Pulm A&P, Breathing

Question 1

Larynx

Answer 1

Connects pharynx to trachea, including epiglottis and vocal cords

Question 2

What is considered part of the respiratory unit?

Answer 2

Bronchioles, alveolar ducts, alveolar sacs, alveoli

Question 3

R vs L lung: How many lobes? What are fissures called? How many segments?

Answer 3

R: 3 lobes, oblique and horizontal fissure, each lobe into segments, 10 in total

L: 2 lobes, oblique fissure, each lobe into segments, 8 in total

Question 4

Primary muscle of inspiration

Answer 4

Diaphragm

Question 5

Accessory muscles of inspiration

Answer 5

Upper ribs raised: Scalenes, SCM
Rest of ribs raised by: levator costarum, serratus
Shoulder girdle fixed: trapezius, pecs, serratus

Question 6

Expiratory muscles

Answer 6

used when quicker/fuller expiration desired

QL, portions of intercostals, abdominal muscles, triangularis sterni

Question 7

How is the diaphragm situated in patients who lack abdominal musculature? (SCI)
What happens to inspiratory reserve/inspiratory capacity?
How does body position affect this?

Answer 7

• Lower resting position of diaphragm
• Decreased inspiratory reserve
• The more upright the body position, the lower the diaphragm and the lower the inspiratory capacity
• More supine, more advantageous for diaphragm

Question 8

What is REEP? When does it occur?

Answer 8

Resting end expiratory pressure (REEP)
Point of equilibrium at which forces of inward pull/outward pull on the lungs is balanced
- Occurs at end tidal expiration

Question 9

Tidal volume (TV)

Answer 9

Amount of gas inhaled (or exhaled) during normal resting breath

Question 10

Inspiratory reserve volume (IRV)

Answer 10

Volume of gas that can be inhaled beyond normal resting tidal inhalation

Question 11

Expiratory reserve volume (ERV)

Answer 11

Volume of gas that can be exhaled. Beyond normal resting tidal exhalation

Question 12

Residual volume (RV)

Answer 12

Volume of gas that remains in the lungs after ERV has been exhaled

Question 13

What are capacities?

Answer 13

2 or more lung volumes added together

Question 14

Inspiratory capacity

Answer 14

IRV + TV

Amount of air that can be inhaled from REEP

Question 15

vital capacity

Answer 15

IRV + TV + ERV

Amount of air that is under volitional control; conventionally measured as forced expiratory vital capacity (FVC)

Question 16

Functional residual capacity

Answer 16

ERV + RV

Amount of air that resides in lungs after normal resting tidal exhalation

Question 17

Total lung capacity

Answer 17

IRV + TV + ERV + RV

Total amount of air that is contained within the thorax during maximum inspiratory effort

Question 18

FEV1

Answer 18

Amount of air exhaled during 1st second of FVC

Question 19

What is normal FVC1

Answer 19

At least 70% of FVC is inhaled within first second (FEV1/FVC x 100 > 70%)

Question 20

Forced expiratory flow rate (FEF ___% - ___%) is the slope of a line drawn between the points __% and __% of exhaled volume on a forced vital capacity exhalation curve. This flow rate is more specific to ___ ___ and shows more dramatic with ___ than FEV1.

Answer 20

25-75
25
75
Smaller airways
Disease

Question 21

Diffusion of gas across alveolar-capillary membrane

Answer 21

Respiration

Question 22

Partial pressure of oxygen in arterial blood (____) depends on integrity of pulmonary system circulatory cysteine, and ___. At room air, it is ___ mmHg.
What are hypoxemia and hyperoxemia values?

Answer 22

PaO2
PaO2
95-100
Hypoxemia: <90
Hyperoxemia: >100

Question 23

Fraction of oxygen in inspired air (____) is percentage of O2 in air based on total of 1.00. Supplemental oxygen increased percentage >21% (room air), and is prescribed when PaO2 is below ____mmHg

Answer 23

FiO2

55

Question 24

PaO2 is related to pulse oximetry (SpO2) by oxyhemoglobin curve. Normal PaO2 of ____ equates to SpO2 of _____%. Between ____ mmHg is point at which oxygen dissociates faster from hemoglobin, corresponding to SpO2 of ___%. ____ ____ should be considered at this point.

Answer 24

90-100
98-100
55-60
88-90
Supplemental

Question 25

Ability to remove carbon dioxide from pulmonary circulation and maintain pH

Answer 25

Alveolar ventilation

Question 26

___ indicates concentration of free-floating hydrogen ions within body. What is normal?

Answer 26

pH | 7.35-7.45

Question 27

PaCO2: partial pressure of CO2 in arterial blood Normal is? Hypercapnea? Hypocapnea?

Answer 27

35-45 mmHg >45 <35

Question 28

How do PaCO2 and pH interact?

Answer 28

Inversely Increase PaCO2, decrease pH Decrease PaCO2, increase pH

Question 29

HCO3- is amount of bicarbonate ions in arterial blood. | Normal is?

Answer 29

22-28 mEq/L

Question 30

How do HCO3- and pH relate?

Answer 30

Direct relationship Increase bicarbonate, increase pH Decrease bicarbonate, decrease pH

Question 31

What is dead space?

Answer 31

Anatomical (conducting A/W) or physiological (diseased) | Space that is well ventilated, but no respiration (gas exchange) occurs

Question 32

What is a shunt?

Answer 32

No respiration occurs because of ventilation abnormality

Question 33

Shunt: complete ___ of a respiratory unit allows blood to travel through pulmonary capillary without gas diffusion

Answer 33

Atelectasis

Question 34

Effects of body position on ventilation perfusion relationship. Perfusion is ___ ___. More pulmonary blood found at ___ of lung in upright position.

Answer 34

Gravity dependent | Base

Question 35

Effects of body position on ventilation perfusion relationship. Ventilation: At static point of REEP, ____ alveoli are fuller than those at ___.

Answer 35

Apical | Base

Question 36

Effects of body position on ventilation perfusion relationship. Ventilation: during dynamic phase of inspiration, more air delivered to the ____-filled alveoli at the bases, causing greater change in VE at the ___.

Answer 36

Less | Bases

Question 37

Effects of body position on ventilation perfusion relationship. Ratio of pulmonary alveolar ventilation to pulmonary capillary perfusion

Answer 37

V/Q ratio

Question 38

Effects of body position on ventilation perfusion relationship. Upright: apices are gravity ___, with lowest blood flow, or ___. More air than blood, resulting in high ___ ratio (___ ___).

Answer 38

Independent, Q | VQ, dead space

Question 39

Effects of body position on ventilation perfusion relationship. Perfusion and ventilation of the middle zone of the lung are ___ ___. Bases are gravity ___, and have most ___. Although VE relatively high, there is more blood than air (low ___, ___).

Answer 39

``` Evenly matched Dependent Q VQ shunt ```

Question 40

The gravity-independent area of the lung, despite the position of the body, acts as ___. Gravity dependent area acts as ___.

Answer 40

Dead space | Shunt

Question 41

Control of ventilation: | What kind of receptors send information to controller?

Answer 41

Baroreceptors, chemoreceptors, irritant, and stretch receptors

Question 42

Control of ventilation: | What are the parts of the central control center?

Answer 42

Cortex, pons, medulla, ANS