Pulmonary- Howell

Question 1

the pressure inside the airways and alveoli of the lungs is called …

Answer 1

intrapulmonary (alveolar) pressure

Question 2

pressure in the pleural cavity is called…

Answer 2

intrapleural pressure

Question 3

pressure in thoracic cavity is called…

Answer 3

intrathoracic pressure

Question 4

lung compliance refers to…

Answer 4

the ease with which lungs can be inflated (like a new balloon that is stiff vs an old floppy one… difference in how well they can inflate and push out air

Question 5

lung compliance is determined by ___ and ____ in the lung, ______ and ______

Answer 5

elastin and collagen fibers in the lung, water content, and surface tension

Question 6

the vol. of air that moves into and out of the respiratory portion of the lungs (gas exchange) is directly related to….and inversely to….

Answer 6

directly: the pressure difference between the lungs and the atmosphere
inversely: to the resistance that the air encounters as it moves through airways

Question 7

airway resistance is usually (in healthy person) less or more during inspiration vs expiration?

Answer 7

less during inspiration b/c volume is low, high in expiration when vol starts high

Question 8

airways are _____ during inspiration and become _____ during expiration. how does this apply to lung disease?

Answer 8

pulled open during insp, narrow during expiration (the –>reason why people with conditions that inc. airway resistance have less difficulty during insp than exp.

Question 9

airway compression: airflow through collapsible airways in the lungs depends on what two things?

Answer 9

distending airway (intrapulmonary) pressures that hold the airways open and the external (intrapleural or intrathoracic) pressures that surround and compress airways.

Question 10

airway pressure minus intrathoracic pressure is called….

Answer 10

transpulmonary pressure

Question 11

for the airflow to occur, the _____ must be greater than ____

Answer 11

distending pressure inside the airways must be greater than compressing pressures outside the airways

Question 12

lung capacities always include_____ lung volumes

Answer 12

2 or more

Question 13

two types of dead space

Answer 13

anatomic: contained in the conducting airways
alveolar: contained in the respiratory portion of lung

Question 14

when alveoli are ventilated but deprived of blood flow, they don’t…. and therefore are considered….

Answer 14

don’t contribute to gas exchange and are therefore considered alveolar dead space.

Question 15

what is a physiological shunt

Answer 15

a mismatching of ventilation and perfusion, resulting in insufficient vent. to provide O2 needed to oxygenate blood in capillaries

Question 16

perfusion without vent (aka ___) results in _____

Answer 16

aka shunt, low V/Q ratio (e.g. atelectasis)

Question 17

vent. without perfusion (aka ____) results in ___

Answer 17

aka dead air space, high V/Q ratio (e.g. with PE)

Question 18

respiratory center of the brain

Answer 18

neurons in pons and medulla

Question 19

two groups of neurons in the respiratory center of the brain

Answer 19

1. dorsal - primary inspiration: control phrenic nerve (that innervates diaphragm) and drive the 2.(ventral) neurons
2. ventral - insp. & expiration: control spinal motor neurons of intercostal and abdominal muscles

Question 20

dorsal nerves of the resp. center are thought to integrate…

Answer 20

sensory input from lungs and airways into the ventilatory response

Question 21

3 types of lung receptors and what do they do?

Answer 21

stretch: monitor lung inflation
irritant: protect against damaging effects of toxic inhalants
J : sense lung congestion

Question 22

two groups of chemoreceptors and what do they do?

Answer 22

1. central: sense change in CO2 levels

2. peripheral: sense arterial blood O2 levels

Question 23

tension pneumothorax occurs when…

Answer 23

intrapleural pressure exceeds atmospheric pressure

Question 24

spontaneous pneumothorax occurs when …

Answer 24

airfilled bleb or blister on the lung surface ruptures

Question 25

3 dangerous results of tension pneumothorax

Answer 25

compression atelectasis of unaffected lung, shift in mediastinum, compression of vena cava with impairment of venous return

Question 26

Dx of pneumothorax can be confirmed by,,,

Answer 26

chest radiograph or CT scan

Question 27

ANS of pulmonary: PNS and SNS

Answer 27

PNS-(Ach)-> vagus nerve –> bronchoconstriction

SNS- (B2)–> bronchodilation

Question 28

what “tone” predominates in the airways in terms of ANS stimulation ?

Answer 28

normally, a slightly vagal-mediated bronchoconstrictor tone predominates

Question 29

ANS: what happens when we exercise?

Answer 29

need for increased airflow, vagal-mediated bronchoconstrictor tone is inhibited and bronchodilator effects of SNS are increased.

Question 30

two commonly recognized types of emphysema

Answer 30

centriacinar- effects bronchioles in the central part of the resp lobule
panacinar - produces initial involvement of peripheral alveoli and later extends to involve more central bronchioles

Question 31

those with chronic bronchitis are unable to _____ by increasing breathing effort

Answer 31

maintain normal blood gases

Question 32

a blood-borne substance lodges in a branch of the pulmonary artery and obstructs the flow.. what is this?

Answer 32

PE

Question 33

3 physiologic factors that contribute to DVT

Answer 33

1. venous stasis (blood flow)
2. venous endothelial injury (injury to blood wall)
3. hypercoaguability states (blood composition)

Question 34

acute respiratory distress syndrome may result in a number of conditions, including…

Answer 34

aspiration of gastric contents, drugs/toxins, infections, trauma/shock, etc.

Question 35

although there are a number of conditions may lead to ARDS…they all produce similar pathologic lung changes including…

Answer 35

diffuse epithelial cell injury w/ increased permeability of alveolar-capillary membrane…protein and fluid leakage…edema, surfactant inactivation, and formation of hyaline membrane that is impervious to gas exchange.