Exam 3: Pulmonary Flashcards
1
Q
Respiratory neurons in brain stem set
A
Basic drive of ventilation
2
Q
Right ventricular output equal to
A
Lungs
3
Q
During inspiration, P alveolar ____ P atm
A
Less than
4
Q
During expiration, P alveolar ____ P atm
A
>
5
Q
At end of inspiration or expiration , P avl ____ P atm
A
=
6
Q
More negative pleural pressure = ____ TPP = ___ recoil
A
Increase
Increase
7
Q
Respiratory centers located
A
Dorsal and ventral medullary group
8
Q
Respiratory centers affect ___ and ____ of ventilation
A
Rate
Depth
9
Q
Respiratory centers influenced by
A
Higher brain centers
Peripheral mechanoreceptors
Peripheral and central chemoreceptors
10
Q
Inspiration muscles increase
A
Thoracic cage volume
11
Q
Expiratory muscles decrease
A
Thoracic cage volume
12
Q
Muscles of inspiration use ___ of total body energy
A
3%
13
Q
___ drops floor of thoracic cage
A
Diaphragm
14
Q
All other muscles of inspiration
A
Lift rib cage
15
Q
Under resting conditions, expiration is ___ and associated with ___ of lungs
A
Passive
Recoil
16
Q
Role in LBP
A
Transverse abdominis
17
Q
Increase in lung volume =
A
Increase in TPP
18
Q
Pleural pressure
A
Neg pressure between parietal and visceral pleura that keeps lungs inflated
19
Q
Alveolar pressure oscillates around
A
Atmospheric pressure
20
Q
Alveolar pressure ___ during inspiration
A
Subatmospheric
21
Q
Alveolar pressure ___ during expiration
A
Supra-atmospheric
22
Q
Transpulmonary pressure
A
Difference between alveolar P and pleural P
23
Q
Measure of recoil tendency of lungs
A
Transpulmonary P
24
Q
TPP higher at end of ____
A
Inspiration
25
Eupnea
Normal breathing
| 12-17 B/min
26
Hyperpnea
Increase in pulmonary ventilation matching increase in metabolic demand
27
Hyperpnea occurs during
Exercise
28
Hyperventilation
Increase in pulmonary ventilation > metabolic demand
29
Hypoventilation
Decrease in pulmonary ventilation < metabolic demand
30
Orthopnea
Dyspnea when recumbent, relieved when upright
31
Lungs have natural tendency to
Collapse
32
If pleural P = atm P, lungs will
Collapse
33
Causes of lungs collapsing
Puncture of parietal pleura
| Erosion of visceral pleura
34
Pleural fluid provides
Lubrication
35
Thin layer of mucoid fluid
Pleural fluid
36
Excess pleural fluid removed by
Lymphatics
37
Pleural effusion
Edema of pleural cavity
38
Possible causes of pleural effusion
Blockage of lymphatic drainage
Cardiac failure
Reduced plasma colloid osmotic pressure
Infection
39
Surfactant
Reduces surface tension forces
| Prevents water-air interface
40
Surfactant produced by
Type 2 alveolar epithelial cells
41
Surfactant composed of
Phospholipids
Proteins
Ions
42
Law of Laplace
Without surfactant; Larger alveolar would get bigger, small would get smaller
43
Surface tension forces responsible for 2/3 of ____ of lung
Collapse tendency
44
Tidal volume
Air moved in/ out per breath
45
Inspiratory reserve volume
Max volume inspired above normal inspiration
46
Expiratory reserve volume
Max volume expired below normal expiration
47
Residual volume
Volume of air left in lungs after max expiratory effort
48
Not measured with basic spirometry
Residual volume
FRC
TLC
49
Helium dilution method for
RV
FRC
TLC
50
VC, IRV, IC decrease with ____ lung conditions
Restrictive
51
Decreased VC =
Restricted lung volume
52
Decrease airflow =
Obstructive condition
53
I + T =
IC
54
E + R =
FRC
55
I + T + E =
VC
56
I + T + E + R =
TLC
57
2 conditions that can cause obstructive conditions
Asthma
| COPD
58
2 components of COPD
Chronic bronchitis
| Emphysema
59
Minute respiratory volume
RR X TV
60
Forced expiratory volume
FEV/VC
61
How to measure maximum ventilatory volume
Max air movement in 12 sec X 5
62
Least affected by obstructive condition
MRV
63
___ generations of branching in lungs
20
64
Order of branching
1. Trachea
2. Bronchi
3. Bronchioles
4. Respiratory bronchioles
5. Alveolar ducts, rise to alveolar sacs, rise to alveoli
65
Trachea composed of
Cartilage
66
Bronchi composed of
Cartilage and smooth muscle
67
Bronchioles composed of
Smooth muscle
68
Chart of FEV and VC, upper left quadrant
Obstructed
69
Chart of FEV and VC, lower left quadrant
Normal
70
Chart of FEV and VC, upper right quadrant
Combined
71
Chart of FEV and VC, lower right quadrant
Restricted
72
Most gas exchange occurs at ___, but some exchange occurs at ____
Alveoli
| Respiratory bronchioles
73
Dead space
Area where gas exchange cannot occur
Includes most of airway volume
74
Physiological dead space
Anatomical + non functional alveoli
75
Pulmonary blood flow =
CO
76
At end of normal expiration most of FRC is at level of
Alveoli
77
SNS ____ receptors cause
Beta
| Dilation
78
SNS direct vs. indirect effect
Direct effect weak- sparse innervation
Indirect predominant- free Epi
79
Major source of free Epi
Adrenal medulla
80
Para ____ receptors cause
Muscarinic
Constriction
81
NANC nerves
Non adrenergic non cholinergic
82
NANC nerves inhibitory release _____ to cause ____
VIP, NO
Bronchodilation
83
NANC nerves stimulatory effect
Neurogenic inflammation
84
Slow adapting receptors are associated with
Smooth muscle of proximal airway
85
___ stimulated by capsaicin
C-fibers
86
Histamine binds to ____ causing constriction
H1 receptors
87
Histamine binds to ____ causing dilation
H2 receptors
88
Prostaglandins E series
Dilation
89
Prostaglandins F series
Constriction
90
Normal level of HCO3
24
91
Metabolic acidosis
HCO3 < 24
+ ventilation
92
Metabolic alkalosis
HCO3 > 24
- ventilation
93
Kidney regulates
HCO3
94
Normal level of CO2
40
95
Respiratory acidosis
Co2 > 40
+ ventilation
96
Respiratory alkalosis
CO2 < 40
- ventilation
97
Lung regulates
CO2
98
Only organ that receives blood flow in excess of CO
Lungs
99
Pulmonary lymphatics remove ____ and escaped protein from vascular system
Particulate matter absorbed from alveoli
100
Pulmonary lymphatics helps to maintain
Negative interstitial pressure which pulls alveolar epithelium against capillary endothelium
“Respiratory membrane”
101
SNS will + a mild ____ on pulmonary vascular smooth muscle
Vasoconstriction
102
Limiting factor in exercise
SV
103
Zone 1
No flow
Normally does not exist
104
Sone 2
Intermittent flow
105
Zone 3
Continuous flow
| Toward base
106
During exercise entire lung
Zone 3
107
CO2 diffusion
20.3
108
Diffusion coefficient order for CO2, O2, N2
CO2
O2
N2
109
Normal V/P ratio
.8
110
V/P ratio decreases
Decreased ventilation
111
V/P ratio increases
Decreased perfusion of lungs
Ventilation wasted
112
VO2 maximum ranges
1.5 cardiac patient
3 sedentary person
6 endurance athlete
113
Most CO2 in form of
Bicarbonate ion (70%)
114
__ blood slightly more acidic
Venous
115
As PO2 falls, hemoglobin releases
More O2
116
oxy-Hb dissociation curve is ___ shape with steep portion below ____
Sigmoid
PO2 of 40
117
Shift to R in oxy-hb dissociation
Promote dissociation
118
Shift Left in curve
Lungs
119
Venous blood higher __ concentration
Cl
120
___ competes with O2 for binding sites on Hb
CO
121
____ of CO can be lethal
.1%
122
__ produced by body in small quantities
CO
123
Functions of CO
Signaling molecule
Vasodilator
Immune, respiratory, GI, kidney, liver functions
124
___ located in solitary nucleus
Dorsal respiratory group
125
DRG termination of
CN IX and X
126
____ excites muscles of inspiration and sets basic drive of ventilation
DRG
127
+ of penumotaxic center
Promotes shallow rapid breathing
128
- of pneumotaxic center
Deeper and slower breathing
129
Penumotaxic center inhibits ____ by turning off DRG ramp signal
Duration of inspiration
130
Ventral respiratory group of neurons works in ____ fashion
Switching
131
Ventral respiratory group located
Bilaterally in ventral aspect of MO
132
Apneustic center located
Lower pons
133
Apneustic center functions to
Prevent inhibition of DRG
Antagonist of pneumotaxic center
134
Primary stimulus for chemosenstive area
H ions
135
H ions can’t cross ___ but CO2 can
BBB
136
____ unresponsive to falls in oxygen
Central chemoreceptors
137
Chemical control of ventilation
Chemosensitive area (central chemoreceptors)
138
Peripheral chemoreceptors
Responsive to hypoxia
139
Most prevalent cause of respiratory depression
Anesthesia/ narcotics
140
Body contains about ___ stored O2 to use for aerobic metabolism
2L
141
Most important adjustment at birth
Respiratory adjustment
142
Respiratory adjustments at birth stimulated by
Cooling of skin
| Slightly asphyxiated state
143
Hypoxia stimulation of
Arterial peripheral chemoreceptors
144
Chronic mountain sickness can result in ___ if not moved to lower altitude
Death
145
To keep lungs from collapsing, air must be supplied at _____
High pressures
146
High PN2 causes
Narcosis in about 1 hour of being submerged
147
High PO2
Oxygen toxicity
Likely lethal to divers
148
High PCO2
Usually not problem
Depth doesn’t increase alveolar PCO2
149
___ not metabolized by body
N2
150
Decompression sickness
N bubbles out of fluids after sudden decompression
Bubbles may block many blood vessels
151
2nd highest organ of metabolism after the liver
Lung
152
One advantage lung has over liver in metabolism
All blood passes through lungs with every complete cycle
153
Potential causes of depression of defensive mechanisms
Chronic alcohol
Smoking
Air pollution
Irritants
154
Cough is ineffective at clearing smaller airways due to
Large total X-sectional area
155
___ clears smaller airways
Mucociliary elevator
156
Principal phagocytes cell in distal air spaces
Alveolar macrophages (dust cells)
157
Antibodies associated with mucosa
IgG - lower respiratory tract
IgA- dominate in upper respiratory tract
IgE- predominantly mucosal Antibody
158
Symptoms of the bends
Pain in joints, muscles of arms and legs
Dizziness, paralysis, unconsciousness
The chokes
159
Nasal turbinates
Highly vascular
Act as radiators to warm air
