Unit 1 (Respiratory) - Respiratory Pathophysiology Flashcards
What has the most significant contribution to airflow resistance?
The radius of the airway
What physiologic systems determine airway diameter?
- PNS (Bronchoconstriction)
- Mast cells & non-cholinergic c-fibers (Bronchoconstriction)
- Non-cholinergic PNS - Bronchodilation
- SNS (Bronchodilation)
What nerve supplies parasympathetic innervation to the airway smooth muscle?
Vagus nerve
Coughing, allergy, and infection activate what three things that amplify the inflammatory response?
IgE, cytokines, and complement
Activation of the beta-2 receptor turns on the Gs protein, which activates what?
Adenylate cyclase
Nitric oxide stimulates what?
cGMP
Pulmonary function tests measure what three things?
Static lung volumes, dynamic lung volumes, diffusing capacity
How much air the lungs can hold at a single point in time
Static lung volume
How quickly air can be moved in and out of the lungs over time
Dynamic lung volume
How well the lungs can transfer oxygen in and carbon dioxide out
Diffusing capacity
Volume of air that can be exhaled in 1 second
Effort dependent
Declines with age, so predicted value takes age into account
FEV1 (Forced Expiratory Volume in 1 Second)
Volume of air that can be exhaled after a deep inhalation
Effort dependent
Forced Vital Capacity (FVC)
Males = 4.8 L
Females = 3.7 L
What is a normal value for diffusing capacity?
17-25 mL/min/mmHg
True or False: RV cannot be measured with spirometry
TRUE
What are patient related risk factors related to postoperative pulmonary complications?
- Age > 60
- ASA III-V
- CHF
- COPD
- Cigarette smoking
What are procedure related risk factors related to postoperative pulmonary complications?
Aortic > Thoracic > Upper abdominal = Neuro = Peripheral vascular > Emergency
Duration > 2.5 hours
General anesthesia
What is the best way to reverse anesthesia-induced atelectasis?
Alveolar recruitment maneuvers (ARMs)
A peak airway pressure of ____________ is required for initial reopening of the atelectatic regions of the alveoli
30 cmH2O
Characterized by small airway obstruction and increased resistance to expiratory flow
Obstructive disease
Characterized by a proportionate reduction in all of the lung volumes
Restrictive disease
Obstructive Disease:
FVC
FEV1
FEV1/FVC Ratio
FEF 25-75%
RV
FRC
TLC
FVC - Normal (Decreased if gas trapping)
FEV1- Normal (Decreased if gas trapping)
FEV1/FVC Ratio - Decreased
FEF 25-75% - Decreased
RV - Normal (Increased if gas trapping)
FRC - Normal (Increased if gas trapping)
TLC - Normal (Increased if gas trapping)
Restrictive Disease:
FVC
FEV1
FEV1/FVC Ratio
FEF 25-75%
RV
FRC
TLC
FVC - Decreased
FEV1 - Decreased
FEV1/FVC Ratio - Normal
FEF 25-75% - Normal
RV - Decreased
FRC - Decreased
TLC - Decreased
