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Cardiopulmonary A & P > Finalll!!! > Flashcards

Finalll!!! Flashcards

1
Q 
As an individual 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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2
Q 
During Exercise, the oxygen consumption (VO2), of the skeletal muscles may account for more than
A.65% of the total VO2
B. 75% of the total VO2
C. 85% of the total VO2
D. 95% of the total VO2
A

D. 95% of the total VO2

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3
Q

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

A

A. True

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4
Q

The max heart rate of a 55 year old person is

A

165 bpm

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5
Q

Most of the lung funtion indices reach their max level between

A

20-25 years of age

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6
Q

Acute mountain sickness is characterized by

A

Sleep disorders, Headaches, Dizziness, palpitation, Loss of appetite

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7
Q

At the onset of exercise, sympathetic discharge causes the

A

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)

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8
Q

During max exercise, the O2 diffusion capacity may

A

increase. (as much as 3 fold)

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9
Q

The O2 diffusion capacity of high altitude natives is about

A

20-25% greater. GREATER

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10
Q

The half life of carboxyhemoglobin when a victim is breathing room air at 1 atm is approx

A

5 hours

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11
Q

During exercise, an increase in heart rate accounts for a greater proportion of the increased CO than the increase in SV T/F

A

true

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12
Q

If a patient has a SaCO level of 20% how long will it take to reduce the level to 10% if he is breathing 100% oxygen

A

B. 5 hours

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13
Q 
During pulmonary rehabilitation programs, the patient is evaluated by a variety of tests, such as PFTs, ambulatory oximetry studies, and nutritional, pyschological, lifestyle, etc... needs. this is done during what phase of the program
A. Phase 1
B. Phase 2
C. Phase 3
D. Phase 4
A

A. Phase 1

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14
Q

Length and intensity of exercise is primarily limited by

A

Cardiac function

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15
Q

Indications of hyperbaric oxygenation might include

A

All of the above- Decompression sickness, Thermal burns, Clostridial gangrene, Carbon monoxide poisoning

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16
Q

A person in a high altitude situation develops crackles in the bases, pink frothy sputum and shortness of breath; which of the following lung conditions is occurring

A

Pulmonary edema

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17
Q

at the start of exercise, what is the FIRST physiologic response

A

Increased HR

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18
Q

The epithelial lining of the tracheobronchial tree is primarily composed of

A

pseudostratified ciliated columnar epithelium

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19
Q

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

A

Submucosal glands

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20
Q

Type II cells produce

A

Surfactant

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21
Q

Mast cells produce

A

Histamine

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22
Q

The first 19 generations of the lower airways are called the

A

Conducting zone and deadspace (where no gas exchange occurs)

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23
Q

Respiratory zone

A

last 4 generations

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24
Q

The visceral pleura lines the

A

lungs

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25
Q

The parietal lines the

A

thorax

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26
Q

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

A

hilum

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27
Q

The phrenic nerve originates from what point of the spinal cord

A

Cervical 3-5

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28
Q

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

A

Epiglottis

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29
Q 
Which of the following have an important function in the immunologic response of pt with asthma
A. Goblet Cells
B. Type 1 cells
C. Beta 2 cells
D. Mast Cells
A

Mast cells- create histamine= bronchospasm (allergic reaction)

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30
Q

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

A

6th

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31
Q

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

A

False ribs

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32
Q

True ribs

A

1-7

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33
Q

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

A

Vallecula

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34
Q

What function do the lympathic vessels in the lung perform

A

Fluid removal

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35
Q 
Which one of the following would facilitate mucocillary transport and sputum clearance
A. Dehydration (8hrs)
B. Cig smoking
C. Humidity
D. Hypoxia
A

C. Humidity

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36
Q

The primary muscles of relaxed breathing are the

A

hemidiaphragms

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37
Q

The submucosal glands empty their contents when which of the following occurs?
A. The sympathetic nerve send a signal
B. The parasympathetic nerves send a signal
C. The voluntary motor nerves send a signal
D. Type II cells are stim

A

B. The parasympathetic nerves send a signal

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38
Q

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

A

Reduce surface tension

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39
Q

The primary innervations of the hemidiaphragms is provided by the

A

Phrenic nerve

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40
Q

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

A

The heart rate decreasing

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41
Q

Stimulation of the heart by the sympathetic nervous system will result in

A

The heart rate increasing

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42
Q

Muscles of inspiration

A

Pectoralis Major, Scalene, Sternocleidomastoids, Trapezius

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43
Q

Muscles of Expiration

A

Transverse abdominis, Internal intercostals, Rectus abdomonis, External intercostals

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44
Q

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

A

carina

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45
Q

All the arteries in the body carry oxygenated blood to their destination T/F

A

False

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46
Q

In infants, this is the narrowest point of the upper airway

A

Cricoid cartilage

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47
Q

When lung compliance decreases

A

Ventilatory rate increases, Tidal volume decreases

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48
Q

Normal Tidal volume range is about

A

3-4 ml/lb

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49
Q

Deadspace

A

Ventilation without perfusion

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50
Q

Shunt

A

Perfusion without ventilation

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51
Q

Physiologic deadspace combination of

A

alveolar and anatomical deadspace

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52
Q

Surfactant is produced by which type of cells

A

Alveolar type II

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53
Q

Which of the following plays the greater role in causing Vent rate to increase in response to a dec PaO2
A. Carotid bodies
B. Aortic bodies

A

A. Carotid bodies

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54
Q

Alveoli falls below the critical closing pressure =

A

the alveoli will collapse

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55
Q

Apnea

A

Complete absense of spontaneous ventilation

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56
Q

Normal breathing

A

Eupnea

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57
Q

Cheyne-Stokes breathing

A

fast to slow to apnea breathing

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58
Q

Hypoventilation breathing

A

shallow/ slow

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59
Q

Increased alveolar ventilation

A

Hyperventilation

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60
Q

Biots breathing

A

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

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61
Q

Rapid rate of breathing is called

A

tachypnea

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62
Q

Anatomical deadspace is estimated by using which equation

A

1ml/lb

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63
Q

Decreased alveolar ventilation

A

Hypoventilation

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64
Q

Cervical vertebrae 3-5

A

Where phrenic nerve originates from

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65
Q 
Auto PEEP can cause
A. Alveoli to collapse
B. Air trapping and alveolar hyperinflation
C. Increased lung compliance
D. Decreased Raw
A

B. Air trapping and alveolar hyperinflation

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66
Q

Ten to thirty sec of apnea, followed by a gradual increase in 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

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67
Q

Normal Vd/Vt ratio is

A

25%-35%

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68
Q

The first 19 generation of the tracheobronchial airways are termed

A

Conduction zone

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69
Q

What readily diffuses the blood brain barrier

A

CO2

70
Q

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

A

Kussmauls breathing

71
Q

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

A

Orthopnea

72
Q

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

A

60mmHg (hypoxic drive kicks in)

73
Q

Which of the following centers control inspiration during normal breathing

A

Ventral

74
Q

This area senses decreased O2 levels in the arterial blood and sends impulses to the resp center to increase ventilation

A

Peripheral Chemoreceptors

75
Q

When airway resistance becomes high, to offset the increased work of breathing, pts vent. patterns is generally

A

Decreased RR and increased Vt

76
Q

When you increase the I:E ration, you are doing what

A

prolonging the expiratory phase

77
Q

If you have a COPD pt that is breathing at a RR=12bpm, with an I:E ratio of 1:3

A

Breath Cycle= 60/12= 5, Inspiratory 5/4= 1.25, Expiratory rate= 5-1.25= 3.75

78
Q

Tidal volume

A

W x 1-5lb

79
Q

Minute ventilation

A

RR x Vt

80
Q

Ventilation deadspace

A

W x RR

81
Q

Valv

A

Ve- Vd

82
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

83
Q

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

A

oxygen levels in the arterial blood

84
Q

Whats the normal pressure of carbon dioxide found in the mixed venous blood of the pulmonary arteries (PvCO2)

A

46 mmHg

85
Q

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

A

40 mmHg

86
Q

What would be a norm pressure of O2 found in the arterial blood (PaO2) on an adult

A

80-100 mmHg

87
Q 
Which of the following is NOT an ex of a clinical condition that decreases the rate of gas diffusion
A. emphysema
B. Asthma
C. Pulmonary Edema
D. Pneumonia
A

B. Asthma

88
Q 
Carbon dioxide diffuses
A. at the same rate then O2
B. Twice as fast as O2
C. Half as fast as O2
D. 20x faster then O2
A

D. 20x faster then O2

89
Q 
The first 19 generations of the lower airways are termed the:
I. Conductive Zone
II. Respiratory Zone
III. Anatomic Deadspace
IV. Alveolar Deadspace
A

I. Conductive Zone and III. Anatomic Deadspace

90
Q

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

A

V>Q

91
Q

V

A

Middle lobes

92
Q

V=Q

A

Lower lobes

93
Q

What is internal respiration

A

Gas exchange between the blood and the tissues (cells)

94
Q

In the upright lung, blood flow is greatest through

A

lower lobes (gravity)

95
Q

Blood flow and ventilation is best matched in what area of the lung

A

Middle lobe

96
Q

Normal O2 consumption is equal to

A

250ml/min

97
Q

Whats the partial pressure of H20 at 37 degree C

A

47 mmHg

98
Q

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

A

bronchodilation

99
Q

Which of the following causes blood to clot after an injury

A

Thrombocytes

100
Q

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

A

6000mL= 6.0L/min

101
Q

Normal CVP

A

0-8mmhg

102
Q

Which of the following are most active in response to a bacterial infection

A

Neutrophils

103
Q

Normal systemic arterial blood pressure is

A

120/80

104
Q

If the meal arterial pressure falls below this value, there is inadequate perfusion to the brain and kidneys

A

60mmHg

105
Q 
Which of the following does NOT affect SV
A. Preload
B. Afterload
C. Contractility
D. Cardiac Index
A

D. Cardiac index

106
Q

Cardiac Index equation

A

CO/BSA

107
Q

Normal pulmonary artery pressure is

A

25/8 mmHg

108
Q

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

A

Eosinophils

109
Q

Inner lining of the heart is the

A

Endocardium

110
Q

These vessels are referred to as resistance vessels and have the most influence on systemic blood pressure

A

Arterioles

111
Q

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

A

veins

112
Q

The degree that the myocardial fiber is stretched prior to contraction best describes

A

Ventricular Preload

113
Q

When the vascular resistance increases, the blood pressure

A

increases

114
Q

This portion of the serous pericardium is on the surface of the heart

A

Visceral pericardium

115
Q

Blood circulation through the heart

A

Superior and Inferior Vena Cava, Right Atrium, Tricuspid Valve, Right Ventricle, Pulmonary Valve, Pulmonary Artery, Pulmonary capillaries, Pulmonary vein, left atrium, mitral valve, left ventricle, aortic valve, aorta

116
Q

Mean arterial pressure equation

A

Systolic+ diastolic x 2 divided by 3

117
Q

CO divided by BSA

A

Cardiac index

118
Q

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

A

Spirometry

119
Q

Flow is made up of what two components

A

Volume and time

120
Q

Test to measure ability of gas diffusion across the alveolar capillary membrane is

A

DLCO

121
Q

With norm lungs, comparing the SVC to the FVC should show that
A. The volumes are essentially the same
B. the flows are essentially the same
C. The FVC volume is larger then the SVC volume
D. The SVC flow is faster then the FVC

A

The volumes are essentially the same

122
Q 
Following the FVC maneuver that prod a flow/time curve tracing, you should be able to calculate the following measurements
I. FVC
II. FEV1
III. MVV
IV.FEF 25-75
V. FEV1/FVC ratio
VI.DLCO
A

I. FVC
II. FEV1
IV. FEF 25-75
V. FEV1/ FVC ratio

123
Q

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

A

80%

124
Q

What affects the prediction of normal lung volumes and flow rates

A

Age Height and gender

125
Q

The reading is a good indicator of the patency of large airways

A

FEF 200-1200

126
Q

MIP and MEP measure

A

muscle strength

127
Q

What forced expiratory measurements reflects the status of the medium and small airways

A

FEF 25-75

128
Q

The FEV1

A

The volume of air exhaled in the first 1 second of the FVC maneuver

129
Q

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

A

decreased

130
Q

Tests that can be performed to measure TLC

A

Helium Dilution, Nitrogen washout, and body plethysmography

131
Q

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

A

first 30%

132
Q 
If a pt develops air trapping bc of obstructive disease, what volume will increase because of air trapping
A. RV
B. VT
C. IC
D. VC
A

A. RV

133
Q

Restrictive lung disease will show up on a PFT as

A

low volumes

134
Q

As a person norm ages , lung volumes and flow rates

A

decrease

135
Q

Body pleth uses a modification of whos law to indirectly measure gases volumes in the lungs

A

Boyles law

136
Q

The peak exp flow rate is the

A

fastest flow point in which air is forcefully exhaled

137
Q

CaO2 formula

A

((Hbg x 1.34) x SaO2) + (PaO2 x 0.003)

138
Q

CvO2 formula

A

((Hgb x 1.34) x SvO2) + (PvO2 x 0.003)

139
Q

CcO2 Formula

A

(Hgb x 1.34 x1) + (PAO2 x 0.003)

140
Q

Arterial Venous content formula

A

CaO2-CvO2

141
Q

O2 ER

A

CaO2-CvO2/ CaO2

142
Q

Oxygen Delivery (DO2)

A

CO x (CaO2 x 10)

143
Q

O2 consumption formula (VO2)

A

CO x ((CaO2-CvO2) x 10)

144
Q

Qs/ Qt (shunt)

A

CcO2-CaO2/ CcO2 - CvO2

145
Q

Alveolar minute ventilation

A

Vt- Vd x RR

146
Q

Normal CaO2 range is approx

A

18-20 vol %

147
Q

CaO2- CvO2 is indicative of

A

Tissue uptake of oxygen

148
Q

Which shift in the oxyhemoglobin dissociative curve is normally more clinically harmful to the pt

A

Left shift

149
Q 
A pt with a Hgb of 8.7 may potential have what type of hypoxia
A. Hypoxic Hypoxia
B. Anemic Hypoxia
C. Circulatory hypoxia
D. Histotoxic hypoxia
A

B. anemic hypoxia (not enough hgb to carry)

150
Q

Each gram of hemoglobin can carry how much oxygen

A

1.34 ml

151
Q

The normal antomical shunt is about

A

2-5%

152
Q

Each heme group of a RBC can carr how many molecules oxygen

A

4

153
Q

You have a post op pt that is sedated and sleeping. You note that their SaO2 is 89% on 1 lpm NC. You increase the liter flow to 5lpm and the SaO2 increases to 95%. this is an ex of

A

Shunt-like effect due to hypoventilation

154
Q

A pt with a core body temp of 101.3 degrees F, will have a shift in the oxyhemoglobin dissociation curve to the

A

right

155
Q

Metabolizing tissue cells consume approx___ of O2 produce approx ___ of CO2 at rest

A

250ml/min and 200ml/min

156
Q

89% of the CO2 transport is provided by

A

RBC transport system

157
Q

The single biggest carrier (63%) of CO2 is the

A

bicarbonate in the RBCs

158
Q

an substance that dissociates completely into H+ and an anion is a

A

strong acid

159
Q

Chemicals that neutralize acids and bases effect on the pH are called

A

buffers

160
Q

pH normal range

A

7.35-7.45

161
Q

PaCO2 normal range

A

35-45

162
Q

HCO3 normal range

A

21-26

163
Q

PaO2 normal range

A

80-100

164
Q

Respiratory compensation can occur much quicker than metabolic (renal) compensation T/F

A

True

165
Q

Common causes of Metabolic Acidosis might include

A

Lactic acidosis, Diarrhea, Ketoacidosis

166
Q

The PaCO2 level increases with both acute and chronic hypoventilation. How can you tell the difference
A. The pH is within the norm range, and the HCO3 is increased , with chronic
B. The pH is low, and the HCO3 is norm, with acute
C. the pH is low, and the HCO3 is low, with acute
D. A and B

A

D. A and B

167
Q

the pH of the human body is actually slightly

A

alkaloid

168
Q

Hypoventilation acidic or alk?

A

Acidic

169
Q

Hyperventilation acid or alk?

A

Alk

170
Q

Respiratory compensation usually occurs in how much time when the pH begins to fall?

A

instantly

Cardiopulmonary A & P (5 decks)

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