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84 Cards in this Set
- Front
- Back
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Define cellular respiration
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Gas exchange in lungs between blood and inspired air occurs due to cellular aerobic metabolism that consumes oxygen and produces carbon dioxide, thereby needing the exchange to occur
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What is the overall reaction of glucose metabolism?
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C6H1206 + O2 -> 6CO2 + 6H20 + Energy
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How is energy stored after aerobic metabolism of one glucose molecule
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As 38 ATPs that stores at the 3rd phosphate bond
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What is the respiratory quotient?
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The ratio of total CO2 production (VCO2) to O2 consumption known as RQ
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What are the common respiratory quotients
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carbs - 1.0, lipids - 0.7, proteins - 0.8
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How else can one estimate oxygen consumption based on weight?
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VO2 = 10 x(wt)^3/4
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How much can the diaphragm go down during inhalation?
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1.5 - 7cm, about 75% of chest movemnt
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What is the function of the tracheobronchial tree
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It is to condunct gas flow to and from the alveoli
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What is the average diameter of the alveoli
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.05-.33mm
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What kind of cells are present in the pulmonary epithelium?
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Type I and II pneumocytes
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What type of substance is made by type II pneumocytes
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surfactant
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How many types of circulation are presnt in the lung?
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Two types - pulmonary and bronchial
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What does the bronchial circulation provide
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Primary comes from the left heart and sustains metabolic needs of tracheobronchial tree
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What does the pulmonary circulation do?
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It provideds deoxygenated blood from the right heart via the pulmonary artery dividing into right and left branches
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What is important about the circulaton in the system and the pulmonary circulation
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Lower pulmonary vascular resistance causes increased pulmonary vascular pressure 1/6th greater than systemic circulation
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How are pulmonary capillaries arranged?
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Pulmonary capillaries are incorporated on the walls of alveoli, each network supplies more than one alveoli
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What is the diameter of pulmonary capillary
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About 10 micrometer
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What is the relationship between the size of alveoli and blood flow
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The larger the alveoli the larger the resistance to blood flow due to smaller cross section of capillaries
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What is the relationship of of gravity and blood flow
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Upright position, the top or apex of lungs have less flow, where the basal capillaries have larger flow
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What are the volumes of lung
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1)Tidal 2) inspiratory reserve 3) expiratory reserve 4) residual volume
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What are the 4 capacities of the lungs
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1) Total 2) Inspiratory 3) Residual 4) Vital
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What is closing capacity
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Volume at which the elastic recoil dependent airways close
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What is vital capacity?
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Maximal volume of gas that can be exhaled after maximal inhalation normally 60-70ml/kg
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What is Reynold's number?
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A description of laminar flow calculated as
Reynolds number = (Linear velocityxDiameterxGas Density)/Gas viscocity |
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What is a low Reynold's number associated with?
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<1000 associated with laminar flow
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What is a high Reynold's number associated with?
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>1500 a high value associated with turbulent flow
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What is the average tidal volume
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500ml
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What is IRV (inspiratory reserve volume)?
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Maximum additional volume inspired over tidal volume about 3000ml
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What is ERV (expiratory reserve volume)?
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Maximum additional volume that can be expired below tidal volume about 1100 ml
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What is Residual Volume (residual volume)?
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Volume remaining after exhalation about 1200ml
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How do you calculate Total Lung Capacity?
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RV+ERV+IRV+VT
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How do you calculate Functional Residual Capacity?
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RV+ERV
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What is minute ventilation
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Minute ventilation = respiratory rate x Tidal Volume about 5L/min
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What is the total energy generated from the glucose?
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Energy + ADP + P = ATP, a total of 1200 kj/mol for the third phosphate bond of ATP. There are 38 ATP molecules created from one glucose molecule
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What is the nature of ATP?
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ATP cannot be stored, it has to be constantly generated from O2 and metabolic substrates
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What is the effect of anesthesia on both VO2 and VCO2?
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It is reduced by about 15%, but the greatest reduction are seen with cerebral and cardiac O2 consumption
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What are the anatomic structures associated with respiration and ventilation?
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Insp=Diaphragm, external intercostal, SCM, scalene, pectoralis. Exp =abdominals-rectus abdominus, external & internal obliques, transversus
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What kind of epithelium permits gas exchange?
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Flat alveolar epithelium
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What types of epithelium are present in the mucose
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Ciliated columnar, cuboidal, flat alveolar
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How does the smaller airways maintain patency?
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They rely on elastic recoil, airway diameter relies on total lung volume
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What types of pressure are present in the pulmonary circulation?
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Relatively low pressure
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What mechanisms effect the flow of blood in pulmonary capillaries
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The size of the alveoli and gravity
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Which size of alveoli tend to have lower blood flow
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Large alveoli, since they have smaller capillary cross sectional area with increased resistance to flow
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Which capillaries tend to have lower blood flows
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In the upright position, it will be the apex
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Which nerve roots innervate the lungs?
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C3-C5 nerve roots bilaterally forming the left and right phrenic nerves
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What nerve is responsible for PANS and sensory innervation to the tracheobronchial tree?
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Vagus nerve
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What nerve roots are responsible for the SANS innervation of the tracheobronchial tree?
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T1 to T4
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What is the normal resting intrapleural pressure?
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-5 cm H20
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What is the equation describing Transpulmonary pressures?
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Ptranspulmonary = Palveolar - Pintrapleural
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What are the effects of general anesthetics on breathing?
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Light anesthesia = irregular breathing pattern with breath holding, usually rapid shallow breaths,
Nitrous oxide results in slow deep breaths |
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What happens to expiratory muscles during anesthesia?
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Respiratory muscles become activated during anesthesia
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What determines the mechanics/movement of lungs?
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It is determined by impedance on the respiratory system divided into elastic resistance of tissues + gas liquid interface and nonelastic resistance to gas flow
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What favors alveolar collapse?
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The surface tension forces that reduce area of interface between the gas and fluid
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When is alveolar collapse more imminent?
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When they are small and when the surface tension is great
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What is Laplace's law
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Pressure = 2x surface tension/radius
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What does pulmonary surfactant do?
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Pulmonary sufactant tends to reduce the surface tension
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How is concentration of pulmonary surfactant related to small alveolar size
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The smaller the size the more concentrated surfactant becomes, increasing surfactant ability to reduce tension, preventing further alveolar collapse
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How is concentration of pulmonary surfactant related to large alveolar size?
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Larger size alveoli, less concentrated surfactant with less ability to reduce tension, therefore higher tension to prevent further alveolar size increase
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How is elastic recoil measured?
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It is measured in terms of compliance, or change in volume / change in pressure
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What factors affect pulmonary compliance?
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Lung volume, pulmonary blood volume, extravascular lung water, pathological processes such as inflammation and fibrosis
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What is Functional Residual Capacity?
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It is the lung volume at the end of normal exhalation
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What is unique about the volume that defines FRC?
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At this volume FRC, inward lung recoil is equal to outward chest recoil (plus diaphragm)
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What factors affect FRC
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body habitus, sex, posture or position, lung disease, diaphragmatic tone
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What is the relationship between FRC and closing capacity?
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Closing capacity is generally less than FRC, but it increases with age
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What happens with pulmonary blood flow with collapsed alveoli?
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Blood flow tends to occur in unventilated dependent areas resulting in intrapulmonary shunting resulting in hypoximia
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Describe Vital Capacity?
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Vital Capacity is the maximum volume that can be exhaled following maximal inspiration
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What is the average normal Vital Capacity
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It is about 60 - 70ml/kg
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What is the equation for laminar flow?
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Flow = pressure gradient/Raw (airway resistance)
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What is the equation for airway resistance?
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Raw = 8(length)(gas viscocity)/Phi(radius)^4
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What factors that determine turbulent flow?
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Airway caliber, high gas flows, sharp angles, branching points
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Define important factors that increase airway resistance
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Bronchospasms, secretions, mucosal edema, volume-related and flow related airway collapse
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During anesthesia what occurs with the airway in terms of resistance and volume
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Resistance decreases as lung volume increases, and decreases as lung volume increases
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PAO2 =
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FiO2 (Patm-PH20) - PCo2/Q
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PAO2 = quick way
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FiO2 x 6
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PaO2 = using age
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102- age/3
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PaO2 =
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60-100
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PvO2 =
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normally 40-60
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PvO2 demonstrates
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overall balance o2 consumption and o2 delivery
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PACO2 represents _________ / __________
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volume co2 produced / aleovolar ventilation (elimination)
Vco2 / Va |
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pulmonary capillary o2 equivalent to ________
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PAO2
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normal PaCo2
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40 mm Hg
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PACO2 - PETCO2
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< 5 mm Hg
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each hemoglobin can hold _____ ml of o2
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1.39
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P50 of an adult
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26.6 mm Hg
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