Lung Diseases Flashcards
1
Q
Which lung disease is associated with lack of radial traction and larger lung volume?
A
Emphysema
2
Q
Which lung disease is associated with excess radial traction and smaller lung volume?
A
Pulmonary Fibrosis
3
Q
Which lung disease is associated with excess collagen and elastin?
A
Pulmonary Fibrosis
4
Q
Which lung disease is associated with difficulty with inspiration? difficulty with expiration?
A
Difficulty with inspiration: pulmonary fibrosis
Difficulty with expiration: emphysema
5
Q
Why is FEV1/FEV is slightly higher in restrictive lung diseases such as pulmonary fibrosis?
A
Airways open during expiration
6
Q
Elastic recoil is due to _________ _____ at air-liquid interface
A
surface tension
7
Q
True or False:
For a constant surface tension, a smaller alveoli will collapse and its air will enter into the bigger one
A
8
Q
True or False: In the presence of surfactant, surface tension increases and the smaller alveolar will collapse
A
False - In the presence of surfactant, surface tension decreases and the smaller alveolar will NOT collapse (alveolar stability)
9
Q
Surfactant reduces surface tension to a greater extent in small alveoli and prevents ____
A
atelectasis (alveoli collapse)
10
Q
Surfactant reduces surface tension and ___ lung compliance while also ___ inspiratory work
A
increases; reducing
11
Q
True or False:
Surfactant reduces surface tension, which increases fluid accumulation in alveoli
A
False
Surfactant reduces surface tension, which REDUCES fluid accumulation in alveoli
12
Q
The lung has ___ elastic recoil that facilitates ____
A
inwards; exhalation
13
Q
The chest wall has ___elastic recoil that facilitates ____
A
outward; inspiration
14
Q
Changes in ventilation rate have an ____effect on PACO2
A
inverse
15
Q
How do you calculate RQ?
A
CO2 produced / O2 consumed
16
Q
The rate of gas exchange is dependent on what four factors?
A
1) pressure gradient
2) SA for diffusion
3) solubility of gases
4) thickness of alveolar membrane
17
Q
What lung condition is associated with an increase in INTERSTITIAL fluid due to increase in vascular permeability or pulmonary pressure (congestive heart failure)?
A
Pulmonary edema
18
Q
What lung disease is associated with chronic airway irritation replaces lung tissue with fibrous tissue
A
Pulmonary Fibrosis
19
Q
What lung disease is associated with inflammatory fluid accumulation within ALVEOLI?
A
Pneumonia
20
Q
Across the pulmonary capillaries, the oxygen partial pressure gradient from alveoli to blood = ___ (100 to __)
A
60 (100 to 40)
21
Q
Across the pulmonary capillaries, CO2 partial pressure gradient from blood to alveoli = ___ (46 to __)
A
6 (46 to 40)
22
Q
Across the systemic capillaries, O2 pressure gradient from blood to tissue cell = __ (100 to 40)
A
60 mmHg
23
Q
Across the systemic capillaries, CO2 partial pressure gradient from tissue cell to blood is = ___ (46 to 40)
A
6 mmHg
24
Q
What is normal alveolar PO2? What is PvO2?
A
100 mmHg; 40 mmHg (therefore: alveolar to blood PO2 gradient = 60 mmHg)
25
Arterial blood (which moves along the ___capillaries) has a PaO2 of ____
pulmonary ; 100 mmHg
26
Venous blood (which moves along the ___ capillaries) has a PvO2 of ____
systemic; 40 mmHg
27
At a lower PvO2 (which can occur if you are exercising) ~70% of O2 can be extracted, which is also known as ___
unloading
28
What is the significance of the broad plateau region of the oxygen-dissociation curve?
Over a broad range of pressures, you can achieve roughly 90-100% saturation
-The plateau assures saturation of Hb
29
What is the significance of the steep region of the oxygen-dissociation curve, which is near the systemic capillaries?
Small shift in PO2 causes significant unloading/delivery of O2 to tissues
-The steep enables greater unloading
30
True or False:
Oxygen binds to Hb in a linear fashion
False
in a sigmoidal fashion
31
In pulmonary capillaries, there is a ___ affinity for O2. However, in the systemic capillaries/tissues, there is a ___ affinity
high; low
32
True or False:
Hemoglobin's affinity for O2 is measured by the pressure required to saturate Hb by 50%
True
33
What four variables cause a right shift?
1) Increase temperature
2) Increase PO2
3) Increased 2,3 DPG
4) Decrease pH
34
Does a left or right shift cause decreased Hb affinity?
Right shift
35
How does decreasing the Hb affinity affect P50?
Decreasing Hb affinity will increase P50
36
The ____ Effect is the rightward shift of the ODC due to a fall in pH
The Bohr Effect
37
How does a left shift of the oxygen-Hb dissociation curve affect hemoglobin affinity and P50?
Increase Hb affinity, decreases P50
38
Blood Oxygen Content = ____ + _____
Dissolved O2 + Bound HbO2
39
What three factors is blood oxygen content dependent on?
1) PO2/gas solubility
2) Hb concentration
3) Hb-O2 saturation
40
What type of hypoxia can decrease PAO2/PIO2 levels and can occur during hypoventilation or at elevated altitudes?
Hypoxic Hypoxia
41
In _____, a type of hypoxia, PO2 is normal but Hb concentration is low and there is decreased oxygen carrying capacity and O2 content. This can occur with CO Poisioning.
Anemic Hypoxia
42
What type of hypoxia is associated with reduced tissue blood flow?
Hypoperfusion Hypoxia
43
What type of hypoxia occurs if a toxic substance interferes with the ability of tissues to utilize O2, such as cyanide
Histotoxic Hypoxia
44
Deoxyhemoglobin has a greater affinity for CO2 than oxyhemoglobin. This is known as the ___ Effect
Haldane Effect
45
CO2 is converted to bicarbonate via ______, which accounts for 90%!!! of CO2 transport. Where does this reaction occur?
Carbonic Anhydrase
-reaction occurs in RBC's
46
What occurs when there is a surplus of CO2 in the tissue?
CO2 will join with water to make carbonic acid. From here, hydrogen and bicarbonate form
(H + HCO3-)
47
True or False:
Tissue cells use CO2 and produce O2
False
Tissue cells produce CO2 and use O2
48
What happens to Cl- in carbon dioxide exchange when it occurs in the systemic circulation (tissue cell / RBC)?
Cl ENTERS the RBC while HCO3 LEAVES the RBC to maintain electrical neutrality (chloride shift)
49
The decrease in oxygen affinity of Hb when the pH of the blood falls is called ______Effect
the Bohr Effect
50
The fact that deoxygenation of the Hb increases its ability to carry CO2 is known as ____Effect
Haldane Effect
51
In the tissues, both the Bohr Effect and Haldane Effect work together in the tissues to increase ___ delivery and ___ uptake
O2; CO2
52
In the lung, CO2 is exhaled and pH ____, which ____ Hb-O2 saturability, which increases Hb-O2 saturation and facilitates CO2 unloading from Hb
increases; increases
53
In the lungs, both the Bohr Effect and the Haldane Effect work together to maximize ____ uptake and ___ delivery
O2; CO2
54
When blood enters the pulmonary arteriole, is it deoxygenated or oxygenated?
Deoxygenated
55
When blood leaves the pulmonary venule, is it oxygenated or deoxygenated?
Oxygenated
56
The pulmonary artery has ___ blood
deoxygenated
57
The pulmonary vein has ___ blood
oxygenated
58
The pulmonary circulation feeds into structures where _____ ____ is occuring
gas exchange
59
True or False: The lung require their own circulatory system
True - bronchial circulation
60
What bronchial structure delivers oxygenated blood to larger lung structures?
Bronchial arteries
61
Deoxygenated blood is collected by the _____and intercostal veins and sent to the ____ atrium
azygos; right atrium
62
True or False: The pulmonary and bronchial circulations are innerconnected
True
63
Define left-right shunt:
Left-Right Shunt: Oxygenated blood mixing with de-oxygenated blood
64
When deoxygenated blood mixes with oxygenated arterial blood, it is called a _______-_____ shunt
Right to Left
(Blood from right ventricle going into the left)
65
Which has a greater pressure - pulmonary or systemic circulation?
Systemic circulation
66
Why are the walls of the pulmonary artery and its branches thinner and contain less smooth muscle elastin than the walls of the aorta?
Because the mean pulmonary pressure is significantly lower than the mean aortic pressure
67
True or False: Pulmonary arterioles are very thin and contain a great deal of smooth muscle
False - pulmonary arterioles are very thin. However, they contain little smooth muscle.
68
True or False: Systemic arterioles have very thin walls composed mainly of circulatory arranged smooth muscle
False -
Systemic arterioles have very thick walls composed mainly of circulatory arranged smooth muscle
69
True or False: The pulmonary arterioles do not have the same capacity for vasoconstriction as systemic arterioles
True
70
True or False: The pulmonary veins are thick and contain a great deal of smooth muscle
False - the pulmonary veins are very thin and possess little smooth muscle
71
Because flow (Q) is high, the pressure in the pulmonary circulation is ___, which means that resistance is very ____
low; very low
72
Why is the pulmonary circulation low resistance system?
The relatively low smooth muscle tone in the pulmonary arterioles (distension) and the large cross sectional area of the pulmonary capillaries (recruitment)
73
When pulmonary arterial or venous pressure increases, pulmonary vascular resistance ____. This effect is due to recruitment of new pulmonary beds and distension of already open pulmonary vessels.
decreases
74
What part of the lung receives more blood flow per unit volume - the apex or the base? Why?
The base receives more blood. Regional differences in blood flow are due to the effects of gravity
75
Why does gravity produce this gradient of pulmonary blood flow?
1) Hydrostatic pressures within pulmonary vessels
2) Effects of Starling resistors
76
Blood flow through a systemic capillary only depends on the difference between ____ and ___ pressure
arterial and venous
77
In the lungs, if the surrounding alveolar pressure is greater than the arterial pressure, the capillary will be squeezed shut. What will happen to blood flow?
There will be no blood flow
78
Alveolar vessels are exposed to surrounding alveolar pressure. Flow through these vessels is determine by the relationship between ____ pressure and pressure within them.
alveolar
79
______ vessels include all arteries/veins that run through lung parenchyma. These vessels are pulled open by radial traction of surrounding tissue and are enlarged with ___
Extra-alveolar; inspiration
80
True or False: Pulmonary capillaries are also known as alveolar vessels
True
81
True or False: Hypoxia induces pulmonary vasodilation
False
Hypoxia induces pulmonary vasoconstriction
82
Hypoxic regions in the lung induce ____ ____ contraction, which shunts blood to regions of the lung that are better ____. This is beneficial in conditions, such as ____
vascular smooth muscle; ventilated; pneumonia
83
Why does blood flow decline as alveolar PO2 declines?
Increased resistance in hypoxic lung areas
84
In global hypoxia, such as occurs at high altitude, hypoxic pulmonary ____ constricts pulmonary arterioles throughout entire pulmonary circulation. How does this affect pulmonary vascular resistance?
vasoconstriction
-Increases pulmonary vascular resistance
85
Which part of the lungs receives greater ventilation per unit volume?
The base of the lung
86
Why are there regional differences in ventilation?
Gravity
87
The tissue at the base of the lungs is relatively ____ by the weight of the tissue above it while the apex of the lung is relatively ___
compressed; expanded
88
The weight of the lungs tends to compress the ____space at the base of the lungs, creating a vertical distribution of intrapleural pressure
intrapleural space
89
Where is the intrapleural pressure slightly less negative (greater) - the base of the lung or the apex?
The base of the lungs
90
What happens at the BASE of the lung when one inhales? Airways are more __ and intra-pleural pressure is more ____
open ; negative
91
What happens at the apex of the lung when one inhales? Airways are ____ and intrapleural pressure is less ___
compressed; intrapleural pressure
92
At FRC, an alveolus at the base of the lung is on the steep part of the compliance curve. Therefore: any change in intrapleural pressure will produce a large increase in the ___ of that alveoli
volume
93
Although an alveolus at the base of the lung has a small resting volume, it has greater expansion during _____
inspiration
94
At FRC, an alveolus at the APEX of the lung has a higher resting volume than the alveolus at the base. Why is this?
Because there's less lung tissue above it and there's a large expanding pressure because the intrapleural pressure is more negative
95
Since the alveolus at the apex of the lung is also on a less steep part of the compliance curve, this meaning that there will be a ____increase in the volume for that alveolus for any change in intrapleural pressure
smaller
96
Although an alveolus at the APEX of the lung has a larger resting volume than the alveolus at the BASE, it has reduced expansion during _____
Inspiration
97
Which are better ventilated - the alveolus at the base of the lungs or the apex?
Alveolus at the base of the lungs
98
Mechanically, why is ventilation greater at the base?
1) Airway at the base is more compliant!
2) Starting volume
99
Ventilation and perfusion are both influenced by ___. Both are lowest at ____ and greatest at ___of the lung
gravity; apex; base
100
Ventilation to Perfusion Ration (V/Q) is highest at the ___ of the lung and lowest at the ___ of the lung
apex; base
101
When a person stands in an upright position, the rate of change in perfusion is ___ than the corresponding rate of change in ventilation
greater
102
What does it mean if V/Q is greater than 1? Less than 1?
V/Q greater than 1 = more ventilation than perfusion
V/Q less than 1 = more perfusion than ventilation
103
What does it mean if V/Q is greater than 1? Less than 1?
V/Q greater than 1 = more ventilation than perfusion
V/Q less than 1 = more perfusion than ventilation
104
What part of the lung is over-ventilated? Over-perfused?
Over-ventilated (apex)
Over-perfused (base)
105
What occurs if you have NO ventilation (but have perfusion)? What affect does it have on V/Q?
-V/Q = approaches zero
-Right to Left Shunt
(deoxygenated blood enters, no gas exchange, then enters into blood that's been oxygenated)
106
In an alveolus that is ventilated but receives no perfusion, V/Q will be ___
infinity
107
In a situation with no ventilation, the PO2 an PCO2 of the blood LEAVING the pulmonary capillary will be ____ as blood ENTERING the pulmonary capillary
the same
108
In a situation with no perfusion, the alveolar PO2 and PCO2 will be the ____ as the inspired air
the same
109
True or False: For gas exchange to occur between alveoli and pulmonary capillary bed, there must be both ventilation and perfusion
True
110
Why is there reduced gas exchange at the apex?
High V/Q ratio but low perfusion
111
Will the PAO2 and PACO2 in the alveoli at the apex of the lung be high or low?
PAO2: high
PACO2: low
112
Why will any blood that passes through the pulmonary capillary beds at the apex of the lung become well-oxygenated?
Due to the high PAO2
113
The base of the lung has a relatively low V/Q ratio - what does that mean for ventilation and perfusion?
Alveoli at the base of the lung receive more ventilation and perfusion compared to apex
114
In the alveoli at the BASE of the lung, PAO2 will be ___ while PACO2 will be ___
PAO2: Low
PACO2: High
115
Because of the greater perfusion at the base there will be more ___ uptake and more ___ output will occur at the base compared to the apex
O2 ; CO2 output
