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Cardiopulmonary Physio 2040 > Week 1 Respiratory Physiology > Flashcards

Week 1 Respiratory Physiology Flashcards

1
Q

Central Controller

A

Brainstem

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2
Q

Effectors

A

receives info from central controllers and causes ventilation to occur

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3
Q

Sensors

A

gathers info and provides feedback to the central controller to allow to adjust output (eg chemoreceptors and mechanoreceptors)

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4
Q

Control of breathing - Sensors

A
  • breathing stimulated and regulated by CO2, H+, & O2 concentrations
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5
Q

What are Chemoreceptors?

A
  • chemical sensors in the brain and blood vessels that identify changing levels of oxygen, carbon dioxide and H+
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6
Q

What do Chemoreceptors - Central (medulla) detect?

A
  • detects change in pH (H+) caused by changes in PCO2

Note: Blood brain barrier impermeable to H+ (CO2 can diffuse through CSF combines with water to give off H+)

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7
Q

What do Chemoreceptors - Peripheral (carotid sinus, aortic arch) detect?

A
  • detects changes in PO2, PCO2, pH
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8
Q

Normal PaCO2

A

38-42 mmHg

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9
Q

What happens when there is an increase of CO2 in blood?

A
  • increased breathing rate and depth of respiration (Increased ventilation
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10
Q

What happens when there is a Decrease of CO2 in blood

A
  • reduced ventilation (less breathing)
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11
Q

Normal PaO2

A

80-100 mmHg

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12
Q

Ventilation is not stimulated by falling….

A

PaO2 until O2 reaches about 50mmHg

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13
Q

Hypercapnia

A

excessive carbon dioxide in the blood

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14
Q

deficiency in the amount of oxygen reaching the tissues

A

Hypoxia

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15
Q

Factors that can affect/override central control

A
  • voluntary: eg. hyperventilation
  • Disease process: eg. brain injury, fractured ribs, thoracic injury
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16
Q

Muscles acting on Thorax during NORMAL INSPIRATION

A
  • diaphragm

-parasternal intercostals

  • scalenes
  • quadratus lumborum
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17
Q

Muscles acting on thorax during NORMAL EXPIRATION

A
  • mainly passive elastic recoil
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18
Q

Movement of ribs 1-6

A

“pump handle” - moves up and down

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19
Q

Movement of ribs 7-10

A

“bucket handle”

  • caused by contraction of the diaphragm
  • increase transverse (lateral diameter of the rib cage)
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20
Q

Movement of ribs 10-12

A

“caliper” movement

  • non fixed ribs (11-12 floating, 8-10 - false ribs)
  • outwards and backwards swing of the ribs
  • also increases lateral diameter
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21
Q

Breathing Inspiration and expiration Process - is it active or passive?

A
  • Inspiration - active
  • Expiration - passive (muscles relax, lungs recoil, compresses air, pressure in alveoli increases and gas moves outward)
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22
Q

Tidal Volume (VT)

A

Amount of air that moves in and out of the lungs during a normal breath

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23
Q

Minute ventilation

A

aka minute volume; amount of air moved in and out of the lungs in one minute

minute ventilation (MV) = tidal volume (Vt) x respiratory rate

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24
Q

Dead space

A
  • ventilation but no perfusion
25
Q

What is Anatomic dead space

A
  • gas in conducting airways
26
Q

What is Alveolar dead space

A
  • gas in respiratory zone where there is no perfusion
27
Q

Physiological Dead space

A

anatomical dead space + alveolar dead space

28
Q

Blood that enters the arterial system without going through ventilated lung is called

A

Shunt

29
Q

Extrapulmonary shunt examples:

A

congenital heart defect, blood going from left side of the heart to the right side of the heart (septal defect)

30
Q

Intrapulmonary shunt

A

blood that goes through the lungs but is not exposed to a ventilated lung
- examples: lung collapse, consolidation - leads to reduction of PaO2

31
Q

what is dead space?

A
  • ventilation but no perfusion
  • High V/Q ratio >1
32
Q

What is a shunt

A
  • perfusion but no ventilation
  • Low V/Q ratio <1
33
Q

What is the response of the pulmonary vasculature when PaO2 alveolar gas is reduced?

A
  • Hypoxic vasoconstriction. Vasoconstriction (opposite to other mms) - acts to divert blood flow to other alveoli with better oxygen exchange
34
Q

What is hypoxic vasoconstriction?

A
  • the response of the pulmonary vasculature when there is a reduction in PaO2.
  • acts to divert the blood to alveoli with better oxygen exchange
35
Q

what is Diffusion?

A

movement of gas molecules across the alveolar capillary membrane

36
Q

What are factors that affect gas diffusion?

A
  • surface area of the membrane
  • thickness and chemical composition
  • pressure gradient of gas across the membrane
  • solubility of the gas
  • molecular weight of the gas
  • Blood volume and Hb concentration
  • lung volume
37
Q

3 means/forms in which CO2 is transported in the blood?

A
  • Dissolved
  • Combines with Hemoglobin (Hb)
  • as Bicarbonate (HCO3-)
38
Q

Does CO2 diffuse quicker than oxygen? True or False

A

True (CO2 is more soluble)

39
Q

What is the measure of the resistance to gas flow through an airway?

A

Airway Resistance (Raw)

40
Q

What are factors that influence airway resistance?

A
  1. Length of tube
  2. Radius of the tube
  3. Driving pressure
  4. Viscosity of gas
41
Q

Expiratory flow

A
  • dependent on lung volumes
  • the higher the lung volume, the greater the airflow
    For example: - you can cough harder if you inhale first (Try coughing without inhaling first)
42
Q

How distensible or elastic the lung is? The elastic properties of the lungs?

A

Lung compliance

43
Q

Compliance equation

A

Compliance = volume change per unit pressure

44
Q

Reduced compliance means…

A

stiffer lungs

45
Q

Increased compliance means…

A

floppy lung

46
Q

Alveoli are supported by?

A

Surfactant and Interdependence

47
Q

What is Interdependence?

A
  • interdependence what we call the alveoli attached and are working together to support each other
  • if one of the alveoli collapses - the expansion of other alveoli exerts a pull on the collapsed ones which may assist in their re-expansion
48
Q

What is Collateral Ventilation?

A
  • alveoli are interconnected in which the alveoli can be ventilated through a different passage
  • alternate pathways of ventilation between adjacent alveoli
49
Q

Amount of time it takes for an alveoli (or region of lung to distend? It is also related to lung stiffness (Compliance) and resistance to airflow

A

Time constants

50
Q

For normal lungs at normal lung volume, the dependent lung receives?

A
  • greater ventilation
    -Note: Dependent lung is lower lung region
51
Q

When side lying, what is the dependent lung?

A
  • the lung at the bottom
52
Q

In upright sitting - the lungs dependent is the…

A

“bases” (lowest parts of middle and lower lobes)

53
Q

For normal lungs at low volume which is a lot easier to expand? Non-dependent or dependent

A

Non dependent (it is more compliant and therefore is better ventilated

54
Q

Is perfusion gravity dependent in the lung (true or false)

A

True - Ie more at the bottom
At the top of the lungs - the capillaries may be squashed
At the Bottom - capillaries may squash alveoli

55
Q

What do you call when ventilation and perfusion does not match?

A

V/Q mismatch
- V/Q mismatch results in a drop in PaO2

56
Q

what is the perfect V/Q

A

1

57
Q

V/Q match in the Apex of the lung

A

Better Ventilation (V) than Perfusion(Q) >1

58
Q

V/Q match in the Middle of the lung

A

even ventilation (V) and Perfusion (Q) = 1

59
Q

V/Q match in the Bottom of the lung

A

better perfusion (Q) than ventilation (V) <1

Cardiopulmonary Physio 2040 (6 decks)

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