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FRCA Physiology > Respiratory physiology > Flashcards

Respiratory physiology Flashcards

1
Q

Consider the following statements regarding functional residual capacity (FRC).
It can be measured using a spirometer

A

False. Measurement requires helium dilution of total body plethysmography.

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2
Q

Consider the following statements regarding functional residual capacity (FRC).
It increases with age

A

True. FRC continues to increase with age as the elastic recoil of the lungs deteriorates

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3
Q

Consider the following statements regarding functional residual capacity (FRC).
It is 10% lower in women than men of similar height

A

True

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4
Q

Consider the following statements regarding functional residual capacity (FRC).
It is unaffected by pregnancy

A

False. As the gravid uterus pushes the diaphragm cephalad, FRC is reduced, as is the extra weight of the breast on the chest wall.

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5
Q

Consider the following statements regarding functional residual capacity (FRC).
It is equal to residual volume + expiratory reserve volume

A

True

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6
Q

Consider the following statements regarding physiological dead space
It is smaller than anatomical dead space

A

False. Physiological dead space = anatomical dead space + alveolar dead space.

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7
Q

Consider the following statements regarding physiological dead space
It is increased by pulmonary embolism

A

True

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8
Q

Consider the following statements regarding physiological dead space
It can be increased if tidal volume drops despite an increase in respiratory rate

A

True. A smaller proportion of the tidal volume reaches the alveoli.

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9
Q

Consider the following statements regarding physiological dead space
It is measured using Fowler’s method

A

False. Fowler’s method is used to measure anatomical dead space. The Bohr equation calculates physiological dead space.

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10
Q

Consider the following statements regarding physiological dead space
Calculation requires knowledge of arterial partial pressure of CO2

A

True. The Bohr equation requires PACO2 and PECO2 to calculate the dead space to tidal volume ratio.

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11
Q

Consider the following statements regarding functional residual capacity.
Helium dilution gives a larger estimation than body plethysmography

A

False. Plethysmography gives a larger, more accurate estimation of FRC, especially in diseased lungs where gas trapping may occur.

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12
Q

Consider the following statements regarding functional residual capacity.
Changes in FRC can affect pulmonary vascular resistance

A

True. Normally, FRC is at the point where PVR is least, but a decrease in FRC may cause an increase in PVR.

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13
Q

Consider the following statements regarding functional residual capacity.
FRC increases in asthma

A

True. Obstructive lung disease can cause gas trapping.

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14
Q

Consider the following statements regarding functional residual capacity.
FRC increases with PEEP

A

True

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15
Q

Consider the following statements regarding functional residual capacity.
FRC increases following administration of neuromuscular blocking agents

A

False. Anything that decreases muscle tone of the diaphragm and intercostal muscles will reduce FRC.

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16
Q

Consider the following statements regarding dead space.

It increases while snorkelling

A

True. The snorkel acts as an increase in the transporting airway.

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17
Q

Consider the following statements regarding dead space.

If increased, it leads to hypoxia

A

False. Dead space per se is not a cause of hypoxia.

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18
Q

Consider the following statements regarding dead space.

It accounts for the difference in arterial and expired CO2 concentrations

A

True

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19
Q

Consider the following statements regarding dead space.

It increases with bronchodilatation and neck extension

A

True

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20
Q

Consider the following statements regarding dead space.

Alveolar dead space decreases with age

A

False

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21
Q

The functional residual capacity

is increased in the obese

A

False

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22
Q

The functional residual capacity

is approx 10% higher in men than women

A

False

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23
Q

The functional residual capacity

falls with general anaesthesia

A

True

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24
Q

The functional residual capacity

increases when changing from supine to standing

A

True

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25
Q

The functional residual capacity

falls with increasing age

A

False

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26
Q

Vital capacity is the volume or air expired from full inspiration to full expiration

A

True

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27
Q

Vital capacity increases gradually with age in adults

A

False

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28
Q

Vital capacity is greater in men than women of a similar age and height

A

True

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29
Q

Vital capacity is equal to the sum of the inspiratory and expiratory reserve volumes

A

False

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30
Q

Vital capacity may be measured by spirometry

A

True

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31
Q

Closing Capacity is larger than functional reserve capacity

A

False

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32
Q

Closing Capacity may be determined by single breath N2 curve following deep breath of O2

A

False

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33
Q

Closing Capacity is high in young children and decreases progressively with age

A

False

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34
Q

Closing Capacity if high may be responsible for arterial hypoxaemia

A

True

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35
Q

Closing Capacity is unaffected by bronchomotor tone

A

False

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36
Q

Closing volume increases with age

A

True

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37
Q

Closing volume decreases with anaesthesia

A

True

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38
Q

Closing volume is increased in the upright position

A

false

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39
Q

Closing volume is increased in obesity

A

false

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40
Q

Closing volume can be measured using single breath nitrogen technique

A

True

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41
Q

FRC can be measured using Helium wash in

A

True

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42
Q

FRC can be measured using nitrogen was out

A

True

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43
Q

FRC can be measured using body plethysmography

A

True

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44
Q

FRC can be measured using spirometry

A

false

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45
Q

FRC can be measured using intra-oesophaeal balloon

A

False

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46
Q

Surfactant is a mucopolypeptide

A

False

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47
Q

Surfactant causes a decrease in surface tension

A

true

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48
Q

Surfactant equilibrates surfae tension for different sized alveoli

A

true

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49
Q

Surfactant causes an increase in compliance

A

true

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50
Q

Surfactant production is reduced after a prolonged reduction in pulmonary blood flow

A

True

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51
Q

pulmonary surfactant is a mixture of phospholipids and proteins

A

True

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52
Q

pulmonary surfactant causes and increase in chest wall compliance

A

false

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53
Q

pulmonary surfactant prevents transudation or fluid from the blood into the alveoli

A

true

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54
Q

pulmonary surfactant deficiencies in babies born to diabetic mothers is due to fetal hyperinulinism

A

true

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55
Q

pulmonary surfactant concentration per unit area is directly proportional to surface tension

A

false

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56
Q

When the V/Q ratio of a lung unit increases the alveolar PO2 rises

A

true

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57
Q

When the V/Q ratio of a lung unit increases the alveolar CO2 rises

A

False

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58
Q

When the V/Q ratio of a lung unit increases end capillary PO2 rises

A

true

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59
Q

When the V/Q ratio of a lung unit increases arterial PO2 increases

A

True

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60
Q

When the V/Q ratio of a lung unit increases hypoxic pulmonary vasoconstriction will compensate for any change in gas exchange

A

false

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61
Q

The distribution of ventilation of an upright subject is related to regional airways diameters

A

True

62
Q

The distribution of ventilation of an upright subject is related to regional differences in compliance

A

True

63
Q

The distribution of ventilation of an upright subject is related to inspired O2 concentration

A

false

64
Q

The distribution of ventilation of an upright subject is related to gravitational forces in the lung

A

True

65
Q

The distribution of ventilation of an upright subject is related to intrathoracic pressure

A

True

66
Q

In an awake, healthy individual in the lateral position, the dependant lung has less ventilation

A

false

67
Q

In an awake, healthy individual in the lateral position, the dependant lung has more perfusion

A

true

68
Q

In an awake, healthy individual in the lateral position, the V/Q ratio is higher in the dependant lung

A

false

69
Q

In an awake, healthy individual in the lateral position, the PACO2 is lower in the lower lung

A

false

70
Q

In an awake, healthy individual in the lateral position, the PAO2 is higher in the lower lung

A

false

71
Q

The following vessels are important in the physiological shunt Bronchial veins

A

true

72
Q

The following vessels are important in the physiological shunt Thebesian veins

A

true

73
Q

The following vessels are important in the physiological shunt coronary sinus

A

false

74
Q

The following vessels are important in the physiological shunt ductus venosus

A

false

75
Q

The following vessels are important in the physiological shunt azygous veins

A

false

76
Q

An area in the lung with increased V/Q ratio represents dead space

A

true

77
Q

An area in the lung with increased V/Q ratio represents shunt

A

false

78
Q

An area in the lung with increased V/Q ratiois responsible for a decrease in the PAO2 with no change in PACO2

A

false

79
Q

An area in the lung with increased V/Q ratio will cause a degree of hypoxia

A

false

80
Q

An area in the lung with increased V/Q ratio may be compensated for by an increase minute ventilation

A

true

81
Q

A pressure volume curve can be used for measuring the owrk of breathing

A

true

82
Q

A pressure volume curve can be used for measuring functional residual capacity

A

false

83
Q

A pressure volume curve can be used for measuring anatomical dead space

A

false

84
Q

A pressure volume curve can be used for measuring compliance

A

true

85
Q

A pressure volume curve can be used for measuring respiratory quotient

A

false

86
Q

body plethysmography can be used to measure compliance

A

true

87
Q

body plethysmography can be used to measure work of breathing

A

true

88
Q

body plethysmography can be used to measure gas exchange

A

false

89
Q

body plethysmography can be used to measure airway resistance

A

true

90
Q

body plethysmography can be used to measure FEV1

A

false

91
Q

concerning lung volumes and capacities the total volume of both lungs is the vital capacity

A

false

92
Q

concerning lung volumes and capacities closing capacity is the sum of the closing volume and the FRC

A

false

93
Q

concerning lung volumes and capacities the volume which may be forcibly exhaled in 1 sec is greater than 85% of the vital capacity

A

false

94
Q

concerning lung volumes and capacities the FRC can be measured with a spirometer

A

false

95
Q

concerning lung volumes and capacities the sum of the insp reserve volume and the exp reserve volume is the vital capacity

A

false

96
Q

Alveolar dead space exceeds tidal volume at rest

A

false

97
Q

Alveolar ventilation decreases as tidal volume increases

A

false

98
Q

Alveolar partial pressure of water vapour exceeds that of carbon dioxide

A

true

99
Q

Alveolar patial pressure of O2 falls within an increase in physiological dead space

A

false

100
Q

Alveolar O2 uptake exceeds alveolar carbon dioxide output

A

true

101
Q

Breathing spontaneously in the lateral position:

Perfusion is greater in the dependent lung

A

True.

102
Q

Breathing spontaneously in the lateral position:

Ventilation is decreased in the uppermost lung

A

True.

103
Q

Breathing spontaneously in the lateral position:

V/Q is higher in the dependent lung

A

False. In the awake adult, ventilation and perfusion are greater in the lower (dependent) lung although perfusion is slightly better than ventilation and so V/Q < 1.

104
Q

Breathing spontaneously in the lateral position:

Dependent lung has a lower PO2

A

True. V/Q is < 1, ie there is a degree of shunt. In areas of shunt alveolar gas tends toward mixed venous so PAO2 is low and PACO2 slighlty raised.

105
Q

Breathing spontaneously in the lateral position:

Non-dependent lung has a higher PCO2

A

False. In the non-dependent lung V/Q > 1, ie a degree of dead space. Alveolar gas now tends toward inspired gas and so PO2 is raised but PCO2 is low.

106
Q

FRC can be measured using:

Body plethysmography

A

True

107
Q

FRC can be measured using:

Nitrogen wash-out

A

True

108
Q

FRC can be measured using:

Spirometry

A

False

109
Q

FRC can be measured using:

Helium wash-in

A

True

110
Q

FRC can be measured using:

Intra-oesophageal balloon

A

False. Intra-oesophageal balloons are used to measure intra-pleural pressure.

111
Q

Concerning 2,3, DPG:

It binds the beta chains of deoxyhaemoglobin

A

True.

112
Q

Concerning 2,3, DPG:

It is formed from a product of glycolysis

A

True. 2,3-DPG is formed in red blood cells from phosphoglyceraldehyde, a product of glycolysis.

113
Q

Concerning 2,3, DPG:

An increased concentration increases oxygen utilisation by cells

A

True. 2,3 DPG shifts the O2 dissociation curve to the right, reducing oxygen binding to haemoglobin and thus increasing oxygen availability for tissue utilization.

114
Q

Concerning 2,3, DPG:

Its red cell concentration is increased by circulating thyroid hormones

A

True. Thyroid hormones, along with growth hormone and angrogens increase 2,3,DPG concentration.

115
Q

Concerning 2,3, DPG:

Is strongly bound by fetal haemoglobin

A

False. Fetal Hb does not contain beta chains.

116
Q

Dipalmitoylphosphatidylcholine:

Is a mucopolypeptide

A

False. It is a phospholipid, found in lung surfactant.

117
Q

Dipalmitoylphosphatidylcholine:

Causes an increase in surface tension

A

False. Surfactants role is to decrease surface tension.

118
Q

Dipalmitoylphosphatidylcholine:

Causes an increase in chest wall compliance

A

False. It increases lung compliance, not chest wall compliance.

119
Q

Dipalmitoylphosphatidylcholine:

Production is reduced in low cardiac output states

A

True. As it is derived from free fatty acids carried in the blood stream.

120
Q

Dipalmitoylphosphatidylcholine:

Maintains the same surface tension for different sized alveoli

A

False. It is more effective at reducing surface tension in small alveoli. This reduces the effect of Laplace’s law, which would otherwise cause small alveoli to collape.

121
Q

Peripheral chemoreceptors:

Are found in the carotid sinus

A

False. They are located in the carotid and aortic bodies.

122
Q

Peripheral chemoreceptors:

Are downregulated in the presence of chronic lung disease

A

False. Central chemoreceptors in the medulla respond to a rise in PaCO2 and CSF pH.

123
Q

Peripheral chemoreceptors:

Are stimulated by elevated levels of carboxyhaemoglobin

A

False.

124
Q

Peripheral chemoreceptors:

Give rise to increased afferent signals when PaO2 falls below 13 kPa

A

True. The carotid body is the prime O2 sensory organ.

125
Q

Peripheral chemoreceptors:

Maintain PaCO2 within the range 4.5-6.0 kPa

A

False. see part D.

126
Q

Carbon dioxide:

Freely diffuses across the blood : brain barrier

A

True. Unlike H+ ions and HCO3-.

127
Q

Carbon dioxide:

Is lagely transported unchanged

A

False. Most is transported as bicarbonate. Around 5% is transported unchanged in the blood.

128
Q

Carbon dioxide:

Gives rise to the same pH change in CSF as it does in blood

A

False. pH changes are greater in the CSF due to the lack of buffers.

129
Q

Carbon dioxide:

Transport by haemoglobin is inhibited by rising oxygen saturation

A

True. By the Haldane effect.

130
Q

Carbon dioxide:

Has direct sympathomimetic activity

A

False. But it does increase activation of the sympathetic system.

131
Q

Pulmonary blood flow:

Is normally less than the cardiac output

A

True. A small proportion of the cardiac output will be anatomical shunt.

132
Q

Pulmonary blood flow:

Has a mean arterial pressure of 25-30 mmHg

A

False. Mean pressure is around 15 mmHg. 25 -30mmHg would be the systolic pressure.

133
Q

Pulmonary blood flow:

In West zone 1, occurs mainly during diastole

A

False. In West zone 1 pA>pa>pv therefore the pulmonary capillary is completely compressed by by the alveolus ceasing. This results in a very high V/Q ratio

134
Q

Pulmonary blood flow:

Of 6000 ml/min with a minute ventilation of 4000 ml/min suggests the presence of a shunt

A

True. As perfusion is significantly greater than ventilation.

135
Q

Pulmonary blood flow:

Is maximal in zone 2

A

False. It is maximal in zone 3.

136
Q

Restrictive lung disease is characterized by:

A fall in FEV1

A

True. Pulmonary function tests generally reveal a decrease in both FEV1 and FVC with a normal FEV1/FVC ratio.

137
Q

Restrictive lung disease is characterized by:

A fall in arterial PO2

A

True. A fall in FRC causes alveolar collapse with a resultant shunt.

138
Q

Restrictive lung disease is characterized by:

A fall in FEV1/FVC ratio

A

False.

139
Q

Restrictive lung disease is characterized by:

Carbon dioxide retention

A

False.

140
Q

Restrictive lung disease is characterized by:

A fall in vital capacity

A

True. As does TLC and FRC.

141
Q

During intermittent positive pressure ventilation:

Mean intrathoracic pressure will be lower than during spontaneous breathing

A

False.

142
Q

During intermittent positive pressure ventilation:

Right ventricular filling falls compared with spontaneous ventilation

A

True. Which will reduce cardiac output.

143
Q

During intermittent positive pressure ventilation:

PEEP will reinflate collapsed alveoli

A

False. PEEP will prevent collapse, but would not normally be high enough to re-inflate collapsed lung.

144
Q

During intermittent positive pressure ventilation:

Right ventricular workload may increase

A

True. PVR may rise during IPPV due to hyperinflation or alveolar collpase (PVR is lowest at FRC and rises above or below this).

145
Q

During intermittent positive pressure ventilation:

Left ventricular workload may decrease

A

True. IPPV reduces LV afterload by decreasing LV cavity size and transluminal wall tension.

146
Q

Hyperventilation produces:

Muscle spasm

A

True. Alkalosis decreases the proportion of ioised calcium, causing tetany.

147
Q

Hyperventilation produces:

A raised pH

A

True.

148
Q

Hyperventilation produces:

Decreased cerebral blood flow

A

True.

149
Q

Hyperventilation produces:

Peripheral vasodilatation

A

False. Hypocarbia causes vasoconstriction by a direct effect.

150
Q

Hyperventilation produces:

Increased cardiac output

A

False. Hypercarbia causes an increase in cardiac output due to increased sympathetic activity. The direct effect of vasoconstriction from hypocarbia will reduce cardiac output.

FRCA Physiology (6 decks)

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