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Phys III > Exam III > Flashcards

Exam III Flashcards

1
Q

If the rib cage is totally immobile, how is inspiration possible?

A

By diapragmatic breathing

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2
Q

During expiration, what is the relationship between alveolar, atmospheric and pleural pressures?

A

Alveolar P > atmospheric P > pleural P

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3
Q

At which point is the only time that alveolar pressure is equal to pleural pressure?

A

End of inspiration and end of expiration

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4
Q

Which muscles are active during inspiration?

A

Diaphragm, external intercostalis, SCM, anterior serratus, scaleni, serratus posterior superior, levator costarum

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5
Q

Which muscles are active during expiration?

A

Rectus abdominus, int/ext obliques, transverse abdominus, internal intercostalis, serratus posterior inferior, transversus thoracis and pyramidal

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6
Q

Which muscle drops the floor of the thoracic cage on inspiration?

A

Diaphragm

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7
Q

Which muscle, in expiration, has a role in lower back pain?

A

Transverse abdominus

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8
Q

True/False: Under resting conditions, expiration is passive.

A

True

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9
Q

If the visceral pleura erodes and allows a region of the alveolar space to communicate with the pleural space, what would happen to the functional residual capacity?

A

It would be decreased

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10
Q

What describes hysteresis at the onset of inspiration?

A

The pleural pressure changes at a faster rate than lung volume

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11
Q

What is the function of a surfactant?

A

Reduce surface tension forces

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12
Q

Surfactants are produced by which cells?

A

Type II alveolar epithelial cells

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13
Q

What effect will histamine binding to H1 receptors have on the airway smooth muscle?

A

Constriction

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14
Q

What effect will histamine binding to H2 receptors have on airway smooth muscle?

A

Dilation

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15
Q

What effect will histamine binding to PG-E receptors have on airway smooth muscle?

A

Dilation

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16
Q

What effect will histamine binding to PG-F receptors have on airway smooth muscle?

A

Constriction

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17
Q

Most of the recoil tendency of the lung is due to:

A

Surface tension forces (2/3)

[1/3 comes from elastic CT]

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18
Q

What are the pathophysiologic consequences of hyperventilation?

A

SV and CO, coronary blood flow, cerebral blood flow and serum potassium all decreased, Repolarization of heart impaired, oxyhemoglobin affinity increased and skeletal muscle spasm/tetani

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19
Q

What is the common thread in most of the pathophysiologic consequences of hyperventilation?

A

Hypocapnic alkalosis

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20
Q

What is the major effect of sympathetic stimulation on airway smooth muscle?

A

Dilate, most of the effect is direct via blood borne (dilate B receptors)

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21
Q

Why is the left ventricular output slightly higher than the right ventricular output?

A

Some bronchial artery blood drains into the pulmonary veins

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22
Q

Which volumes or capacities can’t be determined with basic spirometry?

A

Residual volume, function residual capacity and total lung capacity

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23
Q

Function residual capacity is equal to:

A

The sum of residual volume + ERV

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24
Q

Total lung capacity is equal to:

A

Residual volume + ERV + IRV + TV

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25
Q

What has the greatest effect on constriction of the pre-capillary resistance vessels in the lung?

A

Low alveolar oxygen

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26
Q

Without surfactants, as alveolar radius increases, what happens to the collapse tendency of the lung?

A

Decreases

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27
Q

What is the function of low alveolar oxygen?

A

Causes release of a local vasoconstrictor that shunts blood to better ventilated areas

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28
Q

Rank the solubility of N2, O2 and CO2 from greatest to least aqueous fluid.

A

CO2 > O2 > N2

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29
Q

True/False: During exercise in an upright position, flow throughout the lung is equal.

A

False: In an upright position, more flow will occur toward the base

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30
Q

Which condition would significantly increase total pulmonic blood volume?

A

Mitral valve stenosis (also possibly blood moving from the aorta to pulmonic trunk)

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31
Q

Compared to atmospheric air, alveolar air has a higher concentration of:

A

CO2 and water vapor

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32
Q

Compared to atmospheric air, alveolar air has a lower concentration of:

A

Nitrogen and oxygen

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33
Q

What effect does stimulation of the SNS have on sensitivity of peripheral chemoreceptors to hypoxia?

A

Increases

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34
Q

If ventilation/perfusion ratio increases above normal, which condition would occur?

A

Increase in the amount of physiologic dead space

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35
Q

If ventilation/perfusion ratio decreases below normal, which condition would occur?

A

Increase in the amount of physiologic shunt blood

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36
Q

What happens to virtually all circulating prostaglandins in the blood as they pass through the pulmonary capillaries?

A

They are inactivated/cleared

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37
Q

What happens to angiotensin I as it passes through the lung?

A

Converted to angiotensin II

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38
Q

What percentage of CO2 in the blood is carried in the form of bicarbonate?

A

70%

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39
Q

What percentage of CO2 in the blood is dissolved?

A

7%

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40
Q

What percentage of CO2 in the blood binds to hemoglobin?

A

23%

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41
Q

Stimulation of stretch receptors in the lungs will have what effect on the dorsal respiratory group?

A

Inhibition

42
Q

Which conditions would cause more oxygen to be released from hemoglobin?

A

Decreases in local PO2 and pH, and increases in PCO2 and 2,3 diphosphoglycerate

43
Q

The ventilatory response to a slight increase in CO2 levels is mediated by:

A

Central chemoreceptors in the brain stem (70-80%) and peripheral chemoreceptors in the aortic and carotid bodies (20-30%)

44
Q

The basic ventilatory drive is set by neurons located where?

A

Dorsal respiratory group

45
Q

Normal inspiration is usually terminated by:

A

Pneumotaxic center

46
Q

If the pneumotaxic center can’t terminate normal inspiration, what does?

A

Stretch receptors in the lung

47
Q

What is the most prevalent cause of respiratory depression?

A

Narcotics

48
Q

Stimulation of what receptors would create a feeling of dyspnea?

A

J receptors in the parenchyma

49
Q

In acute mountain sickness, the subject suffers deterioration of nervous system function primarily due to:

A

Hypoxia

50
Q

The negative pleural pressure generated to expand the lung and open the alveoli during the first breath is:

A

-40 to -60 cm H20

51
Q

Respiratory centers are located in the:

A

Brain stem

52
Q

Respiratory centers are influenced by:

A

Higher brain centers, peripheral mechanoreceptors and peripheral/central chemoreceptors

53
Q

The negative pleural pressure generated from inspiration to expiration varies between:

A

-5 and -7.5 cm H20

54
Q

Subatmospheric pressure occurs during _____, while supra-atmospheric pressure occurs during _____.

A

Inspiration; expiration

55
Q

What is the term that describes pleural pressure changing at a faster rate than lung volume?

A

Hysteresis

56
Q

What normally accounts for most of the work of breathing?

A

Compliance work

57
Q

What percentage of total body energy is required for ventilation?

A

3-5%

58
Q

Normal breathing is also termed:

A

Eupnea

59
Q

What is the term describing an increase in pulmonary ventilation matching an increase in metabolic demand?

A

Hyperpnea

60
Q

What is the term describing an increase in pulmonary ventilation that is greater than metabolic demand?

A

Hyperventilation

61
Q

A decrease in CO2 concentration to less than 40 mmHg would be described as:

A

Hyperventilation or respiratory alkalosis

62
Q

What is the term describing a decrease in pulmonary ventilation less than metabolic demand?

A

Hypoventilation

63
Q

An increase in CO2 concentration to greater than 40 mmHg would be described as:

A

Hypoventilation or respiratory acidosis

64
Q

An increased frequency of respiratory rate would be called:

A

Tachypnea

65
Q

Dyspnea when recumbent and relief when standing upright would be called:

A

Orthopnea

66
Q

Absence of breathing is termed:

A

Apnea

67
Q

Difficulty breathing is called:

A

Dyspnea

68
Q

What causes lung collapse?

A

Puncture of the parietal pleura, erosion of visceral pleura and a major airway being blocked by air

69
Q

What is the function of pleural fluid?

A

Provide lubrication

70
Q

True/False: Surface tension forces are eliminated in air-filled lungs.

A

False: They are eliminated in saline-filled lungs

71
Q

Inspiratory capacity is equal to:

A

TV + IRV

72
Q

Vital capacity is equal to:

A

IRV + TV + ERV

73
Q

The first 11 generations of branching in the lung are the:

A

Bronchi

74
Q

The next 5 generations of branching after the first 11 are the:

A

Bronchioles

75
Q

The last 4 generations of branching in the lung are the:

A

Respiratory bronchioles

76
Q

Which receptors in afferent nerves are associated with smooth muscle and stretch receptors involved in reflex control of breathing and cough reflexes?

A

Slow-adapting receptors

77
Q

Which receptors in afferent nerves are sensitive to mechanical stimulation?

A

Rapidly-adapting receptors

78
Q

C-fibers are selectively stimulated by:

A

Capsaicin

79
Q

Which fibers contain neuropeptides such as substance P, neurokinin A and calcitonin gene-related peptide?

A

C-fibers

80
Q

Elicit constriction of airways is mediated by:

A

Parasympathetic reflex and local constrictor responses

81
Q

The normal level of HCO3 is:

A

24 mEq/L

82
Q

What regulates HCO3 levels?

A

Kidneys

83
Q

What regulates CO2 levels?

A

Lungs

84
Q

Total pulmonic blood volume accounts for what percentage of total blood volume?

A

9%

85
Q

What percentage of cardiac output comes from right ventricular output?

A

100%

86
Q

What effects will the ANS have on pulmonary vascular smooth muscle?

A

SNS; mild vasoconstriction

PSNS; mild vasodilation

87
Q

During systole, what is the relationship between capillary and alveolar pressures?

A

Capillary P > Alveolar P

88
Q

During diastole, what is the relationship between capillary and alveolar pressures?

A

Alveolar P > Capillary P

89
Q

What is the third most abundant gas in air behind nitrogen and oxygen?

A

Argon

90
Q

The respiratory membrane consists of what 2 cell layers?

A

Alveolar epithelium and capillary endothelium

91
Q

What percentage of oxygen is bound to hemoglobin? Dissolved?

A

97% bound; 3% dissolved

92
Q

What happens to oxygen in the cells?

A

80% converted to CO2; 20% converted to H20

93
Q

The most common symptom of decompression sickness is:

A

Pain in joints, muscles of arms/legs (85-90%)

94
Q

The cough reflex utilizes which cranial nerve?

A

CNX

95
Q

The sneeze reflex utilizes which cranial nerve?

A

CNV

96
Q

Which antibodies dominate the upper respiratory tract?

A

IgA

97
Q

Which antibody type is predominantly a mucosal antibody?

A

IgE

98
Q

Which antibody type dominates the lower respiratory tract?

A

IgG

99
Q

In the upper respiratory tract, what is the highly vascularized radiator that warms inspired air?

A

Nasal turbinates

100
Q

What condition is associated with an increased incidence of bacterial infections?

A

Chronic alcoholism

Phys III (3 decks)

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