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Phys 3 > Exam 3: Pulmonary > Flashcards

Exam 3: Pulmonary Flashcards

1
Q

Respiratory neurons in brain stem set

A

Basic drive of ventilation

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2
Q

Right ventricular output equal to

A

Lungs

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3
Q

During inspiration, P alveolar ____ P atm

A

Less than

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4
Q

During expiration, P alveolar ____ P atm

A

>

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5
Q

At end of inspiration or expiration , P avl ____ P atm

A

=

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6
Q

More negative pleural pressure = ____ TPP = ___ recoil

A

Increase

Increase

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7
Q

Respiratory centers located

A

Dorsal and ventral medullary group

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8
Q

Respiratory centers affect ___ and ____ of ventilation

A

Rate

Depth

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9
Q

Respiratory centers influenced by

A

Higher brain centers
Peripheral mechanoreceptors
Peripheral and central chemoreceptors

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10
Q

Inspiration muscles increase

A

Thoracic cage volume

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11
Q

Expiratory muscles decrease

A

Thoracic cage volume

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12
Q

Muscles of inspiration use ___ of total body energy

A

3%

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13
Q

___ drops floor of thoracic cage

A

Diaphragm

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14
Q

All other muscles of inspiration

A

Lift rib cage

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15
Q

Under resting conditions, expiration is ___ and associated with ___ of lungs

A

Passive

Recoil

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16
Q

Role in LBP

A

Transverse abdominis

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17
Q

Increase in lung volume =

A

Increase in TPP

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18
Q

Pleural pressure

A

Neg pressure between parietal and visceral pleura that keeps lungs inflated

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19
Q

Alveolar pressure oscillates around

A

Atmospheric pressure

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20
Q

Alveolar pressure ___ during inspiration

A

Subatmospheric

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21
Q

Alveolar pressure ___ during expiration

A

Supra-atmospheric

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22
Q

Transpulmonary pressure

A

Difference between alveolar P and pleural P

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23
Q

Measure of recoil tendency of lungs

A

Transpulmonary P

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24
Q

TPP higher at end of ____

A

Inspiration

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25
Q

Eupnea

A

Normal breathing

12-17 B/min

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26
Q

Hyperpnea

A

Increase in pulmonary ventilation matching increase in metabolic demand

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27
Q

Hyperpnea occurs during

A

Exercise

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28
Q

Hyperventilation

A

Increase in pulmonary ventilation > metabolic demand

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29
Q

Hypoventilation

A

Decrease in pulmonary ventilation < metabolic demand

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30
Q

Orthopnea

A

Dyspnea when recumbent, relieved when upright

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31
Q

Lungs have natural tendency to

A

Collapse

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32
Q

If pleural P = atm P, lungs will

A

Collapse

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33
Q

Causes of lungs collapsing

A

Puncture of parietal pleura

Erosion of visceral pleura

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34
Q

Pleural fluid provides

A

Lubrication

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35
Q

Thin layer of mucoid fluid

A

Pleural fluid

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36
Q

Excess pleural fluid removed by

A

Lymphatics

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37
Q

Pleural effusion

A

Edema of pleural cavity

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38
Q

Possible causes of pleural effusion

A

Blockage of lymphatic drainage
Cardiac failure
Reduced plasma colloid osmotic pressure
Infection

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39
Q

Surfactant

A

Reduces surface tension forces

Prevents water-air interface

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40
Q

Surfactant produced by

A

Type 2 alveolar epithelial cells

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41
Q

Surfactant composed of

A

Phospholipids
Proteins
Ions

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42
Q

Law of Laplace

A

Without surfactant; Larger alveolar would get bigger, small would get smaller

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43
Q

Surface tension forces responsible for 2/3 of ____ of lung

A

Collapse tendency

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44
Q

Tidal volume

A

Air moved in/ out per breath

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45
Q

Inspiratory reserve volume

A

Max volume inspired above normal inspiration

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46
Q

Expiratory reserve volume

A

Max volume expired below normal expiration

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47
Q

Residual volume

A

Volume of air left in lungs after max expiratory effort

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48
Q

Not measured with basic spirometry

A

Residual volume
FRC
TLC

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49
Q

Helium dilution method for

A

RV
FRC
TLC

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50
Q

VC, IRV, IC decrease with ____ lung conditions

A

Restrictive

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51
Q

Decreased VC =

A

Restricted lung volume

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52
Q

Decrease airflow =

A

Obstructive condition

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53
Q

I + T =

A

IC

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54
Q

E + R =

A

FRC

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55
Q

I + T + E =

A

VC

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56
Q

I + T + E + R =

A

TLC

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57
Q

2 conditions that can cause obstructive conditions

A

Asthma

COPD

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58
Q

2 components of COPD

A

Chronic bronchitis

Emphysema

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59
Q

Minute respiratory volume

A

RR X TV

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60
Q

Forced expiratory volume

A

FEV/VC

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61
Q

How to measure maximum ventilatory volume

A

Max air movement in 12 sec X 5

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62
Q

Least affected by obstructive condition

A

MRV

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63
Q

___ generations of branching in lungs

A

20

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64
Q

Order of branching

A
  1. Trachea
  2. Bronchi
  3. Bronchioles
  4. Respiratory bronchioles
  5. Alveolar ducts, rise to alveolar sacs, rise to alveoli
65
Q

Trachea composed of

A

Cartilage

66
Q

Bronchi composed of

A

Cartilage and smooth muscle

67
Q

Bronchioles composed of

A

Smooth muscle

68
Q

Chart of FEV and VC, upper left quadrant

A

Obstructed

69
Q

Chart of FEV and VC, lower left quadrant

A

Normal

70
Q

Chart of FEV and VC, upper right quadrant

A

Combined

71
Q

Chart of FEV and VC, lower right quadrant

A

Restricted

72
Q

Most gas exchange occurs at ___, but some exchange occurs at ____

A

Alveoli

Respiratory bronchioles

73
Q

Dead space

A

Area where gas exchange cannot occur

Includes most of airway volume

74
Q

Physiological dead space

A

Anatomical + non functional alveoli

75
Q

Pulmonary blood flow =

A

CO

76
Q

At end of normal expiration most of FRC is at level of

A

Alveoli

77
Q

SNS ____ receptors cause

A

Beta

Dilation

78
Q

SNS direct vs. indirect effect

A

Direct effect weak- sparse innervation

Indirect predominant- free Epi

79
Q

Major source of free Epi

A

Adrenal medulla

80
Q

Para ____ receptors cause

A

Muscarinic

Constriction

81
Q

NANC nerves

A

Non adrenergic non cholinergic

82
Q

NANC nerves inhibitory release _____ to cause ____

A

VIP, NO

Bronchodilation

83
Q

NANC nerves stimulatory effect

A

Neurogenic inflammation

84
Q

Slow adapting receptors are associated with

A

Smooth muscle of proximal airway

85
Q

___ stimulated by capsaicin

A

C-fibers

86
Q

Histamine binds to ____ causing constriction

A

H1 receptors

87
Q

Histamine binds to ____ causing dilation

A

H2 receptors

88
Q

Prostaglandins E series

A

Dilation

89
Q

Prostaglandins F series

A

Constriction

90
Q

Normal level of HCO3

A

24

91
Q

Metabolic acidosis

A

HCO3 < 24

+ ventilation

92
Q

Metabolic alkalosis

A

HCO3 > 24

  • ventilation
93
Q

Kidney regulates

A

HCO3

94
Q

Normal level of CO2

A

40

95
Q

Respiratory acidosis

A

Co2 > 40

+ ventilation

96
Q

Respiratory alkalosis

A

CO2 < 40

  • ventilation
97
Q

Lung regulates

A

CO2

98
Q

Only organ that receives blood flow in excess of CO

A

Lungs

99
Q

Pulmonary lymphatics remove ____ and escaped protein from vascular system

A

Particulate matter absorbed from alveoli

100
Q

Pulmonary lymphatics helps to maintain

A

Negative interstitial pressure which pulls alveolar epithelium against capillary endothelium

“Respiratory membrane”

101
Q

SNS will + a mild ____ on pulmonary vascular smooth muscle

A

Vasoconstriction

102
Q

Limiting factor in exercise

A

SV

103
Q

Zone 1

A

No flow

Normally does not exist

104
Q

Sone 2

A

Intermittent flow

105
Q

Zone 3

A

Continuous flow

Toward base

106
Q

During exercise entire lung

A

Zone 3

107
Q

CO2 diffusion

A

20.3

108
Q

Diffusion coefficient order for CO2, O2, N2

A

CO2
O2
N2

109
Q

Normal V/P ratio

A

.8

110
Q

V/P ratio decreases

A

Decreased ventilation

111
Q

V/P ratio increases

A

Decreased perfusion of lungs

Ventilation wasted

112
Q

VO2 maximum ranges

A

1.5 cardiac patient
3 sedentary person
6 endurance athlete

113
Q

Most CO2 in form of

A

Bicarbonate ion (70%)

114
Q

__ blood slightly more acidic

A

Venous

115
Q

As PO2 falls, hemoglobin releases

A

More O2

116
Q

oxy-Hb dissociation curve is ___ shape with steep portion below ____

A

Sigmoid

PO2 of 40

117
Q

Shift to R in oxy-hb dissociation

A

Promote dissociation

118
Q

Shift Left in curve

A

Lungs

119
Q

Venous blood higher __ concentration

A

Cl

120
Q

___ competes with O2 for binding sites on Hb

A

CO

121
Q

____ of CO can be lethal

A

.1%

122
Q

__ produced by body in small quantities

A

CO

123
Q

Functions of CO

A

Signaling molecule
Vasodilator
Immune, respiratory, GI, kidney, liver functions

124
Q

___ located in solitary nucleus

A

Dorsal respiratory group

125
Q

DRG termination of

A

CN IX and X

126
Q

____ excites muscles of inspiration and sets basic drive of ventilation

A

DRG

127
Q

+ of penumotaxic center

A

Promotes shallow rapid breathing

128
Q
  • of pneumotaxic center
A

Deeper and slower breathing

129
Q

Penumotaxic center inhibits ____ by turning off DRG ramp signal

A

Duration of inspiration

130
Q

Ventral respiratory group of neurons works in ____ fashion

A

Switching

131
Q

Ventral respiratory group located

A

Bilaterally in ventral aspect of MO

132
Q

Apneustic center located

A

Lower pons

133
Q

Apneustic center functions to

A

Prevent inhibition of DRG

Antagonist of pneumotaxic center

134
Q

Primary stimulus for chemosenstive area

A

H ions

135
Q

H ions can’t cross ___ but CO2 can

A

BBB

136
Q

____ unresponsive to falls in oxygen

A

Central chemoreceptors

137
Q

Chemical control of ventilation

A

Chemosensitive area (central chemoreceptors)

138
Q

Peripheral chemoreceptors

A

Responsive to hypoxia

139
Q

Most prevalent cause of respiratory depression

A

Anesthesia/ narcotics

140
Q

Body contains about ___ stored O2 to use for aerobic metabolism

A

2L

141
Q

Most important adjustment at birth

A

Respiratory adjustment

142
Q

Respiratory adjustments at birth stimulated by

A

Cooling of skin

Slightly asphyxiated state

143
Q

Hypoxia stimulation of

A

Arterial peripheral chemoreceptors

144
Q

Chronic mountain sickness can result in ___ if not moved to lower altitude

A

Death

145
Q

To keep lungs from collapsing, air must be supplied at _____

A

High pressures

146
Q

High PN2 causes

A

Narcosis in about 1 hour of being submerged

147
Q

High PO2

A

Oxygen toxicity

Likely lethal to divers

148
Q

High PCO2

A

Usually not problem

Depth doesn’t increase alveolar PCO2

149
Q

___ not metabolized by body

A

N2

150
Q

Decompression sickness

A

N bubbles out of fluids after sudden decompression

Bubbles may block many blood vessels

151
Q

2nd highest organ of metabolism after the liver

A

Lung

152
Q

One advantage lung has over liver in metabolism

A

All blood passes through lungs with every complete cycle

153
Q

Potential causes of depression of defensive mechanisms

A

Chronic alcohol
Smoking
Air pollution
Irritants

154
Q

Cough is ineffective at clearing smaller airways due to

A

Large total X-sectional area

155
Q

___ clears smaller airways

A

Mucociliary elevator

156
Q

Principal phagocytes cell in distal air spaces

A

Alveolar macrophages (dust cells)

157
Q

Antibodies associated with mucosa

A

IgG - lower respiratory tract
IgA- dominate in upper respiratory tract
IgE- predominantly mucosal Antibody

158
Q

Symptoms of the bends

A

Pain in joints, muscles of arms and legs

Dizziness, paralysis, unconsciousness

The chokes

159
Q

Nasal turbinates

A

Highly vascular

Act as radiators to warm air

Phys 3 (8 decks)

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