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Patho > Resp 2 > Flashcards

Resp 2 Flashcards

1
Q

Equation for Law of Laplace

A

P = (2T)/r

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2
Q

Tendency to collapse on ______ as radius decreases

A

Expiration

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3
Q

______ alveoli have low collapsing pressure and are easy to keep open. ______ alveoli have high collapsing pressure and are more difficult to keep open.

A

Large; small

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4
Q

Surfactant is composed of:

A

Phospholipid, proteins, & Ca

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5
Q

Acts as surface tension reducer by disrupting the intermolecular forces (hydrogen bonds) b/w water molecules of liquid
Act like detergent

A

Surfactant

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6
Q

Reduction in surface tension _____ compliance

A

Increases

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7
Q

What lecithin-to-sphingomyelin (L/S) ratio in amniotic fluid indicates fetal lung maturity

A

> 2:1

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8
Q

Synthesis of surfactant starts when?

A

24 weeks of gestation; almost always present at week 35

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9
Q

Symptoms of neonatal respiratory distress syndrome d/t lack of surfactant

A

Atelectasis
Difficulty reinstating lungs (d/t decreased compliance)
Hypoxemia (d/t decreased V/Q)

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10
Q

Tx for neonatal respiratory distress syndrome

A

Maternal steroid shots before birth (speeds up formation of surfactant)
Artificial surfactant to infants by inhalation

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11
Q

Airflow (Q) =

A

Pressure gradient/ airway resistance (R)

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12
Q

Resistance to flow (R) =

A

(8 n L)/ pie r 4

8 (viscosity of inspired gas) x length of airway/ pie radius to the 4th power

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13
Q

Poiseuille’s equation says air flow is:

A

Directly proportional to the pressure gradient, and pie radius to the 4th power
Inversely proportional to 8 x the viscosity and Length

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14
Q

_____ lung volumes are associated w/ less radial traction and increased airway resistance

A

Low

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15
Q

_____ lung volumes are associated with greater radial traction and decreased airway resistance

A

High

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16
Q

Major site of airway resistance

A

In the medium-sized bronchi

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17
Q

Why do the smallest airways not offer the highest resistance?

A

B/c of their parallel arrangement

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18
Q

Work of inspiration:

A

Compliance work (50%)
Tissue resistance work
Airway resistance work

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19
Q

The volume inspired or expired with each normal breath

A

Tidal volume

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20
Q

the volume that can be inspired over and above the tidal volume (used during exercise)

A

Inspiration Reserve Volume

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21
Q

The volume that can be expired after the expiration of tidal volume

A

Expiratory Reserve Volume

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22
Q

The volume that remains in the lungs after a maximum expiration
Cannot be measured by spirometry

A

Residual Volume

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23
Q

How is residual volume measured?

A

Helium Dilution Method

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24
Q

The sum of tidal volume, inspiration reserve volume, & expiratory reserve volume
“Everything but the residual volume”

A

Vital capacity

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25
Q

Inspiration capacity =

A

TV + IRV

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26
Q

The volume remaining in the lungs after a tidal volume is expired

A

Functional Residual Capacity

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27
Q

FREC =

A

ERV + RV

28
Q

The volume in lungs after a maximum inspiration

The sum of all 4 volumes

A

Total lung capacity

29
Q

prevents large SWINGS of PO2 by acting as a bufffer

A

FRC

30
Q

FRC is reduced by:

A

Supine position
Obesity
Pregnancy
Anesthesia

31
Q

FRC increases by:

A

PEEP, CPAP

Increased airway resistance- asthma

32
Q

Allows for more time (up to 10 min) for airway manipulation

A

Preoxygenation/Denitrogenation before anesthetic induction provides reservoir of O2 by filling FRC with 100 % O2

33
Q

The volume of air that can be forcible expired as hard and as rapid as possible after taking maximum inspiration

A

Forced vital capacity (FVC)

34
Q

Forced Expiratory Volume in 1st second/ Forced Vital Capacity

A

4/5 = 80%

35
Q

In obstructive lung diseases such as asthma & COPD, the FEV1/FVC is ________

A

Decreased

36
Q

In restrictive lung diseases such as pulmonary fibrosis, pneumothorax, scoliosis, myasthenia gravis, or ALS, FEV1/FVC is _______

A

Normal or increased

37
Q

Poor lung expansion can be seen in _____ toxicity

A

Bleomycin (anti cancer)

38
Q

Decreased BP and decreased PCWP =

A

Hypovolemic shock, give fluid

39
Q

Decreased BP, increased PCWP =

A

Failing heart/cardiogenic shock, give inotropes

40
Q

PCWP measures?

A

Left atrial pressure. Normally 10 mmHg

41
Q

Right atrium pressure

A

< 5 mmHg

42
Q

Right ventricle pressure

A

<25 / <5 mmHg

43
Q

Left atrium pressure

A

< 12 mmHg

44
Q

Left ventricle pressure

A

< 150/ 10 mmHg

45
Q

Pulmonary trunk pressure

A

< 25/10 mmHg

46
Q

Aortic pressure

A

< 150/90 mmHg

47
Q

PCWP

A

< 12 mmHg

48
Q

Pulmonary artery pressures

A

25/8
Mean = 15
Capillary = 7

49
Q

In the pulmonary circulation, compliance is ______ and resistance is _______

A

Higher; lower

50
Q

Why does alveolar hypoxia cause vasoconstriction in the lungs?

A

To divert blood away from poorly ventilated regions towards well-ventilated regions of lung. Decrease shunting of blood

51
Q

Why is fetal pulmonary vascular resistance very high

A

D/t hypoxic vasoconstriction/ decreased blood flow

52
Q

What happens with global hypoxia (breathing in thin air at high altitude)?

A

Vasoconstriction of entire lungs > pulmonary HTN > RVF

53
Q

PVR =

A

((Pulm artery pressure - PCWP)/ CO ) x 80

54
Q

PA > Pa > Pv

A

Zone I

55
Q

Pa > PA > Pv

A

Zone II

56
Q

Pa > Pv > PA

A

Zone III

57
Q

Distribution of pulmonary blood flow is uneven d/t

A

Effect of gravity

58
Q

When supine, pulmonary blood flow is

A

Nearly uniform throughout the lung

59
Q

When standing, blood flow is lowest at _______ and highest at _____

A

Apex (zone 1); base (zone 3)

60
Q

Factors that expand West Zone 1:

A

Decreased PA pressure (shock) pulm hypotension
Increased Alveolar pressure (PEEP)
Occlusion of blood vessel (pulmonary embolism)

61
Q

Factors that reduce West Zone 1:

A

Increased PA pressure (pulm hypertension)

62
Q

V/Q ratio is highest (3) at ____ and lowest (0.8) at ____

A

Apex; base

63
Q

If the airways are completely blocked (ventilation 0), but blood flow is normal, the V/Q is? Which is called?

A

0; right-to-left shunt

64
Q

If the blood flow is blocked, but the ventilation is normal, the V/Q is? Which is called?

A

Infinite; dead space

65
Q

100% O2 will improve which type of V/Q mismatch?

A

Blood flow obstruction

Patho (13 decks)

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