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Respiratory > Ventilation > Flashcards

Ventilation Flashcards

1
Q

What is orthopnoea?

A

Positional difficulty in breathing

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2
Q

What is trachypnoea?

A

Abnormally fast breathing rate

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3
Q

What is bradypnoea?

A

Abnormally slow breathing rate

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4
Q

What is dyspnoea?

A

Difficulty in breathing

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5
Q

What is apnoea?

A

No breathing

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6
Q

What is hypopnoea?

A

Decreased breathing depth

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7
Q

What is hyperpnoea?

A

Increased breathing depth

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8
Q

What is physiological dead space?

A

Sum of alveolar and anatomical dead space

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9
Q

What is alveolar dead space?

A

Capacity of the airways that should be able to undertake gas exchange but cannot e.g. alveoli without blood supply

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10
Q

What is anatomical dead space?

A

Capacity of the airways incapable of undertaking gas exchange

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11
Q

What is alveolar ventilation?

A

Volume of air reaching respiration zone

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12
Q

What is respiratory rate?

A

Frequency of breathing per min

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13
Q

What is minute ventilation?

A

Volume of air expired in one minute

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14
Q

What are the two main components of the chest wall?

A

Lungs

Bone, muscle, fibrous tissue

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15
Q

What is the natural recoil of the rib cage and the lungs?

A

The ribs naturally recoil outwards
The lungs recoil inwards
The chest wall combines these so lung is larger than natural

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16
Q

What is the functional residual capacity?

A

At the end of tidal expiration where the rib cage and lungs are at equilibrium

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17
Q

What does the pleural cavity contain, and is its volume fixed?

A

Protein rich fluid

Yes

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18
Q

How does negative pleural pressure allow inspiration?

A

Negative pressure allows the lungs to expand as the chest wall expands

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19
Q

Why does a puncture in the lung/chest wall cause lung collapse?

A

Air/blood (haemo/pneumothorax) fills the pleural space, changing the fixed volume and elastic recoil means lung will collpase

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20
Q

What is tidal volume?

A

The volume of air inspired and expired during regular breathing

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21
Q

What is tidal breathing?

A

Amount of inspiration and expiration to meet metabolic demands

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22
Q

What marks the FRC?

A

End of a tidal breath

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23
Q

What is residual volume?

A

As the alveoli don’t fully empty (to prevent them from sticking together), the air remaining is residual volume

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24
Q

What is inspiratory reserve volume?

A

The volume of air that can be inspired after a tidal inspiration

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25
Q

What is expiratory reserve volume?

A

The volume of air that can be expired after a tidal expiration

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26
Q

What is total lung capacity?

A

It is TV, IRV, ERV and RV combined. Inspire max and fill lungs as much as possible

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27
Q

What is vital capacity?

A

TLC - RV or TV+IRV+ERV

How much we are able to inspire to expire at max

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28
Q

What is functional residual capacity?

A

ERV+RV

Air that is in the lungs during equilibrium

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29
Q

What is inspiratory capacity?

A

TV+IRV

How much extra air can be inhaled in addition to FRC

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30
Q

What are the units for measuring lung volumes?

A

cmH20

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31
Q

What is transmural and transpulmonary pressure?

A

transmural - pressure across tissue(s) e.g.transpulmonary, transthoracic and transrespiratory

transpulmonary - difference between alveolar and intrapleural

32
Q

What is transrespiratory system pressure?

A

pressure difference drawing air in or out

lung and atmosphere

33
Q

What is the standard against which pressure is measured?

A

Atmospheric pressure

34
Q

Give examples of positive and negative pressure breathing

A

Breathing normally in negative

Ventilator uses positive

35
Q

What is dead space?

A

Part of the airway and lung that isn’t involved in exchange

36
Q

What is the alveolar dead space in healthy people?

A

0 - so physiological dead space equals anatomical dead space

37
Q

What is the normal physiological dead space?

A

150ml

38
Q

What is the conducting zone?

A

No gas exchange happens (anatomical dead space). Includes trachea, bronchi, pharynx etc.

39
Q

What is the respiratory zone?

A

Part involved involved in exchange - alveoli mainly (air reaching here is equal to alveolar ventilation)

40
Q

How can dead space be increased?

A

With ventilation - tubes become dead space

41
Q

How can dead space be decreased?

A

Tracheostomy - removing some of the airway

42
Q

How is a volume-time curve plotted?

A

Patients wear nose clip, inhale and then in mouthpiece expire as fast and hard as possible until RV reached (6 seconds)

43
Q

What would a volume-time curve for a healthy person look like?

A

Initially the slope is very steep but then it is hard to get rid of the remaining air

44
Q

What is the FEV1?

A

Volume of air expelled from the lungs in a second

45
Q

What is FVC?

A

The forced vital capacity - how much can be expired after a deep breath

46
Q

In a healthy person, what % of air is expelled in 1 second?

A

75

47
Q

What is FET?

A

Forced expiratory time - amount of time required to expel all of the air from the lungs

48
Q

How does obstructive lung disease affect FEV1, FET and FVC?

A

FEV1 and FVC lower and FET is higher

49
Q

What is a normal FEV1/FVC ratio compared to restrictive and obstructive?

A

normal - 73
restrictive - 87
obstructive - 53

50
Q

What factors affect lung volumes and capacities?

A
  • body size: height and shape
  • sex
  • disease: pulmonary or neurological
  • age: chronological or physical
  • fitness: innate and training
51
Q

At the end tidal expiration (FRC), what are the forces of the lungs and chest wall relative to eachother?

A

In equilibrium - this is the resting position

52
Q

At rest, what is normal Palv, Patm and Ppl?

A

Patm: 0
Palv: 0
Ppl: -5 cmH20

53
Q

At the end of inspiration, what must happen to Palv?

A

must return to 0 or breathing would continue

54
Q

Give an analogy of the movement of the diaphragm and respiratory muscles

A

diaphragm - syringe (pulls in one direction)

respiratory muscles - like bucket handle (swings upwards and outwards)

55
Q

On volume -time curves, what things can be looked for?

A
  • FVC: full to as empty as possible
  • FEV1: tells you about airways thickness e.g. constricted means less air comes out
  • FET: expiratory time
56
Q

What happens during emphysema?

A

surface area is lost

57
Q

How is peak expiratory flow measured?

A

nose clip, inhales, exhale as hard and fast as possible. Exhalation doesn’t have to reach RV. Can compare to normal values

58
Q

Flow volume loops - most modern as everything incorporated into one

A

nose clip, complete one tidal breath (A+B), inhale to TLC (C), exhale as hard and fast as possible (D), continue exhaling till RV reached (E). Then inhale to TLC (F).

59
Q

What does the y axis and x axis mean on a flow volume loop?

A

Y AXIS - FLOW RATE
Anything going down is negative flow rate -
inspiration. Anything going up is expiration.

X AXIS - VOLUME

60
Q

What does the flow volume loop look like in a person with mild obstructive lung disease?

A

Peak is lower, coving (indentation in expiratory curve towards end), displaced to the left

61
Q

What does the flow volume loop look like in a person with severe obstructive lung disease?

A

lower peak, displaced to left and coving is worse (compared to mild obstructive)

62
Q

What does the flow volume loop look like in a person with restrictive lung disease?

A

displaced to right and smaller loop

63
Q

How does an extrathoracic obstruction affect the flow volume loop and why?

A

causes a flattening of the inspiratory curve - affects ability to breathe in

64
Q

What happens to an extrathoracic obstruction when breathing in and out?

A

inspiration - sucked in

expiration - pushed away

65
Q

What happens to an intrathoracic obstruction when breathing in and out?

A

inspiration - pushed away

expiration - sucked in

66
Q

How does an intrathoracic obstruction affect the flow volume loop and why?

A

flattening of the expiratory curve - affects ability to breathe out

67
Q

How does a fixed airway obstruction affect the flow volume loop and why?

A

blunted inspiratory and expiratory curve

68
Q

During inspiration how must the equilibrium between the chest and lung be distorted?

A

inspiratory muscle effort and chest recoil> lung recoil

69
Q

During expiration how must the equilibrium between the chest and lung be distorted?

A

expiratory muscle effort and lung recoil> chest recoil

70
Q

Between the pleura what kind of pressure exists and what causes it?

A

There is small negative pressure caused by lung inward recoil and chest outward recoil

71
Q

What is parenchyma in the lung tissue?

A

functional units - alveoli and the respiratory bronchioles (have some alveoli along their walls)

72
Q

What are the two main things the lungs consist of?

A

Airways and parenchyma

73
Q

How does restrictive lung disease affect FVC, FET and FEV1?

A

It limits the expansion of the thorax so FVC, FEV1 is low and FET is low (have less air in so can move it faster)

74
Q

Give examples of obstructive lung disease

A

Chronic obstructive pulmonary disease (COPD - inc chronic bronchitis and emphysema)
Asthma
Bronchiectasis
Cystic Fibrosis

75
Q

Give examples of restrictive lung diseases

A 
Interstitial lung disease
Sarcoidosis
Pulmonary fibrosis
Asbestosis
Silicosis

Respiratory (23 decks)

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