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Respiratory Part 6
| Question | Answer |
|---|---|
| Name properties that lung elasticity is due to | 50% due to tissue which includes collagen, elastin and smooth muscle. 50% due to surfactant film lining inside of alveolar |
| Compliance | Change in lung volume/change in IPP which equals 0.2 L/cmH2O. The slope of the curve in a lung volume vs. IPP diagram |
| Emphysema and relation to compliance | Emphesyma has increased compliance and decreased elasticity |
| Fibrosis and relation to compliance | Fibrosis has decreased compliance and increased elasticity. |
| Surfactant | Produced by Type II alveolar cells, main component is dipalmitoylphosphatidyl choline, reduces surface tension and increases lung compliance |
| What happens if surfactant is absent? | Surface tension of the film lining the alveolus would be constant and a small alveolus would generate a greater pressure than a large alveolus and would empty more rapidly (prone to collapse) Progressive Atelectasis |
| What does the surfactant do to keep the pressure of a large and small alveolus equal? | Reduces the surface tension more in small alvoli and adjusts the 2S.T./r ratio so that there are no inter-alveolar pressure gradients. |
| Respiratory Distress Syndrome of newborns | High surface tension. Premature birth and maternal diabetes are risk factors. Elasticity is 6-8 x normal. Progressive atelectasis |
| How do you treat RDS? | Pre-treat mother with glucocorticoids to activate secretory machinery. Give surfactant to newborn through trachea. |
| Restrictive Lung Disease | Increase in elasticity and a decrease in all lung volumes |
| Name restrictive lung diseases | RDS, Fibrotic lung disease, Pulmonary vascular congestion, and pulmonary edema (ARDS, pneumonia) |
| What is decreased in restrictive lung disease? | FVC, FEV1sec, FRC, RV and TLC |
| What is increased in restrictive lung disease? | FEV1sec/FVC and FEF25-75% |
| Flow-volume loop of obstructive diseases | Begins and ends at abnormally high lung volumes and the expiratory flow rate is lower than normal. Inspiratory flow rate remains relatively normal |
| Flow-volume loop of restrictive diseases | Flow-volume loop begins and ends at unusually small lung volumes. Expiratory flow rates are somewhat greater than normal. |
| Gas Exchange | Uptake of O2 from alveoli to pulmonary and removal of CO2 from capillary |
| Partial Pressure gradient | The gradient responsible for gas movement is the partial pressure gradient. Diffuse from high partial pressure to low partial pressure |
| What is the partial pressure? | Part of the total barometric pressure for which that gas is responsible. Concentration of the gas * TBP |
| Inspired air | Air that has been inhaled, warmed to 37C and completely saturated with water vapor but has not yet engaged in gas exchange (gas in anatomical dead space) |
| What is the partial pressure of H2O dependent on? | The temperature. At 37C it is 47mmHg. |
| Partial pressure of inspired air | Concentration of gas (TBP-PH2O) |
| What does the partial pressure of alveolar gas depend on? | The ratio of alveolar ventilation (Va) to pulmonary capillary blood flow (Qc). Ideal is Va/Qc is 0.8 O2 leaves alveolus in response to pressure gradient. |
| What happens with low Va/Qc? High Va/Qc? | Low-decreased PO2=below 100. High-increased PO2=above 100 |
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