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Medicine 1 - Physiology > Ventilation: Diffusion, Common Lung Pathologies and Lung Function Tests > Flashcards

Ventilation: Diffusion, Common Lung Pathologies and Lung Function Tests Flashcards

1
Q

Normal adult value for residual volume

A

1200ml (20-25ml/kg)

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2
Q

Normal adult value for expiratory reserve volume

A

1100mL in males

800mL in females

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3
Q

Normal adult value for tidal volume

A

500mL

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4
Q

Normal adult value for inspiratory reserve volume

A

1900-300mL

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5
Q

What does ventilation refer to?

A

Movement of air in and our of lungs

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6
Q

What are the two ways ventilation can be described as?

A

Pulmonary (minute) ventilation

Alveolar ventilation

Both measured in L/min

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7
Q

What is pulmonary ventilation?

A

Total air movement into/out of lungs

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8
Q

What is alveolar ventilation?

A

Volume fresh air getting to alveoli and available for gas exchange

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9
Q

What does Dalton’s Law state?

A

The total pressure of a gas mixture is the sum of the pressures of the individual gases

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10
Q

What is partial pressure?

A

The pressure of a gas in a mixture of gases is equivalent to the percentage of that particular gas in the entire mixture multiplied by the pressure of the whole gaseous mixture.

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11
Q

What is our air a mixture of?

A

Nitrogen (79%).

Oxygen (21%).

Negligible quantities of CO2 in the air (0.03%).

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12
Q

Why is there CO2 in our cells and blood?

A

We make CO2, we do NOT breathe it in.

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13
Q

Why would a patient’s CO2 be increased?

A

If a patient’s CO2 has gone up it is because they can’t get rid of CO2 in their body because they’ve got some kind of respiratory pathology blocking them from exhaling it.

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14
Q

What is PO2?

A

Partial pressure of oxgyegn

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15
Q

What is PCO2?

A

Partial pressure of carbon dioxide

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16
Q

How can alveolar PO2 and PCO2 vary?

A

Hyper and hypo ventilation

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17
Q

What is the normal value for alveolar partial pressure of 03?

A

100mmHg (13.3 kPa)

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18
Q

What is the normal value for alveolar partial pressure of CO2?

A

CO2 is 40mmHg (5.3kPa).

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19
Q

What does the pulmonary artery do?

A

Carries deoxygenated blood away from the heart to the lungs

20
Q

What does the pulmonary vein do?

A

Carries oxygenated blood toward the heart

21
Q

What supplies bronchial circulation?

A

Bronchial arteries arising from systemic circulation to supply oxygenated blood to lung tissues

22
Q

Where does blood drain in bronchial circulation?

A

To left atrium via pulmonary veins

23
Q

What % of left heart output is in bronchial circulation?

A

2%

24
Q

What does pulmonary circulation consist of?

A

Left and right pulmonary arteries originating from the right ventricle

25
Q

Where does the entire cardiac output come from?

A

Right ventricle

26
Q

What does pulmonary circulation supply?

A

The dense capillary network surrounding the alveoli and returns oxygenated blood to the left atrium via the pulmonary vein

27
Q

How can you describe pulmonary circulation?

A

High flow, low pressure

Pressure that is driving flow in pulmonary is much lower than the pressure that is driving flow in the systemic circulation.

28
Q

What is partial pressure of gas?

A

The partial pressure of gas in the alveoli is the same as the partial pressure of gas in the systemic arteries providing we’ve got nice, healthy lungs

29
Q

The rate of diffusion across the membrane is:

A
  • directly proportional to the partial pressure gradient - bigger the gradient, the faster the gas will diffuse
  • directly proportional to gas solubility - the more soluble the gas is, the easier it is to diffuse
  • directly proportional to the available surface area
  • inversely proportional to the thickness of the membrane
  • most rapid over short distances - it doesn’t have so far to go
30
Q

What has a larger partial pressure gradient? Carbon dioxide or oxygen?

A

Oxygen

31
Q

What do the following abbreviations mean?

A
a
v~
PaO2
PaCO2
mmHg
kPa

A

A = alveolar

a = arterial blood

v~ (squiggly line on top) = mixed venous blood (eg in pulmonary artery.

PaO2 = partial pressure of oxygen in arterial blood

PACO2 = partial pressure of carbon dioxide in alveolar air

mmHg = millimetres mercury

kPa = kilopascals

32
Q

What does reduction in surface area cause?

A

Less oxygen can enter that blood so blood flowing away from an emphysemic lung has a lower partial pressure of oxygen than normal.

Lower PO2 in the pulmonary vein and in the systemic arterial blood.

32
Q

What is seen in both fibrosis and emphysema?

A

An increase in partial pressure of carbon dioxide

33
Q

What does asthma cause?

A

No difficulty in gases diffusing between the alveoli and the blood.

Low partial pressure of oxygen in systemic arterial blood

34
Q

To summarise:

What do emphysema, fibrosis, and oedema cause?

A

Emphysema - loss of surface area
Fibrosis - increased thickness of membrane
Oedema - increased diffusion distance

35
Q

What are obstructive lung diseases?

A

Obstruction to air flow, especially on expiration (breathing out)

  • Asthma
  • Chronic bronchitis
  • COPD
  • Emphysema
36
Q

What are examples of restriction of lung expansion?

A

Fibrosis
Infant respiratory distress syndrome
Pulmonary oedema
Pneumothorax

37
Q

What is spirometry used for?

A

A technique commonly used to measure lung function

Measurements can be static or dynamic

38
Q

What are static spirometry results?

A

Where the only consideration made is the volume exhales - for example, “exhaled five litres” end of story

39
Q

What are dynamic spirometry results?

A

Where the time is taken to inhale or exhale a certain volume is what is being measured - more helpful - most clinical respiratory lung function testes work with expired air.

40
Q

What can spirometry measure?

A
  • Tidal volume
  • Inspiratory reserve volume
  • Expiratory reserve volume
  • Inspiratory capacity
  • Vital capacity
41
Q

What is FEV1/FVC ratio?

A

Ratio of the forced expiratory volume in the first one second to the forced vital capacity of the lungs.

42
Q

What is FEV1?

A

Measures how much air you can exhale in one second

43
Q

What is FVC?

A

Total amount of air you can exhale forcefully in one breath

44
Q

What is FEV1/FVC in a healthy adult?

A

80%

45
Q

What would be seen in COPD spirometry?

A
  • The rate at which air is exhaled is much slower
  • Total expired volume (FVC) is also reduced (FRC may be increased)
  • The major effect is on airways and so FEV1 is reduced to a greater extent than FVC
  • Significant fall in ratio also reduced
46
Q

What happens in spirometry in restrictive lung diseases?

A

Both FEV1 and FVC reduced in proportion and the ratio remains normal or may even increase.

Medicine 1 - Physiology (14 decks)

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