CardioPulmonary Physiology - Units 5-6 - SPC
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| Role of Cerebral Cortex in regulation of ventilation | Think CC=CC. Conscious Control of ventilation. Speech and singing
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| Mechanism of rythmic ventilation | Dorsal Resp. Group (DRG), like the SA node of breathing
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| Identify the types of medullary respiratory neurons | DRG, VRG. DRG= maintain normal breathing, VRG= during exercise or diseaseto activate the accessory muscles
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| Where is the apneustic center? | Caudal pons(LOWER), boost inspiratory effort = "GASP"
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| Where is the pneumotaxic center? | Cephalic pons(UPPER/HEAD), responsible for "Panting" , increased rate and tidal V
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| Where are the peripheral chemoreceptors? | Aortic Arch and Carotid Sinus
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| Which nerve innervates the Carotid peripheral chemoreceptors? | Glossophryngeal
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| Which nerve innervates the Aortic bodies? | Vagus
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| Chemical stimulus of the peripheral chemoreceptors? | LOW PO2 <60mmHg, LOW pH
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| Location of chemical chemorecptors? | Ventiolateral= Front and sides, immersed in CSF
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| Stimulation of chemical chemorecptors? | HIGH CO2, LOW pH
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| What is the normal ventilatory response to CO2? | CO2 is the strongest stimuli to ventilation
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| 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)
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| What is the vent response to hypoxemia? | Ve increases, rate increases when PO2<60mmHg
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| Changes in vent response to hypoxia during hypercapnia? | Hypercapnia augments hypoxic response
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| Changes in vent response to hypoxia during hypocapnia? | Hypocapnia diminishes hypoxic drive
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| What is the vent response to acute reduction in pH? | Ve increases, stimulates peripheral chemoreceptors
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| Significance of blood brain barrier and CPF | Gases diffuse easily across and Ions need active transport/slow. CSF pH= 7.32=little buffer capability
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| 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
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| Ketoacidosis causes | stimulation of both CC and PC causing Kussmaul's brething patern(Big R, Big Vt), and PaCO2 drops into the 20s
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| Apneustic Breathing | Gasping= sustained inspiratory maneuver from BRAINSTEM injuries
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| BIOT's Breathing | 10-20 seconds ofapnea followed by 3-5 identical volume breaths. NEURO pts/INCREASE ICP
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| Cheyne-Stokes Respiration | "Crescendo-Decrescendo" pattern, HEART failure or servre brain damage
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| Kussmaul's Breathing | From KETOACIDOSIS, rapid, deep breathing
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| Proprioceptors | sensory end organs in muscles, tendons, ligaments that are stimulated by increased movement associated with changing resp mechanics of lung and chest wall
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| What triggers the proprioceptors? | Decreased lung compliance(edema, fibrosis, consolidation), Decreased chest wall compliance(acities, obesity), Increased airway resistance(secretions and broncospasm), exercise
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| Physiologial role of chest wall proprioceptors? | Control feeling of dypsnea when chronic conditions are present from exercise or disease
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| 3 Pulmonary Vagal sensory reflexes | Pulmonary stretch receptors(Hering-Bruerer), Irritant, and Juxtapulmonary(J) receptors
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| Where are the pulmonary stretch receptors? | Located in smooth muscles of conducting airways
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| What stimulates pulmonary stretch receptors? | Increased lung V, decrease intrapleural P
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| What are the physiological response to stimulation of PSR? | inhibit inspiration(to protect from hyperinflation), Bronchodilation, increased HR
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| Paradoxical Reflex of the Head in newborns when PSR stim. | GASP, with subtle breath stack to create FRC
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| Where are the Irritant recptors? | between the epithelium cells in the conducting airway
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| What stimulates the Irritant recptors? | Dust, smoke, chemicals, or mechanical from foreign bodies
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| What are the pyhsiological responses to stim of Irritant receptors? | Cough, broncoconstrition, hypernea, Laryngeal constriction=GRUNT on Exp.
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| Where are the "J" receptors located? | within the pulmonary interstitium
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| What stimulates the "J" receptors? | edema, emboli
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| What are the physiological responses to stim of "J" receptors? | Rapid shallow breathing, GRUNT, tachypnea, hyponea
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| 3 major fetal circulation shunts | Ductus Venosus, Foramen Ovale, Ductus Arteriosis
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| Ductus Venosus | communicates the umbilical vein with the IVC
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| 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
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| Ductus Arteriosis | communicates the pulmonary artery with the descending aorta, closes as PVR drops and levels of PGE1 drops and PaO2 increases >60mmHg
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| 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
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| Normal pulmonary adaptive changes during exercise | increased Ve, increased aveolar ventilation(up to 65% MBC), increased diffusion x3
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| 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
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| Benefits to cardiopulmonary training | increased SV, lower rest HR, increased muscle strength, decreased myocardial and respiratory O2 cost
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| What altered resistive and elastic forces increase WOB? | Increased resistance, decreased compliance, decreased conductance, decreased elastance
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| normal value of WOB | 0.5 joules/L
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| 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
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| 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
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