What is positive pressure generated by?

A

recoil of lungs

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24
Q

True or False? Both chest wall and chest wall and lung (respiratory system) pressures can be both negative and positive.

A

T

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25
Q

% vital capacity at neutral point:

A

60%

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26
Q

% TLC at FRC:

A

40%

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27
Q

Which is more positive at FRC, chest wall pressure or respiratory system pressure?

A

respiratory system pressure

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28
Q

The slope of the lung pressure vs % vital capacity graph is linear until what % vital capacity?

A

75%

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29
Q

At what % vital capacity are lung pressure and respiratory system pressure equal?

A

about 55%

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30
Q

% TLC at RV:

A

25%

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31
Q

How is surface tension offset?

A

surfactant

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32
Q

Compliance dec w these 2 diseases:

A

Resp Distress Syndrome, Firbrosis

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33
Q

Low compliance require (larger/ smaller) translung pressure

A

larger

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34
Q

Emphysema destroys:

A

elastic recoil of lung, inc compliance

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35
Q

Translung P:

A

diff bw pleural and atmospheric

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36
Q

Compliance =

A

delta V/ delta P

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37
Q

Lungs compliance =

A

delta V/ delta P(pleural)

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38
Q

Average compliance:

A

0.2L / cm H2O

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39
Q

Is the lungs more or less distensible at high volumes?

A

less

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40
Q

What does compliance affect?

A

work of breathing

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41
Q

This disease results in inelastic scar-tissue:

A

Fibrotic Lung disease

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42
Q

This diseases results from a lack of surfactant in the lungs:

A

RDS

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43
Q

Compliance increases with this disease:

A

emphysema

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44
Q

If compliance is increased, will the translung pressure vs vital capacity graph shift up or down?

A

up

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45
Q

What corrects for the decreased compliance at higher volumes?

A

specific compliance

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46
Q

Types of phospholipids in surfactant:

A

DPPC, PG

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47
Q

Functions of proteins in surfactant:

A

regulate surfactant turnover, immune regulation, formation of tubular myelin

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48
Q

What causes the release of surfactant?

A

Beta adreneric agonist, activators of PKC, leukotrienes, purinergic agonist

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49
Q

How is surfactant cleared?

A

repute, lymphatics, macrophages

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50
Q

Which has higher pressure, small or large bubble if they have the same surface tension?

A

small bubble (P = 2T/r)

51
Q

Law of LaPlace:

A

P = 2T/r

52
Q

Without surfactant would the lower lung volumes require greater or less transmural pressure to keep the lungs expanded?

A

greater

53
Q

What, besides surfactant, prevents alveoli from collapsing/

A

interdependence, channels that equalize pressure

54
Q

Does compliance increase or decrease with increase in volume?

A

decrease

55
Q

What does the slope of the P-V curve represent?

A

compliance

56
Q

Does the slope (compliance) increase or decrease as delta p increases.

A

decreases

57
Q

normal compliance value:

A

0.2 L/cm H2O (200 mL of air per 1cm H2O = 200mL/cm H2O

58
Q

Which is on the x-axis in the P-V curve?

A

Pressure

59
Q

Is the slope of the graph for a patient with emphysema greater or less than the normal curve?

A

greater. Remember: steeper curve (delta v/ delta P) = increases compliance. emphysema = high compliance (about 400 mL/cm H2O)

60
Q

Is the slope of the graph for a patient with fibrosis greater or less than the normal curve?

A

less (Remember: steeper curve (delta v/ delta P) = increases compliance). fibrosis = low compliance (about 100 mL/cm H2O)

61
Q

The work of breathing can be determined by the area under the curve of which graph?

A

Flow - Volume Loop

62
Q

How would filling the lungs with fluid affected surface tension?

A

no surface tension

63
Q

Is more or less pressure required to increase volume of lungs when filled with air vs. water

A

more

64
Q

Does the compliance of the lungs increase or decrease when inflated with water?

A

increases

65
Q

Is water inflation or air inflation non-compressible?

A

water inflation

66
Q

Factors affecting lungs recoil;

A

elastic fibers (1/3) and surface tension (2/3)

67
Q

How are compliance and recoil changed with fibrosis?

A

recoil increases. compliance decreases

68
Q

How are compliance and recoil changed with emphysema?

A

recoil decreases, compliance increases

69
Q

Diseases that cause changes in airway resistance:

A

asthma and emphysema

70
Q

Shorthand calculation for airflow resistance:

A

1/r^4

71
Q

What % of the total oxygen consumption and total cardiac output is used for moderate exercise?

A

1-3%

72
Q

What % of the oxygen consumption is used in patients with pulmonary disease?

A

20-30% or more

73
Q

What does lung recoil primarily influence?

A

tidal volume (V(T))

74
Q

How is the tidal volume affected with an increase in compliance?

A

increases tidal volume

75
Q

The lungs and chest walls can get up to what % of cardiac output?

A

20%

76
Q

Expiratory flow rate (Vdot (E)) =

A

V(T) X frequency

77
Q

What does airflow resistance primarily influence?

A

frequency

78
Q

What factors can alter the viscosity of the air?

A

humidity and altitude

79
Q

What can h=physically obstruct the upper airways?

A

mucus and other factors

80
Q

These cause bronchoconstriction:

A

parasympathetic neurons (muscarinic receptors), histamine, leukotrienes

81
Q

Factors affecting airway resistance:

A

length, viscosity, radius, mucus, edema, contraction of bronchial smooth muscle, increase air density (scuba diving)

82
Q

What causes bronochodilation?

A

CO2, epinephrine (Beta 2- receptors)

83
Q

How to calculate the total resistance for a system in series:

A

R1 + R2 + …

84
Q

How to calculate the total resistance for a systems in parallel:

A

1/R1 + 1/R2 +…

85
Q

Does resistance to airflow increase or decrease as lung volume increase?

A

decreases

86
Q

What pulls open the airways?

A

negative pleural pressure of inhalation

87
Q

What causes the flow to be turbulent in the larger airways?

A

higher resistance and in series (and parallel)

88
Q

True or False? Resistance in the large airways in only in series.

A

F. both series and parallel

89
Q

Reynold’s Number =

A

(2r (airwaY) v (airflow) d (of air))/ viscosity (of air)

90
Q

Laminar flow will predominate when Reynold’s number is

A

less than 2000

91
Q

How will airflow be affected if the Reynold’s number is less than 2000?

A

airflow for a given pressure will increase

92
Q

If Reynold’s number is greater than ____ turbulent flow will predominate.

A

2000

93
Q

What 2 factors can increase turbulent flow?

A

increase in airflow velocity or increase in airway radius

94
Q

Expirated ventilation is aka:

A

minute ventilation

95
Q

Expired ventilation =

A

tidal volume X frequency (breathes per minute)

96
Q

The optimum level of work is at how many breathes per minute?

A

15

97
Q

How many mL is our expired ventilation (minute ventilation)?

A

6000 ml/min

98
Q

Tidal volume for emphysema and pulmonary fibrosis relative to normal:

A

doubles to 1000ml for emphysema and about half to 200 for pulmonary fibrosis (breaths per minutes follow the same pattern)

99
Q

Factors affected the rate of airflow through the airways:

A

Laminar vs. turbulent flow, airflow resistance in series and parallel, “flow limitation” (during expiration) and the “equals pressure point”

100
Q

Factors that increase airway resistance:

A

mucus, edema, contraction of smooth muscle, inspired gas density and viscosity

101
Q

How is inspiratory muscle effort affected with volume increases?

A

it increases

102
Q

How is recoil of lung affected with volume increases?

A

it increases

103
Q

How is airway resistance affected with volume increases?

A

it decreases

104
Q

What does RV stand for?

A

Residual Volume

105
Q

What fraction of tidal volume is expired during FEV(1)?

A

2/3

106
Q

Peak flow rate in L/sec for both inspiration and expiration:

A

about 10 L/sec (at 25% of volume expired)

107
Q

PEFR =

A

Maximal effort

108
Q

What region represents the flow limitation?

A

effort-independent region

109
Q

How does the maximum effort curve for a patient with asthma or emphysema compare to the normal curve?

A

lower than, generate less pressure

110
Q

Is the expiratory flow or volume greater or less in a patient with emphysema or asthma?

A

less

111
Q

True or False? The reserve volume for patients with emphysema or asthma is larger than normal.

A

F. smaller

112
Q

average transpulmonary pressure:

A

30 cm H2O

113
Q

Average transairway pressure:

A

30 cm H2O

114
Q

Average pleural pressure:

A

-30 cm H2O

115
Q

How will the pressure be affected if the gas velocity is increased?

A

pressure decreases

116
Q

What is transairway pressure?

A

pressure difference between the airway opening and the alveolus.

117
Q

What is transpulmonary pressure?

A

difference between the alveolar pressure and the intrapleural pressure in the lungs

118
Q

Both transpulmonary and transairway pressures are calculated by subtracting this from a value:

A

pleural pressure

119
Q

What becomes negative, transpulmonary or transairway pressure?

A

transairway

120
Q

How is the resistive drop altered in a diseased state?

A

greater resistive drop

121
Q

How is the equals pressure point affected in the diseased state?

A

it is close to alveoli in non-cartilage airways

122
Q

How does the body try and offset the airway resistance in diseased state?

A

increase lungs volume

123
Q

What will happen as airway resistance continues to increase?

A

crackles and rales on inspiration

124
Q

When is airway compression required?

A

beyond the equal pressure point in expiration (negative transairway pressure)

Physiology (55 decks)

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