Resp A&P High Yield

Question 1

What makes up the anatomic dead space in the lungs?

Answer 1

Conducting zone

Question 2

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

Answer 2

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

Question 3

What comprises the respiratory zone of the resp tree?

Answer 3

resp bronchioles, alveolar ducts, and alveoli

Question 4

Describe the histology of the lining of the respiratory zone?

Answer 4

Cuboidal cells

Question 5

What do Type I pneumocytes look like?

Answer 5

Squamous (thin for optimal gas diffusion

Question 6

What do type II pneumocytes look like?

Answer 6

Cuboidal

Question 7

What are the 2 functions of Type II pneumocytes?

Answer 7

1- Precursors for type I

2- secretion of surfactant

Question 8

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

Answer 8

Collapse in expiration due to decreased radius

Question 9

What is the most important component of surfactant?

Answer 9

Dipalmitoylposphatidylcholine

Question 10

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

Answer 10

Begin @ 26 weeks

Mature @ 35 weeks

Question 11

What cells secrete the proteinaceous component of surfactant?

Answer 11

club/ clara cells

Question 12

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

Answer 12

Lower portion of right inferior lobe

Question 13

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

Answer 13

Superior portion of the right inferior lobe

Question 14

What type of fissure is found in BOTH lungs?

Answer 14

Oblique

Question 15

What level does the IVC go through the diaphragm?

Answer 15

T8

Question 16

What level does the Esophagus go through the diaphragm?

Answer 16

T10

Question 17

What level does the vagus go through the diaphragm?

Answer 17

T10

Question 18

What level does the aorta go through the diaphragm?

Answer 18

T12

Question 19

What level does the throacic duct go through the diaphragm?

Answer 19

T12

Question 20

What level does the azygos vein go through the diaphragm?

Answer 20

T12

Question 21

What nerve (and nerve roots) innervates the diaphragm?

Answer 21

Phrenic nerve–> C3- C5

Question 22

Where does diaphragm irritation refer to?

Answer 22

Shoulder (C5)

Question 23

What level does the common carotid bifurcate?

Answer 23

C4

Question 24

What level does the trachea bifurcate?

Answer 24

T4

Question 25

What level does the abdominal aorta bifurcate?

Answer 25

L4

Question 26

"air that can still be breathed in after normal inspiration"

Answer 26

Inspiratory reserve volume

Question 27

"air that moves into lung with each quiet inspiration"

Answer 27

tidal volume

Question 28

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

Answer 28

Expiratory reserve volume

Question 29

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

Answer 29

reserve volume

Question 30

"IRV + TV"

Answer 30

Inspiratory capacity

Question 31

"RV + ERV"

Answer 31

FRC

Question 32

"TV +IRV + ERV"

Answer 32

Vital capacity

Question 33

"IRV + TV + ERV + RV"

Answer 33

TLC

Question 34

What balances the inward pull of the lungs at FRC?

Answer 34

Outward pull of the chest wall

Question 35

What are airway and alveolar pressures at FRC?

Answer 35

Zero!

Question 36

What are intrapleural pressures ar FRC?

Answer 36

Negative

Question 37

What conditions are associated with decreased compliance?

Answer 37

Pulmonary fibrosis Pneumonia Pulmonary edema

Question 38

What conditions are associated with increased compliance?

Answer 38

Emphysema | Normal Aging

Question 39

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

Answer 39

T

Question 40

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

Answer 40

Shifts to the RIGHT with: Increased Cl- Increased H+ Increased CO2 Increased 2,3- BPG Increased Temp

Question 41

Hb is a buffer for...

Answer 41

H+ ions

Question 42

Methemoglobin has an increased affinity for what molecule?

Answer 42

Cyanide

Question 43

How is methemoglobin treated?

Answer 43

Methylene blue

Question 44

What is a method for inducing methemoglobinemia?

Answer 44

Nitrates followed by thiosulfate

Question 45

What is carboxy Hb?

Answer 45

Hb bound to CO in place of O2

Question 46

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

Answer 46

To the LEFT

Question 47

Why is myoglobin curve not sigmoidal?

Answer 47

Because there is no coopertive binding due to its monomeric nature

Question 48

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

Answer 48

Right shift

Question 49

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

Answer 49

HbF

Question 50

How is O2 content defined?

Answer 50

(O2 binding capacity X % saturation) - dissolved O2

Question 51

How much O2 can 1g Hb bind/.

Answer 51

1.34 mL O2

Question 52

Which is decreased when there is decreased Hb? O2 content O2 saturation Arterial PO2

Answer 52

O2 content decreases The others stay the same

Question 53

What occurs in a decreaesd PAo2?

Answer 53

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

Question 54

What gases are typically perfusion limited?

Answer 54

O2, CO2, N2O

Question 55

"gas equilibrates early along the length of the capillary"

Answer 55

Perfusion limited

Question 56

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

Answer 56

Diffusion limited

Question 57

What gases are diffusion limited?

Answer 57

O2 in emphysema or fibrosis CO

Question 58

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

Answer 58

High altitude Hypoventilation

Question 59

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

Answer 59

V/Q mismatch Diffusion limitatino Right-to- left shunt

Question 60

What is hypoxia?

Answer 60

decreased O2 delivery to tissue

Question 61

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

Answer 61

3

Question 62

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

Answer 62

0.6

Question 63

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

Answer 63

Base

Question 64

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

Answer 64

It increases! Approaches 1

Question 65

How is the majority of CO2 transported in the blood?

Answer 65

As HCO3- (with H+ bound to Hb)

Question 66

Where can CO2 bind Hb?

Answer 66

N terminus of globin chain

Question 67

What is the mechanism through which HCO3 leaves RBCs?

Answer 67

Cl-/ HCO3 - antiporter

Question 68

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

Answer 68

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

Question 69

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

Answer 69

Increased renal excretion of HCO3

Question 70

Why does the pH decrease during strenuous exercise?

Answer 70

Due to lactic acidosis--> aids in Oxygen unloading!