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Step 1 Respiratory-First Aid 2017 > Physiology > Flashcards

Physiology Flashcards

1
Q

Air that can still be breathed in after normal inspiration

A

Inspiratory reserve volume

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2
Q

Air that moves into lung with each quiet inspiration

A

Tidal volume

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3
Q

Volume breathed in during tidal volume

A

500 ml

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4
Q

Air that can still be breathed out after normal expiration

A

Expiratory Reserve Volume

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5
Q

Air that can still be exhaled after normal exhalation

A

Inspiratory Capacity

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6
Q

Lung volumes that make up IC

A

IRV + TV

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7
Q

Volume of gas in lungs after normal expiration

A

Functional Reserve Capacity

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8
Q

Lung volumes that make up FRC

A

ERV and RV

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9
Q

Maximum amount of gas that can be expired after a maximal inspiration

A

Vital Capacity

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10
Q

Lung volumes that make up VC

A

IRV, TV, ERV

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11
Q

Volume of gas present in lungs after a maximal expiration

A

Tidal Volume

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12
Q

Anatomic dead space of conducting airways plus alveolar dead space

A

Physiologic dead space

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13
Q

Formula for Physiologic dead space

A

V(D) = V(T) x PaCO2 - P(E)CO2/PaCO2

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14
Q

In healthy lungs what does physiologic dead space approximate

A

Anatomical dead space

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15
Q

When part of the respiratory zone becomes unable to perform gas exchange

A

Pathologic dead space

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16
Q

Formula for Ventilation

A

V(A) = V(E) - V(D)

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17
Q

Total volume of gas enter lungs per minute

A

Minute ventilation: V(E)

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18
Q

Formula for minute ventilation

A

V(E) = V(T) x RR

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19
Q

Volume of gas per unit time that reaches alveoli

A

Alveolar ventilation: V(A)

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20
Q

Formula for alveolar ventilation

A

V(A) = [V(T) - V(D)] x RR

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21
Q

Normal V(T) in healthy individuals

A

500 ml/breath

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22
Q

Normal physiologic dead space in healthy individuals

A

150 ml/breath

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23
Q

Tendency for lungs to collapse inward and chest wall to spring forward

A

Elastic recoil

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24
Q

When is pulmonary vascular resistance at minimum

A

at FRC

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25
Q

What is the airway and alveolar pressures at FRC

A

Zero

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26
Q

High compliance of lungs is seen in which conditions

A

Emphysema and aging

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27
Q

Low compliance of lungs is seen in which conditions

A

Pulmonary fibrosis, pneumonia, NRDS, pulmonary edema

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28
Q

At what lung capacity are inward pull of lungs balanced by outward pull of chest wall

A

FRC

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29
Q

At what lung capacity is respiratory system pressure atmospheric

A

FRC

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30
Q

Which form of hemoglobin has low affinity for O2

A

Deoxygenated form

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31
Q

What are the different conformations of hemoglobin

A

Tense and relaxed

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32
Q

Conformation of deoxygenated hemoglobin

A

Tense

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33
Q

Which form of hemoglobin has high affinity for O2

A

Relaxed

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34
Q

Cause for increased affinity for O2 in HbF

A

Decreased affinity for 2,3 BPG

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35
Q

Type of air flow found in median bronchi

A

Turbulent flow

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36
Q

Type of air flow found in terminal bronchioles

A

Slow laminar flow

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37
Q

Airways with highest airway resistance

A

Medium bronchi

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38
Q

Airways with lowest airway resistance

A

Terminal bronchioles

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39
Q

Presents with chocolate-colored blood and cyanosis

A

methemoglobinemia

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40
Q

Treatment for methemoglobinemia

A

Methylene blue and vitamin C

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41
Q

Form of iron in hemoglobin that bind O2

A

Fe2+ (reduced state)

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42
Q

Oxidized form of Hb that does not bind O2 as readily but has high affinity for cyanide

A

Methemoglobin

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43
Q

Treatment for cyanide poisoning

A

Nitrites followed by hydroxocobalamin and thiosulfate

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44
Q

When would you induce methemoglobinemia

A

In cyanide poisoning (excreted renally)

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45
Q

Form of Hb bound to CO in place of O2

A

Carboxyhemoglobin

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46
Q

Result of carboxyhemoglobin on O2-dissociation curve

A

Left shifts curve causing decreased O2 unloading to tissues

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47
Q

Treatment in patient presenting with headaches, dizziness and cherry-red skin after smoke exposure

A

100% O2 and hyperbaric chamber

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48
Q

Percentage of carboxyhemoglobin in healthy individuals

A

3%

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49
Q

Percentage of carboxyhemoglobin in smokers

A

10-15%

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50
Q

Percentage of carboxyhemoglobin in CO poisoning

A

Greater than 15%

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51
Q

Type of Hb in patient exposed to nitrites or benzocaine

A

Methemoglobin

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52
Q

Form of iron with decreased O2 affinity and increased cyanide affinity

A

Fe3+

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53
Q

Conditions that promote left-shift in O2-dissociation curve

A

Increased pH

Decreased temp, H+, CO2

54
Q

Conditions that promote right-shift in O2-dissociation curve

A

Decreased pH

Increased temp, H+, CO2

55
Q

What type of curve does HbF have

A

Left-shifted O2-dissociation curve

56
Q

O2 content formula

A

O2 content = (1.34 x Hb x SaO2) + (0.003 x PaO2)

57
Q

Amount of O2 1 g of Hb can bind

A

1.34 ml O2

58
Q

Normal amount of Hb in blood

59
Q

O2 saturation and PaO2 with decreased Hb

60
Q

O2 content of arterial blood with decreased Hb

61
Q

What does O2 delivery to tissues depend on

A

Cardiac out x O2 content of blood

62
Q

Hb concentration in CO poisoning

63
Q

Hb concentration in anemia

64
Q

Hb concentration in polycythemia

65
Q

Percent O2 sat of Hb in CO poisoning

66
Q

Percent O2 sat of Hb in anemia

67
Q

Percent O2 sat of Hb in polycythemia

68
Q

PaO2 in CO poisoning

69
Q

PaO2 in anemia

70
Q

PaO2 in polycythemia

71
Q

Total O2 content in CO poisoning

72
Q

Total O2 content in anemia

73
Q

Total O2 content in polycythemia

74
Q

Effect of decreased P(A)O2 on pulmonary circulation

A

Vasoconstriction - shifts blood to well-ventilated regions of lungs

75
Q

Effect of decreased O2 on systemic circulation

A

Vasodilation to increase blood flow

76
Q

Gases that are perfusion limited

A

CO2, N2O, and O2 (healthy lung)

77
Q

Gases that are diffusion limited

78
Q

How can diffusion be increased in perfusion-limited gases

A

Increasing blood flow

79
Q

Emphysema effects on diffusion of gases

A

Decreased diffusion due to loss of alveoli

80
Q

Fibrosis effects on diffusion of gases

A

Decreased diffusion due to increased alveolar thickness

81
Q

Exercise effects on diffusion of O2

A

Diffusion increased due to increased blood flow

82
Q

What is considered pulmonary HTN

A

Greater than 25 mmHg at rest

83
Q

Consequence of pulmonary HTN

A

Cor pulmonale and subsequent right ventricular failure

84
Q

Affect of inhalation on vessel resistance in lungs

A

Decreased arteriolar resistance; increased alveolar resistance

85
Q

Volume of air remaining in lungs after maximal expiration

86
Q

Affect of exhalation on vessel resistance in lungs

A

Increased arteriolar resistance; decreased alveolar resistance

87
Q

Mechanism of increased alveolar vessel resistance on inhalation

A

Increased lung volumes stretches alveolar vessels making them longer and smaller diameter

88
Q

Mechanism of increased arteriolar vessels resistance on exhalation

A

Decreased lung volumes narrows arteriolar vessels increasing resistance

89
Q

Loud P2 (second heart sound) at left upper sternal border - what is disease

A

Pulmonary HTN

90
Q

Gold standard for diagnosing pulmonary HTN

A

Right heart catheterization

91
Q

Non-invasive method to estimate pulmonary HTN

A

Echocardiogram

92
Q

What can be visualized with echocardiogram

A

Estimate PA pressure and visualize right heart structures

93
Q

Formula for calculating PVR

A

PVR = P(pa) - P(la)/CO

94
Q

Formula for A-a gradient

A

A-a = P(A)O2 - PaO2

95
Q

Normal A-a gradient range

A

10-15 mmHg

96
Q

Alveolar gas equation

A

P(A)O2 = 150 mmHg - (PaCO2/0.8)

97
Q

Conditions that increase A-a gradient

A

Hypoxemia: shunting, V/Q mismatch, fibrosis

98
Q

Decreased O2 delivery to tissues

99
Q

Decreased PaO2

100
Q

Loss of blood flow

101
Q

Conditions that lead to hypoxia

A

Decreased CO, hypoxemia, anemia, CO poisoning

102
Q

Conditions with increased A-a gradient that cause hypoxemia

A

V/Q mismatch, Diffusion limitation, right-to-left shunting

103
Q

Conditions with normal A-a gradient that cause hypoxemia

A

High altitude, hypoventilation

104
Q

V/Q ratio with airway obstruction

A

V/Q = zero

105
Q

V/Q ratio with blood flow obstruction

A

V/Q = infinity

106
Q

What lung zone has the greatest perfusion and ventilation

A

Zone 3 (base of lung)

107
Q

What lung zone has wasted ventilation

A

Zone 1 (apex)

108
Q

V/Q ratio at lung apex

109
Q

Lung zone with wasted perfusion

A

Zone 3 (base)

110
Q

V/Q ration at lung base

111
Q

What condition creates anatomic shunting

A

Airway obstruction

112
Q

Effect of 100% O2 in shunting

A

PaO2 does not improve

113
Q

What condition creates physiologic dead space

A

Blood flow obstruction like pulmonary embolus

114
Q

Effect of 100% O2 in physiologic dead space

A

PaO2 improves

115
Q

Normal V/Q ratio

116
Q

Effect of exercise on V/Q ratio

A

Apical capillaries vasodilate and V/Q approaches 1

117
Q

Phenomenon in which CO2 is released from RBCs

A

Haldane effect

118
Q

Location in body Haldane effect occurs

119
Q

Conditions that promote Haldane effect

A

Oxygenation of Hb promotes dissociation of H+ from Hb causing CO2 formation

120
Q

Phenomenon in which O2 unloads from Hb

A

Bohr effect

121
Q

Location in body Bohr effect occurs

A

Peripheral tissues

122
Q

Conditions that promote Bohr effect

A

Increased H+ from tissue metabolism

123
Q

Hb conformation that favors CO2 binding

124
Q

Form blood CO2 is primarily transported to lungs

A

HCO3- in plasma

125
Q

Forms CO2 is transported from tissues to lungs

A

HCO3-, dissolved CO2, and HbCO2

126
Q

CO2 and Hb combine to form which molecule

A

Carbaminohemoglobin

127
Q

Effect of decreased atmospheric oxygen

A

Decreased PaO2 increases ventilation which decreases PaCO2 causing respiratory alkalosis leading to altitude sickness

128
Q

Response of body to high altitude

A 
Increased ventilation
Increased EPO
Increased 2,3 BPG
Increased mitochondria
Increased renal excretion of HCO3-
Increased pH
Decreased PO2, PCO2, HCO3-
129
Q

Body’s response to exercise

A

Increased CO2, O2 consumption, ventilation, pulmonary blood flow
Decreased pH
V/Q becomes more uniformed

130
Q

Effect of exercise on venous O2 and CO2 content

A

Increased venous CO2 and decreased O2 content

131
Q

Effect of exercise on arterial O2 and CO2 content

A

PaO2 and PaCO2 remain normal

Step 1 Respiratory-First Aid 2017 (5 decks)

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