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Physiology I > Lung Diseases > Flashcards

Lung Diseases Flashcards

1
Q

Which lung disease is associated with lack of radial traction and larger lung volume?

A

Emphysema

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2
Q

Which lung disease is associated with excess radial traction and smaller lung volume?

A

Pulmonary Fibrosis

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3
Q

Which lung disease is associated with excess collagen and elastin?

A

Pulmonary Fibrosis

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4
Q

Which lung disease is associated with difficulty with inspiration? difficulty with expiration?

A

Difficulty with inspiration: pulmonary fibrosis

Difficulty with expiration: emphysema

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5
Q

Why is FEV1/FEV is slightly higher in restrictive lung diseases such as pulmonary fibrosis?

A

Airways open during expiration

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6
Q

Elastic recoil is due to _________ _____ at air-liquid interface

A

surface tension

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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
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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)

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9
Q

Surfactant reduces surface tension to a greater extent in small alveoli and prevents ____

A

atelectasis (alveoli collapse)

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10
Q

Surfactant reduces surface tension and ___ lung compliance while also ___ inspiratory work

A

increases; reducing

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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

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12
Q

The lung has ___ elastic recoil that facilitates ____

A

inwards; exhalation

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13
Q

The chest wall has ___elastic recoil that facilitates ____

A

outward; inspiration

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14
Q

Changes in ventilation rate have an ____effect on PACO2

A

inverse

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15
Q

How do you calculate RQ?

A

CO2 produced / O2 consumed

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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

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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

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18
Q

What lung disease is associated with chronic airway irritation replaces lung tissue with fibrous tissue

A

Pulmonary Fibrosis

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19
Q

What lung disease is associated with inflammatory fluid accumulation within ALVEOLI?

A

Pneumonia

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20
Q

Across the pulmonary capillaries, the oxygen partial pressure gradient from alveoli to blood = ___ (100 to __)

A

60 (100 to 40)

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21
Q

Across the pulmonary capillaries, CO2 partial pressure gradient from blood to alveoli = ___ (46 to __)

A

6 (46 to 40)

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22
Q

Across the systemic capillaries, O2 pressure gradient from blood to tissue cell = __ (100 to 40)

A

60 mmHg

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23
Q

Across the systemic capillaries, CO2 partial pressure gradient from tissue cell to blood is = ___ (46 to 40)

A

6 mmHg

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24
Q

What is normal alveolar PO2? What is PvO2?

A

100 mmHg; 40 mmHg (therefore: alveolar to blood PO2 gradient = 60 mmHg)

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25
Q

Arterial blood (which moves along the ___capillaries) has a PaO2 of ____

A

pulmonary ; 100 mmHg

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26
Q

Venous blood (which moves along the ___ capillaries) has a PvO2 of ____

A

systemic; 40 mmHg

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27
Q

At a lower PvO2 (which can occur if you are exercising) ~70% of O2 can be extracted, which is also known as ___

A

unloading

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28
Q

What is the significance of the broad plateau region of the oxygen-dissociation curve?

A

Over a broad range of pressures, you can achieve roughly 90-100% saturation

-The plateau assures saturation of Hb

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29
Q

What is the significance of the steep region of the oxygen-dissociation curve, which is near the systemic capillaries?

A

Small shift in PO2 causes significant unloading/delivery of O2 to tissues

-The steep enables greater unloading

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30
Q

True or False:
Oxygen binds to Hb in a linear fashion

A

False
in a sigmoidal fashion

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31
Q

In pulmonary capillaries, there is a ___ affinity for O2. However, in the systemic capillaries/tissues, there is a ___ affinity

A

high; low

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32
Q

True or False:
Hemoglobin’s affinity for O2 is measured by the pressure required to saturate Hb by 50%

A

True

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33
Q

What four variables cause a right shift?

A

1) Increase temperature
2) Increase PO2
3) Increased 2,3 DPG
4) Decrease pH

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34
Q

Does a left or right shift cause decreased Hb affinity?

A

Right shift

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35
Q

How does decreasing the Hb affinity affect P50?

A

Decreasing Hb affinity will increase P50

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36
Q

The ____ Effect is the rightward shift of the ODC due to a fall in pH

A

The Bohr Effect

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37
Q

How does a left shift of the oxygen-Hb dissociation curve affect hemoglobin affinity and P50?

A

Increase Hb affinity, decreases P50

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38
Q

Blood Oxygen Content = ____ + _____

A

Dissolved O2 + Bound HbO2

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39
Q

What three factors is blood oxygen content dependent on?

A

1) PO2/gas solubility
2) Hb concentration
3) Hb-O2 saturation

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40
Q

What type of hypoxia can decrease PAO2/PIO2 levels and can occur during hypoventilation or at elevated altitudes?

A

Hypoxic Hypoxia

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41
Q

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.

A

Anemic Hypoxia

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42
Q

What type of hypoxia is associated with reduced tissue blood flow?

A

Hypoperfusion Hypoxia

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43
Q

What type of hypoxia occurs if a toxic substance interferes with the ability of tissues to utilize O2, such as cyanide

A

Histotoxic Hypoxia

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44
Q

Deoxyhemoglobin has a greater affinity for CO2 than oxyhemoglobin. This is known as the ___ Effect

A

Haldane Effect

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45
Q

CO2 is converted to bicarbonate via ______, which accounts for 90%!!! of CO2 transport. Where does this reaction occur?

A

Carbonic Anhydrase
-reaction occurs in RBC’s

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46
Q

What occurs when there is a surplus of CO2 in the tissue?

A

CO2 will join with water to make carbonic acid. From here, hydrogen and bicarbonate form
(H + HCO3-)

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47
Q

True or False:
Tissue cells use CO2 and produce O2

A

False
Tissue cells produce CO2 and use O2

48
Q

What happens to Cl- in carbon dioxide exchange when it occurs in the systemic circulation (tissue cell / RBC)?

A

Cl ENTERS the RBC while HCO3 LEAVES the RBC to maintain electrical neutrality (chloride shift)

49
Q

The decrease in oxygen affinity of Hb when the pH of the blood falls is called ______Effect

A

the Bohr Effect

50
Q

The fact that deoxygenation of the Hb increases its ability to carry CO2 is known as ____Effect

A

Haldane Effect

51
Q

In the tissues, both the Bohr Effect and Haldane Effect work together in the tissues to increase ___ delivery and ___ uptake

A

O2; CO2

52
Q

In the lung, CO2 is exhaled and pH ____, which ____ Hb-O2 saturability, which increases Hb-O2 saturation and facilitates CO2 unloading from Hb

A

increases; increases

53
Q

In the lungs, both the Bohr Effect and the Haldane Effect work together to maximize ____ uptake and ___ delivery

A

O2; CO2

54
Q

When blood enters the pulmonary arteriole, is it deoxygenated or oxygenated?

A

Deoxygenated

55
Q

When blood leaves the pulmonary venule, is it oxygenated or deoxygenated?

A

Oxygenated

56
Q

The pulmonary artery has ___ blood

A

deoxygenated

57
Q

The pulmonary vein has ___ blood

A

oxygenated

58
Q

The pulmonary circulation feeds into structures where _____ ____ is occuring

A

gas exchange

59
Q

True or False: The lung require their own circulatory system

A

True - bronchial circulation

60
Q

What bronchial structure delivers oxygenated blood to larger lung structures?

A

Bronchial arteries

61
Q

Deoxygenated blood is collected by the _____and intercostal veins and sent to the ____ atrium

A

azygos; right atrium

62
Q

True or False: The pulmonary and bronchial circulations are innerconnected

A

True

63
Q

Define left-right shunt:

A

Left-Right Shunt: Oxygenated blood mixing with de-oxygenated blood

64
Q

When deoxygenated blood mixes with oxygenated arterial blood, it is called a _______-_____ shunt

A

Right to Left
(Blood from right ventricle going into the left)

65
Q

Which has a greater pressure - pulmonary or systemic circulation?

A

Systemic circulation

66
Q

Why are the walls of the pulmonary artery and its branches thinner and contain less smooth muscle elastin than the walls of the aorta?

A

Because the mean pulmonary pressure is significantly lower than the mean aortic pressure

67
Q

True or False: Pulmonary arterioles are very thin and contain a great deal of smooth muscle

A

False - pulmonary arterioles are very thin. However, they contain little smooth muscle.

68
Q

True or False: Systemic arterioles have very thin walls composed mainly of circulatory arranged smooth muscle

A

False -
Systemic arterioles have very thick walls composed mainly of circulatory arranged smooth muscle

69
Q

True or False: The pulmonary arterioles do not have the same capacity for vasoconstriction as systemic arterioles

A

True

70
Q

True or False: The pulmonary veins are thick and contain a great deal of smooth muscle

A

False - the pulmonary veins are very thin and possess little smooth muscle

71
Q

Because flow (Q) is high, the pressure in the pulmonary circulation is ___, which means that resistance is very ____

A

low; very low

72
Q

Why is the pulmonary circulation low resistance system?

A

The relatively low smooth muscle tone in the pulmonary arterioles (distension) and the large cross sectional area of the pulmonary capillaries (recruitment)

73
Q

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.

A

decreases

74
Q

What part of the lung receives more blood flow per unit volume - the apex or the base? Why?

A

The base receives more blood. Regional differences in blood flow are due to the effects of gravity

75
Q

Why does gravity produce this gradient of pulmonary blood flow?

A

1) Hydrostatic pressures within pulmonary vessels
2) Effects of Starling resistors

76
Q

Blood flow through a systemic capillary only depends on the difference between ____ and ___ pressure

A

arterial and venous

77
Q

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?

A

There will be no blood flow

78
Q

Alveolar vessels are exposed to surrounding alveolar pressure. Flow through these vessels is determine by the relationship between ____ pressure and pressure within them.

A

alveolar

79
Q

______ 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 ___

A

Extra-alveolar; inspiration

80
Q

True or False: Pulmonary capillaries are also known as alveolar vessels

A

True

81
Q

True or False: Hypoxia induces pulmonary vasodilation

A

False
Hypoxia induces pulmonary vasoconstriction

82
Q

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 ____

A

vascular smooth muscle; ventilated; pneumonia

83
Q

Why does blood flow decline as alveolar PO2 declines?

A

Increased resistance in hypoxic lung areas

84
Q

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?

A

vasoconstriction

-Increases pulmonary vascular resistance

85
Q

Which part of the lungs receives greater ventilation per unit volume?

A

The base of the lung

86
Q

Why are there regional differences in ventilation?

A

Gravity

87
Q

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 ___

A

compressed; expanded

88
Q

The weight of the lungs tends to compress the ____space at the base of the lungs, creating a vertical distribution of intrapleural pressure

A

intrapleural space

89
Q

Where is the intrapleural pressure slightly less negative (greater) - the base of the lung or the apex?

A

The base of the lungs

90
Q

What happens at the BASE of the lung when one inhales? Airways are more __ and intra-pleural pressure is more ____

A

open ; negative

91
Q

What happens at the apex of the lung when one inhales? Airways are ____ and intrapleural pressure is less ___

A

compressed; intrapleural pressure

92
Q

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

A

volume

93
Q

Although an alveolus at the base of the lung has a small resting volume, it has greater expansion during _____

A

inspiration

94
Q

At FRC, an alveolus at the APEX of the lung has a higher resting volume than the alveolus at the base. Why is this?

A

Because there’s less lung tissue above it and there’s a large expanding pressure because the intrapleural pressure is more negative

95
Q

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

A

smaller

96
Q

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 _____

A

Inspiration

97
Q

Which are better ventilated - the alveolus at the base of the lungs or the apex?

A

Alveolus at the base of the lungs

98
Q

Mechanically, why is ventilation greater at the base?

A

1) Airway at the base is more compliant!
2) Starting volume

99
Q

Ventilation and perfusion are both influenced by ___. Both are lowest at ____ and greatest at ___of the lung

A

gravity; apex; base

100
Q

Ventilation to Perfusion Ration (V/Q) is highest at the ___ of the lung and lowest at the ___ of the lung

A

apex; base

101
Q

When a person stands in an upright position, the rate of change in perfusion is ___ than the corresponding rate of change in ventilation

A

greater

102
Q

What does it mean if V/Q is greater than 1? Less than 1?

A

V/Q greater than 1 = more ventilation than perfusion

V/Q less than 1 = more perfusion than ventilation

103
Q

What does it mean if V/Q is greater than 1? Less than 1?

A

V/Q greater than 1 = more ventilation than perfusion

V/Q less than 1 = more perfusion than ventilation

104
Q

What part of the lung is over-ventilated? Over-perfused?

A

Over-ventilated (apex)
Over-perfused (base)

105
Q

What occurs if you have NO ventilation (but have perfusion)? What affect does it have on V/Q?

A

-V/Q = approaches zero

-Right to Left Shunt
(deoxygenated blood enters, no gas exchange, then enters into blood that’s been oxygenated)

106
Q

In an alveolus that is ventilated but receives no perfusion, V/Q will be ___

A

infinity

107
Q

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

A

the same

108
Q

In a situation with no perfusion, the alveolar PO2 and PCO2 will be the ____ as the inspired air

A

the same

109
Q

True or False: For gas exchange to occur between alveoli and pulmonary capillary bed, there must be both ventilation and perfusion

A

True

110
Q

Why is there reduced gas exchange at the apex?

A

High V/Q ratio but low perfusion

111
Q

Will the PAO2 and PACO2 in the alveoli at the apex of the lung be high or low?

A

PAO2: high
PACO2: low

112
Q

Why will any blood that passes through the pulmonary capillary beds at the apex of the lung become well-oxygenated?

A

Due to the high PAO2

113
Q

The base of the lung has a relatively low V/Q ratio - what does that mean for ventilation and perfusion?

A

Alveoli at the base of the lung receive more ventilation and perfusion compared to apex

114
Q

In the alveoli at the BASE of the lung, PAO2 will be ___ while PACO2 will be ___

A

PAO2: Low
PACO2: High

115
Q

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

A

O2 ; CO2 output

Physiology I (5 decks)

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