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JKC Med Phys Spring '24 > Exam 2 Review > Flashcards

Exam 2 Review Flashcards

1
Q

Pulmonary ventilation is the ?

A

mechanisms of breathing

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2
Q

What is respiration?

A

Diffusion of O2 and CO2 between alveoli and blood

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3
Q

What is a factor that determines the homeostatic balance?

A

transport of O2 and CO2

tissues will alter the blood flow without the direction of the nervous system when the O2 level drops

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4
Q

Regulation of ventilation is determined by the ??

A

pH

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5
Q

What muscles are used in inspiration?

A

External intercostals
SCM
Anterior Serratous
Scaleni

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6
Q

What muscles are used in heavy expiration?

A

Abdominal muscles and internal intercostals

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7
Q

What two layers form the pleural cavity?

A

visceral on the lungs

parietal on the thorax

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8
Q

What is creating the negative pleural pressure that allows the lungs to move with the ribs?

A

Continuous suction of excess fluid into the lymph that maintains suction between the visceral and parietal surfaces

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9
Q

What happens if the continuous suction between the ribs does not work?

A

pleural effusions

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10
Q

What is happening during inspiration?

A

the thorax expands causing the alveolar pressure to decrease (become negative) from 0 (normal is 0) and air flows into the lungs

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11
Q

What is happening during expiration?

A

the thorax constricts increasing the alveolar pressure causing the air to flow out of the lungs

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12
Q

What is recoil pressure?

A

the difference between alveolar and pleural pressures

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13
Q

What does the recoil pressure represent?

A

gives you an idea of how much the lungs want to pull away from the parietal pleura and collapse

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14
Q

Name a force that makes the lungs want to collapse

A

Elastin and collagen

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15
Q

What does the compliance represent? DRAW IT!

A

relates the lung volume changes to changes in transpulmonary pressure

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16
Q

To be able to inspire, muscles have to overcome what 2 things?

A
  1. overcome collagen and elastin forces
  2. surface tension
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17
Q

Define tidal volume

A

volume inspired or expired per breath

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18
Q

Inspiratory reserve volume

A

max inspiration at end of tidal inspiration

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19
Q

expiratory reserve volume

A

max expiration at end of tidal expiration

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20
Q

total lung capacity

A

volume in lungs after max inspiration

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21
Q

residual lung volume

A

volume in lungs after max expiration

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22
Q

forced vital capacity

A

max volume expired after max inspiration

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23
Q

inspiratory capacity

A

max volume inspired following tidal expiration

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24
Q

functional residual capacity

A

volume in lungs after tidal expiration

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25
Q

What is minute ventilation

A

expiratory volume in 1 minute

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26
Q

How much in mL is dead space ventilation?

A

around 150 mL

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27
Q

What is physiologic dead space

A

air goes to alveoli without blood flow

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28
Q

what is anatomic dead space

A

air goes to trachea, bronchi, bronchioles and gas exchange does NOT occur

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29
Q

As you go deeper into the respiratory passageway, there is (more/less) connective tissue holding it together

A

LESS the further and further you go down

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30
Q

Trachae has ___ to prevent collapse

A

cartilage rings

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31
Q

____ have less cartilage to expand and contract

A

bronchi

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32
Q

______ are not prevented from collapsing their walls

A

bronchioles

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33
Q

_____ have elastin and connective tissue but no cartilage

A

bronchioles

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34
Q

_____ have low resistance and change with ventilation

A

Bronchioles

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35
Q

??????? ASK SKYE ????? Where is resistance to airflow higher, in smaller bronchioles or larger bronchioles

A
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36
Q

_____ greatly stimulates B2 Adrenergic neurons to dilate the bronchioles

A

epinephrine

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37
Q

_____ cause bronchio constriction and asthma attacks

A

mast cell degranulation

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38
Q

Describe the High pressure, Low flow circulation

A

-blood leaves the heart through the descending aorta to supply the lung tissues
-return from the lungs throught the pulmonary veins and enter the left atria
- the mixing of the deoxygenated blood in the left atria is one of the reasons that you never have 100% saturation

39
Q

Describe the Low pressure, high flow circulation.

Why is the pressure low?

A

-take the deoxygenated blood to the alveolar capillaries when oxygen is added and CO2 is exchanged

because it is spread thin across the lungs to serve around 6 million alveoli

40
Q

Pulmonary edema occurs when?

A

when there is a problem with the LV

LV is weak and cannot pump blood to the aorta which causes blood to back up into the atria, pulmonary veins and pulmonary artery

41
Q

How do you diagnose pulmonary edema?

A

with a Swan-Ganz catheter (>20mmHg) to measure the increased pulmonary artery wedge pressure

42
Q

Blood perfusion is (higher/lower) at the bottom on the lung

A

higher

43
Q

At the top of the lung, ventilation is (higher/lower)

A

Higher

44
Q

If the blood flow is not moving between the alveoli and capillaries, what has happened?

A

the alveolar pressure is GREATER than the capillary pressure

45
Q

During exercise, what happens in terms of the lungs?

A

-blood flow to the lungs increases drastically
- # of capillaries increases
- capillaries distend
- small increase in pulmonary arterial pressure

46
Q

What is the most significant forces driving the absorption of fluid into the capillaries?

A

plasma colloid osmotic pressure

47
Q

What is the plasma colloid osmotic pressure? Need the number

A

-28mmHg

48
Q

What is the mean filtration pressure and where is it going?

A

+1 mmHg coming into the lungs but it taken up by the lymph

49
Q

What is restrictive lung disorder?

A

when you cant get enough air INTO the lungs

limited INSPIRATION

50
Q

Pulmonary fibrosis is restrictive/obstructive?

A

restricted

thick, scarred lungs make it difficult to max inspiration and gas exchange

51
Q

What is an obstructive lung disorder?

A

when you cant get all of the air OUT

expiration is limited

52
Q

Asthma is restrictive/obstructive?

A

obstructive because air is getting trapped and cannot be fully EXHALED due to collapsed bronchioles

53
Q

COPD is restrictive/obstructive

A

obstructive, because air is getting trapped and cannot be fully EXHALED due to collapsed bronchioles

54
Q

Describe small bronchiole disease

A

air gets trapped in and cannot be fully exhaled due to small bronchioles collapsing

55
Q

Be able to draw the Flow-Volume Loop

A

Be able to draw this curve

56
Q

The top of the lung has a (high/low) V/Q ratio

A

HIGH

57
Q

the bottom of the lung has a (low/high) V/Q ratio

A

LOW

58
Q

What is partial pressure?

A

the percent of the gas in the mixture of gasses

59
Q

What are the SET (aka these numbers do not change) of mixtures of O2, N2 and CO2 when the atmospheric pressure is at sea level (760)

A

20.93 for oxygen

79.03 for nitrogen

.04 for Carbon dioxide

60
Q

At sea level, what is the partial pressure for oxygen?

A

159 mmHg

61
Q

At sea level, what is the partial pressure for Nitrogen?

A

600mmHg

62
Q

At sea level, what is the partial pressure for Carbon dioxide?

A

1mmHg

63
Q

Why is it more important to maintain CO2 levels than O2 levels?

A

because CO2 is more closely tied to pH

64
Q

Hemoglobin is made from ____ and _____. Which combine to form _____.

A

succinyl- CoA and glycine

pyrol molecule

65
Q

4 Pyrol molecules form a ______, which combine with _____ to make heme

A

protoporphyrin

iron

66
Q

____ and ____ put together form hemoglobin

A

iron and protein

67
Q

Name some things that can influence the oxygen dissociation

A

-difference in partial pressure of O2
- changes in pH
-changes in temperature

68
Q

What is oxygen dissociation?

A

the ability of hemoglobin to release O2

69
Q

What is the oxygen carrying capacity formula?

A

15gHb/100mL of blood * 1.34 = 20mL

70
Q

Draw the oxygen dissociation curve. What is on the Y, X, Z axis labeled?

A

X= Pressure of oxygen in blood PO2 mmHg

Y= Hemoglobin saturation %

Z= Volumes %

71
Q

When the partial pressure is high, what does hemoglobin do?

A

hemoglobin wants to bind tightly to O2

72
Q

When the partial pressure is low, what does hemoglobin do?

A

hemoglobin wants to release into tissues

73
Q

DRAW the CO2 transport system from Dr. Sheppard

A

Draw the CO2 transport formula from Dr. Sheppard

74
Q

What is the main method of transportation for Carbon Dioxide?

A

plama bicarbonate

75
Q

Acids produce/accept H+

A

produce

76
Q

bases produce/accept H+

A

accept

77
Q

What are the two ways we can regulate acid-base?

A
  1. Respiratory control blowing off excess CO2
  2. Renal control- elimination of H+ in urine OR reabsorption of bicarb
78
Q

Is diabetes metabolic acidosis/alkalosis?

A

acidosis

79
Q

Is diarhhea metabolic acidosis/alkalosis?

A

acidosis

80
Q

Is vomiting metabolic acidosis/alkalosis?

A

alkalosis

81
Q

Is hyperventilation respiratory acidosis/alkalosis?

A

alkalosis

82
Q

The ____ and _____ of the brainstem regulate respiration

A

medulla and pons

83
Q

What is the dorsal respiratory group responsible for?

A

causes inspiration

84
Q

What is the ventral respiratory group is responsible for?

A

causes expiration

utilized when the respiratory drive exceeds normal breathing at rest

85
Q

What is the pneumotaxic center responsible for?

A

controls the “switch-off” point of the inspiratory drive

limit inspiration, may increase the respiratory rate to compensate

86
Q

What is the inspiratory ramp signal?

A

a steady ramp signal for 2 seconds that enable inspiration and ceases abruptly for 3 seconds to stop excitation of teh diaphragm and allow elastic recoil of the lungs (expiration)

-allows for a nice steady increase in lung volume

87
Q

When the lungs become overstretched during inspiration, what happens? at what point does this happen?

A

the inspiratory ramp “switches off”

not activated until the Tidal Volume is 3x normal

88
Q

____ does not have a direct effect on the respiratory center but instead acts on ______. Where are they located?

A

Oxygen

peripheral chemorecptors

carotid and aortic bodies

89
Q

______ are located outside the brain to detect O2. What else do they detect?

A

peripheral chemoreceptors

CO2 and H+

90
Q

Where is it the easiest to collapse the alveoli? (top/middle/bottom)

A

TOP

due to the lack of blood flow

91
Q

____ regulate bicard

A

Kidneys

92
Q

____ regulate CO2

A

Lungs

93
Q
A

JKC Med Phys Spring '24 (18 decks)

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