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Misc Decks > SF3 2 Lecture Material > Flashcards

SF3 2 Lecture Material Flashcards

1
Q

Obstructive Sleep Arpnea

A

Inspiratory process intact but upper airway obstructed due to fat around pharynx. Also can happen due to enlarged tonsils or too much tissue at back of throat (uvula/soft palate). Larger than average tongue or deviated septum in nose.

Pharyngeal muscles do not contract properly

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2
Q

Pressure Inequalities: Zone 1

A

PA > Pa > PV

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3
Q

Dorsal Respiratory Groups (DRGs)

A

Chiefly inspiratory neurons to diaphragm and external intercostal muscles. Responsible for basic rhythm of breathing (12-15 breaths per min)

Input from both chemoreceptor types, stretch receptors, and higher brain centers

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4
Q

Dead Space Volume

A

Air which a person breathes but is not used for gas exchanges. Fills respiratory passages like nose, pharynx, and trachea (150 mL)

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5
Q

Pressure Inequalities: Zone 3

A

Pa > PV > PA

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6
Q

Adult Respiratory Distress Syndrome (ARDS)

A

Severe form of lung injury marked by persistent lung inflammation and increased capillary permeability -> Permeability edema.

X-ray shows airspaces and bilateral alveolar infiltrates.

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7
Q

Diagnosed by Methacholine Test

A

1) Asthma (main)
2) COPD
3) Allergic Rhinitis

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8
Q

Variable Extrathoracic Lesion

A

Region of trachea outside thoracic cage. Difficulty during inspiration.

Ex: Fat deposits, vocal chord paralysis, obstructive sleep apnea

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9
Q

Ear Drum Rupture

A

occurs with hyperbaric descent. Ear canal blocked by cerumen, ear plugs, etc.. Pressure change can rupture ear drum

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10
Q

Vital Capacity

A

Maximal amount of air which can be inhaled/exhaled by a person. Difference with FVC/TLC is it’s done slowly

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11
Q

Eupnea

A

normal spontaneous breathing

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12
Q

Functional Residual Capacity

A

Volume of air in the lung when the lung and chest wall have equal recoil force (2300 mL)

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13
Q

Central Sleep Apnea

A

Pattern of breathing characterized by normal deep inspiratory cycle interchanged with complete cessation of breathing. Problem with how brain controls breathing

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14
Q

Dyspnea

A

difficulty breathing that individual is aware of

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15
Q

P-Value Definition

A

Likelihood to observe data as extreme as the data you actually collected (if null true)

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16
Q

Apnea

A

complete absence of spontaneous breathing

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17
Q

Biot’s Respiration

A

Rhythmic but deep respiratory movement which alternate at regular intervals with long respiratory pause. Associated with damage to respiratory center from (1) trauma, (2) stroke, and (3) opioid use

Meningitis patients and disorders of cerebral circulation

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18
Q

Bronchitis

A

Inflammation of mucous membranes of the bronchi. Primarily a disease of the upper airways

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19
Q

Left-Right Order of Characteristics: Left-Tailed/Skewed Distribution

A

Mean, median, mode

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20
Q

Pulmonary Angiography

A

Measured blood flow distribution. Radiopaque substance is injected into pulmonary artery and its movement is monitored by X-rays

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21
Q

Congenital Center Hypoventilation Syndrome (CCHS)

A

Rare congenital disorder. Central pattern generator inoperative. Insensitivity of chemoreceptors, both to CO2 (pH) and O2.

No automatic control of respiration. Voluntary breathing.. Management via permanent tracheostomy

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22
Q

Kussmaul’s Respiration

A

Hyperventilation, gasping, and deep and labored respiration. State characterized by high degree of acidosis (diabetic ketoacidosis, kidney failure, diabetic coma)

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23
Q

Centrolobular Emphysema (or Centriacinar)

A

Most common. Affects superior part of lungs/lobes. Begins in respiratory bronchioles and spread.

Associated with long-term smoking, exposure to chemicals/dust, etc.

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24
Q

Respiratory Centers in the Pons

A

1) Apneustic Center

2) Pneumotaxic Center

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25
Q

Oxygen Consumption per minute

A

250 mL/min

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26
Q

Measurable by Spirometer

A

1) TV
2) FVC
3) FEV1
4) FEF25-75

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27
Q

Statistical Power

A

Chance an experiment or study finds a positive result assuming that the alternative hypothesis is really true

= 1 - β (aim for 80%)

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28
Q

Change to breathing in Kyphoscoliosis

A

Underventilation of lungs. FRC and RV are lower

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29
Q

Tension Pneumothorax

A

More and more air accumulates in the pleural cavity with each breath

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30
Q

Treatment for Right Heart Failure

A

Nitric Oxide causes smooth muscle relaxation. Nitroglycerin and Nitroprusside are other options but they cause vasodilation everywhere

Required concentration for medication 20 ppm. Toxic at high concentrations

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31
Q

Passive Influence on Pulmonary Vascular Resistance

A

Reason for only modest rises in pressured with increased cardiac ouput

1) Recruitment of unperfused capillaries
2) Distension of existing pulmonary capillaries

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32
Q

Panacinar Emphysema

A

Entire alveolus destroyed uniformly; predominant in lower half.
Observed in patients with Alpha1-antitrypsin deficiency or ritalin induced lung emphysema

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33
Q

Non-Tension Pneumothorax

A

There is air in the pleural cavity but it does not accumulate with each breath

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34
Q

Silicosis/Asbestosis

A

Restrictive Diseases. Pulmonary fibrosis caused by long-term exposure to silica and asbestos.

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35
Q

Line entire respiratory tract..

A

mucus-covered Ciliated Epithelium

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36
Q

Apneustic Center

A

Continually sends neural impulses to stimulate inspiratory neurons of DRG/VRG

“Normal Respiration Cut-Off Switch”

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37
Q

Where do you see Perihilar Patchy Infiltrates and Kerley B lines on X-ray?

A

Hydrostatic/Cardiogenic Edema

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38
Q

Mask Squeeze

A

Occurs with hyperbaric descent. Negative pressure in mask causes capillary rupture and conjunctiva hemorrhage

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39
Q

Hyperpnea

A

Increase depth/volume of breathing with or without increased frequency

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40
Q

Fixed Intra/Extrathoracic Lesion

A

Foreign bodies/scarring which makes airway too stiff to be affected by transmural pressure gradient. Inspiration/expiration both affected

ex: fixed tumor in airway, fibrotic lesion, or tracheal stenosis

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41
Q

Bronchiectasis

A

Scarring of airways seen in Immotile Cilia Syndrome

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42
Q

Normal Hb levels

A

15 g / 100 mL blood

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43
Q

Ventral Respiratory Groups (VRGs)

A

Both inspiratory and expiratory neurons. Control muscles of upper airways expanding during inspiration. Controls muscles of exhalation and accessory muscles of inspiration (stress/heavy exercise)

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44
Q

Variable meaning False Positive

A

α

45
Q

Difference between % by vol of oxygen in Arterial-Venous blood (systemic)

A

approximately 5%

46
Q

Normal DLCO

A

20-30 mL/min per mmHg

47
Q

Apneustic Breathing

A

Respiratory cycle holds in inspiration, periodically interrupted by expiration. Caused by cutting pneumotaxic center out of pons

48
Q

Specific Compliacnce

A

Compliance / FRC

49
Q

PC20

A

In methacholine test; concentration of methacholine in which you produce 20% reduction in FEV1

50
Q

68-95-99 Rule

A

Normal Distribution.

  • 68% of values within 1 sd of mean
  • 95% of values within 2 sd of mean
  • 99.7% of values within 3 sd of mean
51
Q

Total Pulmonary Compliance

A

1/Total Pulmonary Compliance = 1/lung Compliance + 1/chest wall compliance

52
Q

High Altitude Cerebral Edema

A

Ataxia and inability to walk heel-to-toe. Swelling causes brain ischemia and herniation

53
Q

Pulse Oximeter

A

Measures SATURATION of hemoglobin.

Shines photons of light: 650 nm (HbO2) and 900 nm (deoxyHb)

54
Q

Orthopnea

A

dyspnea which occurs when lying flat

55
Q

Non-Respiratory Functions of the Lung

A

1) Defense Mechanism
2) Air-Conditioning
3) Olfaction
4) Filtration and Removal of Particles
5) Blood Filter
6) Blood Reservoir
7) Metabolism of Circulating Substances

56
Q

Forced Vital Capacity

A

Amount of air that can be exhaled quickly during forced exhalation (4600 mL)

57
Q

What level of PC20 is considered clinically important

A

less than 8 mg/mL

58
Q

133Xe Technique

A

Measured blood flow distribution. Xe injected intravenously. Amount of soluble Xe in pulmonary artery blood gives regional blood flow. Not very soluble in blood so it comes out of solution in lungs and enters alveoli and is expelled out.

59
Q

Left-Right Order of Characteristics: Right-Tailed/Skewed Distribution

A

Mode, median, mean

60
Q

Normal P50

A

~26 mmHg PaO2

61
Q

Residual Volume

A

Amount of air in lungs which can’t be exhaled (1-2 L)

62
Q

Type II Error

A

Null hypothesis really is false; experiment fails to yield a p-value below threshold. False negative

63
Q

High Altitude Pulmonary Edema

A

Real altitude killer! Aggravated by physical exercise, most commonly seen in athletic young males. End stage sign is hemoptysis

64
Q

Variable Intrathoracic Lesion

A

Obstruction inside thoracic cage; expiration affected

Ex: Tumor of Lower Trachea

65
Q

Pneumotaxic Center

A

Major Functions: Prevent aneupsis and enhance/fine-tune rhythmicity of breathing

66
Q

Associated issue with Acute Mountain Sickness

A

Fluid retention. Treated with diuretic

67
Q

FEV1/FVC Ratio: Obstructive Disease

A

Lower than 70%

68
Q

Coefficient change for capillary hydrostatic permeability increase

A

Kf increases

69
Q

Muscles of Inhalation

A

1) Diaphragm (Main)
2) External Intercostal Muscles
3) Accessory Muscles of Shoulder Girdle (exercise/patholoy)

70
Q

Bradypnea

A

Decrease of respiratory rate

71
Q

Cheyne-Stokes Breathing

A

10-30 seconds of apnea followed by gradual increase in volume and frequency until another period of apnea. Pulmonary changes in CO2 before neuronal; depth of respiration corresponds with PCO2 in brain.

Hyperventilation and waning of ventilation with periods of no ventilation.

Found in cardiac failure or brain damage

72
Q

Mediastinum Shift: Pneumothorax

A

Opposite side of collapse

73
Q

Z-Score Formula

A

Z = (chi - mu) / sigma

chi - variable sampled
mu - mean
sigma - sd

74
Q

Wegener’s Granulomatosis

A

Presence of pulmonary nodules (Coin Lesions) in lungs

75
Q

Respiratory Exchange Ratio

A

Rate CO2 output / Rate O2 uptake

76
Q

FEV1/FVC Ratio: Restrictive Disease

A

Normal or Higher (>80%)

77
Q

CO2 Production per minute

A

200 mL/min

78
Q

Primary Surfactant

A

Dipamitoyl Phosphatidyl Choline (DPPC)

79
Q

Mediastinum Shift: Atelectasis

A

Side of collapse

80
Q

Lung Elastic Forces

A

1) Lung Tissue Elastic Recoil

2) Surface Tension Forces (main)

81
Q

1 g hemoglobin binds to ____ mL O2

A

1.34 mL O2

82
Q

Immotile Cilia Syndrome

A

More susceptible to respiratory disease due to increase entry of foreign particles into the lung. Mucus not pushed back up. Bronchiectasis

83
Q

Secretes Surfactant

A

Type II Alveolar Cells

84
Q

Alveolar Vessels

A

Elongated during alveolar expansion (inspiration). Resistance to blood flow increases at high lung volume

85
Q

Way(s) to measure FRC

A

1) Helium Dilution Technique

2) Body Box Plethysmography (if high airway resistance)

86
Q

FEV1

A

Amount exhaled in the first second of FVC. Should be 80% of FVC (3800 mL)

87
Q

Change in PCO2 from Arterial to Venous Blood

A

6 mmHg

88
Q

Microaggregates of Albumin

A

Measured blood flow distribution. Labeled with 131-I or 99m-Tc and injected into peripheral vein. Trapped in small pulmonary vessels as enter lungs. Patient stands in front of gamma detector.

Dark regions - few capilaries working
Light regions - working

89
Q

Systolic/Diastolic Mean Pulmonary Arterial Pressure

A

25 mmHg / 8 mmHg

90
Q

Middle Ear Squeeze

A

Occurs with hyperbaric descent. Failure to equalize pressure can caused middle third of Eustachian tube to colapse

91
Q

What does symmetry tell you about the data set?

A

position of line of symmetry equal to both mean and median

92
Q

Partial Pressure of H20 at 37 C

A

47 mmHg

93
Q

Pulmonary Fibrosis

A

Chronic disease causing swelling and scarring of alveoli and interstitial tissues of the lungs. Scar tissue replaces healthy tissue. Causes inflammation, stiffened lungs and breathing difficulty

94
Q

Coefficient change for capillary protein permeability increase

A

sigma decreases

95
Q

Type I Error

A

Null hypothesis really is true, just happened to get a p=value below threshold. False positive

96
Q

Tachypnea

A

rapid rate of breathing

97
Q

Normal CO2 production per day

A

15 mol / day

98
Q

Total Lung Capacity

A

Volume of air in the lungs after a maximal inspiratory effort (6000 mL)

99
Q

Esophageal balloon

A

measures lung compliance (only)

100
Q

Muscles of (Forced) Exhalation

A

1) Abdominal Muscles (internal obliques, rectus abdominus, transverse abdominus)
2) Internal Intercostal Muscles

101
Q

Pressure Inequalities: Zone 2

A

Pa > PA > PV

102
Q

Atelectasis

A

Partial or total collapse of the lung without air entering pleural space.

103
Q

Extralveolar Vessels

A

Exposed to intrapleural pressure. Distend as Transmural Pressure gradient increases (intrapleural pressure more negative). As lung volume increases, resistance decreases.

104
Q

Tidal Volume

A

Volume or air inspired or expired with each breath (500 mL)

105
Q

Problems from Expansion on Ascent in Hyperbaric conditions

A

1) Pneumothorax
2) Dissection of Mediastium (Cardiovascular issues)
3) Gas Emboli
4) Death

106
Q

Variable Meaning False Negative

A

β

107
Q

Bronchial smooth muscle mechanism

A

Low PACO2 causes bronchial smooth muscle contraction in order to divert ventilation away from over-ventilated regions

108
Q

Physiological conditions leading to high amounts of Zone 1

A

Hemorrhage or general anesthesia (low pulmonary systolic pressure)

109
Q

Sarcoidosis

A

Restrictive disease. Abnormal collections of chronic inflammatory cells (granulocytes) form as nodules (granulomas) in lungs/lymph nodes.

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