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Cardiology > Ventilation and Gas Exchange > Flashcards

Ventilation and Gas Exchange Flashcards

1
Q

Define minute ventilation

A

The volume of air expired in one minute

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2
Q

Define respiratory rate

A

The frequency of breathing per minute

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3
Q

Alveolar ventilation

A

The volume of air reaching the respiratory zone

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4
Q

Define respiration

A

The process of generating ATP either with an excess of O2 (aerobic) or a shortfall (anaerobic)

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5
Q

Define anatomical dead space

A

The capacity of the airways incapable of undertaking gas exchange

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6
Q

Define alveolar dead space

A

Capacity of the airways that should be able to undertake gas exchange bu cannot
e.g. hyperperfused alveoli

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7
Q

Define physiological dead space

A

Equivalent to the sum of alveolar and anatomical dead space

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8
Q

Define Hypoventilation

A

Deficient ventilation of the lungs; unable to meet metabolic demand
Increased pCO2- acidosis

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9
Q

Define Hyperventilation

A

Excessive ventilation of the lungs atop pf metabolic demands
Reduces pCO2- alkalosis

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10
Q

Define Hyperpnoea

A

Increased depth of breathing (to meet metabolic demand)

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11
Q

Define Hypopnoea

A

Decreased depth of breathing (inadequate to meet metabolic demand)

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12
Q

Define apnoea

A

Cessation of breathing (no air movement)

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13
Q

Define dyspnoea

A

Difficulty in breathing

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14
Q

Define bradypnoea

A

Abnormally slow breathing rate

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15
Q

Define tachypnoea

A

Abnormally fast breathing rate

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16
Q

Define Orthopnoea

A

Positional difficulty in breathing (when lying down)

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17
Q

What are volumes?

A

Discrete sections of the graph and do not overlap

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18
Q

What are capacities?

A

Sum of two or more volumes

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19
Q

Quantify minute ventilation

A

Tidal Volume (L) x Breathing frequency

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20
Q

Quantify alveolar ventilation

A

(Tidal volume - Dead space) x Breathing frequency

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21
Q

What are the factors affecting lung volumes and capacities?

A 
Body size
Sex
Fitness
Age
Disease
Age
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22
Q

What are the two component of the chest wall?

A

Bone + muscle + fibrous tissue

Lungs

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23
Q

What is FRC?

A

Functional residual capacity

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24
Q

What is functional residual capacity?

A

When we are at the end of tidal expiration

Where the outward recoil of the rib cage and the elastic recoil lungs are in equilibrium

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25
Q

What is the pleural cavity?

A

Space in-between parietal and visceral pleura
Fixed volume
Contains protein-rich pleural fluid
At negative pressure

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26
Q

What does the negative pressure of the pleural cavity allow for?

A

Chest wall to pull lung down as the diaphragm moves down

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27
Q

What are the lungs surrounded by?

A

Visceral pleural membrane

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28
Q

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

A

Parietal pleural membrane

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29
Q

What happens if you get a puncture in the chest wall or lungs?

A

Fixed volume pleural cavity is compromised

Air will fill cavity, elastic recoil will take over and the lung will collapse

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30
Q

What is tidal breathing?

A

The amount of inspiration and expiration the meets metabolic demands
Normal breathing
Usually nasal

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31
Q

What happens to tidal breathing when you exercise?

A

Tidal volume increases

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32
Q

What does the end of a tidal breath mark?

A

Functional residual capacity

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33
Q

Why can you not empty the lungs completely?

A

Surfactant in the alveoli

You cannot empty the lungs fully because you don’t want the alveoli to stick together

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34
Q

What is the remaining volume known as?

A

Residual volume

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35
Q

What are the 4 main volumes?

A

Tidal Volume
Inspiratory reserve volume
Expiratory reserve volume
Reserve volume

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36
Q

What is TLC?

A

Total lung capacity
All volumes combined
When you inspire all the way in and fill your lungs up as much as possible

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37
Q

What is VC?

A

Vital Capacity
How much air is within the confines of what we are able to inspire and expire
TLC-RV

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38
Q

What is FRC?

A

Functional Residual Capacity
The volume of air in the lungs when the outwards recoil of the rib cage and the inward recoil of the lungs are in equilibrium
ERV+RV

39
Q

What is IC?

A

Inspiratory Capacity
How much extra air you can take in on top of the FRC
TV+IRV

40
Q

What drives flow?

A

Pressure gradient

41
Q

What units are used when talking about lung volumes?

A

cmH2O

42
Q

What is transmural pressure?

A

Pressure across a tissue or several tissues

43
Q

What is transpulmonary pressure?

A

Difference between alveolar and intrapleural pressure

44
Q

How do we normally breathe?

A

Using negative pressure breathing

45
Q

What is negative pressure breathing?

A

You inspire when there is lower pressure inside the lungs

46
Q

What is positive pressure breathing?

A

Involves increasing the pressure outside by using a ventilator or CPR

47
Q

Describe the process of ventilation

A

Start: no no transpulmonary pressure
The chest wall expands and creates negative pressure so more air flows in
This establishes a pressure gradient down which air flows
Eventually the pressure gradient will equalise again

48
Q

How can the effect of the diaphragm be described?

A

A syringe

Pulling force in one direction

49
Q

How can the effect of other respiratory muscles be described?

A

A bucket handle

An upwards and outwards swinging force

50
Q

What is dead space?

A

The part of the airways and lung that does to participate in gas exchange

51
Q

What is the conducting zone?

A

16 generations
No gas exchange
Typically 150ml in adults at FRC
Equivalent to anatomical space

52
Q

What is the respiratory zone?

A

7 generations
Gas exchange
Typically 150ml in adults
Air reaching here is equivalent to alveolar respiration

53
Q

What are non-perfused parenchyma?

A

Alveoli without blood supply
No gas exchange
Alveolar dead space
Generally 0ml in adults

54
Q

Why do lungs have a sigmoidal volume-pressure relationship?

A

To get an elastic lung to expand

The bigger the volume the more pressure is needed

55
Q

What is FVC?

A

Forced Vital Capacity

56
Q

What is FEV1?

A

The amount of air forced out of the lung in 1 second

57
Q

What is the % FEV1 in a healthy person?

A

75%

58
Q

What is FET?

A

Forced Expiratory Time

The time taken to expel all the air from the lungs

59
Q

What would be seen in an obstructive lung disease?

A

FEV1 would be much lower (can’t expel air fast)
FET is much higher (takes longer to expel all air)
FVC is much lower

60
Q

Give an example of an obstructive lung disease

A

COPD

61
Q

What would be seen in a restrictive lung disease?

A

Imagine you are trying to breathe and then someone gives you a big bear hug from behind - it limits the expansion of the thorax
FVC is lower
FEV1 is relatively high - because their conducting airways are quite clear they can expel air relatively easily

62
Q

Give examples of values for FEV1/FVC ratios

A

o NORMAL = 73
o Restrictive = 87
o Obstructive = 53

63
Q

How is the rate of flow show on a flow-volume loop?

A

Y axis is the flow rate - the further it deviates from the x-axis, the greater the rate of flow

64
Q

How would a F-V loop differ for a mild obstructive disease?

A

Displaced to the left
Indented exhalation curve
Residual volume expanded

65
Q

How would a F-V loop differ for a severe obstructive disease?

A

Shorter curve
Displaced to the left
Indented exhalation curve
Deeper indentation = more severe

66
Q

How would a F-V loop differ for a restrictive disease?

A

Displaced to the right
Narrower curve
Unable to get to high TLC , restriction to the expansion of the lungs

67
Q

How would a F-V loop differ for a variable extra thoracic obstruction?

A

Blunted inspiratory curve

Otherwise normal

68
Q

How would a F-V loop differ for a variable intra thoracic obstruction?

A

Blunted expiratory curve

Otherwise normal

69
Q

How would a F-V loop differ for a fixed airway obstruction obstruction?

A

Blunted inspiratory curve
Blunted expiratory curve
Otherwise normal

70
Q

What does P stand for?

A

Partial pressure

71
Q

What does S stand for?

A

Hb Saturation

72
Q

What does A stand for?

A

Alveolar

73
Q

What does a stand for?

A

Arterial

74
Q

What is Dalton’s law?

A

Partial pressure of a gas mixture is equal to the SUM of the partial pressures of gases in the mixture

75
Q

What is Fick’s law?

A

Molecules diffuse from regions of high concentration to low concentration at a rate proportional to the CONCENTRATION GRADIENT, the exchange SURFACE AREA and the DIFFUSION CAPACITY of the gas, and inversely proportional to the THICKNESS of the exchange surface

76
Q

What is Henry’s law?

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

77
Q

What is Boyle’s law?

A

at a constant temperature, VOLUME IS INVERSELY PROPORTIONAL TO PRESSURE

78
Q

What is Charles’ law?

A

at a constant pressure, VOLUME IS DIRECTLY PROPORTIONAL TO TEMPERATURE

79
Q

What happens to air as altitude increases?

A

As you get higher the pressure of the atmosphere decreases but the PROPORTIONS OF THE GASES REMAINS THE SAME

80
Q

What is total O2 delivery rest?

A

16 mL∙min-1

81
Q

What is the shape of the oxygen dissociation curve for Hb?

A

Sigmoidal

82
Q

What is P50?

A

The partial pressure of O2 when when Hb is 50% saturated

83
Q

What happens to the ODC during exercise?

A

Shifts to the right

Reflect higher engird consumption

84
Q

What happens to cause the shift to the right?

A

Increase in temperature
Acidosis
Hypercapnia (elevated CO2 because there is more cellular metabolism0
Increase in 2,3-DPG

85
Q

What can happen to cause a shift to the left?

A 
Decrease in temperature
Alkalosis
Hypocapnia
Decrease in 2,3-DPG
pH is lower in the tissues that in the lungs which helps it unload
86
Q

What can cause a downwards shift?

A

Anaemia

Impaired oxygen carrying capacity

87
Q

What can cause an upwards shift?

A

Polycythaemia

88
Q

What is polycythaemia?

A

An increase in the packed cell volume (haematocrit) in the blood - it could be due to an increase in the number of red blood cells

89
Q

What is the overall effect of carbon monoxide on Hb?

A

Reduces amount of Hb that can bind to O2

Decreases capacity

90
Q

How to CO affect the ODC?

A

Downward and leftward shift

91
Q

Why does foetal Hb have a high affinity?

A

Needs to steal O2 from mothers blood

92
Q

What should deoxygenated blood be called?

A

Mixed venous blood

Blood driving has aground 75% oxygen bound

93
Q

How saturated will the blood be when it reaches the tissues?

A

97%

Cardiology (16 decks)

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