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My BDS4 > Sedation Physiology - Respiratory > Flashcards

Sedation Physiology - Respiratory Flashcards

1
Q

What muscle(s) are used when quiet breathing?

A

Diaphragm

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2
Q

What muscle(s) are used during more forceful breathing?

A

Intercostal and accessory muscles

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3
Q

Describe Intrapulmonary pressure in relation to atmospheric pressure during inspiration.

A

Intrapulmonary pressure is less than atmospheric pressure during inspiration

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4
Q

Describe Intrapulmonary Ipressure in relation to atmospheric pressure during expiration.

A

Intrapulmonary pressure greater than atmospheric pressure during expiration

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5
Q

Describe the change in Intrapleural pressure during inspiration.

A

Intrapleural pressure falls during inspiration = brings air into the lungs

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6
Q

Describe the change in Intrapleural pressure during expiration.

A

Intrapleural pressure raises during expiration = takes air out of the lungs

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7
Q

Describe lung tidal volume

A

represents air moving in and out during quiet breathing

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8
Q

Describe inspiratory reserve volume.

A

when you force inspiration to its maximum

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9
Q

Describe expiratory reserve volume.

A

when you force expiration to its maximum

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10
Q

Describe residual volume

A

the volume left even after maximum expiration

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11
Q

Describe how we calculate lung vital capacity.

A

add all of the IRV, TV and ERV volumes

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12
Q

Describe how we calculate total lung capacity

A

Add vital capacity and residual volume

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13
Q

What causes a person to have restricted vital capacity? (5)

A
  • Obesity
  • Pneumonia
  • Fibrosis
  • Tb
  • Pneumoniosis
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14
Q

Describe restricted vital capacity in relation to FEV1.

A

VC value is close to the FEV1 that means small volumes are exchanged but they occur at a similar rate to a normal patient

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15
Q

What causes a person to have an obstructive vital capacity? (3)

A

• Emphysema
• Asthma
• Bronchitis

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16
Q

What occurs in the conducting zone?

A

No gas exchange = anatomical dead space

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17
Q

What anatomy is present in the conducting zone? (3)

A

• trachea
• broncho
• bronchi terminals

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18
Q

What is the volume of dead space in the conducting zones?

A

150ml

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19
Q

What volume of new air is inhaled during breathing and why?

What is the tidal volume?

A

when we inhale air - only 300ml will be new/fresh air

150ml already present as dead space

Tidal volume = 450ml

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20
Q

What occurs in the respiratory zone?

A

Gas exchange

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21
Q

What anatomy is present? (3)

A

• respiratory bronchioles
• alveolar duct
• alveolar sack

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22
Q

What is diffusion of gases determined by?

A

partial pressure gradients
(equivalent to concentration gradients)

23
Q

Describe diffusion barriers during respiration. (4)

A

Gases have to travel through a barrier of:

• Thin and flat type 1 pneumocytes on the alveolar wall
• Endothelial cells of capillaries
• Basement membrane between the 2 cells (0.5 – 2 micrometers)
• Type 2 pneumocytes covering the alveolar wall

24
Q

What is the role of type 2 pneumocytes?

A

have a role producing surfactants

25
Q

What is ventilation?

A

The amount of gases passing through the lungs

26
Q

What is perfusion?

A

The amount of gases travelling through the pulmonary circulation

27
Q

Describe the gas levels of oxygen and CO2 in arterial blood and venous blood. (2)

A

Arterial blood had higher oxygen levels and lower carbon dioxide levels

compared to venous blood which has lower oxygen and higher carbon dioxide levels.

28
Q

What cells have an important role in the transport of blood and CO2?

A

Erythrocytes

29
Q

What protein is important In oxygen transport?

A

Haemoglobin

30
Q

How is nitrous oxide transported in the blood?

A

As a simple solution

31
Q

Describe the structure and composition of haemoglobin. (4)

A
  • Globular protein
  • 2 alpha protein chains
  • 2 beta protein chains
  • 4 haem groups with a porphyrin ring and an iron atom inside the ring
32
Q

How is oxygen transported? (2)

A

• Mostly transported attached to haemoglobin = 97%

• Small amounts dissolved in plasma

33
Q

Describe what occurs to oxygen saturation of haemoglobin and the plasma when an individual inhales pure oxygen.

A

Haemoglobin is already saturated so when more oxygen is provided (via breathing pure oxygen or hyperbaric oxygen) the amount of oxygen bound to haemoglobin only increases slightly whereas the oxygen in the plasma increases much more.

34
Q

Describe what happens to oxygen saturation when an individual has hypothermia or alkalosis. (2)

A

Increases haemoglobins affinity to oxygen

  • easier to harvest oxygen in the lungs but harder to move oxygen into the tissues
35
Q

Describe what happens to oxygen saturation when an individual has increased temperatures, acidosis or increased 2,3 diphosphoglycerate . (2)

A
  • Decreases haemoglobins affinity to oxygen
  • Facilitates haemoglobins ability to release oxygen when dissolved in the tissues
36
Q

What occurs during carbon monoxide poisoning?

A

CO binds to haemoglobin and prevents haemoglobin from carrying oxygen to tissues

37
Q

How is Carbon dioxide transported - give %’s? (3)

A
  • 70% transported as bicarbonate ions
  • 20% transported combined to a protein or in carbamino compounds
  • 10% transported as dissolved CO2
38
Q

What effect does providing an oxygen and nitrous oxide mixture have on perfusion?

A

no effect on perfusion as it saturates the haemoglobin molecule and any excess will be dissolved

39
Q

Describe what occurs if we suddenly stop providing oxygen and nitrous oxide to a patient at the same time?

A

If we remove all of the mixture and let patient breathe air only = sudden drop in ventilated oxygen whilst the nitrous oxide is diffused out slowly = more nitrous oxide present than oxygen

40
Q

What type of process is breathing - describe how it occurs physiologically?

A

an automatic process

a rhythm is generated by respiratory centres in the brainstem and can be modified by various sensory receptor

41
Q

What sensory receptors modify the breathing rhythm in the brainstem - describe how? (5)

A

Modified by the conscious cerebral cortex

Peripheral arterial receptors sense a drop in partial pressure oxygen and increase in ppcarbon dioxide and modify the rhythm

Central chemoreceptors can sense the increase in partial pressure of carbon dioxide in the cerebrospinal fluid and reduction in pH and modify the rhythm

Increase in physical activity the joint and muscle receptors recognise movement and stimulate an increase in rhythm

If a conscious increase in breathing is carried out lung stretch receptors can recognise inflation and reduce the rhythm

42
Q

List the 4 types of hypoxia.

A

• Hypoxic hypoxia
• Anaemic hypoxia
• Stagnant
• Cytotoxic hypoxia

43
Q

Describe hypoxic hypoxia

A

occurs when there is a reduction of oxygen is reaching the alveoli or when there is a reduction in oxygen that is diffusing into the blood

44
Q

Describe anaemic hypoxia

A

reduction of oxygen transport in blood from low haemoglobin or reduction in haemoglobin’s ability to function as a carrier
i.e. carbon monoxide poisoning

45
Q

Describe stagnant hypoxia

A

(ischaemic)

reduction of oxygen transport in blood from low blood flow

46
Q

Describe cytotoxic hypoxia

A

reduce oxygen utilisation by cells

47
Q

what causes anaemic hypoxia to occur?

A

carbon monoxide poisoning

48
Q

What signs indicate cyanosis?

A

Blue colour of skin and mucous membranes

49
Q

What causes cyanosis?

A

Occurs when there is > 5gm of de-oxygenated haemoglobin per dl of blood
(an increase of deoxygenated blood)

50
Q

Name the 2 types of cyanosis

A

Central
peripheral

51
Q

What hypoxia commonly causes central cyanosis?

A

Hypoxic hypoxia - decrease in oxygen deliverey to the blood

52
Q

What causes central cyanosis? (6)

A

Caused by a decrease in oxygen deliverey to the blood (hypoxic hypoxia)

Low atmospheric oxygen conc

reduced airflow in airways (obstruction)

reduced oxygen diffusion into blood

reduced pulmonary blood flow

shunting – where venous blood enters the arteries (from anatomical anomaly)

53
Q

What hypoxia commonly causes peripheral cyanosis?

A

stagnant hypoxia - decrease in blood flow to tissues

e.g. peripheral vascular disease such as atherosclerosis

54
Q

Describe how a pulseoximeter works.

A

Uses the variations in the wavelengths between oxygenated and deoxygenated haemoglobin to calculate the saturation of oxygen in pulsating arterial blood.

My BDS4 (57 decks)

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