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Respiratory > First Aid Physiology > Flashcards

First Aid Physiology Flashcards

1
Q

What structures make up the conducting zone?

A
  • Large Airways
    • Nose
    • Pharynx
    • Larynx
    • Trachea
    • Bronchi
  • Small Airways
    • Bronchioles
    • Terminal bronchioles
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2
Q

How far do the cartilage and goblets cells extend?

A

To the end of the bronchi

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3
Q

How far does the pseudostratified, ciliated, columnar cells extend?

A

To the beginning of the terminal bronchioles

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4
Q

What epithelium is found in the terminal bronchioles?

A

Cuboidal cells

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5
Q

What structures make up the respiratory zone?

A
  • Lung parenchyma
    • Respiratory bronchioles
    • Alveolar ducts
    • Alveoli
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6
Q

What type of epithelium is found in the respiratory bronchioles? Alveolar ducts and Alveoli?

A

Cuboidal

Simple squamous

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7
Q

What defense mechanism is found in the respiratory zone?

A

Alveolar Macrophages

NO cilia

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8
Q

What are the 3 types of pneumocytes found in the lung? Which is most numerous? Which have a proliferative capacity? Which are involved in surfactant production?

A
  1. Type I - most numerous
  2. Type II - stem cells/surfactant
  3. Club (Clara) - granules/secrete component of surfactant
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9
Q

What is the equation for collapsing pressure?

A

CP = 2(surface tension)/radius

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10
Q

When does surfactant synthesis begin? When is it considered adequate?

A

Week 26

Week 35 or L:S ratio of > 2 in amniotic fluid

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11
Q

Where does a peanut go when you’re standing? Lying down?

A

Lower portion of R inferior lobe

Superior portion of R inferior lobe

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12
Q

What inervates the diaphragm?

A

C3, 4, and 5 - Phrenic Nerve

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13
Q

What structures perforate the diaphragm?

A

IVC - T8

Esophagus and Vagus - T10

Aorta, Thoracic Duct, and Azygos Vein - T12

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14
Q

Where is pain from the diaphragm referred to? What might cause it?

A

Shoulder (C5), trapezius ridge (C3, C4)

Air or blood in peritoneal cavity

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15
Q

What does inspiratory reserve volume represent?

A

Air that can still be breathed in after a normal inspiration

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16
Q

What does expiratory reserve volume represent?

A

Air that can still be breathed out after a normal expiration

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17
Q

What does tidal volume represent?

A

Air that moves into the lung w/ each inspiration ~500 mL

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18
Q

What does residual volume represent?

A

Air remaining in lung after maximal expiration - cannot be measured w/ spirometry

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19
Q

What determines inspiratory capacity?

A

TV + IRV

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20
Q

What determines Vital Capacity?

A

ERV + TV + IRV

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21
Q

What determines Total Lung Capacity?

A

RV + ERV + TV + IRV

22
Q

What determines Functional Residual Capacity?

A

RV + ERV

23
Q

How do you calculate the physiologic dead space (VD)?

A

**VD= VT [(PaCO2 - PECO2) / PaCO2] **

Taco, Paco, PEco, Paco

Peco = expired air

24
Q

Minute Ventilation (VE)

A

Total volume of gas entering lungs/min

VT * RR

25
Q

Alveolar ventilation (VA)

A

Volume of gas/unit time that reaches the alveoli

(VT- VD) * RR

26
Q

At FRC, what are the airway and alveolar pressure? Intrapleural pressure?

A

Airway and alveolar pressure = 0

Intrapleural pressure = negative

27
Q

Compliance

A

Δ lung volume / Δ pressure

↑ compliance → ↑Δ lung volume for a given ΔP

28
Q

Which disease processes ↑ compliance?

A

Obstructive diseases i.e. emphysema > asthma > bronchiectasis

Normal aging

29
Q

What diseases ↓ compliance?

A

Restrictive: Pulmonary fibrosis

Pneumonia

Pulmonary Edema

30
Q

What form of Hb has a lower affinity for O2? Where is it found? What induces this?

A

T (taut) - tissues

↑Cl, H, CO2, 2,3-BPG, temperature

“Right” shift

31
Q

What is methemoglobin? How does it present? How do you treat it?

A

Oxidized Hb (Ferric/Fe3+) — Doesn’t bind O2 - binds cyanide

Cyanosis and chocolate colored blood

Methylene blue

32
Q

How do you treat cyanide poisoning?

A
  1. Nitrites: oxidize Hb → bind cyanide
  2. **Thiosulfate: **​bind cyanide → thiocyanate (renally excreted)
33
Q

What is carboxyhemoglobin?

A

Hb bound tight to CO - locked in R state

Left Shift

34
Q

True or False: O2content of arterial blood decreases as Hb falls, but O2 saturation and arterial PO2 do not.

A

True

35
Q

What is perfusion limited? How do you increase diffusion?

A

O2normal health

Gas equilibrates early along length of capillary

Inc. blood flow

36
Q

Diffusion limited

A

Gas does not equilibrate by the time blood reaches the end of the capillary

O2 (emphysema, fibrosis)

37
Q

How do you calculate pulmonary vascualr resistance?

A

(Ppulm artery - PL atrium) / CO

38
Q

What is another word for PL atrium?

A

Pulmonary wedge pressure

39
Q

What is a normal A-a gradient? What would cause an increase?

A

10-15 (PAO2 - PaO2)

Hypoxemia: shunting, V/Q mismatch, fibrosis

40
Q

Does all hypoxemia cuase an ↑ A-a gradient?

A

No. High altitude and hypoventilation

41
Q

What is the significance that the apex of the lung has a V/Q of 3

A

Over-ventilated/Under-perfused

TB likes it here

42
Q

What is the signficance that the base of the lung has a V/Q of .6?

A

Under ventilated/over-perfused

43
Q

When does the V/Q = 0?

A

Airway obstruction - shunt

i.e. 100% O2 won’t help PO2

44
Q

When does the V/Q = ∞?

A

Blood flow obstruction - physiologic dead space

100% O2 will improve PO2

45
Q

Where are ventilation and perfusion greatest?

A

Base of the lung

46
Q

In what 3 forms is CO2 transported to the lungs from the tissues? Which is the most abundant?

A
  1. HCO3- | 90%
  2. Carbaminohemoglobin | 5%
  3. Dissolved CO2 | 5%
47
Q

In peripheral tissue, ↑H+ from tissue metabolism shifts curve to the right, unloading O2. What is this known as?

A

Bohrn Effect

48
Q

In the lungs, oxygenation of Hb promotes Hb dissociation of H+ from Hb. This shifts equilibrium toward CO2formation; therefore CO2 is released from RBCs. What is this known as?

A

Haldane Effect

49
Q

What is the enzyme that converts CO2 and H2O → H2CO3?

A

Carbonic anhydrase

50
Q

What is the response to high altitude?

A

↑ ventilation → resp. alkalosis

↑ erythorpoietin

↑2,3-BPG

↑ mitochondria

↑ renal excretion of HCO3 to compensate for the respiratory alkalosis

51
Q

Response to exercise?

A

↑ CO2 production, O2 consumption — No change in PaO2 and PaCO2

↑ venous CO2 content & ↓ venous O2 content

↑ ventilation to meet demand

V/Q ratio become more uniform

↑ pulmonary blood flow

↓ pH during strenuous exercise

Respiratory (6 decks)

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