Respiration Physiology

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tsbatiste
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258122
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Respiration Physiology
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2014-02-08 19:38:43
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VTHT Anesthesia Surgery
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review of the respiratory system
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  1. This is the total process whereby oxygen is supplied to and used by body cells and carbon dioxide is eliminated by means of gradients (high to low)
    Respiration
  2. This is the movement of gas in and out of the alveoli
    Ventilation
  3. This is the maximum amount of oxygen with which each gram of hemoglobin can be combined
    1.36mL O2
  4. The oxidation of this molecule produces the end product CO2
    Glucose
  5. What compound is formed by carbon dioxide in the presence of carbonic anhydrase and water?
    Carbonic acid
  6. This phase of respiration is the active process that requires energy
    Inspiration
  7. The muscles involved in inspiration are:
    • External intercostal muscles
    • Diaphragm
  8. This phase of respiration is the passive process resulting from the natural recoil of the lung and the chest wall
    Expiration
  9. The muscles involved when expiration needs to be forced are:
    • Abdominal muscles
    • Internal intercostal muscles
  10. Three areas of pulmonary ventilation
    • Muscles - cause lung expansion and contraction
    • Movement of air-pressure changes cause a complete collapse of the lung and expulsion of air
    • Pleural Pressure - negative pressure surrounding the lung create a suction to hold lungs open
  11. Anesthetics suppress primarily 2 bodily functions
    • 1. heart rate
    • 2. respiration
  12. This refers to normal quiet breathing
    Eupnea
  13. This is labored breathing
    Dyspnea
  14. This refers to fast and/or deep breathing
    Hyperpnea
  15. This refers to rapid shallow panting
    Polypnea
  16. This is the total but usually not permanent cessation of breathing
    Apnea
  17. This refers to a slow and/or shallow breathing
    Hypopnea
  18. This refers to long, gasping inspirations with several subsequent ineffective exhalations often seen with cyclohexylamine administration
    Apneustic respiration
  19. This refers to a sequence of gasps, apnea, and several deep gasps
    Biot respiration
  20. This is an increase in rate and depth of respiration then become slower, followed by a brief period of apnea
    Cheyne-Stokes respiration
  21. This refers to regular deep respirations without pause
    Kussmaul respirations
  22. This abbreviation represents the concentration of oxygen attached to hemoglobin
    SpO2 (SaO2)
  23. This abbreviation represents the concentration of oxygen free in the plasma
    PO2
  24. This abbreviation represents the concentration of carbon dioxide free in the plasma
    PCO2
  25. This abbreviation represents adequate oxygen delivery
    DO2
  26. This abbreviation represents reduced oxygen consumption usually only measure in humans and thoroughbreds
    VO2
  27. Which is larger: the amount of oxygen dissolved in plasma or bound to hemoglobin?
    Oxygen bound to hemoglobin
  28. This is the volume of air inspired or expired in one respiration and is often very associated with the patient's weight.
    Tidal Volume
  29. This is the volume of air that can be inspired over and above normal Tidal Volume (TV)
    Inspiratory Reserve Volume (IRV)
  30. This is the volume of air that can be expired by forceful expiration after normal tidal expiration
    Expiratory Reserve Volume (ERV)
  31. This is the volume of air remaining in the lungs after the most forceful expiration
    Residual Volume (RV)
  32. True or False: there is no difference between a ventilator and a respirator.
    True
  33. This is used to describe the amount of gas moved per minute
    Minute Volume (MV)
  34. Mammalian normal Tidal Volume
    5-10 mL/lb
  35. Minute Volume =
    MV = Tidal Volume(TV)  x Respiratory Rate (RR)
  36. Normally if the respiratory rate increases, what happens to the tidal volume?
    It decreases
  37. What portion of ventilation is important for and contributes to gas exchange?
    Alveolar ventilation
  38. This refers to the area ventilated by tidal volume where there is little or no diffusion of O2 and CO2
    Dead space ventilation
  39. What areas comprise the dead space in ventilation?
    • Mouth
    • Trachea
    • Bronchii
    • Bronchioles
  40. What is the percentage of dead space ventilation in normal tidal and minute volumes?
    30-40%
  41. This is when you breathe for the animal via respiratory bag, ambu bag and blowing into the tracheal tube
    Positive Pressure Ventilation (PPV)
  42. What level of hypercarbia/hypercapnia (CO2) requires PPV?
    CO2 > 60 mmHg
  43. What level of desaturation (SpO2) in spite of oxygen therapy requires PPV?
    SpO2 <95%
  44. What level of hypoxemia (PO2) requires PPV?
    PO2 < 100 mmHg
  45. Other cases requiring PPV
    • 1. Open chest surgery - eg diaphragmatic hernia
    • 2. Neuromuscular disease - eg tick paralysis
    • 3. Chest wall trauma that results in an open wound
    • 4. Abdominal enlargements - eg gastric torsion/dilation complex
    • 5. Pulmonary parenchymal disease - pneumonia
  46. What is the RQ?
    The Respiratory Quotient is found by the O2/CO2 in respiratory exchanges (results should always be a decimal)
  47. This refers to the amount of air that can be breathed beginning at the normal expiratory level and distending the lungs to the maximum amount
    Inspiratory Capacity (IC)

    IC=TV+IRV
  48. This is the amount of air remaining in the lungs at the end of a normal expiration
    Functional Residual Capacity (FRC)

    FRC = ERV + RV
  49. This is the maximum amount of air that can expelled from the lungs after first filling the lungs to their maximum extent and then expiring to the maximum extent
    Vital Capacity (VC)

    VC = IRV + TV + ERV
  50. This is the maximum volume the lungs can be expanded with the greatest possible inspiratory effort
    Total Lung Capacity (TLC)

    TLC = VC + RV
  51. What are the secondary functions of respiration?
    • Phonation - Voice production
    • Body Temperature regulation
    • Acid-Base balance
    • Olfaction - Sense of smell
  52. These structures may contribute to the resonance and characteristics to phonation
    • Nose
    • Sinuses
    • Mouth
    • Pharynx
    • Thorax
  53. This is caused by two connective tissue bands stretching across the larynx and vibrating as air passes over them
    Phonation or voice production
  54. How does breathing provide body temperature control?
    A network of superficial blood vessels under the nasal epithelium warm air as it passes through which prevents chilling of the blood in the lungs
  55. This is the unit used to express the relative acidity or alkalinity representing the negative logarithm of the hydrogen ion concentration
    pH
  56. Neutral blood pH
    7.4
  57. Acceptable range for blood pH
    7.35 - 7.45
  58. This system contributes to the process of acid-base control by altering the CO2 content of the blood by adjusting the amount and rate of CO2 coming in and out
    respiratory system
  59. A higher concentration of CO2 makes the blood:
    acidotic
  60. A too low concentration of CO2 makes the blood:
    alkalinotic
  61. These causes substances like lactic acid and CO2 to constantly accumulate in the blood
    breakdown of food and glucose oxidation
  62. Name and describe the methods that the body uses to maintain neutral blood pH
    • 1. sodium bicarbonate release from the pancreas - neutralizes acids
    • 2. normal respiration - brings in more O2 (RQ 700:1)
    • 3. Kidneys retain Na+ and excrete H- and Cl-
  63. Condition that can result in metabolic acidosis
    • diarrhea - loss of sodium bicarbonate
    • ketosis - starvation
    • severe infectious disease - septicemia
    • renal insufficiencies - loss of Na+/retention of H- & Cl-
    • administration of acid drugs (abx)
    • shock
  64.                    causes the retention of CO2 in the blood and results in                     
    • Hypoventilation
    • respiratory acidosis
  65. This refers to excess CO2 in the blood
    Hypercapnia or hypercarbia
  66. Conditions that can result in metabolic alkalosis
    • vomiting - loss of Cl- ions/retention of Na+ ions
    • corticosteroid overdose
  67.                  causes an increase in O2 in the blood and results in                 
    • Hyperventilation
    • respiratory alkalosis
  68. This refers to a decrease of CO2 in the blood
    Hypocarbia or hypocapnia
  69. Animals are considered functionally                 and                
    • nearsighted
    • colorblind
  70. This is term for the sense of smell
    Olfactory sense
  71. This is the exchange of oxygen and carbon dioxide between the blood in the capillaries in the body and the cells/tissues of the the body
    Internal respiration
  72. This device is used to measure volumes of air in the lungs during the respiratory process and tests lung performance in thoroughbreds and humans
    Spirometer
  73. This is the basic force behind gas exchange as the molecules move from an area of higher concentration(high pressure) to an are of lower concentration(low pressure)
    passive diffusion
  74. Atmospheric air consists of:
    • Nitrogen ~ 79%
    • Oxygen ~ 20%
    • Carbon dioxide ~ 0.03%
  75. List the layers gas travels through from the alveoli to the RBC:
    • 1. Phospholipid Surfactant lining of the alveoli
    • 2. Alveoli epithelium
    • 3. Capillary endothelium with intercellular clefts
    • 4. Plasma
    • 5. Erythrocyte membrane
  76. This is the approximate distance from the surfactant lining of the alveoli to the rbc membrane
    less than 1 micron
  77. At complete saturation each hemoglobin molecule is combined with how many oxygen molecules?
    4 O2 molecules
  78. This refers to the percentage of oxygen consumed during normal activity
    Utilization Coefficient = 25%
  79. Strenuous activity might increase the utilization coefficient to what percentage?
    75%
  80. These two things directly influence O2 and CO2 concentrations
    • circulation - cardiac control
    • respiration - respiratory control
  81. Control by circulation and respiration is done by what two things?
    • glossalpharyngeal and vagus nerves
    • regulation of O2 and CO2
  82. Another name for the cardioinhibitory center
    central respiratory center
  83. Central respiratory centers are located where?
    • Medulla Oblongata
    • Pons
  84. What are the central respiratory centers?
    • Cardioinhibitory center
    • vasomotor center
  85. These detect concentrations of O2 and CO2 at the aortic arch and carotid sinus
    Peripheral Chemoreceptors
  86. These measure blood pressures at the aortic arch and carotid sinus
    Peripheral Pressoreceptors (Baroreceptors)
  87. With what 3 areas are the central respiratory centers in direct nervous contact?
    • Carotid sinus
    • Aortic arch
    • Bifurcation of the trachea in the lungs
  88.                    generally respond to O2 and CO2 concentrations to                      respiration.
    • Chemoreceptors
    • increase
  89.                      generally respond to blood pressures to                    respiration.
    • Pressoreceptors
    • inhibit
  90. This is the bifurcation of the carotid artery to form the internal carotid arteries
    Carotid sinus
  91. Respiration and Circulation receptors and connections:
    • 1. Impulses from Aortic Arch > Vasomotor and Cardioinhibitory centers via Vagus nerve
    • 2. Impulses from Carotid Sinus > Vasomotor and Cardioinhibitory centers via Glossapharyngeal nerve
    • 3. Impulses from the Cardioinhibitory center > Heart and Lungs via Vagus nerve
  92. Circulation has one further receptor/connection relationship.
    Impulses from the Vasomotor center > blood vessels via Sympathetic neurons (& reduction of vagus nerve stimulation
  93. Chemoreceptors are stimulated by:
    • lack of O2 < 70mmHg
    • increase in CO2 - this is how analeptics function
  94. Hering - Breuer Inflation Reflex
    • 1. A volume exceeding tidal volume activates the stretch receptors in the bronchi.
    • 2. An impulse via the vagus nerve goes to the Central respiratory center (cardioinhibitory center) to terminate inflation
  95. Hering-Breuer Deflation Reflex
    • 1. Usually associated with an accidental deflation of a lung - activates stretch receptors in the alveoli.
    • 2. An impulse via the vagus nerve goes to the Central respiratory center (cardioinhibitory center) to accelerate respiration
  96. Name techniques used to manually stimulate the Hering-Breuer reflexes:
    • 1. slight manual compression of the chest
    • 2. slapping the chest
    • 3. "run the ribs"
  97. Cough sequence of events
    • 1. Irritation to respiratory passage sends impulse via vagus nerve to medulla.
    • 2. A liter of air is inspired
    • 3. The epiglottis and vocal folds close and shut tightly to trap the air in the lungs
    • 4. The abdominal muscles contract and push against the diaphragm
    • 5. the vocal folds and epiglottis open widely so the air under pressure explodes outward
  98. Sneeze reflex
    • Similar to the cough reflex with two important distinctions:
    • 1. the impulse travels from the nasal passages to the medulla via the trigeminal nerve
    • 2. the uvula or soft palate is depress forcing the large amount of air out through the nose to help clear the irritant
  99. This refers to a slow, deep breath taking through a wide-open mouth
    Yawn
  100. What two factors may stimulate a yawn?
    • 1. slight decrease in O2 level of the blood
    • 2. boredom, drowsiness, or fatigue
  101. This is a slightly deeper than normal breath not normally associated with a wide-open mouth
    Sigh reflex
  102. This is a spasmodic contraction of the diaphragm accompanied by a sudden closure of the glottis and epiglottis
    Hiccup reflex
  103. What 3 serious conditions can result in hiccuping?
    • 1. nerve irritation
    • 2. indigestion
    • 3. CNS damage
  104. This means the state of decreased O2 availability
    Hypoxia
  105. Name the immediate responses to hypoxia:
    • 1. Dilation of the coronary and cerebral blood vessels - unconsciousness
    • 2. Constriction of peripheral vessels
    • 3. Respiratory increase
    • 4. Elevation of pulse rate and blood pressure
    • 5. Increase in cardiac output
    • 6. Vomiting and Nausea
    • 7. Reduced RBC
    • 8. Dilated pupils - terminal sign of death
  106. Name the chronic responses to hypoxia:
    • 1. No real noted change to coronary or cerebral vessels
    • 2. Fall in pulse rate and blood pressure
    • 3. Slow decrease in cardiac output
  107. Shock cycle
    Accumulation of waste (CO2)  > Capillaries dilate > increased capillary permeability > loss of blood plasma into tissues > Hemoconcentration > Reduced blood flow > Accumulation of waste (CO2)
  108. This is a condition where the normal negative pressure of the pleural cavity is interrupted and air is allowed inside
    Pneumothorax
  109. The two types of pneumothorax are:
    • 1. Open - communication between the inside of the thorax and the outside environment - penetrating wound
    • 2. Closed - no communication between the inside of the thorax and the outside environment - crushed lung
  110. Another name for a closed pneumothorax
    Spontaneous Pneumothroax
  111. Paradoxical Respiration Movement
    • 1. Air into the collapsed lung first
    • 2. Then into the intact lung
    • collapsed lung becomes smaller upon inspiration
    • 3. Air expired first into the collapsed lung
    • 4. Then out into the environment
    • collapsed lung becomes larger upon exhalation
  112. This is the condition is caused pus from foreign bodies or puncture wounds through the chest wall.
    Pyothorax
  113. This is the most common foreign body in a pyothorax
    grass awn
  114. This is the condition where chyle accumulates in the thorax usually from a thorax duct rupture from trauma
    Chylothorax
  115. This is triglyceride-rich lymphatic fluid from the intestinal lymphatics that usually empties into the venous system at the azygos vein
    Chyle
  116. This condition results from mediastinal lymphoma
    Neoplastic effusion
  117. Resuscitation steps (ABCD)
    • 1. Make sure the animal is on its right side
    • 2. Airway must be immediately established with a endotracheal tube
    • 3. Breathing is assisted with Positive Pressure Ventilation (PPV) @ 12 breaths per minute & Tidal volume of 5-10mL/#
    • 4. Cardiac compressions at 60/min. >30 # use both hands, <30 # use thumb and fingers
    • 5. Drugs - initiate 1 minute after starting compression via IV
  118. Where is Kussmal respirations seen most?
    Methoxyfluorane (Metafane)
  119. This is the most common hernia
    umbilical hernia
  120. This is the second most common hernia
    diaphragmatic hernia
  121. This is a hernia at the intersection of the diaphragm and the esophagus
    hiatal hernia
  122. Name the ventral hernias
    • umbilical
    • scrotal
    • inguinal

  123. Which respiratory volume cannot be controlled?
    Residual Volume
  124. These factors can cause RQ variance.
    • breed
    • age
    • conditioning
  125. These factors can affect hemoglobin saturation
    • Condition
    • Age
    • Disease state
  126. Conditions that often cause in chronic hypoxia
    • Heart Disease
    • Chronic Lung Infection
    • Kidney failure
    • Diabetes Mellitus and Insipidis

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