A/p 2 Unit 2C

Front 1

Define negative pressure breathing

Back 1

movement of air into the lungs as the result of intra-pulmonic pressure being less than atmospheric pressure

Front 2

What is movement of air into the lungs as the result of intra-pulmonic pressure being less than atmospheric pressure?

Back 2

negative pressure breathing

Front 3

How do we write subatmospheric pressure?

Back 3

with a negative symbol

Front 4

How do we write pressure above atmospheric?

Back 4

with a positive symbol

Front 5

At beginning of inspiration what is the intra-alveolar pressure at end expiration?

Back 5

-1 or -2 cm H2O

Front 6

What are types of negative pressure breathing?

Back 6

normal physiologic breathing, iron lung, cuirass (chest respirator, breastplate), drowning resusitation

Front 7

How does the iron lung work?

Back 7

as pressure in iron lung increases, then exhale. As decreases, inhale.

Front 8

What are examples of positive pressure breathing?

Back 8

mechanical ventilator, scuba diving, mouth to mouth resuscitation

Front 9

How does positive pressure breathing work?

Back 9

increase in pressure causes inhalation, decrease causes exhalation.

Front 10

What is Boyle's Law?

Back 10

as temp remains same, volume and pressure are inversely related

Front 11

What is Charles' Law?

Back 11

as pressure remains same, volume and temp are directly related

Front 12

What is Gay Lassac's Law?

Back 12

as volume remains same, pressure and temp are directly related

Front 13

What law states that as temp remains the same, volume and pressure are inversely related?

Back 13

Boyle's Law

Front 14

What law states that as pressure remains the same, volume and temp are directly related?

Back 14

Charles' Law

Front 15

What law states that as volume remains the same, pressure and temp are directly related?

Back 15

Gay Lassac's Law

Front 16

Define expiration.

Back 16

movement of air out of lungs as a result of increased intra-pulmonic pressure secondary to decreased lung volume.

Front 17

What is movement of air out of the lungs as a result of increased intra-pulmonic pressure secondary to decreased lung volume?

Back 17

expiration

Front 18

What law does expiration follow?

Back 18

Boyle's Law d/t decreasing volume causing an increased pressure

Front 19

What changes first in expiration: volume or pressure?

Back 19

volume

Front 20

What are two types of expiration?

Back 20

active expiration and passive expiration

Front 21

What is passive expiration?

Back 21

requires no muscular activity to achieve expiration

Front 22

What requires no muscular activity to achieve expiration?

Back 22

passive expiration

Front 23

When is passive expiration utilized?

Back 23

at rest and during mild to moderate levels of physical activity

Front 24

Which expiration is utilized at rest and during mild to moderate levels of physical activity?

Back 24

passive expiration

Front 25

During onset of passive expiration, how do muscles of inspiration relax?

Back 25

gradually

Front 26

What is the advantage of the way muscles of inspiration relax during passive expiration?

Back 26

gradual expiration allows for a smooth expiratory effort

Front 27

For passive expiration, what is the factor responsible for decreasing lung volume?

Back 27

inward recoil of lungs

Front 28

What are two factors contributing to lung recoil?

Back 28

recoil of stretched elastic tissue and recoil d/t surface tension phenomena

Front 29

What is alveolar elastic recoil?

Back 29

Levitsky uses this to refer to recoil from elastic tissue and surface tension phenomena

Front 30

What is active expiration?

Back 30

expiration that requires muscular activity for expiration

Front 31

What is expiration that requires muscular activity?

Back 31

active expiration

Front 32

When is active expiration used?

Back 32

heavy exertion and with COPD, valsava maneuver

Front 33

What kind of expiration is used during heavy exertion, COPD and valsalva maneuver?

Back 33

active expiration

Front 34

What is the overall function of the muscles of expiration?

Back 34

decrease the volume of the thorax and more importantly the lungs which causes increased IPP

Front 35

What are some specific functions of the muscles of expiration?

Back 35

accelerate exhalation processes, increase respiratory rate, increase volume of air exhaled

Front 36

How do muscles of expiration accelerate the exhalation process?

Back 36

shorten expiratory phase by speeding up expiration

Front 37

How do the muscles of expiration increase the respiratory rate?

Back 37

by shortening the period of time spent in exhalation

Front 38

How do the muscles of expiration increase the volume of air exhaled?

Back 38

they must be contracted to get to the ERV

Front 39

What are the primary muscles of expiration?

Back 39

abdominal muscles and internal costal muscles

Front 40

What are the abdominal muscles involved in expiration?

Back 40

external oblique, internal oblique, transverse abdominis, rectus abdominis

Front 41

How is the orientation of the external and internal oblique muscles of the abdomen similar to the intercostal muscles?

Back 41

External is oriented the same as external ICMs, same with internal

Front 42

What is the origin of the rectus abdominis?

Back 42

symphysis pubis

Front 43

What muscle originates at the symphysis pubis?

Back 43

rectus abdominis

Front 44

What is the insertion of the rectus abdominis?

Back 44

lower ribs (probably rib 6)

Front 45

What muscle inserts at the lower ribs (probably rib 6)?

Back 45

rectus abdominis

Front 46

What is the function of the contraction of the abdominal muscles?

Back 46

pull down on thorax (decreases tran and AP), increase intra-abdominal pressure (decrease vert), fix lower thorax

Front 47

What dimensions of the thorax do the abdominal muscles change?

Back 47

transverse, anterior-posterior, and vertical

Front 48

What are the functions of the internal intercostal muscles?

Back 48

pull down on rib above (decrease tran and AP), gives rigidity to ICS to prevent paradoxical breathing

Front 49

What dimensions of the thorax do the internal intercostal muscles change?

Back 49

decrease transverse and anterior-posterior dimensions

Front 50

What expiratory muscles decrease the transverse, anterior-posterior, and vertical dimensions of the thorax?

Back 50

abdominals

Front 51

What expiratory muscles decrease the transverse and anterior-posterior dimensions of the thorax?

Back 51

internal intercostals

Front 52

What can be used to determine the strength of the expiratory muscles?

Back 52

valsava maneuver

Front 53

What can the valsalva maneuver be used for?

Back 53

to determine the strength of the expiratory muscles

Front 54

What is the pleural cavity?

Back 54

the potential space between the visceral and parietal pleura

Front 55

What is the potential space between the visceral and parietal pleuras?

Back 55

the pleural cavity

Front 56

What is intra-pleural pressure (IPP)?

Back 56

pressure which exists within the pleural cavity

Front 57

What is the pressure which exists within the pleural cavity?

Back 57

intra-pleural pressure (IPP)

Front 58

What is the intra-pleural pressure (IPP) at end-expiration?

Back 58

-4 torr (mmHg) or -5 cm H2O or 756 torr (mmHg)

Front 59

what are the opposing factors responsible for the negative pressure at end-expiration?

Back 59

inward recoil of the lungs and outward recoil of the chest wall

Front 60

What are three factors responsible for the negative pressure at end expiration?

Back 60

(elastic tissue recoil + surface tension phenomena) + outward recoil of the chest wall

Front 61

What is the major factor for negative IPP?

Back 61

inward recoil of the lungs

Front 62

What is the IPP (intra-pleural pressure) following an inspiration of a normal tidal volume?

Back 62

-8 cm H2O or -6 mmHg

Front 63

Why is IPP greater at end-inspiration than end-expiration?

Back 63

inward recoil causes a larger pull on the pleura

Front 64

If given 2 different IPP values at end-inspiration, which would indicate the greater effort?

Back 64

the more negative number

Front 65

Why is the bell jar balloon model incorrect according to Reinke?

Back 65

he says lung expansion is due to increasing volume of the thorax, not IPP changes

Front 66

What causes IPP to become positive?

Back 66

active expiration and inspiratory phase of mechanical ventilation

Front 67

Active expiration and inspiratory phase of mechanical ventilation cause what?

Back 67

the IPP to become positive

Front 68

Where is IPP reflected?

Back 68

throughout the entire lung, the entire thorax, but NOT in the airways

Front 69

What is the thoracic pump?

Back 69

changes in IPP effect venous return

Front 70

What is the phenomena called that changes venous return d/t changes in IPP?

Back 70

thoracic pump

Front 71

What does the thoracic pump due primarily to?

Back 71

changes in intrathoracic pressure

Front 72

How does the thoracic pump work during inspiration and expiration?

Back 72

inspiration - increased blood flow, expiration = decreased blood flow

Front 73

How does the thoracic pump work during inspiration specifically?

Back 73

decreased IPP reflected to around vena cava, vessel dilates, decrease resistance, increased flow

Front 74

How does the thoracic pump work during expiration specifically?

Back 74

increased IPP reflected to around vena cava, vessel narrows, increase resistance, decreased flow