Alveolar destruction & +++ pulmonary artery press.

Question 1

True or false type two respiratory failure is any cause of inadequate ventilation?

Answer 1

True

Question 2

What’s diffuses easier across the alveolar membrane: CO2 or O2?

Answer 2

CO2

Question 3

Approximately how many alveoli do you have in your lungs?

Answer 3

200 to 300 million

Question 4

What four things are the alveolar capillary membrane composed of?

Answer 4

Player of surfactant
type alveolar cell
basement membrane
vascular endothelial cell

Question 5

How thick is the alveoli – capillary membrane?

Answer 5

2 cells thick

Question 6

What is the average surface area for diffusion of gases in the lungs?

Answer 6

75 m2

Question 7

Why are the lungs ideally suited for gas exchange?

Answer 7

Large surface area and thinness

Question 8

3 physiological effects of disrupting the a – c membrane?

Answer 8

1. abnormal gas exchange
   2 abnormal lung mechanics
   3 pulmonary vascular complications

Question 9

What does Fick’s law determine??

Answer 9

Rate of diffusion of the gas

Question 10

Should there be a limitation in diffusion of oxygen in a normal person at maximum exercise?

Answer 10

Nope. only perfusion limited

Question 11

When would you get a diffusion limitation of oxygen transfer? 2 situations

Answer 11

at rest if abnormal A-C membrane

during exercise if less severe disease

Question 12

How much faster does CO2 diffuse out compared to O2?

Answer 12

20x faster

Question 13

When is one of the only times he would get a high PaCO2?

Answer 13

low ventilation ie. type 2 reap failure

Question 14

How is emphysema an exception in the restrictive lung disease category?

Answer 14

It has increased lung compliance not stiffer

Question 15

What is the pattern of breathing for restrictive lung diseases?

Answer 15

Short and shallow rate

Question 16

Increased work of breathing needs to overcome the stiffness of what in the lungs?

Answer 16

elastic/reduced compliance of lungs

Question 17

What is the PaO2 and PaCO2 of someone in respiratory muscle fatigue/failure?

Answer 17

PaO2 is less than 60mmHg

PaCO2 is greater than 50 mmHg

Question 18

What is a hallmark reduction in someone with stiff lungs?

Answer 18

reduced vital capacity

Question 19

Compliance of the lungs are affected by two things they are?

Answer 19

Tissue composition

Surface tension in alveoli

Question 20

Over compliant/elastic lungs are what disease?

Answer 20

Emphysema

Question 21

Pulmonary fibrosis does what to the compliance of the lungs?

Answer 21

decreased/stiff

Question 22

For a minute ventilation a person will adopt a pattern of breathing that is what?

Answer 22

Minimizes the work of breathing

Question 23

how is maximum ventilation affected in restrictive lung diseases?

Answer 23

reduced especially in exercise

Question 24

What does asbestosis do to lungs?

Answer 24

abnormal increases in fibrosis and diffuse inflammation that destroys A-C membrane

Question 25

What kind of crackles do you hear with asbestosis?

Answer 25

inspiratory crackles of airways popping open due to collapses

Question 26

What does the following indicate?
Tachypnea
finger clubbing/cyanosis
increase JVP
bassal crepitations
tender pulsatile hapatomegaly
ascites
peripheral oedema

Answer 26

Pulmonary hypertension

Question 27

How do you get a tricuspid pan-systolic murmur?

Answer 27

when you have right ventricular dilatation and the cusps don’t come together perfectly due to inexperience with higher pressures

Question 28

Pulmonary hypertension does what to the right atrial and systemic venous pressures??

Answer 28

increased

Question 29

What is ascites?

Answer 29

accumulation of fluid in the peritoneal cavity causing swelling

Question 30

What happens when you increase systemic venous pressure to the systemic capillary bed? 3 things:

Answer 30

peripheral oedema
ascites
pleural effusions

Question 31

Three most common causes of increased pulmonary area vascular resistance:

Answer 31

vasoconstriction (hypovent)
obstruction (emboli, pulm HTN)
obliteration (emphysema, fibrosis)

Question 32

The three most common causes of pulmonary hypertension?

Answer 32

Increased left atrial pressure (mitral stenosis)
Increased pulmonary blood flow (shunts, HTN)
Increased pulmonary vascular resistance

Question 33

What is lassitude ?

Answer 33

a state of physical or mental weariness