EXAM I Pulmonary

Question 1

fetal lungs are not fully inflated with air until when?

Answer 1

2 weeks after birth

Question 2

in fetal lungs, surfactant that lowers alveolar surface tension is not present until ___

Answer 2

late in fetal development and may not be present in premature babies

Question 3

in cystic fibrosis, over-secretion of thick mucus clogs the ___

Answer 3

respiratory system

Question 4

what is common in the aged respiratory system?

Answer 4

• elasticity of lungs decreases
• vital capacity decreases; max amount of air moved in 1 breath
• blood oxygen levels decrease
• stimulating effects of carbon dioxide decreases
• more risks of respiratory tract infection

Question 5

describe how respiration rate differs between newborns and adults

Answer 5

rate often increases with age

Question 6

the respiratory membrane forms the ___ barrier

Answer 6

air-blood

Question 7

what is the mechanical process of pulmonary ventilation?

Answer 7

• depends on volume changes in the thoracic cavity
• volume changes lead to pressure changes, which lead to equalize pressure of flow of gases
• 2 phases
  
  • inspiration and expiration

Question 8

during the process of gas exchange, ___ enters the blood as ___ enters the alveoli

Answer 8

• oxygen
• carbon dioxide

Question 9

which cells provide protection during gas exchange? what coats the gas-exposed alveolar surfaces?

Answer 9

• macrophages
• surfactant

Question 10

describe the process of inspiration

Answer 10

• diaphragm and intercostal muscles contract
• the size of the thoracic cavity increases
• external air is pulled into the lungs due to an increase in intrapulmonary volume

Question 11

normal breathing moves about ___ml of air with each breath. this describes the ___

Answer 11

• 500
• tidal volume

Question 12

what are some factors that affect respiratory capacity?

Answer 12

• a person’s size
• sex
• age
• physical condition
• pulmonary diseases
  
  • restrictive lun diseases
  • chronic obstructive pulmonary disease (COPD)

Question 13

___ is the amount of air that can be taken in forcibly over the tidal volume, and is usually between ___ and ___ ml

Answer 13

• inspiratory reserve volume (IRV)
• 2100-3200ml

Question 14

___ is the amount of air that can be forcibly exhaled, and is approximately ___ml

Answer 14

• expiratory reserve volume (ERV)
• 1200ml

Question 15

___ is air remaining in the lung after expiration, and is usually about ___ml

Answer 15

• residual volume
• 1200ml

Question 16

___ is air that actually reaches the respiratory zone, and is usually about ___ml

Answer 16

• functional volume
• 350ml

Question 17

respiratory capacities are measured with a ___

Answer 17

spirometer

Question 18

during neural regulation of respiration, activity of respiratory muscles is transmitted to the brain by which two nerves?

Answer 18

phrenic and intercostal nerves

Question 19

neural centers that control rate and depth of respiration are located in the ___

Answer 19

medulla oblongata

Question 20

which part of the brain smooths our respiratory rate?

Answer 20

the pons

Question 21

what is eupnea?

Answer 21

normal respiratory rate; 12-15 per minute

Question 22

___ is increased respiratory rate, often due to extra oxygen need

Answer 22

hyperpnia

Question 23

what are some possible causes of shortness of breath?

Answer 23

• asthma
• mucus plugs
• PE/pneumothorax
• COPD/pulmonary edema
• poor inspiratory effort: restricting or obstructing

Question 24

what is PAINT?

Answer 24

• pulmonary alveolar interstitial neuromuscular thoracic - a form of chronic restrictive lung disease
• the restrictive lung disease patient has a problem with expansion, so the lung volume is small

Question 25

the following are characteristics of what respiratory disorder? restricted lung expansion, decreased lung volume, decreased total lung capacity, parenchyma altered/pleural linings altered, interstitial lung diseases

Answer 25

PAINT chronic restrictive lung disease

Question 26

what are some interstitial lung diseases that can result from PAINT?

Answer 26

pneumonitis, sarcoidosis, mesothelioma, connective tissue autoimmune diseases

Question 27

chronic obstructive pulmonary disease is exemplified by ___ and \_\_\_

Answer 27

chronic bronchitis and emphysema

Question 28

what respiratory disorder is a major cause of death and disability in the US?

Answer 28

COPD

Question 29

what are some features of patients with COPD?

Answer 29

* history of smoking * labored breathing (dyspnea) * coughing and frequent pulmonary infections * most victims retain carbon dioxide * have hypoxic and respiratory acidosis * those infected will ultimately develop respiratory failure

Question 30

in \_\_\_, the alveoli enlarge as adjacent chambers break through the terminal bronchioles

Answer 30

emphysema (pink puffers)

Question 31

with emphysema, the destruction of alveoli leads to loss of \_\_\_

Answer 31

capillary beds

Question 32

emphysema results in an increased ___ to ___ mismatch

Answer 32

ventilation to perfusion

Question 33

low cardiac output, muscle wasting, weight loss, large amount of energy needed to exhale, and over-inflation of the lungs causing a barrel chest are characteristics of \_\_\_

Answer 33

emphysema

Question 34

what causes emphysema patients to have a "pink puffer" appearance?

Answer 34

hyperventilation/ less hypoxemia

Question 35

\_\_\_ is a result of inflammation of the mucosa of the lower respiratory passages; metaplasia of goblet cells

Answer 35

chronic bronchitis (blue bloaters)

Question 36

in chronic bronchitis, mucus production increases and there is chronic inflammation around \_\_\_

Answer 36

bronchi

Question 37

in chronic bronchitis, pooled mucus around bronchi impairs \_\_\_, which can cause \_\_\_

Answer 37

* ventilation and gas exchange * polycythemia due to increased ventilation/perfusion mismatch and cardiac output increases

Question 38

in chronic bronchitis, the risk of ___ increases, and ___ is common

Answer 38

lung infection, pneumonia

Question 39

\_\_\_ and ___ occur early in chronic bronchitis, causing increased CO2 hypercapnia and bloating

Answer 39

hypoxia and cyanosis (cyanotic refers to the "blue" in blue bloaters)

Question 40

\_\_\_ is chronic inflammation of the bronchiole passages, and often responds to irritants with dyspnea, coughing, and wheezing on expiration

Answer 40

COPD: asthma

Question 41

what are imporant questions to ask asthmatic patients?

Answer 41

* last attack * precipitant (what causes attack) * ever hospitalized/intubated * carry inhaler - daily meds, childhood asthma

Question 42

what are some causes of dyspnea and asthma that are a medical emergency/ respiratory distress?

Answer 42

COPD, CVD, aspiration, PE, pneumonia

Question 43

what are some signs/symptoms of dyspnea and asthma that are a medical emergency/ respiratory distress?

Answer 43

* wheezing * anxiety * increased respiratory rate, efforts * diaphoresis * flushing of face or gray, mottled appearance

Question 44

what is the treatment for dyspnea and asthma that are a medical emergency/ respiratory distress?

Answer 44

* establish, maintain airway/ anxiety relief/ meds/ nitrous oxide * 100% oxygen except with COPD * monitor * identify cause/ treat if possible * ER