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Cardiovascular & Respiratory Medicine > 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 or per minute

volume of air entering and leaving the lungs

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2
Q

What is the respiratory rate RF?

A

-the frequency of breathing per minute

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3
Q

What is the alveolar ventilation (Valv)?

A
  • the volume of air reaching the respiratory zone per minute

- (volume of air 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 the 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

-the capacity of the airways should be able to undertake gas exchange but cannot (e.g hypoperefused alveoli)

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7
Q

What is the 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- unable to meet demands (increased PO2- acidosis)

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9
Q

What is hyperventilation?

A

-excessive ventilation

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 hypopnea?

A

-decreased depth of breathing

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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

-difficult 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

How is minute ventilation calculated and units?

What is normal?

A

tidal volume (L) x breathing frequency (breaths/min)

L/min

6 L/min

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18
Q

How is alveolar ventilation calculated and units?

What is normal?

A

(tidal volume (L) - dead space (L) ) x breathing frequency (breaths/min)

4.2 L/min

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19
Q

What 5 factors affect lung volume and capacities?

A
  • body size
  • fitness
  • sex
  • disease (pulmonary, neurological)
  • age
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20
Q

What is the conducting zone?

A
  • 16 generations
  • no gas exchange
  • typically 150ml in adults at FRC (functional residual capacity)
  • equivalent to anatomical dead space
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21
Q

What is equivalent to the anatomical dead space?

A

-the conducting zone

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22
Q

What is the respiratory zone?

A
  • 7 generations
  • gas exchange
  • typically 350 ml in adults
  • air reaching here is equivalent to alveolar ventilation
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23
Q

What is non-perfused parenchyma?

A
  • alveoli without a blood supply
  • no gas exchange
  • typically 0ml in adults
  • called alveolar dead space
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24
Q

Which area is called the alveolar dead space?

A

-the non-perfused parenchyma

25
Q

What is the physiological dead space?

A

-anatomical + alveolar dead space

26
Q

How can you decrease the volume of dead space?

A
  • tracheostomy (making hole to place tube)

- cricothyrocotomy

27
Q

How can you increase the volume of dead space?

A
  • anaesthetic circuit

- snorkelling

28
Q

What is the chest wall relationship?

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
  • inspiration when inspiratory muscle effort + chest recoil > lung recoil
  • expiration when expiratory muscle effort + lung recoil > chest recoil
29
Q

When are the lung-chest forms at equilibrium?

A
  • at FRC

- chest recoil = lung recoil

30
Q

What is the inner surface of the chest wall covered by?

A

-the parietal pleural membrane

31
Q

What is the pleural cavity?

A
  • gap between the pleural membrane (visceral and parietal)

- fixed volume containing protein-rich pleural fluid

32
Q

What surrounds the lungs?

A

-visceral pleural membrane

33
Q

What happens in a haemothorax?

A

-intrapleural bleeding

34
Q

What happens in a pneumothorax?

A
  • perforated chest wall

- could be caused by punctured lung

35
Q

What is type of pressure breathing is normal breathing?

A

-negative

36
Q

What are some examples of positive pressure breathing?

A
  • mechanical ventilation
  • CPR
  • fighter pilots
37
Q

What is PTT?

A

-transthoracic pressure

= Ppl - Patm
cmH2O

38
Q

What is PTP?

A

-transpulmonary pressure

=Palv - Ppl
cmH2O

39
Q

What is is PRS?

A

-transrespiratory system pressure

= Palv - Patm
cmH2O

40
Q

What is Ppl?

A

-intrapleural pressure

cmH2O

41
Q

What will a negative PRS (trans-respiratory system pressure) lead to?

A

-inspiration

42
Q

What will a positive PRS (trans-respiratory system pressure) lead to?

A

-expiration

43
Q

How is inspired gas modified?

A

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

44
Q

What is HbA made of?

A
  • 2 alpha

- 2 beta

45
Q

What is HbA2 made of?

A
  • 2 alpha

- 2 delta

46
Q

What is HbF made of?

A
  • 2 alpha

- 2 gamma

47
Q

What type of protein is Hb?

A

-allosteric

48
Q

What causes a leftwards shift on the oxygen dissociation curve?

A

increased affinity (loading)

  • decrease in temperature
  • alkalosis
  • hypocapnia
  • decreased 2,3-DPG (in RBC determines the ease with which Hb releases oxygen into the tissues)
49
Q

What causes a rightwards shift on the oxygen dissociation curve?

A
  • increase in temperature
  • acidosis- bohr effect
  • hypercapnia (elevated CO2)
  • increased 2,3- DPG
50
Q

What causes an upwards shift on the oxygen dissociation curve?

A
  • polycythaemia

- increased oxygen-carrying capacity

51
Q

What causes a downwards shift on the oxygen dissociation curve?

A
  • anaemia

- impaired oxygen-carrying capacity

52
Q

What effect does carbon monoxide have on the oxygen dissociation curve?

A
  • downwards and leftwards shift
  • decreased capacity
  • increased affinity
  • increased HbCO
53
Q

Contrast the oxygen dissociation curves for myoglobin and HbA and foetal.

A

-myoglobin has much greater affinity than adult HbA and foetal Hb to extract oxygen from circulating blood and store it.

54
Q

How is carbon dioxide transported?

A

-CO2 + H2O -> H2CO3
H2CO3 -> H+ + HCO3-

CO2 into RBC
CO2 + H2O -> H2CO3 via carbonic anhydrase
H2CO3 -> H+ + HCO3-
negative chloride ions enter the RBC to maintain resting membrane potential via AE1 transporter
H2O enters RBC
CO2 + Hb -> HbCO2

55
Q

What effect will supplemental oxygen therapy have on the oxygen dissociation curve?

A
  • oxygen therapy will increase the partial pressure of oxygen, and increase concentration of dissolved oxygen
  • dissolved oxygen doesn’t really affect Hb saturation above 13 kPa
56
Q

What effect will blood doping have on the oxygen dissociation curve?

A
  • doping involves exogenous or autologous transfusion of RBCs to improve endurance performance
  • this would stretch the ODC upwards, but not right
57
Q

What effect will 30 mins sunbathing in 30 degrees have on the oxygen dissociation curve?

A
  • sunbathing in the heat has the potential to increase body temperature, but unlikely to have an effect
  • human are thermoregulatory
58
Q

What effect will uncontrolled type 1 diabetes have on the oxygen dissociation curve?

A

-uncontrolled diabetes may lead to diabetic ketoacidosis, and the increased acidity displaces the ODC rightwards

59
Q

lecture slides

A

https://d3c33hcgiwev3.cloudfront.net/X-Nfu2GaRfGjX7thmtXx1w_759626291f6740fe98f7685856c7a7ae_Final_SV_CVR_LE05Gas_transport_and_exchange.pdf?Expires=1582588800&Signature=JOGZvqOe9~rFdTr0AL2iO72HoAxguAqb6aW16oM-VE9fTJcbD3VcQjtlFuvV6uHLtGqWVHsGd5lnKq2lrhfXNudRRrQll-Kui4Aa4CN2TBsfG5hkKCFklDNIHtW5F2Y0zN6HndcOTXz~NitdyhMqlcU48fZYaimKo0DdpO9dT7s&Key-Pair-Id=APKAJLTNE6QMUY6HBC5A

Cardiovascular & Respiratory Medicine (15 decks)

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