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Anatomy & Physiology: Respiratory

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
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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