Ventilation Flashcards

1
Q

Tidal volume

A

. Vt = VD + alveolar ventilation
. VD = dead space
. 500 mL of air that enters body w/ each inspiration
. Volume of gas inspired or expired in a single respiratory cycle

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2
Q

Respiratory quotient

A
. Ratio of CO2 produced to O2 consumed 
. RQ = VCO2/VO2
. Varies w/ the foods consumed 
. Average VO2: 250 ml/min 
. Average VCO2: 200 ml/min 
. Average RQ: 0.8
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3
Q

Minute volume

A

. Amount of air exhaled per minute
. VE = Vt x n
. Vt: tidal volume
.n= respiratory rate

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4
Q

Dead space

A

. Within each tidal volume there is a volume of gas that does not participate in gas exchange
. Nonfunctional air in terms of diffusion of O2 and CO2
. Primarily is the volume of air contained in the conducting airways that do not do gas exchange
. Every pound of weight gives 1 ml of dead space

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5
Q

Alveolar ventilation

A

. Alveolar ventilation = VA x n
Alveolar ventilation = VE - VD
. Alveolar ventilation = VCO2/PaCO2
. VA = alveolar volume: amt. of air entering lungs w/ each inspiration that participates in gas exchange
. VE = minute ventilation
. VD = dead space
.n= respiratory rate
. VCO2 = volume of CO2 expired per unit time
. PaCO2= partial pressure of CO2 in arterial blood

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6
Q

T/F the partial pressure of CO2 of alveolar gas and arterial blood CO2 are identical

A

T

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7
Q

T/F changing alveolar ventilation via hyper or hypoventilation will change arterial blood gases

A

T

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8
Q

Anatomic dead space

A

. Volume of air contained w/in pharynx, larynx, and conducting airways
. Much greater than alveolar dead space
. Normally 150 ml

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9
Q

Alveolar dead space

A

. Volume of air w/in unperfused alveoli

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10
Q

Physiologic dead space

A

. Anatomic dead space + alveolar dead space
. Functional measurement
. In normal subject the anatomic and physiologic dead space is usually the same, but physiologic dead space can be much greater than anatomic in someone w/ lung disease

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11
Q

Fowler’s method

A

. Measure of anatomic dead space
. Single breath pure O2 inspired to total lung capacity
. Then conc. Of N2 gas of subsequent exhalation is measured w/ rapid nitrogen analyzer
. Initial portion of exhaled air has anatomic dead space and contains no N2
. As exhalation continues the N2 conc. Rises and is mix of anatomic dead space and alvolar gas
. Plateau at uniform N2 conc. Represents our alveolar gas
. Plotted on graph w/ phase II divided w/ vertical line, anatomic dead space is phase I plus volume of phase II up to vertical line

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12
Q

Bohr’s equation function

A

. Measured physiologic dead space
. Determines fraction of tidal volume that doesn’t participate in gas exchange and contributed to “washed” ventilation
. Normal physiologic dead space to tidal volume ration os 0.2- 0.35

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13
Q

How to examine static lung volume

A

. . Spirometer
. Measures volume of air breathed out
. Can’t measure RV, FRC, TLC, and anatomic dead space

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14
Q

Inspiratory reserve volume (IRV)

A

. Max volume of gas that can be inspired starting at the end of normal inspiration
. Typically 3000 ml

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15
Q

Expiratory reserve volume (ERV)

A

. Max volume of gas that can be expired starting from the end of normal expiration
. Normally 1100 ml

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16
Q

Residual volume (RV)

A

. Volume of gas that remains in lungs after a max expiration
. Normally 1200 ml

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17
Q

Forced expiratory volume (FEV1)

A

. Max amount of gas that can be expired in the 1st second of a FVC following a max inspiration
. Typically 3800 ml
. Can be expressed as percentage of FVC (FEV1/FVC)
. Normally 0.8

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18
Q

Total lung capacity (TLC)

A

. Total amount of gas in lungs at end of maximum inspiration (sum of all 4 lung volumes)
. RV+ ERV+ Vt+ IRV
. Typically 5800 ml

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19
Q

Vital capacity (VC)

A

. Max volume of gas that can be expired after max inspiration (ERV +Vt + IRV)
. Typically 4600 ml

20
Q

Functional residual capacity (FRC)

A

. Amount of gas in lungs at end of normal expiration
. ERV+RV
. Typically 2300 ml

21
Q

Forced vital capacity (FVC)

A

. Amount of gas that can be expelled from the lungs by expiring as forcibly possible after a maximum inspiration
. Typically under 4600 ml

22
Q

Measurement of FRC

A

. Spirometer w/ He dilution
. Can then determine RV and TLC
. When He is inspired, it remains in lungs bc it is blood insoluble
. Measure FRC: patient breathes in air w/ known air volume and known He conc.
. Patient breathes a few breathes, the He molecules are contained Volume w/in spirometer plus volume w/in lungs
. This causes He to have new concentration
. FRC = (V1C1)/C2 - V1

23
Q

Airflow

A

. Airflow in a tube is equal to the pricing pressure in the tube divided by resistance (Ohm’s)
. Vdot = P/R
. Driving pressure of airflow during respiration is generated by muscles of inspiration working in conjunction w/ recoil forces of lung

24
Q

Poiseuille’s Equation

A
. Vdot = (P(pi)r^4)/8nl
. Vdot: airflow 
. P: driving pressure 
. R: tube radius 
.n: viscosity 
.l: length of tube
. Airflow directly proportional to 4th power of tube radius 
. Directly proportional to driving pressure 
. Inversely proportional to viscosity
. Inversely proportional to length
25
Q

Equation for resistance in respiratory system

A

R = P/V = 8nl/(pi)r^4
. Directly proportional to viscosity
. Directly proportional to length
. Inversely proportional to the 4th power of tube radius

26
Q

Turbulent flow of air

A

. Disorganized flow w/ no smooth sheets of flow
. Needs greater driving pressure
. May occur in trachea, esp. when flow velocities are high

27
Q

Laminar flow in respiratory system

A

. Parabolic profile
. Smooth flow
. Only occurs in very small airways

28
Q

Transitional flow in respiratory system

A

. Mix of turbulent and laminar flows

. Occurs in most of the bronchial tree

29
Q

Resistance to airflow down the bronchial tree

A

. Airway resistance peaks w/in medium sized bronchi
. Very small bronchioles contribute little airway resistance due to total cross sectional area of airways inc. very rapidly w/ airway branching
. As total airway cross sectional area inc., air resistance dec.

30
Q

Effect of volume of dynamic airway resistance

A

. During inspiration, lung volume inc. towards TLC and lung tissue exerts radial traction forces on airways to stretch them open and airway resistance dec. (opposite at low lung volumes)

31
Q

Parasympathetic control on airway smooth muscle

A

. Bronchocontriction
. Inc. airway resistance
. Has greatest influence on airway smooth muscle tone

32
Q

Sympathetic control of airway smooth muscle

A

. Produces bronchodilation
. Dec. airway resistance
. Use E and NE reacting w/ beta-2 adrenergic receptors
.

33
Q

Mast cell control of airway smooth muscle

A

. Located in CT underlying smooth muscle
. Release histamine and leukotrienes that constrict muscles producing bronchoconstriction
. Histamine binds to H1 receptors
. Both histamine and leukotrienes inc. prostaglandin production

34
Q

Psotaglandin effect on airway smooth muscle

A

. E causes dilation

. F-2alpha causes contraction

35
Q

How does smoke, dust, and SO2 effect airway smooth muscle

A

. Initiates release of ACH from efferent parasympathetics to cause constriction
. Binds to irritant receptors w/in airway submucosa

36
Q

FEV1 in restricted lung diseases

A

. Pulmonary fibrosis
. Both FEV and FVC are reduced
. FEV1/FVC may be normal or increased

37
Q

FEV1 in obstructive diseases

A

. Bronchial asthma
. FEV1 is reduced much more than FVC
. Dec. FEV1/FVC
. If less than 0.6 then it indicated moderate airway obstruction
. Less than 0.4 indicates severe airway obstruction

38
Q

Forced expiratory flow rate (FEF)

A

. Measured over middle half of FVC (btw 25-75% of vital capacity)

39
Q

FEF in obstructive lung diseases

A

. Deceased
. Decrease is proportional to severity of obstruction
. Time required to expel vital capacity is prolonged

40
Q

Obstructive lung disease

A

. Inc. in airway resistance
. Asthma, bronchitis, emphysema CF, sarcoidosis(granulomas of airway) seen below carina
. Above carina: foreign body, croup/tracheitis, epiglottitis, tumors, neuromuscular disease/parkinson)

41
Q

Asthma

A

. Inc. responsiveness of airway smooth mm. To stimuli causing widespread narrowing of airways
. Bronchoconstriction is reversible spontaneously or after treatment

42
Q

Bronchitis

A

. Prolonged exposure to bronchial irritants that leads to airway obstruction
. May involve hypersecretion of mucous and/or hypertrophy of smooth mm.

43
Q

Emphysema

A

. Destruction of lung parenchyma

. Results in reduction of radial traction w/in small airways and enlargement of alveoli

44
Q

Restrictive diseases

A

. Expansion of lung is restricted from alterations in lung parenchyma of pleura disease, chest wall, or neuromuscular apparatus
. Reduced VC but airway resistance is not inc.
. Examples: MG, guillain barre, pleural effusion, flail chest/broken ribs, massive obesity, diaphragm paralysis

45
Q

Pulmonary fibrosis

A

. Thickening of interstitial spaces
. Cause inc. radial traction w/in small airways
.dec. airway resistance