Damjanov chapter 5

Question 1

Bronchioli are devoid of

Answer 1

cartilage

Question 2

Type II pneumocytes produce

Answer 2

surfactant

Question 3

Mucus made by mucus glands have

Answer 3

GAGS, glycoproteins, complex carbs, IgA, macrophages

Question 4

Left upper lobe drains into; right upper lobe drains into

Answer 4

right lymphatic duct; thoracic duct

Question 5

Pulmonary immune response includes

Answer 5

mucosa-associated lymphoid tissue (MALT); see T, B cells and resident macrophages and Ag-presenting cells like Langerhans cells

Question 6

Total ventilation is

Answer 6

VE = f x VT

Question 7

Fick’s law is

Answer 7

Vgas = A x D(P1 - P2) / T

Question 8

In restrictive lung diseases

Answer 8

diffusion of CO from alveolar air into blood is reduced;

Question 9

V/Q ratio is normally

Answer 9

.8 (defects in obstruction of the airflow passages like obstructive lung disease, or obstruction of pulmonary blood blow like PE)

Question 10

Respiratory centers:

Answer 10

1. medullary respiratory: inspiratory in dorsal medulla (glossopharyngeal and vagus stimulatory, efferent through phrenic nerve) and expiratory in ventral medulla that’s usually dormant
2. Apneustic center: lower pons; prolongs contraction of the diaphragm
3. Pneumotaxic center: upper pons that inhibits respiration by reducing tidal volume

Question 11

In metabolic acidosis the chemoreceptors

Answer 11

respond to lowered pH by increasing respiration rate

Question 12

Receptors responding to stretch in smooth muscles of bronchi activate; irritant receptors can cause

Answer 12

Hering-Breuer reflex;

bronchoconstriction, sneezing, pain (link to C type nerve fibers)

Question 13

Which values can be measured by spirometer? What can’t be?

Answer 13

VC, IC, ERV;

FRC and TLC need additional special studies

Question 14

Lung equations:

Answer 14

RV = FRC - ERV;
IC = VT + IRV;
TLC = IRV + VT + ERV + RV;;
FRC = ERV + RV;
VC = ERV + VT + IRV

Question 15

Forceful coughing may cause

Answer 15

lightheadedness and syncope b/c increased intrathoracic pressure may compress the venae cavae and reduce return of venous blood into R heart

Question 16

Cough can be suppressed with

Answer 16

1. drugs that anesthetize respiratory receptors (benzonatate or phenol-containing drugs)
2. raising the threshold for the sensory impulses in the medullary cough center (dextromethorphan)

Question 17

Blood expectorated from lungs is

Answer 17

arterial and red and alkaline (in hematemesis blood is dark red and acidic)

Question 18

Kussmaul breathing characterized by

Answer 18

very deep rapid breathing (feature of metabolic acidosis, like diabetic ketoacidosis)

Question 19

Obstructed sleep apnea associated with

Answer 19

loss of muscle tone of pharyngeal muscles that occurs during REM sleep;
think PICKWICKIAN syndrome with someone who is obese

Question 20

Central sleep apnea though to be the cause of

Answer 20

sudden infant death syndrome (SIDS)

Question 21

Early inspiratory crackles, late inspiratory crackles, and paninspiratory crackles found in:

Answer 21

E: obstructive lung disease, severe CHF;
L: chronic interstitial disease or pulmonary fibrosis; maybe atelectasis or chronic heart failure
P: both cardiac and pulmonary disease

Question 22

Five examples of decreased DLCO:

Answer 22

1. Pneumonia (exudate)
2. Interstitial
3. Pulmonary fibrosis (alveolar fibrosis)
4. Emphysema (loss of alveoli)
5. CHF (edema and alveolar fibrosis)

Question 23

Hypercapnia of hypoventilation is typically associated with

Answer 23

respiratory acidosis; whereas hypocapnia of hyperventilation associated with respiratory alkalosis