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Flashcards in Exam 4 Deck (68):
1

Regulation of pulmonary ventilation

Parasympathetic - bronchiolar constriction
Sympathetic- bronchiolar dilation

2

What controllers are involved in breathing

Cerebral cortex - voluntary breathing
Medulla oblongata- Involuntary breathing

3

Where are central chemo-receptors located

medulla -- sensitive to CO2

4

Where are peripheral chemo-receptors located

Carotid bodies and aortic bodies
sensitive to increase of CO2
decreases in O2

5

What are the two circulations of the lungs

Bronchial - nourishes lung tissue
Pulmonary- blood supply

6

What is venous admixture

dilution of oxygenated blood (bronchial veins dumping into pulmonary veins) brings PAO2 down (104 to 100)

7

What is Boyle's law

At constant temps, pressure is inversely related to volume

8

explain the movements of inspiration and expiration

inspiration- diaphragm contracts, rib cage expands
expiration- diaphragm relaxes, rib cage retracts

9

explain how a pneumothorax affects the lungs

a puncture in the pleural space allows air into the cavity separating the serous membrane. the lungs collapse do to air on the outside.
Puncture of the lungs allows air to enter the space....same as above

10

What is lung compliance, what affects compliance

compliance is the ease at which lungs can be distended
lung elasticity and alveolar surface tension

11

VT

tidal volume

12

IRV

inspiration reserve volume

13

ERV

expiration reserve volume

14

RV

reserve volume

15

TLC

total lung capacity

16

FRC

functional reserve capacity
ERV + RV

17

inspiratory capacity

VT+IRV

18

Vital capacity

ERV+VT+IRV

19

FVC

forced vital capacity
amount of air that can be forced exhaled

20

FEV1

forced expiratory volume first second
amount of air that can be forced exhaled in the first second

21

FEV1/FVC

ratio of air expelled in the first second compared to total expiration

22

Why is VA more important than VE

VA is F(VT-VD)
VE is F x VT
VA takes into account deadspace and residual air

23

what 3 methods control contraction of bronchials

Autonomic regulation -PNS/SNS
reflex regulation- irritant receptors
local regulation- chemical (hypoxic vasoconstriction

24

High VA/Q

dead space- lots of air no blood

25

Low VA/Q

shunt lots of blood no air

26

Decreased PAO2 (hypoxic vasoconstriction)

shunts blood to alveoli that has air

27

Decreased PCO2 controls

causes bronchialconstriction limiting CO2 offloading

28

What pushes the oxygen-hemoglobin curve to the right

-decreased affinity-
decreased pH
High CO2
increased temp
high levels 2,3DPG

29

What pushes the oxygen-hemoglobin curve to the left

-higher affinity-
increased pH
Low CO2
decreased temp
low levels of 2,3DPG

30

what are the signs and symptoms of pulmonary disease/injury

Dyspnea
Cough
Abnormal breathing patterns
Hypo/Hyperventilation
Cyanosis
Chest pain
Clubbing
Sputum Abnormalities

31

COCA

color
odor
consistency
amount

32

Conditions caused by pulmonary disease/injury

Hypercapnia- high CO2
Hypoxemia- low O2
Acute respiratory failure
Pulmonary edema
aspiration
atelectasis- collapsed lung
bronchiectasis- prolonged dilation of bronchial
bronchiolitisis- inflammatory blockage of bronchial
pleural abnormalities
chest wall restrictions
flail chest- series of broken ribs
inhalation disorders

33

Types of pneumothorax

Traumatic
Tension
Spontaneous

34

Types of pleural effusion

Transudative- water from capillaries
Exudative- fluid rich in proteins from capillaries
Hemothorax- blood
empyeme- pus from infection

35

Causes of hypoxemia

Decreased F1O2-high alt
Hypoventilation-COPD
Alveolocapillary diffusion abnormality- edema
VA/Q mismatch- asthma

36

What causes pulmonary edema

Heart disease- pumonary HP exceeds oncotic
Capillary injury- increased permeability
Obstruction of lymphatic system

37

Restrictive vs obstructive lung disease

Restrictive is decreased compliance - decreased volume
Obstructive is increased resistance - increased volume

38

Three types of obstructive lung disease

Asthma
COPD (Emphysema and chronic bronchitis
Cystic Fibrosis

39

IRDS is primarily a lack of __________

surfactant

40

Triad for asthma

Bronchoconstriction
excessive mucus production swelling of bronchial mucosa

41

clinical manifestations of chronic bronchitis

Decreased exercise tolerance
Wheezing, SOB and productive cough
Airway obstruction as evidence by decreased FEV1
BLUE BLOATER

42

clinical manifestations of emphysema

Dyspnea
non productive cough (or no cough)
low TBW
barrel chested
PINK PUFFER

43

What causes barrel chested

residual volume in lungs

44

Triad for pulmonary embolism

Virchows triad
sluggish blood flow
Hypercoagulability
damage to venous intima

45

three basic processes of the nephron

glomerular filtration
tubular reabsorbtion
tubular secretion

46

What controls renal glomerular filtration rate

Auto regulation
hormonal
neural

47

Hormones that cause dilute urine

ANP/BNP
decrease Adolsterone and ADH

48

Hormones that cause concentrated urine

ADH and Aldosterone
decreased ANP/BNP

49

5 types of renal/urinary alterations

urinary tract obstruction
urinary tract infection
glomerular disorders
AKI
CKD

50

Renal/bladder tumor triad

TOO LATE TRIAD
Hematuria
flank pain
flank/abdominal mass

51

UTI triad

FUD
frequency
urgency
dysuria

52

4 types of renal calculi

calcium containing (oxalate 70%, phosphate 30%)
struvite stones
uric acid stones
cystine stones

53

Alkaline urine produces ____ stones

calcium phosphate
struvite stones

54

acidic urine produces _____ stones

uric acid stones
cystine stones
calcium oxalate stones

55

clinical manifestations of renal calculi

pain
hematuria
sweating
N/V
dysuria
urgency

56

Three types of AKI

prerenal -most common blood going to kidney
intrarenal- damage to kidney
postrenal- obstructions

57

Three stages of acute tubular necrosis

oliguria - 500-mL/day
Recovery - stable

58

ANS on the GI

SNS- inhibits
PNS- stimulates

59

Three phases in digestion

cephalic
gastric
intestinal

60

secretions from salivary glands

Amylase

61

secretions from stomach

goblet cells- mucous
chief cells- pepsin gastrin
parietal cells- HCl and intrinsic factor

62

secretions from small intestines

Secretin
CCK

63

secretions from Pancreas

Pancreatic juice
HCO3

64

clinical manifestations`gastrointestinal dysfunction

Anorexia
Pain
Vomiting
Diarrhea
Constipation

65

Types of pain associated with GI

Visceral- organ pain not well localized
Parietal- well localized
Referred

66

Types of Diarrhea

Osmotic
Secretory
Motility
Exudative

67

predisposing factors in the development of peptic ulcer

Smoking
Age
NSAIDS
Alcohol
H.pylori
chronic disease

68

Three bowel diseases are

Ulcerative collitis
Chrons
Diverticula