Term
| what is a gauge pressure in regards to the lungs |
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Definition
Pressure is often measured as gauge pressure, which is defined as the absolute pressure minus the atmospheric pressure.
lungs gauge pressure starting at apex is -10 and -2 at base. |
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Term
| when during the respiratory cycle is the pressure inside the alveoli equilibriated to the atmosphere? What would be the gauge pressure then? |
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Definition
| at END expiration . Gauge pressure = 0 |
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Term
| When would the gauge pressure in the lungs be = 0 |
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Definition
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Term
| as transpulmonary pressure increases what happens to lung volume |
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Definition
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Term
Increased collagen deposition in
lung tissue in “pulmonary fibrosis” increases or decreases lung compliance? |
|
Definition
Increased collagen deposition in
lung tissue in “pulmonary fibrosis” decreases lung compliance. |
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Term
| Gradual loss of lung elastic tissue with advanced age increases or decreases lung compliance? |
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Definition
| Gradual loss of lung elastic tissue with advanced age increases compliance of the lungs bc now there is not as much resistance to counteract the compliance since there is less elasticity. |
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Term
Pulmonary surfactant is produced by
Type ___ alveolar cells and reduces alveolar surface tension by? |
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Definition
Pulmonary surfactant is produced by
Type II alveolar cells and reduces alveolar surface tension by
interspersing itself between the water molecules. |
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Term
| surfactant will increase or decrease lung compliance? will it increase or decrease tendancy of lung to recoil inward? |
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Definition
| This increases lung compliance and reduces the tendency of the lungs to recoil inward. |
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Term
| what is transmural pressure |
|
Definition
Transmural pressure refers to the pressure inside relative to
outside of a compartment. Under static conditions, the transmural
pressure is equal to the elastic recoil pressure of the compartment. The
transmural pressure of the lungs is also called transpulmonary
pressure .
Since the lungs have a tendency to recoil inwards, inflating them
requires an increase in transpulmonary pressure. Transpulmonary
pressure can be increased by either 1) increasing the pressure inside
relative to the pressure outside the lungs or 2) by decreasing the
pressure outside relative to the pressure inside the lungs. |
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Term
| equation for transmural distending pressure |
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Definition
| intra-alveolar pressure - pleural pressure |
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Term
| when would the transpulmonary pressure = 0? |
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Definition
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Term
| For a given lung volume the transpulmonary pressure is equal/more/less and opposite to the elastic recoil pressure of the lung. |
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Definition
| For a given lung volume the transpulmonary pressure is equal and opposite to the elastic recoil pressure of the lung. |
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Term
| where on the lung is the highest V/Q mismatch |
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Definition
| at the apex due to low Ventilation and VERY low Q |
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Term
| highest overall volume of ventilation is at the base or apex |
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Definition
| base. Thick about the size of the lung and where it is the widest also remember where hte lung is able to expand those most (Base) b/c the diaphragm expands the AP diameter and pulls the lung down. |
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Term
| highest Q (perfusion) is at the base or apex |
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Definition
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Term
| The lowest V/Q mismatch naturally is at the apex, base or middle lungs |
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Definition
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Term
| can you increase Hb saturation by increase PO2 above 100? |
|
Definition
| NO. BUT IF YOU WANT TO INCREASE PaO2 then increase PAO2. Do this by increasing inhaled FiO2, ensuring all exhaled CO2 is removed or increasing the ATM pressure of any FiO2 entering (hyperbaric chamber) Then your arterial PaO2 will increase substantially and can compensate for extreme demand states or shitty Hb carryign capacity. |
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Term
| what two patients should you expect have atelectasis |
|
Definition
1. obese patients
2. pregnant patients |
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Term
| the respiratory pacemaker complex responds primarily to what factor |
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Definition
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Term
| Why do you need a higher than normal CO2 to get spontaneous breathing back in a anesthetized patient |
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Definition
| b/c anesthesia agents inhibit chemoreceptors! |
|
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Term
| what anesthesia agents inhibit the chemoreceptors |
|
Definition
1. propofol
2. narcotics
3. Gas |
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Term
| the cardinal feature of asthma is? |
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Definition
| airway hyper-responsiveness |
|
|
Term
| four basic features of asthma |
|
Definition
1. hyper-reactivity
2. reversible airway obstruction (pluggin)
3. chornic inflammation
4. airway remodeling |
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Term
| What happens to the bronchial muscles in patients with asthma |
|
Definition
| due to constant use of smooth muscles in bronchioles they become hypertrophied during all those asthma attacks. |
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Term
| What do fibroblasts do to asthma patients airways |
|
Definition
| increase basement membrane and increase content of inflammatory meidators. |
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Term
| what is your BP if your absolute pressure is 870 and atm pressure is ATM 1 |
|
Definition
Absolute pressure 870 - ATM (760 ) = 110.
SBP = 110
Gauge pressure = 110. |
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Term
| pressure of the pleural space at the apex, middle and base are? |
|
Definition
Apex: -10
middle: -5
Base: -2.
The highest pressure here is -2. -2 is bigger than -5 or -10. Base has the highest pressure. |
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Term
| are alveoli more compliant at the base or apex |
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Definition
| at the base because they were completely squeezed clean of their air and can be expanded again through inspiration than the apex alveoli which have a intra-alevolar pressure of +10 since their intrapleural pressure = -10. GAs likes going to where there is less resistance and at the base there is less resistance. |
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Term
| pulmonary artery supplies blood to lungs gas areas at the level of what landmark |
|
Definition
| carina (At the middle of the lung) |
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|
Term
| would a PaO2 in blood be higher at the apex or base..why |
|
Definition
| at the APEX there is a high V/Q mismatch since there is more ventilatoin than perfusion and results in abnormally higher PaO2. While at the base there is a lower V/Q mismatch resulting in way more perfusion than ventilation can keep up with so the PaO2 is lower |
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Term
| how do muscle relaxants effect lung ventilation and physiology |
|
Definition
| screws with the chest's opposing forces |
|
|
Term
| what is the respiratory quotient |
|
Definition
| a dietary measure or basal metabolic rate |
|
|
Term
| what type of patients can have bronchoconstriction to benign stimuli |
|
Definition
|
|
Term
| bronchial hyperresponsivness is? |
|
Definition
|
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Term
| characteristics of asthma |
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Definition
1. smooth muscle hypertrophy
2. incrase size/activity of goblet cells
3. increase infiltration of inflmamatory cells
4. thickening of the basement membrane proteins. |
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Term
| we should bronchodilate asthmatics with what two drug classes |
|
Definition
1. B2 agonist
2. anticholinergics |
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Term
| which chemoreceptors primarily sense o2 |
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Definition
| peripheral chemoreceptors |
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Term
| the prebotzinger complex is located where? Importance? |
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Definition
| group of neurons in the rostral ventrolateral medulla. Thought to be the main rhythmic control center for breathing via its pacemaker cells. |
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Term
|
Definition
| are peripheral chemoreceptors located in the carotid body or aortic notch. |
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Term
| ventilation is directly related to PO2 or CO2 content |
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Definition
| CO2 content. The gain of the response to CO2 is also affected by O2 content. |
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Term
| where exactly does propofol blunt the chemoreceptors |
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Definition
| blunts peripheral chemoreceptors by blocking influx of calcium |
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Term
| what is the physiology for how narcotics affect respiratory cycle |
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Definition
| binds to prebotzinger complex and opens K channels. |
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