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Bioregulatory systems 3 > 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(Rf)?

A

The frequency of breathing per minute

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3
Q

Define Alveolar ventilation(Valv)?

A

The volume of air reaching the respiratory zone per minute

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4
Q

Define Respiration?

A

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

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5
Q

Define anatomical dead space?

A

The capacity of the airways incapable of undertakings 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 but cannot(e.g. hypoperfused 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 PO2 –acidosis)

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9
Q

Define Hyperventilation?

A

Excessive ventilation of the lungs atop of metabolic demand (Results in reduced PO2=alkalosis)

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10
Q

Define Hyperpnoea?

A

Increased depthof 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 capacities?

A

the sum of two or more volumes

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18
Q

How do you calculate minute ventilation and define?

A

-Gas entering and leaving the lungs Tidal volume(L) x Breathing frequency(breaths/min) = minute ventilation(L/min) *tidal volume =volume of air breathed out /in per breath

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19
Q

How do you calculate Alveolar ventilation and define?

A

-Gas entering and leaving the alveoli [Tidal volume(L) - Dead Space(L)] x breathing frequency(breaths/min)

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20
Q

What is hyperventilation?

What can it lead too?

A

high frequency of breaths but low volume

-can lead to Respiratory acidosis is a condition that occurs when the lungs can’t remove enough of the carbon dioxide (CO2) produced by the body

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21
Q

What factors effect lung volumes and capacities?

A

-Body size(height, shape) -Sex -Disease(pulmonary, neurological) -fitness(innate-inheritance, training) -age(chronological-years alive, physical -state of your body)

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22
Q

What is the respiratory system separated into?

A

Conducting zone and respiratory zone

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23
Q

What is the conducting zone?

A

-consists of the nose, pharynx, larynx, trachea, bronchi, and bronchioles. -These structures form a continuous passageway for air to move in and out of the lungs -no gas exchange happens hear -equivalent to the anatomical dead space

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24
Q

What is the capacity of the conducting zone?

A

150ml in adults at FRC

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25
Q

What is the respiratory zone?

A

-found deep inside the lungs and is made up of the respiratory bronchioles, alveolar ducts, and alveoli. -where gas exchange happens -air reaching here is equivalent to alveolar ventilation

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26
Q

What is the capacity of the respiratory zone?

A

350ml

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27
Q

What is a non perfused parenchyma?

A

-abnormal -alveoli without a blood supply -called alveoli dead space -typically 0ml in adults

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28
Q

How can you increase and decrease someones dead space?

A

decrease:

  • tracheostomy
  • cricothyrocotomy

Increase:

General anesthesia

– multifactorial, including loss of skeletal muscle tone and bronchoconstrictor tone

  • Anesthesia apparatus/circuit
  • Artificial airway
  • Neck extension and jaw protrusion (can increase it twofold)
  • Positive pressure ventilation (i.e. increased airway pressure)
  • Upright posture as opposed to supine (because of decreased perfusion to the uppermost alveoli)
  • Pulmonary embolus, PA thrombosis, hemorrhage, hypotension, surgical manipulation of pulmonary artery tree

– anything that decreases perfusion to well

  • ventilated alveoli
  • Emphysema (blebs, loss of alveolar septa and vasculature)
  • Age
  • Anticholinergic drugs
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29
Q

How can you increase and decrease someones dead space?

A

decrease: -tracheostomy -cricothyrocotomy Increase: -General anesthesia – multifactorial, including loss of skeletal muscle tone and bronchoconstrictor tone -Anesthesia apparatus/circuit -Artificial airway -Neck extension and jaw protrusion (can increase it twofold) -Positive pressure ventilation (i.e. increased airway pressure) -Upright posture as opposed to supine (because of decreased perfusion to the uppermost alveoli) -Pulmonary embolus, PA thrombosis, hemorrhage, hypotension, surgical manipulation of pulmonary artery tree – anything that decreases perfusion to well-ventilated alveoli -Emphysema (blebs, loss of alveolar septa and vasculature) -Age -Anticholinergic drugs -snorkling

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30
Q

What is the chest wall relationship with the lungs?

A

ribcage/chest wall naturally spring OUTWARDS and the lung naturally recoils INWARDS at the same time

At FRC(forced residual capacity-neutral position of the lungs) these forces are in equilibrium

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31
Q

When are the lung chest forces in equilibrium?

A

At the functional residual capacity(FRC) at the end of tidal respiration

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32
Q

What causes inspiration?

A

inspiratory muscle effort+chest/ ribs recoils more than lung recoils

33
Q

What causes expiration?

A

lung recoils more than the chest+expiratory muscle effort

34
Q

Describe the basic chest wall anatomy?

A

VISERAL PLEURAL MEMBRANE-surrounds the lungs

PARIETAL PLEURAL MEMBRANE- covers the inner surface of the chest wall

PLEURAL CAVITY- gap between the the 2 membranes, which has a FIXED VOLUME and contains protein rich pleural fluid

35
Q

What is a haemothorax and what can it be caused by?

A

-collection of blood in the pleural cavity -caused by sharp ot blunt trauma to the chest

36
Q

What is a pneumothorax?

A
  • a collapsed lung
  • occurs when air leaks into the space between your lung and chest wall-pleural cavity(if lung is punctured or the chest wall is perforated) This air pushes on the outside of your lung and makes it collapse -can be complete or partial collapse of the lung
37
Q

Why is normal breathing known as negative pressure?

A

When you inhale, the diaphragm and muscles between your ribs contract, creating a negative pressure—or vacuum—inside your chest cavity. The negative pressure draws the air that you breathe into your lungs

38
Q

Give an example of positive pressure?

A

Examples: -singing/screaming -fighter pilots -before you go into water -CPR -blowing -blowing into another person

when imternal pressure is greater than atmospheric=breathing out

39
Q

How are pressure gradients linked to air flow?

A

air flows from areas of high to low pressure

40
Q

describe the pressure in negative pressure breathing?

A

alveolar pressure is reduced below atmospheric pressure causing the air to move down its pressure gradient into the alveoli when you breath in

41
Q

describe the pressure in positive pressure breathing?

A

atmospheric pressure is increased above alveolar pressure

42
Q

What is the transmural pressure in the lungs referring to?

A

-refers to the pressure inside the alveoli vs the pressure outside the alveoli in the pleural cavity(intrapleural pressure) -in the lungs the transmural pressure is specifically called the TRANSPULMONARY PRESSURE(PTP)

43
Q

How do you calculate the Transmural pressure in the lungs? What can a negative/positive transmural pressure mean?

A

Pressure inside - pressure outside

  • negative will lead to INSPIRATION
  • positive will lead to expiration
44
Q

What is the transthoracic pressure gradient?

A

-the difference between the pressure in the pleural space and the pressure at the body surface, and represents the total pressure required to expand or contract the lungs and chest wall.

45
Q

What is the effect of the diaphragm during inspiration?

A

a pulling force in one direction

46
Q

What is the FVC?

A

Forced vital capacity- the amount of air that can be forcibly exhaled from your lungs after taking the deepest breath possible, as measured by spirometry.

47
Q

What is the FEV1?

A

the amount of air you can force from your lungs in one second.

48
Q

What is the normal FEV1/FVC ratio?

A

84%

49
Q

What is a restrictive pulmonary disease?

What is the FEV1/FVC for restrictive pulmonary diseases?

A

restricts lung expansion=decreased lung volume

(above 85%) 97%

50
Q

What is obstrictive lung disease give examples?

What is the FEV1/FVC ration for obstructive pulmonary diseases?

A

Find it difficult tpo breath out due to obstuction e.g. 2 types of COPD-emphysema and chronic brochitis

less than 70% e.g 53%

51
Q

What are the key laws that describe gas behaviour?

A

DALTON: -pressure of a gas mixture is equal to the sum of the partial pressure of gases in that mixture

FICK: -molecules diffuse from regions of high concentrations to low concentrations at a rate proportional to the concentration gradient, the exchange surface area(A) and the diffusion capacity of the gas, and inversely proportional to the thickness of the exchange surface (How easily a gas molecule will move across a membrane) V gas =A/T x D x (p1-p2)

HENRY: -At the constant temperature, the amount of 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 (How much gas goes into mixture based on the partial pressure)

BOYLE: -At a constant temperature, the volume of a gas is inversely proportional tot he pressure of that gas P gas = 1/V Gas

CHARLES: -At a constant pressure the volume of a gas is proportional to the temperature of that gas V gas= T gas (= is proportional sign for this and one above)

52
Q

What is the solubility co efficient?

A

The volume of a gas that can be dissolved by a unit volume of solvent at a specified pressure and temperature.

53
Q

What is the solubility coefficient of gases in the air at sea level?

A

N2: 1.1 x 10-2

o2: 2.4 x 10-2

Ar: 2.6 x 10-2

CO2: 0.57

54
Q

What has your patient been breathing in if she is undergoing oxygen therapy?

A

40% nitrogen 59% oxygen other gases same amount

55
Q

What gases has your patient been breathing in if they were in a house fire?

A

78% nitrogen 9% CO2 3% CO 9% O2 the other bases are the same

56
Q

How is inspired gas modified in the airways?

A

warmed, humidified, slowed and mixed as air passed down the airways-dilution of gases

57
Q

How much O2 is lost due to mixing as air travels down the pathways?

A

1/3

58
Q

What is the partial pressure of oxygen,carbon-dioxide and H2O in dry air at sea level vs conducting airways vs respiratory airways?

A

Sea level: PO2=21.3kPa PCO2=0 H2O=0 Conductiing airways: PO2=20kPa PCO2=0 PH2O=6.3kPa Respiratory airways: PO2 =13.kPA PCO2=5.3Kpa PH2O=6.3kPa oxygen is lost and co2 and h2op are produced as waste products of respiration

59
Q

What is the total O2 delivery at rest?

A

-16mL/min

60
Q

Why is oxygen transported via haemoglobin?

A

because only 1.5 % of oxygen is dissolved in the blood which isn’t enough to rely on

61
Q

What is the structure of haemoglobin?

A

-fe2+ ion (haem ) at the centre of a tetrapyyrole porphyrin ring connected to a protein chain (-globin) that is covalentlt bonded at the proximal HISTAMINE residue -consists of 4 polypeptide chains( 2 alpha + 2 beta)

62
Q

What is meant by ‘haemoglobin has allosteric behaviour’?

A

-when the first oxygen binds it introduces structural changes in the adjacent globin chains making the hb more RELAXED - this increases the affinity of haemoglobin binding sites to other oxygen molecules -As more more O2 binds the hb chains get more relaxed =higher affinity for O2

63
Q

What protein controls the release of oxygen from haemoglobin?

A

-Red cell 2,3-diphosphoglycerate(2,3-DPG) -increase in the concentration of 2,3-DPG decreases oxygen affinity and vice versa.

64
Q

What is cooperativity?

A

02 binding to haemoglobin, the more that binds the more that wants to join , but spaces are running out

65
Q

What is normal reading for a pulse oximeter?

A

oxygen saturation: 95-100%, below 90 is considered low pulse rate: 60-100

-measures o2 saturation of the blood

66
Q

If a pulse oximeter shows a higher pulse rate what does this indicate?

A

oxygen delivery problem

67
Q

How could the local environment cause left shift in the o2 dissociation curve?

A
  • decrease temp
  • alkalosis
  • hypocapnia (reduced C02)
  • decrease in 2,3 -DPG

(haemoglobin has increased affinity for o2)

68
Q

How could the ,local environment cause right shift in the o2 dissociation curve?

A
  • increase temp
  • acidosis
  • hypercapnia
  • increase in 2,3 -DPG
69
Q

What is meant by left shift and right shift of the oxygen dissociation curve?

A

leftshift: at the same pp of o2 the saturation/affinity of Hb fro o2 is more

right shift: at the same pp of O2 the saturation/affinity of Hb for oxygen is less

70
Q

What can cause an upwards shift of the oxygen dissociation curve?

A

POLYCYTHAEMIA- increases the oxygen carrying capacity of haemoglobin due to having more red blood cells

71
Q

What can cause a downwards shift of the oxygen dissociation curve?

A

ANAEMIA-impairs oxygen carrying capacity

72
Q

How does CO2 effect the oxygen dissociation curve?

A

decrease in carbon dioxide=increased affinity for 02=harder to unload

73
Q

What is the affinity of foetal Hb for O2 compared to adult Hb?

A

greater affinity as it has to extract O2 from mothers blood in the placenta

74
Q

What is the affinity of myoglobin for O2 compared to adult Hb?

A

much greater affinity than HbA as it extracts o2 from circulating blood and stores it

75
Q

describe the loading and unloading of o2?

A

-loading of O2 inthe lungs as there is a high P02 of O2 here and therefore Hb will have a high affinity for O2 here -unloading of O2 in respiring tissues because there is a low PO2 and a high PCO2 here = low affinity for of Hb for O2 so oxygen is unloaded here

76
Q

What is the pulmonary transit time?

A

amount of time for a molecule to pass pulmonary surface during exercise

77
Q

How can pumonary transit time be used clinically?

A

might be suitable to quantify the severity of congestive heart failure, a disease characterized by increased circulation times and elevated filling pressures

78
Q

What shape is the oxygen dissosiation curve?

A

sigmoidal

Bioregulatory systems 3 (11 decks)

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