CRRAB2

Question 1

What is the branch after Segmental bronchi?

Answer 1

Terminal brnochiole

Question 2

At rest, how long is blood in the capillary?

Answer 2

0.75 seconds

Question 3

how much is in functional residual capacity?

Answer 3

2.5 L

Question 4

What is total capacity of lungs?

Answer 4

7 L

Question 5

How do you calculate functional residual capacity?

Answer 5

Helium! C1V1=C2(V1+V2) solve for V2

Question 6

How do you calculate alveolar ventilation?

Answer 6

Alveolar ventilation = VCO2/PCO2 X K VCO2 is rate at which CO2 is produced. PCO2 is doubled, VA is 1/2

Question 7

How do you calculate anatomical dead space?

Answer 7

Nitrogen is inhaled then look for steepest part of graph

Question 8

How do you calculate physiologic dead space?

Answer 8

VD/VT=(PACO2-PExhaledCO2)/PACO2 Volume deadspace/tidal volum = Alveolar CO2 pressure - Exhaled CO2 all over Alveolar CO2

Question 9

If there is unequal solubility in blood and blood-gas barrier, what kind of limitations does it have getting into blood?

Answer 9

Diffusion limited

Question 10

How do you calculated diffusion capacity?

Answer 10

=Volume of CO transfered/partial pressure difference of CO.

Question 11

Meanarterial pressure calculation?

Answer 11

Systolic pressure minus 2/3 difference

Question 12

Normal atrial pressure is what?

Answer 12

5

Question 13

Fick equation

Answer 13

Ecstasy stuff. XTC. you know it

Question 14

rankings or pressure for zone 2 in breathing

Answer 14

Part>Palv>PVenous

Question 15

How do hypoxic alveoli make capillaris close?

Answer 15

block voltage gated potassium channels and cause depolarization and calcium channels open

Question 16

Causes of hypoxia

Answer 16

hypoventilation, diffusion limitations, shunt, ventilation:perfusion mismatch

Question 17

How do you calculate the oxygen in air?

Answer 17

Air pressure-47 X 0.2093 (to take out humidity then the ratio that is oxygen

Question 18

See if this is the same equation listed above for alveolar ventilation

Answer 18

Question 19

/How do you calculate diffusion through a tissue in relation to area, thickness, molecular weight and solubility?

Answer 19

i. Area
ii. 1/thickness
iii. 1/(molecular weight)-1
iv. solubility

Question 20

What is the calculation for alveolar PO2 with hypoventilation?

Answer 20

PAO2 = PIO2 – [PACO2/R]

P inspired dO2 - Alveolar CO2/R. R is Respiratory quotient which is produced CO2/O2. R is 1 with carbohydrate as substrate, R is 0.7 with fatty acid. normal is 0.8

Question 21

How do you calculate flow through a shunt?

Answer 21

Question 22

Does the base of the lung have a high or low ventilation to ratio?

Answer 22

The base has a low ventilation to perfusion ratio, so PO2 will be a little less than 100 and PCO2 will be a little more than 40. 89 and 42. Note, it has higher ventilation than the apex, but there is just that much perfusion.

Note, apex is opposite.

Question 23

If a patient ahs a PO2 and PCO2 of 60 mmHg at normal atmospheric pressure normal?

Answer 23

No, PA-Pa calculation

PAO2 is calculated as PO2 inspired-(PCO2 arterial/R)

PAO2=149-60/0.8=74, and what was measured was 50, so the difference is 24 and it should never be mroe than 10 for young healthy individual, so ventilation to perfusion mismatch

Question 24

Do a normal alveolar gas equation calculation.

Answer 24

PAO2=PIO2-PAlveolarCO2/R

100=150-40/0.8

Question 25

Hemoglobin binding of oxygen in ml/g. Normal hemoglobin in blood. Hemoglobin binding at normal 760 mmHg pressure?

Answer 25

1.39 ml/g hemoglobin normal hemoglobin is 15g/100ml Max binding is 20 mlO2/100ml blood

Question 26

What is oxygen concentration in blood required to live?

Answer 26

5 mlO2/100 mL blood. Hyperbaric oxygen will get it to dissolve at that much if carbon monoxide poisoning

Question 27

What will cause oxygen shifts to the right in hemoglobin?

Answer 27

Decreased pH, Increased CO2 Increased temp Increased 2, 3 diphosphoglycerate (end product of RBC metabolism when hypoxic state to kick out O2 to tissues)

Question 28

How much hemoglobin is dissolved in blood at normal alveolar O2?

Answer 28

0.3 mlO2/100ml blood if it were 200 mmHg, oxygen is 0.6 mlO2/100 ml blood. It is linear. Remember, hemoglobin gets maxed out with the curve

Question 29

How does high carbon dioxide concentration effect RBC carrying capacity of O2?

Answer 29

decreases because it buffers with carbonic anhydrase and holds on to hydrogen like shown in the picture

Question 30

What is the pH equation?

Answer 30

pH = pK + log (HCO3/CO2) Higher pH with more HCO3 (more bicarb)

Question 31

What is the herring breuer reflex?

Answer 31

Stretch receptor in lung suppresses further inspiration, slows breathing and heart rate. It calms you.

Question 32

What is the stimulus for increased breathing in exercise?

Answer 32

Joint and muscle receptor from movement of limbs increasing resp rate

Question 33

What is the compliance of the lung? What is something that increases it and worsens it?

Answer 33

200 mL/cm H2O. Change in volume/ change in pressure. Emphysema increases compliance (obstructive lung disease destroys elasticity). Fibrotic lung disease is restrictive and reduces compliance

Question 34

What the shit is dipalmitoyl phosphatidylcholine

Answer 34

It is the fancy name for surfactant

Question 35

How do you treat a premature baby respiratory wise? Why do you do it?

Answer 35

Surfactant is not sufficient until about 28 weeks (production starts in week 20). if too early, hyaline membrane disease and Respiratory Distress Syndrome(causes 20% of newborn baby deaths) Give mom glucocorticoids before the birth to make baby produce it sooner, give the baby surfactant.

Question 36

What causes airway closure? When do you see it?

Answer 36

Increased pressure from exhallation can push airway closed. Only happens at low volumes if young and healthy Can be at functional residual capacity in old people with respiratory disease and cause air trapping

Question 37

Pressure in intrapleural space?

Answer 37

-5 at rest, -8 during inspiration

Question 38

What 2 things decrease airway resistance?

Answer 38

Sympathetics: epinephrine hits those beta two receptors and cAMP and airway dilation. Larger lung volumes as negative pressure pulls airway open with inspiration INCREASED RESISTANCE with parasympathetics hiting muscarinic receptors and more IP3 and Ca and airway constriction

Question 39

What happens to Forced Expiratory Volume (FEV1) in first second of exhalation after a maximum inhalation in emphysema? In pulmonary fibrosis? What happens to the Forced Expiratory Volume in first second to Fored Vital Capacity in emphysema? In pulmonary fibrosis?

Answer 39

Emphysema: Low FEV1 and low FEV1/FVC b/c low elasticity can't get air out quickly, but can still put air into lung. Restrictive lung disease (pulmonary fibrosis): low FEV1 but normal FEV1/FVC b/c can't fill lung easily.

Question 40

Breathing style if restrictive lung disease and obstructive lung disease? Work is force times distance.

Answer 40

Restrictive: short rapid breath, obstructive is slow deep breath

Question 41

Most important receptor for breathing?

Answer 41

Central chemoreceptors which respond toH+ which is indirectly tied to PCO2 b/c CO2 has to cross BBB then carbonic anhydrase makes it into bicarb and H+ and that H+ stimulates to breath more. THIS CAN BE COMPENSATED over time with COPD, so that is why you see slow breathing despite high PCO2 and low O2 in the resp disease patients. Their driving force is mostly low O2 (peripheral receptors), which is not as strong.

Question 42

Why do you breath more with exercise?

Answer 42

Joint and muscle receptors sense moving to make you breath and a higher CO2 load to the lungs maybe. B/c you actually see a fall in PCO2 and a rise in PO2!!! pH is stable until you see lactic acid build up

Question 43

What happens to PCO2 and PO2 in exercise?

Answer 43

fall in PCO2 and rise in PO2, probably b/c joint and muscle receptors moving and increased CO2 to the lung.

Question 44

What creates baseline control of respiration?

Answer 44

Brainstem pacemakers that are in medulla and pons. Have unstable resting potential to make pacemaker actvity similar to the heart. CORTEX can override and allow panic attacks or breath holding.

Question 45

H