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Respiratory Physiology Flashcards

1
Q

Volume of air inspired or expired with each normal breath?

A

Tidal volume

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2
Q

Air that cans still be breathed in after normal inspiration?

A

Inspiratory Reserve Volume

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3
Q

Air that can still be breathed out after a normal expiration?

A

Expiratory Reserved Volume

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4
Q

Air in the lung after maximal expiration?

A

Residual Volume

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5
Q

Air that can be breathed in after normal expiration?

A

Inspiratory Capacity

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6
Q

Air that remains in the lungs after a normal expiration?

A

Functional Residual Capacity

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7
Q

Marker of lung function?

A

Functional Residual Capacity

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8
Q

Maximum volume of gas that can be expired after a maximal inspiration?

A

Vital Capacity

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9
Q

Volume of gas present in the lungs after a maximal inspiration?

A

Total Lung Capacity

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10
Q

Volume of air utilized for continual gas exchange to occur between breaths?

A

Residual Volume

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11
Q

Lung volume that can not be measured by spirometry?

A

Residual Volume

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12
Q

What is the effect on resistance and airflow if there’s a decreased airway radius by a factor of 4 ?

A

By the Poiseuille Law, radius is raised to the fourth power.

-Resistance will increase by a factor of 256 and airflow will decrease by a factor of 256. (Poiseuille Law)

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13
Q

What lung disease?
Low FEV1
Low FVC
FEV1<FVC 📍
High FRC 📍

A

Obstructive Lung Disease : Asthma or COPD

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14
Q

What lung disease?
Low FEV1
Low FVC
FEV1<FVC
High FRC
Normal DLCO 📍

A

Asthma

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15
Q

What lung disease?
Low FEV1
Low FVC
FEV1<FVC
High FRC
Low DCLO 📍

A

COPD

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16
Q

What lung disease?
Low FEV1
Low FVC
FEV1>FVC📍
Low FRC 📍

A

Restrictive Lung Disease

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17
Q

Where is this formula used?
PO2 x Solubility of O2 in blood = _____________

A

Dissolved gases

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18
Q

What happens to the net diffusion of O2 when the partial pressures of O2 in alveolar air and pulmonary capillary are equal?

A

There is no more net diffusion of O2 ( Ficks Law)

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19
Q

Expected alveoli finding in an infant born prematurely with neonatal respiratory distress syndrome?

A

Collapse of the small alveoli

Surfactant appears between 24th and 35th gestational week. In the absence of surfactant , surface tension is too high , the small alveoli will collapse into larger alveoli.

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20
Q

Hypoxia causes vasoconstriction in this vascular bed?

A

Pulmonary

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21
Q

12/M cyanotic, had a severe asthmatic attack with arterial PO2 of 60mmHg and PCO2 of 30mmHg. What is the explanation for low PCO2?

A

His arterial PCO2 Is lower than normal because hypoxemia is causing him to hyperventilate.

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22
Q

12/M cyanotic, had a severe asthmatic attack with arterial PO2 of 60mmHg and PCO2 of 30mmHg. What is the drug classification of the treatment ?

A

B2 adrenergic agonist

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23
Q

Intrapleural pressure level during inspiration?

A

Intrapleural pressure is more negative than it is during expiration.

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24
Q

Volume that remains in the lungs after a tidal volume is expired?

A

Functional Residual Capacity

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25
Q

35/M with this following lung volumes, what’s the ERV?
VC: 5L
TV: 0.5 L
IC: 3.5 L
FRC: 2.5L

A

1.5 L

ERV= VC - IC

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26
Q

Blood flow in the lungs when a person is standing is highest where?

A

Highest at the base because that is where the difference between arterial and venous pressure is greatest.

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27
Q

What happens to the FRC during atmospheric pressure?

A

When an airway pressure is equal to the atmospheric pressure, it is designated as zero pressure.

  • when the airway pressure is zero ( atmospheric) , the volume of the combined system is the functional residual capacity.
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28
Q

Site of highest airway resistance?

A

Medium sized bronchi

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29
Q

49/M with pulmonary embolism and with complete blocked blood flow to his left lung. Effect on alveolar PO2 of the left lung?

A

Alveolar PO2 in the left lung will be approximately equal to the PO2 in inspired air.

  • this is because there is no blood flow to the left lung , and no gas exchange between the alveolar air and pulmonary capillary blood.
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30
Q

Strenuous exercises causes a shift from where ?

A

Shift from curve A to curve B
aka
Shift to the right; Increased unloading of O2, decreased affinity of O2

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31
Q

Effect on P50 when there’s a shift from curve A to curve B / shift to the right?

A

Increased P50

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32
Q

Volume remains in the lungs after a maximal expiration?

A

Residual volume

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33
Q

Resistance in the pulmonary circulation compared to systemic circulation?

A

Lower resistance

  • blood flow or cardiac output is nearly equal. Pulmonary circulation is characterized as having both lower pressure and resistance.
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34
Q

65/M compute for the alveolar ventilation with the following values:
TV: 0.45L
RR: 16
Arterial PCO2 : 41
Expired PCO2: 35

A

6.14 L/ min

  • Alveolar ventilation is the difference between tidal volume and dead space multiplied by breathing frequency.
  • Dead space= 0.45 x (41-35/41) = 0.066L
  • Alveolar ventilation = (0.45L- 0.066L) x 16bpm = 6.14 L/min
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35
Q

PCO2 at the base of the lungs compared with the apex ?

A

Higher pulmonary capillary PCO2

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36
Q

Hypoxemia produces hyperventilation by a direct effect on the __________ and ____________.

A

Carotid & Aortic body chemoreceptors
Vs
Medullary chemoreceptors which which are stimulated by CO2 or H+

37
Q

Effect of strenuous exercise on ventilation rate and O2 consumption together ?

A

Ventilation rate and O2 consumption increases to the same extent

38
Q

Pulmonary capillary in an area of a lung not ventilated will have PO2 that is equal to what?

A

Equal to mixed venous PO2

  • If an area of the lung is not ventilated , there can be no gas exchange in that region. The pulmonary capillary blood serving that region will not equilibrate with alveolar PO2 but will have a PO2 equal to that of the mixed venous blood.
39
Q

Occurs in the venous blood during CO2 transport from tissues ?

A

Conversion of CO2 and H2O to H+ and HCO3 in the red blood cells.

40
Q

Occurs in the venous blood during CO2 transport from tissues.

A

Conversion of CO2 and H2O to H+ and HCO3 in the red blood cells (RBCs)

41
Q

Diseases with hypoxia, with decreased arterial PO2 and an increased A-a gradient. (3)

A
  1. R-L cardiac shunt
  2. V/Q defect
  3. Fibrosis
42
Q

42/F with severe pulmonary fibrosis
ABG
pH : 7.48
PaO2: 55
PCO2: 32
What’s the explanation for PaCO2?

A

The decreased PaO2 stimulates breathing via peripheral chemoreceptors.

43
Q

38/F moved to Colorado 10,200 feet above sea level. What will happen to the Hgb-O2 curve?

A

Shift to the right .

At high altitudes, PO2 of alveolar air is decreased and hypoxemia occurs causing hyperventilation and respiratory alkalosis , 2-3BPG also increases adaptively.

44
Q

The pH of venous blood is only is only slightly more acidic than the pH of arterial blood because?

A

The H+ generated from CO2 and H2O is buffered by deoxyhemoglobin in venous blood.

45
Q

Total volume expired in maximal expiration?

A

Vital Capacity or FVC

46
Q

In which V/Q defects is supplement O2 beneficial?

A

Low V/Q

Regions with low V/Q have the highest blood flow. Thus, breathing high PO2 air will raise the PO2 of a large volume of blood and have the greatest influence on the total blood flow leaving the lungs.

47
Q

48/F breaths a gas mixture containing 21% O2. What is the cause of her hypoxemia?
ABG
PaO2= 60 mmHg
PaCO2= 45 mmHg
Normal DLCO
Choices:
a. Carbon monoxide poisoning
b. Fibrosis
c. R-L shunt

A

R- L Shunt

  • Carbon monoxide should have a decreased O2 content of blood but would not have an decreased PaO2. Not hypoxemic.
  • Fibrosis should have a low DLCO and is usually a diffusion defect.
  • Calculation of A-a gradient:
    PIO2 = (760mmHg- 47 mmHg) x 0.21 = 150mmHg
    PAO2= 150mmHg -45 mmHg / 0.8 = 94 mmHg
    A-a gradient = 94mmHg - 60mmHg = 34mmHg , which is increased and consistent with right to left shunt
48
Q

62/ M breaths a gas mixture containing 21% O2. Cause of her hypoxemia?
ABG
PaO2 = 60mmHg
PaCO2= 70mmHg
Choices:
a. R-L shunt
b. Fibrosis
c. Hypoventilation

A

Hypoventilation

PaCO2 of 70mmHg

49
Q

Formula of Physiologic Deadspace ?

A

Physiologic Dead Space = Anatomic Dead space + Alveolar Dead space
Alveolar Dead space = TV x [(PaCO2- PECOs)/ (PaCO2)]

50
Q

Associated with Barrel-Chest?

A

Emphysema ( Increased lung compliance, Increased FRC)

51
Q

V. cholerae causes diarrhea because?

A

It increasses Cl- secretory channels in Crypt Cells

52
Q

What is the alveolar ventilation?
VT 0.45L
Arterial PCO2 41mmHg
PCO2 of expired air 35mmHg
RR 16

A

Alveolar ventilation computation:
6.14 L

53
Q

Marked by high respiratory drive + Abnormal compliance
( Not Specific to COVID-19)

54
Q

Drugs that can cause interstitial lung disease / restrictive lung disease. (3)

A
  1. Busulfan
  2. Amiodarone
  3. Methotrexate
55
Q

Microscopic crystals composed of eosinophil protein galectin -10

A

Charcot- Leyden Crystals

56
Q

Charcot- Leyden Crystals are seen in? (2)

A

Asthma & Parasitic Pneumonia

57
Q

Main pressure that moves fluid from capillaries to pulmonary interstitium?

A

Capillary Pressure

58
Q

Rupture of the alveolar walls occur at ____________.

A

Any positive pressure in the interstitial spaces greater than alveolar pressure (>0mmHg) that causes dumping of fluid from the interstitial spaces to the alveoli.

59
Q

Pulmonary edema can cause death by suffocation in 20-30 minutes in which scenario?

A

Severe acute left heart failure

60
Q

What exerts the greatest pressure in mmHg to move fluid from capillaries to the pulmonary interstitium?

A

Pulmonary Capillary Hydrostatic Pressure (+7mmHg)

61
Q

Location of defective alveolar walls in patients with emphysema. (2)

A

Panacinar emphysema - more severe in lower lobes.
Centroacinar emphysema- more severe in upper lobes.

CUPL

62
Q

In patient rapidly breathing due to asthma , we expect?

A

Lower than normal arterial PCO2 because hypoxemia triggers hyperventilation.

63
Q

Drug we give to patients with asthma?

A

Beta 2 Adrenergic Agonist (B-2 Agonist)

64
Q

Characterizes asthma ? (4)

A
  1. Bronchoconstriction ( spastic contraction of bronchiolar smooth muscles)
  2. Increased mucus production
  3. Problem with expiration rather than inspiration
  4. FRC increased during asthma attack
65
Q

High in patients with asthma?

66
Q

Air in the lungs after expiring Tidal volume ?

67
Q

Normal Pulmonary Arterial Pressure (PAP) ?

A

15-25 / 8-10 mmHg

68
Q

Normal ratio of systemic to pulmonary pressure?

A

0.125694444

69
Q

Decreases O2 affinity? (5)

A
  1. Inc CO2
  2. Acidosis
  3. Inc 2,3-BPG
  4. Exercise
  5. Inc Temperature

CABET do the RIGHT thing, Let go.

70
Q

Muscles for breathing used by runner?

A

Forced Inspiration ( Occurs during exercise)
1. External Intercostals
2. Accessory Muscles : (6)
SCM, ANT SERRATI, SCALENE, ALA NASI, GENIOGLUSSUS , ARYTENOID

Forced Expiration ( Occurs during exercise)
1. Internal Intercostals
2. Abdominal muscles : (4)
RECTUS ABDOMINIS , INTERNAL AND EXTERNAL OBLIQUE, TRANSVERSUS ABDOMINIS

71
Q

Accessory Muscles used in Forced Inspiration? (6)

A

Accessory Muscles : (6)
SCM, ANT SERRATI, SCALENE, ALA NASI, GENIOGLUSSUS , ARYTENOID

72
Q

Abdominal Muscles used for Forced Expiration? (4)

A

Abdominal muscles: (4)
RECTUS ABDOMINIS , INTERNAL AND EXTERNAL OBLIQUE, TRANSVERSUS ABDOMINIS

73
Q

Location of bronchial Kulchitsky cell ( pulmonary neurondocrine cells).

A

Basement membrane of bronchi and bronchioles

74
Q

Characteristics of Type I pneumocytes? (4)

A

Thin, Flat , For gas exchange, Does not secrete surfactant.

75
Q

Pressure in the pulmonary veins is equal to the pressure in _____________.

A

PCWP ( Pulmonary Capillary Wedge Pressure)

76
Q

Hyperventilation causes which acid -base abnormality?

A

Respiratory Alkalosis

77
Q

Formula for PAO2 ?

A

PAO2 = (FiO2 x (Patmos-PH2O))- (PaCO2/RespQ)

78
Q

Formula for Capacitance?

79
Q

Thermoregulatory centers for heat loss and heat conservation respectively:

A

Heat Loss: Anterior
Heat Conservation: Posterior

80
Q

What is the purpose of brown bag in hyperventilation?

A

Increase PaCO2

81
Q

Stimulation of Beta-2 receptors in the lungs will cause?

A

Bronchodilation

82
Q

Blood pathway from pulmonary vein? (14)

A
  1. Pulmonary Vein
  2. Left atrium
  3. Left Ventricle
  4. Aorta
  5. Other arteries
  6. Arterioles
  7. Capillaries
  8. Veins
  9. SVC / IVC
  10. Right atrium
  11. Right Ventricle
  12. Pulmonary Artery
  13. Pulmonary Arteriole
  14. Pulmonary Capillaries
83
Q

I+T+E ?

84
Q

Living in high altitude can cause?

A

Shift to the right O2 - Hgb dissociation curve

85
Q

Bronchiole capable of gas exchange?

A

Respiratory bronchiole

86
Q

Last bronchiole not capable of gas exchange?

A

Terminal bronchioles

87
Q

Inhalation through nostrils vs mouth?

A

Better air conditioning if through nostrils
- humidification and warming occurs as air enters

88
Q

Respiratory quotient increases in?

A

High carbohydrate diet

Physiology (11 decks)

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