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CardioPulmonary

CardioPulmonary Physiology - Units 5-6 - SPC

QuestionAnswer
Role of Cerebral Cortex in regulation of ventilation Think CC=CC. Conscious Control of ventilation. Speech and singing
Mechanism of rythmic ventilation Dorsal Resp. Group (DRG), like the SA node of breathing
Identify the types of medullary respiratory neurons DRG, VRG. DRG= maintain normal breathing, VRG= during exercise or diseaseto activate the accessory muscles
Where is the apneustic center? Caudal pons(LOWER), boost inspiratory effort = "GASP"
Where is the pneumotaxic center? Cephalic pons(UPPER/HEAD), responsible for "Panting" , increased rate and tidal V
Where are the peripheral chemoreceptors? Aortic Arch and Carotid Sinus
Which nerve innervates the Carotid peripheral chemoreceptors? Glossophryngeal
Which nerve innervates the Aortic bodies? Vagus
Chemical stimulus of the peripheral chemoreceptors? LOW PO2 <60mmHg, LOW pH
Location of chemical chemorecptors? Ventiolateral= Front and sides, immersed in CSF
Stimulation of chemical chemorecptors? HIGH CO2, LOW pH
What is the normal ventilatory response to CO2? CO2 is the strongest stimuli to ventilation
Factors which affect vent response to CO2? Drugs depress the medullary center, Narcotics like heroin, Morphine, and Barbituates, Pent, and Sero. Also airway obstruction(COPD, athsma)
What is the vent response to hypoxemia? Ve increases, rate increases when PO2<60mmHg
Changes in vent response to hypoxia during hypercapnia? Hypercapnia augments hypoxic response
Changes in vent response to hypoxia during hypocapnia? Hypocapnia diminishes hypoxic drive
What is the vent response to acute reduction in pH? Ve increases, stimulates peripheral chemoreceptors
Significance of blood brain barrier and CPF Gases diffuse easily across and Ions need active transport/slow. CSF pH= 7.32=little buffer capability
Chronic Resp. Acidoiss HCO3 increases in CSF and central chemmorectors are made non-responsive, then the LOW PO2stimulate the peripheral chemorecptors creating a hypoxic drive
Ketoacidosis causes stimulation of both CC and PC causing Kussmaul's brething patern(Big R, Big Vt), and PaCO2 drops into the 20s
Apneustic Breathing Gasping= sustained inspiratory maneuver from BRAINSTEM injuries
BIOT's Breathing 10-20 seconds ofapnea followed by 3-5 identical volume breaths. NEURO pts/INCREASE ICP
Cheyne-Stokes Respiration "Crescendo-Decrescendo" pattern, HEART failure or servre brain damage
Kussmaul's Breathing From KETOACIDOSIS, rapid, deep breathing
Proprioceptors sensory end organs in muscles, tendons, ligaments that are stimulated by increased movement associated with changing resp mechanics of lung and chest wall
What triggers the proprioceptors? Decreased lung compliance(edema, fibrosis, consolidation), Decreased chest wall compliance(acities, obesity), Increased airway resistance(secretions and broncospasm), exercise
Physiologial role of chest wall proprioceptors? Control feeling of dypsnea when chronic conditions are present from exercise or disease
3 Pulmonary Vagal sensory reflexes Pulmonary stretch receptors(Hering-Bruerer), Irritant, and Juxtapulmonary(J) receptors
Where are the pulmonary stretch receptors? Located in smooth muscles of conducting airways
What stimulates pulmonary stretch receptors? Increased lung V, decrease intrapleural P
What are the physiological response to stimulation of PSR? inhibit inspiration(to protect from hyperinflation), Bronchodilation, increased HR
Paradoxical Reflex of the Head in newborns when PSR stim. GASP, with subtle breath stack to create FRC
Where are the Irritant recptors? between the epithelium cells in the conducting airway
What stimulates the Irritant recptors? Dust, smoke, chemicals, or mechanical from foreign bodies
What are the pyhsiological responses to stim of Irritant receptors? Cough, broncoconstrition, hypernea, Laryngeal constriction=GRUNT on Exp.
Where are the "J" receptors located? within the pulmonary interstitium
What stimulates the "J" receptors? edema, emboli
What are the physiological responses to stim of "J" receptors? Rapid shallow breathing, GRUNT, tachypnea, hyponea
3 major fetal circulation shunts Ductus Venosus, Foramen Ovale, Ductus Arteriosis
Ductus Venosus communicates the umbilical vein with the IVC
Foramen Ovale communicates the Right and Left Atria via one way valve, closes when cord is clamped and Right atrial P drops as IVC blood flow drops
Ductus Arteriosis communicates the pulmonary artery with the descending aorta, closes as PVR drops and levels of PGE1 drops and PaO2 increases >60mmHg
What are cardiopulm. adaptive changes in high alt. dwellers? increased lung size, polycythemia due to hypoxemia=erythropoetin from kidneys to stim bone marrow to make more RBC
Normal pulmonary adaptive changes during exercise increased Ve, increased aveolar ventilation(up to 65% MBC), increased diffusion x3
Normal cardiovascular adaptive changes during exercise increased O2 comsuption, increased ER, decreased SvO2 as more go to tissues, increased C(a-v)O2, increased HR x 200%, CO reaches 90% max
Benefits to cardiopulmonary training increased SV, lower rest HR, increased muscle strength, decreased myocardial and respiratory O2 cost
What altered resistive and elastic forces increase WOB? Increased resistance, decreased compliance, decreased conductance, decreased elastance
normal value of WOB 0.5 joules/L
Define and state normal value for oxygen cost of breathing O2 consupmtion of resp. muscles <5% of total O2 consumption(12ml/min)out of 250
Increased O2 cost of breathing is from ? increased resistance, decreased compliance, decreasedconductance, decreased elastance, empysema is too elastic but uses 120ml/min O2 consumption=almost 1/2
Created by: mac6672