Ventilation And Gas Exchange Flashcards

1
Q

What is hyperventilation and how does it differ from tachypnoea

A

Excessive ventilation or lungs atop of metabolic demand (reduced PCO2, alkalosis)

Tachypnoea is abnormally fast breathing rate

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2
Q

After max inspirtsoty effort, why is there a plateauing then sudden drop of the chart

A

Requires too much muscular effort from respiratory muscles to maintain the abnormal pressure

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3
Q

What volume of air is measured during,ignition respiratory effort

A

Tidal volume

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4
Q

What are
Vital capacity
Inspiratory/expiratory reserve volume
Residual volume

A

Difference between max and min air that you can have in your lungs
Extra Volume that can be breathed in/out above/below tidal volume during a forceful breath in/out
Vol of air that remains in lungs after max expir effort

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5
Q

What is functional residual capacity (FRC)

A

Vol remaining in lungs after normal passive exhalation, point where lung tissue elastic recoil and chest wall outwards expansion are balanced and equal

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6
Q

What is the difference between volumes and capacities

A

Volumes are discrete sections and don’t overlap

Capacities are sums of 2 or more volumes

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7
Q

How do you calculate minute ventilation

How do you calculate alveolar ventilation

A
Tidal volume (L) x breathing frequency (breaths/min)
Unit is L/min

(Tidal volume (L) - dead space (L)) x breathing frequency

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8
Q

What affects lung volumes and capacities

A
Body size
Sex
Disease (pulmonary or neurological) (COPD increases total lung capacity and residual volume, vital capacity shrunk down)
Age
Fitness
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9
Q

What are the differences between anatomical and alveolar dead space
What do they add to produce

A

Anatomical is in conducting zone; no gas exchange, 16 generations, typically 150mL

Alveolar is non perfumed parenchyma, alveoli without blood supply, no gas exchange, should be 0mL in adults

Physiological dead space

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10
Q

Which zone has 7 generations, gas exchange and air reaching it is equivalent to alveolar ventilation?
What volume is this typically in adults

A

Respiratory zone

Typically 350mL

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11
Q

What two reversible procedures could you do to
Decrease
Increase
Someone’s dead space?

A

Decrease: tracheostomy (get past upper airway, shortens airway, go to where cartilaginous tracheal support is as wont collapse), cricothyrocotomy

Increase: anaesthetic circuit, snorkelling

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12
Q

What is the chest wall relationship, and when is it at equilibrium

How are inspiration and expiration brought about (using equations)

A

Chest wall has tendency to spring outwards, lung has tendency to recoil inwards
Equilibrium at end tidal expiration (FRC), which is neutral position of intact chest

Inspiratory muscle effort + chest recoil > lung recoil
Chest recoil < lung recoil + expiratory muscle effort
Distort pressure equilibrium!

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13
Q

What can ruin pleural cavity integrity

A

Haemothorax (intrapleural bleeding)

Pneumothrorax (collapsed lung caused by perforated chest wall or punctured lung)

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14
Q

What type of breathing is
Negative pressure
Positive pressure

A

Normal breathing

CPR, Mechanical ventilation, fighter pilots

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15
Q

What laws describe gas behaviour

A
Dalton = total partial pressures = pressure of mixture
Fick = molecules diffuse high to low proportionally to conc grad, surface area, diffusion capacity, inverse proportional to thickness of surface
Henry = solubility proportional to partial pres
Boyle = vol inversely proportional to pres
Charles = vol proportional to temp
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16
Q

What gases would be present in the following situations :
Oxygen therapy
Smoke ( house fire)
High altitude

A

More O2

Less O2, more CO2 and COs

Percentages remain the same, pressure lower

17
Q

How is inspired air modified in the airways

A

Conducting airways increases humidity, small decrease in pO2

Respiratory airways decrease in pO2, increase in pCO2

Air warmed, humidified, slowed and mixed down respiratory tree

18
Q

What binding site is created in the middle of the relaxed Haemoglobin molecule, and what is its function

A

2,3-DPG (glycolytic byproduct),
facilitates unloading;
as 2,3-DPG increases, usually proportional to metabolic demand, need to deliver more oxygen

19
Q

What is the pO2 of the systemic vs pulmonary circulation

A

Systemic 1.5-5.5

Pulmonary 9.5-13.5

20
Q

How would you interpret a pulse oxidiser reading of 99%

A

Normal binding of O2 to Hb
HOWEVER
If there is less Hb, patient may still be ischaemic

Be cautious
Check cog function, pallor, FBC

21
Q

What may cause the oxygen dissociation curve to shift to the
Left
Right

A

Left = lower temp, alkalosis, hypocapnia, lower 2,3 DPG

Right (Bohr shift)= higher temp, acidosis, hypercapnia (high CO2), higher 2,3 DPG
Occurs during EXERCISE

22
Q

What may cause a downwards or upwards shift of the oxygen dissociation curve

A

Downwards = anaemia (impairs oxygen carrying capacity)

Upwards = polycythaemia

23
Q

What may cause a downwards and leftwards shift in the oxygen saturation curve

A

Carbon monoxide poisoning - decreased capacity, increased affinity for CO, reduced affinity for O2

24
Q

What gas binding proteins shift the Oxygen dissociation curve to the left

A

Foetal Hb left, extracts O2 from mother’s blood in placenta

Myoglobin even more left, extracts O2 from circulating blood and store it

25
Q

How is carbon dioxide transported in the blood

A

In plasma
CO2 + H2O to H2CO3 (reversible, non enzymatic)
H2CO3 dissociates into H+ and HCO3-

In RBC
Same equation, catalysed by carbonic anhydrase (5000x greater than plasma)
HCO3- replaced with Cl- (chloride shift to maintain resting membrane potential) via AE1 transporter

Or binds with Hb to produce carbaminohaemoglobin
Free H+ binds to Hb, acts as buffer, Ph inside stays stable for enzyme activity