EXAM 2 - Week 6 (Respiratory)

Question 1

Typical ventilation-perfusion ratio

Answer 1

9:1

Good ventilation, poor perfusion = HIGH ratio
Low ventilation, good perfusion = LOW ratio

Question 2

Example of ventilation but poor perfusion

Answer 2

Respiration is occurring but the oxygen/blood isn’t getting to the lungs; no gas exchange

Pulmonary emboli

Question 3

Example of poor ventilation but perfusion

Answer 3

Blood is getting to the lungs but problems with inspiration, expiration, or diffusion at ACJ
COPD, Asthma

Question 4

Sneezing

Answer 4

Reflex response to irritation in upper respiratory tract that helps remove irritant

Associated with inflammation or foreign material

Question 5

Coughing

Answer 5

Irritation due to nasal discharge, inflammation or foreign material in lower respiratory tract due to inhaled irritants

Question 6

Tidal Volume

Answer 6

Amount of air exchanged with normal inspiration and expiration (500 mL of air)

Question 7

Residual Volume

Answer 7

The amount of air left in lungs after max expiration

Question 8

Inspiratory reserve volume (IRV)

Answer 8

Max volume of air inspired in excess of normal

IRV = ERV - TV

Question 9

Expiratory reserve volume (ERV)

Answer 9

Max volume of air expelled after normal/passive expiration (RV - TV)

Question 10

Vital Capacity

Answer 10

Forced vital capacity = max amount of air expired following max inspiration

TV + ERV + IRV

Question 11

Total lung capacity

Answer 11

Total amount of air in lungs after max inspiration

Question 12

Forced expiratory volume in 1 second (FEV1)

Answer 12

Blow out air for as long as you can after max inhalation and measure for 1 second

Question 13

Carbonic Anhydrase

Answer 13

catalyzes decomposition of carbonic acid into carbon dioxide and H2O – facilitates transfer of CO2 from tissues to blood and from blood to alveolar air

-helps CO2 diffuse into red blood cells

Question 14

Retractions

Answer 14

Superclavicular region will suck in and retract when someone is trying to change the thoracic pressure so much that it is pulling and retracting in some areas without bone

Question 15

Abnormal breathing pattern - Eupnea

Answer 15

Rhythm is smooth and even with expiration longer than inspiration (~20 breaths/min)

Question 16

Tachypnea

Answer 16

Rapid superficial breathing, regular or irregular rhythm

Question 17

Bradypnea

Answer 17

Slow respiratory rate, deeper than usual depth, regular rhythm (less than 20/min)

Question 18

Apnea

Answer 18

Cessation of breathing

Question 19

Hyperpnea

Answer 19

Increased depth of respiration with a normal to increased rate and regular rhythm

Question 20

Cheyne-Stokes Respiration

Answer 20

Periodic breathing associated with periods of arena, alternating regularly with a series of respiratory cycles; the respiratory cycle gradually increases then decreases in rate and depth.

Question 21

Ataxic Breathing

Answer 21

Periods of apnea alternating irregularly with a series of shallow breaths of equal depth

Question 22

Kussmaul’s Respiration

Answer 22

Deep regular sighing respirations with an increase in respiratory rate

Question 23

Apneusis

Answer 23

Long, gasping respiratory phase followed by a short, inadequate expiratory phase

Question 24

Obstructed breathing

Answer 24

Long, ineffective expiratory phase with shallow increased respirations

Long expiratory phase b/c trying to get air out, and shallow b/c too much air is trapped

Question 25

Crackles

Answer 25

Constricted, narrow airways from fluid accumulation
-High pitched near alveoli

Ex: pneumonia, CHF, adylectasis

Question 26

Wheezing

Answer 26

Obstruction in small airways/high pitched whistling sound

Ex: Asthma

Question 27

Rhonchi

Answer 27

Low pitch snoring sound, usually caused by mucous (clear by cough)

Question 28

Stridor

Answer 28

High pitched squeaking sound r/t obstruction in larynx and pharynx

Question 29

Alpha-1 Anti-Trypsin

Answer 29

Gets rid of proteolytic enzymes near alveoli - when the proteolytic enzymes are not removed, they can degrade the alveoli themselves

Question 30

Difference between emphysema and chronic bronchitis

Answer 30

Emphysema: destruction of alveolar wall leads to hyperinflation, thus reduced airway patency; mainly difficulty with expiration

Chronic Bronchitis: no damage of wall, rather, inflammation of bronchial tree of airway + hypertrophy/hyperplasia of mucous glands leads to difficulty getting air in AND out

Question 31

A single small embolus may be…

Answer 31

“silent”

Question 32

Multiple small emboli equivalent to…

Answer 32

large embolus blocks circulation

Question 33

Moderate size embolus…

Answer 33

likely to cause respiratory distress and pulmonary infarction

Question 34

Very large embolus….

Answer 34

blocks all pulmonary circulation leading to shock and cardiac arrest

Question 35

Large embolus causes…

Answer 35

decreased blood returning in pulmonary vein and decreased cardiac output

Question 36

Components of Virchow’s Triad

Answer 36

Circulatory stasis, endothelial injury, and hyper coagulability

Question 37

TB is caused by what bacteria?

Answer 37

M. tuberculosis

Question 38

How is TB spread?

Answer 38

Oral droplets