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What are the types of internal energy?
- 1. potential energy - the energy of position
- 2. kinetic energy - the energy of motion
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Is temperature and kinetic energy of gases are directly or indirectly related?
directly
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What is absolute zero?
Theoretical level or calculated where there would be cessation of kinetic activity of a gas
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What is the SI (System International or the International System of units) based on?
Kelvin, with a zero point equal to absolute zero (0o K). There is 100 degrees between freezing and boiling points of water so it is also called the centigrade scale.
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What is the cgs (centimeter-gram-second) system based on?
Celsius units (o C). It is also a centigrade scale (100 degrees between freezing and boiling points of water). Zero degree Celsius is freezing temperature of water
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How do you convert from Celsius to Kelvin?
- K = C + 273
- and to get Celsius you do
- C = K - 273
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How do you convert from Fahrenheit to Celsius?
C = 5/9 (F - 32)
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How do you convert from Celsius to Fahrenheit?
F = (9/5 X C) + 32
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What the four main ways that heat transfers?
- 1. Conduction
- 2. Convection
- 3. Radiation
- 4. Evaporation/Condensation
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How does Conduction heat transfer work?
Heat is directly transferred between hot and cold molecules
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How does Convection heat transfer work?
mixing of fluid molecules at different temperatures
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How does Radiation heat transfer work?
without direct physical contact such as the sun warming the earth
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How does Evaporation/Condensation heat transfer work?
- Vaporization - the change of state from liquid to gas and the process requires heat energy. It must come from its surroundings.
- �evaporation� - is a form of vaporization where heat is taken from the surrounding air of the liquid, and cools it. Nonheated humidifiers cool the gas above as evaporation occurs.
- Condensation - is the opposite of evaporation. Gaseous vapor turns back into a liquid and heat must be given back to the surroundings.
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What principle explains Buoyancy?
Archimedes� Principle
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What does Archimede's principle explain?
Archimedes� principle: the buoyant force must equal the weight of the fluid displaced by the object
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What is viscocity?
force that opposes a fluid�s flow; The weaker the cohesive forces the less viscosity and the less opposition to flow. The stronger the forces the greater the viscosity and the more opposition to flow
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What is Adhesion/Cohesion?
- Cohesion is the attraction molecules that are alike.
- Adhesion is the attraction of molecules that are not
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What is surface tension and what happens to alveoli if there is too much of it?
force exerted by like molecules at a liquid�s surface. It is cohesion. On the surface of a drop, the molecules are attracted to each other and they pull toward each other and inward forming a sphere or drop
alveoli will collapse
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What is La Place's principle and how do you calculate it?
- Surface tension increases the pressure inside a liquid drop or bubble
- It is 4(surface tension) divided by the radius
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When surface tension increases, what happens to the internal pressure?
Increases
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When radius increases, what happens to the internal pressure?
decreases
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What is Absolute humidity?
the actual amount or weight of water vapor in a gas
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What is relative humidity?
the ratio of a gases actual water vapor content to its saturated capacity at a given temperature
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What is Percent Body Humidity?
ratio of its actual water vapor content to the water vapor capacity in saturated gas at body temperature (37 C).
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What is the saturation capacity of the body?
Saturated gas (capacity) at body temperature is 43.8 mg/L (44 mg/L)
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What is the humidity deficit?
the amount of water vapor that must be added to a gas to increase it to full saturation
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What is body humidity deficit?
the amount of water vapor our body must add to the inspired gas to achieve saturation at body temperature (37 C)
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What is the diffusion fo gases?
process whereby molecules move from areas of high concentration to areas of lower concentration due to kinetic energy
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In a person with a tumor, a narrow area, and you want to deliver medication, what type of gas would you want to use?
a lighter gas that moves faster, suchas Heliox
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Which law pertains to solubility?
Henry's Law
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What is Boyle's law?
Temperature: P1V1 = P2V2 The volume of a gas varies inversely with its pressure
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What is Charle's Law?
Pressure: V1 / T1 = V2 / T2 The volume of a gas varies directly with changes in temp. (K)
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What is Gay-Lussac�s Law?
Volume: P1 / T1 = P2 / T2 The pressure exerted by a gas varies directly with its absolute temperature
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What is the Universal Gas Law?
P1V1 / T1 = P2V2 / T2
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Flow in the respiratory tracts is mostly what?
Transitional; however, in the upper airways there will be more turbulent flow, and in the lower airways it is laminar
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What is the Bernoulli Effect?
When a fluid flows through a tube of uniform diameter, pressure decreases progressively over the tube length. When the fluid passes through a constriction, the pressure drop is much greater.
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How does a venturi work?
If an open tube is placed distal to the constriction, the negative pressure can pull another fluid into the primary flow stream, this is usually placed at a 15 degree angle
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What does ventilation deal with?
pressure gradients
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What are the different pressure gradients?
- transrespiratory
- transpulmonary
- transthoracic
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What is the formula for transrespiratory gradient?
- causes gas to flow into and out of the alveoli during breathing
- Prs = Palv - Pao
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What is the formula for transpulmonary gradient?
- equals the pressure difference between the alveoli and pleural space
- PL = Palv - Ppl
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What is the formula for transthoracic gradient?
- pressure across the wall - total pressure necessarey to expand or contract the lungs and chest wall together
- PW = PPL - Pbs
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What is lung compliance?
distendability of the lung
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What is elastance?
resistance to deformation
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What is normal compliance in healthy adults?
0.2 L/cmH20
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What does surfactant do to the lungs?
lowers surface tension
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Compliance, given value of normal , i.e. .2 and .2, combined = what?
.1
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What is Total Compliance?
lung compliance (CL) plus the compliance of the thorax (CT)
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What are the two frictional (non elastic) resistances?
tissue viscous and airway resistance
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What is Tissue Viscous Resistance?
- impedance of motion caused by displacement of tissues during ventilation
- accounts for 20% of total resistance
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What is Airway resistance?
- resistance due to gas flow through the airways
- accounts for about 80% of total resistance
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What is compliance?
change in volume / change in pressure
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What is airway resistance?
change in pressure / change in flow
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Approximately __% of the resistance to gas flow occurs in the nose mouth and large airways
80
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__% of total resistance to flow is due to airways smaller than 2 mm in diameter
20
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What is equal pressure point (EPP)?
the transmural pressure drop finally reaches a point where airway pressure and pleural pressure are the same. After this point the airway can collapse
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What is Dynamic Compliance?
- used to assess pressure-volume relationships during breathing (it includes airway resistance).
- dynamic compliance decreases as the respiratory rate increases
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Will COPD increase or decrease compliance?
increase
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Will Kyphoscoleosis increase or decrease compliance?
decrease
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What is the most important indication of ventilation?
CO2
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Does Minute Ventilation include dead space in the calculation?
- Yes
- Minute ventilation = tidal volume x frequency
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Does Alveolar Ventilation inculde dead space in the calculation?
- No
- Alveolar ventilation = tidal volume x frequency � dead space
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What is Tonicity?
the degree of osmotic pressure exerted by a solution.
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What are the different levels of Tonicity?
- Isotonic: are solutions that have osmotic pressures equal to the average intracellular pressure in the body. This is roughly equivalent to a saline solution (NaCl of 0.9%) This will cause no overall change in cellular water content.
- Hypertonic: solution are those with higher osmotic pressure or more tonicity. This will �draw� water out of cells.
- Hypotonic: solution are those with lower osmotic pressure or less tonicity. This will cause water to be absorbed from the solution into cells.
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What is a saturated solution?
has the maximum amount of solute that can be held by a solvent, at a given temperature
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What is a supersaturated solution?
contains more solute than a saturated solution, at the same temperature and pressure
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What is osmotic pressure?
the force produced by the mobility of solvent particles under certain conditions
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What is the Ratio Solution way of expressing a solution?
Ratio solution. The relationship of the solute to the solvent is expressed as a proportion (i.e., 1:100; solute:solvent).
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What is the Weight per volume solution (W/V) way of expressing a solution?
Weight per volume solution (W/V). This is used for solids dissolved in liquids. They are expressed as grams of solute per 100 mL of solution. An example is 5 g of glucose dissolved in 100 mL of solution, here is considered to be a 5% solution.
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What is the Percent solution way of expressing a solution?
Percent solution. This solution is the weight of solute per weight of solution. An example is 5 grams of glucose dissolved in 95 g of water. The glucose is 5% of the total solution weight of 100g (solute + solvent). It is a true percent solution.
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What is an acid?
compound that increase the hydrogen ion concentration when placed in an aqueous solution. It is also a proton donor
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What is a base?
a compound that gives up hydroxyl ions (OH-) when placed into an aqueous solution. It is known as a proton acceptor.
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How many nanomoles per liter does water (neutral) have?
100
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A change of 1 pH unit is equivalent to a _______ change in [H+].
tenfold
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A change in pH of 0.3 units equals a ________ change in [H+].
twofold
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What is mainly responsible for water excretion?
Kidneys
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What are the extracellular electrolytes?
- 1. sodium
- 2. chloride
- 3. bicarbonate
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What are the intracellular electrolytes?
- 1. potassium
- 2. magnesium
- 3. phosphate
- 4. sulfate
- 5. protein
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What are the two ways water is replenished?
- 1. Ingestion - This is the main form of replacement. The average adult drinks 1,500 to 2000 ml of water per day and gets 500 to 600 ml from foods
- 2. Metabolism - This water comes from the oxidation of fats, carbohydrates, proteins in the body and from the destruction of cells. Normal amount of water produced is 250 ml per day.
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How does Insensible water loss occur?
Skin and Lungs
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How does Sensible water loss occur?
Urine, Intestinal, and Sweat
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What are the 7 major electrolytes, their charges, and normal values?
- Sodium (Na+), 136-145
- Chloride (Cl-), 98-106
- Calcium (Ca2+), 4.5 to 5.25 mEq/L
- Potassium (K+), 3.5-5.0
- Magnesium (Mg2+), 1.5 to 2.5 mEq/L
- Phosphate (HPO42-), 1.2 to 2.3 mEq/L
- Bicarbonate (HCO3-), 22 to 26 mEq/L
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What will ionize almost completely in an aqueous solution?
Strong acid
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What will ionize only to a small extent?
Weak acid or base
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What are the buffer systems?
- "OBE": Open, Bicarbonate, Erythrocyte and Plasma
- "CNH": Closed, Nonbicarbonate, Hemoglobin/Organic phosphates/Inorganic phosphates/Plasma Proteins
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How does the Henderson-Hasselbalch Equation look at pH?
- the biologic acid-base relationship by looking at one specific component of the system, namely the carbonic acid (H2CO3) to bicarbonate ion (HCO3) relationship
- it is expressed at have Bicarbonate (kidneys) in the numerator, and CO2 (lungs) in the denominator
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What is the following blood gas: pH = 7.25, PaCO2 = 55, Bicarbonate = 20, BD = -4
Mixed Respiratory and Metabolic Acidosis
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In respiratory acidosis (hypoventilation), what will the kidneys do?
restore pH by reabsorbing bicarbonate
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In respiratory alkalosis (hyperventilation), what will the kidneys do?
eliminate Bicarbonate throuhg urine
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In metabolic acidosis what will the lungs do?
hyperventilate
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In metabolic alkalosis what will the lungs do?
hypoventilate
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What is the normal Anion Gap range?
9-14
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Is potassium (K+) taken into account when calculating anion gap?
no, too small
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What does iatrogenic result from?
the use of diuretics, low-salt diets, and gastric drainage
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which reflex is generated by stretch receptors located in the smooth muscle of both large and small airways. In adult, this reflex is activated only by large VT (.800 ml-1.0 L or more).
Hering-Breuer Inflation Reflex
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What does the following describe: Sudden collapse of the lung stimulates strong inspiratory efforts via the vagus nerve. It causes hyperpnea (e.g., pneumothorax)
Deflation Reflex
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What does the following describe: helps with deep breaths during exercise, periodic deep sighs during quiet breathing, and baby�s first breath. The receptors for this reflex stop firing promptly after the volume change occurs so they are called �rapidly adapting receptors�.
Head's Paradoxical Reflex
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What does the following describe: Stimulation can be by inhaled irritants or mechanical factors causing bronchoconstriction, coughing, sneezing, tachypnea, and narrowing of the glottis. They are called vagovagal reflexes which are responsible for laryngospasm, coughing, and slowing of the heart rate. (e.g., airway suctioning, ET intubation, bronchoscopy)
Irritant Receptors
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What does the following describe: found in the lung parenchyma near the pulmonary capillaries. They are stimulated by alveolar inflammation, pulmonary vascular congestion, and edema. When stimulated cause rapid, shallow breathing; a sensation of dyspnea; and expiratory narrowing of the glottis.
J Receptors
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What does the following describe: are in the muscles, tendons, and joints, as well as pain receptors in muscles and skin. They send impulses to the medullary respiratory center to increase inspiratory activity causing hyperpnea. Moving the limbs, slapping or splashing cold water on the skin, and other painful stimuli increase ventilation. May be important in starting and maintaining increased ventilation at the start of exercise.
Peripheral proprioceptors
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What is contained bilaterally in the medulla and how does it regulate breathing?
Central Chemoreceptors, and they regulate breathing by sensing H+. More H+, increased breathing rates.
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Apneustic breathing indicates damage to the _____.
pons
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The rhythmic cycle of breathing originates mainly from neurons in the
Medulla Oblongota
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During quiet breathing the inspiratory neurons from the ___ and ___ fire with increasing frequency for approximately _ seconds then they switch off allowing expiration for _ seconds
DRG; VRG; 2; 3
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What is this indicative of: the respiratory rate and tidal volume gradually increase, then gradually decrease to complete apnea which may last several seconds.
Cheyne-Stokes respiration
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What is this indicative of: similar to Cheyne-Stokes except that tidal volumes are of identical depth. It occurs in patients with increased intracranial pressure
Biot's Respiration
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What indicates damage to the pons. It is related to midbrain and upper pons damage associated with head trauma, severe brain hypoxia, or lack of blood flow to the brain. This is gasping inspirations.?
Apneustic Breathing
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