4: Physiology II

Question 1

What are the major inspiratory muscles?

Answer 1

Diaphragm

Intercostal muscles

Question 2

What are some accessory muscles of inspiration?

Answer 2

Pectoralis major

Pectoralis minor

Sternocleidomastoid

Scalenus muscles

Rhomboids major and minor

Latissimus dorsi…

Question 3

Can the residual volume be measured by spirometry?

Answer 3

No

Question 4

What can increase the residual volume of the lungs?

Answer 4

Loss of elastic recoil (e.g in emphysema)

Question 5

What two kinds of lung disease can be diagnosed by dynamic lung volumes?

Answer 5

Restrictive lung disease

Obstructive lung disease

Question 6

What is FVC?

Answer 6

Forced Vital Capacity

i.e the maximum volume which can be expelled from the lungs after a maximal inspiration

Question 7

What is FEV₁?

Answer 7

Forced Expiratory Volume in 1 second

i.e the volume of air expelled in the 1st second of an FVC determination

Question 8

What dynamic lung volume is used to diagnose obstructive and restrictive lung disease?

Answer 8

FEV₁ / FVC ratio

Question 9

Normally, the FEV1 / FVC ratio should be > __%.

Answer 9

70%

Question 10

What is the FEV1 / FVC ratio in obstructive lung disease?

Answer 10

<70%

Question 11

Describe the FVC, FEV₁ and FEV1 / FVC ratio in obstructive lung disease.

Answer 11

FVC is normal

FEV₁ is low

so the FEV1 / FVC ratio is low

Question 12

Describe the FVC, FEV₁ and FEV1 / FVC ratio in restrictive lung disease.

Answer 12

FVC is low

FEV₁ is low

so the FEV1 / FVC ratio is normal

Question 13

What is the primary determinant of airway resistance? (Hint - similar to that for blood flow.)

Answer 13

Radius of airway

Question 14

Sympathetic stimulation causes broncho___.

Answer 14

bronchodilatation

Question 15

Parasympathetic stimulation causes broncho___.

Answer 15

bronchoconstriction

Question 16

What is dynamic airway compression?

Answer 16

Pressure applied to airway during active expiration, when intrathoracic pressure rises

Question 17

Dynamic airway compression is a good thing in healthy people as it ___ pressure upstream and drives air out of the airways.

Answer 17

increases

Question 18

If there is an ___ disease in the airway, dynamic airway compression is likely to cause ___ rather than better air flow.

Answer 18

obstructive

collapse

Question 19

What does a peak flow meter give an estimate of?

Answer 19

Peak flow rate

Question 20

Give two examples of obstructive lung disease.

Answer 20

Asthma

COPD

Question 21

Peak flow rate gives an indication of the extent of ___ lung disease.

Answer 21

obstructive

Question 22

What is lung compliance?

Answer 22

A measure of the effort than goes into stretching the lungs

i.e the volume change per unit pressure change

Question 23

The less compliant the lungs are, the ___ work that needs to be done to inflate them.

Answer 23

more

Question 24

Name some respiratory conditions which can result in reduced pulmonary compliance.

Answer 24

Pulmonary fibrosis

Pulmonary oedema

Lung collapse

Pneumonia

Lack of surfactant

Question 25

What spirometry pattern would be associated with diseases causing reduced pulmonary compliance?

Answer 25

Restrictive

Question 26

Lungs become ___ compliant if their elastic recoil is lost.

Answer 26

more

Question 27

Name a respiratory condition which causes increased pulmonary compliance.

Answer 27

Emphysema

Question 28

What sign is associated with emphysema? (Hint - would be noticeable on examination of chest expansion.)

Answer 28

Hyperinflation of lungs

Question 29

What issue will also be hampering the breathing of patients with emphysema?

Answer 29

Dynamic airway compression

Question 30

What signs indicate the effort a patient is putting into their breathing?

Answer 30

RR

Accessory muscle use

Nasal flaring

Recession

Grunting

Question 31

What signs indicate the efficacy of a patient’s breathing?

Answer 31

Conscious level

Cyanosis

Chest expansion

Oxygen saturations

Breath sounds