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SF3 Pulm Test > Questions Derived From BRS Phys > Flashcards

Questions Derived From BRS Phys Flashcards

1
Q

Volume of lungs that does not participate in gas exchange

May be greater than anatomic dead space in lung dz w/ ventilation/perfusion defects

A

Physiologic dead space

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2
Q

The sum of tidal volume and inspiratory reserve volume is

A

Inspiratory capacity

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3
Q

Alveolar pressure minus intrapleural pressure

A

Transmural pressure

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4
Q

The major site of airway resistance is?

A

Medium size bronchi

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5
Q

Parasympathetic stimulation, irritants, and the slow-reacting substance of anaphylaxis (asthma) ______ the airways, _______ the radius, and _______ the resistance to airflow

A

Constrict

Decrease

Increase

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6
Q

Sympathetic stimulation and sympathetic agonists (isoproterenol) _____ the airways via beta-2 receptors, _______ radius, and _______ resistance to airflow

A

Dilate

Increase

Decrease

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7
Q

High lung volumes are associated with greater traction on airways and _______ airway resistance

A

Decreased

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8
Q

______ are associated w/ less traction and increased airway resistance, even to the point of airway collapse

A

Low lung volumes

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9
Q

Intrapleural pressure can be measured by ?

A

A balloon cath in the esophagus

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10
Q

Obstructive disease in which expiration is impaired

Characterized by decreased FVC, FEV1, and FEV1/FVC ratio.

Air that should have been expired is not, leading to air trapping, increased FRC

A

Asthma

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11
Q

Obstructive dz w/ increased lung compliance in which expiration is impaired

Decreased FVC, FEV1, FEV1/FVC ratio.

Increased FRC

Barrel chest

Pink puffers or blue bloaters

Combo of chronic bronchitis and emphysema

A

COPD

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12
Q

COPD type

Mild hypoxemia, maintained alveolar ventilation

Normocapnia

Primarily emphysema

A

Pink puffers

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13
Q

COPD type

Severe hypoxemia

Do not maintain alveolar ventilation so they become hypercapneic

Right ventricular failure and systemic edema.

Cyanosis

A

Blue bloaters

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14
Q

Restrictive dz w/ decreased lung compliance in which inspiration is impaired

Decreased in all lung volumes.

FEV1/FVC may be increased or normal

A

Fibrosis

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15
Q

Lung diffusing capacity increases during exercise because:

A

There are more open capillaries and thus more SA for diffusion

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16
Q

For a perfusion-limited process, diffusion of gas can be increased only if the _________ increases

A

Blood flow

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17
Q

Perfusion-limited exchange is what O2 does in ____________ conditions

A

Normal

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18
Q

Diffusion limited exchange is what O2 does in

A

Emphysema, fibrosis, strenuous exercise

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19
Q

In _________, the gas does not equilibriate by the time blood reaches the end of the pulmonary capillary

A

Diffusion-limited exchange

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20
Q

Hemoglobin increases O2 carrying capacity of blood by

A

70 fold

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21
Q

Causes sickle cell disease

The alpha subunits are normal and the beta subunits are abnormal

In deoxygenated form, makes sickle shaped rods that deform RBC’s

A

Hemoglobin S

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22
Q

Right shifts for hemoglobin oxygen associated curve

A

Increase 2,3-DPG concentration

Increase temperature

Increase in pCO2

Decrease pH

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23
Q

Left shifts on the hemoglobin-O2 dissociation curve

A

Increased affinity of hemoglobin for O2

CO poisoning

HbF

Decreased pCO2

Increased pH

Decreased temperature

Decreased 2,3 DPG concentration

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24
Q

A normal A-a gradient is

A

Between 0 and 10 mmHg

25
Q

The A-a gradient is increased if ?

A

O2 doesn’t equilibriate between alveolar gas and arterial blood (diffusion defect, V/Q defect, R-L shunt)

And PAO2 is greater than PaO2

26
Q

Pressures are ____ in pulmonary circulation than in the systemic circulation

A

Much lower

27
Q

Resistance is _____ in the pulmonary circulation than in the systemic circulation

A

Much lower

28
Q

When a person is supine, blood flow is _____ throughout the lung

A

Nearly uniform

29
Q

When a person is standing, blood flow is uneven. It is lowest at the _____ and hight at the ______

A

Apex

Base

30
Q

Zone of lung

Blood flow highest

Arterial pressure > venous pressure > alveolar pressure

A

Zone 3

31
Q

Zone of lung

Blood flow medium

Arterial pressure > alveolar pressure > venous pressure

A

Zone 2

32
Q

Zone of lung

Blood flow low

Alveolar pressure > arterial pressure > venous pressure

A

Zone 1

33
Q

In the lungs, hypoxia causes vaso________

A

Constriction

34
Q

Hypoxia induced vasoconstriction is the opposite of effect of hypoxia in other organs (most organs, hypoxia —> vasodilation) what effect does this have?

A

Local vasoconstriction redirects blood from poorly ventilated, hypoxic regions of the lung and towards the well ventilated regions, where the blood can pick up more oxygen

35
Q

Fetal pulmonary vascular resistance is ______ because of ___________

A

Very high

Generalized hypoxic vasoconstriction

36
Q

Right to left shunts always result in ? ?

A

A decrease in arterial pO2

37
Q

Left to right shunts do what to arterial pO2?

A

Do not result in decrease

38
Q

Ratio of alveolar ventilation (V) to pulmonary blood flow (Q)

A

V/Q ratio

39
Q

With normal breathing rate, tidal volume, and cardiac output, the VQ ratio is approximately ____ and arterial pO2 is _______ and arterial pCO2 is _______

A

0.8

100mmHg

40mmHg

40
Q

Ventilation and perfusion are both lowest at ____ and highest at _____, but there is more of a difference in perfusion

A

Apex

Base

41
Q

V/Q ratio is higher at the ________ of the lung and lower at the ________ of the lung

A

Apex

Base

42
Q

Regional differences in pO2 are ______ than regional differences for pCO2

A

Greater

43
Q

V/Q ratio in pulmonary embolism

A

infinite (dead space)

44
Q

V/Q ratio in airway obstruction

A

V/Q = 0

45
Q

Resistance to blood flow decreases as you go to the _______ of the lung

A

Bottom

46
Q

Perfusion is _______ in the top and _______ in the lowest part of the lung

A

Smallest

Greatest

47
Q

Pulmonary vascular smooth muscle _______ in low pO2

A

Contracts

48
Q

How does COPD lead to right heart failure?

A

People w/ obstructive/restrictive lung dz. alveolar pO2 is low. So overall pO2 is low, causes the entire lung to vasoconstrict (normal response to low pO2) and this increases vascular resistance, making the right heart insufficient.

49
Q

What accounts for the only marginal increase in pulmonary artery pressure in exercise, with increased cardiac output?

A
  1. Recruitment; opening up of previously closed arteries

2. Distention; increase in the radius of the existing blood vessels which decreases resistance

50
Q

Resistance to blood flow through the alveolar vessels ________ as the alveoli expand because the alveolar vessels are longer and their radii are smaller

A

Increases

51
Q

Resistance is ______ to length

A

Directly proportional

52
Q

Resistance is ________ to radius to the fourth power

A

Inversely proportional

53
Q

Inhibits inspiration, therefore regulating inspiratory volume and respiratory rate.

Inhibitory signals to apneustic center

A

Pneumotaxic center

54
Q

What stimuli increases breathing rate in peripheral chemoreceptors, but does not in central chemoreceptors

A

Decreased oxygen level

55
Q

The distribution of V/Q ratios is ________ during exercise than when at rest

A

More even

There is resulting decrease in physiologic dead space

56
Q

The volume remaining in the lungs after the expiration of a tidal volume

A

Functional residual capacity

57
Q

Flow rates from large airways are effort ____

A

Dependent

58
Q

Flow rates from small airways are effort _____

A

Independent

SF3 Pulm Test (10 decks)

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