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CVP > Final Exam > Flashcards

Final Exam Flashcards

1
Q

Respiratory neurons located where set the basic drive for ventilation?

A

Brain stem in general, dorsal respiratory group more specifically

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2
Q

All muscles of inspiration lift up the rib cage except the __.

A

Diaphragm

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3
Q

T/F: The SCM is a muscle of inspiration

A

True

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4
Q

Expiratory muscles work to ___ thoracic cage volume.

A

Decrease

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5
Q

Is it better to lose inspiratory muscles or expiratory muscles?

A

Expiratory b/c passive expiration is possible, (the only thing we couldn’t do is cough/sneeze/other forced expiration)

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6
Q

Which muscle of expiration may also play a role in low back pain if weakened?

A

Transverse abdominis

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7
Q

What is responsible for the passive recoil of the lungs?

A

Surface tension forces

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8
Q

When is alveolar pressure equal to the atmospheric pressure?

A

At the end of inspiration and at the end of expiration

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9
Q

What is responsible for keeping the lung inflated against the chest wall?

A

Pleural pressure (negative pressure that exists between parietal and visceral pleura)

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10
Q

Alveolar pressure is ___ atmospheric during inspiration and __ atmospheric during expiration.

A

Sub-atmospheric -insp

Above atmospheric -expir

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11
Q

T/F: As transpulmonary pressure increases, the lung has more recoil tendency.

A

True

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12
Q

When does transpulmonary pressure peak?

A

At end of inspiration–>passive recoil of expiration

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13
Q

What is hysteresis?

A

At the onset of inspiration, the pleural pressure changes at a faster rate than the lung volume.

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14
Q

Which is easier to inflate: air filled lung or saline filled lung?

A

Saline filled lung b/c loss of surface tension forces

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15
Q

What is eupnea?

A

Normal pattern of breathing

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16
Q

___ is the pattern of breathing that occurs by increasing pulmonary ventilation to match metabolic demand

A

Hyperpnea (ex: happens during exercise)

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17
Q

What is orthopnea and what can it be indicative of?

A

Difficulty breathing when lying down, relieved by standing; congestive heart failure or lung failure

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18
Q

What is pleural fluid?

A

Mucus-like fluid that provides lubrication

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19
Q

What is pleural effusion and what normally prevents it?

A

Accumulation of large amts of free fluid in pleural space; doesn’t occur if lymphatics are removing excess fluid like normal

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20
Q

Type __ alveolar epithelial cells produce ___, which is a aqueous fluid that reduces surface tension in the lung.

A

Type II; surfactant

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21
Q

What size alveoli are more susceptible to collapse if surfactact is absent?

A

Smaller

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22
Q

__ volume is the amount of air moved in and out with each breath.

A

Tidal volume

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23
Q

What is the maximum volume one can exchange in a respiratory cycle?

A

Vital Capacity (IRV+TV+ERV)

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24
Q

What is volume of air left in the lungs after a normal expiration?

A

Functional Residual Capacity (ERV + RV)

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25
Q

What are the 3 volumes that can be detected using spirometry?

A

TV, ERV, IRV

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26
Q

If all muscles of respiration were paralyzed what would be the volume in the lungs?

A

Functional residual capacity

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27
Q

What volumes/capacities cannot be determined with basic spirometry?

A

RV, TLC, FRC

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28
Q

What is decreased in a restrictive lung condition?

A

Decr vital capacity

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29
Q

What is decreased in an obstructive lung condition?

A

Decr flow rate

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30
Q

Is it possible to have both an obstructive and a restrictive lung condition?

A

Yes, COPD for example

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31
Q

T/F: The trachea, bronchi, and bronchioles are all dead space.

A

True

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32
Q

Do bronchi have cartilage? bronchioles?

A

Bronchi do…bronchioles do not!

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33
Q

At the end of a normal expiration, most of the FRC is at the level of the ___.

A

Alveoli

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34
Q

What is the difference between anatomical dead space and physiological dead space?

A

Anatomical is just the volume in the airways; physiological is the anatomical plus any non-functional alveoli

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35
Q

T/F: Anatomical dead space is always greater than physiological dead space.

A

False: Physiological is always greater than or equal to anatomical

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36
Q

Which is more powerful: SNS direct effect or SNS indirect effect?

A

Indirect SNS

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37
Q

What are NANC nerves?

A

Non-adrenergic, Non-cholinergic nerves that can be either stimulatory–>bronchoconstriction or inhibitory–>bronchodilation

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38
Q

Where in the airways do you find slow-adapting receptors?

A

Smooth muscle of proximal airways

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39
Q

T/F: The cough reflex is associated with rapidly adapting receptors.

A

False: …slow adapting receptors

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40
Q

T/F: C-fibers are involved in a bronchoconstriction response.

A

True

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41
Q

When bound to histamine, H1 receptors cause __, whereas H2 receptors cause __.

A

H1-constriction

H2-dilation

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42
Q

Prostaglandins _ series cause dilation and prostaglandins _ series cause constriction.

A

E-dilate (ease)

F-constrict

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43
Q

In general, which of the following with increase ventilation: acidosis or alkalosis?

A

Acidosis

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44
Q

The __ regulates HCO3- and the __ regulates CO2.

A

Kidney-HCO3-

Lung- CO2

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45
Q

An increase in HCO3- will lead to __ ____ which will inhibit ventilation.

A

metabolic alkalosis

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46
Q

An increase in CO2 will lead to __ ___ which will stimulate ventilation.

A

Respiratory acidosis

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47
Q

Metabolic acidosis results from an __ in HCO3-, which will ___ ventilation.

A

decrease; stimulate

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48
Q

T/F: Mitral stenosis can cause a decrease in pulmonary volume.

A

False: ..incr in pulmonary volume (mitral is between left atria and left ventricle so think that the blood will be backed up into the lungs)

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49
Q

Triscuspid stenosis can result in what?

A

Decreased pulmonary volume and increased systemic volume

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50
Q

What is the only organ to receive blood flow in excess of cardiac output?

A

Lungs

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51
Q

T/F: Left ventricle output is equal to right ventricle output.

A

False: LV slightly higher (1%) then RV

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52
Q

Into which lymphatic duct will most of the lymph and filtrate drain?

A

Right lymphatic duct

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53
Q

What is unique about pulmonary lymphatics?

A

Can remove plasma filtrate and particulate matter in addition to lymph

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54
Q

What is unique about pulmonary blood flow regarding it’s distribution?

A

Distributed to well ventilated areas. (In tissues, low oxygen causes vasodilation)

55
Q

What causes the major constrictor effect on pulmonary vascular smooth muscle?

A

Low alveolar oxygen

56
Q

T/F: Under resting conditions, blood is fully oxygenated by the time it passes the first third of the pulmonary capillary.

A

True b/c of this even under high CO transit time, full oxygenation still occurs

57
Q

What is the limiting factor in exercise?

A

Stroke volume

58
Q

What type of zone normally does not exist in the lung?

A

Zone 1 where alveolar pressure is so much greater than capillary pressure it actually squeezes the caps shut

59
Q

Comparing capillary pressure and alveolar pressure, during systole ___ pressure is higher and during diastole __ pressure is higher.

A

Systole: capillary P>
Diastole: alveolar P>

60
Q

What is zone 3?

A

Continuous flow; capillary P>alveolar P

61
Q

The entire lung is a zone (1, 2, or 3) during exercise?

A

Zone 3

62
Q

PV=nRT is a combination of which 3 gas laws?

A

Boyles, Charles, and Avogadros

63
Q

T/F: Larger gases diffuse more slowly.

A

True

64
Q

T/F: Solubility trumps size which is why CO2 is 20x more diffusible than O2.

A

True

65
Q

What are the three most common components of air, in order?

A

N, O, Ar

66
Q

Alveolar air contains more __ and __ than atmospheric air.

A

Water vapor, CO2

67
Q

Alveolar air has lesser concentration of which two elements as compared to atmospheric air?

A

Oxygen, Nitrogen

68
Q

T/F: The respiratory membrane is only one cell layer thick.

A

False the functional respiratory membrane is made up of the capillary’s endothelium and the alveolar epithelium (2 cells thick)

69
Q

The first 100 mL of expired air is from __ __, and the last 250mL of expired air is from __ ___.

A

Dead space; Alveolar air

70
Q

How many breaths does it take for complete turnover of alveolar air?

A

6-7 breaths

71
Q

What is the normal ventilation-perfusion ratio?

A

4/5= 0.8 (4L/min of air to 5L/min of blood)

72
Q

A low V/P ratio is usually due to decreased ventilation that results in ___ in PO2 and ___ in PCO2.

A

decr PO2

incr PCO2

73
Q

Which would result in an increase in ‘physiologic shunt blood’: low V/P ratio or high V/P ratio?

A

Low V/P ratio: more blood not getting oxygenated as it passes thru the lungs

74
Q

An increased V/P ratio is due to decreased ___ of the lungs resulting in an increase in ___dead space.

A

perfusion; physiologic

75
Q

What is the maxium oxygen that can be absorbed from the lungs and delivered to the tissue per minute?

A

VO2 Maximum

76
Q

Which is the limiting factor for VO2 max: cardiac output or pulmonary ventilation?

A

cardiac output

77
Q

A VO2 max of 6.0 L/min is likely ____ individual whereas a VO2 max of 3.0 L/min is likely ___ individual.

A

Active; sedentary

78
Q

97% of oxygen in the body is where?

A

bound to hemoglobin

79
Q

Arterial blood is slightly more (acidic, basic) than venous blood.

A

Basic

80
Q

T/F: In exercise, venous blood can become even more acidic.

A

True

81
Q

What 2 options does oxygen have when it comes into the cells?

A

80% of the time, converted to CO2

20% of the time its converted to water (metabolic water)

82
Q

People with a diet high in __ __ could increase their metabolic water production by up to 30%.

A

Fatty acids

83
Q

How much metabolic water is produced if only carbs are used for energy?

A

No metabolic water

84
Q

What 4 things cause a shift to the right, promoting dissociation at the tissues?

A
  1. Incr T
  2. Incr CO2
  3. Decr pH
  4. Decr in 2,3 DPG
85
Q

T/F: RBC’s do not use oxygen…they only carry it.

A

True

86
Q

T/F: Carbon monoxide competes with oxygen for binding sites on hemoglobin but oxygen usually wins.

A

False: CO has 250x affinity for hemoglobin (oxygen will lose)

87
Q

T/F: Carbon monoxide has no physiologic purpose in the body

A

False: acts as a vasodilator for the NS

88
Q

Where is the dorsal respiratory group located?

A

Nucleus tractus solitaries in the medulla

89
Q

The DRG is the termination point of which 2 cranial nerves?

A

CN 9 and 10

90
Q

T/F: The DRG is self excitatory, causes the ramp signal and excites the muscles of inspiration

A

True

91
Q

___ center shuts off the ramp signal by inhibiting the duration of inspiration and is located in the nucleus parabrachialis of the upper pons.

A

Pneumotaxic center

92
Q

T/F: The ventral respiratory group of neurons can stimulate both inspiratory and expiratory respiratory muscles

A

True

93
Q

Where is the apneustic center and what does it do?

A

Lower pons; prevents inhibition of DRG

94
Q

Under resting conditions, which respiratory center dominates?

A

Pneumotaxic center

95
Q

The Herring-Breuer Inflation reflex (stimulates or inhibits) the DRG.

A

Inhibits

96
Q

Stimulation of the irritant receptors can lead to sneezing/coughing and possible broncho___.

A

constriction

97
Q

T/F: Central chemoreceptors are sensitive to hydrogen, carbon dioxide, and oxygen changes.

A

False: Hydrogen-yes but cannot cross BBB
Carbon dioxide-yes, particularly to incr CO2
Oxygen-NO b/c lack of O2 depresses neuronal activity

98
Q

What is hypercapnia?

A

Increased CO2 in the blood

99
Q

T/F: Peripheral chemoreceptors are sensitive to carbon dioxide and oxygen changes.

A

True: hypoxia (decr oxygen)

hypercapnia (incr CO2)

100
Q

What is the effect of brain edema on respiratory centers?

A

depression or inactivation

101
Q

T/F: Hyperventilation decreases all of the following: SV, CO, Coronary blood flow, cerebral blood flow, and serum K+.

A

True

102
Q

What are the 2 notable features that are increased with hyperventilation?

A

Oxyhemoglobin affinity

Skeletal muscle tone (spasms and tetany)

103
Q

What is the most prevalent cause of respiratory depression?

A

Anesthesia/narcotics

104
Q

How much stored oxygen does the body contain for aerobic metabolism?

A

2 L (most combined w/ hemoglobin, otherwise in lungs, muscle myoglobin, and body fluids)

105
Q

T/F: After exercise, ventilation and O2 uptake remain high until O2 debt is repaid.

A

True

106
Q

Which type of oxygen debt is greater post exercise: alactacid oxygen debt or lactic acid oxygen debt?

A

Lactic Acid (8.0L whereas alactacid is only 3.5L)

107
Q

Which type of oxygen debt is repaid first?

A

Alactacid oxygen debt

108
Q

What 2 things stimulate taking the first breath as neonates?

A

Cooling of the skin

Slighly asphyxiated state (incr CO2)

109
Q

What happens to pulmonic resistance at birth?

A

Decreases b/c the lungs opening

110
Q

T/F: As one ascends, the barometric pressure increases

A

False: …decreases

111
Q

Chronic mountain sickness results in thicker blood, __pulmonary arterial BP, an enlarged __ ventricle, and __ in total peripheral resistance.

A

Incr; right; decrease

112
Q

What is the cure for chronic mountain sickness?

A

Person must be moved to lower altitude

113
Q

T/F: A person who is acclimatized to living at high altitude has an increased ability to use oxygen, an increase in RBC, and an increase in pulmonary ventilation.

A

True

114
Q

Increased 2,3 DPG seen in high-altitude acclimatized people shift the hemoglobin dissociation curve to the ___, which is advantageous for ___ but not for___.

A

Right; tissues; lungs

115
Q

What is hyperbarism?

A

Air supplied to lungs is at high pressure –> high alveolar gas pressures to keep the lung from collapsing

116
Q

A high partial pressure of which gas can cause narcosis and can resemble alcohol intoxication?

A

N2

117
Q

Is oxygen toxicity preventable when deep sea diving?

A

Yes, if one doesn’t exceed the established max. depth of a given breathing gas

118
Q

Which tissue is particularly susceptible to oxygen toxicity?

A

Nervous tissue–>brain dysfunction

119
Q

Which of the partial pressures is least likely to cause damage when deep sea diving? Most likely to cause damage?

A

Least…PCO2

Most..PN2

120
Q

Is N2 metabolized in the body?

A

No, dissolves in tissues until N2 pressure in the lungs decreases (timely process)

121
Q

T/F: It takes the same amount of time for nitrogen dissolved in water to equilibrate as it takes for nitrogen dissolved in fat to equilibrate.

A

False: Nitrogen dissolved in fat takes several hours to equilibrate, (dissolved in water is usually less than 1 hr)

122
Q

What is decompression sickness?

A

“Bends”; nitrogen bubbles out of fluids following a sudden decompression and these bubbles can block small vessels

123
Q

What are some symptom manifestations of the ‘bends’?

A

Pain in joints and muscles 85-90% of the time,
Nervous system defects 5-10%
Pulmonary capillaries can become blocked off 2% of time

124
Q

What is the number one organ of metabolism? Number 2?

A 
#1: Liver
#2: Lung
125
Q

What is one advantage the lung has over the liver with regards to metabolism?

A

All blood passes thru the lungs with every complete cycle

126
Q

What are 3 factors that depress the immune system of the lungs?

A

Chronic alcohol-(incr bacT infections)
Cig Smoke (incr chronic bronchitis and emphysema)
Occupational irritants

127
Q

T/F: Coughing is effective at clearing all areas sensitive to irritants.

A

False: (Sensitive to irritants: trachea to alveoli)

Coughing cannot clear small airways b/c lacks sufficient velocity in small areas

128
Q

How does a sneeze differ from a cough?

A

Uvula depressed in sneezing to send large amounts of air thru nasal passages to clear it

129
Q

The velocity of air from sneezing and coughing has been clocked at speeds of what?

A

75 to 100 MPH

130
Q

If coughing can’t clear small airways, what process clears these areas?

A

Mucociliary elevator

131
Q

The mucus produced for the mucociliary elevator is produced by ___ cells in the epithelium and ___ ____ glands.

A

Goblet; small submucosal

132
Q

What is the speed of mucus flow in mucociliary elevator and where does the mucus end up?

A

1 cm/min; swallowed (acid will destroy organisms) or coughed out

133
Q

What is the principle phagocytic cell of the distal air spaces?

A

Alveolar macrophages/dust cells

134
Q

What antibody is associated with the upper respiratory tract? The lower respiratory tract?

A

Upper=IgA

Lower=IgG

CVP (2 decks)

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