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A&P II > Exam III- Spring 2024 > Flashcards

Exam III- Spring 2024 Flashcards

1
Q

What is the formula to calculate Transpulmonary Pressures (PTP)? What other pressure does this formula work for?

A
  • PTP= Aveolar Pressure (PA) - Pleural Pressure (PIP)
  • Elastic Pressure (PEL)
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2
Q

What is the formula for Tidal Volume?
What is the formula in minute ventilation?
What are the normal values for each?

A
  • VT= VDS + VA
  • Minute Vent= VT x (RR)
  • Resp. Rate= 12 bpm
  • Tidal Volume= 500 mL; 6 L/min
  • Dead Space Volume= 150 mL; 1.8 L/ min
  • Aveolar Volume= 350 mL; 4.2 L/ min
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3
Q

What are the normal volumes for:

Tidal Volume
Residual Volume
Expiratory Reserve Volume
Inspiratory Reserve Volume

A
  • TV= 500 mL
  • RV= 1.5 L
  • ERV= 1.5 L
  • IRV= 2.5 L
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4
Q

Which volumes make up the following capacities and their normal values:

Total Lung Capacity
Inspiratory Capacity
Functional Residual Capacity
Working/ Vital Capacity

A
  • TLC= 6 L
  • IC= IRV+VT= 3.0 L
  • FRC= ERV+RV= 3.0 L
  • VC= IRV+VT+ERV= 4.5 L
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5
Q

PA>Pv>Pa

A
  • West Perfusion Zone 1
  • no blood flow
  • In a healthy lung, there should not be a zone 1
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6
Q

Pa>PA>Pv

A
  • West Perfusion Zone 2
  • Pulsatile flow; “In between”
  • Pulsatile blood flow during higer pressures times of the cardiac cycle and tapers off with a lower pulm blood pressure
  • top portions of the lung
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7
Q

Pa>Pv>PA

A
  • West Perfusion Zone 3
  • Continuous flow; “always on”
  • Normally in the bottom 1/2 of the lung
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8
Q

The effects of the weight of the lung on blood flow at the very base of the lung that sits on the diaphragm

A
  • West Perfusion Zone 4
  • A subset of Zone 3; reduces the amount of blood flow in the very bottom portion of the base
  • the weight of the lungs compress the easily collapsable pulm vein and arteries
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9
Q

When does cyanosis occur as it pertains to deoxyhemoglobin?

A

When deoxyhemoglobin >5 g/ dL

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10
Q

What is the Fick Equation for C.O.?

A

CO= O2 absorbed per min (mL/ min)/ Arteriovenous O2 difference (ml/ L)

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11
Q

What is Guyton’s formula for calculating PVR?
What is normal?

A

PVR= MPAP-LAP/ C.O.

Normal= .14 PRU

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12
Q

What is Miller’s Formula for calculating PVR?
What is normal?

A

PVR= MPAP- PAWP/ C.O. (x 80 converts units to CGS)
Normal= 96 mmHg/L/min

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13
Q

What is a CGS?
What are its units?
What is the equivalent PRU?

A
  • Centimeters Gram Second
  • mmHg/ L/ min or dyne x sec/ cm^5
  • 1 CGS= 1333 x PRU
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14
Q

What volumes make up the vital capacity?

A

Expiratory Reserve Volume (ERV), Tidal Volume (TV), and Inspiratory Reserve Volume (IRV)

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15
Q

What volumes make up functional residual capacity (FRC)?

A

ERV, RV

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16
Q

Alveolar resistance gets higher ___ , gets lower ___

A

Lung volumes get higer; as lung volume gets lower

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17
Q

The higher the pulmonary blood flow, the lower the ______.

A

PVR

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18
Q

What are the two ways that our body reduces PVR when C.O. increases?

A

Recruitment and distension

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19
Q

What happens with right heart failure?

A

With decreased C.O., lungs decruit and vessels narrow, increasing PVR, increasing afterload for RH

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20
Q

What would increase PVR?

A
  • Decreased/ Increased lung volume (above FRC)
  • Decreased RH C.O.
  • PPV
  • Loss of alveoli
  • Increased Interstitial pressure
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21
Q

What would decrease PVR?

A
  • Increased C.O.
  • Increased PAP
  • Increased LAP
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22
Q

What are the pulmonary capillary pressures?

A
  • Pc= 7 mmHg
  • ∏p= 28 mmHg
  • Pic= -8 mmHg
  • ∏if= 14 mmHg
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23
Q

What is the formula for calculating net filtration and net flow?

A
  • Net filtration= Pc-Pif-∏p+∏if
  • Net flow= Kf x (Pc-Pif) - (∏p-∏if)
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24
Q

HPV is primarily an effect of what gas?

A

Primarily O2; secondarily CO2

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25
Q

2/3 of lungs elastic recoil pressure is ____ ____ and 1/3 is from the ____ itself.
Which is more important?

A

Surface tension; Tissue
The behavior of the tissue is most important because as long as the lungs are healthy, there should always be enough surfactant.

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26
Q

Top of lung doesnt get emptier than ?
Bottom lung doesn’t get emptier than ?

A

Top: 30%
Bottom: 20%

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27
Q

FRC intrapleural pressure:
RV intrapleural pressure:

A

FRC: -5 cm H2O (-8.5; -1.5)
RV: +2 cm H2O (-2.2; +4.8)

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28
Q

Functions of Club Cells

A
  • Found in the bronchioles, produces surfactant at much lower rate than alveoli type II cells
  • Progenitor cell for damaged areas of lungs
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29
Q

Type 1 and Type 2 alveolar cell percentage

A
  • Type 1: 90-95% of alveolar surface area
  • Type 2: 5-10% of alveolar surface area
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30
Q

Increasing lung volume does what to PVR? Why?

A

Increases
At very high lung volumes Total PVR is elevated because Alveolar resistance is elevated

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31
Q

Decreasing lung volume does what to PVR? Why?

A

Increases
At very low lung volumes Total PVR is elevated because extraalveolar resistance is elevated

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32
Q

Decreasing lung volume does what to airway resistance?

A

Decreases

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33
Q

FRC volumes standing v supine

A

Standing- 3 L
Supine- 2 L

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34
Q

FRC drops in supine pt because of?

A

reduction in ERV

“…diaphragm is getting pushed up from all the mass of the stuff that’s in your abdomen. So the volume that gets squeezed out is the ERV. “

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35
Q

What is the normal airway compliance value for the lungs?

A

200 mL/ per cm H20

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36
Q

____% of expired air should be CO2

A

5%

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37
Q

At what transpulmonary pressure is TLC?

A

25-30 cm H2O

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38
Q

What are the effects on volumes and capacities with Restrictive Lung Disease?

A
  • Decrease: RV, ERV, TV, VC, FRC, and TLC
  • IRV may be low to normal depending on how the stage of disease
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39
Q

What are the effects on volumes and capacties with Obstructive Lung Disease?

A
  • Large increase in TLC
  • Increase RV –> decrease in ERV and IRV
  • VC decreases and is almost equal to TLC as the disease worsens
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40
Q

Which of the following conditions are reasonable explanations for a patient’s decreased static pulmonary compliance (the pressure-volume curve for the lungs shifted to the right)?

A
  • Decreased functional pulmonary surfactant
  • Fibrosis of the lungs
  • Surgical removal of one lobe
  • Pulmonary vascular congestion
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41
Q

Which of the following tend to increase airways resistance?

A
  • Stimulation of the parasympathetic postganglionic fibers innervating the bronchial and bronchiolar smooth muscle
  • Low lung volumes
  • Forced expirations
  • Breathing through the nose instead of the mouth
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42
Q

Which of the following statements concerning alveolar pressure
is/are correct?

A

a. Alveolar pressure is lower than atmospheric pressure during a
normal negative-pressure inspiration.
b. Alveolar pressure is greater than atmospheric pressure during
a forced expiration.
c. Alveolar pressure equals the sum of the intrapleural pressure
plus the alveolar elastic recoil pressure.
d. Alveolar pressure equals atmospheric pressure at the end of a
normal tidal expiration.

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43
Q

True statements concerning small airways

A
  • The total resistance to airflow decreases with successive generations of airways because there are increasing numbers of units arranged in parallel.
  • The linear velocity of airflow decreases as the airways
    decrease in size because their total cross-sectional area increases.
  • Alveolar elastic recoil plays an important role in determining the resistance to airflow in small airways because alveolar septal traction helps to oppose dynamic compression.
  • Airflow in small airways is usually laminar.
44
Q

Compliance Formula

45
Q

____ meaures how hard it is to get current through this circuit
____ measures how easy it is to get current through this circuit

A
  • Resistance
  • Conductance
46
Q

Easy way to calculate anatomical dead space

A
  • 1 mL/ lb of body mass
47
Q

What is the time for a normal healthy person to dilute their N2 concentration to ____ %?

A
  • 2.5% with 7 minutes of breathing
48
Q

Nitrogen Washout
Which lung disease has an increased time for N2 washout?
Which may be normal ?

A
  • Obstructive Lung Disease
  • Restrictive Lung Disease
49
Q

What is the main difference between Closing Volume/ Capacity test and Fowler’s test?

A

Closing volume/ capacity looks at a breath from TLC to RV and Fowler’s only looks at Vt.

50
Q

What is Phase I of the CVC?

A
  • No N2 coming out; similar to 1st part of Fowler’s
  • Air from anatomical dead space
51
Q

What is Phase II of the CVC?

A
  • Rapid upstroke of N2
  • Transitional phase; similar to Fowler’s
  • Air from alveoli and respiratory bronchioles
52
Q

What is Phase III of the CVC?

A
  • Plateau Phase; smiliar to Fowler’s
  • Air is coming different places within the system
53
Q

What is Phase IV of the CVC?

A
  • Closing Volume
  • The result of small airways at the base of the lungs collapsing
54
Q

What is the FEV:FVC? Disease?

A

3.8 L/ 5 L= about 76%
Probably a healthy person

55
Q

What is the FEV:FVC? Disease?

A

2.5 L/ 3 L= about 83%
Likely Restrictive Lung Disease

56
Q

What is the FEV:FVC? Disease?

A

1.75 L/ 2 L= about 87%
Likely Restrictive Lung Disease

57
Q

What is the FEV:FVC? Disease?

A
  • Higher ratio- FEV1 1.5 L/
  • Definitely Obstructive Lung Disease
    *Takes up to 10 secs to expire all the air
58
Q

What are the FEV1, FVC, Ratio, TLC, RV, FRC for:
Asthma

A
  • FEV1-decreased
  • FVC- decreased
  • Ratio- decreased
  • TLC- Normal to increased
  • RV- increased
  • FRC- Normal to increased
59
Q

What are the FEV1, FVC, Ratio, TLC, RV FRC for:
COPD

A
  • FEV1-decreased
  • FVC- normal to decreased
  • Ratio- decreased
  • TLC- Normal to increased
  • RV- increased
  • FRC- Normal to increased
60
Q

What are the FEV1, FVC, Ratio, TLC, RV, FRC for:
Fibrosis

A
  • FEV1-decreased
  • FVC- decreased
  • Ratio- normal to increased
  • TLC- decreased
  • RV- decreased
  • FRC- decreased
61
Q

What are the FEV1, FVC, Ratio, TLC, RV FRC for:
Muscle Weakness

A
  • FEV1-decreased
  • FVC- decreased
  • Ratio- normal to increased
  • TLC- Normal to increased
  • RV- Normal to increased
  • FRC- Normal
62
Q

What are the FEV1, FVC, Ratio, TLC, RV, FRC for:
Kyphoscoliosis

A
  • FEV1-decreased
  • FVC- decreased
  • Ratio- Normal to increased
  • TLC- decreased
  • RV- normal to decreased
  • FRC- decreased
63
Q

What is the normal value for PO2 in 1 mL of blood? What about per dL?

A
  • 0.00003 mL O2/ mmHg/ mL of blood
  • 0.003 dL O2/ mmHg/ dL of blood
64
Q

How many mL O2 are in arterial and venous blood, respectively?

A
  • 0.3 mL O2/ dL
  • 0.12 mL O2/ dL
65
Q

Normal value for hemoglobin?

A

15 g/ dL
*women will be lower

66
Q

What is the normal carrying capacity of O2?

A
  • 1.34 mL O2
67
Q

What is the normal amount of O2 in a dL of blood (assuming 100% saturation of Hb)?

A

20.1 mL O2/ dL blood

68
Q

What are two reasons we don’t normally have 100% saturation?

A
  • Methemoglobin
  • Bronchiolar admixture
69
Q

What can shift O2 Curve left (either comparatively or clinically)?

A
  • HbF- higher affinity
  • HbCO - higher affinity
  • ↓ CO2 (Bohr)/ ↑ pH/ ↓H+
  • ↓ 2,3-BPG
  • ↓ temp
    *hypthermia may not cause a shift because tissue metabolism decreases also
70
Q

What can shift O2 Curve right (either comparatively or clinically)?

A
  • ↑CO2 (Bohr)/↓ pH/ ↑H+
  • ↑ 2,3- BPG
  • ↑ temp
  • Anemia
71
Q

Fetal Hb is very similar to ?

72
Q

What is the normal range of Hb saturation coming back from the tissues?
Leaving the lungs?

A
  • About 20%-75%
  • 90%-100% (duh Mebin)
73
Q

What are all the names for 2,3-BPG?

A
  • 2,3 Bisphosphoglycerate
  • 2,3 Diphosphoglycerate
  • Bisphosphoglyceric Acid
74
Q

What is the P50 dependent on?

A
  • Hb affinity for O2
75
Q

What are the two forms of O2 and their respective amounts?
Total?

A
  • Dissolve O2: 0.3 mL
  • Bound O2: 20 mL
  • Total= 20.3
76
Q

What are the different forms of CO2? Total?

A
  • Bicarb/ carbonic acid- 90% or 43.2 mL CO2/ dL blood
  • Dissolved- 5% or 2.4 mL CO2/ dL blood
  • Carbamino Compound- 5% or 2.4 mL CO2/ dL blood
    *Total is 48 mL CO2/ dL for CaCO2
77
Q

What is the normal value for PCO2 in 1 mL of solution?
What about per dL?

A
  • 0.0006 mL CO2/ mmHg/ mL
  • 0.06 mL CO2/ mmHg/ dL
    *CO2 is 20x more soluble than O2
78
Q

What is the normal CaCO2 and CvCO2?

A
  • 48 mL CO2/ dL blood
  • 52.5 mL CO2/ dL blood
    *difference is 4.5 mL CO2
79
Q

In exhange for the ____ mL O2/ dL blood we drop off ____ mL CO2/ dL blood

80
Q

Normal CO2 production (exchange) per minute?

A
  • 4.5 ml CO2/ dL blood x 50 dL blood/ min= 225 mL CO2/ min
    *we drop off 250 mL O2 and pick up 225 mL CO2 each minute
81
Q

What is diffusivity depedent on?
Formula?

A
  • Solubility of the gas and molecular weight of the molecule
  • D= Solubility/(√Molecular Wt)
82
Q

How do you determine the minute ventilation of a gas?

A

Fick’s Law

83
Q

Other conditions that would decrease FRC

A
  • 3rd Trimester Pregnancy
  • Obesity
84
Q

Changes in Vol. and Capactities when changing from supine to upright?
* FRC, RV, ERV, TLC, VT, IRV, IC, VC

A
  • FRC- ↑
  • RV- No change
  • ERV- ↑
  • TLC- No change or slight ↑
  • VT- No change
  • IRV- ↓
  • IC- ↓
  • VC- No change
85
Q

Situations that decrease PVR?

A
  • Moderate Exercise
86
Q

Situations that lead to an increased amount of West Zone 1

A
  • Blood loss secondary to trauma
  • PPV with PEEP
87
Q

Circumstances that contribute to pulm. edema

A
  • Overtransfusion with saline
  • Occulstion of lymph drainage of an area in the lung
  • LV failure
  • Low plasma concentration
  • Destruction of portions of the pulmonary capillary endothelium by toxins
88
Q

Situations that would occur with a partial occlusion of right main-stem bronchus

A
  • R-lung PAO2↓ and PACO2 ↑ than L-lung
  • ↑ VQ ratio
  • ↓PO2
89
Q

Lying on right side, R-lung will expect (compared to L-lung):

A
  • ↓ PAO2 and ↑ PACO2
  • ↑ blood flow per unit volume
  • ↑ ventilation per unit volume
90
Q

Conditions to expect the diffusing capacity (DL) of lungs
a. supine to upright
b. exercise
c. valsalva maneuver
d. anemia
e. ↓CO d/t blood loss
f. diffuse interstitial fibrosis of lungs
g. Emphysema

A

a. supine to upright- ↓
b. exercise- ↑
c. valsalva maneuver- ↓
d. anemia- ↓
e. ↓CO d/t blood loss- ↓
f. diffuse interstitial fibrosis- ↓
g. Emphysema- ↓

91
Q

Hb loss from 15 to 12, expect a decrease in:

A
  • Blood O2-carrying capacity
  • Arterial O2 content
92
Q

Which would increase P50?
a. Hypercapnia
b. Acidosis
c. ↑ 2,3-BPG
d. ↑ body temp

93
Q

PFTs consistent with?

A

Obstructive Lung Disease

94
Q

Dynamic lung volumes not improved with bronchodilator. Likely disease?

A

COPD, primarily emphysema

95
Q

PFTs consistent with?

A

Restrictive Lung Disease

96
Q

Voluntary apnea for 90 secs will:

A
  • ↑ PCO2
  • ↓PO2
  • stimulate arterial chemorecptors
  • stimulate central chemoreceptors
97
Q

Occurs in an untrained athlete during exercise?

A
  • ↓ PVR
  • ↑ CO
  • ↑ homogenous VQ ratios
  • ↑ diffusing capacity
98
Q
99
Q
100
Q
101
Q

Graham’s Law

A

Compares one gas to another MW

102
Q

Henry’s Law

A
  • Movement of a gas into a solution is dependent on ∆P and solubility
103
Q

How many scalene muscles are there and where are the attachment points?

A
  • 3 Scalene Muscles
  • 5: Anterior; C3-C6 and attach to Rib 1
  • 6: Middle; C3-C7 and attach to Rib 1
  • 7: Posterior; C5-C7 and attach to Rib 2
104
Q

What are the three openings and their orientation in the body?

A
  • Caval Aperture- most anterior
  • Aortic Aperture- most posterior
  • Esphogeal Aperture- between the two
105
Q

What makes up 62% of all surfactant’s phospholipids?

A

Unsaturated Phosphatidylcholine and Dipalmitoyl Phosphatidylcholine

106
Q

Hydrophobic surfact protein

A

SP-B and SP-C

107
Q

Surfactant make up % between protein and lipids

A

90% lipid, 10% protein

A&P II (5 decks)

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