Lecture 22 - Pulmonary Ventilation

Question 1

These anatomical structures of the nasal cavity serve to humidify and warm incoming air. A. Uvulae B. Respiratory epithelium C. Nasal conchae D. Nasal blood vessels

Answer 1

C. Nasal conchae

Question 2

This region is comprised of psuedostratified columnar epithelium containing goblet cells. There is also incomplete cartilaginous rings. A. Carina B. Trachea C. Bronchi D. Lung lobes

Answer 2

B. Trachea

Question 3

This region is the branching of the trachea into the primary bronchi. It is sensitive to irritation and produces a cough reflex. A. Carina B. Trachea C. Bronchi D. Lung lobes

Answer 3

A. Carina

Question 4

These contain numerous branchings, is comprised of ciliated columnar epithelium, and numerous cartilaginous plates. A. Carina B. Trachea C. Bronchi D. Lung lobes

Answer 4

C. Bronchi

Question 5

This branching of the bronchi supplies the lungs. A. Primary B. Secondary C. Tertiary

Answer 5

A. primary

Question 6

Small (<1mm diameter) regions of the trachebronchiol tree. They lack cartilage and contain much smooth muscle.

Answer 6

Bronchioles

Question 7

This branching of the bronchi supplies lung lobules A. Primary B. Secondary C. Tertiary

Answer 7

C. tertiary

Question 8

Region of the tracheobronchial tree immediately preceding the region of gas exchange. A. Alveoli B. Tertiary bronchi C. Alveolar ducts D. Bronchioles

Answer 8

C. Alveolar ducts

Question 9

This branching of the bronchi supplies the lung lobes A. Primary B. Secondary C. Tertiary

Answer 9

B. secondary

Question 10

This muscle is the primary muscle of inhalation. During its contraction, it increases the volume of the chest cavity. A. Serratus anterior muscle B. Rectus abdominus C. Diaphragm D. External intercostal muscles

Answer 10

C. Diaphragm

Question 11

A patient is transported by EMS to the ED for severe respiratory distress. During report, the attending paramedic states the patient has “…significant accessory muscle use.” When examining the patient, which muscle would you know is being used that is not an accessory muscle? A. Serratus anterior muscle B. Rectus abdominus C. Diaphragm D. External intercostal muscles

Answer 11

C. Diaphragm

Question 12

Expiration occurs as an (active/passive process).

Answer 12

Passive. The relaxation of the respiratory diaphragm results in a decrease in chest cavity volume. This produces increased pressure, which causes exhalation.

Question 13

Contraction of the ____________ causes an increased vertical and anterior/posterior diameter of the chest cavity. A. external intercostals B. internal intercostals

Answer 13

A. external intercostals

Question 14

When relaxed, the accessory muscles ________ cause a decrease in chest cavity volume. A. external intercostals B. internal intercostals

Answer 14

B. internal intercostals

Question 15

More than two lung volumes is considered a _________.

Answer 15

capcity

Question 16

Non-overlapping, non-anatomical “sub-compartments” are known as lung _________

Answer 16

volumes

Question 17

maximum volume to which the lungs can be expanded with the greatest possible effort (about 5800 milliliters); equals vital capacity plus the residual volume

Answer 17

Total Lung Capacity

Question 18

Air inspired or expired with each breath at rest; equal to approximately 500 mL

Answer 18

Tidal volume

Question 19

The amount of air that can be inspired with forceful inspiration; is equal to approximately 3000 mL of air

Answer 19

Inspiratory reserve volume (IRV)

Question 20

Additional air that can be expired at end of tidal volume with forceful expiration; equal to approximately 1100 mL

Answer 20

Expiratory reserve volume (ERV)

Question 21

Air remaining after forceful expiration; appx. 1200 mL

Answer 21

Residual volume

Question 22

Answer 22

Question 23

4600 mL; is the sum of all volumes inhaled or expired. Inspiration to the maxiumum extent plus exhalation to the maximum extent.

Answer 23

Vital capacity

Question 24

5800 mL; sum of all volumes

Answer 24

Total lung capacity

Question 25

Tidal volume + IRV

Answer 25

inspiratory capacity

Question 26

Expiratory reserve volume + residiual volume

Answer 26

Functional reserve capacity

Question 27

A patient is in obvious respiratory distress. The patient’s family states he has been sick recently with an upper airway infection. The patient is noted to be breathing at a rate of 32 breaths per minute. He has a minute ventilation (Ve) of 8000mL/min. What is his tidal volume?

Answer 27

Ve = RR x TV

8,000mL/min = 32 BPM x TV

TV = (8000mL/min)/32 BPM

TV = 250 mL

Question 28

A patient has severe emphysema (a clinical condition where alveoli collapse and are unable to participate in gas exchange). During an emphysema flare-up, the patient is found breathing at 40 breaths per minute. Due to the emphysema, the patients tidal volume is reduced from 500 mL to 350 mL per breath. Alveolar ventilation is noted to be 1500 mL/min. What is the physiologic dead space present, if one assumes all dead space is physiological?

Answer 28

1500 mL/min = 40 BPM x (350 mL - x)

1500 mL/min = (14000 BPM/min) - 40(x)

1500 mL/min + 40BPM(x) = 14000 BPM/min

Question 29

This regions does not participate in gase exchange. What is its name and formula?

Answer 29

Dead space;

Vd = Vtotal x (PaCO2-PeCO2)/PaCO2

PaCO2= partial pressure of arterial CO2

PeCO2 = partial pressure of expired CO2

Question 30

Pressure between parietal and visceral pleura

Answer 30

pleural pressure

Question 31

Pressure within alveoli

Answer 31

alveolar pressure

Question 32

A patient has an alveolar pressure of 32 cm H2O and a pleural pressure of 16 cm H2O. What is the transpulmonary pressure?

Answer 32

P = Ppleural - Palveolar

P = 16-32

P = -16 cmH2O

Question 33

The volume to which lungs will expand for each unit of increase of transpulmonary pressure.

Answer 33

compliance

Question 34

Compliance is equal to:

Answer 34

distensibility x volume

Volume/Pressure = compliance

Question 35

In regard to surface tension, the water surface within alveoli lead to a tendencey for the alveoli to (contract/expand).

Answer 35

contract

Question 36

Surfactant is produced by:

A. Type I alveolar cells

B. Type II alveolar cells

C. Type III alveolar cells

D. Type IV alveolar cells

Answer 36

B. Type II

Question 37

The primary component of surfactant responsible for decreased alveolar surface tension is _____________.

A. Calcium

B. Water

C. Apoprotein

D. Phosphatidylcholine

Answer 37

D. Phosphatidylcholine

Question 38

If air flow into an alveolus is blocked, the alveoli collapses due to increased surface tension. What is the pressure inversely proportional to?

A. Surface tension

B. alveolar radius

C. Amount of CO2 present in the alvolus

Answer 38

B. alveolar radius