HY

Question 1

pulmonary hypertension

Answer 1

mean pulmonary pressure > 25 mmHg at rest
>35 mmHg during exercise

(normal = 15 mmHg)

Question 2

pulmonary edema occurs when

Answer 2

pulmonary capillary pressure >25 mmHg

Question 3

calculate partial pressure of gas (O2, CO2) in a location

Answer 3

PO2 = (Ptotal - PH2O) x .21

Humidity (PH2O) changes based on location

.21 –> 21% oxygen in atmoshperic air

Question 4

total minute ventilation =

Answer 4

tidal vol x respiratory rate

normal: 5-6 L/min

Question 5

alveolar ventilation =

Answer 5

(tidal volume - dead space volume) x respiratory rate

Question 6

physiologic dead space =

Answer 6

=VD/VT

=(PaCO2-PECO2)/PaCO2

Question 7

PaCO2 =

Answer 7

VCO2/VA

VCO2: CO2 production
VA: alveolar ventilation

Question 8

transmural pressure =

Answer 8

P(alv) - P(intrapleural)

Question 9

categories of obstructive disease

Answer 9

FACES

Foreign body
Asthma
Chronic bronchitis/bronchiectasis
Emphysema
Small airways disease (bronchiolitis)

Question 10

PFT patterns: obstructive

Answer 10

FEV1: decr
FVC: decr
FEV1/FVC: decr (<70%)

(FEV1 decreases more than FVC)

Question 11

categories of restrictive disease

Answer 11

PAINT

Pleural disease
Alveolar filling process
Interstitial disease
Neuromuscular disease
Thoracic cage obesity

Question 12

PFT patterns: restrictive

Answer 12

FEV1: decr
FVC: decr
FEV1/FVC: normal or incr

(FEV1 and FVC decrease symmetrically)

Question 13

alveolar gas equation

Answer 13

PAO2 = FiO2(PB-PH2O) - PaCO2/R

Question 14

V/Q mismatch:
PaCO2?
A-a gradient?
Response to 100% O2?

Answer 14

PaCO2: variable
A-a gradient: wide
Response to 100% O2: >500 mmHg

Question 15

Shunt:
PaCO2?
A-a gradient?
Response to 100% O2?

Answer 15

PaCO2: decreased
A-a gradient: wide
Response to 100% O2: no/minimal

Question 16

Diffusion Abnormality:
PaCO2?
A-a gradient?
Response to 100% O2?

Answer 16

PaCO2: decreased
A-a gradient: wide
Response to 100% O2: improves

worse with exercise

Question 17

Hypoventilaition:
PaCO2?
A-a gradient?
Response to 100% O2?

Answer 17

PaCO2: INCREASED
A-a gradient: NORMAL
Response to 100% O2: improves

usually due to drug

Question 18

Reduced inspired O2 (FiO2, PiO2)
PaCO2?
A-a gradient?
Response to 100% O2?

Answer 18

PaCO2: decreased
A-a gradient: normal
Response to 100% O2: improves

high altitude, fire

Question 19

Pulmonary edema can occur when _____________ pressure is too high or _____________ pressure is too low

Answer 19

Pulmonary edema can occur when intravascular hydrostatic pressure is too high or intravascular oncotic pressure is too low

Question 20

Primary determinants of pulmonary arterial pressure

Answer 20

Pulmonary vascular resistance
Pulmonary blood flow
Left atrial pressure

Question 21

scalenes:

Innervation?
Action?
If paralyzed?

Answer 21

Scalenes:

Innervation: C4-C8

Action: moves upper rib cage up and out (pump handle)

Paralysis: upper rib cage paradox if diaphragm still active

Question 22

parasternals:

Innervation?
Action?
If paralyzed?

Answer 22

Parasternals:

T1-T5

Action: lifts upper rib cage

Paralysis: upper rib cage paradox

Question 23

intercostals

Innervation?
Action?
If paralyzed?

Answer 23

Intercostals:

T1-T12

External: inspiratory
Internal: expiratory

Paralysis: URC paradox, increased WOB

Over time, URC stiffens & paradox decreases

Question 24

abdominal muscles

Innervation?
Action?
If paralyzed?

Answer 24

Abdominals

T7-L1

Action: pull RC down and in; compress abd contents upwards; displaces diaphragm; decr lung volume

Paralysis: difficulty exhaling, looks similar to obstruction

Question 25

bulbar muscles

Innervation?
Action?
Flow volume loop?

Answer 25

Pharyngeal/Laryngeal Adductors

CN IX-XII, C1

Action: keep airway open on inspiration, help swallow

FVL: inspiratory gap