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BRS Cardio & Respiratory > Ventilation and Gas Exchange > Flashcards

Ventilation and Gas Exchange Flashcards

1
Q

What is minute ventilation?

A

The volume of air expired in one minute (VE) or per minute (V”E)
Gas entering and leaving the lungs

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2
Q

What is respiratory rate?

A

The frequency of breathing per minute (Rf)

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3
Q

What is alveolar ventilation?

A

The volume of air reaching the respiratory zone per minute (Valv)
Gas entering and leaving the alveoli

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4
Q

What is respiration?

A

The process of generating ATP either with an excess of oxygen (aerobic) and a shortfall (anaerobic)

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5
Q

What is anatomical dead space?

A

The capacity of the airways incapable of undertaking gas exchange

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6
Q

What is alveolar dead space?

A
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7
Q

What is physiological dead space?

A

Equivalent to the sum of alveolar and anatomical dead space

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8
Q

What is hypoventilation?

A

Deficient ventilation of the lungs; unable to meet metabolic demand (increased PO2 – acidosis)

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9
Q

What is hyperventilation?

A

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

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10
Q

What is hyperpnoea?

A

Increased depth of breathing (to meet metabolic demand)

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11
Q

What is hypopnoea?

A

Decreased depth of breathing (inadequate to meet metabolic demand)

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12
Q

What is apnoea?

A

Cessation of breathing (no air movement)

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13
Q

What is dyspnoea?

A

Difficulty in breathing

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14
Q

What is bradypnoea?

A

Abnormally slow breathing rate

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15
Q

What is tachypnoea?

A

Abnormally fast breathing rate

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16
Q

What is orthopnoea?

A

Positional difficulty in breathing (when lying down)

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17
Q

What is alveolar dead space?

A

Capacity of the airways that should be able to undertake gas exchange but cannot (e.g. hypoperfused alveoli)

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18
Q

What is represented on a time (s) to lung volume (ml) graph? (8)

A

Inspiratory reserve volume
Tidal volume
Expiratory reserve volume
Residual volume
Functional residual capacity
Inspiratory capacity
Vital capacity
Total lung capacity

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19
Q

What are volumes on the time/volume graphs?

A

they are discrete sections of the graph and don’t overlap

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20
Q

What are capacities on the time/volume graphs?

A

they are the sum of 2 or more volumes

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21
Q

What is vital capacity?

A

the air you have access to

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22
Q

What is tidal volume?

A

it starts at the default reference point of the graph

It is not just about rest, it is how much you need in that given time
- e.g., during exercise it increases

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23
Q

What happens during functional capacity?

A

where lung recoil and chest recoil are same effort

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24
Q

Why is there residual volume?

A

due to mechanical properties of the lungs

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25
Q

What is the expiratory reserve volume?

A

what you can get out after a normal breath

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26
Q

Why is there this weird descent on the blue line, when taking max inspiratory and expiratory effort?

A

because a person requires a couple seconds to reach maximum and minimum

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27
Q

When testing someone’s breathing to put on the graph, what are the 3 stages encountered?

A

Light respiratory effort
Max inspiratory effort
Max expiratory effort

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28
Q

How do you calculate minute ventilation?

A

Minute ventilation (L/min)
= tidal volume (L) x breathing frequency (breaths/min)

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29
Q

How do you calculate alveolar ventilation?

A

alveolar ventilation (L/min)
= (tidal volume (L) - dead space (L)) x breathing frequency (breath/min)

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30
Q

What are the factors affecting lung volumes and capacities?

A

Body size (not really mass, mostly height)

Fitness (innate, training)

Age (chronological, physical)

Disease (pulmonary, neurological)

Sex (male, female)

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31
Q

What is the respiratory zone?

A

7 generations
Gas exchange
Air reaching here is equivalent to alveolar ventilation

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32
Q

What is the conducting zone?

A

16 generations
No gas exchange
Typically 150 mL in adults at FRC (functional residual capacity)
Equivalent to anatomical dead space

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33
Q

What is the non-perfused parenchyma?

A

Alveoli without a blood supply
No gas exchange
Typically 0 mL in adults
Called alveolar dead space

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34
Q

What procedures can decrease the normal volume of dead space?

A

tracheostomy
cricothyrotomy
(they decrease airway space)

35
Q

What procedures can increase volume dead space?

A

anaesthetic circuit (extending tube)
snorkelling

bronchodilation increases dead space

36
Q

What is the chest wall relationship with the lungs?

A

The chest wall has a tendency to spring outwards, and the lung has a tendency to recoil inwards

These forces are in equilibrium at end tidal expiration (functional residual capacity; FRC), which is the ‘neutral’ position of the intact chest.

37
Q

What combination results in inspiration?

A

inspiratory muscle effort + chest recoil > lung recoil

38
Q

What combination results in expiration?

A

lung recoil + expiratory muscle effort > chest recoil

39
Q

describe the chest wall anatomy.

A

The lungs are surrounded by a visceral pleural membrane

The inner surface of the chest wall is covered by a parietal pleural membrane

The pleural cavity (the gap between pleural membranes) is a fixed volume and contains protein-rich pleural fluid

40
Q

What fluid do the pleuras have to benefit the lungs?

A

Parietal pleura and visceral pleura have serous fluid to lubricate

41
Q

What does the pressure gradient help with the flow?

A

drive it

42
Q

What is normal breathing in terms of pressure?

A

negative pressure breathing

43
Q

What are the types of breathing in terms of pressure, and how do they correlate to Palv and Patm?

A
44
Q

What are examples of negative pressure breathing?

A

mechanical ventilation
CPR
Fighter pilots

45
Q

What is the result of the inspiratory muscle the diaphragm?

A

it is like a syringe, a pulling force in one direction
diaphragm induced breathing

46
Q

What is the effect of the other respiratory muscles?

A

it is like a bucket handle
an upwards and outwards swinging force

47
Q

Do you know what the symbols
P
F
S
C
Hb
mean?

A
48
Q

How can you describe the pleural cavity?

A

a partial vacuum

49
Q

What does maximum ventilation involve?

A

full inspiratory muscle recruitment (syringe and bucket handle movement)

50
Q

What is Dalton’s law that describes gas behaviour?

A

Pressure of a gas mixture is equal to the sum (Σ) of the partial pressures (P) of gases in that mixture

𝑷𝑮𝒂𝒔 𝒎𝒊𝒙𝒕𝒖𝒓𝒆 = #𝑷𝑮𝒂𝒔𝟏 + 𝑷𝑮𝒂𝒔𝟐 + ⋯ + 𝑷𝑮𝒂𝒔𝒏

51
Q

What is Fick’s law that describes gas behaviour?

A

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

52
Q

What is Henry’s law that describes gas behaviour?

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

53
Q

What is Boyle’s law that describes gas behaviour?

A

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

54
Q

What is Charle’s law that describes gas behaviour?

A

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

55
Q

What is the percentage of each gas in the air and their partial pressures (relatively) ?

A
56
Q

What is the most soluble gas in the air?

A

CO2 (by a lot)

57
Q

How much is a patient breathing of each gas at high altitudes, idea wise?

A

still 21% O2 and 78% nitrogen, etc. but it is proportional, so there is just less of the air overall

58
Q

What is your patient breathing in a smoke (house fire)?

A

lot more CO2, more CO, less O2

59
Q

What can increase your oxygen intake?

A

oxygen therapy

60
Q

How is inspired gas modified in the airways?

A

warmed, humidified, slowed and mixed as air passes down the respiratory tree

61
Q

What is the difference ,idea wise, in the partial pressures of O2, CO2, and H2O as it goes down the airway?

A

Dry air at sea level…

conducting airways…

Respiratory airways…

62
Q

What is the total O2 delivery ar rest?

A

about 16 mL.min-1

63
Q

What is resting VO2?

A

It is approximately 250 mL.min-1

  • so obviously relying on dissolved oxygen alone is not conducive with life
  • so we have more effective transport mechanisms
64
Q

What is haemoglobin structure like?

A

Haemoglobin monomers consist of a ferrous iron ion (Fe2+; haem- ) at the centre of a tetrapyrrole porphyrin ring connected to a protein chain (-globin); covalently bonded at the proximal histamine residue

65
Q

What type of protein is Hb?

A

al allosteric protein

66
Q

How does Hb bind to oxygen?

A

reversibly
- binding to one makes it more accepting, have a greater affinity for O2
- that is why it has a sigmoid shape
- quaternary shape changes to reveal a binding site

67
Q

Is saturation enough to know if someone is ok, I.e., they have high saturation?

A

No, it is important to know the amount of Hb because blood can still be very saturated you just don’t have a lot of Hb.

68
Q

What does an Oxygen dissociation curve look like?

A
69
Q

What can cause a leftward shift in the dissociation curve?

A

increased affinity loading

70
Q

What can cause a rightward shift in the dissociation curve?

A

decreased loading

71
Q

What does hypercapnia entail?

A

increased CO2

72
Q

What can cause an upward or downward shift in the dissociation curve?

A

assume 20 is normal Hb

73
Q

What happens when there is CO in the dissociation curve?

A

Unloading of O2 is harder

74
Q

What happens to the dissociation curve with foetal haemoglobin and myoglobin?

A
75
Q

Where is myoglobin found?

A

in our skeletal muscle for high intensity low time stuff

76
Q

What is the transit time for gas exchange?

A

0.75s

77
Q

What does fick state affects gas exchange?

A

partial pressure gradient, surface area, diffusion capacity, membrane thickness

78
Q

How is carbon dioxide transported pt.1, what are the reactions it has and where do they occur?

A
79
Q

How is carbon dioxide transported pt.2, the chloride shift?

A
80
Q

How is carbon dioxide transported pt.3, the total CO2 flux?

A
81
Q

How is O2 transported around the blood % wise?

A

2% in solution, roughly 98% bound to hb

82
Q

How is CO2 transported around the blood?

A

as bicarbonate molecules (HCO3-) and as carbamino compounds (e.g., HbCO2)

83
Q

What is the shape of the oxygen dissociation curve?

A

sigmoid shape

BRS Cardio & Respiratory (28 decks)

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