Inspiration Describe
1. ________ nerve controls ______ muscle
2. _______ neuron
3. _____movement ribs and _______ movement diaphragm
4. Contract or relax?
5. Active or Passive?
- phrenic –> diaphragm
- motor neuron
- upward movment ribs ; downward (flatteing) diaphragm
- Contract
- Active
Expire is opposite 3-5
Pes = estimate of ___ which is
Inspire – [neg / pos]
Expire – [neg / pos]
Esophageal pressure at end expire
Ppl
In: neg (deep = more neg)
Ex: less neg
pleural pressure
Compliance is highest at ______ volumes
Volume ↑ –> compliance ___
moderate (500mL)
↓
Surface Tension wants _______ surface area possible
Pressure is higher in _____ SA
The name of this law is?
State law:
smallest
smaller
Laplace
pressure inverse proportion to radius
- Surfactant released by _______ cells
- Helps ____ surface tension
- ______ alveoli get more surfactant to _____ pressure
- Ratio for lung maturity
- What increases surfactant?
- What decreases surfactant?
- type II alveolar
- decrease
- small ; decrease
- > 2
- Glucocorticoids / EGF
- TNF-alpha/beta; insulin
Loss of collagen / elastin means _______ compliance and _____ elasticity
increase ; decrease
Greatest resistance found
Gen 2-5 airway (bronchii / bronchioles)
M3 AChR directly mediates sm ____
________ for asthma test
_______ treat obstructive disease
contraction
Methacholine
PDE 3/4 Inhibitors
Asthma Cells
detritic:
lymphoctye:
mast:
macro:
sm muscle:
epithelial:
Eosinophil:
d: innate immune
l: drive allergic inflammation; IL
mast: IgE / hist
macro: IgE
sm: constriction, hypertrophy, cytokines
Epi: cytokines, NO
Eo: disease severity
Dead Spaces define
Anatomical
Functional
Physiological
a: vol conducting airways (4-16 - bronchioles)
f: inflated alveoli w/ no gas exchange
p: anatomic + functional
Measurement Physiological Dead Space
Vd =
Vt x (PaCO2 - PeCO2) / PaCO2
Vt = tidal volume
Disribution vent in different lung areas uses ———- for measurement.
radio gas 133Xenon-O2
________ position improves vent
prone
Which lobes have less vent?
These lobes are [more/less] neg?
Which lobes have more vent?
These lobes are [more/less] neg?
Upper; more
Lower; less
bc already expanded so they can’t expand more to make “more” vent
Only _________ gas molecules generate PP
List affinity Hb and limit
N2O:
O2:
CO:
CO2:
free
N: none ; perfusion
O: relative high ; perfusion or diffusion
CO: high ; diffusion
CO2: n/a ; perfusion limited
total PVR is lowest when lung volume ________
if volume ↑ then _______
if volume ↓ then _______
if blood flow ↑ then ______
= FRC
radius ↓; length ↑ –> ↑ PVR
radius ↓ ; pressure ↑ –> ↑ PVR
PVR ↓
Normal PO2 is A-a < ?
Hypoxia w normal PA-a from?
Hypoxia w/ ↑ PA-a from?
15 mmHg
hypoventilation
impaired O2
Gas exchange depends on vent (V) and blood flow (Q)
Vent perfusion matching is ______ and ideally is between ____ and ____
if ratio is < ____ then ___ in alv vent
if > ____ then ___ cap perfusion
V/Q
0.8 - 1.0
0.8 ; decrease
1.0 ; decrease
Bohr effect
↑Pco2/ ↓ pH / ↑ temp / ↑ 23BPG
↓ Pco2 / ↑ pH / ↓ temp / ↓ 23BPG
right shift, ↓ O2 binding / ↑ unloading
left shift, ↑ O2 binding / ↓ unloading
CO2 largest transport factor
HCO3-
a base, which transports the major source of acid in body
ABG Normals
pH
PaCO2
PaO2
HCO3-
7.35-7.45
33-45 mmHg
75 - 105 mmHg
22 - 26 mmHg
Critical control of breathing is ____
____ resp group –> phrenic and 9/10 cranial
____ resp group –> in and ex neurons
pons
dorsal
ventral
Central vs Peripheral chemoreceptors
Location
Slow/Fast
Respond to?
Central:
L: ventral medulla
Slow
R: ↑ PaCO2 (very sensitive)
Peripheral:
L: carotid / aortic body
Fast
R: ↓ PaO2
What two receptors decrease vent?
Which is fast and which is slow?
Which is found in smooth muscle and which is epithelial?
Lung Stretch: slow, sm muscle
Irritant: fast, epithelial
