Respiratory Physiology Flashcards

1
Q

On which side of the bronchial tree does aspiration pneumonia & choking occur more often and why?

A

R side is more vertical & shorter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which zone in the bronchial tree is where air is pushed through but there’s no respiration (also known as dead space)?

A

Conducting zone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

At what level of the bronchial tree does bronchitis occur?

A

Respiratory bronchioles (17-19)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe the order of the bronchial tree.

A

Conducting zone: larynx, trachea, primary bronchi, secondary bronchi, tertiary bronchi, small bronchi, bronchioles, terminal bronchioles. Respiratory zone: resp bronchioles, alveolar sac.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What type of patient can hypercapnia & hypoxemia be seen in?

A

COPD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What 4 muscles promote pressure gradient (lower pressure in thoracic)?

A
  • Intercostals
  • Diaphragm
  • SCM
  • Scalenes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe the difference between levels of atmospheric pressure, intrapulmonic pressure, & intrapleural pressure at rest.

A
  • Atmospheric = intrapulmonic
  • Intrapleural less than both
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the significance of intrapleural pressure being lower than atmospheric during inspiration?

A

Keeps lungs expanded

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the difference between levels of atmospheric pressure, intrapulmonic pressure, & intrapleural pressure at inspiration.

A

Both intrapulmonic & intrapleural lower than atmospheric but intrapleural is the lowest out of the 3.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe the difference between levels of atmospheric pressure, intrapulmonic pressure, & intrapleural pressure at expiration.

A
  • Intrapulmonic higher than atmospheric
  • Intrapleural lower than both
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is minute ventilation & what is needed for there to be an adequate level of it?

A
  • In/out in a min (tidal volume x RR)
  • Alveoli need to be ventilated, lungs must expand & collapse to move enough volume, air must flow through airways @ good rate, minimal barrier b/t alveolar air & pulm capillary for O2.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Alveoli are better ventilated when there’s an (increase/decrease) in RR & an (increase/decrease) in tidal volume.

A
  • Decrease
  • Increase
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the significance of RBCs needing to pass close to the alveolar-capillary wall?

A

Because O2 doesn’t diffuse as well or fast as CO2.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How does pulmonary edema or any disease that has fluid/scar tissue cause hypoxemia?

A

Makes space b/t capillaries & alveoli bigger so blood goes through capillaries slower.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are levels of CO2 influenced by mostly? How about O2?

A
  • CO2: changes in vent
  • O2: changes in vent & diffusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the 2 compartments of the trunk & what structure regulates the pressure?

A
  • Thorax & abd
  • Diaphragm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What seals the trunk at both ends?

A

Larynx & PF muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How does intrathoracic pressure change when a patient is holding their breath & lifting heavy? How does this affect venous return?

A

Increase intrathoracic pressure –> decrease venous return

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What lowers surface tension in the lungs to allow it to expand since it has a tendency to collapse?

A

Surfactant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is functional residual capacity?

A
  • Amount of air left in lung after normal exhalation
  • Balance point of lung recoil & chest wall forces
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Amount of opposing forces between thorax & lungs causes ________ intrapleural pressure.

A

Negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What type of conditions would paralyze surfactant producing cells which would lead to a collapsed lung?

A

Burn, inhalation injury, acute distress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

If intra-alveolar pressure is lower than atmospheric pressure, what can occur with a deep breath?

A

Air can get all the way to alveoli.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What type of pressure is due to interaction of lung & chest wall forces that is usually negative but can be positive with effusions, scarring, & inflammation?

A

Intrapleural

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Intra-alveolar pressure is negative on __________ & positive on __________.
- Inhalation - Exhalation
26
Where is pressure most negative during inhalation & positive during exhalation?
Distal airways
27
How do small airways expand & remain open during inhalation?
Negative intrathoracic pressure
28
In which position does the diaphragm want to go up? How does this affect FRC?
Supine --> FRC decreases
29
True or False: Exhalation is active at rest.
F (passive)
30
What does CPAP do to help increase FRC?
Inflate lungs & push diaphragm down
31
In patients with restrictive diseases, describe their lung compliance & the resulting pressure during exhalation.
- Hypocompliant - Higher pos pressure gradient
32
What type of lungs such as in obstructive diseases retain O2?
Hypercompliant
33
What 4 things make up total lung volume?
- IRV - TV - ERV - RV
34
What 2 things make up inspiratory capacity?
- Inspiratory reserve volume - Tidal volume
35
What 2 things make up FRC?
- Expiratory reserve volume - Residual volume
36
What is vital capacity?
How much air in/out maximally
37
What is inspiratory reserve volume? How about expiratory reserve volume?
- Amount of air inhaled above TV - Exhaled below TV
38
How is residual volume affected in COPD over time & why?
Increases because hard time exhaling.
39
How is total lung volume affected in obstructive vs restrictive?
- Obstructive: increases - Restrictive: decreases
40
What is the term for amount of air moved in/out each breath?
TV
41
What is the term for air left after max expiration?
Residual volume
42
What is the term for max volume one can inspire during inspiratory effort?
Inspiratory capacity
43
What is the term for max volume one can exchange in 1 cycle?
Vital capacity
44
What is the term for air in lungs at full inflation?
Total lung capacity
45
What 3 things make up vital capacity?
- IRV - TV - ERV
46
Which 3 static lung volumes/capacities cannot be measured with basic spirometry?
- RV - FRC - TLC
47
How are VC, IRV, & IC affected with restrictive?
Decrease
48
True or False: Expiratory flow is measured with normal exhalation.
F (forced)
49
What is FEV1? What % should it be at?
- Forced expiratory volume in 1 sec - > 80% of predicted
50
What is FEV1/FVC? What % should it be at?
- % of vital capacity exhaled in 1 sec of forced exhalation - > 70%
51
What type of patients have below 80% of FEV1 & below 70% of FEV1/FVC?
Obstructive
52
How is FRC & RV affected with increased lung compliance?
Also increase
53
How does increased lung compliance affect PaO2 & PaCO2?
- Decrease O2 - Increase CO2
54
Increased lung compliance --> _________ intrathoracic pressure & _______ airway resistance on exhalation.
- Decreased (more neg) - Increased
55
What type of patient has increased lung compliance (be specific)?
Emphysema
56
Besides RV, what else is decreased when there's decreased lung compliance?
VC
57
Airway resistance progressively _________ with decreased lung volumes & forced exhalation.
Increases
58
Inhalation & exhalation flow rates are different, what does exhalation flow depend on?
Lung volume
59
What does alveolar ventilation + dead space ventilation equal?
TV
60
True or False: Increasing breathing rate increases both alveolar vent & dead space vent.
T
61
What does increasing tidal volume when breathing increase in terms of ventilation?
Alveolar only
62
What 3 diseases can lead to perfusion without ventilation?
- Pneumonia - COPD - Asthma
63
What can lead to ventilation without perfusion?
Pulmonary embolus
64
In areas with high relative ventilation & high V/Q, does O2 or CO2 have the higher concentration?
O2
65
Which region of the lungs contribute the greatest quantity of O2 to the body due to large amount of blood flow?
Bases
66
Why would sidelying with affected side up with pneumonia/consolidation of right lung help?
Better ventilation/oxygenation because more upwards.
67
Which membrane does O2 diffuse across to enter bloodstream? How about through plasma --> erythrocyte?
- Alveolar capillary - Pulmonary capillary
68
63 mmHg is the net driving force to move (O2/CO2) out of alveoli & 6 mmHg is net driving force to move (O2/CO2) into alveoli.
- O2 - CO2
69
55 mmHg is the driving force to move oxygen from where to where?
Arterial system to tissues
70
What are some disorders that affect diffusion?
- Bronchopulm dysplasia - Chronic fibrotic pulm disorders - Pulm edema/pneumonia - ARDS/IRDS - Pulm HTN - Restrictive
71
What is the normal value of pulmonary arterial pressure?
20 mmHg @ rest, can be 25-30 with exercise
72
What determines PaO2 of blood to help regulate respiration?
Dissolved O2 in blood
73
What 3 factors cause Hgb to release O2 & shift curve to the RIGHT?
- Lowered pH - Increased PCO2 - Increased temp
74
How do disorders that reduce alveolar ventilation affect PaCO2?
Increase it
75
What is the most common way CO2 is found in the body?
Bicarb (HCO3-)
76
When does bicarb serve as a buffer?
Metabolic acidosis or alkalosis
77
What is the term for deep & rapid breathing due to diabetic ketoacidosis or metabolic acidosis?
Kussmaul's
78
What structures pick up on H+/CO2 concentration?
Central chemoreceptors
79
What are peripheral chemoreceptors/carotid bodies sensitive to?
PO2 in arteries
80
Stretch receptors in the lungs trigger (inhalation/exhalation).
Exhalation
81
What level of PaO2 would stimulate breathing?
< 60 mmHg
82
What is the #1 reason for hypoxemia?
V/Q mismatch
83
True or False: Right-to-left shunt cannot be helped by supplemental O2.
T
84
What is the term for when blood bypasses regions of lung --> L heart to be pumped?
Large intrapulmonary shunt
85
What cause of hypoxemia does CNS depression & morbid obesity cause?
Hypoventilation
86
From which 3 arteries can blood be drawn for ABG studies?
- Radial - Brachial - Femoral
87
What level of PaO2 = hypoxemia usually due to diffusion issue but can also be because of hypoventilation?
< 80 mmHg
88
Which patients could PaO2 be chronically low in (<50 mmHg)?
COPD
89
True or False: Low PaO2 can be associated with decreased SaO2.
T
90
What ABG determines ventilation?
PaCO2
91
What level of PaCO2 is hypercapnia? What about hypo?
- Hyper > 45 - Hypo < 35
92
Increased excretion of HCO3- (lowers/raises) pH.
Lowers