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732 > Session 9_Pulmonary Ventilation and Circulation > Flashcards

Session 9_Pulmonary Ventilation and Circulation Flashcards

1
Q

What is the highest recorded “sneeze speed”?

A

99 miles per hour

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2
Q

What is the surface area of the lungs roughly the same size as?

A

a tennis court

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3
Q

How much water do we lose everyday through breathing?

A

1/2 liter

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4
Q

How many lobes does the right lung have?

A

3

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5
Q

How many lobes does the left lung have?

A

2

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6
Q

The lungs occupy all thoracic cavity except:

A

mediastinum

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7
Q

3rd cervical vertebra, to 6th =

A

location (posteriorly) larynx

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8
Q

Larynx separates:

A

separation of food of air

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9
Q

The right lung has 2 fissures =

A

horizontal and oblique fissures

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10
Q

The left lung has 1 fissure =

A

oblique fissure

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11
Q

The left lobe also has the little extension of:

A

lingula

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12
Q

What is the potential pathology of the pleurisy/ pleuritis?

A

inflammation of pleural cavity –> rough –> friction rub

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13
Q

What are some potential causes of pleurisy?

A

chest trauma, cancer, pulmonary embolis, autoimmune disease (lupis), rheumatoid arthritis.

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14
Q

What part of the O2 transport system would be involved in pleurisy?

A

????

inspiration

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15
Q

What type of connective tissue is the lung tissue?

A

primarily elastic

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16
Q

What does the elasticity of healthy lungs help reduce?

A

Reduce the work of breathing

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17
Q

The bronchopulmonary segments of the lungs are separated by:

A

connective tissue septa

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18
Q

The bronchopulmonary segments of the lungs are served by own:

A

lung and artery

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19
Q

The bronchopulmonary segments received air from:

A

individual bronchus

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20
Q

Cancer caught early in bronchopulmonary segments, can be removed without:

A

affecting other parts –> people can survive

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21
Q

What are three regions of the Right Upper bronchopulmonary segments?

A
  1. apical
  2. anterior
  3. posterior
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22
Q

What are the 2 regions of the Right middle bronchopulmonary segments?

A
  1. lateral

2. medial

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23
Q

What are the 5 regions of the Right lower (base) bronchopulmonary segments?

A
  1. anterior
  2. superior
  3. lateral
  4. posterior
  5. medial
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24
Q

What are the 4 regions of the Left Upper bronchopulmonary segments

A
  1. apical posterior
  2. anterior
  3. superior (lingula)
  4. inferior (lingula)
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25
Q

What are the 4 regions of the Left Lower(base) bronchopulmonary segments?

A
  1. anterior
  2. superior
  3. lateral
  4. posterior
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26
Q

How many auscultation spots are there?

A

9

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27
Q

How would you located the Right lung using surface landmarks?

A
  • 1” above rib 1
  • crosses costal cartilage 6
  • midclavicular at rib 6
  • midaxillary at rib 8
  • vertebral border at rib 10
  • inferior border 2 rib widths above diagphram
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28
Q

How would you located the Left lung using surface landmarks?

A
  • 1” above rib 1
  • deep to manubroclavicular joint
  • midsternally to rib 4
  • jogs to left, continues to rib 6
  • midaxillary rib 8
  • vertebral border at rib 10
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29
Q

The upper respiratory tract is from:

A

nasal and oral orifices to the false vocal cords in the larynx

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30
Q

The upper respiratory tract includes what 4 structures?

A
  1. nose
  2. nasal cavity
  3. pharynx (naso-, oro-, layrngo-)
  4. Larynx
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31
Q

The lower respiratory tract includes what 7 structures?

A
  1. trachea
  2. R & L primary bronchi (bronchus -singular)
  3. secondary, tertiary, etc. bronchi
  4. bronchioles
  5. terminal bronchioles
  6. respiratory bronchioles
  7. alveolar ducts –> alveolar sacs –> alveoli
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32
Q

The lower respiratory tract is from level of:

A

true vocal cords to the alveoli

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33
Q

The lower respiratory tract is divided into what 2 regions?

A
  1. conducting

2. respiratory zones

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34
Q

What side does aspiration usually happen on?

A

R side, R> vertical

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35
Q

What is the conducting zone?

A

trachea through terminal bronchioles

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36
Q

Where does the trachea bifurcate?

A

~ T7

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37
Q

The trachea bifurcates into:

A

R and L main bronchi

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38
Q

The R and L main bronchi further divide into:

A

lobar bronchi: 3 on right, 2 on left

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39
Q

The lobar bronchi further divide into:

A

segmental bronchi (tertiary)

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40
Q

What helps move mucous out?

A

cilia

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41
Q

About how many orders of branching air passageways are there?

A

~23

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42
Q

The bronchioles (air passages) of the conducting zone, are ____________________ in diameter?

A
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43
Q

The terminal bronchioles of the conducting zone, are ____________________ in diameter?

A
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44
Q

Conducting zone + upper airway =

A

ANATOMIC DEAD SPACE

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45
Q

Space in respiratory passage where gas exchange does not occur = ~

A

~150mls

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46
Q

Where is most of the are?

A

in respiratory bronchioles and alveoli

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47
Q

The transition and respiratory zone begins where terminal bronchioles feed into:

A

respiratory bronchioles

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48
Q

Terminal bronchiole –>

A

respiratory bronchioles –> alveolar duct–> alveoli (multiple = alveolar sac)

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49
Q

The respiratory zone contains about how many liters of air at rest?

A

~2.5L

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50
Q

The respiratory zone contains about how many liters of air with max. inspiration?

A

4.6L

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51
Q

The respiratory zone comprises the majority of:

A

the 4-6L lung capacity

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52
Q

What are the walls of the alveoli composed of?

A

single layer of Type I cells; squamous epithelial

surrounded by basement membrane

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53
Q

The external surface of the alveoli are covered by:

A

a ‘web’ of capillaries

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54
Q

How much air vs blood =

A

0.8 (4L O2: 5L blood)

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55
Q

Albeolar + capillary walls+ fused basement membrane =

A

respiratory membrane

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56
Q

~250ml O2 leave alveoli to blood, 200ml CO2 diffuse from blood to gas in:

A

alveoli per minute

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57
Q

What type of cells in the alveoli secrete surfactant?

A

Type II cells

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58
Q

The alveoli also have ___________ and _______________.

A

pores and macrophages

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59
Q

Provide one example of a pathology that affects efficiency of the alveoli?

A

pulmonary edema (auscultation - may hear crackles)

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60
Q

Respiratory membrane =

A

alveoli, capillaries and basement membrane

- also for respiration

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61
Q

What part of O2 transport system involved with a pathology affecting alveoli?

A

???

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62
Q

Dead space =

A

can’t do gas exchange

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63
Q

Anatomical deal space =

A

volume of all the space of the respiratory system other than alveoli and their closely related gas exchange areas

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64
Q

Physiological dead space =

A

alveolar dead space + anatomical dead space

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65
Q

In a healthy individual anatomical and physiological dead spaces will be:

A

similar

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66
Q

Blood supply to the lung tissue:

A

bronchial arteries & pulmonary veins

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67
Q

Bronchial arteries come of aorta and go into the lungs through the:

A

hilum
1-2% of cardiac output

** to supply lung tissue

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68
Q

Where do pulmonary veins carry blood?

A

carrying oxygenated blood –> artrium

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69
Q

The parasympathetic NS =

A

constrict air tubes

70
Q

Sympathetic NS =

A

dilate air tubes (motor fibers)

71
Q

During parasympathetic activation ACh is release –>

A

smooth muscle contraction

72
Q

Parasympathetic NS innervation increases:

A

airway resistance

73
Q

Parasympathetic NS innervation slows and reduces:

A

volume of airflow

74
Q

Sympathetic NS innervation is:

A

weak direct control by sympathetic nerve fibers

75
Q

Sympathetic NS activation by EPI and NE –>

A

smooth muscle relaxation

76
Q

The stronger effect by EPI and NE released in blood:

A

released by adrenal medulla following SNS stimulation

77
Q

Sympathetic NS innervation reduces:

A

airway resistance and enhances flow

78
Q

Name the 5 major functional events of respiration:

A
  1. pulmonary ventilation
  2. external respiration
  3. Transport of respiratory gasses
  4. Internal respiration
  5. Regulation of respiration / ventilation
79
Q

pulmonary ventilation

A

mass movement of air

80
Q

external respiration =

A

lung level (move O2 from alveoli –> capillaries

81
Q

respiration = _____________ process

82
Q

Internal respiration =

A

@ tissue level (blood –> tissue)

83
Q

Pulmonary ventilation is defined as

A

movement of air into and out of lungs - commonly called “breathing”

84
Q

Mechanisms of expansion / contraction of lungs =

A
  • contraction of diaphragm: lengthens or shortens the chest cavity
  • elevation / depression of ribs
85
Q

What is the role of the diaphragm in pulmonary ventilation?

A
  • quiet inspiration
  • contracts: dome shape “flattens”
  • increases thoracic volume
86
Q

During expiration, the diaphragm:

A

relaxes back to dome shape

and decreases thoracic volume

87
Q

External intercostals (additional inspiration muscles) function in pulmonary ventilation to:

A

elevate ribs

88
Q

Other muscles that assist in pulmonary ventilation are:

A

SCM, scalenes, anterior serrati, pectoralis minor and erector spinae muscles

89
Q

One clinical intervention =

A

inspiratory muscle training (IMT)

90
Q

Expiration muscles involved in pulmonary ventilation are:

A
  1. internal intercostals

2. rectus abdominis

91
Q

The expiration muscles in pulmonary ventilation are recruited with increased:

A

respiratory demands/ forced expiration

92
Q

Respiratory pressures are always described relative to:

A

atmospheric pressure (Patm)

93
Q

Atmospheric pressure =

A

760 mmHg @ sea level

94
Q

Intrapulmonary pressure (Ppul or Palv) =

A

alveolar pressure

95
Q

Intrapulmonary pressure wants to equalize with what?

A

atmospheric pressure

96
Q

Intrapleural pressure (Pip) =

A

pressure in the pleural cavity

97
Q

About how many mmHg is intrapleural pressure?

A

~.4 mmHg (lower than Patm by ~4mmHg)

98
Q

As the pressures change in the alveoli w/ stimulation of breathing, will see air pulled in or pushed out?

99
Q

Boyle’s Law: @ constant temperature, the pressure of a gas varies _______________ with its volume

A

@ constant temperature, the pressure of a gas varies INVERSELY with its volume

100
Q

P1V1 =

101
Q

Alveolar pressure (Palv) =

A

pressure inside lung alveoli

102
Q

During inspiration: Palv drops slightly to:

A

~-1 cm H2O

103
Q

During inspiraiton the Palv pressure drop is enough change to allow 500 ml air to be pulled into lungs in about how many second?

A

~ 2 seconds

104
Q

During expiration, Palv rises to:

A

~ 1 cmH2O

driving air out of alveoli in ~2-3 seconds

105
Q

Transpulmonary pressure (Palv - Pip) =

A

keeps air spaces of lungs open

106
Q

Transpulmonary pressure is the difference between the alveolar pressure and the:

A

pleural pressure

107
Q

Lung collapse (or partial) =

A

atelectasis

108
Q

Presence of air in intrapleural space =

A

pneumothorax

109
Q

The measure of the change in lung volume that occurs with a given change in transpulmonary pressure =

A

lung compliance

110
Q

Lung compliance is determined by:

A

distensibility (elastic forces) of lung tissue and

alveolare surface tension (surfactant)

111
Q

Interstitial lung disease =

A

severe, quick/ acute, decreased distensibility

112
Q

What does surfactant help reduce?

A

helps reduce surface area to avoid collapsing

113
Q

What is the surface tension principle?

A
  • “raindrop”
  • alveoli w/o surfactant
  • smaller the alveolus, greater the alveolar pressure caused by the surface tension
114
Q

what is surfactant made up of?

A

phospholipids, proteins, and ions

115
Q

What is the function of surfactant?

A

greatly reduce surface tension (prevent collapsing)

116
Q

surfactant reduces the effort required by respiratory muscles to expand the:

117
Q

Less surfactant =

A

less distensible

118
Q

What 2 forces act to pull the lungs from the thorax wall (parietal pleura)?

*which would cause lung collapse

A
  1. lungs natural tendency to recoil

2. surface tension of alveolar fluid

119
Q

Is intrapleural pressure negative or positive?

120
Q

Why is the intrapleural pressure negative?

A
  • it is opposed by natural elasticity of chest wall
  • it maintains pleural fluid adhesive force
  • combination of all forces
121
Q

During inspiration, the diaphragm ______________. The ____________________ dimension of thoracic cavity increase.

A

contracts

superior-inferior

122
Q

During inspiration the external intercostal muscles lift the rib cage and pull the sternum _________________ and there is _________________ expansion of the thoracic cage

A

sternum superiorly-lateral

anterior-posterior expansion of thoracic cage

123
Q

During inspiration, the thoracic ________________ increases by ~__________ .

A

VOLUME increases by ~500ml

124
Q

An increase in volume during inspiration leads to _________________ in pressure.

125
Q

During (quiet) expiration, the diaphragm ___________________, the rib cage ___________________ and the lungs ___________________

A

diaphragm relaxes

rib cage resumes resting position

lungs recoil

126
Q

During expiration, thoracic and intrapulmonary volumes ______________ –> compressing the alveoli.

127
Q

During expiration Palv ___________.

128
Q

If Palv > Patm?

A

gases flow out of the lungs

129
Q

What are the 3 components working during quiet breathing?

A
  1. compliance work or elastic work
  2. tissue resistance work
  3. airway resistance work
130
Q

During pulmonary ventilation, how much energy expenditure is required?

A

3-5% total body energy expenditure required for pulmonary ventilation

131
Q

When does forced inspiration/ expiration occur?

A

occurs when need an increase in gas exchange

** accessory muscles are recruited

132
Q

see photo on slide 51

A

see photo on slide 51

133
Q

For airway resistance, the non-elastic source is:

134
Q

What is the equation for airway resistance?

A

F = ∆ P / R

135
Q

lung capacity =

A

2 or more volumes added together

136
Q

see slide 53

A

see slide 53

137
Q

tidal volume (TV) =

A

amount of air inhaled or exhaled w/ each breath under resting conditions

138
Q

inspirations reserve volume (IRV)

A

amount of air that can be forcefully inhaled after a normal tidal volume inhalation

139
Q

expiration reserve volume (ERV)

A

amount of air that can be forcefully exhaled after a normal tidal volume exhalation

140
Q

Residual volume (RV)

A

amount of air remaining in the lungs after a force exhalation

141
Q

Total lung capacity (TLC)

A

maximum amount of air contained in lungs after a maximum inspiration effort

142
Q

vital capacity (VC)

A

maximum amount of air that can be expired after a maximum inspiratory effort

143
Q

Inspirations capacity (IC)

A

maximum amount of air that can be inspired after a normal expiration

144
Q

functional residual capacity (FRC)

A

volume of air remaining in the lungs after a normal tidal volume expiration

145
Q

TLC =

A

TV + IRV + ERV + RV

146
Q

VC =

A

TV + IRV + ERV (should be 80% TLC)

147
Q

IC =

148
Q

FRC =

149
Q

V1(1) ==

150
Q

VE (1)=

151
Q

Minute respiratory volume=

152
Q

FVC =

153
Q

FEV (1)=

154
Q

Surfactant is not secreted into alveoli until:

A

~7 months gestation

155
Q

What are the pulmonary complications if a baby is born prematurely @ ~ 7 months gestation?
List 2 physiological explanations for the complications:

A

infant will require greater effort by respiratory muscles to expand lungs

  1. more surface tension, more pressure to collapse
  2. less distensible b/c lacks surfactant
156
Q

distensibility =

A

a determinant of stress on the vessel wall. A decreased distensibility might increase the risk of arterial wall damage.

157
Q

Alveolar ventilation (Va) =

A

total volume of new air entering the alveoli and their adjacent gas exchange areas each minute

158
Q

Va =

A

Freq X (Vt - Vd)

159
Q

Alveolar ventilation (per minute) is a major factor in determining the concentration of:

A

O2 and CO2 in the alveoli

160
Q

Describe normal respiratory conditions:

A

larger bronchioles and bronchi near trachea provide the greatest amount of airflow.

161
Q

Normal respiratory conditions: Why do the bronchioles and bronchi near the trachea provide the greatest amount of resistance to airflow?

162
Q

In disease conditions: Why do smaller bronchioles provide greater resistance to airflow?

A

???????

more constricted???

163
Q

What are 4 characteristics of pulmonary arteries?

A
  1. thin walled
  2. short
  3. larger diameters than systemic counterparts
  4. much more compliant: can accommodate stroke volume output of R ventricle
164
Q

The lungs have about ~450Mml of blood.. How much is in the pulmonary capillaries?

165
Q

Blood from lungs gets distributed to:

A

alveoli (with best oxygenation)

166
Q

Low (O2) in alveoli causes capillary constriction which is _____________________ to systemic capillary reaction to low (O2).

167
Q

Why is the response of the alveoli to low O2 (capillary constriction) opposite to the systemic capillary reaction to low O2?

168
Q

If Palv > Ppc –>

A

capillaries close and no blood flow

169
Q

With EX blood volume increases up to:

170
Q

Additionally, with EX, blood volume:

A
  • increases the # of open capillaries
  • distends(swell) capillaries and therefore increases rate of flow
  • increases pulmonary pressure - minimally

732 (12 decks)

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