[1] Review of Normal Structure and Function of the Lung

Question 1

Mucociliary Clearance is under Sympathetic or Parasympathetic Control?

Answer 1

Parasympathetic

Question 2

Composition of Mucus

Answer 2

95% Water
3% Mucin
1% Lipid
< 0.3% DNA

Question 3

Bonds present in Mucus

Answer 3

Disulfide Bonds

Calcium Ion Bonds

Question 4

Why should you increase water intake when mucus is hard to expectorate?

Answer 4

Increase in the Sol Layer

Question 5

Liquid Volume of Sol Layer is determined by?

Answer 5

NaCl Amount

Question 6

What produces the Sol Layer?

Answer 6

Epithelial Serous Layer

Question 7

Amount of Alveoli in a Human Body

Answer 7

300 Million

Question 8

Diameter of an Alveoli

Answer 8

1/3mm.

Question 9

Area of Alveoli

Answer 9

85 square meters

Question 10

Width of Blood-Gas Barrier

Answer 10

<0.5 microns

Question 11

What maintains patency of the alveolar cells?

Answer 11

Surfactants

Question 12

What mainly produces surfactants?

Answer 12

Alveolar Type II Cells

Question 13

Technical name of Surfactant

Answer 13

Phospholipid Dipalmitoyl Phosphatidyl Choline

DPPC

Question 14

What is Laplace’s Law?

Answer 14

Larger the surface area, the smaller the surface tension

Question 15

Formula for Compliance

Answer 15

Compliance = P / V

Question 16

Effect of Emphysema on Lung Compliance

Answer 16

Decreased elastic recoil -> High Compliance

Question 17

Effect of Fibrosis on Lung Compliance

Answer 17

Low Compliance

Question 18

Effect of Expiration on Pleural Pressure

Answer 18

Becomes less negative

Question 19

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

Answer 19

Interstitium

Question 20

How does exercise help unmask hypoxemia?

Answer 20

Shortens transmit time giving RBCs less time to complete gas exchange

Question 21

Which part of the lung is more perfused?

Which part is more ventilated?

Answer 21

Both are the lower part of the lung because of the lower pleural pressure that allows it to expand

Question 22

Expansion is greater at the Apex of the Lung or the Base?

Answer 22

Base

Question 23

Ventilation / Perfusion ratio is greater at which part of the lung?

Answer 23

The Top since the Ventilation would become greater than the Perfusion

(Keep in mind that in both cases, ventilation and perfusion are still greater at the base of the lung)

Question 24

How come Bacilli prefer the top of the lung better than the bottom?

Answer 24

More ventilation than perfusion

Question 25

What do you call situations with high flow but no perfusion?

Answer 25

Shunt

Question 26

Most potent vasoconstrictor of Pulmonary Blood Vessels?

Answer 26

Lack of Oxygen

Question 27

Is CO2 more or less soluble in liquid compared to O2?

Answer 27

More soluble, by 20x

Question 28

Is there CO2 present usually in alveolar area?

Answer 28

No

Question 29

Receptors Mainly Important for Detecting Elevated PCO2 Levels

Answer 29

Carotid Artery Surroundings

Question 30

5 Mechanisms Causing Hypoxemia

Answer 30

1. Low Inspired O2 2. Ventilation-Perfusion Mismatch (Most Common) 3. Shunting 4. Decrease in Diffusing Capacity 5. Hypoventilation

Question 31

Hallmark of Alveolar Hypoventilation

Answer 31

Pa CO2 Always Increased | Increase in PACO2 triggers hyperventilation, since CO2 is very diffusible, it will cause the increase

Question 32

Effect of Supplemental O2 on PaO2

Answer 32

PaO2 does not improve significantly because of shunted blood causing no perfusion

Question 33

How come Adult Respiratory Distress Syndrome mimics a Shunt?

Answer 33

The alveoli are full of liquid already resulting in no ventilation, and since it cannot ventilate the perfusion is also affected (Perfusion does still occur, making it different from shunts)

Question 34

The only time a Ventilation Abnormality is obstructive?

Answer 34

Airway Problem Everything else is restrictive

Question 35

Most pulmonary diseases manifest with?

Answer 35

Cough and Dyspnea

Question 36

Level of the Larynx

Answer 36

C4-C6

Question 37

Level of the Carina Expiration Inspiration

Answer 37

E: T5 I: T6

Question 38

Aspirated material is more likely to enter the right or left lung?

Answer 38

The right, since the main bronchus is less sharply angled here as compared to the left

Question 39

Anatomic Division of Upper and Lower Respiratory Tract in Adults

Answer 39

Vocal Cords

Question 40

Anatomic Division of Upper and Lower Respiratory Tract in Children

Answer 40

Cricoid Cartilage

Question 41

Conducting Zone spans which generations of airway?

Answer 41

1st 16 generations

Question 42

Where are the chief sites of greatest resistance?

Answer 42

Medium-sized Bronchi (5th-7th Generations)

Question 43

What is the Reid Index

Answer 43

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

Question 44

Normal Reid Index

Answer 44

<0.4

Question 45

Is there gas exchange in the Transitional Zone?

Answer 45

Yes

Question 46

Is air flow turbulent or laminar in the Central Airways?

Answer 46

Turbulent Bulk Flow

Question 47

Which provides more airway resistance? Central or peripheral airways?

Answer 47

Central: 80 Peripheral: 20

Question 48

Effect of Cystic Fibrosis on the Mucus Layer

Answer 48

Abnormal Cl- channels cause lack of water in the sol layer and in the end causing very thick mucous

Question 49

What are responsible for secretion of surfactant precursors in the Type II Pneumocytes?

Answer 49

Cytosomes

Question 50

When is Equal Point Pressure achieved?

Answer 50

When intrapleural pressure equals airway pressure

Question 51

Most potent vasoconstrictor of pulmonary blood vessels

Answer 51

Lack of O2

Question 52

Situations that would cause a right shift of Hemoglobin-O2 Binding Curve

Answer 52

``` CO2 Acidity DPG Exercise Temperature ```

Question 53

Where is the respiratory center located?

Answer 53

Medulla Oblongata