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BRS > ventilation and airways > Flashcards

ventilation and airways Flashcards

1
Q
  • What is the difference between hyperventilation and tachypnoea?
A

Tachypnoae- Abnormally fast breathing rate

Hyperventilation - Excessive ventilation of the lungs atop of metabolic demand (results in reduced PCO2 - alkalosis)

So the difference lies in the decrease in CO2 and therefore the increase in pH
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2
Q

What is the inspiratory reserve volume?

What is the expiratory reserve volume?

What is the Tidal volume?

A

extra volume of air that can be inspired with maximal effort after reaching the end of a normal, quiet inspiration

amount of extra air above normal volume that is exhaled during a forceful breath out

Volume of each breath as measured during inspiration or expiration or averaged for the entire respiratory cycle

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3
Q

What is the Residual volume?

What is the inspiratory capacity?

What is the functional residual capacity?

A

air remaining in lung that holds lung structure to prevent collapsing

Maximum volume of air that can be inspired after reaching the end of a normal, quiet expiration

Volume of air present in the lungs at the end of passive expiration

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4
Q

What is the Vital capacity?

what is the total lung capacity?

A

Pink = Vital capacity - greatest volume of air that can be expelled from the lungs after taking the deepest possible breath

Black = Total lung capacity - volume of air present in the lungs upon maximum effort of inspiration
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5
Q
  • Why is there a residual volume?
A

Because the lungs hold their structure together to prevent them from collapsing

The residual volume functions to keep the alveoli open even after maximum expiration

In healthy lungs, the air that makes up the residual volume is utilized for continual gas exchange to occur between breaths
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6
Q
  • What is the minute ventilation and how would you calculate this?
A

Gas entering and leaving the lungs (L/min)

Tidal volume x Breathing frequency
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7
Q
  • What is the average minute ventilation of a 70Kg healthy male?
  • What is alveolar ventilation and how would you calculate this?
A

6 L/min

Gas entering and leaving the alveoli
(Tidal volume - Dead space) x Breathing Rate
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8
Q
  • What are the factors affecting lung volumes and capacities?
A

Body and Size - The taller someone is, the larger their lungs (weight is not a factor)

Sex - Average male has larger lung volume than the average female

Disease - Can cause breakdown of the tissue inside

Age - Older you are, lower the lung volume

Fitness -If you have athletic parents, you are more likely to have larger lungs than someone w/o them

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9
Q
  • What is meant by dead space?
  • What is anatomical dead space?
  • What is alveolar dead space?
A

Volume of air that does no participate in gas exchange

Volume of air located in the respiratory tract segments that are responsible for conducting air to the alveoli and respiratory bronchioles but do not take part in process of gas exchange

Sum of the volumes of the alveoli which have little or no blood flowing through their adjacent pulmonary capillaries

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10
Q
  • What are the 2 main areas of dead space found in the bronchi?
A

Conducting zone (anatomical dead space)

Non-perfused parenchyma (alveolar dead space)
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11
Q
  • What volume can the conducting zone typically carry in and out for adults at FRC (Functional Residual Capacity)?
  • Can gas exchange occur in the repiratory zone?
A

150ml

Yes, Air reaching here is equivalent to alveolar ventilation
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12
Q
  • In adults, typically how much air can the repiratory zone carry in and out?
  • What is meant by parenchyma?
A

350 ml

The functional tissue of an organ as distinguished from the connective and supporting tissue
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13
Q
  • What is considered the alveolar dead space in the lungs?

- How would you calculate the physiological dead space?

A

Non-perfused parenchyma
Alveolar is without blood supply, therefore no gas exchange

Anatomical + alveolar dead space
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14
Q
  • How do you reversibly increase the amount of dead space?

- How could you reversibly decrease the amount of dead space?

A

Intubation
Anything above the mouth would then be dead space as gas exhange cannot occur in those areas

Tracheostomy/cricothyrocotomy
Reduces the amount of air passing through the conducting zone
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15
Q
  • Why are the lung-chest forces at equilibrium at FRC?

- During inspiratory muscle effort, which is higher, the chest or lung recoil?

A

The chest recoil = lung recoil
Where the ribcage naturlly recoils outwards and the lungs naturally recoil inwards

Chest recoil
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16
Q
  • When lung recoil is higher than chest recoil, what process does this lead to?
  • What is the membrane surrounding the lungs called?
  • What is the membrane covering the inner surface of the chest wall called?
A

Expiration

Visceral pleural membrane

Parietal pleural membrane
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17
Q
  • What is meant by the pleural cavity?

- What does the pleural cavity contain?

A

The gap between the pleural membranes which is a fixed volume

Protein-rich pleural fluid
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18
Q
  • How does intrapleural bleeding affect the the ability the person has to ventilate and what is it called when this happens?
  • When you have a perforated chest wall or punctured lung, what happens to the lungs?
A

Reduces it, Haemothorax

The lung will collapse on itself as it recoils into its preferred position due to the leakage of the pleural cavity, this makes it very difficult to be able to ventilate
19
Q
  • How does negative pressure breathing occur?

- How does positive pressure breathing occur?

A

Diaphragm is pulled down and the rib cage is pulled out, this reduces the alveolar pressure to below the atmospheric pressure, This allows flow into the lungs

When the pressure in the atmosphere is increased to above the alveolar pressure and so air is forced out of the lungs down the pressure gradient
20
Q
  • Give examples of positive pressure breathing
A

Recussitation - CPR

CPAP - Continuous Positive Airway Pressure

Mechanical Ventilation

Fighter pilots use +ve airway pressures due to G-Force speeds
21
Q
  • Why is there a negative pleural pressure?

- What is meant by a transmural pressure?

A

The ribcage is naturally recoiling outwards whereas the lungs recoil inwards, creating a negative pressure in the pleural cavity

Refers to the pressure inside relative to outside of a compartment
22
Q
  • What process does a negative and a positive transrespiratory pressure lead to respectively?
  • How do you calculate the transrespiratory system pressure?
A

Negative -Inspiration, Positive - Expiration

P(alveolar) - P(atmospheric)

23
Q
  • Describe the action of the muscle forces during inspiration
A

Diaphragm contracts, creating a pulling force in one direction

The external intercostal muscles contract, pulling the ribcage in an upwards and outwards direction
24
Q
  • Describe what Dalton’s Law shows
A

The pressure of a gas mixture is equal to the sum of the partial pressures of gases in that mixture

25
Q
  • Describe what Fick’s Law shows
A

Molecules diffuse from regions of high conc. to low conc. at a rate proportional to the conc. gradient (P1-P2), the exchange surface area (A) and the diffusion capacity (D) of the gas, and inversely proportional to the thickness of the exchange surface (T)

26
Q
  • Describe what Henry’s Law shows
A

At a constant temperature, the amount of a given gas that dissolves in a given type and volume of liquid is directly proportional to the partial pressure of that gas in equilibrium with that liquid

27
Q
  • Describe what Boyle’s Law shows
A

At a constant temperature, the volume of a gas is inversely proportional to the pressure of that gas

28
Q
  • Describe what Charles’ Law shows?
A

At a constant pressure, the volume of a gas is proportional to the temperature of that gas

29
Q
  • Describe the process of Haemoglobin Cooperativity?
A

Once an oxygen molecule binds to Hb, the structure of Hb is altered so that another oxygen molecule is more likely to bind and this continues until all four binding sites have been occupied

30
Q
  • What role does 2,3-DPG play in the role of Haemoglobin?
A

It is a metabolic product so it is found at sites where there is more respiration occurring and therefore a higher demand of oxygen

Once more oxygen molecules have bound to the Hb molecule, 2.3-DPG is more likely to bind to the Hb and this facilitates the unloading of oxygen
31
Q
  • What type of protein could Haemoglobin be described as?

- Is it possible to interpret the oxygen levels from the saturation of oxygen in the blood and the bpm?

A

Allosteric protein

No, you cannot interpret without knowing what the Hb levels are
32
Q
  • In what conditions would there be a right shift of the oxygen dissociation curve?
A 
^ Temperature
    Acidosis
    Bohr effect
    Hypercapnia - build up of carbon dioxide in your bloodstream, affects people 
    with COPD
    increased 2,3-DPG
    occurs during exercise
33
Q
  • In what conditions would there be a left shift of the oxygen dissociation curve?
A

Decreased Temperature

Alkalosis

Hypocapnia

Decreased 2,3-DPG
34
Q
  • In what conditions would there be an upwards shift of the oxygen dissociation curve?
  • In what conditions would there be a downwards shift of the oxygen dissociation curve?
A

Polycythaemia - Increased oxygen-carrying capacity due to more RBCs

Anaemia - Impaired oxygen-carrying capacity
35
Q
  • What type of shift would carbon monoxide cause in the oxygen dissociation curve?
A

Downwards and Leftwards

Decreased capacity as oxygen cannot bind to the spcaes occupied by carbon monoxide

Increased affinity for carbon monoxide and so there is less unloading
36
Q
  • What type of shift does Foetal Hb show in the oxygen dissociation curve?
  • What type of shift does Myoglobin show in the oxygen dissociation curve?
A

Left shift- Greater affinity than adult HbA to ‘extract’ oxygen from the mother’s blood in the placenta as they are parasites

Far Left shift- Much greater affinity than adult HbA to 'extract' oxygen from the circulating blood and store it
37
Q
  • Why is there a decrease in partial pressure of oxygen in the blood unloaded at the tissues from when it was loaded in the lungs?
  • What is meant by the oxygen flux?
A

The venous bronchial circulation dumps blood with less oxygen into it and this dilutes the blood

The change in the oxygen content in the blood after it has unloaded oxygen to a respiring cell
38
Q
  • What makes Hb a good buffer in red blood cells?

- Why is the oxygen flux not the same as the carbon dioxide flux?

A

Binds to the protons from when carbonic acid disociates and this enables the pH inside to stay stable

Water is produced as a by-product of the respiration occurring in the cells that blood unloads to
So carbon dioxide flux is less than oxygen flux
39
Q
  • Is the gas exchange time for carbon dioxide less or more than that for oxygen at the alveoli?
A

Less

40
Q
  • How are the characteristics of air modified as it passes down the respiratory tree?
  • Why is there at higher pC02 and a lower p02 at the lungs than what was inhaled?
A

It is warmed, humidified, slowed and mixed

Partial pressure of Oxygen decreases when it gets to the respiratory airways because there was already air here, with low 02 (as it has been used) and high C02 (that needs to be expired

so there is a higher partial pressure of Carbon Dioxide and a lower partial pressure of Oxygen

41
Q
  • At rest, how much oxygen is needed by your body?
A

250ml/min

42
Q
  • Why is there a decrease in partial pressure of oxygen in the blood unloaded at the tissues from when it was loaded in the lungs?
A

The venous bronchial circulation dumps blood with less oxygen into it and this dilutes the blood

43
Q

how does the partial pressure of oxygen, carbon dioxide and water change going from dry air to conducting airway to respiratory airway?

A

conducting airway

  • oxygen, decreases
  • c02, same
  • water, increases (humidified here)

respiratory airway

  • oxygen, decreases
  • c02, increases (mixes with air in lung here)
  • water, same

BRS (41 decks)

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