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Board Study > Respiratory Physiology > Flashcards

Respiratory Physiology Flashcards

1
Q

Where does anatomic dead space begin and end?

A
  • mouth & nares to terminal bronchioles

- conducting zone (no gas exchange)

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2
Q

Where does gas exchange begin?

A
  • respiratory bronchioles to the alveolar sacs

- respiratory zone (gas exchange takes place)

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3
Q

What is considered part of the transitional zone?

A
  • respiratory bronchioles and alveolar ducts

- serves as an air conduit where some gas exchange takes place

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4
Q

What is transpulmonary pressure?

A

Alveolar pressure - Intrapleural pressure

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5
Q

What is alveolar pressure?

A

pressure inside the lungs

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6
Q

What is intrapleural pressure?

A

pressure outside the lungs

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7
Q

Transpulmonary pressure is always positive or negative?

A

positive (keeps the airways open)

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8
Q

Intrapleural pressure is always positive or negative?

A

negative (keeps lungs inflated)

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9
Q

When is the only time that intrapleural pressure becomes positive?

A

during forced expiration (besides pneumothorax)

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10
Q

What muscles contract during inspiration?

A
  • diaphragm

- external intercostals

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11
Q

What are the accessory muscles of inspiration?

A
  • sternocleidomastoid

- scalene muscles

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12
Q

Expiration is usually passive, but what muscles are used during active exhalation?

A
  • rectus abdominis
  • transverse abdominis
  • internal and external oblique
    “ I let the air out of my TIREs”
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13
Q

`When does exhalation become active?

A
  • when minute ventilation increases

- pts w/ lung disease (COPD)

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14
Q

What is the vital capacity required for an effective cough?

A

15 mL/kg

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15
Q

How much dead space is in a 70 kg pt?

A
  • 2 mL/kg or 150 mL
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16
Q

Increased dead space widens the PaCO2-EtCO2 gradient and causes?

A

CO2 retention

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17
Q

How does atropine increase dead space?

A
  • atropine is a bronchodilator, so it increases the volume of the conducting zone
18
Q

How does positive pressure ventilation increase dead space?

A
  • it increases alveolar pressure, which increases ventilation relative to perfusion (inc dead space)
19
Q

By what percent does mechanical ventilation increase the Vd/Vt ratio?

A

50%

20
Q

What is the most common cause of an increase in Vd/Vt ratio under general anesthesia?

A

decreased CO

21
Q

The Bohr Equation can be used to calculate what?

A

physiologic dead space

22
Q

What is ventilation and perfusion in L/min and what is the V/Q ratio?

A 
ventilation = 4
perfusion = 5
V/Q = 0.8
23
Q

What is the most common cause of hypoxemia in the PACU?

A
  • V/Q mismatch (specifically atelectasis)

- treatment: humidified O2 and maneuvers to reopen the airways

24
Q

CO2 diffuses how many times faster than O2?

A

20

25
Q

What happens to combat zone I?

A

Bronchioles constrict unperfused alveoli

26
Q

What happens to combat Zone III?

A

Hypoxic Pulmonary Vasoconstriction

27
Q

What are 3 normal anatomic shunts?

A
  • Thesbian veins (drain left heart)
  • Bronchiolar veins (drain bronchial circulation)
  • Pleural veins (drain bronchial circulation)
28
Q

What dose a respiratory quotient (RQ) >1 and <0.7 indicate?

A
  • RQ >1 = lipogenesis (overfeeding)

- RQ <0.7 = lipolysis (starvation)

29
Q

What causes of hypoxemia cause a normal A-a gradient?

A
  • hypoxic mixture

- hypoventilation

30
Q

What causes of hypoxemia cause an increase in A-a gradient?

A
  • diffusion limitation
  • V/Q mismatch
  • shunt
31
Q

When breathing room air, what is the normal A-a difference?

A

<15 mmHg

32
Q

How do you calculate the estimation of shunt?

A

Shunt increases 1% for every 20 mmHg

33
Q

What are ways to measure FRC?

A
  • nitrogen washout
  • helium wash in
  • body plethsmography
34
Q

How is closing capacity measured?

A
  • washout of tracer gas (nitrogen or xenon-133)
35
Q

What is the Bohr Effect?

A
  • CO2 and H+ cause Hgb to release O2
36
Q

In banked blood does the level of 2,3-DPG increase or decrease?

A

decrease

37
Q

What is the P50 of Hgb F?

A

19

38
Q

What are drugs that cause a left shift in the CO2 ventilator response curve?

A
  • salicylates
  • aminophylline
  • doxapram
  • norepinephrine
39
Q

What are some conditions that impair the hypoxic ventilator response?

A
  • carotid endarterectomy (why we don’t do bilat)

- subanesthetic doses of inhaled and IV anesthetics (MAC 0.1)

40
Q

What are some conditions that do not stimulate the hypoxic ventilatory response?

A
  • anemia
  • carbon monoxide poisoning
  • even thought the CaO2 is reduced, the PaO2 is usually normal

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