Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pathophysiology > Pulmonary Diseases > Flashcards

Pulmonary Diseases Flashcards

1
Q

Oxygen is ______ ______ in blood

A

poorly soluble

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

The high oxygen needs of complex internal organs are met by a soluble protein that binds oxygen rapidly, reversibly, and with a high storage capacity. What is this protein called?

A

hemoglobin!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is hemoglobin? Talk about its subunits, what it contains, and what its capable of

A

hemoglobin is a complex tetramer of 1 alpha and 2 beta polypeptide chains, each of which contains a heme group with an iron atom in the ferrous form (Fe+2) at its center capable of binding to molecular oxygen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Each molecule of hemoglobin can bind ____ oxygen molecules

A

4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Blood oxygen content is the sum of…..

A

dissolved oxygen and oxygen bound to hemoglobin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

oxygen bound to hemoglobin is the product of…..

Hint: 3 things

A

1) oxygen-carrying capacity
2) hemoglobin conc.
3) hemoglobin saturation (SO2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Inflation of the lungs must overcome 3 opposing forces. What are they?

A

1) elastic recoil (including surface forces)
2) inertia of the respiratory system
3) resistance to airflow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Increased elastic forces predominate in 2 common disorders. Name them

A

1) diffuse parenchymal fibrosis
2) obesity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Most of the resistance in normal breathing arises from what?

A

medium-sized bronchi and not in smaller bronchioles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is bronchoconstriction?

A

abnormal narrowing of the airways

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

The volume of gas in the lungs is divided into ______ and ________

A

volumes, capacities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Lung volumes are primary. What does this mean?

A

they do not overlap each other

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is tidal volume (VT)?

A

the amount of gas inhaled and exhaled with each resting breath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is residual volume (RV)?

A

the amount of gas remaining in the lungs at the end of a maximal exhalation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Lung capacities are composed of _____ lung volumes

A

2+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is vital capacity (VC)?

A

the total amount of gas that can be exhaled after a maximal inhalation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

The vital capacity and the residual volume together constitute the _____
_______ ________, or the total amount of gas in the lungs at the end of a maximal inhalation

A

total lung capacity (TLC)

The vital capacity and the residual volume together constitute the total lung capacity (TLC), or the total amount of gas in the lungs at the end of a maximal inhalation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the functional residual capacity (FRC)?

A

the amount of gas in the lungs at the end of a resting tidal breath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

The lungs inflate and deflate _______ in response to changes in pleural pressure

A

passively

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Control over respiration lies in control of what muscles?

A

striated muscles, specifically the diaphragm, intercostals, and abdominal wall change the pleural pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

The breathing muscles are under what type of NS control?

A

automatic and voluntary control!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the main lung function?

A

gas exchange (exchanging O2 for CO2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Lungs see blood from 2 sources. What are they?

A

1) pulmonary circulation
2) bronchial circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the pulmonary circulation pathway?

A

blood is going from RV to drop off CO2 and pick up O2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What does RV do in pulmonary circulation?

A

RV pumps blood to the lungs for gas exchange and returns to left side of heart (and repeat)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How does pulmonary circulation differ from systemic circulation?

A

pulmonary circulation has much lower pressure and resistance than systemic

this is because pulmonary vessels have less smooth muscle in the vessel walls = less pressure+resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

_______ arterioles are very sensitive to hypoxia, and so they have strong autoregulation. Additionally, they are sensitive to alveolar PO2

A

pulmonary arterioles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

If there is low O2 in the area, are pulmonary arterioles going to dilate or constrict?

A

vasoconstrict

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What’s the purpose of pulmonary capillaries? Why does vasoconstriction make sense when there is low O2 in the area regarding to this function?

A

gas exchange!

If there’s no O2 in the alveoli, then theres no reason to vasodilate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What happens where there’s low O2 in the alveoli (for pulmonary circulation)?

A

will vasoconstrict until it reaches alveoli w/ oxygen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

autoregulation in the pulmonary system is ________ than the rest of body

A

opposite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

bronchial circulation is NOT for…..

A

gas exchange

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is bronchial circulation?

A

blood supply of conducting airways

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Where do bronchial arteries branch from?

A

aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Most lung tumors are fed by the _______ arteries

A

bronchial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Love you, don’t kill me for this flashcard

bronchial ______ drain the lungs, and empty into the _____ atrium by the ______ vein and then into the _____ atrium by ______ veins

A

1) veins
2) right (atrium)
3) azygous (vein)
4) left (artium)
5) pulmonary (veins)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

T/F:

There is never 100% oxygenated blood, theres always a mix. This is why there is drainage into both L/R atriums

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

pulmonary valve is approx ____cm below lung apex

A

20

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

T/F:

pulmonary valve location of pressure is necessary to blood flow

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

R ventricle generates pulmonary arterial pressure of ____ mmHg

A

15

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Blood vessels in pulmonary circulation have less smooth muscle than systemic vessels and the apex of lungs is far above the pulmonary valve. What does this mean for pulmonary vessels and lungs?

A

the pulmonary vessels and lungs are subject to gravity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Gravity does not have any effect on lungs when? What does this mean?

A

supine

all air is perfused equally in the lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

When pt is erect, gravity exerts a downward force and causes decreased pressure above the heart by ____ mmHg for each cm of vertical distance

A

1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

With gravity and pt upright, pulmonary blood flow is lowest at the _____ of lung, also known as zone ___

A

apex, zone 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

With gravity and pt upright, pulmonary blood flow is highest at the _____ of lung, also known as zone ___

A

base, zone 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Zone 1 has more or less blood flow than zone 2?

A

less blood flow than zone 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

T/F:

The blood capillaries are closed in zone 1

A

true!!!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Why are the blood capillaries closed in zone 1 of the lung model?

A

GRAVITY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What helps keep the capillaries closed in zone 1 of the lung model?

A

alveolar pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Compre PA, Pa, and PV for zone 1 of the lung model

A

PA > Pa > PV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is PA?

A

alveolar pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What is Pa?

A

arteriole pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What is PV?

A

venous pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

When is PA > Pa > PV normal? When is this detrimental?

A

PA > Pa > PV is perfectly normal for average person in zone 1 of lung model, but this can be detrimental for person with injury, trauma, disease, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Zone 2 has less or more blood flow than zone 3?

A

less blood flow than zone 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

T/F:

the capillaries are closed in zone 2 of lung model

A

FALSE- they are partially open/closed in zone 2 (not fully closed like in zone 1)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Which zone is blood flow medium flow?

A

zone 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Compre PA, Pa, and PV for zone 2 of the lung model

A

Pa > PA > PV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Compre PA, Pa, and PV for zone 3 of the lung model

A

Pa > PV > PA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Which zone of the lung model has full capillary blood flow?

A

zone 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Zone 3 is below the pulmonary valve. What does this mean for blood flow?

A

Blood flow is highest here

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What is the only organ in body that is subject to gravity?

A

the lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

T/F:

Ideally, there should be mixture of oxygenated and deoxygenated blood

A

FALSE It’s the opposite

there ideally SHOULDN’T be a mixture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Systemic circulation is not always….

A

100% saturated with oxygen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What is venous admixture?

A

mixture of oxygenated and deoxygenated blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What are the 2 main causes for venous admixture?

A

1) shunts (anatomic or physiologic)
2) low ventilation/ perfusion (VA/Q) ratio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What are shunts?

A

where venous blood bypasses exchange of the lungs and goes from one side of heart to the next

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What are the 2 types of shunts?

A

anatomic and physiologic shunts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What is an example of an anatomical shunt? What happens here?

A

atrial septal defect

this is an opening between the R/L atrium that shouldn’t be there and blood will leak through the hole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

T/F:

Physiological shunts are ALWAYS due to some kind of disease

A

true!!!!!!!!!!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What are some factors affecting rate of diffusion through a cell membrane?

A

1) lipid solubility
2) molecular size
3) conc. gradient
4) membrane surface area
5) composition of lipid bilayer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What is Fick’s law of diffusion?

A

the rate of diffusion depends on:
1) SA
2) conc. gradient
3) membrane permeability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

In patients with emphysema, the alveoli are destroyed. What does this mean for gas exchange?

A

less surface area for gas exchange

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

In patients with fibrotic lung disease, what happens to the alveoli and lungs?

A

thickened alveolar membrane slows gas exchange

loss of lung compliance may decrease alveolar ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

What is the difference between emphysema and fibrotic lung disease?

A

in emphysema the alveoli walls break down, this means that decreased alveoli= decreases SA + gas exchange

In fibrotic lung disease, you’re not losing alveoli, but the walls of alveoli are thickening. The alveoli should be simple squamous epithelium, but thats getting replaced with fibrotic tissue. This decreases membrane permeability and diffusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Is V/Q ratio autoregulated?

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

If ventilation decreases in a group of alveoli, P(CO2) ________ and P(O2) _________. Blood flowing past those alveoli does not get oxygenated

A

increases, decreases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Ventilation is no longer matched with perfusion. What is this called?

A

V/Q mismatch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

arterioles are ________ vessels

A

resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

What happens to arterioles during V/Q mismatch caused by under-ventilated alveoli?

A

arterioles vasoconstrict and shunt blood to other alveoli that are filled with oxygen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Lungs have approx 500 million alveoli, so if a couple are infected with pneumonia or something else what happens?

A

no biggie, body will fight off infection, pt wont die from it if just a few are infected

this is because the arterioles can vasoconstrict and shunt blood to other alveoli that are filled with oxygen/ healthier

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

T/F:

When you have a V/Q mismatch, not all alveoli are ventilated, but you have normal blood flow

A

TRUE!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

What is the V/Q ratio for a V/Q mismatch caused from under-ventilated alveoli?

A

V/Q ratio = 0

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

What is normal V/Q ratio?

A

V/Q ratio = 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Is a high V/Q or V/Q greater than 1, also considered a V/Q mismatch?

A

YES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

What does a high V/Q ratio mean?

A

low perfusion relative to its ventilation

impaired perfusion, not enough blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

What causes a high V/Q ratio of V/Q greater than 1?

A

hypotensive states or a partial obstruction of pulmonary blood vessels present in pulmonary embolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Low perfusion with normal alveoli, means what for V/Q ratio?

A

high V/Q ratio!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

If a pt has a pulmonary embolism what happens to the lungs and body?

A

air in alveolus will not change, they will still have oxygen, but nothing is there to pick up the oxygen so there is a lack of gas exchange

more CO2 = body will undergo hyperventilation to try to compensate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Why do V/Q ratios matter?

A

good measure of pulmonary function + health

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

How do you test pt’s V/Q ratio?

A

use radioactive tracers while scanning lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

How many primary bronchi are there?

A

2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

As bronchioles get smaller and smaller towards the bottom of the lungs, ______ increases (generally speaking)

A

resistance

(Beth do not overthink this)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

T/F:

Medium sized bronchi are the airways with the highest resistance

A

true!!!!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Terminal respiratory units- look at them as units, not as individual bronchioles. They are all the same size, so _______ and ________ are decreased here because of the huge cross-sectional area of ALL bronchioles

A

pressure and resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Why are medium sized bronchi the ones with the most resistance?

A

because they’re the last airways that are interpreted as “individuals” as opposed to a whole unit of bronchioles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

The numbers increase in SA for all terminal bronchioles that pressure is divided between all of them (compensation), this results in…..

A

less resistance in smaller airways just because there are SO many

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

What is the main function of alveoli?

A

gas exchange

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

How many alveoli are there per lung?

A

300-500 million

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

Each alveolus is moistened w/ a thin film of alveolar fluid that creates _______ ________

A

surface tension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

Alveolar fluid that is coating alveoli is primarily _______

A

water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

Alveoli are always on point of collapse because of _______ _______

A

surface tension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

Surface tension is counteracted by what? Where is it synthesized and released from?

A

surfactant

surfactant is synthesized and released by type 2 pneumocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

What is surfactant composed of?

A

combination of proteins and phospholipids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

What is the Law of LaPlace?

A

pressure is greater in the smaller bubble

If 2 bubbles have the same surface tension, the smaller bubble will have higher pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

What does surfactant do?

A

reduce surface tension in lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

Is there the same amount of surfactant everywhere in the lungs?

A

No, the smaller alveoli have more surfactant, which equalizes the pressure between large and small alveoli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

Surfactant has 3 functions. What are they?

A

1) promotes alveolar stability
2) increase compliance of lungs
3) help keep lungs dry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

What law is under surfactants function for alveolar stability? What does this mean?

A

Law of LaPlace (P=2T/R)

surface tension will be the same in both bubbles, but pressure is higher in smaller one

surfactant counteracts/decreases surface tension to equalize pressure along all the alveoli

smaller alveoli have more pressure and surface tension, so they will be covered with more surfactant than larger alveoli

surfactant gives alveolar stability bc it equalizes pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

Surfactant increases lung compliance. What does this mean?

A

lungs have a lot of elastic tissue

main component of elastic tissue is that it can recoil (like a rubberband)

surfactant decreases surface tension in alveoli and makes it more easier to breathe bc alveoli are not collapsed in

surfactant makes lungs more compliant and this means that lungs can expand much easier than w/o surfactant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

Define lung compliance

A

amount of pressure necessary to inflate the lungs to a given volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

Surfactant helps to keep lungs dry. Explain this

A

surfactant decreases pressure and maintains the same pressure across all alveoli, so this also decreases the pressure gradient between alveoli and the interstitium

decrease pressure gradient= NO fluid in the alveoli and this keeps lungs dry

surfactant helps to decrease pressure gradient between alveoli and interstitial fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

T/F:

In a normal lung at rest, pleural fluid keeps the lung adhered to the chest wall

A

true!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

Healthy lungs are subject to 2 equal and opposite forces at rest. What are they?

A

1) compliance (trying to expand)
2) elastic recoil (elastance- trying to make lungs smaller)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

Generally speaking, what is the function of muscles?

A

to contract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

What happens to the lung when you inhale?

A

they expand!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

compliance ________ w/ age due to the deposition of connective tissue

A

decreases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

Lungs are filled w/ elastic tissue. What is the function of elastic tissue?

A

to recoil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

What do the 2 forces do to the lung pressure? What is this pressure called and where is it?

A

they generate neg. pressure in the intrapleural space

this is known as intrapleural pressure (PPI)

this is pressure between the parietal and visceral pleura

P(PI) = -3mmHg

120
Q

What is the atmospheric pressure in mmHg, atm, and in relation to lungs at rest?

A

760 mmHg
1 atm
0 (in relation to lungs at rest)

121
Q

If something breaches the pleural space, such as a stabbing, what happens?

A

air will rush in until it equalizes and lungs will lose negativity (-3mmHg)

this will cause lungs to collapse because neg. pressure helps keep lungs open

air flowing into lung = pneumothorax

122
Q

The amount of oxygen that the blood carries depends on…..

A

hemoglobin saturation

123
Q

What is oxygen saturation?

A

measure of the number of occupied oxygen binding sites

124
Q

How many heme(s) are there on 1 Hb molecules?

A

4 (each heme will allow oxygen to bind to it)

125
Q

What does 100% saturation mean?

A

each hemoglobin is carrying 4 oxygens

126
Q

Where do you see 100% saturation in the body?

A

arterial blood

127
Q

What does it mean if one heme is not carrying oxygen?

A

its not fully saturated

128
Q

Where do you see 75% saturation in the body?

A

venous blood

129
Q

What does 75% saturation mean?

A

not every hemoglobin molecule is 3/4 (75%), this is just an average of all the hemoglobins

some can be 1/4, 2/4, 3/4, 4/4, but overall average is 75% saturation

130
Q

Venous blood has less than _____mmHg of O2

A

40

131
Q

Venous blood follows the pressure gradient to get 100 mmHg at the alveoli. What happens next?

A

venous blood will equilibrate to 100 mmHg (from its original 40) as it passes the lungs and turns into arterial blood

132
Q

On the dissociation curve, the plateau starts at….

A

60 mmHg

133
Q

At 60 mmHg, hemoglobin is ______ saturated

A

90%

134
Q

T/F:

Arterial blood goes to cells and drops off 1 molecules of oxygen, as it drops it off, the hemoglobin affinity decreases for oxygen. Oxygen will be able to unload and continue to do so until no oxygen is left. Blood will circle back around and get more oxygen and repeat

A

true!!!!

sorry idk how to make this into better flashcard

135
Q

More CO2= more _______ environment

A

acidic

136
Q

Metabolism generates what 3 things that can affect the lungs/oxygen affinity?

A

1) CO2
2) heat
3) 2.3 DPG

137
Q

What 3 things decrease Hb affinity for oxygen and will have oxygen unload easily?

A

1) heat
2) CO2
3) acid

138
Q

How does temp. affect lungs/oxygen affinity?

A

increase temp = hemoglobin loses its affinity for O2, dissociation curve will shift to right, and O2 is unloaded

139
Q

What is an example of a time temp. will change and affect lungs/oxygen affinity?

A

strenuous exercise

muscle temp. can increase by approx. 3 degrees Celsius, which will help hemoglobin unload more oxygen

140
Q

How does P(CO2) affect lungs/oxygen affinity?

A

CO2 binds to the globin part of Hb (DOES NOT BIND TO HEME)

more CO2= more Hb loses its affinity for oxygen and curve will shift to right, and oxygen is unloaded

141
Q

When you produce CO2 in the body, it dissolves in water. What does this produce?

A

carbonic acid

142
Q

What happens with carbonic acid in the body?

A

it quickly disassociates because its a weak acid

it will dissociate into H ion and bicarbonate ions

143
Q

Whenever you produce CO2, you’re also generating what?

A

H+ ions in the body, which creates an acidic environment

144
Q

An acidic environment with CO2 means what?

A

the dissociation curve will shift to R with more H+ ions, and this is known as bohr effect

145
Q

What is the equation Roop said to never forget?

A

CO2 + H20 ->/<- H2CO3 ->/<- H+ +HCO3-

146
Q

What do H+ ions do to hemoglobin?

A

stabilize deoxygenated form of Hb

more H+ = more R shift = Bohr effect

147
Q

What effect does 2,3 DPG have on the lungs and oxygen affinity?

A

more 2,3 DPG = more stabilization of the deoxygenated form of Hb = more Hb loses affinity for oxygen and curve shifts to R, and unload O2

148
Q

Where is 2,3 DPG (diphosphoglycerate) abundant?

A

in RBCs

149
Q

2, 3 DPG is another byproduct of ________

A

metabolism

150
Q

A decrease in 2, 3 DPG, H+ ions, temp., or CO2 results in what?

A

dissociation curve will shift to left, hemoglobin affinity increases for O2, and Hb holds on tightly to O2

151
Q

T/F;

Maternal and fetal hemoglobin have different oxygen-binding properties

A

true

152
Q

What chains does HbA have?

A

2 alpha, 2 beta chains

153
Q

What chains does HbF have?

A

2 alpha, 2 gamma chains

154
Q

What do the gamma chains do for HbF?

A

gamma chains enhance ability of HbF to bind oxygen in low oxygen environments like the placenta

155
Q

At 30% mmHg of O2, HbF is….

A

85% saturated (even at a low oxygen level!)

156
Q

At 30% mmHg of O2, HbA is…..

A

55% saturated

157
Q

HbF has a much higher affinity for O2 than ______

A

HbA

158
Q

HbF changes to HbA after how many days of birth?

A

approx 120 days (like RBCs)

159
Q

T/F: carbonic acid is not strictly regulated in body

A

FALSE

it is strictly regulated

160
Q

Why is carbonic acid strictly regulated in body?

A

CNS needs to maintain plasma pH/pH of arterial blood at 7.35-7.45

this should never change in a healthy person

161
Q

Effect of acid on plasma pH is estimated by the…

A

Henderson- Hasselbach (HH) eq

162
Q

decreased CO2 with increased pH means….

A

alkalosis

163
Q

increased CO2 with decreased pH

A

acidosis

164
Q

For respiratory acidosis, retaining CO2 means that plasma CO2 _____

A

increases

165
Q

For respiratory acidosis, alveolar hyperventilation causes what?

A

plasma CO2 to increase

166
Q

In respiratory acidosis, alveolar hyperventilation can be due to…

hint: 5 things

A

1) respiratory depression due to certain drugs/alcohol
2) increased airway resistance (ex: asthma)
3) decreased gas exchange
4) muscle weakness (ex: muscular dystrophy)
5) COPD (includes emphysema + chronic bronchitis)

167
Q

What is the most common cause of CO2 retention/ alveolar hyperventilation?

A

COPD (includes emphysema + chronic bronchitis)

168
Q

Respiratory acidosis has a number of things that are elevated. What are they?

A

high CO2, H+ ions, and bicarbonate ions

169
Q

How does the body compensate with respiratory acidosis?

A

kidneys will excrete more H+ ions and reabsorb more bicarbonate ions

this will decrease pH with increased bicarbonate ion levels

170
Q

What drug causes more respiratory depression than any other medication?

A

morphine

171
Q

respiratory alkalosis is the _________ of respiratory acudosis

A

opposite

172
Q

For respiratory alkalosis, decreased CO2 results in _________ H+ ions and bicarbonate ions

A

decreased

173
Q

T/F:

Respiratory acidosis is much less common than respiratory alkalosis

A

False! Respiratory acidosis is way more common

174
Q

What is the most common reason for respiratory alkalosis?

A

hyperventilation

175
Q

For respiratory alkalosis what happens with CO2?

A

blowing off more CO2, but not making anymore CO2, so it decreases

176
Q

What is the most common medical cause for respiratory alkalosis?

A

artificial ventilation

177
Q

What is the treatment for hyperventilation?

A

breath into brown paper bag to bring back/recycle CO2 and reverse the alkalosis

178
Q

What is the compensation in the body for respiratory alkalosis?

A

kidneys will reabsorb H+ ions and secrete bicarbonate ions

179
Q

Do COPD patients have a harder time inhaling or exhaling?

A

exhaling

180
Q

What happens to elastic tissue in COPD patients?

A

they lose that elastic tissue, so they don’t have good recoil

181
Q

What do COPD pts have to do to feel better with breathing?

A

tripod position and forcefully blow air out

182
Q

COPD includes chronic bronchitis. What makes breathing hard here?

A

huge mucus production, which will lead to decreased oxygen intake

183
Q

What is a “medical” name for patients with chronic bronchitis from COPD?

A

blue bloaters

this is because they tend to have cyanotic lips, nails, etc.

184
Q

COPD includes emphysema. What makes breathing hard here?

A

they lost elastic recoil/elastic tissue

so they have to use accessory muscles to breath out

they tend to hyperventilate w/ expiration

185
Q

What is a “medical” name for patients with emphysema from COPD?

A

pink puffers

186
Q

What are some tests you can run for pulmonary problems?

hint: there’s 7

A

1) spirometry (monitor pt lung volumes)
2) ABG (arterial blood gases)
3) C&S (culture & sensitivity)
4) pulse oximeter
5) bronchoscopy (look at lesion or take biopsy)
6) exercise tolerance test (monitor resp. ability)
7) x-ray (for pneumonia and TB)

187
Q

What is ABG (arterial blood gases) checking the lungs for?

A

oxygen, carbon dioxide, and hydrogen ion levels

tests for hypoxemia and hypoxia!

188
Q

What are some S&S of respiratory disease?

hint: 6 things

A

1) sneezing
2) hypoxemia (low oxygen in blood)
3) hypoxia (low oxygen in tissues)
4) coughing
5) sputum
6) pleural pain

189
Q

What is sneezing typically caused from?

A

reflex due to irritant in nasal mucosa/URT, or inflammation

190
Q

What is hypoxemia?

A

low oxygen in blood

191
Q

What is hypoxia?

A

low oxygen in tissues

192
Q

What can hypoxia be caused from?

Hint: 4 things

A

1) low RBCs/hemoglobin
2) hemorrhage (low blood flow )
3) thrombus (blocks blood flow)
4) CO poisoning (can cause anemia hypoxia)

193
Q

What is the coughing center of the brain?

A

medulla

194
Q

What is coughing typically due to?

A

irritant or nasal drip

195
Q

What does yellowish/green sputum typically mean?

A

bacterial infection

196
Q

What is hemoptysis?

A

blood in sputum

197
Q

What does rusty sputum (deep red/brown color) typically mean?

A

pneumococcal pneumonia

198
Q

What does thick sticky sputum typically mean?

A

asthma or CF

199
Q

What is pleural pain?

A

pleura is infected or inflamed

can mimic pain of heart attack

center of chest pain (not on L side like with the heart)

200
Q

What is hypoxic hypoxia?

A

low arterial P(O2)

201
Q

What are some typical cases for hypoxic hypoxia?

hint: 4 things

A

1) high altitude
2) alveolar hypoventilation
3) decreased lung diffusion capacity
4) abnormal V/Q ratio

202
Q

What is anemic hypoxia?

A

decreased total amount of oxygen bound to hemoglobin

203
Q

What are some typical cases for anemic hypoxia?

hint: 3 things

A

1) blood loss
2) anemia (low Hb or altered HbO2 binding)
3) CO poisoning

204
Q

What is ischemic hypoxia?

A

reduces blood flow

205
Q

What are some typical cases for ischemic hypoxia?

A

1) heart failure (whole body hypoxia)
2) shock (peripheral hypoxia)
3) thrombosis (hypoxia in a single organ)

206
Q

What is histotoxic hypoxia?

A

failure of cells to use O2 because cells have been poisoned

207
Q

What are some typical cases for histotoxic hypoxia?

A

cyanide and other metabolic poisons

208
Q

What organ does hypoxia affect first? How does it compensate?

A

brain (very dependent on O2)

comp=
1) tachycardia (try to generate more blood)
2) increase bp to try to move more blood
3) increase in EPO + RBCs (too many RBCs can also lead to polycythemia)

209
Q

What is EPO and where is it synthesized?

A

hormone needed for RBC production and it is synthesized in the kidneys

210
Q

Define eupnea

A

normal quiet breathing/normal rate of respiration, 12-18 bpm

211
Q

What is hyperpnea? Ex of when this can happen?

A

increased respiratory rate and/or volume in response to increased metabolism

ex: exercise

212
Q

What is hyperventilation? Ex of when this can happen?

A

increased respiratory rate and/or volume without increased metabolism

ex: emotional hyperventilation or blowing up a balloon

213
Q

What is hypoventilation? Ex of when this can happen?

A

decreased alveolar ventilation

ex: shallow breathing, asthma, restrictive lung disease

214
Q

What is tachypnea? Ex of when this can happen?

A

rapid breathing usually increased respiratory rate w/ decreased depth

ex: panting

215
Q

What is dyspnea? Ex of when this can occur?

A

difficulty breathing (a subjective feeling sometimes described as “air hunger”)

ex: hard exercise

216
Q

What is apnea? Ex of when this can happen?

A

cessation of breathing

ex: voluntary breathing-holding, depression of CNS control centers

217
Q

What is kussmaul’s respiration?

A

its a form of hyperventilation, shows up in metabolic acidosis

breath fast and deep

218
Q

What are the 4 types of breath sounds we learned?

A

1) rales
2) stridor
3) wheezing
4) rhonchi

219
Q

What are rales breath sounds?

A

crackling sounds as air is mixing w/ secretions in the lungs

deeper sounds as air is mixing w/ mucus

220
Q

What are stridor breath sounds?

A

high-pitched sound, usually due to blockage or obstruction in upper airways

221
Q

What are wheezing breath sounds?

A

whistling sounds, usually due to blockage or obstruction in lower airways

222
Q

What is orthopnea?

A

difficulty breathing while laying down

223
Q

What is paroxysmal nocturnal dyspnea?

A

SOB while sleeping (will wake you up!), will feel better sitting up

224
Q

If pt is waking up in the middle of the night w/ SOB it can be due to…..

A

L sided congestive heart failure

225
Q

What is the most common URT infection?

A

common cold (infectious rhinitis)

226
Q

What is common cold (infectious rhinitis) caused by?

A

a virus, usually be a rhinovirus

227
Q

How contagious is the common cold (infectious rhinitis)?

A

very contagious in first few days

228
Q

Is common cold (infectious rhinitis) self-limiting?

A

yes

229
Q

For common cold (infectious rhinitis), mucus membranes of nasal mucosa and pharynx can become inflamed. What does this result in?

A

headache and sore throat, sometimes it can spread even further and develop into bronchitis or laryngitis

230
Q

What is the treatment for common cold (infectious rhinitis)?

A

acetaminophen and/or decongestants

231
Q

Strep throat (pharyngitis) is caused by what?

A

Streptococcus that invades tissues that are already inflamed

232
Q

How do you confirm strep throat (pharyngitis)?

A

w/ a throat culture

233
Q

What are the S&S with strep throat (pharyngitis)?

A

severe fever, pain, sore throat

234
Q

How do you treat strep throat (pharyngitis)?

A

antibiotics

235
Q

Sinusitis is what type of infection?

A

usually a bacterial infection that goes along w/ cold or allergies

236
Q

What is sinusitis?

A

infection of the sinuses

237
Q

Where is sinusitis found?

A

frontal, ethmoid, sphenoid, and maxillary sinuses

238
Q

What happens to the sinuses in sinusitis?

A

sinuses are filled w/ mucus (can cause headache or face pain)

239
Q

What is sinusitis caused from?

A

streptococcus or pneumococcus

240
Q

What is the treatment for sinusitis?

A

decongestants and/or analgesics

241
Q

What is the medical name for croup?

A

laryngotracheobronchitis

242
Q

What age group is croup common in?

A

babies/ children 1-2 y/o

243
Q

How does croup start? What happens after?

A

starts as URT infection, but then mucosa of larynx and trachea become inflamed and this obstructs the airways

244
Q

What is the clinical presentation of croup?

A

barking cough and stridor breath sounds

245
Q

Is croup self limiting?

A

yes

246
Q

What are the treatments for croup?

A

humidifiers

severe cases: put baby on oxygen

247
Q

What are the 2 types of LRT infections we learned about?

A

1) bronchiolitis (RSV)
2) pneumonia

248
Q

What is another name for bronchiolitis?

A

respiratory syncytial virus infection (RSV)

249
Q

Where does bronchiolitis (RSV) come from?

A

myxovirus

250
Q

What age group is bronchiolitis (RSV) commonly seen in?

A

children, especially before the age of 1

251
Q

T/F:

72% of all bronchiolitis (RSV) cases are caused by RSV myxovirus

A

true!

252
Q

Who is more susceptible to bronchiolitis (RSV)?

A

babies living in homes w/ smokers

253
Q

What happens to the body w/ bronchiolitis (RSV)? S&S?

A

inflammation of small bronchi and bronchioles, so this causes edema and excess mucus production in small airways, and in severe cases obstruction

S&S:
-wheezing
-stridor
-fever
-dyspnea

254
Q

Is bronchiolitis (RSV) self-limiting?

A

yes

255
Q

How are severe cases of bronchiolitis (RSV) treated?

A

oxygen

256
Q

pneumonia can be a primary infection, but usually it is a _________ infection

A

secondary

257
Q

When does pneumonia usually occur?

A

when cilia is damaged in the respiratory airways

cilia is unable to move secretions, so fluid accumulates in the lungs

258
Q

What are the pneumonia classifications based on agent/microbe?

A

1) viral pneumonia
2) fungal pneumonia
3) bacterial pneumonia

259
Q

What are the pneumonia classifications based on anatomy?

A

1) bronchopneumonia (diffuse throughout lungs)
2) lobar pneumonia (affect 1-2 lobes)
3) interstitial pneumonia/ alveolar septae (between all the connective tissues of lungs)

260
Q

What are the pneumonia classifications based on how it was acquired?

A

1) nosocomial infection
2) community infection

261
Q

What are some common risk factors for pneumonia?

A

1) HIV infection
2) organ/bone marrow transplant pt
3) COPD
4) smoking
5) structural lung disease
6) alcoholism
7) injection drug abuse
8) environmental or animal exposure
9) nosocomial
10) post influenza

262
Q

What is another name for lobar pneumonia?

A

pneumococcal pneumonia

263
Q

What is lobar pneumonia/pneumococcal pneumonia caused by?

A

strep pneumoniae

264
Q

What is the 1st stage of lobar pneumonia/pneumococcal pneumonia?

A

congestion

this is where the alveolar walls are inflamed and eventually they will thicken

thick = disrupts flow of oxygen

265
Q

What is the 2nd stage of lobar pneumonia/pneumococcal pneumonia?

A

consolidation

alveoli are filled w/ inflammatory material neutrophils, RBCs, and fibrin will form solid masses in alveoli (RBCs os why there is red/rusty colored sputum)

macrophages will come in a phagocytosis all the material in the alveoli

266
Q

What happens if all the inflammation continues in lobar pneumonia/pneumococcal pneumonia stage 2?

A

it can cause pleurisy, which is inflammation of pleural membranes

267
Q

If the infection is not treated/resolved in lobar pneumonia/pneumococcal pneumonia stage 2, what happens?

A

it can cause empyema, which is infection of pleura where there is pus in the pleural cavity

this can be severe bc it interferes with the neg. pressure you should have in the lungs

268
Q

What are the treatments for lobar pneumonia/pneumococcal pneumonia ?

A

1) antibiotics (penicillin)
2) fluids replacement
3) vaccine (pneumococcal vaccine is recommended for elderly)

269
Q

Where is bronchopneumonia typically found?

A

throughout the lungs, but it usually is found in the inferior parts more than anywhere else

270
Q

What is bronchopneumonia caused by?

A

multiple strains of bacteria

271
Q

What happens if bronchopneumonia is not treated/resolved?

A

it will spread to alveoli and affect oxygen diffusion

272
Q

What is the most noticeable sign with bronchopneumonia?

A

yellowish/green sputum

273
Q

What is another name for interstitial pneumonia?

A

primary atypical pneumonia (PAP)

274
Q

What type of pneumonia is interstitial pneumonia/PAP

A

can be a viral pneumonia or mycoplasmic pneumonia

275
Q

If interstitial pneumonia/PAP is a mycoplasmic pneumonia, what is it caused by?

A

mycoplasma pneumoniae

276
Q

If interstitial pneumonia/PAP is a mycoplasmic pneumonia, what age group is it most prevalent in?

A

young adults

277
Q

If interstitial pneumonia/PAP is a mycoplasmic pneumonia, what is its severity/contagious level?

A

not very serve or contagious

278
Q

If interstitial pneumonia/PAP is a mycoplasmic pneumonia, what is the treatment?

A

antibiotics such as erythromycin or tetracycline

279
Q

If interstitial pneumonia/PAP is a viral pneumonia, what is it caused by?

A

influenza A or B, or RSV

280
Q

Is interstitial pneumonia/PAP as a viral pneumonia self limiting?

A

yes

281
Q

If interstitial pneumonia/PAP is a viral pneumonia, what does it affect in the body?

A

interstitium of lungs, NOT the alveoli (so in this case, you won’t have a problem w/ diffusion of oxygen)

282
Q

If interstitial pneumonia/PAP is a viral pneumonia, what is the treatment?

A

antibiotics such as erythromycin

283
Q

What does SARS stand for?

A

severe acute respiratory syndrome

284
Q

When was SARS identified?

A

2003

285
Q

What is SARS?

A

a coronavirus, known as SARS-CoV

its an RNA virus

(now we also have SARS-CoV2 from 2020)

286
Q

Where is SARS found geographically?

A

primarily in the east

287
Q

What is SARS incubation period?

A

2-7 days

288
Q

What is the clinical presentation of SARS?

A

-first started w/ flu-like symptoms
-then developed diarrhea
-then a cough (congestion spread throughout lungs)
-hypoxia was possible (pt need respirator)
-lymphopenia and thrombocytopenia

289
Q

For SARS, respiratory distress was fatal for _____ of patients, and _____ of all deaths were the elderly (60+ y/o)

A

10%, 50%

290
Q

Where is TB on the rise?

A

nationally and in Florida

291
Q

T/F:

1-2% of all TB cases are resistant to multiple antibiotics

A

TRUE

292
Q

What is TB caused by?

A

mycobacterium tuberculosis

it is a slow growing bacillus bacteria w/ a cell wall

293
Q

What is the function of the cell wall on the TB bacterium?

A

the cell wall prevents immune system from penetrating it

294
Q

TB is primarily a ______ disease, but can spread to other areas of body

A

lung

295
Q

What is the 1st stage of TB (primary infection)?

this is long i apologize in advance

A

1) inhale bacterium and it gets into lungs
2) causes inflammatory response where macrophages will come and phagocytosis it
3) some macrophages will go to lymph nodes and cause type 4 hypersensitivity rxn

4) pts w/ high resistance:
-macrophages, lymphocytes, and neutrophils will come in a create a granuloma (surround the microbes)
-inside the granuloma is a tubercle, which is the active bacteria
-Ghon complexes= fibrous material surround granulomas and calcify
-necrosis occurs in the center of granuloma (caseation necrosis) because the center is so far from nutrients

4) pts w/ low resistance will get the active infection

296
Q

What is the 2nd stage of TB (secondary or reinfection)?

A

If pt is once again exposed to microbe or for some reason resistance decreases, the tubercles will become reactivated and multiply

then it will break through Ghon complexes and spread throughout the lungs and becomes contagious!

297
Q

Who is extremely susceptible to TB?

A

anyone taking biologics bc your immune system is suppressed

Pathophysiology (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions