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Final Exam Review RE
Respiratory Care Therapy
| Question | Answer |
|---|---|
| Pulmonary Surfactant is produced by: | Type II alveolar cells |
| According to Poiseuille's law, reducing the radius of an airway to one-third will increase its resistance how many fold? | 81 |
| This reflex is seen in adults at large tidal volumes. | The Hering Breuer inflation reflex |
| These are activated by changes in the pH of the surrounding extracellular fluid. | Central Chemoreceptors |
| The elevation of lateral shaft of rib is called? | Bucket handle movement |
| Predicts when flow will change from laminar to turbulent. | Reynold's number |
| The sources of anatomic shunt are: | Thebesian veins, bronchial veins, and pleural veins |
| What is defined as the change in volume/ change in pressure? | Compliance |
| What are the accessory muscles of breathing? | 1. Sternocleidomastoid 2. Pectoralis major 3. Abdominals 4. Trapezius |
| What are the primary ventilatory muscles? | 1. Diaphragm 2. Intercostals 3. Scalene |
| An increase in surface tension will cause: | The alveoli to decrease in size and collapse, increase elastic resistance to ventilation, increase work of breathing |
| Until the underlying cause of the issue is resolved, this particular abnormal breathing will not be resolved. | Kussmal's |
| What is the function of the pulmonary circulation? | Barrier to regulate the fluid balance within the lungs. Participates in production, processing and clearance of chemicals and blood clots. Delivers blood flow for the exchange of gases to the alveolar capillary bed. |
| What part of the central nervous system excretes norepinephrine? | Sympathetic and Autonomic. |
| A decrease in arterial blood pH below 7.35 will result in which condition? | Acidemia |
| What are the Pores of Kohn and the Canals of Lambert, respectively? | Openings between alveoli that allow for gas movement, and connections between terminal bronchioles and nearby alveoli. |
| What are the two types of rib movement? | 1. Pump handle - superior and anterior movement of sternum 2. Bucket handle - Elevation of lateral shaft of rib. |
| What is a shunt? | A shunt is blood the enters the left side of the heart without being oxygenated by the lungs. |
| What is the DRG(Dorsal respiratory group)? | The dorsal respiratory group is composed mainly of inspiratory neurons located bilaterally in the medulla. |
| What is the percentage of a normal anatomic shunt? | Normal anatomic shunt is approximately 2-5%. |
| What are the characteristics of pulmonary blood flow? | 1. Low Pressure 2. Low Resistance 3. Gravity Dependent 4. Low Metabolic Need |
| What are the pressure gradients in ventilation? | 1. Transpulmonary |
| Resistance to Ventilation, elastic resistance. | A.Surface Tension B.Compliance |
| Prs=Transrespiratory/transairway Pressure | –Means “across the airway” –Determined by: •Palv-Paoor PA-Pao |
| PL=Transpulmonary Pressure | •Means “across the lung” •Determined by: Palv-Pplor PA-Ppl |
| PW=Transthorax Pressure | •Means “across the chest wall” •Determined by: Ppl-Pbs |
| Resistance to Ventilation, non-elastic resistance | A.Airway Resistance B.Tissue Resistance |
| What is surface tension? | •Forces that cause a liquid to occupy the smallest volume possible •In the lungs, cause the alveoli to decrease in size or collapse |
| Surface tension is described by: | Laplace’s LawP=(2T)/r –where T= surface tension and r = radius •Which means: for a given surface tension, smaller alveoli require a higher distending pressure than larger |
| How does surfactant affect surface tension? | Decreases surface tension. |
| An increase in surface tension causes? | An increase in elastic resistance to ventilation and an increase in the work of breathing |
| What is compliance? | Defined as: –Ease of distention of the lung/thorax system –C= change in volume(cc) change in pressure (cmH2O) (units of measure= cc/cmH2O) |
| Elastance is: | –the mathematical reciprocal of compliance –Elastance= 1/C |
| Decrease Compliance, increased elastance | Difficult for lungs to expand –Examples: pneumothorax, ARDS, thoracic deformities, abdominal distension, consolidation, pulmonary edema Lungs are stiff! |
| Increase Compliance, decrease elastance | Easy for the lungs to expand –Examples: alveolar septal wall destruction/emphysema Lungs are floppy/baggy/stretched out!! |
| Airway Resistance | Described by: –Raw = (change in pressure)/(flow rate) Makes up 85% of the non elastic resistance Units of measure= cmH2O/L/sec |
| Tissue Resistance | •Force necessary to overcome bone and pleurae sliding •Responsible for 15% of non-elastic resistance |
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