Term
| what are the parts and function of the conducting system |
|
Definition
nose
larynx
trachea
R. bronchus > 3 secondary > 10 tertiary for the bronchopulmonary segments
left bronchus > 2 secondary > 8 tertiary for the bronchopulmonary segments
function: warm, moisten, filter air |
|
|
Term
|
Definition
reestablishing flow past an obstruction in trachea
passing a tube from mouth or nose to larynx and trachea |
|
|
Term
|
Definition
| incision in trachea below cricoid when larynx is obstructed |
|
|
Term
|
Definition
| bundles of lymphatic, arterioles, venules, terminal bronchioles, respiratory bronchioles, alveolar ducts, alveolar sacs, and alveoli in the bronchopulmonary segments |
|
|
Term
| what are the types of alveoli (pneumocyte) cells (and cells around alveoli) what are their functions |
|
Definition
type 1: simple squamous, site of gas exchange
type 2: secrete alveolar fluid with surfactant to lower surface tension and prevent collapse on expiration
alveolar dust cells: wandering macrophages |
|
|
Term
| what are the layers of the respiratory membrane |
|
Definition
pneumocyte cell membrane
epithelial basement membrane
capillary basement membrane
capillary / endothelial wall |
|
|
Term
| explain how the histology of the lungs changes from top to bottom |
|
Definition
epithelium: pseudostratified cilliated columnar to non-ciliated simple cuboidal
cartilage: incomplete rings to smooth muscle to connective tissue |
|
|
Term
| what controls muscle tone of the bronchi and their segments |
|
Definition
autonomic nervous system
vagus constricts via parasympathetic (M3)
sympathetic dilates (B2) |
|
|
Term
| how is pressure calculated, what is atmospheric pressure in kPa, torr, and mmHg |
|
Definition
pressure = force / area
101.3 kPa, 760 torr, 760 mmHg |
|
|
Term
| what contributes to pleural pressure |
|
Definition
pressure in the pleural cavity which can be increased by contraction of the diaphgram
elastic recoil of chest wall tries to pull chest out and recoil of the lungs tries to pull it in |
|
|
Term
| what contributes to alveolar pressure |
|
Definition
| pressure inside the alveoli |
|
|
Term
| how is transpulmonary pressure calculated |
|
Definition
| transpulmonary pressure = alveolar pressure - pleural pressure |
|
|
Term
| explain the difference between positive and negative pressure and suction and vaccum |
|
Definition
vaccum is the absence of a gas
negative pressure is below atmospheric and cause suction
positive pressure is above atmospheric |
|
|
Term
| what are the laws of gasses |
|
Definition
PV=PV
V/T=V/T volume is constant
P/T=P/T pressure is constant
(PV)/T=(PV)/T |
|
|
Term
| quiet inspiration muscle, air, and pressure changes explination |
|
Definition
diaphragm contraction, external intercostals
increases volume air goes in (negative pressure breathing)
alveolar pressure 758 mmHg |
|
|
Term
| forced inhalation muscle movements and pressure changes |
|
Definition
SCM, scalenes, pec minor
same air and pressure theory as quiet inspiration |
|
|
Term
| quiet expiration air, muscle, and pressure changes |
|
Definition
alveolar pressure > atmospheric
elastic recoil decreases volume and increases pressure
alveolar pressure 762 mmHg |
|
|
Term
| what is active respiration |
|
Definition
| labored breathing when air movement out of the lungs is impeded |
|
|
Term
| forced expiration air, muscle, and pressure changes |
|
Definition
contraction of internal intercostals and abdominal muscles (force diaphragm up)
same air and pressure as quiet |
|
|
Term
| how do you calculate compliance, what is the relationship to recoil |
|
Definition
C = volume / pressure
inversly proportional to recoil |
|
|
Term
|
Definition
| resistance = (pressure in mouth - pressure in alveoli) / flow rate |
|
|
Term
| hoe is laminar flow claculated |
|
Definition
R = (8nl) / (pi r^4)
radius is most important |
|
|
Term
| what is the opposition to flow |
|
Definition
|
|
Term
|
Definition
| normal respiration, adult 12-20 breaths per minute, infant higher |
|
|
Term
|
Definition
slow breathing
in post anesthetic, barbituate overdose, hypnotics |
|
|
Term
|
Definition
fast breathing
exercise, oxygenation issue, ridding CO2 |
|
|
Term
| kussmaul breathing: what, why |
|
Definition
deep, noisy (sigh), high rate
ill patient, blood gas issue, diabetic ketoacidosis |
|
|
Term
| biot's respiration: what, why |
|
Definition
abrupt and irregular periods of apenia
increased intracranial pressure |
|
|
Term
| chyene-stokes respirations: what, why |
|
Definition
small, shallow, increase in frequency and amplitude then go to apena in a 2 min cycle
damage to respiratory center, in newborns with premature respiratory systems |
|
|
Term
|
Definition
cessation of breathing
sleep apena, upper airway obstruction |
|
|
Term
|
Definition
difficulty breathing, shortness of breath with no relief
COPD, heart failure |
|
|
Term
| costal breathing: what, why |
|
Definition
uses intercostals and extracostals to increase ventilation
singing, diaphragmatic breathing |
|
|
Term
| explain the process of coughing |
|
Definition
| deep inspiration, closure of rima glottis, blast of air out |
|
|
Term
| explain the process of hiccuping |
|
Definition
| spasmodic contraction of diaphragm and quick closure of rima glottis with a sharp inspiratory sound |
|
|
Term
|
Definition
pleural pressure = 0
lung collapses |
|
|
Term
|
Definition
| in premature babies, alveoli collapse on exhalation |
|
|
Term
| what could reduce lung compliance |
|
Definition
| TB, scar tissue, pulmonary edema, reduced surfactant, paralysis |
|
|
Term
| what could increase lung compliance |
|
Definition
|
|
Term
| what is the difference between diffusion and perfusion |
|
Definition
diffusion: movement of gas across alveolar and capillary walls
perfusion: blood flow through pulmonary capillaries |
|
|
Term
|
Definition
| each gas in a mix exerts its own pressure as it all other gasses wernt present |
|
|
Term
|
Definition
| increasing pressure causes in crease in gas dissolving (in ratio with the solubility coefficient) |
|
|
Term
| what are the partial pressures in O2 and CO2 in the alveoli, arteries, and veins, |
|
Definition
alveoli: 150 mmHg O2, 40 CO2
arteries: 100 O2, 40 CO2
cells: 40 O2, 45 CO2
veins: 40 O2, 45 CO2 |
|
|
Term
| what factors effect rate of diffusion |
|
Definition
partial pressure of the air (PO2 is 160)
surface area (70m2)
diffusion distance (1/2 micron)
solubility (CO2 is more soluble)
molecular weight
altitude |
|
|
Term
| functional residal capacity |
|
Definition
| volume of air in lungs after passive expiration (2,400 mL) |
|
|
Term
|
Definition
| exhaling after a normal passive exhale (1,200 mL) |
|
|
Term
|
Definition
| air in lungs after expiratory reserve (1,200 mL) |
|
|
Term
| calculating functional residual capacity |
|
Definition
| expiratory reserve + residual volume = 2,400 mL |
|
|
Term
|
Definition
inhaling after a normal inhale (3,100 mL)
uses SCM, scalenes, pec minor |
|
|
Term
|
Definition
air in/out in quiet breathing (500 mL)
uses external intercostals and diaphgram only |
|
|
Term
| minute volume and how to calculate |
|
Definition
gas inhaled per minute (6,000 mL)
tidal volume x respirations/min |
|
|
Term
| respiratory capacity and calculation |
|
Definition
| inspiratory reserve + tidal volume - 3,600 mL |
|
|
Term
| functional residual capacity and calculation |
|
Definition
| expiratory reserve + residual volume = 2,400 mL |
|
|
Term
| vital capacity and calculation |
|
Definition
| total lung capacity - residual volume = 4,800 mL |
|
|
Term
| what is the normal for alveolar ventilation (Va), how many breaths does it take to fully exchange functional residual capacity, why do we care |
|
Definition
4,200 mL
6-7 breaths
slow turnover stabilizes respiratory control mechanisms and avoids large O2, CO2 and pH variations |
|
|
Term
|
Definition
rate of O2 absorbed by blood via perfusion (Q)
rate of O2 entry into the lungs (V)
keeping them in proper ratio is important for function |
|
|
Term
| what is max Q/V for O2, what is normal |
|
Definition
max: 250 mLO2/min
normal: 1000 mLO2/min |
|
|
Term
| what is normal V and normal Q |
|
Definition
normal V = 4.2 L/min
normal Q = 5 L/min |
|
|
Term
explain how the Q/V ratio is regluated
1. decreased O2 (dec. ventilation)
2. increased CO2 systemic
3. decreased CO2 systemic
4. increased CO2 lungs |
|
Definition
1. constrict pulmonary arteries to redirect flow to areas with more gas
2. arterioles dilate
3. arterioles constrict
4. bronchioles dilate |
|
|
Term
| what is lung diffusion capacity, how is it tested |
|
Definition
how well O2/CO2 are transferred (diffusion testing)
inhale CO, hold, and exhale. measure for CO in exhaled portion.
CO<40% is severe impairment
note: higher when supine due to increased pulmonary capillary volume |
|
|
Term
| what sould someone have a low lung diffusion capacity (DL) |
|
Definition
membrane thickness, capillary surface area or volume, Hb concentration issues
obstructive lung disease, interstitial lung disease
left heart failure (pulmonary edema)
pneumonia |
|
|
Term
| what does body size tell us about the lungs |
|
Definition
| body size, lung SA, and lung volume are all prortional |
|
|
Term
| explain how Q/V is adjusted in exercise |
|
Definition
1. increased cardial output, distends pulmonary capillaries increasing ventilation/perfusion matching
2. lung diffusion capacity increases SA to shorted diffusion time
(may cause incomplete O2 transfer) |
|
|
Term
| what is the difference between hypoexmic, anemia, ischemia, and histotixic hypoxia |
|
Definition
hypoxemia: low PO2 <80 mmHg
anemic: normal O2, low Hb or saturation
ischemic: decreased flow, normal O2
histotoxic: cells cant use O2, perfusion issue (cyanide) |
|
|
Term
| concentration of O2 dissolved in plasma is proportional to... |
|
Definition
|
|
Term
| how much O2 is transported on Hb, describe the Hb molecule |
|
Definition
98%
globulin and heme pigment and 4 Fe |
|
|
Term
when Hb is 100% saturated, how much O2 does it have
what is the normal amount of Hb per 100 mL blood, at what point is this considered to be low |
|
Definition
1.34 mL
15g/100mL (low is <13.5g male and 12g female) |
|
|
Term
| for 100 mmHg PaO2 how many mL O2 are there |
|
Definition
|
|
Term
what raises the Hb saturation curve (more saturated)
what lowers it |
|
Definition
raises: increased pH, decreased CO2, temp, BPG
lowers: decreased pH, increased CO2, temp, BPG |
|
|
Term
what is the normal mmHg of O2 in...
1. systemic A
2. veins
3. veins during exercise |
|
Definition
1. 60-100 mmHg
2. 40 mmHg
3. 20 mmHg |
|
|
Term
| what do thyroxae and HG do to the body |
|
Definition
| increase BPG in increased altutide, can cause airway obstruction and low tissue O2 (which would lead to increased BPG) |
|
|
Term
| how do you calculate Hb saturation |
|
Definition
| Hb amount (g/dL) x venous O2 content (g of O2/Hb) = max Hb saturation |
|
|
Term
| how do you calculate O2 amount in the blood |
|
Definition
Hb amount (g/dL) x (mL of O2 /dL) = max O2 capacity
max O2 capacity x saturation % = O2 in the blood (mL/dL) |
|
|
Term
| how is CO2 transported, how much by each method |
|
Definition
7% dissolved in plasma
23% on Hb globin (carbaminoHb)
70% on bicarbonate |
|
|
Term
|
Definition
O2 consumed = O2 added
CO2 made = CO2 expired |
|
|
Term
| what is the respiratory quotient (RQ), what does it depend on, what is the average for aerobic and anaerobic respiration |
|
Definition
CO2 made / O2 consumed
depends on nutrients needed in the body
0.8 average for aerobic
>1 for anaerobic |
|
|
Term
| explain the chloride shift, what is the function, what is the reaction |
|
Definition
RBC releases Cl to plasma at the lungs and takes up a bicarbonate
RBC releases bicarbonate to plasma at the cells and takes up a Cl
function: keep plasma ion balance, buffer H+
enzyme: carbonic anhydrase
HCO3 + H -> H2CO3 -> CO2 in alveolar capillary (releasing Cl) |
|
|
Term
| what is the haldane effect |
|
Definition
deoxygenation increases RBC CO2 affinity and decreases O2 (via bohr effect)
H + HbO2 <-> H + Hb + O2
enhances CO2 removal and RBC release when O2 combines |
|
|
Term
| where are the capillaries in the lungs, explain the walls and pressure |
|
Definition
in alveolar septa
low pressure (but higher than venous)
thin, distensible |
|
|
Term
| what are the systolic, diastolic, mean and capillary pressures of the pulmonary artery and capillaries |
|
Definition
systolic: 25 mmHg
dastolic: 8 mmHg
mean: 15 mmHg
capillary: 8-12 mmHg |
|
|
Term
| what is the pulmonary capillary wedge pressure, how is it calculated, what is the function |
|
Definition
estimates pulmonary artery pressure at distal port and RA pressure at proximal port
central venous pressure (measured at the vena cava) is basically the same as RA EDP (preload) and can show changes in blood volume (LV faulure, MV stenosis) |
|
|
Term
| explain the effects of gravity on the lungs |
|
Definition
going above the heart decreases pressure and below increases
pressure increases at base of lungs and decreases at apex (due to hydrostatic pressure involvement)
PA is constant, Pa and Pv change |
|
|
Term
| why would one have a high central venous pressure |
|
Definition
deceased venous compliance (sympathetic activation, ang II, catecholamines)
increased venous return (increased BV)
right sided heart failure
standing to supine |
|
|
Term
| why would someone have a low central venous pressure |
|
Definition
| hypovolemia, decreased venous return |
|
|
Term
| explain the effects of gravity in the different zones of the lungs |
|
Definition
zone 1 apex: PA > Pa > Pv
zone 2 3cm above heart: Pa > PA > Pv
zone 2 RV systole: Pa > PA
zone 2 RV diastole: PA > Pa
zone 3 base: PA > Pv > Pa |
|
|
Term
| how is vascular resistance calculated, why is it low |
|
Definition
capillaries have thin walls (high compliance), minimal resting tone, short vessels
R = change in P / Q |
|
|
Term
| how is pulmonary vascular resistance calculated |
|
Definition
PVR = (pulmonary MAP - LA pressure) / CO
normal = 10-15 which is 1/12 or SVR |
|
|
Term
| what things vasoconstrict |
|
Definition
| sympathetic, a-adrenergic agonist, thromboxane, endothelial, angiotensin, histamine, alveolar hypoxemia |
|
|
Term
|
Definition
| parasympathetic, ACh, B adrenergic, PEF1, prostacycline, NO, bradykinin |
|
|
Term
| how is systemic vascular resistance (SVR) calculated |
|
Definition
| SVR = (MAP - RA pressure) / CO |
|
|
Term
| how is blood flow calculated |
|
Definition
flow = (Pa - Pv) / R
pulmonary flow (Q) = CO |
|
|
Term
|
Definition
CO = (O2 consumption) / (PvO2 - PaO2)
VO2 = Q (CaO2 - CvO2)
oxygen consumption = Q(arterial O2 - venous O2) |
|
|
Term
| how is capillary flux calculated |
|
Definition
Jv = Kf x NFP
Kf increases when capillary is less permeable. tells number or pores, size, and SA of capillary |
|
|
Term
| what does the reflection coefficient measure (RC) |
|
Definition
capillary permeability
1 is impermeaible |
|
|
Term
| what are the starling's forces in the pulmonary capillaies |
|
Definition
HP: 13 mmHg (varies with gravity)
IFHP: 0 or slighty negative
OP: 25 mmHg
IFOP: 17 mmHg
reflecion coefficient: 0.5 |
|
|
Term
|
Definition
| serous transudate due to CHF, renal failure, nephrosis, liver failure, or cancer |
|
|
Term
|
Definition
| pus in pleural cavity due to bacteral infection from adjacent pneumonia, abcess rupture, or trauma |
|
|
Term
|
Definition
| effusion of lymphe (chyle) due to trauma, inflammation, or obstruction |
|
|
Term
|
Definition
| blood in pleural cavity due to surgery, injury, tumor, or aneurysm |
|
|
Term
| what does bronchial circulation supply, where does it branch from, where does it drain |
|
Definition
CT or lungs and airwas with blood
comes from aorta, veins drain into pulmonary veins |
|
|
Term
| what are the steps of respiration regulation |
|
Definition
sensory
sensory neuron
central controler
somatic motor neuron
effector |
|
|
Term
| what are the sensors that gather information to regulate respiration |
|
Definition
chemical influences
chemoreceptors
pulmonary receptors |
|
|
Term
| what are the central controllers of respiration regulation, what are they controlled by overall |
|
Definition
involuntary: medulla respiratory center, pons respiratory center (pneumotaxic and apneustic), limbic system, reticular activating system
volunary: cerebral cortex, avoiding noxious gas or water
overall control: somatic motor system |
|
|
Term
| where are central chemoreceptors, what are they sensitive to |
|
Definition
chemosensitive area of medulla connected to respiratory center
sensitive to CO2 and H (especially in brain tissue) |
|
|
Term
| where are peripherial chemoreceptors, what makes them activate, what are they connected to and how |
|
Definition
in aortic and carotid bodies
activated at O2 80mmHg (normal 95-100)
activated at CO2 > 40mmHg
activated at pH < 7.4
connected to respiratory center by CN IX and CN X |
|
|
Term
| what are the pulmonary receptors that regulate respiration, what are they stimulated by, what reflexes do they do |
|
Definition
pulmonary stretch (mechanoreceptors): hering-breuer volume and deflation reflexes
lung irritant receptors: reflex hyperpena
proprioceptors: respond to muscle movement and joint reflex, transmits directly to respiratory center
J receptors (juxtacapillary): respond to decrease in oxygenation (pulmonary edema, emboli, pneumonia) |
|
|
Term
| explain the hering-breuer volume reflex |
|
Definition
receptors between smooth muscle of airways prevent over inflation
sends AP via vagus to respiratory center inhibiting inspiration area of medulla and apneustic area of pons |
|
|
Term
| explain the hering-breuer deflation reflex |
|
Definition
shortens exhalation when lung is deflated
excessive deflation activates inspiratory neurons
prevents atelectasis (deflation), opens collapsed lung |
|
|
Term
| how are neurons organized in the medulla respiratory center |
|
Definition
ventral: inspiration and expiration
dorsal: mostly inspiration
some cells function for both |
|
|
Term
| what area of the brain determines breathing rhythm, explain the rhythm, how does it do this |
|
Definition
medulla respiratory center
inspiratory neurons active 2 sec
expiratory neurons inactive in quiet breathing (3 sec if active)
it does this with pre-botzinger complex |
|
|
Term
| what is the pre-botzinger complex |
|
Definition
| neuron with intrinsic bursting properities that stimulate neurons dorsal root ganglion in upper medilla respiratory center |
|
|
Term
| where is the pneumotaxic center, what does it do |
|
Definition
upper pons
inhibits apneustic center, coordinates transition between inspiration and expiration, establishes normal respiratory rhythm |
|
|
Term
| what does the apneustic center do |
|
Definition
sends impulse to prolong inspiration, controling depth
can kick start inspiration if you are not breathing |
|
|
Term
| how does the limbic system regulate respiration |
|
Definition
| causes emotional responses |
|
|
Term
| how does the reticular activating system regulate respiration |
|
Definition
cholinergic and adrenergic compounds exhibit synergic and competitive effects that regulate thalamocortical activity and correspond with behavior
stimulates respiratory ventilation when active and reduces it whe not active (sleep) |
|
|
Term
| what are dissorders of the reticular activating system |
|
Definition
| schozophrenia, PTSD, parkinsons, REM behavior disorder, narcolepsy, progressive supranuclear palsy (PSP), depression, autism, alsheimers, ADD, sleep apnea |
|
|
Term
| what is the difference between sleep apnea, obstructive apnea and central apena |
|
Definition
sleep: decreased ventilation during sleep
central: reduced CNS respiratory drive and intermitent cesation. hypoxia wakes them up. obesity and CNS malformation relations.
obstructive: increased upper airway resistance (laryngospasm, fat on neck) hypoxia wakes someone up
all can cause sudden infant death syndrome |
|
|
Term
| what can depress respiratory center spontaneous activity |
|
Definition
| drug overdose, ondine's curse, congenital central hypoventilation syndrom |
|
|
Term
| how can vonuntary control of the respiratory system be overridden |
|
Definition
| increased H or CO stimulation in respiratory centers |
|
|
Term
| what somatic motor neurons control respiraton, what muscles, what is a rule for them |
|
Definition
inspiratory neurons: control muscles of inspiration
expiratory neurons: control muscles of axpiration, only active when forced
they are mutually inhibitory: not active at the same time |
|
|
Term
| hypo vs hyper ventilation |
|
Definition
hypo: not enough for metabolic need CO2 > 42 mmHG
hyper: too much ventilation for need CO2 < 38 mmHg |
|
|
Term
|
Definition
hyper: increased CO2 and H. stimulates central chemoreceptors and respiratory center, causes inspiration and hyperventilation
hypo CO2 < 40 mmHg. chemoreceptors not stimulated, body waits until CO2 accumulates to 40 mmHg |
|
|
Term
| what does decreased ventilation cause in the body |
|
Definition
| decreased BP, fear (via limbic system), increased temp, prolonged pain |
|
|
Term
|
Definition
| air is pushed against closed glottis, external sphinctor relaxed, increased intra-abdnominal pressure, respiratory muscles contract filling lungs and increasing pressure, pressure on sigmoid and rectum |
|
|
Term
| what occurs that affects respiration in a smoker |
|
Definition
nicotine: constricts terminal bronchiles
mucous: in excess due to irritants trapping WBC so they cant fight
CO: binds to Hb
irritants: increase mucous, inhibit cilia, destory elastic causing emphysema
scar tissue: replaces elastic tissue |
|
|
Term
PACO2 = PaCO2 = ?
what is the equation that utilizes this relationship |
|
Definition
40 mmHg
PACO2 = VCO2 /VA
VCO2: CO2 delivered to lungs
PACO2:how adequate ventilation is for CO2 production
VA: ventilation |
|
|
Term
| what causes high PACO2 / hypercapnia |
|
Definition
ventilation is inadequate for CO2 production
failure in respiratory system
CNS depression
weak respiratory muscles
too much dead space
increased CO2 production |
|
|
Term
| when should you never administer a sedative and why |
|
Definition
| when CO2 is high because they decrease ventilation (VA) |
|
|
Term
| what causes low PACO2 / hypocapnia |
|
Definition
ventilation is in excess of CO2 production
<35 mmHg
hyperventilation |
|
|
Term
| why cant you assess PACO2 at the bedside |
|
Definition
cant determine dead space or rate of CO2 production
breathing hard does not always mean hyperventilation
no direct relationship to respiratory rate and PACO2 |
|
|
Term
how can PAO2 be calculated
what is normal PAO2 |
|
Definition
PAO2 = PiO2 - PACO2 / R
R= respiratory quotient
PAO2 = 99.7 mmHg |
|
|
Term
| what is the normal differene between PAO2 and PaO2 |
|
Definition
|
|
Term
| how is the respiratory quotient calculated |
|
Definition
|
|
Term
|
Definition
ventilation perfusion inbalance
pulmonary diffusion capacity
O2 entering pulmonary A |
|
|
Term
what is the henderson-hasselbalch equation
what is the equation for the bicarbonate buffering syste, |
|
Definition
pH = pKa + log(base/acid)
pH = pKa + log(bicarb/(0.3xPaCO2)) |
|
|
Term
| what is the acute response to increased altitude |
|
Definition
hypoxia driven hyperventilation
partial reversal of PAO2
increased VA > PCO2 decrease |
|
|
Term
| what is the chronic response to increased altitude |
|
Definition
body adjusts to low PO2 (160 is normal)
hypoxia stimulates EPO production in kidney increasing RBC |
|
|
Term
| what does spirometry measure, how is it done |
|
Definition
pulmonary funnction test
volume and speed of inhale and exhale
patient inhaled deep and exhales hard, then rapidly inhales (when asseessing upper airway obstruction) |
|
|
Term
| what are infectious agents of the respiratory system and they symptoms |
|
Definition
most common: pneumococcus and strep
community aquired: strep
hospital aquired: S. aureus MRSA
cause inflammation, increased fluid, reduction of SA, reduced V/Q, hypoxia, hypercapnia |
|
|
Term
| what are the respiratory obstructive diseases, what are the symptoms / attributes / causes (6 conditions) |
|
Definition
lumen: excess secretions, aspiration
airway: contraction of smooth muscle
alveoli: destruction
chronic inflammatory: allergins, infections, cold air, exercise, drugs. induce IgE and bronchoconstriction
COPD: noxious gas and genetics cause it. hypoxia, hypercapnia, airway narrowed, poorly reversible
bronchiectasis: irreversible dilation of bronchial tree, inflammation, and easy collapse. caused by necrotising bacteria, genetics, TB |
|
|
Term
| what are the restrictive diseases of the respiratory system |
|
Definition
| emphysema, cystic fibrosis, interstitial lung disease |
|
|
Term
| what are the effects on the lung in emphysema |
|
Definition
loss of elastcity, increased compliance
alpha 1 antitrypsin deficiency
small airway collapse
panacinary
centroacinary
chronic bronchitis |
|
|
Term
|
Definition
| destruction of alveoli in young adults with chronic bronchitis |
|
|
Term
|
Definition
| detruction of bronchiole mucosa in older adults with chronic bronchitis |
|
|
Term
|
Definition
cyanosis due to decreased sensitivity to CO2
prolonged PCO2 raised causes respiratory center to be insensitive to hypercapnia (blue bloaters) |
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Term
| what are the differences when someone has mild emphysema |
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Definition
| maintains O2 levels by hyperventilating (pink puffers) |
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Term
| what causes respiratory (and GI) issues in cystic fibrosis |
|
Definition
thick mucous in digesive tract causes poor growth, malnutrition, and infection
mucous in bronchi cause breathing issues
cystic fibrosis proteins and Cl channels do not let Cl out of cells |
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Term
| what is another name for interstitial lung disease, what areas does this disease impat |
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Definition
diffuse parenchymal lung disease (DPLD)
impacts: interstitium of lung, alveolar epithelium, pulmonary capillary endothelium, basement membrane, perivascular and perilymphatic tissues |
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Term
| what are the causes of interstitial lung disease |
|
Definition
inhaled substances
drugs (antibiotics, chemo)
CT disease (sclerosis, RA)
infection (pneumonia, TB, sarcodisis)
milgnancy |
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Term
| what impact does interstitial lung disease have on the lung and body |
|
Definition
hypoxemia
pulmonary hypertension
cor pulmonale: right sided heart failure
respitory failure |
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Term
| what is pleuritis, what makes it worse |
|
Definition
inflammation of pleura
worse by deep breath, may referr to shoulder |
|
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Term
| what diseases have pleural effusion |
|
Definition
| hydrothorax, emphysema, ehylothorax, hemothorax, eudate |
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Term
|
Definition
inflammation
malignancy
infection: TB, empyema |
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Term
| what are the different types of pneumothoraxx |
|
Definition
primary spontaneous: air filled blister on lung surface ruptures
secondary spontaneous: due to lung disorder (COPD)
traumatic
tension: pleural pressure > atmospheric. air can enter but not leave |
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Term
| what is atelectasis, what is the causes |
|
Definition
incomplete expansion of lung
causes: post surfical, pleural effusion, obstruction |
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Term
| what can cause issues with respiratory blood flow |
|
Definition
pulmonary embolism
pulmonary hypertension |
|
|
Term
| pulmonary embolism: most likley spot, things that block stuff, symptoms |
|
Definition
DVT is most likley
blocked by: thrombus, air pocket, fat, bone, tumor
syptoms: chest pain, dyspena, trachypena |
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|
Term
| what causes acure respiratory distress syndrome |
|
Definition
| injury to respiratory membrane, aspiration of gastric contents, drugs, toxins, drounding, infection, trauma, shock |
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Term
| what causes respiratory failure |
|
Definition
impaired ventilation: obstruction, injury
ventilation perfusion miss match: COPD, pneumonia
impaired diffusion: edema, ARDS |
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Term
| what is the cause of idiopathic (primary) pulmonary hypertension |
|
Definition
| inherited, not really known |
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Term
| waht causes secondary pulmonary hypertension |
|
Definition
increased pulmonary pressure: MV stensosis, LV heart failure
increased pulmonary BV: atria or ventricle septal defect
pulmonary vascular obstruction: embolism
hypoxemia: vasoconstriction |
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Term
| what are the complicatins of pulmonary hypertension |
|
Definition
cor pulmonale
blood clots
arrhythmia
hemoptysis (bleeding into lungs) |
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|
Term
| what is physiological dead space |
|
Definition
air not participating in gas exchange(nose, trachea, etc)
it is expired first, before alveolar air |
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Term
| how do you measure dead space |
|
Definition
| patient takes in a deep breath of O2 (reminder: this does not replace all of the alveolar air) and expires. the first portion of air comes out of dead space. alveolar air has more nitrogen |
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|
Term
| what is the normal dead space volume |
|
Definition
| 150 mL, increases with age |
|
|
Term
| what is the difference between anatomic and physiologic dead space |
|
Definition
anatomic dead space is normal: nose, throat, trachea, etc
alveoli that are not participating in gas exchange (abnormal) PLUS the anatomical dead space = physiological |
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|
Term
| how is physiological dead space calculated |
|
Definition
| alveolar dead space + anatomical dead space |
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|
Term
what is alveolar ventilation
how is it calculated
what is the normal |
|
Definition
total volume of new air enering the alveoli per minute
VA = VT - VD
VA: volume of alveolar ventilation per min
VT: tidal volume
VD: physiological dead space volume
normal VA: 4200 mL/min |
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|
Term
| how is physiological dead space related to PeCO2 |
|
Definition
physiologic dead space / tidal volume
=
(arterial CO2 - CO2 of mixed expired air) / (arterial CO2)
VD/VT = (PaCO2 - PeCO2) / PaCO2 |
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Term
| how is the rate of diffusion calculated |
|
Definition
V = (D x A x change in P) / change in X
D: diffusion coefficient
A: surface area
x: membrane thickess
P: gas partial lpressure |
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|
Term
| how is the diffusion coefficient calculated |
|
Definition
| D is proportional to soulblity / sq root of MW |
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Term
| what is the P of alveoli and pleura at rest, inhale, and exhale |
|
Definition
rest: alv 760, pleural 756
inhale: alv 758, pleural 754
exhale: alv 762, pleural 756 |
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|
Term
| how much does the alveolar pressure and the pleural pressure deviate |
|
Definition
alveolar: +- 2
pleuralo: -4 or -6 |
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|
Term
| how does the chest wall resist lung collapse, what is the result of this |
|
Definition
| holds lungs away making a negative pleural pressure |
|
|
Term
| what is the difference between resistance and compliance |
|
Definition
| resistance can be overcome over time |
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|
Term
| what is the normal PO2 in alveoli, what is the max |
|
Definition
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Term
| when V/Q changes, what are the normal patterns of change |
|
Definition
high V/Q is caused by decreased Q
low V/Q is caused by decreased B |
|
|
Term
| what causes low and high V/Q |
|
Definition
high: pulmonary embolism, R. AV or pulmonary valve issue
low: asthma, COPD, pneumonia |
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|
Term
| how do you calculate CaO2 |
|
Definition
| [Hb] x (amount you could bind if fully saturated (1.34)) x (% saturated to correct) |
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|
Term
| how is cardiac output calculated using fick's law |
|
Definition
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