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BMS 615 Cardiovascular > Test 3: Wk12: 1 V/Q Balance Special Breathing Patterns - Puri > Flashcards

Test 3: Wk12: 1 V/Q Balance Special Breathing Patterns - Puri Flashcards

1
Q

FRC is the

A

point of equilibrium

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2
Q

At FRC Chest wall recoil — Lung recoil

A

=

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3
Q

Volume above FRC Chest Wall Recoil — Lung Recoil

A

less than

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4
Q

Volume Below FRC Chest Wall Recoil — Lung Recoild

A

> greater than

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5
Q 
At FRC 
atmospheric pressure=
Intrapleural pressure = 
Alveolar pressure =
Transpulmonary pressure =
A

atmospheric pressure= 0
Intrapleural pressure = neg
Alveolar pressure = 0
Transpulmonary pressure = pos

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6
Q

the slope of the PV compliance curve =

A

compliance

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7
Q

PTP (Transpulmonary Pressure) =

A

PTP = PA - PIP

PA Alveolar Pressure
PIP Intrapleural Pressure

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8
Q

As diaphragm contracts PIP (intrapleural pressure) becomes

A

more negative

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9
Q

PIP is equal and opposite to

A

PTP (transpulmonary pressure)

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10
Q

— is the only pressure that fluctuates above and below 0 during regular quiet breathing

A

alveolar pressure

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11
Q

emphysema shifts curve

A

left, increase in compliance

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12
Q

Restrictive lung Dz shifts curve

A

right, decrease in compliance

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13
Q

higher the compliance higher the

A

resting lung volume

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14
Q

Airflow =

A

Palveolar - PBarometric / r

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15
Q

— contribute most to resistance

A

central, segmental airways

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16
Q

Bronchodilation Nerves

A

sympathetic

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17
Q

Bronchodilation receptors

A

B2 adrenergic

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18
Q

nonadrenergic, noncholinergic bronchodilators nerves VIP

A

Bronchodilation

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19
Q

Bronchoconstriction Nerves

A

Parasympathetic (Vagal)

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20
Q

Bronchoconstriction Receptors

A

Muscarinic Cholinergic Receptors M3

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21
Q

Alpha-adrenergic Receptors

A

Bronchoconstriction

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22
Q

airway resistance — and lung volume decreases

A

increases

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23
Q

At high lung volume

A

conduction airways are filled with air and expanded

radial traction applied by adjacent alveoli expands airways

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24
Q

intrapleural pressure only becomes positve during

A

forceful exhalation

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25
Q

Frictional resistance causes a fall in this driving pressure along the length of the conducting airways. At some point, the driving pressure will equal the surrounding pleural pressure; in this event, the net transmural pressure is zero

A

equal pressure point

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26
Q

in emphysema and bronchitis, the qeual pressure point is shifted

A

down towards lower airways

27
Q

barrel chest is due to

A

lung hyperinflation from increased compliance

28
Q

Pursed lips do what

A

increase air resistance at mouth increasing airways preventing collapse during expiration

29
Q

In restrictive lung dz the equal pressure point is

A

shifted towards upper airways

airflow increased

30
Q

airway resistance — in restrictive dz due to dynamic compression of upper airways

A

increases

31
Q

— is the only volume that us decreased in obstructive lung dz

A

Expiratory Reserve Volume

32
Q

why is residual volume increased so much in obstructive lung dz

A

air is trapped from dynamic compression

33
Q

steady state

A

Vol CO2 produced = Vol O2 taken up

300mL/min = 300 mL/min

34
Q

Hyperventilation

A

disproportionate increase in alveolar ventilation as

compared to metabolic state

35
Q

Hypoventilation

A

a disproportionate decrease in alveolar ventilation as

compared to metabolic state

36
Q

Total Ventilation Equation

A

VE = VT x F

37
Q

Alveolar ventilation =

A

VA = VT-D x f

38
Q

Total Ventilation in L/min

A

~ 6 L/min

39
Q

Alveolar Ventilation in L/min

A

~4.2 L/min

40
Q

Alveolar Gas Equation

A

PAO2 = [(Patm - 47) x .21] - (PACO2 / 0.8)

41
Q

only 2 ways to change PACO2

A

change alveolar ventilation

change metabolism

42
Q

Change in alveolar ventilation effect on PAO2

A

no effect bc O2 is coming from environment

43
Q

PAO2 =

A

PiO2 - PACO2

44
Q

Extraalveolar and alveolar vessels are arranged in

A

series

45
Q

Total PVR is lowest

A

at FRC

46
Q

↑ lung volume above FRC → ↑

Alveolar PVR by compression of alveolar vessels →

A

↑ Total PVR

47
Q

↓ lung volume below FRC → ↑

Extraalveolar PVR by compression and less traction on extraalveolar vessels →

A

↑ Total PVR

48
Q

Hypoxic Pulmonary Vasoconstriction

A

response to Alveolar O2

Decrease in PAO2 leads to precapillary pulmonary vasoconstriction which increases PVR

49
Q

Hypoxic Pulmonary Vasoconstriction Occurs in

A

High Altitude

Hypoxemia caused by hypoventilation , shunting, V/Q mismatch

Fetal Circulation

50
Q

Opioids suppress respiration by acting on the

A

central pattern generator

51
Q

in chronic hypoventilation

A

PaCO2 is increased and PaO2 is decreased

52
Q

Oxygen inducted hypoventialtion

A

administration of high concentrations of oxygen to a person with chronic hypercapnia will increase PaO2 and knock out hypoxic drive

53
Q

Hypoxic Drive

A 
central chemoreceptors are no longer stimulated by CSF acidosis, the
main stimulus to breathe becomes the ↓ PaO2, which is mediated by the carotid
body chemoreceptors (
54
Q

Hypoxic (↓PaO2) ventilatory drive–primarily mediated by — accentuated by

A

peripheral chemoreceptors

hypercapnia (respiratory acidosis

55
Q

Hypercapnic (↑PaCO2) ventilatory drive—primarily mediated by — accentuated by

A

central chemoreceptors

Hypoxia and metabolic acidosis

56
Q

Opiates and BZDs reduce or abolish

A

ventilatory drive

to hypoxia and hypercapnia

57
Q

Apneusis

A

prolonged inspirations separated by brief expirations, typically seen in
animals with lesions of the rostral pons—rare

58
Q

Cheyne-Stokes Respiration

A

cycles of a gradual increase in tidal volume, followed by a

gradual decrease in tidal volume, and then a period of apnea

59
Q

Cheyne-Stokes Respiration Seen with

A

bilateral
cortical disease or congestive heart failure, or in healthy people during sleep at high
altitude

60
Q

Ataxic Breathing (Biot’s)

A

highly irregular inspirations, often separated by long

periods of apnea—medullary lesions

61
Q

Cluster Breathing

A

similar to ataxic breathing, with groups of breaths, often of
differing amplitude, separated by long periods of apnea—medullary or pontine lesions

62
Q

Kussmaul breathing

A 
hyperventilation seen with metabolic acidosis, especially
diabetic ketoacidosis (DKA)
63
Q

Thus, V/Q ratio is greater at the

A

apex

64
Q

V/Q ratio is lowest at the

A

base

BMS 615 Cardiovascular (49 decks)

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