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Respiratory Care > Week 1 - Anatomy, Phys, Basic Concepts > Flashcards

Week 1 - Anatomy, Phys, Basic Concepts Flashcards

1
Q

What is the route of gas down to the alveoli? (In order)

A

From the oropharynx or nasopharynx, larynx, trachea, and finally bronchi and bronchioles.

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2
Q

The trachea divides at what point into two different main stems?

A

Corina

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3
Q

How many lobar bronchi are inthe right lung and in the left lung?

A

Three on the right, two on the left

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4
Q

The conducting airways separate about how many times down to the level of the terminal bronchioles?
- Do they participate in gas exchange?

A

15 - 20 times down to the terminal region
- No

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5
Q

Conducting airways include?

A

All airways down to the terminal bronchioles

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6
Q

Beyond the terminal bronchioles includes what components?

A

Respiratory bronchioles, alveolar ducts, and alveoli

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7
Q

The terminal unit is also called the?

A

Acinus

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8
Q

The terminal unit that consists of the bronchioles and beyond are involved in _____ ______

A

Gas exchange

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9
Q

At the terminal level, inhaled gas comes in contact with alveolar (1)______ (septa) and the pulmonary (2)____ blood loads O2 and unloads CO2 as it courses through

A

Walls
capillaries

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10
Q

Approximately how many alveoli are in an adult human lung?

A

300 million

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11
Q

Both lungs and chest wall have what kind of properties?

A

Elastic

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12
Q

If the lungs were removed from the chest, what would happen to them (Considering there would be no external force)?

A

they would collapse to the point of being almost completely airless

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13
Q

There is a _____ pressure being applied through the airway and thus inversely, a _____ airway outside of the lungs.

A

Positive pressure in the airway causes the negative pressure outside of the lungs that causes expansion. (Works inversely when expiration occurs)

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14
Q

So, in retrospect, either internal pressure can be made ____ or external pressure can be made ____ and the net affect is the same.

A

Internal pressure: Positive
external: Negative

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15
Q

Within the lungs inside the chest wall, the internal pressure is _____ pressure (Palv)

A

Alveolar pressure

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16
Q

Whereas external pressure is the pressure within the pleural space. Therefore, the ______ pressure is referred to as Ppl

A

Transpulmonary

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17
Q

For air to be present in the lungs, Ppl must be _____ in contrast to Palv, resulting in ______ transpulmonary pressure

A
  1. Negative
  2. Positive
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18
Q

How do you find transpulmonary pressure?

A

Alveolar pressure minus pleural pressure

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19
Q

As transpulmonary pressure increases, lung volume naturally _____

A

Increases

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20
Q

The relationship between transpulmonary pressure and lung volume is not _______ but rather ______

A

Not linear but rather curvilinear

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21
Q

When lungs reach their maximum volume, the lung reach their maximum ________.
- True/False: a rather large increase in transpulmonary pressure results in significant increases in lung volume

A

Distensibility
- False, it does not result in a significant difference in lung volume

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22
Q

When no external or internal pressures are applied to the chest wall, what happens to it?

A

The chest wall would expand

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23
Q

The pressure across the chest wall is ____ to the transpulmonary pressure

A

Akin or similar to

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24
Q

The pleural pressure across the chest wall is the pleural pressure minus the ______ pressure surrounding the chest wall

A

external or atmospheric pressure

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25
Q

The compliance curve becomes relatively flat at low lung volumes, at which the chest wall becomes _____

A

Stiff

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26
Q

The compliance curve of the chest walls relates to the volume _____ by the chest wall to the pressure ____ the chest wall

A

Enclosed
Across

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27
Q

Remember that the elastic properties of each (chest wall and lungs) are _____ and are acting in ____ directions

A

Coupled
opposite directions

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28
Q

When the lungs are in isolation, the Ppl is typically ____

A

negative

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29
Q

At Functional residual capacity (FRC), the inward elastic recoil of the lung is ______ by the outward elastic recoil of the chest wall

A

Balanced

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30
Q

The transrespiratory system pressure is _____ pressure minus _____ pressure

A

Airway (internal)
Atmospheric (external)

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31
Q

at a transrespiratory pressure of “0”, the respiratory system is known as being in ______

A

Functional Residual Capacity (FRC)

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32
Q

What is Total lung Capacity? (TLC)

A

The volume of gas within the lungs at the end of a maximal inhalation

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33
Q

When we exhale as much as possible, we reach _____ volume

A

Residual Volume (RV)

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34
Q

RV is determined primarily by the balance of the _____ recoil of the chest wall and the _____ action of the expiratory musculature

A

Outward recoil
contracting

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35
Q

The simple RV model only applies to ____ people as if there’s any pathologies, it may be limited

A

young

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36
Q

At RV, either ____ recoil of the chest wall or ____ of airways prevents further expiration

A

Outward recoil
Closure of airways

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37
Q

An average adult male breathes in approx. ___ mL of oxygen while an average female breathes in approx. ___ mL of oxygen per breath

A

Male: 500
Female: 400

38
Q

minute ventilation (VE) in females is _____ than that in males

A

Less

39
Q

The volume of each breath, known as tidal Volume (VT) is not all completely used, this “wasted” volume is formally known as?

A

Dead space (VD)

40
Q

The tidal volume that reaches gas exchange is formally known as _____?

A

Alveolar volume (VA)

41
Q

How many mL is the dead space consistent of?

A

150 mL

42
Q

Arterial PCO2 equation is:
PaCO2 = VCO2/VA

Where PaCO2 is arterial PCO2
VCO2 is the body’s rate of CO2 production

A

Remember this equation

43
Q

arterial PCO2 is ______ proportional to alveolar ventilation and ________ proportional to CO2 production

A

Inversely
Directly

44
Q

When a normal individual exercises, ____ increases but VA _____ proportionally so that PaCO2 remains relatively constant.

A

VCO2
increases

45
Q

The anatomic dead space consists of the ____ airways

A

Conducting

46
Q

Dead Space Equation:

VD/VT = (PaCO2-PECO2)/PaCO2

A

REMEMBER THIS EQUATION

47
Q

the PCO2 of dead space gas is ____ because it never reaches gas exchange

A

Zero

48
Q

If expired gas came entirely from perfused alveoli, PeCO2 would _____ PaCO2

A

Equal

49
Q

If expired gas came entirely from dead space, it would contain no CO2, and therefore the VD/VT would equal _____
AND PeCO2 would also equal _____

A

VD/VT = one
PeCO2 = Zero

50
Q

Elimination of CO2 by the lungs is ____ to VA
Therefore, PaCO2 is _____ proportional to VA and not to VE

A

proportional to VA
inversely proportional to

51
Q

How much blood does the pulmonary circulation handle per minute?

A

5 L

52
Q

What is the normal Mean pulmonary artery pressure?

A

15 mm HG

53
Q

As a result of gravity, there is more blood flow to the _____ regions of the lung

A

Dependent

54
Q

Apical vessels have a much _______ pressure than the dependent regions

A

Lower

55
Q

At the apex of the lung, alveolar pressure exceeds both _____ and _____ pressures, thus what kind of flow results?

A

arterial and venous; No flow results

56
Q

In the middle of the lung, Zone 2, arterial but not venous pressure _____ venous pressure. (Pa>PA>PV)

A

exceeds

57
Q

In Zone 3, what pressures exceed alveolar pressure?
- What is the driving force of zone 3?

A

Arterial and Venous; Driving force is the difference between arterial and venous pressures

58
Q

In the oxygen dissociation curve, When the curve shifts to the left what happens to the:
- pH
- Pco2
- Temp.
- 2,3-DPG

A

-pH Elevated
- Decreased Pco2
- Decreased Temp
- Decreased 2,3-DGP

59
Q

If the Oxygen dissociation curve shifts to the right, What happens to the:
- pH
- Pco2
- Temp
- 2,3-DPG

A
  • pH is decreased
  • Everything else is increased
60
Q

What does it mean when the O2 dissociation curve shifts to the right? In terms of binding or unloading O2

A

easier to unload O2, harder to Bind O2 for any given PO2

61
Q

What does it mean when the O2 dissociation curve shifts to the left? in terms of unloading or binding O2

A

Harder to unload, easier to bind O2 for any given PO2

62
Q

The O2 dissociation curve properties help ensure there’s adequate oxygen to metabolically active tissues. Because, intense anaerobic metabolism results in ____ pH whereas intense aerobic metabolism causes increased _______ and _____ generation

A

Anaerobic: decreased
Aerobic: heat and CO2

63
Q

Deoxygenated hemoglobin has a ____ affinity for CO2, than oxygenated hemoglobin. This is known as the _____ effects

A

Greater;
Haldane

64
Q

Blood flow is heavily determined by ____ forces and _____

A

Hydrostatic forces and gravity

65
Q

the ratio of ______ (V) to _____(Q) is higher in apical regions of the lung

A

Ventilation to perfusion

66
Q

The V/Q ratio is ____ in dependent regions of the lung

A

Lower

67
Q

From the top to the bottom of the lung the gradient is more marked for ____ than for ______

A

Perfusion (Q) than for ventilation (V)

68
Q

When V is maintained and Q approaches zero, the V/Q approaches ______.
- Is there any perfusion?

A

Infinity
- No perfusion occurs because its at 0

69
Q

When V approaches zero and Q is preserved, V/Q approaches _____.
- When V is equal to zero, what exists?

A

zero
- A shunt exists when theres no ventilation

70
Q

When alveolar ventilation and perfusion (Va/Q) approaches infinity, there is a ____ in the alveolar space, it becomes a dead space.

A

Shunt

71
Q

When _______ is obstructed, there’s a shunt and perfusion is preserved.

A

Ventilation

72
Q

General Rule of thumb:

V/Q = infinity, it means there’s _____

V/Q = Zero, it means there is _______

A

V/Q = infinity is ‘Dead space’

V/Q = 0 there is a ‘Shunt’

73
Q

Is there any CO2 exchange when there’s a ventilation shunt? (V=0)

A

yes

74
Q

Is there CO2 exchange when there’s a alveolar dead space? (V/Q = infinity)

A

No

75
Q

What is worse, a V/Q mismatch or a shunt?

A

A shunt

76
Q

Regions of the lung with _____ V/Q ratios and a ____ PO2 cannot compensate for regions with a low V/Q ratio and low PO2

A

High x 2

77
Q

A high PO2 in blood coming from a region with a high V/Q ratio (1.Can/Cannot) fully compensate for blood with a low PO2 from a region with low V/Q.

A

Cannot

78
Q

Hypoxemia is classified by?

A

decreased arterial PO2

79
Q

Hypercapnia is classified by?

A

Increased PCO2

80
Q

What are the common causes of a shunt (There’s 3)

A

Intracardiac lesions, structural abnormalities of the pulmonary vasculature, and Pulmonary diseases

81
Q

What is an example of a intracardiac lesion?

A

A right to left shunt at the atrial or ventricular level

82
Q

Example of Right to left shunt?

A

An atrial or ventricular septal defect

83
Q

what does AaDO2 stand for?

A

Alveolar-arterial oxygen difference or Gradient

84
Q

Left to right shunts doesn’t effect either _______ or ______

A

AaDO2 or arterial PO2

85
Q

What’s the net affect of a left to right shunt?

A

To recycle already oxygenated blood through the pulmonary vasculature, not to dilute oxygenated blood with desaturated blood

86
Q

What is an example of structural abnormalities in pulmonary vasculature?

A

Pulmonary arteriovenous malformations

87
Q

What are the two important mechanisms for elevations of the Alveolar-arterial O2 difference?

A

V/Q mismatch and Shunting

88
Q

When AaDO2 increases, what condition results?

A

Hypoxemia

89
Q

What’s a third special case that causes elevated AaDO2?

A

Diffusion block

90
Q

When hypoventilation is the sole cause of hypoxemia, AaDO2 is _______

A

Normal

91
Q

What are the four mechanisms of hypoxemia?

A

1.Shunt
2. V/Q mismatch
3. Hypoventilation
4. Low inspired PO2

92
Q

A decrease in alveolar ventilation is the primary mechanism that causes _______

A

Hypercapnia

Respiratory Care (30 decks)

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