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Physiology III - Freedman > Unit 3: Pulmonary Physiology Pt 1 > Flashcards

Unit 3: Pulmonary Physiology Pt 1 Flashcards

1
Q

What sets the basic drive for ventilation?

A

respiratory neurons in the brain stem, the Dorsal Respiratory Group

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2
Q

What are three things the Respiratory neurons in the brain stem, the Dorsal Respiratory Group, does?

A
  • sets basic drive of ventilation
  • descending neural traffic to spinal cord
  • activation of muscles of inspiration
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3
Q

What does the alveolar pressure oscillate around?

A

atmospheric pressure

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4
Q

When does alveolar pressure = atmospheric pressure?

A

at the end of inspiration or expiration

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5
Q

When is alveolar pressure less than atmospheric pressure?

A

during inspiration

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6
Q

When is alveolar pressure greater than atmospheric pressure?

A

during expiration

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7
Q

What is transpulmonary pressure and when is it the greatest?

A

= a measure of the net collapsing force, or recoil pressure (diff b/w alveolar pressure and pleural pressure)

at the end of inspiration

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8
Q

When is pleural pressure more negative..during inspiration or expiration?

A

inspiration—> creates a negative pressure that creates a suction and keeps lungs pulled to wall

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9
Q

What sensory organ will detect changes in blood PCO2, PO2 and pH?

A

chemoreceptors

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10
Q

During Expiration what is happening to the levels of O2 and CO2?

What about inspiration?

A

O2 is decreasing and CO2 is increasing

O2 is increasing and CO2 is decreasing

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11
Q

Where are the respirator centers located?

A

in brain stem (MO)

  • Dorsal and Ventral Medullary group
  • Pneumotaxic and Apneustic centers
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12
Q

What three things are the respiratory centers influenced by?

A
  1. higher brain centers–> cerebral cortex
  2. peripheral mechanoreceptors
  3. peripheral and central chemoreceptors
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13
Q

What do the respiratory centers affect about ventilation?

A

affect rate and depth of ventilation

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14
Q

Do inspiratory muscles increase the thoracic cage volume or decrease it? What do expiratory muscles do?

A

inspiratory–> increase thoracic cage volume

expiratory –> decrease thoracic cage volume

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15
Q

What are the muscles of inspiration?

A
  1. Diaphragm
  2. External Intercostals
  3. SCM
  4. Ant. Serrratus
  5. Scaleni
  6. serratus posterior superior
  7. Levator Costarum
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16
Q

What are the muscles of Expiration?

A
  1. Rectus abdominus
  2. external and internal obliques
  3. transverse abdominis*
  4. internal intercostals
  5. serratus posterior inferior
  6. transversus thoracics
  7. pyramidal
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17
Q

What muscles drops the floor of the thoracic cage in order to increase thoracic cage volume?

A

diaphragm

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18
Q

What do all the muscles of inspiration have in common (except the diaphragm)?

A

they lift the rib cage

the diaphragm drops floor of thoracic cage

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19
Q

What percentage of the Total Body Energy do the muscles on inspiration use?

A

3%

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20
Q

T/F. Expiration is passive under resting conditions and is associated with recoil of the lungs.

A

True

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21
Q

What are the three considerations for the movement of air in and out of the lungs?

A
  1. Pleural Pressure
  2. Alveolar Pressure
  3. Transpulmonary Pressure
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22
Q

What is the negative pressure b/w the parietal and visceral pleura that keeps lulngs inflated against the chest wall?

A

Pleural presssure

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23
Q

What does the pleural pressure vary b/w?

A

-5 and -7.5 cm (inspiration to expiration)

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24
Q

What is the alveolar pressure compared to the atmospheric pressure during inspiration and expiration?

A

inspiration–> subatmospheric

experation–> supra-atmospheric

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25
Q

What is the difference called b/w alveolar P and pleural P and is the measure of recoil tendency of the lung called?

A

Transpulmonary pressure

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26
Q

When is the Transpulmonary Pressure increased? Decreased?

A

increased–> during inspiration

decreased–> during expiration

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27
Q

How do we max out or Transpulmonary pressure?

A

lungs fully inflated; so breath in as much air in as possible

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28
Q

What is the compliance of the lung “equation”?

A

change of volume / change of pressure

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29
Q

What is the term for the idea that at the onset of inspiration the pleural pressure changes at faster rate than lung volume?**

A

“hysteresis” –(slinky-dog affect)

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30
Q

Is it easier to inflate a saline filled lung or an air filled lung? Why?

A

saline filled lung b/c surface tension forces have been eliminated in the saline filled lung

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31
Q

How is the visceral pleura of the lung held to the parietal pleura?

A

by negative pleural pressure

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32
Q

What pleura is attached firmly to the rib cage and reflects back at the hilum to form the visceral pleura?

A

parietal pleura

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33
Q

What exists between the pleural that creates a suction such that visceral pleura will follow the parietal pleura?**

A

a negative pleural pressure*

–expansion of the thoracic cage will increase lung volume overriding the natural recoil tendency of the lung

34
Q

When all respiratory muscles are relaxed, what does the volume in the lungs equal?

A

Functional Residual Capacity (FRC)

35
Q

When are Chest wall forces (CWF) opposite but equal to Lung recoil forces (LRF)?**

A

at the end of normal expiration

36
Q

How much does the effect of the thoracic cage on the lung, reduces compliance by around functional residual capacity?

A

(so at the end of normal expiration)

reduces by about 1/2

37
Q

How is compliance affected at high or low lung volumes?

A

is it greatly reduced

38
Q

What normally accounts for more of the work of breathing?**

A

compliance work (elastic work)

39
Q

What three things are considered for the work of breathing?

A
  1. compliance work (most of it)
  2. Tissue resistance work (viscosity of chest wall and lung)
  3. Airway resistance work
40
Q

What is the percentage of total body energy used by breathing, is it primarily inspiration or expiration?*

A

3-5% and it primarily inspiration*

41
Q

During inspiration how is the airway resistance work in bronchioles impacted?

A

decreased during inspiration

increase lung vol–> decease airway caliber –> decrease airway resistance

42
Q

During expiration how is the airway resistance work in bronchioles impacted?

A

increased during expatriation

decrease lung vol –> decrease airway caliber –> increase airway resistance

43
Q

What is normal breathing called? and what is the normal rate of breaths per minute? What is the arteriol CO2 equal to?**

A

Eupnea (12-17 B/min)

Arterial CO2 = 40 mmHg*

44
Q

What is it called when we increase pulmonary ventilation to match the increase in metabolic demand? What does Arteriol CO2 equal?

A

Hyperpnea

Arterial CO2 = 40 mmHg (still same as Eupnea)

45
Q

What is it called when increased pulmonary ventilation is greater than metabolic demand? What is the Arterial CO2?

A

Hyperventilation

decrease arteriol CO2 to less than 40 mmHg

46
Q

What is it called when decreased in pulmonary ventilation is less than metabolic demand? What is the Arterial CO2 equal?

A

Hypoventilation

increase arteriol CO2 to more than 40 mmHg

47
Q

What is the term for increased blood levels of CO2?

A

Hypercapnia

abnormal high levels of CO2 in blood

48
Q

What is the term for increase in frequency of respiratory rate?

A

Tachypnea

49
Q

What is the term for absence of breathing?

A

Apnea (e.g. Sleep Apnea)

50
Q

What is the term for difficulty or labored breathing?

A

Dyspnea

51
Q

What is the term for when one has dyspnea when recumbent (lying down), and is relieved when upright?

A

Orthopnea

Ex: congestive heart failure, asthma, lung failure

52
Q

T/F. Lungs have a natural tendency to collapse.

A

True

53
Q

What is normally responsible for 2/3 of the collapse tendency of the lung? What is the other 1/3?

A

Surface tension forces

1/3 elastic fibers

54
Q

What will happen when the pleural space communicates with the atmosphere?

A

lung will collapuse

i.e. pleural pressure = atmospheric pressure

55
Q

What could cause a lung to collapse?

A
  1. Puncture of parietal pleura
  2. Erosion of visceral pleura
  3. Major airway is blocked, the air trapped distally will be absorbed by blood and segment of lung will collapse
56
Q

How many bronchopulmonary segments does each lunch have?

A

10

57
Q

How many lobes does the right lung have? left?

A 
right = 3 lobes
left = 2 lobes
58
Q

What occurs when there is a loss of negative pleural pressure?

A

lung collapses!
- separation of parietal and visceral pleura
- chest wall expands and diminished Chest Wall Force and Lung Recoil Force
(pleural cavity will increase in space)

59
Q

What is in the pleural cavity?

A

pleural fluid = thin layer of mucoid fluid

60
Q

What does the Pleural Fluid in the pleural cavity provide? What is it made of? How much is the total amount?

A
  1. lubrication
  2. transudate (interstitial fluid + protein)
  3. total amount is only a few ml’s
61
Q

How is excess pleural fluid removed? Why is this good?

A

by lymphatics on:

  • mediastinum
  • superior surface of diaphragm
  • lateral surfaces of parietal pleura

~ helps create negative pleural pressure

62
Q

What is the collection of large amounts of free fluid in pleural space called?

A

Pleural Effusion

  • edema of pleural cavity
63
Q

What are possible causes of Pleural Effusion?

A

(collection of large amounts of free fluid in pleural space)

  • blockage of lymphatic drainage
  • cardiac failure
  • reduced plasma colloid osmotic pressure
  • infection/inflam of pleural surfaces–> breaks down membranes
64
Q

What reduces the surface tension forces by forming a monomolecular layer b/w aqueous fluid lining alveoli and air and preventing a water-air interface?

A

Surfactant

65
Q

What produces surfactant?

A

type II alveolar epithelial cells

66
Q

What is surfactant made up of?

A

complex mix of phospholipids, proteins, and ions

– dipalmitoyl lecithin, surfactant apoproteins, Ca++ ions

67
Q

What is the term for the size of one alveoli determined in part by surrounding alveoli?

A

Interdependence (can’t expand unless rest of alveoli around it decrease in size)

68
Q

What does the Law of Laplace have to do with in the lungs? What is the equation for it?

A

the role of surfactant

P = 2T/r

P = collapse pressure
T = surface tension
r= radius

(think about blowing up a balloon and how it gets easier once larger, but when smaller it collapses easier)

69
Q

Without surfactant what would happen to the smaller alveoli that have increased collapse pressure?

A

they would tend to empty into larger alveoli

Law of Laplace

70
Q

How does surfactant offset the physical tendency of what the Law of Laplace proves?

A

as the alveolar size decreases, surfactant is concentration –> which will decrease surface tension forces–> off-setting the decrease in radius

71
Q

What is the amount of air moved in or out each breath?*

A

Tidal Volume (500ml) –> (smallest number of static lung volumes**

72
Q

What is the maximum volume one can inspire above normal inspiration?*

A

Inspiratory Reserve Volume (3000ml) –> (largest number of static lung volumes)

73
Q

What is the maximum volume one can expire below normal expiration?*

A

Expiratory Reserve Volume

74
Q

What is the volume of air left in the lungs after maximum expiratory effort?*

A

Residual Volume

75
Q

What cannot be determined with basic spirometry?**

A
  1. Residual volume (air can never get ride of)
  2. Functional Residual Capacity
  3. Total Lung Capacity
    (anything that contains RV_
76
Q

What is the volume of air left in the lungs after a normal expiration, and is the balance point of lung recoil and chest wall forces?**

A

Functional Residual Capacity

Residual Volume + Expiratory Reserve Volume

77
Q

What is the maximum volume one can inspire during an inspiration effort?

A

Inspiratory Capacity

Tidal Volume + Inspiratory Reserve Volume

78
Q

What is the maximum volume one can exchange in a respiratory cycle?

A

Vital Capacity

IRV + TV + ERV

79
Q

What is the air in the lungs at full inflation?

A

Total Lung Capacity

IRV + TV + ERV + RV

80
Q

What three volumes of the lungs will decrease with restrictive lung conditions?

A
  1. VC (vital capacity)
  2. IRV (inspiratory reserve volume)
  3. IC (inspiratory capacity)

slide 33-34

81
Q

How are Pulmonary Flow Rates compromised?

A

with obstructive conditions

slide 35 ??

Physiology III - Freedman (18 decks)

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