Respiratory physiology 1

Question 1

Anatomic dead space begins at the mouth and ends in the:
a. small airways
b. terminal bronchioles
c. respiratory bronchioles
d. alveolar ducts

Answer 1

b. terminal bronchioles

Question 2

The airway is functionally divided into 3 zones:

Answer 2

conducting
respiratory
transitional

Question 3

Ventilation is the process of

Answer 3

exchanging gas (O2 & Co2) between the atmosphere and the lungs

Question 4

A coordinated effort between the brain and the respiratory muscles is required to produce

Answer 4

cyclic pressure changes that allow air to move into and out of the lungs

Question 5

___________ & ________________ during inspiration

Answer 5

The diaphragm and external intercostals contract

Question 6

Exhalation is usually

Answer 6

passive

Question 7

Accessory muscles for inspiration include

Answer 7

the sternocleidomastoid and scalene muscles

Question 8

Accessory muscles for active expiration include

Answer 8

the rectus abdominis, transverse abdominis, internal obliques, and external obliques

Question 9

A vital capacity of _________ is required for an effective cough

Answer 9

at least 15 mL/kg

Question 10

What is the action of the conducting zone?

Answer 10

does not participate in gas exchange
function: bulk gas movement

Question 11

What is the transitional zone?

Answer 11

serves a dual function of air conduit and gas exchange

Question 12

What is the respiratory zone?

Answer 12

participates in gas exchange

Question 13

The transpulmonary pressure is

Answer 13

the difference between alveolar pressure and pleural pressure

Question 14

Alveolar pressure is the

Answer 14

pressure inside an airway

Question 15

Pleural pressure is the

Answer 15

pressure outside of the airway

Question 16

An airway stays open if transpulmonary pressure is

Answer 16

positive

Question 17

An airway collapses when transpulmonary pressure is

Answer 17

negative

Question 18

The _____________ increases the superior-inferior dimension of the chest

Answer 18

diaphragm

Question 19

The ________ increase the anterior-posterior diameter

Answer 19

external intercostals

Question 20

What is the mnemonic for active exhalation?

Answer 20

I let the air out of my TIREs
transverse abdominis, internal oblique, rectus abdominis, external oblique

Question 21

Exhalation becomes an active process when

Answer 21

minute ventilation increases or in patients with lung disease such as COPD

Question 22

What anatomical structures are included in the conducting zone

Answer 22

trachea
bronchi
bronchioles

Question 23

What anatomical structures make up the transitional zone?

Answer 23

respiratory bronchioles

Question 24

What anatomic structures make up the respiratory zone?

Answer 24

alveolar ducts
alveolar sacs

Question 25

To prevent airway collapse, the pressure inside the airway must be

Answer 25

greater than the pressure outside the airway

Question 26

During tidal breathing, transpulmonary pressure

Answer 26

is always positive (keeps tha airway open)

Question 27

During tidal breathing, intrapleural pressure is always

Answer 27

negative (keeps the lungs inflated)

Question 28

Aside from pathologic states, such as pneumothorax, the only time that intrapleural pressure becomes positive is during

Answer 28

forced expiration

Question 29

What is the primary determinant of carbon dioxide elimination?
a. minute ventilation
b. tidal volume
c. alveolar ventilation
d. respiratory rate

Answer 29

C. alveolar ventilation

Question 30

A tidal volume is

Answer 30

the amount of gas that is inhaled and exhaled during the breath (6-8 mL/kg)

Question 31

What is minute ventilation?

Answer 31

tidal volume x respiratory rate

Question 32

What is alveolar ventilation?

Answer 32

(tidal volume- dead space) x respiratory rate

Question 33

When you take a breath, only part of the Vt is delivered to the _________ while the remainder sits in the ____________

Answer 33

respiratory zone; conducting zone (dead space)

Question 34

When you exhale, ______________ gas is removed first.

Answer 34

conducting zone

Question 35

Any condition that increases the volume of the conducting zone (Vd) makes it more

Answer 35

difficult to eliminate expiratory gases from the lungs
-if alveolar ventilation is not increased, then the patient will retain CO2

Question 36

In a healthy, 70 kg adult, the normal dead space is

Answer 36

~2 mL/kg or 150 mL

Question 37

Alveolar ventilation removes _________ from the minute ventilation equation.

Answer 37

dead space

Question 38

Alveolar ventilation is directly proportional to

Answer 38

Carbon dioxide production
(a higher CO2 production stimulates the body to breathe deeper and faster so it can eliminate more CO2)

Question 39

Alveolar ventilation is inversely proportional to

Answer 39

PaCO2 (faster & deeper breathing reduces PaCO2)

Question 40

Which conditions will MOST likely increase the PaCO2 to EtCO2 gradient? (select 3).
a. positive pressure ventilation
b. laryngeal mask airway
c. hypotension
d. endotracheal tube
e. neck flexion
f. atropine

Answer 40

a. positive pressure ventilation
c. hypotension
f. atropine

Question 41

Why does hypotension increase dead space?

Answer 41

hypotension reduces pulmonary blood flow, which increases alveolar dead space

Question 42

Why does atropine increase dead space?

Answer 42

atropine is a bronchodilator, so it increases anatomic dead space by increasing the volume of the conducting zone

Question 43

Why does positive pressure ventilation increase dead space?

Answer 43

increases alveolar pressure, which increases ventilation relative to perfusion.

Question 44

Dead space is reduced by anything that

Answer 44

reduces the volume of the conducting zone
or increases pulmonary blood flow

Question 45

What are the four types of dead space?

Answer 45

anatomic
alveolar
physiologic
apparatus

Question 46

What is anatomic dead space?

Answer 46

air confined to the conducting airways

Question 47

What is alveolar deadspace?

Answer 47

alveoli that are ventilated but not perfused

Question 48

What is physiologic dead space?

Answer 48

anatomic Vd + alveolar Vd

Question 49

What is apparatus dead space?

Answer 49

Vd added by equipment