Block 1 Missed Concepts

Question 1

C3, 4, 5 ….

Answer 1

Keep the diaphragm alive- innervation by the phrenic nerve

Question 2

For flow to occur….

Answer 2

There must be a pressure gradient

Question 3

A normal RQ (respiratory quotient) is

Answer 3

0.8 (4L/min ventilation, 5L/min cardiac output perfusion)

Question 4

Indications for Hyperbaric Oxygenation therapy

Answer 4

Diabetic, necrotizing wounds, CO poisoning, Cyanide poisoning

Question 5

According to ficks law, what will decrease the diffusion of gas in the ACM

Answer 5

Decreased pressure gradient
Decreased surface area
Thickened ACM
Decreased diffusion coefficient

Question 6

At rest, capillary blood is exposed to the alveoli for 0.75s
Equilibrium across the ACM…

Answer 6

Equilibration across the ACM typically takes 0.25s in healthy lungs

Question 7

Calculate the alveolar gas equation (PAO2)

Answer 7

PAO2 = ((PB760 - PH2O47) x FIO2) - (PACO2/0.8)

PB ALWAYS IS 760
PH2O ALWAYS 47

Question 8

Which of the following venous drainage systems contribute to the anatomic shunt?

Answer 8

Thebesian
Bronchial
Visceral pleural
Anterior cardiac vein

Question 9

Surfactant function is to reduce surface tension ….

Answer 9

Stabilizing the alveoli so they don’t collapse

Question 10

Describe the effects of stimulating the SNS, Alpha 1, Beta 1, Beta 2 receptors

Answer 10

Alpha 1- vasoconstriction
Beta 1 - increase heart rate and constriction
Beta 2- muscle relaxation, vasodilation, bronchodilator

Question 11

If a medication is given to your patient and their HR, BP goes up and had an allergic reaction, they were given

Answer 11

Sympathomimetic or parasympatholytic

Question 12

The primary functions of the nose are to

Answer 12

Heat, humidify, and filter

Question 13

Discuss the difference between diffusion limitation and perfusion limitation

Answer 13

Perfusion limitation is limited by cardiac output, increase cardiac output, increase diffusion across ACM. Decrease cardiac output, decrease diffusion across ACM

Diffusion limitation is limited by the gas ability to move through. Increase cardiac output, thicker ACM. Decrease cardiac output, ACM thins out

Question 14

When a mast cell degranulates, it releases…

Answer 14

SRS- A, chemotaxic signals, histamine, protease, leukotrienes, heparin, cytokines

Question 15

Aspirations lead to foreign substances lodging in…

Answer 15

Trachea, right middle lobe, right lower lobe

Question 16

The glottis separates…

Answer 16

Upper and lower airways

Question 17

Type 2 alveolar cells..

Answer 17

Produce surfactant and serve as replacement for damaged type 1 cells

Question 18

Set VT based on IBW

Question 19

What is capillary shunt? What is Anatomic shunt?

Answer 19

Capillary shunt is the mixing of blood from non- ventilated areas of the lung with oxygenated blood.

Anatomic shunts introduce deoxygenated blood into the pulmonary veins

Question 20

Differentiate between Cheyne-Stokes, Kussmaul’s, Biot’s and apnea

Answer 20

Biots: deep breath followed by apnea

Cheye-stokes: waxing and waning (deep and shallow breaths)

Kussmaul’s: deep rapid breathing at a consistent pace

Apnea: breathing is momentarily cut off

Question 21

Calculate Cst

Question 22

Calculate RCT

Question 23

Differentiate between hypoventilation (high CO2), hyperventilation (low CO2), tachypnea (RR>20 b/min, adults), and bradypnea (RR<12 b/min)

Question 24

Differentiate between deadspace ventilation and Shunt

Answer 24

Shunt: perfusion is greater than ventilation
Ex- consolidation; atelectasis, pulmonary edema

Deadspace: ventilation is greater than perfusion
Ex- disruption in blood flow; COPD, pulmonary embolism

Question 25

Given gender, calculate IBW

Question 26

To keep flow constant…

Answer 26

Pressure increases IF diameter decreases/length increases

If pressure is constant then FLOW will decrease

Question 27

The patient with the highest RAW…

Answer 27

High RAW = low flow for same pressure gradient

Low RAW = high flow for same pressure gradient

Question 28

Restrictive lung disease/ Obstructive lung disease association

Answer 28

Restrictive lung disease is associated with LOW Cst
Obstructive lung disease is associated with HIGH Raw

Question 29

Calculate minute ventilation (VE)

Question 30

Given the four lung volumes calculate the VC, IC, TLC, FRC

Answer 30

VC = IET
IC = IT
TLC = all
FRC = RE

Question 31

What methods are used to measure FRC?

Answer 31

Helium dilution test
Nitrogen washout
Body plethysmography

Question 32

MIPS and MEPS

Answer 32

MIP: spontaneous breathing
(-25) anything less negative is bad
Ex: -5,-10,-15

anything more negative is good
Ex: (-30,-35,-45

MEP: ability to have an effective cough
Ex: >60 is good ; <40 is bad

Question 33

Indications for hyperbaric oxygen therapy

Answer 33

Wound healing, diabetics, necrotic tissue, cyanide poisoning, and CO poisoning

Question 34

Differentiate between Normal, restrictive, obstructive PFT

Answer 34

FVC and FEV both greater than 80 is normal

FEV1/FC = below 70% is obstructive
FEV1/FC = above 70% is Restrictive