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Cardiopulm Final > Respiratory PHYSIology > Flashcards

Respiratory PHYSIology Flashcards

1
Q

what structures are in the conducting zone?

A

larynx
trachea
primary bronchi
secondary bronchi
tertiary bronchi
small bronchi
bronchioles
terminal bronchioles

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2
Q

what structures are in the respiratory zone?

A

respiratory bronchioles
alveoli

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3
Q

T/F: the structures within the bronchial tree function independently of each other

A

T

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4
Q

which bronchi is straighter/more vertical & shorter and implicated more in diseases & choking

A

Right bronchi

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5
Q

at what division is bronchitis or other infections more likely to happen?

A

17-19 respiratory bronchiole

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6
Q

which zones are conducting zones? why are they called this?

A

zones 1-16
there is no gas exchange = dead space

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7
Q

the process of gas exchange occurs through ____

A

diffusion

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8
Q

is diffusion more sensitive to O2 or CO2

A

CO2!!!

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9
Q

what causes more of a trigger to breath?

A

high CO2 rather than low O2

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10
Q

CO2 diffusion occurs ____ times faster than O2

A

4 times

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11
Q

COPD patients are _____capnic

A

HYPER

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12
Q

Muscles produce pressure gradient in thoracic cage that is _____ than atmospheric

A

lower

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13
Q

the pressure in the interpleural space is ____ than the atmospheric pressure to keep the lung inflated

A

lower

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14
Q

which side of the diaphragm sits higher?

A

Right (d/t liver)

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14
Q

when a person inhales, the pressure in the lungs ____

A

increases

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14
Q

how does weakness in the ribs and/or diaphragm make it harder to breath?

A

can’t create negative pressure in pulmonic space –> work harder to breathe

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15
Q

what is minute ventilation?

A

Volume of air that is breathed in and out in 1 min

Tidal volume x RR

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16
Q

which is better to ventilate the alveoli:
a) higher tidal volume with lower RR
b) lower tidal volume with higher RR

A

a

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17
Q

where does blood go through vessels slower?

A

at the capillaries

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18
Q

how does the Valsalva maneuver decrease perfusion?

A

Causes decreased venous return and more blood pumped out

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19
Q
A
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20
Q

what is surfactant?

A

fluid to keep lungs open (prevent collapse)

decreased –> SIDS, burns, acute respiratory distress

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21
Q

intrapleural pressure should be

A

negative

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22
Q

if intra-alveolar pressure is decreased, the volume of air ____ (increases/decreases) and air goes _____ (closer/farther)

A

increases
farther

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23
Q

what creates the pressure gradient in the lungs?

A

muscle groups

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24
Q

when a person exhales, pressure ______ (increases/decreases)

A

increases

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25
Q

what can cause the diaphragm to migrate upwards?

A

supine position
obesity
decreased tone

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26
Q

after pulmonary surgery, is reduced which cause exhalation to be harder

A

Function Residual Capacity (FRC)

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27
Q

what is Function Residual Capacity (FRC)?

A

Ability to exhale beyond normal and still have air in the lungs
ER + RV = FRC

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28
Q

Exhalation is ____; inhalation is ____ (passive/active)

A

passive
active

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29
Q

increased compliance or a lung that is too stretch out leads to what type of disease?

A

obstructive (too much O2 left in lungs)

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30
Q

decreased compliance leads to what type of disease?

A

restrictive

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31
Q

there is a higher ____ pressure gradient in restrictive lung diseases

A

positive

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32
Q

what is expiratory reserve?

A

Amount of air can force out after normal exhale

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32
Q

what is residual volume?

A

Air left in lungs after maximal exhale

33
Q

obstructive diseases have a/an _____ residual volume (increased/decreased)

A

increased

34
Q

restrictive diseases have a/an _____ residual volume (increased/decreased)

A

decreased

35
Q

which type of lung disease has a decreased tidal volume?

A

restrictive

36
Q

what is vital capacity?

A

inspiratory capacity + expiratory reserve volume + tidal volume

how much can maximally inhale and exhale

37
Q

total lung capacity _____ (increases/decreases) with COPD

A

increases

38
Q

total lung capacity _____ (increases/decreases) with restrictive diseases

A

decreases

39
Q

T/F: residual volume, functional residual capacity, and total lung capacity can be determined with basic spirometry

A

F (calculated mathematically)

40
Q

what is a normal FEV 1?

A

80%

41
Q

an FEV 1 of <80% indicates a ____ disease

A

obstructive

42
Q

FEV 1 is estimated based on

A

Age, gender, race, height

43
Q

what is a normal FEV1/FVC = forced vital capacity?

A

70%
(<70% = COPD)

44
Q

should inhalation or exhalation be focused on with restrictive disorder patients?

A

inhalation

45
Q

should inhalation or exhalation be focused on with obstructive disorder patients?

A

exhalation

46
Q

why does exhalation take longer is obstructive diseases?

A

decreased elasticity

47
Q

what is a normal ventilation-perfusion ratio?

A

0.8 (ideal = 1)

48
Q

what occurs if there is more perfusion than ventilation?

A

shunting
(occurs in pneumonia, COPD, asthma)

49
Q

what occurs if there is less perfusion than ventilation?

A

dead space

50
Q

where is there more perfusion in an upright position?

A

bases

51
Q

relatively, there is more perfusion in the ____ part of the lungs and more ventilation at the ______ parts

A

more perfusion - bases
more ventilation - upper & middle

52
Q

what position is gravity reduced for the diaphragm?

A

prone

53
Q

how does the ventilation/perfusion ratio change during exercise?

A

the upper lobes become more perfused and VPR is closer to 1

54
Q

which type of diseases have diffusion issues?

A

restrictive (space between alveoli and capillaries are increased)

55
Q

diffusion is maintained by

A
  • slow blood at capillaries
  • thin membrane b/w capillaries
    and alveoli
  • capillaries are close to RBC size
56
Q

what occurs in bronchopulmonary dysplasia?

A

Bronchial tree more fibrotic
Increased distance b/w alveoli and capillaries

57
Q

there is mass vaso____ through pulmonary system with pulmonary HTN

A

vasoconstriction

58
Q

how is pulmonary HTN monitored?

A

with a Swan Ganz catheter (R heart cath)

59
Q

what pulmonary pressure is too high during exercise?

A

> 40 mm Hg

60
Q

what pulmonary pressure is indicative of pulmonary HTN?

A

> 20 mm Hg at rest

61
Q

what is the #1 reason for ventilation perfusion mismatch?

A

hypoxemia

62
Q

what is the only situation in which supplemental O2 will not help?

A

large intrapulmonary shunt (large pulmonary embolism)

63
Q

Most CO2 is transported as

A

bicarbonate

64
Q

ways in which CO2 in transported in the blood

A

bicarbonate (mostly)
bound to Hb (5%)
in plasma (5%)

65
Q

how does breathing change with metabolic acidosis?

A

Kussmaul’s respirations:
rapid and deep breaths

66
Q
A
67
Q

how is O2 mainly transported?

A

bound to Hb

68
Q

what are the controls of respiration?

A
  • chemoreceptors in medulla
  • motor cortex, cerebellum, reticular formation
  • carotid bodies
  • skeletal muscles mechanoreceptors
  • more air in the lungs causing stretch (increase RR)
  • temperature (higher = inc RR)
69
Q

how does a rebreather mask help with respiration?

A

the inspired CO2 stimulates inhales - increases RR

70
Q

what is a normal blood pH?

A

7.4

71
Q

when CO2 levels are high (hypercapnia), there is ____ventilation and an ____ environment

A

hyperventilation
acidic

72
Q

what mm Hg of PaO2 is considered hypoxemia?

A

<80 mm
(note: COPD pts may be asymptomatic at <50)

73
Q

how will the body compensate with high bicarbonate levels?

A

produce ketones

74
Q

a right shift of the oxygen saturation curve indicates ___ SpO2 and more blood in the ____

A

low
plasma

75
Q

during hypoventilation, CO2 is ____ and the environment is ____

A

increased
acidic

76
Q

during hyperventilation, CO2 is ____ and the environment is ____

A

decreased
basic

77
Q

what type of ventilation is seen during ketoacidosis?

A

hyperventilation

77
Q

how long does it take the metabolic system to to control acid/base balance?

A

days

78
Q

how long does it take the respiratory system to to control acid/base balance?

A

quick - minutes

79
Q

what controls the acid/base balance in the metabolic system?

A

kidneys retain or release bicarbonate

80
Q

components of vital capacity

A

tidal volume + inspiratory reserve volume + expiratory reserve volume

81
Q

functional residual capacity components

A

expiratory reserve volume + residual volume

Cardiopulm Final (6 decks)

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