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phys. 3 > CVP exam 3 > Flashcards

CVP exam 3 Flashcards

1
Q

Where are respiratory neurons located?

A

Brainstem

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2
Q

What are the fcts. of those neurons?

A

Set basic drive of ventilation & activation of muscles of respiration

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3
Q

What are the two respiratory centers?

A

Dorsal and ventral medullary group & pneumotaxic and apneustic centers

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4
Q

The respiratory centers are influenced by? (3 things)

A
  1. higher brain centers 2. peripheral and central chemoreceptors 3. peripheral mechanoreceptors
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5
Q

What are the major inspiratory muscles?

A

Diaphragm & external intercostals

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6
Q

What are the major expiratory muscles?

A

Abdominals & internal intercostals

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7
Q

Under resting conditions, expiration is passive and is associated with recoil of the lungs? (True/False)

A

True

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8
Q

What is pleural P?

A

Negative P between parietal and visceral pleura that keeps lung inflated against chest wall

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9
Q

Where does the alveolar P stands compared to the atmospheric P during inspiration?

A

Sub-atmospheric (Supra-atmospheric during expiration)

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10
Q

Transpulmonary P peaks at the end of inspiration? (True/False)

A

True

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11
Q

What 2 forces are opposed during inspiration?

A

Chest wall F v.s. lung recoil F

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12
Q

É required for ventilation is 3.5% of tot. body É? (True/False)

A

True

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13
Q

What is hyperventilation?

A

Pulmonary ventilation > metabolic demand

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14
Q

What is hypoventilation?

A

Pulmonary ventilation

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15
Q

What’s a pleural effusion?

A

Collection of large amount of free fluid in pleural space

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16
Q

Surfactant reduces surface tension? (True/False)

A

True

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17
Q

Only interdependence plays a role in stabilization of alveolar size? (True/False)

A

False, surfactant also plays a role

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18
Q

What is tidal volume (TV)?

A

Amount of air moved in or out each breath

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19
Q

What is inspiratory reserve volume (IRV)?

A

Max. vol. one can inspire above normal inspiration

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20
Q

What is expiratory reserve volume (ERV)?

A

Max. vol. one can expire above normal expiration

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21
Q

What is residual volume (RV)?

A

Vol. of air left in the lungs after max. expiratory effort

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22
Q

What is functional residual capacity (FRC)?

A

Vol. of air left in the lungs after a normal expiration (RV + ERV)

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23
Q

What is inspiratory capacity (IC)?

A

Max. vol. one can inspire during an inspiration effort (TV + IRV)

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24
Q

What is vital capacity (VC)?

A

Max. vol. one can exchange in a respiratory cycle (IRV + TV + ERV)

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25
Q

What is total lung capacity (TLC)?

A

Air in the lungs at full inflation (IRV + TV + ERV + RV)

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26
Q

What diminishes with restrictive lung condition? (3 things)

A

VC, IRV & IC

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27
Q

There is around 300 million alveoli with a surface area of 150-200 square meter? (True/False)

A

False, 50-100 square meter

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28
Q

What is the anatomical dead space?

A

Airways (~150 ml)

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29
Q

What is the physiological dead space?

A

Anatomical + non functional alveoli

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30
Q

If the rib cage is immobile, how is inspiration possible?

A

By diaphragmatic breathing

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31
Q

What is transpulmonary pressure?

A

Measure of the recoil tendency of the lung

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32
Q

Which muscle of respiration is a stabilizer of the lumbar spine?

A

Transversus abdominis

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33
Q

If the visceral pleura erodes and allows a region of the alveolar space to communicate with the pleural space, what would happen to the functional residual capacity?

A

Decreased

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34
Q

What is hysterisis?

A

At the onset of inspiration, lung vol. changes at a slower rate then the pleural P changes

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35
Q

What act as a lubricant between pleura?

A

Pleural fluid

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36
Q

What effect will histamine binding to H1 receptors have on the airway smooth muscle

A

Constrict (H2 receptors = dilation)

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37
Q

Most of the recoil tendency of the lung is due to what?

A

Surface tension forces

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38
Q

What are the pathophysiologic consequences of hyperventilation?

A

SV & CO decreased; coronary blood flow decreased; repol. of heart impaired; oxyhemoglobin affinity increased; cerebral blood flow decreased; skeletal muscle spasm and tetany; serum potassium decreased

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39
Q

What is the major effect of sympathetic stimulation on airway smooth muscle?

A

Dilate, most of the effect is indirect via blood borne (circulating epinephrine)

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40
Q

Why is the left ventricular output slightly higher (1%) than the right ventricular output?

A

Some bronchial artery blood drains into the pulmonary veins

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41
Q

Which volumes or capacities cannot be determined with basic spirometry?

A

RV; FRC & TLC

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42
Q

What local effect will Prostaglandin E series have on airway smooth muscle?

A

Dilation (Prostagladin F series = constriction)

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43
Q

What has the greatest effect on constriction of the pre-capillary?

A

Low alveolar oxygen

44
Q

Without surfactant, as alveolar radius increases, what happens to the collapse tendency of the lung?

A

Increase

45
Q

During exercise in upright position, flow throughout the lung is equal? (True/False)

A

False

46
Q

What condition can significantly increase total pulmonic blood volume?

A

Mitral valve stenosis

47
Q

Compared to atmospheric air, alveolar air has a higher concentration of which gases?

A

CO2 and H2O

48
Q

What effect does stimulation of the SNS have on sensitivity of peripheral chemoreceptors to hypoxia?

A

Increases

49
Q

0.1% CO (P(CO) = 0.6 mmHg) can be lethal? (True/False)

A

True

50
Q

What are the major fcts. of CO?

A
  1. Signaling molecule in NS 2. Vasodilator
51
Q

Not enough pulmonary blood flow (perfusion) for the amount of ventilation results in a decrease of physiologic dead space? (True/False)

A

False (Increase in physiologic dead space)

52
Q

If the ventilation/perfusion ratio decreases below normal, what condition happen?

A

Increase in the amount of physiologic shunt blood

53
Q

What happens to virtually all circulating prostaglandins in the blood as they pass through the pulmonary capillaries?

A

They are inactivated/cleared

54
Q

What percentage of CO2 in the blood is carried in the form of the bicarbonate ion?

A

70%

55
Q

Stimulation of stretch receptors in the lungs will have what effect on the dorsal respiratory group?

A

Inhibit

56
Q

What would cause more oxygen to be released from hemoglobin? (shift to the right)

A

Decrease P(O2); increase P(CO2); decrease pH; increase in 2,3 diphosphoglycerate

57
Q

Most of the ventilatory response to a slight increase in CO2 levels is mediated by?

A

Central chemoreceptors in the brain stem

58
Q

The basic ventilatory drive is set by neurons in which area of the NS?

A

Dorsal respiratory group

59
Q

Normal inspiration is usually terminated by which area of the NS?

A

Pneumotaxic center

60
Q

What is the most prevalent cause of respiratory depression?

A

Narcotics

61
Q

What are the complications associated with chronic mountain sickness?

A

Increase hematocrit; increase pulmonary arterial BP; enlarged right ventricle; decrease total peripheral resistance

62
Q

Stimulation of what receptors, would create a feeling of dyspnea?

A

J receptors in the parenchyma

63
Q

In acute mountain sickness, the subject suffers deterioration of nervous system function primarily due to what?

A

Hypoxia

64
Q

What is the negative pleural pressure generated to expand the lung and open the alveoli during the first breath?

A

-40 to -60 cm H2O

65
Q

Parasympathetic-muscarenic receptors cause bronchodilation? (True/False)

A

False (bronchoconstriction)

66
Q

NANC nerves can either bronchodilate or bronchocontrict? (True/False)

A

True

67
Q

How does environmental pollution affect the control of airway smooth muscle?

A

Elicit constriction of airways with parasympathetic reflex or local constrictor responses

68
Q

How does the body react to respiratory acidosis?

A

Increase ventilation

69
Q

How does the body react to respiratory alkalosis?

A

Decrease ventilation

70
Q

What regulates CO2 P?

A

Lungs

71
Q

What regulates HCO3 P?

A

Kidneys

72
Q

The lungs are the only organ that receive blood flow in excess of the cardiac output? (True/False)

A

True

73
Q

Under resting conditions, when is blood fully oxygenated?

A

By the time it has passed the 1st 1/3 of pulmonary capillaries

74
Q

What is the oxygenation limiting factor in exercise?

A

Stroke Volume (SV)

75
Q

During exercise, the entire lung is like a zone 1, which means that capillary P > alveolar P (blood flow from the capillaries to the alveoli)? (True/False)

A

False (entire lung is like a zone 3)

76
Q

How is the excess fluid removed from the pulmonary capillaries?

A

Lymphatics

77
Q

What is the solubility order of the pulmonary gases?

A

CO2 > O2 > He > CO > N2

78
Q

Why is the alveolar air turnover slow?

A

Because it prevents a large changes in gas [C] in alveoli

79
Q

What limits VO2 max?

A

Cardiac Output, not ventilation

80
Q

What percentage of O2 is transported in a dissolved form?

A

3%

81
Q

What percentage of O2 is transported bound to hemoglobin?

A

97%

82
Q

What percentage of CO2 is transported in a dissolved form?

A

7%

83
Q

What percentage of O2 is transported bound to hemoglobin (and other proteins)?

A

23%

84
Q

How does the dorsal respiratory group (DRG) set the basic drive of ventilation?

A

It is rhythmically self excitatory (ramp signal and muscles of inspiration excitement)

85
Q

What effect has the pneumotaxic center?

A

Turns off the DRG ramp signal which inhibits the duration of inspiration

86
Q

What effect has the apneustic center?

A

Prevent inhibition of DRG

87
Q

What effect has the ventral respiratory group of neurons?

A

Increased both inspiratory and expiratory group of muscles during increased ventilatory drive

88
Q

What is the Herring-Breuer inflation reflex?

A

Inhibition of the DRG when the stretch receptors in the airways wall are activated

89
Q

Hydrogen ions are the primary stimulus of the chemical control of ventilation, when they cross the Blood Brain Barrier (BBB)? (True/False)

A

False (can’t cross the BBB)

90
Q

Can CO2 cross the BBB?

A

Yes

91
Q

What percentage of CO2 induced will increase ventilation at the central chemoreceptors?

A

70-80%

92
Q

Is the central chemosensitive area of the respiratory center responsive to fall in oxygen?

A

No

93
Q

What percentage of CO2 induced will increase ventilation at the peripheral chemoreceptors?

A

20-30%

94
Q

The peripheral chemoreceptors are not sensitive to hypoxia? (True/False)

A

False (they are)

95
Q

What is the effect of brain edema on ventilation?

A

Depression or inactivation of the respiratory centers

96
Q

What is the O2 debt?

A

The extra O2 that is consumed post-exercise to replenish O2 stores and remove lactic acid

97
Q

Pulmonic resistance decreases (elimination of hypoxia) at birth? (True/False)

A

True

98
Q

What happens in acute mountain sickness?

A

Cerebral edema –> hypoxia & local vasodilation

Pulmonary edema –> hypoxia & local vasoconstriction

99
Q

What are some natural acclimatization to high altitude?

A
  1. high ration of ventilatory capacity to body mass 2. increased size of right ventricle 3. shift in oxy-hemoglobin dissociation curve
100
Q

Why can hyperbaric conditions (high pressure) be lethal?

A

Because it exposes the pulmonary capillary to extremely high blood P

101
Q

What is the effect of high partial P of N2?

A

It causes narcosis (similar to alcohol intoxication)

102
Q

What is the effect of high partial P of O2?

A

It leads to oxygen toxicity (seizures and free radicals damage can occur)

103
Q

What is decompression sickness “bends”?

A

Nitrogen bubbles out of fluids after sudden decompression; bubbles will block blood vessels

104
Q

The lung is ranked 3rd after the liver and the heart as an organ of body metabolism? (True/False)

A

False, it is ranked 2nd after the liver

105
Q

What antibodies are involved in the immune reaction in the lung?

A

IgG –> lower respiratory tract
IgA –> dominate upper respiratory tract
IgE –> predominantly a mucosal antibody

phys. 3 (1 decks)

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