35: Pulmonary Pathophysiology - Tran

Question 1

most important factor in controlling breathing

Answer 1

increases in PCO2 level

look at slide 4

Question 2

generation __ is the respiratory air way beginning

Answer 2

17

Question 3

last conduction airway

Answer 3

terminal bronchiole, the next generation the respiratory bronchioles are gas exchange areas

Question 4

4 obstructive diseases:

Answer 4

1. bronchitis = inflammation of bronchial epithelium
2. asthma, infection, decreased cilia function = secretions from epithelium
3. asthma = constriction of smooth muscle
4. tumors, aspiration = physical blockade

Question 5

what level of airway has smooth muscle and no cartilage

Answer 5

bronchiole

Question 6

most important factor in determining airway resistance

Answer 6

radius (to the power of 4)

see slide 7 for equation

Question 7

parasympathetic ___ resistance, sympathetic ____ resistance

Answer 7

para - increase via M3 activation

symp - decrease via B2 activation

Question 8

epinephrine and albuterol would _____ airway resistance

Answer 8

decrease - sympathetic activators

Question 9

asthma and muscarinic agonists would _______ resistance

Answer 9

increase- parasymp activators

Question 10

obstruction related to loss of lung parenchyma =

Answer 10

emphysema

Question 11

how many generations of branching are there?

Answer 11

23

Question 12

site of gas exchange =

Answer 12

respiratory membrane

Question 13

** composition of respiratory membrane

Answer 13

• surfactant fluid layer
• alveolar epithelium
• epithelial basement membrane
• interstitial space
• capillary basement membrane
• capillary endothelial membrane

Question 14

prominent cells of the interstitium

Answer 14

fibroblasts

produce collagen and elastin –> distensibility and elastic recoil of lungs

Question 15

factors affecting gas diffusion across respiratory membrane =

Answer 15

• partial pressure difference b/w alveoli and blood
• surface area
• distance

Question 16

what can change the partial pressure difference?

Answer 16

high altitude

• O2 mask
• restrictive lung disease

Question 17

what can change the surface area?

Answer 17

atelectasis

tumor

Question 18

what can change the distance?

Answer 18

pulmonary edema

pneumonia

Question 19

what pleura is “on the lung”

Answer 19

visceral

Question 20

which pleura has holes in it for stoma?

Answer 20

parietal

Question 21

pleural effusion is most commonly seen with…

Answer 21

CHF

increased pulmonary venous hydrostatic pressure from the visceral side

could also be caused by : decreased microvascular oncotic pressure, decreased pleural pressure, blockade of lymph drainage

Question 22

result of decreased expansion of the lungs due to alteration in lung parenchyma, pleura, chest wall, or neuromuscular function

Answer 22

restrictive pulmonary disorders

list on slide 20

Question 23

bronchial circulation generates a …

Answer 23

physiological shunt

1-2% of CO goes to the bronchiole and empties into the pulmonary v.

Question 24

describe hypoxic pulmonary vasocconstriction

Answer 24

ventilation and perfusion matching –> areas not well ventilated will have less blood flow

unique to lungs

Question 25

average V/Q (ventilation/perfusion ratio)

Answer 25

0.8

Question 26

high V/Q =

Answer 26

little blood flow

Question 27

low V/Q =

Answer 27

little ventilation

Question 28

V/Q = infinity

Answer 28

no blood flow (dead space) with no ventilation V/Q = 0 (shunt)

Question 29

what can not be measured by spirometry?

Answer 29

residual volume see slide 27

Question 30

what can be completely measure by spirometry?

Answer 30

vital capacity = inspiratory reserve + tidal volume + expiratory reserve see slide 27

Question 31

PEF =

Answer 31

peak expiratory flow

Question 32

PIF =

Answer 32

peak inspiratory flow

Question 33

FEF =

Answer 33

forced expiratory flow

Question 34

amount you can blow out in 1 sec

Answer 34

FEV1

Question 35

FEV1/FVC

Answer 35

ability of lungs to force air out within a certain amount of time. Represents resistance within the system

Question 36

large airways are __ on flow-volume curve, small airways are ___

Answer 36

see slide 29 large are the fast upstroke, small are the slower downstroke

Question 37

obstructive lung disease looks like ...

Answer 37

slide 30 ("the punch") large airways not much affected, small airways limited greatly

Question 38

upper airway obstruction looks like...

Answer 38

upper limits of flow stopped slide 31 ("the chop")

Question 39

restrictive lung disease looks like ...

Answer 39

slide 32 (" the push")

Question 40

normal FEV1/FVC =

Answer 40

0.8 80% of vital capacity can be forcibly expired in first second

Question 41

obstructive lung disease FEV1/FVC =

Answer 41

both FVC and FEV1 decrease but FEV1 decreases more DECREASED RATIO

Question 42

restrictive lung disease FEV1/FVC =

Answer 42

INCREASED RATIO both FVC and FEV1 are decreased, but FEV1 decreases less

Question 43

check out the online pulmonary function video

Answer 43

its on d2L