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Medical Physiology I > Block 5 Exam > Flashcards

Block 5 Exam Flashcards

1
Q

Key components of respiratory system

A

An air pump
Mechanisms for carrying O2 and CO2 in the blood
A surface for gas exchange
A circulatory system
A mechanism for locally regulating the distribution of ventilation and perfusion
A mechanism for centrally regulating ventilation

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2
Q

What does magnitude of inspiratory reserve volume depend on?

A 
Current lung volume
Lung compliance
Muscle strength
Comfort
Flexibility of the skeleton
Posture
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3
Q

Total lung capacity

A

Sum of all four volumes

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4
Q

Functional residual capacity

A

Sum of ERV and RV

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5
Q

Inspiratory capacity

A

Sum of IRV and TV

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6
Q

Vital capacity (VC)

A

Sum of IRV, TV, and ERV

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7
Q

Dalton’s law

A

Total pressure is the sum of the individual partial pressures

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8
Q

Henry’s law

A

The concentration of O2 dissolved in water is proportional to PO2 in the gas phase

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9
Q

BTPS

A

Body temperature and pressure, saturated with water vapor

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10
Q

ATPS

A

Ambient temperature and pressure, saturated with water vapor

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11
Q

STPD

A

Standard temperature and pressure/dry

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12
Q

Bronchi

A

Generations 1-10

Contain cartilage

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13
Q

Bronchioles

A

Begin at generation 11

Cartilage free

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14
Q

Conducting airways

A

Nose and lips to alveoli free bronchioles

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15
Q

Terminal bronchioles

A

Most distal conducting airways

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16
Q

Anatomic dead space

A

Small fraction of total lung capacity

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17
Q

What happens with increasing generation?

A

Cartilage, mucus, and linear velocity decrease

Cross sectional area increases

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18
Q

Lung elastic recoil

A

inward

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19
Q

Chest wall/diaphragm elastic recoil

A

outward

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20
Q

P(AW)

A

Airway pressure

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21
Q

P(TM)

A

Transmural pressure

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22
Q

P(TP)

A

Transpulmonary pressure
Static component
Controls lung volume

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23
Q

P(IP)

A

Intrapleural pressure

Relative vacuum

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24
Q

P(A)

A

Alveolar pressure
Dynamic component
Controls airflow

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25
Primary muscles of inspiration
Diaphragm | External and internal intercostal muscles
26
Most important muscle of inspiration
Diaphragm
27
Secondary (accessory) muscles of inspiration
Scalenes Sternocleidomastoids Neck and back muscles Upper respiratory tract muscles
28
Scalenes
Lift the first two ribs
29
Sternocleidomastoids
Lift the sternum outward | Contributing to the water-pump handle effect
30
Neck and back muscles of inspiration
Elevate the pectoral girdle and extend the back
31
Upper respiratory tract muscles
Decrease airway resistance
32
Primary muscles of expiration
NONE
33
Accessory muscles of expiration
Abdominal muscles Intercostals Neck and back muscles
34
Abdominal muscles
Increases intra-abdominal pressure and forces the diaphragm upward into the chest cavity Decreasing the rostral-caudal diameter of the thorax and increasing P(IP)
35
Intercostals
Reduce both the anterior-posterior and the transverse diameters of the thorax Important for coughing
36
Neck and back muscles in expiration
Lowering of pectoral girdle reduces the cross-sectional area of the thorax, whereas flexion of the trunk reduces the rostral-caudal diameter
37
Hysteresis
Different curves are followed during inspiration and expiration Harder to open a collapsed airway than to keep an airway open
38
Static compliance (C)
Property of the alveoli | Decreases with increasing lung volumes
39
Obstructive disease effects
More compliance Less elastic recoil Increased volume Can't exhale
40
Restrictive disease effects
Less compliance More elastic recoil Decreased lung volume Can't inhale or exhale
41
Pulmonary surfactant
Made by type II pneumocytes
42
Role of pulmonary surfactant
``` Easier to inhale Promotes more uniform alveolar diameters Reduces surface tension Increases compliance Minimizes fluid accumulation in alveolus ```
43
Stages of V(L) during reinflation
Stable V(L) Opening of airways Linear expansion of open airways Limit of airway inflation
44
What to optimize during cardiorespiratory transition from fetus to neonate
Continuous breathing Pulmonary vasorelaxation Resorption of lung fluid
45
What to avoid during cardiorespiratory transition from fetus to neonate
Apnea Pulmonary vasoconstriction Retention of lung fluid
46
What leads to inhibition of fetal respiratory activity
``` Hypoxia (through adenosine) Placental unity (prostaglandin) Descending pontine inhibition Hyperthermia Non-REM sleep ```
47
What drug is used for late preterm delivery with surfactant therapy
Betamethasone
48
Saturated phosphatidylcholine in pulmonary surfactant
50%
49
Unsaturated phosphatidylcholine in pulmonary surfactant
20%
50
Neutral lipids in pulmonary surfactant
8%
51
Phosphatidylglycerol in pulmonary surfactant
8%
52
Other phospholipids in pulmonary surfactant
6%
53
What causes BPD/CLD
``` Low gestation Genetic susceptibility Low birthweight Baro/volutrauma Increased inspired O2 Sepsis/inflammation Nutritional deficit ```
54
Neonatal contributors to altered airway function
Modulated neural output Parenchymal (alveolar) injury Airway dysfunction
55
How does hypoxia affect pulmonary vessel diameter
Causes pulmonary vasoconstriction
56
Ductus Venosus
Shunts blood from the umbilical vein to the inferior vena cava Bypasses the liver
57
Foramen Ovale
Shunts blood from right atrium to left atrium | Bypasses the lungs
58
Ductus Arteriosus
Shunts blood from the pulmonary artery to the aorta | Bypasses the lungs
59
What taste is associated with ENaCs
Salt
60
What cells contain ENaCs in the kidney
Principal cells in the kidney
61
Release of what endogenous hormone is thought to be associated with the transition of the ENaCs at birth
Glucocorticoids/cortisol
62
Why is betamethasone used?
Can cross the placental barrier
63
What is considered late preterm infant?
34-36 weeks
64
What is the primary component of pulmonary surfactant
Saturated phosphatidylcholine
65
Contributing factors to neonatal respiratory distress syndrome
Surfactant deficiency | Inefficient fluid absorption (37-38 weeks)
66
Treatment of Neonatal respiratory distress syndrome
Glucocorticoids Artificial surfactant therapy CPAP Intubation
67
Impact of C-section on Neonatal respiratory distress syndrome
Increases risk of neonate respiratory distress by showing lower SpO2
68
What can happen when you don't have sufficient surfactant
Atelectasis
69
Atelectasis
Alveoli collapse
70
What are the two roles of glucocorticoids that were discussed?
Promotes resorption of fluid | Increases production of surfactant
71
What leads to a right shift of O2-Hb curve
``` Increased temp Increased [H+] Decreased pH Increased [CO2] Increased [2,3-DPG] ```
72
What leads to left shift of O2-Hb curve
``` Decreased temp Decreased [H+] Increased pH Decreased [CO2] Decreased [2,3-DPG] HbF ```
73
CO2 transport in blood
Dissolved CO2 HCO3 - Carbamino compounds
74
Spirometer
Measures changes in V(L) Doesn't measure RV Can measure FEV1
75
He Dilution
Measures absolute volumes Can measure RV, FRC, TLC Closed system Volume of distribution approach
76
N2 washout
Measures absolute volumes Can measure RV, FRC, TLC Open system Volume of distribution approach
77
Plethysmograph
Air tight telephone booth Use Boyle's law Estimates RV Measures changes in volume and pressure
78
Aggregate lung volume
5-6 L
79
Laplace's law
P= 2T/r
80
What increases R(AW)
COPD/Emphysema/Chronic Bronchitis Vagal tone => parasympathetic activity Histamine => Bronchoconstriction Reduced lung volumes
81
Change of 1 unit in pH
10x in [H+]
82
Change in 0.3 unit of pH
2x change in [H+]
83
Buffering power
Amount of OH-/H+ (mM) needed to change the pH by one unit
84
Cause of respiratory acidosis
Increased PCO2
85
respiratory acidosis leads to
decreased blood pH
86
Clinical causes of respiratory acidosis
Decreased alveolar ventilation Decreased lung diffusing capacity Ventilation/perfusion mismatch
87
Compensation of respiratory acidosis
Metabolic alkalosis
88
Cause of respiratory alkalosis
Decreased PCO2
89
respiratory alkalosis leads to
increased pH
90
clinical causes of respiratory alkalosis
Increased alveolar ventilation Hypoxia Anxiety
91
Compensation of respiratory alkalosis
Metabolic acidosis
92
Cause of metabolic acidosis
Decreased HCO3 -
93
metabolic acidosis leads to
Decreased pH
94
Clinical causes of metabolic acidosis
Decreased urinary secretion of H+ Ketoacidosis Lactic acidosis Severe diarrhea
95
Compensation of metabolic acidosis
Respiratory alkalosis
96
Cause of metabolic alkalosis
Increased HCO3 -
97
metabolic alkalosis leads to
increased pH
98
Clinical causes of metabolic alkalosis
Increased HCO3 - load | Severe vomiting
99
Compensation of metabolic alkalosis
Respiratory acidosis
100
Intracellular metabolic acidosis response
Stimulate acid extruders | Inhibit acid loaders
101
Intracellular metabolic alkalosis response
Stimulate acid loaders | Inhibit acid extruders

Medical Physiology I (8 decks)

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