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Respiratory
Anatomy & Physiology: Respiratory
| Question | Answer |
|---|---|
| 1. What is the pulmonary systolic pressure? 2. What is the systemic systolic pressure? 3. What is the normal ventilation rate? | 1. 15 mmHg 2. 100 mmHg 3. 5L/min (same as cardiac output) |
| 1. What is the Cardiac Output of the pulmonary and systemic circulation? 2. How can the right and left heart have the same cardiac output with different pressures? | 1. 5 L/minute 2. the pulmonary arteries have lower pressure but also lower resistance (more compliant vasculature) |
| Purpose of Clara cells | secrete component of surfactant |
| 1. What directions will H+ and bicarbonate go if an acid base disorder is respiratory? 2. What directions with they go if the disorder is metabolic? | 1. they will change in the same direction 2. they will go in opposite directions |
| What is the PO2 of: 1. venous alveolar capillaries 2. alveoli 3. exiting alveolar capillaries | 1. 40 mmHg 2. 100 mmHg 3. 95 mmHg |
| What is the PCO2 of: 1. venous alveolar capillaries 2. alveoli 3. exiting alveolar capillaries | 1. 45 mmHg 2. 40 mmHg 3. 40 mmHg |
| How is Oxygen transported in the blood? | Dissolved or bound to hemoglobin |
| How is the majority of carbon dioxide transported in the blood? | bicarbonate |
| What are the muscles of inspiration during exercise? | 1. external intercostals 2. sternocleidomastoid 3. scalenes |
| What are the muscles of expiration during exercise? | 1. internal intercostals 2. internal & external obliques 3. rectus and transversus abdominis |
| What is the relation of the pulmonary artery to the bronchus at each lung hilus? | RALS 1. Right Anterior 2. Left Superior |
| 1. The diaphragm is innervated by which nerve segments? | 1. C3,4,5 (phrenic nerve) keeps the diaphragm alive |
| 1. When are J receptors activated? 2. What do they produce? 3. Which nerve innervates J receptors? | 1. When pulmonary capillaries are engorged with blood or from interstitial edema. 2. rapid, shallow breathing and dyspnea 3. vagus |
| How does ↓ oxygen affect: 1. bronchioles 2. pulmonary arteries | 1. bronchodilation 2. vasoconstriction |
| 1. What effect does increased ventilation have on PO2 and PCO2? 2. What effect does increased blood flow have on PO2 and PCO2? | 1. ↑ PaO2 & ↓ PaCO2 (more O2 inhaled/more CO2 exhaled) 2. ↓ PaO2 & ↑ PaCO2 (less O2 inhaled/less CO2 exhaled) |
| What acts to oppose lung compliance(2)? | 1. elastic recoil of the lung 2. surface tension of alveoli |
| What is the V/Q ratio of an individual with a pulmonary embolism (near the embolism and at other sites)? | 1. increased in embolized regions from lack of blood flow (Q) 2. decreased in non-embolized regions from increased blood flow |
| 1. What events lead to hyperventilation when a patient has a pulmonary embolism? 2. Why does a pulmonary embolism also cause dyspnea? | 1. hypoxemia stimulates peripheral chemoreceptors (carotid and aortic bodies) to increased ventilation rate 2. hypoxemia stimulates chemoreceptor → ↑ cardiac output → ↑ perfusion of non-embolized regions → congestion & stimulation J receptors |
| 1. What is a normal alveolar ventilation rate (AVR)? 2. What is the normal PaCO2? 3. What equation is used to determine if the AVR is abnormal? | 1. 4.2 L/min 2. 40 mmHg 3. 40 mmHg/patients PaCO2 x 4.2 L/min |
| 1. At which lung volumes is lung compliance greatest? 2. At which lung volumes is pulmonary resistance lowest? | 1. at moderate lung volumes 2. at middle lung volumes |
| 1. What is the source of pulmonary resistance at low lung volumes? 2. What is the source at high lung volumes? | 1. narrowing of extra-alveolar vessels 2. narrowing of vessels due to expanded alveoli |
| 1. Where in the lung is alveolar compliance greatest? 2. What is this due to? | 1. at the base of the lung 2. gravity pulls alveoli open |
| 1. What is the respiratory exchange ratio? 2. What are the units? | 1. CO2 produced/O2 consumed 2. mL/min |
| How will breathing a gas with increased CO2 effect air flow and blood flow in the lungs? | 1. bronchodilation - air flow increases 2. vasoconstriction - blood flow decreases |
| What is the main factor causing atelectasis from a pulmonary embolism? | impaired surfactant synthesis by type II alveolar epithelial cells |
| If a large increase in PO2 occurs from giving a hypoxic individual oxygen, what can you say about the cause of hypoxia? | intrapulmonary shunting most likely |
| What is the equation for system pressure? | SP = recoil pressure + chest wall pressure |
| 1. What is the equation for recoil pressure? 2. What is recoil pressure equal to at functional residual capacity? | 1. P alveolar - P intrapleural 2. Ptp = 0 - (-5) = +5 |
| How specifically does pulmonary resistance change at birth? | first breath increases the PAO2 leading to vasodilation and a decreased pulmonary vascular resistance |
| 1. What is the system pressure of the lungs equal to 2. What is the system pressure at funtional residual capacity? | SP = RP + CWP SP = (+5) - (-5) = 0 |
| How does forced expiration change PIP and lead to airway collapse? | increases PIP so that the transmural pressure = 0 in the non cartilageneous regions of the lung |
| Why would you not want to give oxygen to a patient with emphysema? | it would decrease their hypoxic drive and lead to hypoventilation ↑O2 →↓CO2➞↓hypoxic drive |
| What is the forced vital capacity a measurement of? | the max a person can exhale after maximum inhalation FVC = IRV +TV + ERV |
| What are the two major components to lung elasticity? | 1. Collagen and elastic fibers 2. Surface tension |
| How does pulmonary surfactant affect 1. surface tension 2. elasticity 3. compliance | 1. decreases surface tension 2. decreases elasticity 3. increases compliance |
| 1. What week of gestation is surfactant most abundantly produced? 2. What ratio of lecithin-to-sphingomyelin in amniotic fluid indicates fetal lung maturity. | 1. week 35 2. > 2.0 |
| 1. What is alveolar pressure relative to atmospheric pressure during inspiration? 2. What is alveolar pressure relative to atmospheric pressure during expiration? | 1. alveolar < atmospheric 2. alveolar > atmospheric |
| What is the main factor in determining airway resistance? | radius |
| 1. How does forced expiration affect P IP? 2. What affect does forced expiration have on the equal pressure point (EPP)? | 1. increases P IP 2. EPP shifts closer to the alveoli and causes a greater amount of airway compression |
| 1. What is the normal Alveolar-arterial gradient? 2. Why is there normally a difference? | 1. 100-95 = 5 2. 2% of the cardiac output bypasses alveolar ventilation through bronchial circulation |
| Increased Cardiac Output decreases the pulmonary vasculature resistance by: | 1. distension of individual vessels 2. recruitment of previously collapsed vessels |
| What is oxygen capacity? | max amount of oxygen that can be bound to Hb [Hb] x 1.3 (ml/dL) |
| What is oxygen content? | amount of oxygen actually in blood (O2 binding capacity x % saturation) + dissolved O2 |
| 1. What circumstances decrease oxygen affinity to Hemoglobin? 2. Which direction does the hemoglobin dissociation curve shift to? | CADET face Right 1. CO2, Acid/Altitude, DPG, Exercise, Temp 2. Right |
| When is the ventral respiratory group of the medulla activated? | when expiration is greater than normal |
| Which chemoreceptor is the main drive for ventilation? | peripheral oxygen receptors |
| The carotid bodies send afferents in the __ nerve while the aortic bodies send afferents in the __ nerve. | glossopharyngeal, vagus |
| 1. Receptors that respond to noxious gases and smoke. 2. What does stimulation of these receptors cause? | 1. irritant receptors 2. bronchoconstriction, coughing, mucus production |
| What happens in tissue to facilitate O2 unloading? | H+ shift the O2 dissociation curve to the right (Bohr Effect) |
| What is the Equal Pressure Point? | Point in the airway where the transmural pressure (recoil pressure) equals zero. |
| 1. How does increase the force of expiration affect the Intrapleural Pressure (P IP)? 2. How does this change the equal pressure point (EPP)? | 1. since volume decreases, Intrapleural pressure increases 2. Moves the EPP closer to the alveoli. |
| What is the intrapleural pressure at functional residual capacity? | negative |
| How are systemic venous return and right ventricular output affected by an inspiration? | they both increase with inspiration |
| How do the following relate to the V/Q scan? 1. alveolar dead space 2. intrapulmonary shunt | 1. increased V/Q ratios 2. decreased V/Q ratios |
| How do the following affect the equal pressure point in the lung: 1. increased lung compliance 2. increased expiratory effort | 1. move EPP closer to alveoli 2. move EPP closer to alveoli |
| Where in the lung is the PIP more negative? Why? | top of the lung from the force of gravity |
| What function does Angiotensin-Converting Enzyme serve (ACE)? | 1. converts angiotensin I → angiotensin II → vasoconstriction 2. degrades bradykinin, a vasodilator |
| NEW NOTECARDS START HERE!!!!!!!!! | |
| Which pneumocytes: 1. line the alveoli for gas diffusion 2. secrete surfactant 3. serve as stem cells for more type I and type II pneumocytes 4. proliferate during lung damage | 1. Type I 2. Type II 3. Type II 4. Type II |
| Which structures pass through the diaphragm | IVC, esophagus, vagus, aorta, thoracic duct, azygous vein |
| Which structure passes through the diaphgragm next to: 1. esophagus 2. aorta | 1. 2 trunks of the vagus 2. thoracic duct and azygous vein |
| How does alveolar size relate to tendency of the alveoli to collapse? | collapses as radius decreases; collapsing pressures is inversely related to radius |
| What is fetal hemoglobin affinity to 2,3-BPG relative to adult hemoglobin? | less affinity |
| How does methemoglobin and carbon monoxide effect: 1. oxygen saturation 2. oxygen content | 1. decrease 2. decrease |
| Which gas is diffusion limited in the lungs? | carbon monoxide |
| 1. What is the normal pulmonary artery pressure? 2. What is pulmonary artery pressure in pulmonary hypertension? | 1. 10-14 mmHg 2. > 25 mmHg or > 35 mmHg during exercise |
| What metabolite leaves peripheral tissues and causes unloading of O2? | H+ (Bohr effect) |
| How does renal handling of bicarbonate change with higher altitude? | ↑ in respiration → respiratory alkalosis → ↑ renal excretion of bicarbonate |
| 1. anatomic dead space 2. physiologic dead space | 1. volume of conducting airways 2. volume of lungs that does not participate in gas exchange |
| For the following causes of hypoxemia, what is the A-a gradient: 1. high altitude 2. right-to-left shunt 3. V/Q mismatch | 1. normal 2. ↑ 3. ↑ |
| For the following causes of hypoxemia, what is the A-a gradient: 1. Hypoventilation 2. Diffusion limitation | 1. normal 2. ↑ |
| What are the following values at the base of the lung: 1. ventilation 2. perfusion 3. V/Q | 1. ↑↑ 2. ↑ 3. ↓ |
| What are the following values at the apex of the lung: 1. ventilation 2. perfusion 3. V/Q | 1. ↓↓ 2. ↓ 3. ↑ |
| At what point in the respiratory cycle is the pulmonary vascular resistance lowest? | functional residual capacity |
Created by:
amichael87
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