Yin

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Author:
pretty4Jesus
ID:
64076
Filename:
Yin
Updated:
2011-02-08 02:16:41
Tags:
Physio Block
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Description:
lungs
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  1. Pressure
    P~ conc. dissolved gas / solubility
  2. Tidal Volume (VT)
    • V entering/leaving mouth/nose each breath
    • 400-500ml
    • VT=VD+VA
  3. FRC- Functional residual capacity
    Volune left after normal expiration
  4. VC- Vital Capacity
    max volume exhaled after max inspiration
  5. RV- Residual Colume
    volume after max expiration
  6. TLC- Total Lung Capacity
    total volume at max inspration
  7. Draw graph
  8. Helium dilution technique
    • [He]i x Vsp = [He]f x (Vsp + VL)
    • VL= FRC
    • Assume all airspaces are vent, so may underestimate FRC.
  9. Minute Ventilation VdotE or VdotT
    VdotT= VT x f
  10. Efficient breathing
    • Increasing VT (deep breaths) increases VA more efficiently than panting (shallow breaths @ high respiratotory rate)
    • Through training
  11. AVE
    • VA= (VECO2 / PACO2) x K
    • K= 0.863
    • Increase rate of CO2 generation-> increases vent to get rid of it
    • PACO2 is inversely related to VA. Cuz more vent-> means less PACO2
    • PA/a
  12. AGE
    • PAO2= PIO2 - (PA/aCO2/R)
    • R= 0.8
    • PAO2= 150- (PA/aCO2/0.8)
  13. Inspiration
    diaphram contracts, increasing thorax V->decreasing Ppl! And cause lungs to expand.
  14. PA and Ppl
    • As chest wall expand, Ppl gets MORE neg.
    • PA- neg: during insp; pos: during expiration; 0 at end-insp & end-expir (no air flow)
  15. PA
    PTP
    • PA: Ppl + Pel
    • PTP: PA - Ppl
    • -"inside - outside"
  16. Surface tension
    • Collapsing pressure due to water interactions @ gas-liquid interface lining alveoli.
    • Collapsing P ~ ST and inv ~ to radius. (small alveoli WOULD collapse)
    • Surfactant decreases ST
  17. Surfactant
    • Surfactant decreases ST
    • work
    • Inc compliance
    • minimize leakeage/pulm edema in cap's
    • week 24-35
  18. Resistance
    • **R= 8nl / πr4
    • Rtot in series (conducting airways) add them up.
    • Rtot in parallel (smaller airways)-> 1/Rtot= 1/R1... (tot R less than indiv.)
  19. velocity
    • v=Q/A
    • Q is contant so as A inc, v decreases.
  20. EEP (Equal Pressure Pt)
    • WHERE airway P is = to Ppl (PTP=0)
    • At large V: (effort-dep flow) EPP in large airways, protected by cartilage
    • At low V: (effort-indep flow) dynamic compression sooner in peripheral airways, can't ovecome with effort. (emphysema problem)
  21. Bronchodilators/constrictors
    • opp of what you'd think. refer to Stull
    • P-bronchoconstrictors
    • S-bronchodilators
  22. O2 capacity
    • max O2 can be combined with Hb (100% saturation)
    • 20.1
  23. O2 content
    • TOTAL O2
    • O2 content= (O2 binding capacity x %HB sat) + dissolved O2
  24. Dissolved O2
    • =PO2 x solubility
    • =100 x 0.0031
    • =0.31
  25. O2 Sat (SO2)
    • percent of Hb binding sites bound by O2
    • %SO2= [O2 bound Hb / O2 capacity] x 100
    • =[O2 content - O2 dissolved] / O2 capacity] x 100
  26. VdotO2 (body consumes)
    200-250ml/min
  27. CO
    VdotO2 / (CaO2 - CvO2) (contents)
  28. Zones
    • Slinky/wet sponge model: alveoli at top are more open and bigger than base aveoli
    • The smaller base alveoli are more compliant so can inc V more than the big apex ones.
  29. HPV
    • Local/Regional
    • Generalized HPV: high alt, prolonged hypoxia, COPD, CF
    • -Inc PVR->pulm hypertension & edema-> RHF
  30. Hypoxia & Hypoxemia
    Hypoxia- lo O2 in tissue (O2 content)

    • Hypoxemia- low PaO2 (chemR respond)
    • causes: hypovent, diff impairment, R-to-L shunt, low V/Q, decreased PIO2.
  31. Draw p.457
  32. FEV1- Forced Expiratory Volume
    FVC- Forced Vital Capacity
    • FEV1- volume of 1st sec of forced expiration
    • FVC- max volume exhaled after max inspiration
    • FEV1/FVC ratios:
    • Obstructive- reduced
    • Restrictive- increased/normal
  33. COPD
    • now small airways have lots of R
    • Chronic bronhitis- BB, inflammatory edema, V/Q mismathc, cyanotic

    Emphysema- PP, V/Q match, NOT cyanotic, barrel chest b/c of increase lung V
  34. Dorsal respiratory group
    • In medulla
    • inspiration/rhythm
    • Inputs: vagus and glossopharyngeal
    • Outputs: phrenic to diaphram
  35. Ventral respiratory group
    • In medulla
    • ONLY active with active EXPIRATION (exercise)
  36. Pneumotaxic center
    • upper pons
    • Shuts down dorsal (limits insp)
    • regulates insp V and rate
  37. Apneustic center
    • lower pons
    • prolonged and deep inspirations
    • Inhib by pneumotaxic center and vagus
  38. Central chemoreceptors
    • breathing responds to CO2 and H+
    • NOT O2
  39. Peripheral chemoreceptors
    • breathing responds to all 3- O2, CO2, H+
    • 1. Carotid bodies- glossopharygeal to dorsal
    • 2. Aortic - vagus to dorsal
    • 3. hypoxic vent response
  40. hypercapnic vs hypoxic vent repsonse
    • more sensitive to hypercapnia.
    • both chemoR sensitive to it
    • hypoxic response kicks it later after PaO2 drops below 60
  41. Herring-Bruer response with Stretch R
    Irritant R
    J R
    Chest wall R
    • Herring-Bruer response with Stretch R: distention activates stretchR activate pneumotaxic center to protect from overinflation
    • Irritant R: smoke, noxious gases cause bronchocnstrictions, coughng, sneezing
    • J R: stim when pulm cap's engorgw with blood, cause rapid shallow breathing/dyspnea
    • Chest wall R: detect force by resp muscles, cause dysnea
  42. Cheyene-Stokes breathing
    • breaths deeply for short interval, then not at all
    • delay in CO2 flow going to brain
  43. Sleep apnea
    • Central sleep apnea- dec central drive to breath
    • Obstructive sleep apnea- blockage of airway; weight, pregnancy, age
    • Generalized HPV and it's symptoms
  44. dead space
    • VD= VT x [(PaCo2 - ExpiredCO2) / PaCO2]
    • VT= VA + VD

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