CH 2 notes

Spontaneous breathing
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Terms in this set (63)
Spontaneous breathing
negative pressure breathing b/c of vacuum created by diaphragm, lungs and chest wall
Driving pressure
p1-p2
P1: mouth breathing (barometric)
P2: Intrapleural pressure
Gas flows from ____ to ____
High;Low
Boyle's law
Temp is constant but Pressure and Volume are inversely (opposite) related.
Positive pressure breathing
Assisting breathing w/ a bag valve mask device
Lung Compliance (Cl)
How easy elastic forces of the lung accept inspired air
CL= V/p
Units: L/cmH2O
More compliance means _____ volume?
Increased
Less compliance means _____ volume
less
Lung compliance decreases as Alveoli do what?
Reach their total filling capacity
Functional Residual Capacity (FRC)
volume of air remaining in the lungs after a normal exhalation
During inspiration the Diaphragm moves _____The diaphragm moves DownwardDuring inspiration the diaphragm moves downward which causes the thoracic volume to do what?The thoracic volume increaseDuring inspiration the diaphragm moves downward causing the thoracic volume to increase which causes the intrapleural and intra-alveolar pressure gradient to do what?The pressure gradient decreaseWhat happens to the diaphragm during expiration?it relaxes and moves upwardWhat happens to the thoracic volume during expiration?The thoracic volume decreasesWhat happens to the intrapleural and intra-alveolar presssures gradient during expiration?The pressure gradient increasesPtp (transpulmonary pressure)Driving pressure that Causes airflow in and out of the conducting airwaysSurfactantlubricant that helps lungs stretch to breath/open upWhat 2 characteristics cause a lung to recoil?1) Elastic properties of the lung tissue 2) Surface tension produced by surfactantWhat happens if the lung's elastance exceeds it's limits?It will break and cause a pneumothoraxWhat is alveolar collapse?AtelectasisWhat can cause atelectasis?lack of surfactantPoiseuille's lawIBW for Women105 + 5 (Ht-60)IBW for men106 + 6 (ht-60)Definition of time constanttime in seconds necessary to inflate a certain region for 60%What is average lung compliance?0.1 Liters/cm .H2O (100 mL/ cm H20)When Cl decrease, the patient's vent rate (RR) and the Vt does what?Vent rate/Respiratory Rate: increases Vt: decreasesWhat happens when airway resistance increases?pt's vent/RR: decreases Vt: increasesAuto peeppressure w/in alveoli where there's still positive gas left within alveoli during next inspiratory phaseAuto peep is also known as (there's 5)Air trapping Intrinsic peep occult peep inadvertent peep Covert peepDead space is basically equal to what?your body weight example: 150 lbs = 150 ml/lb of dead spaceWhat's more effective in increasing an individual's total alveolar ventilation? A. Increase Tidal Volume (increased depth of breathing) B. Increase in RR/FTidal Volume (deep breaths vs shallow breaths)What are the 3 types of Dead Space Ventilation?Anatomic Alveolar PhysiologicAlveolar Ventilation (Va)inspired air that reaches the alveoli for gas exchangeDead Space Ventilation (Vd)Gas that doesnt reach the alveoli not effectiveAnatomic Dead spaceVol of gas that remains in conducting airways after inspirationAlveolar Dead spaceoccurs when alveolus is ventilated but not perfused w/ pulmonary blood flowConditons that cause alveolar dead spacePulm. Embolus Pulm. Edema COPD ARDS Pulm. fibrosis Shock Pulm. HypertensionWhy should you start with the lowest tidal volume (6-8 mL/kg) when setting vents?Because it can cause pressure buildup leading to a pneumothroaxTCT60/FTI =TCT/I+ETE=TCT - TIVA=(Vt-Vd) fWhat can profoundly alter the total Va?breathing patterns (rate and depth)Hooke's Law (think of a spring being pulled)The law stating that the stress of a solid is directly proportional to the strain applied to it. example if the spring is stretched beyond it's limits it will snapLungs w/ High compliance usually have _______ elastancelow elastanceLungs w/ low compliance usually have _______ elastancehigh elastanceWhat is created during normal/spontaneous breathing?Pressure difference/gradientPvO240 (O2)PvCO2 Gas exchange46 (CO2)PAO2 normal value (gas exchange)80-100 torr Gas exchange: 100 mm Hgmm HGTorrPaCO2 normal range (gas exchange)40 (CO2)PH2O47 torrBeta 2 receptors (RT's Best friend)Causes bronchodilationbeta-1 and alpha 1 receptorsWhat cells produce pulmonary surfactant?Type 2 alveolar cellsType 2 alveolar cells can produce type 1 alveolar cells but?Type 1 just stay the sameHooke's law definitionNatural ability of matter to respond directly to force and to return to its original resting position or shape after the external force no longer existsElastanceP/VSympathomimetic drugsdrugs that mimic the effects of sympathetic stimulationWhat does the sympathetic nervous system do?fight or flight; causes heart to increase rate and strength of contraction; Bronchial smooth muscle relax Decrease secretions in bronchial glands and salivary glands Decrease motility in the stomach and the intestines Eyes: pupils widen