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Step 1 Review > Resp A&P High Yield > Flashcards

Resp A&P High Yield Flashcards

1
Q

What makes up the anatomic dead space in the lungs?

A

Conducting zone

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2
Q

Which can be found further down the conducting zone…goblet cells or pseudostratified ciliated columnar cells? Why is this important?

A

pseudostratified ciliated columnar cells–> because it help to “beat up” the mucus produced

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3
Q

What comprises the respiratory zone of the resp tree?

A

resp bronchioles, alveolar ducts, and alveoli

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4
Q

Describe the histology of the lining of the respiratory zone?

A

Cuboidal cells

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5
Q

What do Type I pneumocytes look like?

A

Squamous (thin for optimal gas diffusion

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6
Q

What do type II pneumocytes look like?

A

Cuboidal

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7
Q

What are the 2 functions of Type II pneumocytes?

A

1- Precursors for type I

2- secretion of surfactant

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8
Q

When do alveoli have a tendancy to collapse (insp or exp)? Why is this?

A

Collapse in expiration due to decreased radius

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9
Q

What is the most important component of surfactant?

A

Dipalmitoylposphatidylcholine

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10
Q

When does surfactant synthesis begin? When are the levels high enough?

A

Begin @ 26 weeks

Mature @ 35 weeks

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11
Q

What cells secrete the proteinaceous component of surfactant?

A

club/ clara cells

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12
Q

If you were to aspirate while upright where would the aspirate go?

A

Lower portion of right inferior lobe

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13
Q

If you were to aspirate while supine where would the aspirate go?

A

Superior portion of the right inferior lobe

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14
Q

What type of fissure is found in BOTH lungs?

A

Oblique

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15
Q

What level does the IVC go through the diaphragm?

A

T8

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16
Q

What level does the Esophagus go through the diaphragm?

A

T10

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17
Q

What level does the vagus go through the diaphragm?

A

T10

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18
Q

What level does the aorta go through the diaphragm?

A

T12

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19
Q

What level does the throacic duct go through the diaphragm?

A

T12

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20
Q

What level does the azygos vein go through the diaphragm?

A

T12

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21
Q

What nerve (and nerve roots) innervates the diaphragm?

A

Phrenic nerve–> C3- C5

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22
Q

Where does diaphragm irritation refer to?

A

Shoulder (C5)

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23
Q

What level does the common carotid bifurcate?

A

C4

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24
Q

What level does the trachea bifurcate?

A

T4

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25
Q

What level does the abdominal aorta bifurcate?

A

L4

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26
Q

“air that can still be breathed in after normal inspiration”

A

Inspiratory reserve volume

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27
Q

“air that moves into lung with each quiet inspiration”

A

tidal volume

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28
Q

“air in lung that can still be breathed out after normal expiration”

A

Expiratory reserve volume

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29
Q

“air in lung after maximal expiration; cannot be measured on spirometry

A

reserve volume

30
Q

“IRV + TV”

A

Inspiratory capacity

31
Q

“RV + ERV”

A

FRC

32
Q

“TV +IRV + ERV”

A

Vital capacity

33
Q

“IRV + TV + ERV + RV”

A

TLC

34
Q

What balances the inward pull of the lungs at FRC?

A

Outward pull of the chest wall

35
Q

What are airway and alveolar pressures at FRC?

A

Zero!

36
Q

What are intrapleural pressures ar FRC?

A

Negative

37
Q

What conditions are associated with decreased compliance?

A

Pulmonary fibrosis
Pneumonia
Pulmonary edema

38
Q

What conditions are associated with increased compliance?

A

Emphysema

Normal Aging

39
Q

Which form of Hemoglobin has a low affinity for O2… T or R?

A

T

40
Q

What factors favor the T form (deoxygenated) of Hb? Which way does the curve shift?

A

Shifts to the RIGHT with:

Increased Cl-

Increased H+

Increased CO2

Increased 2,3- BPG

Increased Temp

41
Q

Hb is a buffer for…

A

H+ ions

42
Q

Methemoglobin has an increased affinity for what molecule?

A

Cyanide

43
Q

How is methemoglobin treated?

A

Methylene blue

44
Q

What is a method for inducing methemoglobinemia?

A

Nitrates followed by thiosulfate

45
Q

What is carboxy Hb?

A

Hb bound to CO in place of O2

46
Q

Which way does the O2 binding curve shift in CO poisoning?

A

To the LEFT

47
Q

Why is myoglobin curve not sigmoidal?

A

Because there is no coopertive binding due to its monomeric nature

48
Q

A decreased affinity is indicated by a ____ shift in the curve.

A

Right shift

49
Q

Which Hb curve is further to the left…HbF of HbA?

A

HbF

50
Q

How is O2 content defined?

A

(O2 binding capacity X % saturation) - dissolved O2

51
Q

How much O2 can 1g Hb bind/.

A

1.34 mL O2

52
Q

Which is decreased when there is decreased Hb?

O2 content
O2 saturation
Arterial PO2

A

O2 content decreases

The others stay the same

53
Q

What occurs in a decreaesd PAo2?

A

Hypoxic vasoconstriction that shifts blood away from poorly ventilated regions of lung to well ventilated regions of lung to well ventilated regions of lung

54
Q

What gases are typically perfusion limited?

A

O2, CO2, N2O

55
Q

“gas equilibrates early along the length of the capillary”

A

Perfusion limited

56
Q

“gas does not equilibrate by the time blood reaches the end of the capillary”

A

Diffusion limited

57
Q

What gases are diffusion limited?

A

O2 in emphysema or fibrosis

CO

58
Q

What can cause hypoxemia (decreased PaO2) with a normal A-a gradient?

A

High altitude

Hypoventilation

59
Q

What can cause hypoxemia (decreased PaO2) with an increased A-a gradient?

A

V/Q mismatch

Diffusion limitatino

Right-to- left shunt

60
Q

What is hypoxia?

A

decreased O2 delivery to tissue

61
Q

What is V/Q at the apex of the lung?

A

3

62
Q

What is the V/Q at the base of the lung?

A

0.6

63
Q

Where are ventilation and perfusion BOTH greater…base or apex of the lung?

A

Base

64
Q

During exercise what happens to the V/Q ratio at the base of the lungs?

A

It increases! Approaches 1

65
Q

How is the majority of CO2 transported in the blood?

A

As HCO3- (with H+ bound to Hb)

66
Q

Where can CO2 bind Hb?

A

N terminus of globin chain

67
Q

What is the mechanism through which HCO3 leaves RBCs?

A

Cl-/ HCO3 - antiporter

68
Q

What happens to 2,3 BPG levels in high altitudes?

A

They increase…in an effort to derease Oxygen binding affinity–> to allow for oxygen to be unloaded in the tissues

69
Q

How does the body compensate for the respiratory alkalosis created by hyperventiation in response to altitude?

A

Increased renal excretion of HCO3

70
Q

Why does the pH decrease during strenuous exercise?

A

Due to lactic acidosis–> aids in Oxygen unloading!

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