Test 3: Wk12: 1 V/Q Balance Special Breathing Patterns - Puri

Question 1

FRC is the

Answer 1

point of equilibrium

Question 2

At FRC Chest wall recoil — Lung recoil

Answer 2

=

Question 3

Volume above FRC Chest Wall Recoil — Lung Recoil

Answer 3

less than

Question 4

Volume Below FRC Chest Wall Recoil — Lung Recoild

Answer 4

> greater than

Question 5

At FRC 
atmospheric pressure=
Intrapleural pressure = 
Alveolar pressure =
Transpulmonary pressure =

Answer 5

atmospheric pressure= 0
Intrapleural pressure = neg
Alveolar pressure = 0
Transpulmonary pressure = pos

Question 6

the slope of the PV compliance curve =

Answer 6

compliance

Question 7

PTP (Transpulmonary Pressure) =

Answer 7

PTP = PA - PIP

PA Alveolar Pressure
PIP Intrapleural Pressure

Question 8

As diaphragm contracts PIP (intrapleural pressure) becomes

Answer 8

more negative

Question 9

PIP is equal and opposite to

Answer 9

PTP (transpulmonary pressure)

Question 10

— is the only pressure that fluctuates above and below 0 during regular quiet breathing

Answer 10

alveolar pressure

Question 11

emphysema shifts curve

Answer 11

left, increase in compliance

Question 12

Restrictive lung Dz shifts curve

Answer 12

right, decrease in compliance

Question 13

higher the compliance higher the

Answer 13

resting lung volume

Question 14

Airflow =

Answer 14

Palveolar - PBarometric / r

Question 15

— contribute most to resistance

Answer 15

central, segmental airways

Question 16

Bronchodilation Nerves

Answer 16

sympathetic

Question 17

Bronchodilation receptors

Answer 17

B2 adrenergic

Question 18

nonadrenergic, noncholinergic bronchodilators nerves VIP

Answer 18

Bronchodilation

Question 19

Bronchoconstriction Nerves

Answer 19

Parasympathetic (Vagal)

Question 20

Bronchoconstriction Receptors

Answer 20

Muscarinic Cholinergic Receptors M3

Question 21

Alpha-adrenergic Receptors

Answer 21

Bronchoconstriction

Question 22

airway resistance — and lung volume decreases

Answer 22

increases

Question 23

At high lung volume

Answer 23

conduction airways are filled with air and expanded

radial traction applied by adjacent alveoli expands airways

Question 24

intrapleural pressure only becomes positve during

Answer 24

forceful exhalation

Question 25

Frictional resistance causes a fall in this driving pressure along the length of the conducting airways. At some point, the driving pressure will equal the surrounding pleural pressure; in this event, the net transmural pressure is zero

Answer 25

equal pressure point

Question 26

in emphysema and bronchitis, the qeual pressure point is shifted

Answer 26

down towards lower airways

Question 27

barrel chest is due to

Answer 27

lung hyperinflation from increased compliance

Question 28

Pursed lips do what

Answer 28

increase air resistance at mouth increasing airways preventing collapse during expiration

Question 29

In restrictive lung dz the equal pressure point is

Answer 29

shifted towards upper airways airflow increased

Question 30

airway resistance --- in restrictive dz due to dynamic compression of upper airways

Answer 30

increases

Question 31

--- is the only volume that us decreased in obstructive lung dz

Answer 31

Expiratory Reserve Volume

Question 32

why is residual volume increased so much in obstructive lung dz

Answer 32

air is trapped from dynamic compression

Question 33

steady state

Answer 33

Vol CO2 produced = Vol O2 taken up 300mL/min = 300 mL/min

Question 34

Hyperventilation

Answer 34

disproportionate increase in alveolar ventilation as | compared to metabolic state

Question 35

Hypoventilation

Answer 35

a disproportionate decrease in alveolar ventilation as | compared to metabolic state

Question 36

Total Ventilation Equation

Answer 36

VE = VT x F

Question 37

Alveolar ventilation =

Answer 37

VA = VT-D x f

Question 38

Total Ventilation in L/min

Answer 38

~ 6 L/min

Question 39

Alveolar Ventilation in L/min

Answer 39

~4.2 L/min

Question 40

Alveolar Gas Equation

Answer 40

PAO2 = [(Patm - 47) x .21] - (PACO2 / 0.8)

Question 41

only 2 ways to change PACO2

Answer 41

change alveolar ventilation | change metabolism

Question 42

Change in alveolar ventilation effect on PAO2

Answer 42

no effect bc O2 is coming from environment

Question 43

PAO2 =

Answer 43

PiO2 - PACO2

Question 44

Extraalveolar and alveolar vessels are arranged in

Answer 44

series

Question 45

Total PVR is lowest

Answer 45

at FRC

Question 46

↑ lung volume above FRC → ↑ | Alveolar PVR by compression of alveolar vessels →

Answer 46

↑ Total PVR

Question 47

↓ lung volume below FRC → ↑ | Extraalveolar PVR by compression and less traction on extraalveolar vessels →

Answer 47

↑ Total PVR

Question 48

Hypoxic Pulmonary Vasoconstriction

Answer 48

response to Alveolar O2 Decrease in PAO2 leads to precapillary pulmonary vasoconstriction which increases PVR

Question 49

Hypoxic Pulmonary Vasoconstriction Occurs in

Answer 49

High Altitude Hypoxemia caused by hypoventilation , shunting, V/Q mismatch Fetal Circulation

Question 50

Opioids suppress respiration by acting on the

Answer 50

central pattern generator

Question 51

in chronic hypoventilation

Answer 51

PaCO2 is increased and PaO2 is decreased

Question 52

Oxygen inducted hypoventialtion

Answer 52

administration of high concentrations of oxygen to a person with chronic hypercapnia will increase PaO2 and knock out hypoxic drive

Question 53

Hypoxic Drive

Answer 53

``` central chemoreceptors are no longer stimulated by CSF acidosis, the main stimulus to breathe becomes the ↓ PaO2, which is mediated by the carotid body chemoreceptors ( ```

Question 54

Hypoxic (↓PaO2) ventilatory drive--primarily mediated by --- accentuated by

Answer 54

peripheral chemoreceptors hypercapnia (respiratory acidosis

Question 55

Hypercapnic (↑PaCO2) ventilatory drive—primarily mediated by --- accentuated by

Answer 55

central chemoreceptors Hypoxia and metabolic acidosis

Question 56

Opiates and BZDs reduce or abolish

Answer 56

ventilatory drive | to hypoxia and hypercapnia

Question 57

Apneusis

Answer 57

prolonged inspirations separated by brief expirations, typically seen in animals with lesions of the rostral pons—rare

Question 58

Cheyne-Stokes Respiration

Answer 58

cycles of a gradual increase in tidal volume, followed by a | gradual decrease in tidal volume, and then a period of apnea

Question 59

Cheyne-Stokes Respiration Seen with

Answer 59

bilateral cortical disease or congestive heart failure, or in healthy people during sleep at high altitude

Question 60

Ataxic Breathing (Biot’s)

Answer 60

highly irregular inspirations, often separated by long | periods of apnea—medullary lesions

Question 61

Cluster Breathing

Answer 61

similar to ataxic breathing, with groups of breaths, often of differing amplitude, separated by long periods of apnea—medullary or pontine lesions

Question 62

Kussmaul breathing

Answer 62

``` hyperventilation seen with metabolic acidosis, especially diabetic ketoacidosis (DKA) ```

Question 63

Thus, V/Q ratio is greater at the

Answer 63

apex

Question 64

V/Q ratio is lowest at the

Answer 64

base