| Terms |
Definitions |
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c'
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end-capillary
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T
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Tidal
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D
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Dead Space
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R
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Respiratory exchange ratio
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Airway branches in order
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Trachea
Bronchi
Bronchioles
Terminal bronchioles
Respiratory bronchioles
Alveolar ducts
Alveolar sacs
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normal pulmonary capillary blood
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70ml
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Hysteresis
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Difference between inhalation and exhalation pressure/volume curves.
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STPD
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standard temp, pressure, dry..... used when measuring gas exchange in metabolism,,, such as O2 consumption to CO2 elimination.
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C
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conc. of gas in blood
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MUSCARINIC RECEPTORS:
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CONDUCTIVE AIRWAY SMOOTH MUSCLE RECEPTOR FOR CHOLENERGIC MOLECULES OF THE PARASYMPATHETIC SYS; LEADS TO CONSTRICTION.
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Surfactants
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Surface material lining the alveoli that interfere with the surface tension of the fluid lining the alveoli. Produced in type II alveolar cells. Helps alveoli stay open, stay dry, and reduces work of breathing.
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alveolar ventilation
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(Vt - Vd) x breaths/minute
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IRV
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inspiratory reserve volume -volume you can inspire beyond normal tidal inspiration
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fill in the normal values
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values above
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Angeotensin II
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One of the most powerful vasoconstrictors known. Important for water balance.
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Stretch Receptors
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Located in chest wall. During expansion of chest wall, at a certain point send messages to stop inspiration. Will also prompt inspiration during prolong periods of no breathing.
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57. With an obstructive lung disease, would you see an FEV1/FVC higher or lower than normal?
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Lower
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Irritant Receptors
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Located in large airways, stimulated by smoke noxious gases, particulates in inspired air. Cause coughing, muscus secretion, bronchoconstriction, breath-holding.
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hysteresis
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the inspiration (filling) limb of the lung's pressure-volume loop has a different slope (compliance) than the expiration limb
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obstructive lung disease
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-clogged airways prevent proper ventillation -asthma, emphysema, chronic bronchitis -higher residual volume b/c expire against obstruction
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What is the normal A-a gradient?
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5-10 mmHg
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Inspiratory capacity
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IC=VT+IRV
Max air able to inhale during normal resting expiration
males approx.3.5L
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MINUTE VENTILATION FORMULA
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Vt(TIDAL VOL) x BREATHS/MINUTE = MINUTE VENTILATION
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Edema
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When the amount of fluid entering the interstitium is greater than the lymph drainage.
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O2 Saturation
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Amount of oxygen in combination with hemoglobin divided by the amount of oxygen hemoglobin can carry.= O2 with Hb * 100 / O2 Capacity
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13. What is the term for decreased VENTILATION that is below metabolic needs?
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Hypoventilate
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31. The P-H2O remains constant as long as what else remains constant?
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Temperature
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35. Where are our respiratory centers located?
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In brainstem
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What is the normal blood pH?
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7.33 to 7.4
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Athelectasis
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Incomplete expansion of the lung or a portion of the lung. Causes varying degree of dyspnea and hypoxia.
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Haldane effect
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greater binding of CO2 to hemoglobin in its deoxygenated form
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Total lung capacity
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TLC= RV+ERV+VT+IRVvolume of air in the lungsat the end of maximal inspiration
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Vital capacity
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Maximal air that can expired after maximal inspiration. 5,500ml
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what is shunt?
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small amount of ventilation relative to blood flow
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EXPIRATORY RESERVE VOLUME:
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ADDITIONAL VOLUME THAT CAN BE EXPIRED BELOW TIDAL VOLUME (1200mL)
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Functional Residual Capacity
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= Expiratory Reserve Volume + Tidal Volume
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4.What type of respiration is the gas exchange between the blood and body cells?
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Internal respiration
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4.What P is the atmospheric air pressure outside the body?
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Barometric air pressure
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2. About what % of all O2 is transported via hemoglobin?
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98.5%
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Define hypoxia.
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Low levels of oxygen in the air, blood, or tissues
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Lung Compliance
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Measure of change in volume for a given change in pressure. Increasing makes it possible to change more volume with less pressure.
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What is diffusion capacity?
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Diffusion capacity is a measument of the ability of respiratory memebranes to permit transport of gases. Think - thickness and permiability
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Alveolar ventilation
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Tidal volume - anatomic dead space X respiratory rate.
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Tidal volume
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volume of air taken in and exhaled, normal approx. 500ml per breath
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Difference btw hypoxia and hypoxemia
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hypoxia- low oxygen delivery to tissue
hypoxemia- low blood oxygen
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2 TREATMENTS FOR NEONATAL REPIRATORY DISTRESS:
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1. POSITIVE PRESSURE OXYGEN2. INTRODUCE SURFACTANT INTO LUNGS
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2.What is the term for the movement of air into and out of the lungs?
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Pulmonary ventilation
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25. If the atmospheric pressure is 760 mm Hg, what is the partial pressure of oxygen?
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160 mm Hg
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41. Which respiratory groups regulate the duration of inspiration?
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Pontine respiratory group and apneustic center
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What is a cough?
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An action when the receptors are stimulated causing deep inspiration and a violent expiration
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in normal persons, what percentage of the vital capacity is expired in the first second of forced expiration?
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80%i.e. FEV1/FVC is 0.8
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expiratory reserve volume
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volume of air that can be exhaled after normal expiration
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Ventilation/perfussion relationship at the base of the lungs
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Blood flow is higher than ventilation, the relationship is less than 0.8; the bases are underventilated, ↑ shunts
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expiratory reserve volume
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volume of air that can be exhaled after normal expiration
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What are important lung products?
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1. surfactant - increases compliance, decreases surface tension, decreases work of inspiration
2. prostaglandins
3. Histamine - increase bronchoconstriction
4. ACE - converts AT I to AT II; inactivates bradykinin (ace inhibitors increase bradykinin and produce angioedema and cough)
5. Kallikrein - activates bradykinin
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Hydrostatic pressure in different parts of the lungs
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Hydrostatic pressure gets higher as we get down the lung, and this affects blood flow
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1.What are the functions of the respiratory system?
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Gas exchange, acid/base balance, protection, voice production
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8. If you increase CO2, what happens to pH?
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it decreases (more acidic)
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What is carbonic anydrase?
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An enzyme present in RBCs but not plasma, carbonic aid dissociates rapidly into bicarbonate ion and hydrogen ion which then exchanges bicarbonate for chloride resulting in the chloride shift.
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Name the four standard lung volumes
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1. Tidal volume (VT)2. Inspriatory reserve volume(IRV)3. Expiratory reserve volume (ERV)4. Residual volume (RV)
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normal FEV / FVC ratio?
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Normal subjects can expire at least three fourths of FVC within the first second of the forced expiratory maneuver. The FEV1, the most frequently employed value, is normally ≥75% of the FVC, or FEV1/FVC ≥ 0.75.
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Area of lung most ventilated
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lower zones of the lung (found using radiactive Xe-133)
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68. What is the term for the volume of air that can be forcefully expired from the lungs after a maximal inspiration?
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Vital capacity (VC)
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7.Pleural pressure is due to a combination of what?
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Lung recoil and chest wall expansion
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What are the effects of the autonomic nervous system on airway resistance?
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Epineprine relaxes airway smooth muscle by an effect on beta adrenergic receptors.
Leukotrienes produced in lungs during inflammation contract the muscle.
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PO2 in patent ductus arteriosus
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No change in right atrial PO2 nor right ventricular PO2, ↑ pulmonary artery PO2, ↑ pulmonary flow and pressure
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When V/Q = infinity what has happened?
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Q = 0
blood flow obstruction (physiologic dead space)
as long as there is not 100% dead space giving 100% O2 will improve the PO2
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Describe effects of V/Q on alveolar gas tensions
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if there is no ventilation, but continued perfusion, the alveolar pressure of oxygen and carbon dioxide will be equal to that of mixed venous blood
less fresh air, less oxygen, more carbon dioxide (change in pressures)
if no perfusion with ventilation, alveolar oxygen pressure much greater and alveolar CO2 pressure much lower
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91. What is the average minute ventilation?
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(500 ml/breath) x (12 breaths/min) = 6,000 ml/min
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56. With an obstructive lung disease, what lung volumes or capacities are increased?
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Residual volume (so therefor, TLC and FRC too)
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how is the diffusion coefficient related to the MW and solubility of a gas?
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D is inversely correlated with the MW of the gas and directly correlated with the solubility of the gas
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Lung mechanics before inspiration
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Glotis is open but no air is flowing - alveolar pressure = 0. Intrapleural pressure and lung recoil are equal but opposite. Gravity decreases intrapleural pressure at the apex and increases it at the bases. Apex alveoli are more distended.
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What is the alveolar gas equation?
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PAO2 = PIO2 - (PACO2/R)
R = CO2 produced/O2 consumed
PAO2 - alveolar PO2
PaO2 - arterial PO2
PIO2 - PO2 of inspired air
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WHAT 2 FORCES ARE RESPONSIBLE FOR NEG PRESSURE MAINTAINED IN THE PLEURAL SPACE?
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ELASTIC RECOIL OF TISSUE AND LYMPHATIC DRAINAGE OF PLEURAL FLUID
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12. During inspiration, what is the relationship between P-alv and P-b?
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P-alv becomes less than P-b, (-1 cm H2O) and air goes into lung down P gradient
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How does metabolic acidosis affect the respiratory system?
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The metabolic acidosis occurs due to a non-carbon dioxide acid source such as the addition of lactic acid to the blood in strenuous exercise.
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Name two ways that the residual volume can be measured?`
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1. Gas dilutioneg. helium- has to mix to read accuratly2. Plethysomgraphy-thick of a phone booth- accounts all gases by measurment of pressure.
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What does a right shift in the oxygen - hemoglobin dissociation curve mean?
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Hemoglobin has a decreased affinity for oxygen - facilitates unloading of O2 at the tissues
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29. What is the average volume of exchange that can be held in the alveoli?
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about 3,000 ml per lung (total lung capacity - TLC is about 6,000 ml)
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What does a shift to the right of the oxyhemoglobin dissociation curve signify?
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It signifies higher amounts of hemoglobin saturation.
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When V/Q = 0 what has happened?
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V = 0
shunt (piece of steak in the airway) - giving 100% O2 will NOT increase the PO2 because the airway is blocked
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43. Why is the P-O2 of the blood in the left side of the heart less than the P-O2 of blood in the pulmonary veins?
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because of the physiologic shunt (some bronchial veins draining into pulmonary veins and because of thebesian veins)
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What does an increase in Cl-, H+, CO2, 2,3 BPG and temperature do to hemoglobin?
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changes the R hemoglobin form into T hemoglobin form - shifts dissociation curve to the right - increased unloading of O2 in the tissues
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47. Now that some oxygen has left the capillaries, what is the P-O2 in venous blood?
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40 mm Hg - same as the arteriole end of pulmonary capillary
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