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Cardiopulmonary A & P > Final > Flashcards

Final Flashcards

1
Q 
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
A
  1. An increased ventilatory rate 2. A decreased tidal volume
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2
Q

Normal Tidal volume range is about

A

3-5 ml/lb

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3
Q

What is the normal I:E ratio

A

1:2

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4
Q

Physiologic deadspace is a combination of

A

Alveolar and anatomical deadspace

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5
Q

The excursion of the diaphragm during normal breathing is approx

A

1.5cm

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6
Q

what will happen if the volume of gas in the alveoli falls below the critical closing pressure

A

the alveoli will collapse

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7
Q

which of the following terms describes straigh even air flow

A

Laminar

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8
Q

What is used to determine minute ventilation

A

Vt x RR

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9
Q

The difference between the alveolar pressure and the mouth pressure is the

A

transairway pressure

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10
Q

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

A

20cmH20

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11
Q

With the transairway pressure, if the mouth pressure is 759 mmHg and alveolar pressure is 755 mmHg, the driving pressure would equal

A

+4 mmHg

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12
Q

When airway resistance becomes high, to offset the increased work of breathing, patients ventilatory pattern is generally

A

increased RR and decreased Vt

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13
Q

The point at which the trachea bifurcates into the right and left main stem bronchi is

A

carina

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14
Q

List three primary functions of the nose

A

humidify air, cool/warm air, filter air

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15
Q

the epithelial lining of the traceobranchial tree is primarily composed of

A

pseudostratified ciliated columnar epithelium

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16
Q

Most of the mucus that lines the lumen of the tracheobronchial tree is produced by the

A

Submucosal glands

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17
Q

the length of the trachea is about

A

11-13 cm

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18
Q

Which of the following structures make up the respiratory zone

  1. alveoli
  2. respiratory bronchioles
  3. segmental bronchi
  4. alveolar savs
A

1, 2, 4

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19
Q

The first 19 generations of the lower airways are called the

A

Conducting Zone, Deadspace

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20
Q

Terminal bronchioles permit gas to enter in adjacent alveoli via the

A

channels of lambert

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21
Q

the visceral pleura lines

A

the lungs

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22
Q

The right and left stem bronchi blood vessels and nerves enter and exit the lungs through the

A

hilum

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23
Q

Small holes in the walls of the interalveolar septa are called the

A

pores of kohn

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24
Q

The phrenic nerve originates from what point of the spinal cord

A

Cervical 3-5

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25
Q

This opens and closes over the glottis to prevent aspiration of fluids/ solids during inspiration and expiration

A

epiglottis

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26
Q

the intercostals spaces including veins, arteries, and nerves. how are they located in relationship to the ribs

A

inferior

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27
Q

which of the following have an important function in the immunologic response of patients with asthma

A

Mast Cells

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28
Q

The conchae (turbinates) aid in what process

A

Warm and humidify inspired air

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29
Q

Which of the following is the largest cartilage on the larynx

A

Thyroid

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30
Q

Which of the following represents a correct sequence of the trachelbronchial tree, starting at the mouth and ending at the alveoli

A

Bronchioles, segmental bronchi, respiratory bronchioles, and alveolar ducts

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31
Q

About what percentage of the total alveolar surface is composed of Type I

A

95%

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32
Q

Anteriorly, the base of the lungs extends to about the level of which of the following ribs

A

6th

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33
Q

Ribs eight, nine, and ten are referred to as the

A

false ribs

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34
Q

The area between the base of the tongue and the epiglottis is callled

A

Vallecula

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35
Q

What function do the lympathic vessels in the lung perform

A

fluid remove

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36
Q

Which of the following is associated with sympathetic nervous system

  1. Epinephrine
  2. Beta 2 receptors
  3. Norepinephrine
  4. Alpha 1 Receptors
A

all of the above

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37
Q

The pharyngeal tonsils are located in the

A

Oropharynx

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38
Q

Croup in normally viral infection causing subglottic swelling of the airway and is characterized by

A

inspiratory stridor

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39
Q

What would facilitate mucocillary transport and sputum clearance

A

Humidity

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40
Q

Type I cells are actually

A

simple squamous epithelium

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41
Q

The angle of the left main stem bronchi in an adult is approx

A

40-60 ddegrees

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42
Q

False ribs get their term because

A

they connect indirectly to the sternum by cartilage

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43
Q

Lymphatic vessles

A

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

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44
Q

The primary muscles of relaxed breathing are the

A

Hemidiaphragms

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45
Q

The alveoli are protected from infection by the

A

macrophages

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46
Q

which of the following are part of the sternum

  1. Oblique fissure
  2. Xiphoid process
  3. floating ribs
  4. manubrium
A
  1. xiphoid process 4. manubrium
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47
Q

The submucosal glands empty their contents when which of the following occurs

A

the parasympathetic nerves send a signal

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48
Q

the surfactant that is produced by the type II cells in the alveolis main function is to

A

reduce surface tension

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49
Q

The primary innervations of the hemidiaphragms is provided by the

A

phrenic nerve

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50
Q

the stimulation of the heart by the parasympathetic nervous system will result in

A

the heart rate decreasing

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51
Q

Which of the following are called “Capacitance vessels”

A

Veins

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52
Q

Cartilage is absent in which of the following structures of the tracheobronchial tree

A

Bronchioles and terminal bronchi

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53
Q

4 things found in the mediastinum

A

part of esophagus, heart, larynx, some arteries and veins going to/ from heart

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54
Q

Ciliated cells disappear at which level of the tracheobronchial tree

A

Respiratory bronchioles

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55
Q

Muscles of Inspiration

A

Pectoralis major, Scalene, Sternocleidomastoids, Trapezius

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56
Q

Muscles of Expiration

A

Transverse Abdominis, Internal Intercostals, Rectus abdomonis, External intercostals

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57
Q

The palatine and pharyngeal tonsils are thought to by types of lymphoid tissue T/F

A

True

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58
Q

The Eustachian tubes serve to equalize pressure in the middle of the ear T/F

A

True

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59
Q

Visceral pleura is attached to the inner surface of the chest T/F

A

False

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60
Q

the lungs have a natural tendency to want to expand T/F

A

False

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61
Q

The thorax has a natural tendency to want to

A

expand

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62
Q

The point at which the trachea bifurcates into the right and left main stem bronchi is called

A

the carina

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63
Q

What does the stimulation by the sympathetic nervous system cause to occur to the bronchial smooth muscle

A

Bronchodilation

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64
Q

Air moves in and out of the conductive airways because of

A

pressure changes

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65
Q

in infants this is the narrowest point of the upper airway

A

cricoids cartilage

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66
Q

How many lobes in right lung

A

3

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67
Q

The potential space between the parietal and visceral pleura is called the

A

pleural space

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68
Q

if an endotracheal tube is inserted too far into the trachea, it will most likely enter the

A

right lung

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69
Q

When the ___ receptor sites in the bronchial smooth muscle are stimulated, bronchodilation occurs

A

Beta2

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70
Q

Gases move back and forth from the alveoli and capillaries by means of

A

diffusion

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71
Q

what structure moves in an upward direction to close off the nasopharynx from the oropharynx during swallowing

A

soft palate

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72
Q

the pharyngotympanic tubes (eustachian tubes) are found in the

A

nasopharynx

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73
Q

Nasotracheal suction causing nose bleed, termed as

A

Epitaxis

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74
Q

This structure lies posterior of the trachea and descends down to the cardiac sphincter, through the diaphragm , and into the stomach

A

Esophagus

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75
Q

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

A

pneumothroax

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76
Q

Thoracentesis, she noted that the physician introduces the needle where to the rib

A

over the top of the rip (superior)

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77
Q

Stimulation of this area causes a profound cough

A

carina

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78
Q

how many pair of ribs are there

A

12

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79
Q

As an indiv ages, the

a. Vital capacity decreases
b. functional residual capacity decreases
c. expiratory reserve volume increases
d. residual volume decreases

A

a. vital capacity decreases

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80
Q

During exercise, the oxygen consumption (VO2), of the skeletal muscles may account for more than

A

95% of the total VO2

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81
Q

During very heavy exercise, the

  1. Increased pH
  2. Decreased PaCO2
  3. Constant PaO2
  4. Decreased pH
  5. Increased PaCO2
A

2, 3, and 4

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82
Q

When an individual is subjected to a high altitude for a prolonged period of time, which of the following is seen?

A

An increased RBC production, A decreased PaCO2, A decreased alveolar ventilation

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83
Q

Between 20 and 60 years of age, the RV/TLC ration increases from 20%

A

35%

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84
Q

With advancing age, the

A

PaO2 decreases, C(a-v)O2 decreases

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85
Q

The concentration of myoglobin in skeletal muscle is increased with high altitude natives T/F

A

true

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86
Q

The maximum heart rate of a 55 year old person is

A

175 bpm

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87
Q

Most of the lung function indices reach their maximum levels between

A

20-25 years of age

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88
Q

Acute mountain sickness is characterized by

A

Sleep disorders, headaches, dizziness, palpitations, loss of appetite

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89
Q

During exercise, the P(A-a)O2 begins to increase then the oxygen consumption reaches about what % of its maximum

A

40%

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90
Q

The so called PCO2 respiratory drive breaking point during a dive is about 55mmHg T/F

A

true

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91
Q

Natives who have been at high altitudes for generations commonly demonstrate a

A

Mild respiratory alkalosis

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92
Q

At the onset of exercise, sympathetic discharge causes the

  1. HR to increase
  2. Peripheral vascular system to constrict
  3. Heart to increase its strength of contraction
  4. blood vessels of the working muscles to dilate
A

All of the above

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93
Q

With advancing age, the

  1. Stroke Volume Decreases
  2. Heart work decreases
  3. Cardiac output increase
  4. Blood pressure increase
A
  1. Stroke Volume Decreases
  2. Heart work decreases
  3. Blood Pressure Increase
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94
Q

The maximum alveolar ventilation generated during heavy exercise under normal conditions is about what % of the MVV

A

30-40%

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95
Q

As an individual ages, the

  1. FVC increases
  2. PEFR decreases
  3. FEV1 increases
  4. MVV increases
A

c. 2 & 4

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96
Q

during exercise, heat production may increase as much as

A

20 fold

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97
Q

With advancing age, the

  1. Lung compliance decreases
  2. Chest wall compliance increases
  3. Lung compliance increases
  4. Chest wall compliance decreases
A
  1. Lung compliance and 4. Chest wall compliance decreases
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98
Q

During Exercise, the stroke volume reaches its peak when the cardiac output is at about what % of its maximum

A

50%

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99
Q

Between 30 and 80 years of age, the CO decreases by about

A

40%

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100
Q

During maximum exercise, the oxygen diffusion capacity may increase as much as

A

3 fold

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101
Q

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

A

True

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102
Q

The oxygen diffusion capacity of high-altitude natives is about

A

20-25% greater than predicted

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103
Q

over the course of life, the diffusion capacity decreases by about

A

20%

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104
Q

During strenuous exercise, and adults alveolar ventilation can increase

A

20 fold

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105
Q

the half life of COHb when a victim is breathing room air at 1 atm is approx

A

5 hours

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106
Q

During exercise, an increase in HR accounts for a greater proportion of the increased CO than the

A

increase in SV

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107
Q

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

A

5 hours

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108
Q

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

A

Phase 1

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109
Q

Length and intensity of exercise is primarily limited by

A

cardiac function

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110
Q

Cardiac output is calculated from which two valves

A

Heart Rate, Stroke Volume

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111
Q

a patient has a SaCO level of 20%, what is the patients max SaCO

A

80%

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112
Q

Indications of Hyperbaric Oxygenation might include

A

Decompression sickness, thermal burns, Clostridial gangrene, Carbon Monoxide poisoning

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113
Q

If a CO poisoning patient was in the ER and a hyperbaric chamber was not available what would be best treatment for this patient

A

non-rebreather mask at 15 lpm

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114
Q

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

A

pulmonary edema

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115
Q

what is the best way to treat the patient in pulmonary edema in high altitude

A

Rapid decent of altitude

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116
Q

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

A

polycythemia

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117
Q

Max. heart is calculated by

A

220-age

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118
Q

At the start of exercise, what is the first physiologic response

A

increase heart rate

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119
Q

Acclimation occurs after being exposed to a high altitude after what length of time

A

4 days

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120
Q

Small holes in the walls of the interalveolar septa are called

A

pores of Kohn

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121
Q

Terminal bronchioles permit air/gases to enter adjacent ares via the

A

Canals of Lambert

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122
Q

What is the function of type II cells in alveoli

A

Produce surfactant to reduce alveolar surface tension

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123
Q

What would slow the rate of mucocillary transport

A

Cigarette smoking, hypoxia (low blood oxygen level), Dehydration

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124
Q

What does the sympathetic nervous system stimulation cause to occur in the bronchial smooth muscle

A

Vasodilation

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125
Q

If you reduce the radius of the tube a gas is flowing through, how will this affect flow, if all else remains stable?

A

flow will decrease

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126
Q

When lung compliance decreases, the patient commonly has

A

An increased Ventilatory rate, a decrease tidal volume

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127
Q

At rest, the normal intrapleural pressure change during quiet (tidal) breathing is about

A

2-4 mmHg

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128
Q

Normal tidal volume range is about

A

3-4 ml/lb

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129
Q

what is the normal I:E ratio

A

1:2

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130
Q

Define deadspace

A

perfusion without gas exchange

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131
Q

Shunt

A

gas exchange without perfusion

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132
Q

Physiologic deadspace is a combination of

A

alveolar and anatomical deadspace

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133
Q

Surfactant is produced by which type of cells

A

alveolar type II

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134
Q

The excursion of the diaphragm during normal breathing is approx

A

1.5cm

135
Q

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

A

Carotid bodies

136
Q

What will happen if the volume of gas in the alveoli falls below the critical closing pressure

A

The alveoli will collapse

137
Q

Complete absence of spontaneous ventilation is called

A

Apnea

138
Q

Increased alveolar ventilation (produced by any ventilatory patter that causes the PaCO2 decrease)

A

Hyperventilation

139
Q

Static compliance assesses which of the following

a. lung compliance
b. airway resistance
c. stiffness of the lung
d. Both A & B

A

Lung compliance

140
Q

Short episodes of rapid, uniformly deep inspirations, followed by 10-30 seconds of apnea is called

A

Biots breathing

141
Q

Which of the following terms describes straight even air flow

A

Laminar

142
Q

Which of the follow is used to determine minute ventilation

A

Vt x RR

143
Q

Chemical reaction that occurs when CO2 moves into the cerebrospinal fluid and results in a decreased pH

A

CO2 + H2O H2CO3 HCO3 + H

144
Q

A rapid rate of breathing is called

A

Tachypnea

145
Q

Ventilation is

A

The movement of air in and out of the lungs

146
Q

Surfactant is chemically a

A

Phospholipid

147
Q

The difference between the alveolar pressure and the mouth pressure is the

A

transairway pressure

148
Q

decreased alveolar ventilation (produced by any ventilatory pattern that causes the PaCO2 to increase), is called

A

hypoventilation

149
Q

Anatomical deadspace is estimated by using which equation

A

1ml/lb

150
Q

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

A

Cheyne-stokes breathing

151
Q

Normal airway resistance is equal to approx

A

0.5-1.5 cmH20/L/Sec

152
Q

When alveoli or particularly large numbers of alveoli collapse it is termed

A

atelectasis

153
Q

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

A

20cmH2O

154
Q

Phrenic nerve originates from the spinal column at the level of

A

Cervical vertebrae 3-5

155
Q

This type of breathing increases both the depth and rate of breathing to lower PaCO2 and is commonly associated with diabetic ketoacidosis

A

Kussmauls breathing

156
Q

Raw is commonly high in patients with

A

COPD

157
Q

Auto-PEEP can cause

A

Air trapping and alveolar hyperinflation

158
Q

normal Vd/Vt ratio is

A

5-10%

159
Q

A condition in which an indiv is able to breath most comfortably only in an upright position and commonly associated with servere COPD

A

Orthopnea

160
Q

Which of the following readily diffuses the blood brain barrier

A

CO2

161
Q

Which of the following cause the inspiration to cease at very high volumes

A

hering-breur reflec

162
Q

Failure of the medulla can be from all the following except

a. Increased ICP (intracranial pressure)
b. Poliomyelitis
c. CNS Depressants
d. Caffeine

A

D. caffeine

163
Q

What has the most powerful effect on the respiratory components of the medulla

A

Increased H+

164
Q

A patients subjective report that they are having difficulty breathing is

A

dyspnea

165
Q

The peripheral chemoreceptors are significantly activated when the PaO2 decreases to about

A

60mmHg

166
Q

If unchecked what center will cause strong gasping inspiratory efforts

A

Apneustic

167
Q

Which of the following centers controls inspiration during normal breathing

A

Ventral

168
Q

The conduction zone of the tracheobronchial airway is essential

A

The anatomical deadspace

169
Q

This area senses decreased oxygen levels in the arterial blood and sense impulse to the respiratory center to increase ventilation

A

peripheral chemoreceptors

170
Q 
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
A

I, II, and III

171
Q

with the transairway pressure, if the mouth pressure is 759 mmHg and the alveolar pressure is 755 mmHg, the driving pressure would equal

A

+4mmHg

172
Q

The point at which the trachea bifurcates into the right and left main stem bronchi is

A

carina

173
Q

During high levels of exercise, the diaphragmetic excursion can increase to

A

6-10cm

174
Q

Which of the following protects the lungs from excessive inflation

A

Hering-breuer reflex

175
Q

Which of the following will readily diffuse across the blood brain barrier

A

CO2

176
Q

Suppression of the peripheral chemoreceptors begin when the PaO2 falls below

A

30mmHg

177
Q

The molecular cohesive force at the liquid gas interface is called

A

Surface tension

178
Q

When airway resistance becomes high, to offset the increased work of breathing, patients ventilatory pattern is generally

A

Increased RR and Decreased Vt

179
Q

A rapid and shallow ventilatory pattern is called

A

tachypnea

180
Q

In the normal individual in the upright position

A

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

181
Q

The difference between the alveolar pressure and the pleural pressure is called the

A

transpulmonary pressure

182
Q

In the healthy lung, when the alveolus decreases in size during a normal exhalation the

A

Surface tension decreases and Surfactant to alveolar surface area increases

183
Q

if the pressure at the mouth is 756mmHg and at the lungs it is 756 mmHg, this would represent

A

End inspiration, End-Expiration

184
Q

The resp components of the PONS consists of

A

Apneustic center, Pneumotoxic center

185
Q

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

A

Beta 2 Receptors

186
Q

To correct auto-PEEP you could

A

Increased I:E ratio

187
Q

Which would

A

Prolong the expiratory phase

188
Q

Define diffusion

A

Movement of gas from high concentration to an area of low concentration

189
Q

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

A

0.25 seconds

190
Q

What is the normal oxygen level found in the mixed venous blood of the pulmonary arteries (PvO2)

A

40 mmHg

191
Q

The peripheral chemoreceptors are special O2-sensitive cells that react to reduction in

A

Oxygen levels in the arterial blood

192
Q

What is the normal pressure of Carbon dioxide found in the mixed venous blood of the pulmonary arteries (PvCO2)

A

46 mmHg

193
Q

Which of the following structures make up the respiratory zone

A

I. Alveoli
II. Respiratory Bronchioles
IV. Alveolar Sacs

194
Q

What would be a normal pressure of carbon dioxide found in the arterial blood (PaCO2) on an adult

A

40mmHg

195
Q

The right and left main stem bronchi, blood vessels, and nerves enter and exit the lungs through the

A

hilum

196
Q

What would be a normal pressure of oxygen found in the arterial blood (PaO2) on an adult

A

80-100 mmHg

197
Q

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

A

B. Atelectasis

198
Q 
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
A

Asthma

199
Q

Alveolar Air Equation

A

FiO2 (Pb-47) - (PaCO2 x 1.25)

200
Q

Oxygen moving from the alveoli to the capillaries can be

A

Perfusion and diffusion limited

201
Q

Carbon Dioxide diffuses

A

20x faster then oxygen

202
Q

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

A. hypoventialtion

203
Q

The first 19 generations of the lower airways are termed the

A

Conductive Zone, anatomic deadspace

204
Q

What is the ventilation to perfusion relationship in the upright lung, upper lung region (apex)

A

V>Q

205
Q

What is internal respiration

A

Gas exchange between the blood and the tissue (cells)

206
Q

In the upright lung, blood flow is greatest through

A

the lower lobes

207
Q

Blood flow and ventilation is best matched in what area of lungs

A

Middle lobe

208
Q

What is the overall, average ventilation to perfusion ratio of the lungs (V/Q ratio)?

A

4:5 or 0.8

209
Q

When lung compliance decreases the patient commonly

A

Increases respiratory rate, Decreases tidal volume

210
Q

Normal Oxygen consumption is equal to

A

250 ml/ min

211
Q

Daltons law

A

the sum of partial pressures of each gas will equal the total pressure of that mixture of gases

212
Q

The primary muscles of relaxed breathing are the

A

hemidiaphragms

213
Q

what is the barometric pressure at sea level

A

760mmHg

214
Q

What is the partial pressure of H20 at 37 degree C

A

47 mmHg

215
Q

What does the stimulated sympathetic nervous system cause to occur in the bronchial smooth muscle

A

Bronchodilation

216
Q

What function do the lymphatic vessels in the lung perform

A

Fluid removal

217
Q

Which of the following is believed to be responsible for the basic rhythm of ventilation

A

dorsal resp group

218
Q

The area between the base of the tongue and the epiglottis is called

A

Vallecula

219
Q

Where are the peripheral chemoreceptors located?

A

In the carotid arteries, Aortic arch

220
Q

The amount of O2 dissolved in the plasma is equal to how many mls per mmHg of the PAO2/100 mls of blood

A

0.003ml

221
Q

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

A

True

222
Q

Each gram of hemoglobin carries this amount of O2

A

1.34ml

223
Q

A SaO2 of 90% on the Oxyhemoglobin Dissociation curve is equal to

A

a PaO2 of 60mmHg

224
Q

Normal Male Hemoglobin is

A

14-16g/ 100ml of blood

225
Q

An abnormally high RBC count is known as

A

Polycythemia

226
Q

The testing is done to obtain volume and flow rate parameters, such as the FVC, FEV1, and FEF25-75, is called

A

Spirometry

227
Q

When lung compliance decreases, the pt commonly has

A

Increased ventilatory rate, a decreased tidal volume

228
Q

The visceral pleura lines the

A

Lungs

229
Q

Flow is made up of what two components

A

Volume and time

230
Q

The best defines functional residual capacity

A

The volume of air remaining in the lungs after a normal exhalation

231
Q

Normal tidal volume range is about

A

3-4 ml/lb

232
Q

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

A

0.25 seconds

233
Q

The test to measure the ability of gas diffusion across the alveolar-capillary membrane is

A

DLCO

234
Q

Expiratory wheezing throughout the lung fields. The patient says they are having a difficult time exhaling. What physiologic mechanism explains this situation?

A

Static compression of the small airways

235
Q

In normal lungs the residual Volume (RV) makes up how much of the total lung capacity?

A

20%

236
Q

With normal lungs, comparing the SVC to the FVC should show that

A

the volumes are essentially the same

237
Q

The volume of the FEV1 should be what % of the FVC volume

A

80%

238
Q

Which of the following does affect the prediction of normal lung volumes and flow rates

A

Age, Height, and gender

239
Q

Which of the following causes blood to clot after an injury

A

Thrombocytes

240
Q

MIP and MEP measure

A

muscle strength

241
Q

What best defines the inspiratory reserve volume (IRV)

A

The max volume of air that can be inhaled after a normal Vt inhalation

242
Q

Which of the following forced expiratory measurements reflects the status of medium and small airways

A

FEF 25-75

243
Q

The FEV1 is

A

the volume of air exhaled in the first 1 sec of the FVC maneuver

244
Q

What best defines the expiratory reserve volume

A

The max amount of gas that can be exhaled after anormal Vt exhaled

245
Q

The parameter is a reflective of the emptying of the small-medium airways during a FVC maneuver

A

FEF 25-75

246
Q

In obstructive lung disease, the FEV1 and FEV1/FVC ratio are

A

decreased

247
Q

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

A

loss of surface area

248
Q

A pt has a HR of 75 and SV of 80ml, what is their CO

A

6.0 L/min

249
Q

Tests that can be performed to measure TLC are

A

Helium dilution, Nitrogen Washout, Body plethysmography

250
Q

Surfactant is produced by which type of cells

A

Alveolar type II

251
Q

Which portion of a FVC maneuver is referred to as “effort dependent”

A

First 30%

252
Q

In restrictive lung disease, the FVC and FEV1 are decreased. the FEV1/FVC ratio is

A

Generally normal

253
Q

Vt+ERV+IRV equals which of the following

A

VC

254
Q

What would be anormal pressure of carbon dioxide found in the arterial blood (PaCO2) on an adult

A

40mmHg

255
Q

if a patient develops air trapping because of obstructive disease, what volume will increase because of air trapping

A

RV

256
Q

In a patient with obstructive lung disease such as asthma, which of the following is usually found

A

Expiratory flows are decreased

257
Q

Restrictive lung disease will show up on a PFT as

A

Low Volumes

258
Q

As a person normally ages, lung volumes and flow rates

A

Decrease

259
Q

The amount of air that is needed for normal ventilation with tidal breathing is what percentage of the TLC

A

7-10%

260
Q

What function do to the lymphatic vessels in the lung perform

A

Fluid remove

261
Q

Body plethysmography uses a modification of whos law to indirectly measure gas volumes in the lungs

A

Boyles Law

262
Q

The peak expiratory flow rate is the

A

Fastest flow point in which air is forcefully exhaled

263
Q

Tidal volumes in obstructive disease tend to increase. this is probably due to

A

Increased airway resistance

264
Q

The largest volume of air that can be breathed voluntarily in and out of the lungs in 1 minute is known as the

A

MVV

265
Q

Complete absence of spontaneous ventilation is called

A

apnea

266
Q

Nebulizers target what cells in the airway and cause what type of response

A

Beta 2 cells and smooth muscle relaxation

267
Q

The best defines tidal volume

A

The volume of air that moves in and out of the lungs during quiet breathing

268
Q

The surfactant that is produced by the Type II cells in the alveolis main function is to

A

reduce surface sension

269
Q

Normal Cardiac Index (CI) range

A

2.5 to 4.0 L/min/m2

270
Q

What is most active in responsding to tissue destruction by bacteria

A

Neutrophils

271
Q

Normal hematocrit for an adult %

A

45%

272
Q

This lines the inner surface of the heart chambers

A

endocardium

273
Q

Approx what % of the bodys blood is contained within the venous system

A

60%

274
Q

The sympathetic nervous system regulates systemic blood pressure by either dilation of contriction of

A

Arterioles

275
Q

The maximum pressure generated during ventricular contraction is the

A

Systolic pressure

276
Q

Compared to the pulmonary pressures, the systemic pressures are

A

ten times as much

277
Q

The degree that the myocardial fiber is stretched prior to contraction is the definition of

A

Ventricular preload

278
Q

in general, when the contractility of the heart decreases, the CO

A

Decreases

279
Q

The coronary arteries originate from the

A

Aorta

280
Q

During contraction of the ventricles, if blood flows back into the atrium , it is termed

A

regurgitation

281
Q

Normal central venous pressure (CVP) of an adult be

A

0-8mmHg

282
Q

Pulmonary Vascular Resistance could be a result of

A

Pulmonary emboli , Emphysema, and positive end expiratory pressure from a ventilator

283
Q

The average, normal systemic arterial blood pressure is

A

120/80mmHg

284
Q

If the mean arterial pressure falls below this value, theres inadequate perfusion to the brain and kidneys

A

60mmhg

285
Q

Force against which the ventricles must work to pump blood best describes

A

Ventricular afterload

286
Q

What affects stroke volume

A

Preload, afterload, contractility

287
Q

Pulmonary artery carries deoxygenated oxygen T/F

A

TRUEEE

288
Q

Which of the following pulmonary capillary wedge pressures is within normal limits

A

4-12 mmHg

289
Q

Normal pulmonary artery pressure is

A

25/8

290
Q

An increase in which WBC indicates an allergic response such as asthma

A

Eosinophils

291
Q

What is the max pressure generated during ventricular contraction called

A

systolic

292
Q

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

A

25/0

293
Q

Granulocyte

A

Neutrophil, Eosinophil, Basophil

294
Q

The coronary artery travels towards the apex of the heart and supplies blood to both anterior walls of the ventricular and the interventricular septum

A

Anterior Interventricular branch

295
Q

60% of the total vascular blood volume is located in the

A

veins

296
Q

PVR reflects the

A

afterload of the right ventricular

297
Q

PVR increases in response to

A

Acidemia, Mechanical ventilation, Epinephrine

298
Q

An increased myocardial contractility is called

A

positive inotropism

299
Q

This has the greatest influence on how blood flows through all the different lung regions

A

gravity

300
Q

When the arterial pressure falls, the baroreceptors cause the

A

Heart rate to increase, arterioles to constrict, and heart to contract more forcefully

301
Q

If the MAP is less than 60mmHg the result is

A

low perfusion to the brain and kidneys

302
Q

Which coronary artery supplies blood to the lateral walls of the right atrium

A

Marginal

303
Q

The pulmonary and systemic arterioles are under control of which nervous system

A

Sympathetic

304
Q

CO divided by the body surface area equals

A

The cardiac index

305
Q

The ideal behind optimal PEEP is to

A

Improve oxygenation by increasing diffusion surface area, not compromise vascular blood flow

306
Q

The normal CaO2 range is approximately

A

18-20 vol %

307
Q

The normal hgb range for adult males and females is

A

males: 14-16g% and females 12-15g%

308
Q

CaO2-CvO2 is indicative of

A

tissue uptake of oxygen

309
Q

Hemoglobin not bound with oxygen is called

A

reduced hemoglobin

310
Q

Clincally, aggressive cardiopulmonary supportive measures are usually required when the pulmonary shunting is greater than

A

20%

311
Q

Which shift in the oxyhemoglobin dissociation curve is normally more clinically harmful to the patient

A

left shift

312
Q

A pt with a hgb of 8.7 may potential have what type of hypoxia

A

Anemic hypoxia

313
Q

Ventilation without perfusion is termed

A

dead space

314
Q

each gram of hemoglobin can carry how much O2

A

1.34 ml

315
Q

Normal anatomical shunt is about

A

2-5%

316
Q

Under normal conditions, the O2ER is about

A

25%

317
Q

Total oxygen delivery depends on

A

Oxygenation of the blood, Hemoglobin amount, Cardiac output

318
Q

Total number of RBCs in relation to the volume of blood is the

A

Hematocrit

319
Q

Pt with a core body temp over 101.3 degrees F will have a shift in the oxyhemoglobin dissociation curve to the

A

right

320
Q

Metabolizing tissue cells consume approx__ of oxygen produce approximately__ of CO2 at rest

A

250ml/min and 200 ml/min

321
Q

CO2 is transported from the tissues to the alveolie via

A

Plasma and RBCs

322
Q

89% of the CO2 transport is provided by

A

RBC transport system

323
Q

I:E ratio, RR 20bpm

A

1:2, Inspiratory Cycle= 1, Expiratory cycle=2 sec, Breath cycle= 3 sec

324
Q

RR 10bpm, I:E 1:2

A

60/10= 6 breaths (breath cycle), 1:2.. 1+2=3… 6/3=2 Inspiratory breath cycle, 6-2=4 Expiratory cycle

325
Q

Tidal volume norm

A

3-5 ml/lb

326
Q

Deadspace norm

A

1/lb

327
Q

Lung compliance

A

increase ventilatory rate, Decrease tidal volume

328
Q

Deadspace

A

ventilation without perfusion

329
Q

Shun

A

Perfusion without ventilation (pneumonia)

330
Q

Vt formula

A

weight x 3-5 ml

331
Q

Minute ventilation

A

Vt x RR (Lpm)

332
Q

Vd

A

Weight x 1ml (lpm) x RR

333
Q

Valv

A

Ve - Vd

Cardiopulmonary A & P (5 decks)

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