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SF3 Pulm Test > Dasgupta - Respiratory Mechanics > Flashcards

Dasgupta - Respiratory Mechanics Flashcards

1
Q

Venous blood gas tells you ____ about respiratory function

A

Nothing

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2
Q

The volume of air that you cannot get out of the lung at zero pressure

A

Residual volume

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3
Q

Flow in large airways is _____

A

Fast and turbulent

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4
Q

Lesions inside the thoracic cage will be affected to a greater extent by?

A

Expiration

Trachea tumor is example

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5
Q

destroys the entire alveolus uniformly and is predominant in the lower half of the lungs. generally is observed in patients with homozygous alpha1-antitrypsin (AAT) deficiency or Ritalin-induced lung emphysema. This condition called the Ritalin lung is seen in people who abuse Ritalin. They crush the pills and then inject them intravenously. This pills contain fillers which are insoluble particles. These particles block the fine blood vessels of the lung. Although the lung has millions of blood vessels, routine intravenous administration of Ritalin can block sufficient blood vessels to cause pulmonary hypertension and damage lung tissue to cause _____ emphysema. This is also observed in people who Ritalin by inhalation. In people who smoke, focal ____ emphysema at the lung bases may accompany centrilobular emphysema.

A

Panacinar emphysema

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6
Q

Normal spontaneous breathing

A

Eupnea

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7
Q

Low pO2 in ABG

A

Hypoxemia

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8
Q

The volume of air present in the lungs at the end of passive expiration. At _____ the opposing elastic recoil forces of the lungs and chest wall are in equilibrium and there is no exertion by the diaphragm or other respiratory muscles

A

Functional residual capacity

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9
Q

A complex mixture of phospholipids (90%) and protein (10%) secreted by type II alveolar cells.

Functions to lower surface tension by inserting itself between water molecules along surface

A

Pulmonary surfactant

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10
Q

What are the two kinds of dead space?

A

Anatomical dead space (large airways w/o alveoli)

Physiological dead space (alveoli that are ventilated but not perfused and the anatomical dead space values combined)

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11
Q

If alveolar ventilation is doubled (hyperventilation) but CO2 production remains the same, the alveolar and arterial PCO2 will be _____

A

Halved

This raises blood pH and causes respiratory alkalosis

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12
Q

In the absence of surfactant (premature infants) lung recoil forces are —______

A

Very high

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13
Q

The compliance measurements made by spirometry measure ?

A

Both lung and chest wall compliance (Total compliance)

[if dx can assume chest wall is normal, then you can assume this measure is lung compliance]

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14
Q

The pressure in the lung due to gravity is more negative at the ____

A

Top

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15
Q

The chest wall exerts and elastic recoil force to _____

A

Expand the lung

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16
Q

Decrease of respiratory rate

A

Bradypnea

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17
Q

Expiration is low and prolonged because of high compliance and dynamic collapse in

A

Obstructive disease

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18
Q

Normal venous blood gas bicarb

A

24-30meq / mL

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19
Q

Obstructive disease is characterized by?

A

High airway resistance

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20
Q

Amount of air in lungs which can’t be exhaled or pushed out of lungs

A

Residual volume (RV)

In adults; 1-2 liters

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21
Q

Obtructions not effected by inspiratory or expiratory effort

A

Fixed obstructions

[caused by foreign bodies or scarring which makes region of airway too stiff to be affected by transmural pressure gradient]

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22
Q

Bernoulli’s effect:

A

The faster the airflow, the lower the pressure

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23
Q

The greatest airway resistance is in the ____ airways

A

Largest

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24
Q

Lung compliance alone can be measured by using ?

A

Esophageal balloon

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25
Q

Normal ABG bicarb

A

22-26 meq/mL

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26
Q

_____ % of barometric pressure is exerted by oxygen and ____ % is exerted by N2 Molecules

A

21

79

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27
Q

Inflammation of the pleural cavity

A

Pleuritis

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28
Q

Compliance:

A

Change in volume

_______________

Change in pressure

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29
Q

Normal venous blood gas PO2

A

38-42mmHg

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30
Q

Restrictive lung diseases are characterized by :

A

Low lung compliance or increased stiffness of the lung and increased lung recoil

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31
Q

The pattern for FEV1 in restrictive lung disease is described as?

A

Witch hat shaped

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32
Q

Amount of air that can be exhaled as quickly during a forced exhalation

Normal 4600mL

A

Forced vital capacity (FVC)

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33
Q

Greatest flow velocities of air are observed in ________ airways

A

Large

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34
Q

If alveolar ventilation is halved (Hypoventilation) but CO2 production remains the same, the alveolar and arterial PCO2 will ____

A

Double

This lowers blood pH and causes respiratory acidosis

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35
Q

Main contributor to lung recoil is ?

A

Surface tension

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36
Q

A rapid rate of breathing

A

Tachypnea

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37
Q

Reasons for a decrease in compliance of a lung

A

Interstitial lung disease (fibrosis)
Loss of surfactant

[remember this is things making it harder to fill]

{right shift on PV curve and TLC is reduced}

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38
Q

High pCO2 in ABG

A

Hypercapnia

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39
Q

Increased depth (volume) of breathing w/ or w/o increased frequency

A

Hyperpnea

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40
Q

“Accessory muscles” of the shoulder girdle are not involved in quiet breathing, but are involved in ______

A

Breathing during exercise

Coughing

Sneezing

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41
Q

Volume of air in the lung when the lung and chest wall have equal recoil force

A

Functional residual capacity

(FRC)

Normal: 2300mL

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42
Q

The lungs elastic recoil forces act to -____

A

Collapse the lung

43
Q

Dead space Volume =

A

150mL

44
Q

Primary surface tension lowering pulmonary surfactant

A

DPPC

Dipamitoyl phosphatidyl choline

45
Q

FEV1 should be about _____ % of FVC

A

80-100%

46
Q

When room air is drawn into airways, what other species of gas is added to the mix to change the partial pressure?

A

Water vapor

47
Q

The pressure difference inside and outside of a given system

A

Transmural pressure (Ptm)

48
Q

During gas exchange, the oxygen consumption is _____ mL/min and the CO2 production is ____ mL / min

A

250

200

49
Q

Lungs are stiffer and only a small volume is inhaled and expired quickly in

A

Restrictive disease

50
Q

Specific compliance =

A

Compliance / functional residual capacity

51
Q

The air which a person breathes but is not used for gas exchange. It fills respiratory passages like the nose pharynx and trachea

A

Dead space volume (Vd)

Normal adult value (150mL)

52
Q

Dyspnea which occurs when lying flat, causing the person to have to sleep propped up in bed or sitting in a chair

A

Orthopnea

53
Q

Normalizes compliance value to the FRC

A

Specific compliance

54
Q

Volume of air inspired or expired with each breath

A

Tidal volume

Normal adult (500mL)

55
Q

Pneumothorax will cause a mediastinum shift to the

A

Side opposite the collapse

56
Q

Partial or total collapse of the lung without air entering the pleural space

A

Atelectasis

57
Q

Amount exhaled in the first second.

Should be 80% of FVC

A

FEV1
Forced expiratory volume in 1 second

Normal: 3800 liters

58
Q

The lowest part of the lung is ventilated _____ than the uppermost part

A

More

(This holds true whether standing or supine, and does not refer to the apex of the lung, but the part of the lung that is lower to earth)

59
Q

Increases in age lead to a ______ in FRC

A

Increase in FRC because there is a decrease in elastic recoil of lung and an increase in compliance leading to increase in FRC

60
Q

Obstructions in which the cross-sectional area of the obstruction is dependent on inspiratory or expiratory effort

A

Variable obstructions

61
Q

As airway size decreases, velocity of flow is ___________

A

Increased

62
Q

What is the methacholine challenge test used to detect?

A

Hyperactive airways. It is a sensitive test for asthma

63
Q

Lying down decreases functional residual capacity by _____

A

10-15%

64
Q

Forced exhalation uses what extra muscles?

A

Abdominal muscles (internal oblique, rectus abdominus, and transverse abdominus these push gut into the diaphragm)

Internal intercostals (move ribs down and back

65
Q

Difficulty breathing that the individual is aware of

A

Dyspnea

66
Q

Respiratory problems associated with kyphoscoliosis?

A

Underventilation of the lungs —> FRC and RV lower

67
Q

Laplace’s Law states that Pressure is inversely proportional to _______

A

Radius

68
Q

Normal arterial blood pH

A

7.35 - 7.45

69
Q

Factors involved in lung elastic recoil forces.

A

Lung tissue elastic recoil (from collagen and elastin)

Surface tension forces (each alveolus is water lined and surface tension forces reduce size of surface)

70
Q

What is a shunt through the lung?

A

A vascular pathway in which there is no gas exchange

71
Q

Normal arterial blood gas PO2

A

80-100mmHg

72
Q

Volume of air left in unperfused alveoli which is a measure of lung disease or ventilation-perfusion mismatch

A

Alveolar dead space

73
Q

Alveolar ventilation is always ______ than total ventilation

A

Less

Because it subtracts the volume of dead space in the lung and therefore considers only the volume of air actually participating in gas exchange.

74
Q

is the most common morphological subtype of emphysema This affects the central portion of secondary pulmonary lobules, around the central respiratory bronchioles, typically involving the superior part of the lungs or lobes. It begins in the respiratory bronchioles and spreads peripherally. this form is associated with long-standing cigarette smoking, occupational exposure to chemicals, dust etc. and predominantly involves the upper half of the lungs.

A

Centrilobar emphysema

75
Q

Flow in small airways is ____-

A

Slow and laminar

76
Q

Type of pneumothorax in which there is air in the pleural cavity but it does not accumulate with every breath

A

Non-tension pneumothorax

77
Q

Complete absence of spontaneous ventilation

A

Apnea

78
Q

Doubling radius increases surface tension of alveoli by a factor of _

A

4

79
Q

Normal ABG PCO2

A

35-45mmHg

80
Q

The measurement of physiological dead space with Bohr’s method is based on which 3 assumptions:

A

The content of CO2 in atmosphere is 0.04% and negligible

All expired CO2 comes from alveoli

All CO2 comes from the ventilated and perfused alveoli and not from dead space

81
Q

Complete atelectasis is accompanied with a mediatinum shift to the

A

Side of the collapse

82
Q

Why is tension pneumothorax a medical emergency?

A

Because the air that accumulates with each breath puts pressure on the organs of the chest

83
Q

The intrapleural pressure is ______

A

Negative

[subatmospheric]

84
Q

Type of pneumothorax due to medical procedure

A

Iatrogenic pneumothorax

85
Q

Volume of air in lungs after the maximum inspiratory effort

A

TLC

Total lung capacity

86
Q

What molecules that make up the physical lung will cause lung tissue elastic recoil forces which act to deflate the lung

A

Elastin and collagen

87
Q

Surfactant has a hydrophilic and hydrophobic region, allowing it to reside _________

A

At the air-water interface

88
Q

Venous blood gas pH

Normal

A

7.34 - 7.37

89
Q

O2 exchange takes place where?

A

Alveolar sacs

Alveolar ducts
These are the last 4 divisions of the airways

90
Q

Forced exhalation in emphysema patients can cause

A

Airway collapse

Which leads to increased resistance and decreased exhalaltion

91
Q

Type of pneumothorax in which air accumulates within the chest with every breath

A

Tension pneumothorax

92
Q

The reduced area in a PEF graph suggests

A

Some ventilatory limitation

93
Q

Airways or alveoli being attached to their neighbors

A

Tethering

94
Q

Rate of alveolar ventilation depends on:

A

Respiratory rate

Tidal volume

Dead space volume

95
Q

What do surgical removal of a lobe, obesity, pulmonary vascular congestion, and decreased pulmonary surfactant do to the pressure - volume curves ?

(PV curve, pressure on x axis)

A

Right shift

96
Q

Examples of variable extrathoracic lesions:

A

Vocal cord paralysis, fat deposits, obstructive sleep apnea

97
Q

Normal venous blood gas PCO2

A

44-46mmHg

98
Q

Reasons for an increase in compliance

A

Emphysema
Loss of elastic fibers (w/ age sometimes)

Lung becomes easier to inflate

PV curve shifts left and TLC is increased

99
Q

Sitting or standing leaning forward in respiratory distress. With upper body with hands on knees for support

A

Tripod stance

100
Q

An abnormally low FEV1 is highly diagnostic of a patient with

A

Obstructive pulmonary disease

FEV1 basically tells you airway resistance, because max expiratory flow rates are largely effort INdependent

101
Q

Compared to a person who is standing, the FRC of a supine person is ______

A

Less

Gut is pushing into diaphragm in supine

102
Q

What happens to FRC as a person grows older?

A

FRC increases

103
Q

Obstructions in which the cross-sectional area of the obstruction is dependent on inspiratory and expiratory effort

A

Variable obstructions

104
Q

Variable intrathoracic lesions will be affected to a greater extent by _________

A

Expiration

SF3 Pulm Test (10 decks)

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