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Finals > Witwer Barton Lower Resp Tract > Flashcards

Witwer Barton Lower Resp Tract Flashcards

1
Q

Type one alveolar cells comprise the cell well while type two have the important function of producing 1._______. Which reduces 2.______ ______ and prevents alveolar collapse

A
  1. Surfactant

2. surface tension

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2
Q

The respiratory membrane between the capillary and alevolus is about ______ to _____ micron ( an RBC is 8 microns )

A

.5 to 1 micron

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3
Q

Witwer would really like you to know that surfactant does what…

A

increases lung compliance

Prevents atelectasis

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4
Q

The primary muscles of inspiration are

A

Diaphragm

external intercostals

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5
Q

Active breathing occurs when

a. always
b. excercise and pathological states
c. only when sleeping

A

b. exercise & pathological states

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6
Q

this effing guy poiseuille made a law. Basically the ______ of the airway plays a big role in respiration a. lengthb. elasticity c. diameter d. blood flow

A

c. diameter

straw analogy

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7
Q

Pressure in the alveoli is _______ to the pressure in the environment a. the same b. lessc. more

A

a. the same

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8
Q

In obstructive respiratory diseases what is the source of the pathology, the airway or the ability of the lung to fuly expand

A

the airway

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9
Q

Elasticity is _____ related to compliance a. directly b. not related c. inversley

A

c. inverse

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10
Q

Elasticty is …..

A

recoil property of the lungs and chest wall

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11
Q

Compliance

A

measure of the ability of the lungs and chest wall to expand / distend (change in volume for a given pressure)

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12
Q

In restrictive disease the compliance is ______

A

low (the lungs are stiff)

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13
Q

increase in intrathoracic pressure will ______ the diameter of the airways and result in increased expiratory ______a. decrease, resistanceb. increase, resistance c. decrease, compliance

A

a. decrease

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14
Q

One liter of blood hold ______ ml of O2a. 300b. 200c. 400

A

b 200mL of O2

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15
Q

Ideal V/Q ratio is _____a. 1.0b. 1.5 c. 2

A

a. 1.0
because the ideally one liter of blood should have 200 ml of o2 and one liter of air should have 200 ml of o2 200/200= you get it

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16
Q

Ideal V/Q ratios do not acutally happen. Normally the ratio is actually ______.

A

0.8 the alveolar ventilation in L/ min is 80 % of the value for pulm blood flow per minute

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17
Q

Upper lungs have the _____ blood flow and ventilation. Lower lungs have ____a. greatest, lowest b. equal c. Lowest, greatest

A

c. LOWEST, GREATEST

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18
Q

When there is perfusion but NO GAS EXCHANGE there is_____

A

right to left pulmonary shunt
in this situation there is always hypoxemia.

This hypoxemia cannot be corrected with oxygen admin

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19
Q

In right to left cardiac shunts hypoxemia occurs NOT because there is no gas exchange but because there is ……

A

mixing of oxygenated and deoxygenated blood

dont get this confused with pulm shunts

20
Q

When there is ventilation and no perfusion there is ______

A

dead space

this can occur with a PE

21
Q

value of tidal volume

A

.5 L

22
Q

Value of vital capacity

A

4.5 L

This is what is used in the Forced Vital Capacity FEV1 Test

23
Q

Value of anatomic dead space

A

150ml

24
Q

Alveoli that do not participate in gas exchange

A

functional dead space

25
Q

The acinar unit is composed of

A

bronchioles alveoli pulmonary blood vessels

26
Q

Most common cause of Lung CA (80% of cases)

A

Non Small Cell Lung Cancer (NSCLC)

27
Q

Pancoast Tumor cause

Findings?

A

primary small cell lung cancer

Destruction of Cervical Sympathetic
Ganglion>Horner’s Syndrome

28
Q

Asbestosis

A
  1. occupational dz
  2. no longer used
  3. thickening of plura, superimposed mesothelioma.
29
Q

Rational For O2 therapy

beware of?

A
  1. Supplemental O2
  2. COPD SPO2 <88% or PaO2 <55mmHg
    (target 88-92%)

O2 toxicity
Retrolentil fibroplasia in infants=blindness
↓ O2 drive to breathe (COPD)= worsening Hypercapnea

30
Q

Mechanical ventilation goals (4)?

Method used?

A
  1. Oxygenation- critically ill or under anesthesia
  2. CO2 elimination
  3. Maintain adequate Tidal Vol
  4. Maintain RR

(+) Pressure ventilation

31
Q

Indications for Mechanical Ventilation

A 
1. Acute Resp Failure
(PNA, Sepsis, Postop infect, HF, ARD, Trauma, Aspiration)
2. Coma
3. COPD exacerbation
4. Neuromuscular weakness
32
Q

Mechanical Ventilation Variables

A
  1. TV
  2. RR
  3. PEEP
  4. Fraction of inspired O2= FIO2
  5. Peak Pressure
  6. Plateau Pressure
  7. Trigger sensitivity
  8. Flow Rate
  9. Flow Pattern
33
Q

PEEP

too mcuh/too little precautions?

A

Positive End Expiratory Pressure
= alveolar pressure above ATM pressure @ END EXPIRATION (1mmHg=3-5cmH2O)

This keeps alveoli, bronchioles, bronchi open
prevents collapse

too much PEEP= blow out alveoli
too little PEEP= alveoli wont open

34
Q

Mechanical Ventilation Precautions (7)

A
  1. Lung Inj
  2. Overinflation
  3. Sheer stress between adjacent structures
  4. Collapse of bronchi, bronchioles, and alveoli
  5. Alveolar damage w/ loss of surfactant
  6. Atelectasis
  7. Oxygen Toxicity to lungs occurs above a FIO2 of 50%
35
Q

What is obstructed in Obstructive Lung Dz?

A

The air flowing through airways.

Work needed to overcome
flow resistance in abnormal airways

36
Q

What is obstructed in Restrictive Lung Dz?

A

The ability of the lung to expand.

Work needed to overcome elastic forces of abnormal lung

37
Q

What is obstructed in Restrictive Lung Dz?

A

The ability of the lung to expand.

Work needed to overcome elastic forces of abnormal lung

38
Q

Residual volume

A

1.5L

39
Q

Total lung capacity

A

6L

40
Q

Inspiratory capacity

A

4.5L

41
Q

Neonate respiratory distress syndrome is a risk of premies born before _____ since this is when _______ is produced.

A
  1. 28th week

2. Surfactant

42
Q

What happens to lung volumes in Obstructive lung Dz?

Lung capacities?

A

Decreased vital capacity
INCREASED functional residual capacity (HIGH increase in residual volume)

FEV1/FVC decrease
FEV1 decreased even more so.
(ratio <0.8)

43
Q

Resistance to Inspiration – alveoli don’t open adequately

A

Restrictive lung disease

44
Q

Restrictive lung Dz examples

A 
-Stiff lungs with thick alveolar walls
(inflammatory, connective tissue disease) 
-Stiff chest wall
-Respiratory Muscle weakness
-Central Sleep Apnea
45
Q

What happens to lung volumes in Restrictive lung Dz?

Lung capacities?

A

Decrease Vital Capacity
Decreased Functional Residual Capacity

Esp decrease total ratio of FEV1/FVC
will be close to NL but overall low

Finals (24 decks)

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