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OS 213 Respiratory EXAM 1 > Review of pulmonary physiology > Flashcards

Review of pulmonary physiology Flashcards

1
Q

Main function of Lungs

A

continuous gas exchange

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2
Q

Metabolic function of Lungs

A

Angiotensis I -> Angiotensin II

Removal of amines, arachidonic acid metabolites

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3
Q

Metabolic function (PEPTIDES)

A

Angiotensin I - converted
Angiotensin II
Vasopressin
Bradykinin - 80% inactivated

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4
Q

Metabolic function (Amines)

A

Serotonin - completely removed
Norepinephrine - 30% removed
Histamine
Dopamine

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5
Q

Metabolic function (Arachidonic acid metabolites)

A

PG E2 and F2 - almost completely removed
PG A2
Prostacyclin
Leukotrienes - almost completely removed

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6
Q

start of lung development

A

5th week AOG (Arise from ventral wall of the foregut)

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7
Q

Level of Carina

A

T5 at expiration and T6 in inspiration

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8
Q

Main bronchus that is prone to aspiration

A

RIGHT

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9
Q

Boundary of Upper and Lower

A

Adults - vocal cords

pediatrics - cricoid cartilage

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10
Q

T or F, Lower respiratory tract is sterile

A

False

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11
Q

Boundaries of pleura and lungs ANTERIORLY

A

clavicle to 8th rib

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12
Q

Boundaries of pleura and lungs LATERALLY

A

10th rib l

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13
Q

Boundaries of pleura and lungs Posteriorly

A

level of T12

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14
Q

ANTERIOR CHEST WALL (PE)

A

R Lung - UPPER and MIDDLE LOBE

L Lung - UPPER LOBE

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15
Q

Type of airflow in conducting zone

A

bulk flow

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16
Q

Type of airflow in respiratory zone

A

diffusion

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17
Q

volume of anatomic dead space

A

150 ml

no gas exchange

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18
Q

ADS + alveolar dead space

A

Physiologic dead space

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19
Q

Overall volume that do not participate in ventilation

A

Physiologic dead Space

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20
Q

Areas with ventilation but poor perfusion

A

alveolar dead space

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21
Q

Chief sites of greatest resistance

A

Medium sized bronchi

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22
Q

Part of the conducting zone where glands and cartilage first disappear

A

bronchioles

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23
Q

cuboidal, non ciliated, secrete surfactants and GAGs

A

Clara cells

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24
Q

site of gas exchange due to the presence of alveoli

A

RESPIRATORY ZONE

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25
Q

Most of the lung volume is in the?

A

Respiratory zone - 3 L

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26
Q

volume that is inhaled and then exhaled with each normal breathing

A

Tidal volume -500ml

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27
Q

The maximum volume that can be exhaled from the resting end-expiratory level

A

ERV- 1100ml

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28
Q

The maximum volume that can beinhaled above a normal tidal inspiration

A

IRV - 3000ml

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29
Q

Volume remaining in lungs after maximum expiration (cannot be measured by spirometry)

A

RV - 1200ml

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30
Q

Maximum volume that can be inhaled from normal resting end-expiratory level

A

Inspiratory capacity - 3500ml

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31
Q

Volume remaining in lungs during regular breathing

A

Functional residual capacity

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32
Q

Maximum volume that may be exhaled following a maximum insiration or inhaled following a maximum expiration

A

Vital Capacity

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33
Q

Formula for Vital capacity

A

TLC - RV

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34
Q

Volume contained within the lungs following maximum inspiration

A

5800ml

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35
Q

Normal pulmonary capillary blood flow

A

70ml

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36
Q

Histology of bronchi

A

ciliated pseudostratfied columnar

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37
Q

Histology of bronchioles

A

cuboidal

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38
Q

Histology of alveoli

A

squamous

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39
Q

Ratio between thickness of submucosal mucus glands and wall thickness between epithelium and cartilage that covers the bronchi

A

REID index

Normal : <0.4
Chronic bronchitis >0.4

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40
Q

Innervation of smooth muscle in the airway

A

parasympathetic

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41
Q

Type of receptor predominantly found in the airway

A

beta 2

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42
Q

Primary determinant of resting bronchomotor tone

A

cholinergic system

43
Q

Decreases vagal tone

44
Q

autoinhibitory effect on acetylcholine release and have negative inhibitory effect

A

M2 receptor

45
Q

Normal ciliary beating

46
Q

Bronchial glands

A

terminal bronchioles

Parasympathetic control

47
Q

Gel layer

A

Mucin +lipids

48
Q

Sol layer

A

water + electrolytes

49
Q

Liquid in Sol layer Regulation

A

Na channel
cAMP mediated Cl channel
cystic fibrosis transmembrane conductance regulator
Ca activated CL channel

50
Q

Cystic fibrosis

A

defective CFTR

sweat gland test

51
Q

Secretes glycosaminoglycans to protect bronchial lining

A

clara cells

52
Q

Blood gas barrier

A

0.3-0.4 micron

53
Q

Type I cells

A

flattend; forms 95% of alveolar wall

54
Q

Type II cells

A

cuboidal, secretes surfactants (cytosomes)

moremetabolically active

55
Q

SUrfactants

A

Phospholipid Dipalmitoyl Phosphatidyl Choline

56
Q

multilamellar bodies, precursors to pulmonary surfactants

57
Q

Laplace Law

A

lager SA, smaller surface tension

58
Q

Compliance

59
Q

normal lung compliance =

A

0.15/L cm H2O

60
Q

Compliance differ on inspiration and expiration for identical volumes

A

Hysteresis

61
Q

Keeps airsacs open even in maximum exhalation

A

hysteresis

62
Q

Lung is stiffer during?

63
Q

Emphysema = high or Low compliance

A

High (decreased elastic recoil)

64
Q

Fibrosis = high or Low compliance

65
Q

point where pressure outside the airways and pressure inside the airways are equal

A

Equal pressure point

66
Q

formula for Alveolar Pressure (Palv)

A

Pleural Pressure (Ppl) + Elastic Pressure (Pel)

67
Q

When you inhale = more positive or negative?

A

more negative

68
Q

Exhalation is an active or a passive process?

69
Q

FEV1/FVC ratio of restrictive pathology

70
Q

FEV1/FVC ratio of Obstructive pathology

71
Q

Physiological attributes of COPD

A

airway obstruction + low elastic recoil

72
Q

Trapped air due to inability to expel right amount

A

HYPERINFLATION

73
Q

Dynamic hyperinflation

A

Unmasked during exercise
Increased RR
More aair trapped

74
Q

SPace that lies between the epithelial basement membrane and the vascular basement membrane

A

Interstitium

75
Q

Architectural framework of the lung

A

Interstitium

76
Q

Cellular components of interstitium

A

Macrophages
Mesenchymal cells
Lympocytes

77
Q

Major component of the EC matrix of interstitium

A

Collagen IV

78
Q

Controls porosity of interstitium

79
Q

Controls rigidity of interstitium

A

Hyaluronan

80
Q

Diameter of alveolo-capillary membrane

81
Q

time for oxgenation of each RBC

82
Q

Law governing diffusion of oxygen and carbon dioxide

A

Fick’s law

83
Q

Solubillity of CO2

A

20x than oxygen

84
Q

Blood supply

A

Pulmonary arteries and veins

85
Q

Flow of blood to thelungs/pulmonary capillaries

A

Perfusion (Q)

86
Q

Flow of air into alveolar spaces

A

Ventilation (V)

87
Q

More perfusion more ventilation (lobe of lung)

A

Lower lungs

88
Q

Ventilation is greater where?

A

base due to lower interpleural pressure

89
Q

At the upper lungs (Ventilation is __ compared to perfusion)

90
Q

Bad ventilation, good perfusion

91
Q

good ventilation, bad perfusion

A

Dead space

92
Q

PULMONARY VS SYSTEMIC

A

Lower pressure in pulmonary
Higher capacitance in pulmonary
Less resistance in pulmonary

93
Q

Most potent vasoconstrictor

A

Oxygen (hypoxemia)

94
Q

Normal PaO2 sustainable for life?

95
Q

Increased O2 affinity, decreased O2 release

A

Shift to the LEft

96
Q

Decreased O2 affinity, Increased O2 release

A

Shift to the right

97
Q

Where do bleeding from hemoptysis comes from?

A

bronchial circulation

98
Q

Central respiratory center

A

Medulla oblongata

99
Q

Peripheral chemoreceptors

A

located in carotid artery and aortic arch bifurcation

Connected to the medulla via glossopharyngeal and vagus nerve

100
Q

5 mechanisms causing hypoxemia

A
  1. Low inspired O2
  2. V/Q mismatch
  3. Shunting
  4. Decrease in diffusing capacity
  5. Hypoventilation
101
Q

hallmark of alveolar hypoventilation

A

paCO2 always increased

102
Q

hallmark of Shunt

A

Hypoxemia is refractory to supplemental oxygen

103
Q

ARDS

A 
All the air sacs are filled with liquid
Not able to ventilate
NOT  a vascular shunt
No VENTILATION BUT PERFUSION CONTINUES
Physiologic dead space is increased

OS 213 Respiratory EXAM 1 (19 decks)

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