Final Flashcards
When lung compliance decreases the patient commonly has I. An increased ventilatory rate 2. A decreased Tidal Volume 3. an Increased tidal volume 4. A decreased Vent Rate
- An increased ventilatory rate 2. A decreased tidal volume
Normal Tidal volume range is about
3-5 ml/lb
What is the normal I:E ratio
1:2
Physiologic deadspace is a combination of
Alveolar and anatomical deadspace
The excursion of the diaphragm during normal breathing is approx
1.5cm
what will happen if the volume of gas in the alveoli falls below the critical closing pressure
the alveoli will collapse
which of the following terms describes straigh even air flow
Laminar
What is used to determine minute ventilation
Vt x RR
The difference between the alveolar pressure and the mouth pressure is the
transairway pressure
if the radius of the airways with a driving pressure of 10cm H20 is decreased by 16% because of bronchospasm, the new driving pressure would have to be ___ to maintain the same flow of air
20cmH20
With the transairway pressure, if the mouth pressure is 759 mmHg and alveolar pressure is 755 mmHg, the driving pressure would equal
+4 mmHg
When airway resistance becomes high, to offset the increased work of breathing, patients ventilatory pattern is generally
increased RR and decreased Vt
The point at which the trachea bifurcates into the right and left main stem bronchi is
carina
List three primary functions of the nose
humidify air, cool/warm air, filter air
the epithelial lining of the traceobranchial tree is primarily composed of
pseudostratified ciliated columnar epithelium
Most of the mucus that lines the lumen of the tracheobronchial tree is produced by the
Submucosal glands
the length of the trachea is about
11-13 cm
Which of the following structures make up the respiratory zone
- alveoli
- respiratory bronchioles
- segmental bronchi
- alveolar savs
1, 2, 4
The first 19 generations of the lower airways are called the
Conducting Zone, Deadspace
Terminal bronchioles permit gas to enter in adjacent alveoli via the
channels of lambert
the visceral pleura lines
the lungs
The right and left stem bronchi blood vessels and nerves enter and exit the lungs through the
hilum
Small holes in the walls of the interalveolar septa are called the
pores of kohn
The phrenic nerve originates from what point of the spinal cord
Cervical 3-5
This opens and closes over the glottis to prevent aspiration of fluids/ solids during inspiration and expiration
epiglottis
the intercostals spaces including veins, arteries, and nerves. how are they located in relationship to the ribs
inferior
which of the following have an important function in the immunologic response of patients with asthma
Mast Cells
The conchae (turbinates) aid in what process
Warm and humidify inspired air
Which of the following is the largest cartilage on the larynx
Thyroid
Which of the following represents a correct sequence of the trachelbronchial tree, starting at the mouth and ending at the alveoli
Bronchioles, segmental bronchi, respiratory bronchioles, and alveolar ducts
About what percentage of the total alveolar surface is composed of Type I
95%
Anteriorly, the base of the lungs extends to about the level of which of the following ribs
6th
Ribs eight, nine, and ten are referred to as the
false ribs
The area between the base of the tongue and the epiglottis is callled
Vallecula
What function do the lympathic vessels in the lung perform
fluid remove
Which of the following is associated with sympathetic nervous system
- Epinephrine
- Beta 2 receptors
- Norepinephrine
- Alpha 1 Receptors
all of the above
The pharyngeal tonsils are located in the
Oropharynx
Croup in normally viral infection causing subglottic swelling of the airway and is characterized by
inspiratory stridor
What would facilitate mucocillary transport and sputum clearance
Humidity
Type I cells are actually
simple squamous epithelium
The angle of the left main stem bronchi in an adult is approx
40-60 ddegrees
False ribs get their term because
they connect indirectly to the sternum by cartilage
Lymphatic vessles
Start in the region of the alveolar ducts and flow towards the hilum, are more numberous over the left lower lobe as compared to the right lower lobe
The primary muscles of relaxed breathing are the
Hemidiaphragms
The alveoli are protected from infection by the
macrophages
which of the following are part of the sternum
- Oblique fissure
- Xiphoid process
- floating ribs
- manubrium
- xiphoid process 4. manubrium
The submucosal glands empty their contents when which of the following occurs
the parasympathetic nerves send a signal
the surfactant that is produced by the type II cells in the alveolis main function is to
reduce surface tension
The primary innervations of the hemidiaphragms is provided by the
phrenic nerve
the stimulation of the heart by the parasympathetic nervous system will result in
the heart rate decreasing
Which of the following are called “Capacitance vessels”
Veins
Cartilage is absent in which of the following structures of the tracheobronchial tree
Bronchioles and terminal bronchi
4 things found in the mediastinum
part of esophagus, heart, larynx, some arteries and veins going to/ from heart
Ciliated cells disappear at which level of the tracheobronchial tree
Respiratory bronchioles
Muscles of Inspiration
Pectoralis major, Scalene, Sternocleidomastoids, Trapezius
Muscles of Expiration
Transverse Abdominis, Internal Intercostals, Rectus abdomonis, External intercostals
The palatine and pharyngeal tonsils are thought to by types of lymphoid tissue T/F
True
The Eustachian tubes serve to equalize pressure in the middle of the ear T/F
True
Visceral pleura is attached to the inner surface of the chest T/F
False
the lungs have a natural tendency to want to expand T/F
False
The thorax has a natural tendency to want to
expand
The point at which the trachea bifurcates into the right and left main stem bronchi is called
the carina
What does the stimulation by the sympathetic nervous system cause to occur to the bronchial smooth muscle
Bronchodilation
Air moves in and out of the conductive airways because of
pressure changes
in infants this is the narrowest point of the upper airway
cricoids cartilage
How many lobes in right lung
3
The potential space between the parietal and visceral pleura is called the
pleural space
if an endotracheal tube is inserted too far into the trachea, it will most likely enter the
right lung
When the ___ receptor sites in the bronchial smooth muscle are stimulated, bronchodilation occurs
Beta2
Gases move back and forth from the alveoli and capillaries by means of
diffusion
what structure moves in an upward direction to close off the nasopharynx from the oropharynx during swallowing
soft palate
the pharyngotympanic tubes (eustachian tubes) are found in the
nasopharynx
Nasotracheal suction causing nose bleed, termed as
Epitaxis
This structure lies posterior of the trachea and descends down to the cardiac sphincter, through the diaphragm , and into the stomach
Esophagus
The introduction of gas/ air into the pleural cavity through an opening in the chest wall or a rupture of the lung is referred to as
pneumothroax
Thoracentesis, she noted that the physician introduces the needle where to the rib
over the top of the rip (superior)
Stimulation of this area causes a profound cough
carina
how many pair of ribs are there
12
As an indiv ages, the
a. Vital capacity decreases
b. functional residual capacity decreases
c. expiratory reserve volume increases
d. residual volume decreases
a. vital capacity decreases
During exercise, the oxygen consumption (VO2), of the skeletal muscles may account for more than
95% of the total VO2
During very heavy exercise, the
- Increased pH
- Decreased PaCO2
- Constant PaO2
- Decreased pH
- Increased PaCO2
2, 3, and 4
When an individual is subjected to a high altitude for a prolonged period of time, which of the following is seen?
An increased RBC production, A decreased PaCO2, A decreased alveolar ventilation
Between 20 and 60 years of age, the RV/TLC ration increases from 20%
35%
With advancing age, the
PaO2 decreases, C(a-v)O2 decreases
The concentration of myoglobin in skeletal muscle is increased with high altitude natives T/F
true
The maximum heart rate of a 55 year old person is
175 bpm
Most of the lung function indices reach their maximum levels between
20-25 years of age
Acute mountain sickness is characterized by
Sleep disorders, headaches, dizziness, palpitations, loss of appetite
During exercise, the P(A-a)O2 begins to increase then the oxygen consumption reaches about what % of its maximum
40%
The so called PCO2 respiratory drive breaking point during a dive is about 55mmHg T/F
true
Natives who have been at high altitudes for generations commonly demonstrate a
Mild respiratory alkalosis
At the onset of exercise, sympathetic discharge causes the
- HR to increase
- Peripheral vascular system to constrict
- Heart to increase its strength of contraction
- blood vessels of the working muscles to dilate
All of the above
With advancing age, the
- Stroke Volume Decreases
- Heart work decreases
- Cardiac output increase
- Blood pressure increase
- Stroke Volume Decreases
- Heart work decreases
- Blood Pressure Increase
The maximum alveolar ventilation generated during heavy exercise under normal conditions is about what % of the MVV
30-40%
As an individual ages, the
- FVC increases
- PEFR decreases
- FEV1 increases
- MVV increases
c. 2 & 4
during exercise, heat production may increase as much as
20 fold
With advancing age, the
- Lung compliance decreases
- Chest wall compliance increases
- Lung compliance increases
- Chest wall compliance decreases
- Lung compliance and 4. Chest wall compliance decreases
During Exercise, the stroke volume reaches its peak when the cardiac output is at about what % of its maximum
50%
Between 30 and 80 years of age, the CO decreases by about
40%
During maximum exercise, the oxygen diffusion capacity may increase as much as
3 fold
When exercising in hot, humid conditions, the body temp can rise to 106-108 degree F. As much as 5-10 pounds of body fluid can be lost in one hour! T/F
True
The oxygen diffusion capacity of high-altitude natives is about
20-25% greater than predicted
over the course of life, the diffusion capacity decreases by about
20%
During strenuous exercise, and adults alveolar ventilation can increase
20 fold
the half life of COHb when a victim is breathing room air at 1 atm is approx
5 hours
During exercise, an increase in HR accounts for a greater proportion of the increased CO than the
increase in SV
If a patient has a SaCO level 20% how long will it take to reduce the level to 10% if he is breathing 100% oxygen
5 hours
During pulmonary rehabilitation programs, the patient is elvaluated by a variety of tests, such as PFTs, ambulatory oximetry studies, and nutritional, psychological, lifestyle, ect… needs. this done during what phase of the program
Phase 1
Length and intensity of exercise is primarily limited by
cardiac function
Cardiac output is calculated from which two valves
Heart Rate, Stroke Volume
a patient has a SaCO level of 20%, what is the patients max SaCO
80%
Indications of Hyperbaric Oxygenation might include
Decompression sickness, thermal burns, Clostridial gangrene, Carbon Monoxide poisoning
If a CO poisoning patient was in the ER and a hyperbaric chamber was not available what would be best treatment for this patient
non-rebreather mask at 15 lpm
A person in a high altitude situation develops crackels in the bases, pink frothy sputum and shortness of breath; which of the following lung conditions is occuring
pulmonary edema
what is the best way to treat the patient in pulmonary edema in high altitude
Rapid decent of altitude
with time, one of the physiologic changes that occurs with living at a high altitude is an increase in the production of RBC, this condition is termed as
polycythemia
Max. heart is calculated by
220-age
At the start of exercise, what is the first physiologic response
increase heart rate
Acclimation occurs after being exposed to a high altitude after what length of time
4 days
Small holes in the walls of the interalveolar septa are called
pores of Kohn
Terminal bronchioles permit air/gases to enter adjacent ares via the
Canals of Lambert
What is the function of type II cells in alveoli
Produce surfactant to reduce alveolar surface tension
What would slow the rate of mucocillary transport
Cigarette smoking, hypoxia (low blood oxygen level), Dehydration
What does the sympathetic nervous system stimulation cause to occur in the bronchial smooth muscle
Vasodilation
If you reduce the radius of the tube a gas is flowing through, how will this affect flow, if all else remains stable?
flow will decrease
When lung compliance decreases, the patient commonly has
An increased Ventilatory rate, a decrease tidal volume
At rest, the normal intrapleural pressure change during quiet (tidal) breathing is about
2-4 mmHg
Normal tidal volume range is about
3-4 ml/lb
what is the normal I:E ratio
1:2
Define deadspace
perfusion without gas exchange
Shunt
gas exchange without perfusion
Physiologic deadspace is a combination of
alveolar and anatomical deadspace
Surfactant is produced by which type of cells
alveolar type II
The excursion of the diaphragm during normal breathing is approx
1.5cm
Which of the following plays the greater role in causing ventilator rate to increase in response to a decreased PaO2? Carotid bodies or Aortic bodies
Carotid bodies
What will happen if the volume of gas in the alveoli falls below the critical closing pressure
The alveoli will collapse
Complete absence of spontaneous ventilation is called
Apnea
Increased alveolar ventilation (produced by any ventilatory patter that causes the PaCO2 decrease)
Hyperventilation
Static compliance assesses which of the following
a. lung compliance
b. airway resistance
c. stiffness of the lung
d. Both A & B
Lung compliance
Short episodes of rapid, uniformly deep inspirations, followed by 10-30 seconds of apnea is called
Biots breathing
Which of the following terms describes straight even air flow
Laminar
Which of the follow is used to determine minute ventilation
Vt x RR
Chemical reaction that occurs when CO2 moves into the cerebrospinal fluid and results in a decreased pH
CO2 + H2O H2CO3 HCO3 + H
A rapid rate of breathing is called
Tachypnea
Ventilation is
The movement of air in and out of the lungs
Surfactant is chemically a
Phospholipid
The difference between the alveolar pressure and the mouth pressure is the
transairway pressure
decreased alveolar ventilation (produced by any ventilatory pattern that causes the PaCO2 to increase), is called
hypoventilation
Anatomical deadspace is estimated by using which equation
1ml/lb
Ten to thirty seconds of apnea, followed by a gradual increase in the volume and frequency of breathing, followed by a gradual decrease in the volume of breathing, until another period of apnea occurs is called
Cheyne-stokes breathing
Normal airway resistance is equal to approx
0.5-1.5 cmH20/L/Sec
When alveoli or particularly large numbers of alveoli collapse it is termed
atelectasis
If the radius of the airways with a driving pressure of 10cm H2O is decreased by 16% because of bronchospasm, the new driving pressure would have to be __ to maintain the same flow of air
20cmH2O
Phrenic nerve originates from the spinal column at the level of
Cervical vertebrae 3-5
This type of breathing increases both the depth and rate of breathing to lower PaCO2 and is commonly associated with diabetic ketoacidosis
Kussmauls breathing
Raw is commonly high in patients with
COPD
Auto-PEEP can cause
Air trapping and alveolar hyperinflation
normal Vd/Vt ratio is
5-10%
A condition in which an indiv is able to breath most comfortably only in an upright position and commonly associated with servere COPD
Orthopnea
Which of the following readily diffuses the blood brain barrier
CO2
Which of the following cause the inspiration to cease at very high volumes
hering-breur reflec
Failure of the medulla can be from all the following except
a. Increased ICP (intracranial pressure)
b. Poliomyelitis
c. CNS Depressants
d. Caffeine
D. caffeine
What has the most powerful effect on the respiratory components of the medulla
Increased H+
A patients subjective report that they are having difficulty breathing is
dyspnea
The peripheral chemoreceptors are significantly activated when the PaO2 decreases to about
60mmHg
If unchecked what center will cause strong gasping inspiratory efforts
Apneustic
Which of the following centers controls inspiration during normal breathing
Ventral
The conduction zone of the tracheobronchial airway is essential
The anatomical deadspace
This area senses decreased oxygen levels in the arterial blood and sense impulse to the respiratory center to increase ventilation
peripheral chemoreceptors
In addition to a low PaO2 , the peripheral chemoreceptors are also sensitive to a/an I.Decreased pH II. Increased PaO2 III. Decreased pH IV. Increased temp
I, II, and III
with the transairway pressure, if the mouth pressure is 759 mmHg and the alveolar pressure is 755 mmHg, the driving pressure would equal
+4mmHg
The point at which the trachea bifurcates into the right and left main stem bronchi is
carina
During high levels of exercise, the diaphragmetic excursion can increase to
6-10cm
Which of the following protects the lungs from excessive inflation
Hering-breuer reflex
Which of the following will readily diffuse across the blood brain barrier
CO2
Suppression of the peripheral chemoreceptors begin when the PaO2 falls below
30mmHg
The molecular cohesive force at the liquid gas interface is called
Surface tension
When airway resistance becomes high, to offset the increased work of breathing, patients ventilatory pattern is generally
Increased RR and Decreased Vt
A rapid and shallow ventilatory pattern is called
tachypnea
In the normal individual in the upright position
I. The negative intrapleural pressure is greater in the upper lung regions
II. The alveoli in the lower lung regions are larger than the alvioli in the upper lung regions
IV. The intrapleural pressure is always below atmospheric pressure during a normal ventilatory cycle
The difference between the alveolar pressure and the pleural pressure is called the
transpulmonary pressure
In the healthy lung, when the alveolus decreases in size during a normal exhalation the
Surface tension decreases and Surfactant to alveolar surface area increases
if the pressure at the mouth is 756mmHg and at the lungs it is 756 mmHg, this would represent
End inspiration, End-Expiration
The resp components of the PONS consists of
Apneustic center, Pneumotoxic center
You give the patient an Albuterol neb. Treatment to relieve the bronchospasm, by dilating the smooth muscle of the airways, the medication is targeting the
Beta 2 Receptors
To correct auto-PEEP you could
Increased I:E ratio
Which would
Prolong the expiratory phase
Define diffusion
Movement of gas from high concentration to an area of low concentration
In normal lungs, what is the amount of time needed for oxygen and carbon dioxide to reach equilibrium between the alveoli and the pulmonary capillaries
0.25 seconds
What is the normal oxygen level found in the mixed venous blood of the pulmonary arteries (PvO2)
40 mmHg
The peripheral chemoreceptors are special O2-sensitive cells that react to reduction in
Oxygen levels in the arterial blood
What is the normal pressure of Carbon dioxide found in the mixed venous blood of the pulmonary arteries (PvCO2)
46 mmHg
Which of the following structures make up the respiratory zone
I. Alveoli
II. Respiratory Bronchioles
IV. Alveolar Sacs
What would be a normal pressure of carbon dioxide found in the arterial blood (PaCO2) on an adult
40mmHg
The right and left main stem bronchi, blood vessels, and nerves enter and exit the lungs through the
hilum
What would be a normal pressure of oxygen found in the arterial blood (PaO2) on an adult
80-100 mmHg
Which of the following is NOT an example of a clinical condition where perfusion limits the movement of O2 into the blood from alveoli
A. Anemia
B. Atelectasis
C. Decreased Cardiac Output
B. Atelectasis
Which of the following is NOT an example of a clinical condition that decreases the rate of gas diffusion A. Emphysema B. Asthma C. Pulmonary Edema D. Pneumonia
Asthma
Alveolar Air Equation
FiO2 (Pb-47) - (PaCO2 x 1.25)
Oxygen moving from the alveoli to the capillaries can be
Perfusion and diffusion limited
Carbon Dioxide diffuses
20x faster then oxygen
Cardiopulmonary disorders that result in an increased V/Q (V>Q) ratio includes all EXCEPT which of the following
a. hypoventilation
b. Decreased cardiac output
c. Pulmonary emboli
d. hyperventilation
A. hypoventialtion
The first 19 generations of the lower airways are termed the
Conductive Zone, anatomic deadspace
What is the ventilation to perfusion relationship in the upright lung, upper lung region (apex)
V>Q
What is internal respiration
Gas exchange between the blood and the tissue (cells)
In the upright lung, blood flow is greatest through
the lower lobes
Blood flow and ventilation is best matched in what area of lungs
Middle lobe
What is the overall, average ventilation to perfusion ratio of the lungs (V/Q ratio)?
4:5 or 0.8
When lung compliance decreases the patient commonly
Increases respiratory rate, Decreases tidal volume
Normal Oxygen consumption is equal to
250 ml/ min
Daltons law
the sum of partial pressures of each gas will equal the total pressure of that mixture of gases
The primary muscles of relaxed breathing are the
hemidiaphragms
what is the barometric pressure at sea level
760mmHg
What is the partial pressure of H20 at 37 degree C
47 mmHg
What does the stimulated sympathetic nervous system cause to occur in the bronchial smooth muscle
Bronchodilation
What function do the lymphatic vessels in the lung perform
Fluid removal
Which of the following is believed to be responsible for the basic rhythm of ventilation
dorsal resp group
The area between the base of the tongue and the epiglottis is called
Vallecula
Where are the peripheral chemoreceptors located?
In the carotid arteries, Aortic arch
The amount of O2 dissolved in the plasma is equal to how many mls per mmHg of the PAO2/100 mls of blood
0.003ml
If a patient has a SaO2 of 97% on RA, by putting them on 100% NRB mask will dramatically increase the amount of O2 delivered to the tissues T/F
True
Each gram of hemoglobin carries this amount of O2
1.34ml
A SaO2 of 90% on the Oxyhemoglobin Dissociation curve is equal to
a PaO2 of 60mmHg
Normal Male Hemoglobin is
14-16g/ 100ml of blood
An abnormally high RBC count is known as
Polycythemia
The testing is done to obtain volume and flow rate parameters, such as the FVC, FEV1, and FEF25-75, is called
Spirometry
When lung compliance decreases, the pt commonly has
Increased ventilatory rate, a decreased tidal volume
The visceral pleura lines the
Lungs
Flow is made up of what two components
Volume and time
The best defines functional residual capacity
The volume of air remaining in the lungs after a normal exhalation
Normal tidal volume range is about
3-4 ml/lb
In normal lungs, what is the amount of time needed for O2 and carbon dioxide to reach equillibrium between the alveoli and the pulmonary capillaries
0.25 seconds
The test to measure the ability of gas diffusion across the alveolar-capillary membrane is
DLCO
Expiratory wheezing throughout the lung fields. The patient says they are having a difficult time exhaling. What physiologic mechanism explains this situation?
Static compression of the small airways
In normal lungs the residual Volume (RV) makes up how much of the total lung capacity?
20%
With normal lungs, comparing the SVC to the FVC should show that
the volumes are essentially the same
The volume of the FEV1 should be what % of the FVC volume
80%
Which of the following does affect the prediction of normal lung volumes and flow rates
Age, Height, and gender
Which of the following causes blood to clot after an injury
Thrombocytes
MIP and MEP measure
muscle strength
What best defines the inspiratory reserve volume (IRV)
The max volume of air that can be inhaled after a normal Vt inhalation
Which of the following forced expiratory measurements reflects the status of medium and small airways
FEF 25-75
The FEV1 is
the volume of air exhaled in the first 1 sec of the FVC maneuver
What best defines the expiratory reserve volume
The max amount of gas that can be exhaled after anormal Vt exhaled
The parameter is a reflective of the emptying of the small-medium airways during a FVC maneuver
FEF 25-75
In obstructive lung disease, the FEV1 and FEV1/FVC ratio are
decreased
A DLCO study on a pt with emphysema shows that their measured DLCO is only 55% of predicted. with this pt, you would suspect that the diffusion impairment is probably due to
loss of surface area
A pt has a HR of 75 and SV of 80ml, what is their CO
6.0 L/min
Tests that can be performed to measure TLC are
Helium dilution, Nitrogen Washout, Body plethysmography
Surfactant is produced by which type of cells
Alveolar type II
Which portion of a FVC maneuver is referred to as “effort dependent”
First 30%
In restrictive lung disease, the FVC and FEV1 are decreased. the FEV1/FVC ratio is
Generally normal
Vt+ERV+IRV equals which of the following
VC
What would be anormal pressure of carbon dioxide found in the arterial blood (PaCO2) on an adult
40mmHg
if a patient develops air trapping because of obstructive disease, what volume will increase because of air trapping
RV
In a patient with obstructive lung disease such as asthma, which of the following is usually found
Expiratory flows are decreased
Restrictive lung disease will show up on a PFT as
Low Volumes
As a person normally ages, lung volumes and flow rates
Decrease
The amount of air that is needed for normal ventilation with tidal breathing is what percentage of the TLC
7-10%
What function do to the lymphatic vessels in the lung perform
Fluid remove
Body plethysmography uses a modification of whos law to indirectly measure gas volumes in the lungs
Boyles Law
The peak expiratory flow rate is the
Fastest flow point in which air is forcefully exhaled
Tidal volumes in obstructive disease tend to increase. this is probably due to
Increased airway resistance
The largest volume of air that can be breathed voluntarily in and out of the lungs in 1 minute is known as the
MVV
Complete absence of spontaneous ventilation is called
apnea
Nebulizers target what cells in the airway and cause what type of response
Beta 2 cells and smooth muscle relaxation
The best defines tidal volume
The volume of air that moves in and out of the lungs during quiet breathing
The surfactant that is produced by the Type II cells in the alveolis main function is to
reduce surface sension
Normal Cardiac Index (CI) range
2.5 to 4.0 L/min/m2
What is most active in responsding to tissue destruction by bacteria
Neutrophils
Normal hematocrit for an adult %
45%
This lines the inner surface of the heart chambers
endocardium
Approx what % of the bodys blood is contained within the venous system
60%
The sympathetic nervous system regulates systemic blood pressure by either dilation of contriction of
Arterioles
The maximum pressure generated during ventricular contraction is the
Systolic pressure
Compared to the pulmonary pressures, the systemic pressures are
ten times as much
The degree that the myocardial fiber is stretched prior to contraction is the definition of
Ventricular preload
in general, when the contractility of the heart decreases, the CO
Decreases
The coronary arteries originate from the
Aorta
During contraction of the ventricles, if blood flows back into the atrium , it is termed
regurgitation
Normal central venous pressure (CVP) of an adult be
0-8mmHg
Pulmonary Vascular Resistance could be a result of
Pulmonary emboli , Emphysema, and positive end expiratory pressure from a ventilator
The average, normal systemic arterial blood pressure is
120/80mmHg
If the mean arterial pressure falls below this value, theres inadequate perfusion to the brain and kidneys
60mmhg
Force against which the ventricles must work to pump blood best describes
Ventricular afterload
What affects stroke volume
Preload, afterload, contractility
Pulmonary artery carries deoxygenated oxygen T/F
TRUEEE
Which of the following pulmonary capillary wedge pressures is within normal limits
4-12 mmHg
Normal pulmonary artery pressure is
25/8
An increase in which WBC indicates an allergic response such as asthma
Eosinophils
What is the max pressure generated during ventricular contraction called
systolic
While assisting the insertion of a pulmonary artery catheter, what pressure reading would indicate that the tip of the catheter is in the right ventricle
25/0
Granulocyte
Neutrophil, Eosinophil, Basophil
The coronary artery travels towards the apex of the heart and supplies blood to both anterior walls of the ventricular and the interventricular septum
Anterior Interventricular branch
60% of the total vascular blood volume is located in the
veins
PVR reflects the
afterload of the right ventricular
PVR increases in response to
Acidemia, Mechanical ventilation, Epinephrine
An increased myocardial contractility is called
positive inotropism
This has the greatest influence on how blood flows through all the different lung regions
gravity
When the arterial pressure falls, the baroreceptors cause the
Heart rate to increase, arterioles to constrict, and heart to contract more forcefully
If the MAP is less than 60mmHg the result is
low perfusion to the brain and kidneys
Which coronary artery supplies blood to the lateral walls of the right atrium
Marginal
The pulmonary and systemic arterioles are under control of which nervous system
Sympathetic
CO divided by the body surface area equals
The cardiac index
The ideal behind optimal PEEP is to
Improve oxygenation by increasing diffusion surface area, not compromise vascular blood flow
The normal CaO2 range is approximately
18-20 vol %
The normal hgb range for adult males and females is
males: 14-16g% and females 12-15g%
CaO2-CvO2 is indicative of
tissue uptake of oxygen
Hemoglobin not bound with oxygen is called
reduced hemoglobin
Clincally, aggressive cardiopulmonary supportive measures are usually required when the pulmonary shunting is greater than
20%
Which shift in the oxyhemoglobin dissociation curve is normally more clinically harmful to the patient
left shift
A pt with a hgb of 8.7 may potential have what type of hypoxia
Anemic hypoxia
Ventilation without perfusion is termed
dead space
each gram of hemoglobin can carry how much O2
1.34 ml
Normal anatomical shunt is about
2-5%
Under normal conditions, the O2ER is about
25%
Total oxygen delivery depends on
Oxygenation of the blood, Hemoglobin amount, Cardiac output
Total number of RBCs in relation to the volume of blood is the
Hematocrit
Pt with a core body temp over 101.3 degrees F will have a shift in the oxyhemoglobin dissociation curve to the
right
Metabolizing tissue cells consume approx__ of oxygen produce approximately__ of CO2 at rest
250ml/min and 200 ml/min
CO2 is transported from the tissues to the alveolie via
Plasma and RBCs
89% of the CO2 transport is provided by
RBC transport system
I:E ratio, RR 20bpm
1:2, Inspiratory Cycle= 1, Expiratory cycle=2 sec, Breath cycle= 3 sec
RR 10bpm, I:E 1:2
60/10= 6 breaths (breath cycle), 1:2.. 1+2=3… 6/3=2 Inspiratory breath cycle, 6-2=4 Expiratory cycle
Tidal volume norm
3-5 ml/lb
Deadspace norm
1/lb
Lung compliance
increase ventilatory rate, Decrease tidal volume
Deadspace
ventilation without perfusion
Shun
Perfusion without ventilation (pneumonia)
Vt formula
weight x 3-5 ml
Minute ventilation
Vt x RR (Lpm)
Vd
Weight x 1ml (lpm) x RR
Valv
Ve - Vd
