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A&P2 Spring 25’ > Final: 6 May 25 THE FINAL LECTURE > Flashcards

Final: 6 May 25 THE FINAL LECTURE Flashcards

(112 cards)

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1
Q

What is the primary enzyme responsible for breaking down elastic tissue in the lungs?

A

Neutrophil elastase

Neutrophil elastase is a type of protease that destroys the elastic tissue in the lungs, contributing to emphysema.

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2
Q

What happens to the alveoli in emphysema?

A

They become fewer and larger

The destruction of alveolar walls leads to larger air spaces and a decrease in the number of alveoli, which impairs gas exchange.

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3
Q

In obstructive lung disease, what happens to residual volume (RV)?

A

It increases

The inability to expel air effectively leads to a buildup of air in the lungs, increasing RV.

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4
Q

What is the effect of emphysema on total lung capacity?

A

It increases

Emphysema causes an expansion of lung volumes due to trapped air.

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5
Q

Fill in the blank: In restrictive lung disease, all lung volumes are typically _______.

A

lower than normal

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6
Q

What is tidal volume (TV)?

A

The amount of air inhaled or exhaled during normal breathing

Tidal volume represents the volume of air exchanged in each breath under resting conditions.

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7
Q

What does an increase in tidal volume typically indicate in patients with COPD?

A

The presence of alveolar dead space

Increased tidal volume in COPD, particularly emphysema, is often a compensatory response to dead space.

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8
Q

True or False: The nose filters and humidifies the air we breathe.

A

True

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9
Q

What are the two types of muscles associated with the hyoid bone?

A

Suprahyoid muscles and infrahyoid muscles

These muscles connect to the hyoid bone and influence movements related to swallowing and speech.

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10
Q

What are the three main divisions of the trigeminal nerve?

A
  • Ophthalmic division
  • Maxillary division
  • Mandibular division
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11
Q

What is lateral inhibition?

A

The ability to reduce pain signals by applying pressure to an injured area

This concept can also apply to reflexes such as sneezing, where manipulating nearby tissue can suppress the sneeze reflex.

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12
Q

What is the recurrent laryngeal nerve responsible for?

A

Controlling the ability to speak

Damage to this nerve during thyroid surgery can lead to voice problems.

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13
Q

Fill in the blank: The left recurrent laryngeal nerve wraps around the _______.

A

aortic arch

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14
Q

What is the difference between the recurrent laryngeal nerve and the inferior laryngeal nerve?

A

The recurrent laryngeal nerve becomes the inferior laryngeal nerve after making a hairpin turn

The inferior laryngeal nerve innervates muscles of the larynx.

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15
Q

What happens to the chest wall in advanced emphysema?

A

It becomes hyperinflated

The chest wall stretches to accommodate increased lung volumes, limiting airflow.

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16
Q

What is the function of the inferior laryngeal nerve?

A

It innervates five of the six sets of laryngeal muscles.

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17
Q

Which muscle is innervated by a branch of the vagus nerve?

A

Cricothyroid muscle.

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18
Q

What are the two branches of the superior laryngeal nerve?

A
  • Internal branch
  • External branch
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19
Q

What does the internal branch of the superior laryngeal nerve provide?

A

Sensory coverage in the larynx.

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20
Q

What is the role of the external branch of the superior laryngeal nerve?

A

It provides motor innervation for the cricothyroid muscle.

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21
Q

True or False: Galen’s anastomosis is a functional connection between the inferior and superior laryngeal nerves.

A

False.

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22
Q

What does the recurrent laryngeal nerve innervate?

A

It provides sensory innervation to the trachea.

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23
Q

What is a foramen?

A

An opening in the thyrohyoid membrane for the internal branch of the superior laryngeal nerve.

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24
Q

Name the three sets of pharyngeal constrictor muscles.

A
  • Superior constrictor
  • Middle constrictor
  • Inferior constrictor
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25
What is the function of pharyngeal constrictor muscles?
They typically squeeze the upper airway.
26
What are the suprahyoid muscles?
* Digastric muscle * Stylohyoid muscle * Mylohyoid muscle * Geniohyoid muscle
27
What is unique about the digastric muscle?
It has two muscular parts called bellies.
28
What connects the hyoid bone to the mandible?
Anterior belly of the digastric muscle.
29
What is the attachment point of the posterior belly of the digastric muscle?
Mastoid process.
30
What is the role of the omohyoid muscle?
It has two parts and helps in moving the hyoid bone.
31
Fill in the blank: The muscle that connects the hyoid bone to the sternum is called the _______.
Sternohyoid muscle.
32
What is the thyrohyoid muscle connected to?
It connects the hyoid bone to the thyroid cartilage.
33
What is the unique feature of the omohyoid muscle compared to other infrahyoid muscles?
It has two bellies and an intermediate tendon.
34
How does movement of the hyoid bone affect the larynx?
Moving the hyoid bone also moves the larynx.
35
What is the styloid process?
A fragile projection of the skull located near the mastoid process.
36
What are the super hyoid muscles?
Muscles located above the hyoid bone that assist in its movement.
37
What is the function of the infra hyoid muscles?
They help lower the hyoid bone.
38
List the infra hyoid muscles.
* Sternohyoid muscle * Sternothyroid muscle * Thyrohyoid muscle * Omohyoid muscle
39
What is the body of the hyoid bone?
The thick central part of the hyoid bone.
40
What are the two types of horns on the hyoid bone?
* Lesser horn * Greater horn
41
What is agonal breathing?
Irregular breathing that may indicate brain damage.
42
Describe Cheyne-Stokes breathing.
Periodic bursts of inspirations that progressively increase in size, followed by a period of apnea.
43
What is the primary cause of Cheyne-Stokes breathing?
Brain damage or opiate overdose.
44
What is the normal breathing rate?
12 to 20 breaths per minute.
45
Tachypnea refers to what condition?
Rapid breathing, typically exceeding 20 breaths per minute.
46
What distinguishes hyperventilation from tachypnea?
Hyperventilation is rapid or deep ventilation that exceeds metabolic needs.
47
What is Kussmaul breathing?
Deep, rapid breathing typically associated with diabetic ketoacidosis.
48
What are J receptors?
Stretch receptors in the lungs that help regulate the respiratory cycle.
49
What is the inflation reflex?
A reflex that shuts down inspiration when the lungs are fully inflated.
50
What is the significance of capnography?
It provides information about the composition of air inside the lungs.
51
What happens to PCO2 levels during hypoventilation?
PCO2 levels increase in the blood.
52
What is the expected waveform during hyperventilation on a capnograph?
Lower than normal waveforms due to reduced PCO2.
53
What can cause a progressive decrease in capnograph waveforms?
Insufficient blood flow through the lungs, possibly due to heart failure.
54
What does a spike in capnograph readings indicate?
Increased metabolic rate or hyperthermia.
55
What is the relationship between the heart and capnography?
The heart must pump adequate blood through the lungs for proper gas exchange.
56
What does the term 'Bo breathing' refer to?
Irregularly interspersed breathing at a much lower rate, often associated with opiate overdose.
57
What is the role of stretch receptors in the lungs?
They gauge how full the lung is to regulate the respiratory cycle.
58
Fill in the blank: The _______ muscle is located between the thyroid cartilage and the hyoid bone.
thyrohyoid
59
What condition occurs when the heart is no longer pumping adequate amounts of blood through the lungs?
Hypoventilation ## Footnote Hypoventilation can lead to inadequate oxygenation and carbon dioxide removal.
60
What can cause an abrupt spike in end-tidal PCO2 during malignant hyperthermia?
Increased metabolism ## Footnote Increased metabolism due to muscle contractions leads to higher CO2 production.
61
What is the antidote for malignant hyperthermia that acts on calcium release channels?
Dantrolene ## Footnote Dantrolene helps to prevent excessive calcium release from the sarcoplasmic reticulum.
62
What is a key indicator that CPR is effective?
Increasing end-tidal CO2 ## Footnote A rise in end-tidal CO2 indicates improved circulation and ventilation.
63
What waveform pattern might indicate bronchospasm?
Sharp fin type pattern ## Footnote This pattern suggests uneven emptying of the lungs.
64
What indicates possible esophageal intubation when monitoring end-tidal CO2?
Goose eggs or a rapidly disappearing waveform ## Footnote This can occur due to air escaping from the stomach.
65
What physiological change occurs upon releasing a tourniquet after prolonged ischemia?
Increased CO2 production ## Footnote Reperfusion leads to a surge in metabolic activity and CO2 generation.
66
What effect does hypothermia have on CO2 levels?
Decreases CO2 production ## Footnote Lower temperatures slow metabolism, resulting in reduced CO2 output.
67
What condition can lead to elevated CO2 levels during pregnancy?
Increased metabolic rate ## Footnote Pregnant individuals produce more CO2 due to increased metabolic demands.
68
What happens to the end-tidal CO2 waveform during hyperventilation?
It decreases ## Footnote Hyperventilation leads to excessive CO2 elimination, lowering end-tidal CO2.
69
Fill in the blank: The first warning sign of malignant hyperthermia is an abrupt spike in _______.
end-tidal PCO2
70
What is a common cause of decreased end-tidal CO2 levels during ventilation?
Airway obstruction ## Footnote Blocked airways prevent effective CO2 exhalation.
71
What does a split waveform pattern indicate in a patient with a single lung transplant?
Different emptying times between lungs ## Footnote The good lung empties faster than the diseased lung.
72
What effect does increased cardiac output have on CO2 levels?
Increases CO2 elimination ## Footnote More blood flow through the lungs enhances CO2 removal.
73
What is the relationship between bicarbonate infusion and CO2 levels?
Increased CO2 production ## Footnote Bicarbonate can convert to CO2, raising CO2 levels.
74
True or False: Pregnancy typically leads to lower end-tidal CO2 levels.
False ## Footnote Pregnancy increases metabolic rate, which raises CO2 levels.
75
What can cause a rapid decrease in end-tidal CO2 levels during surgery?
Disconnection of the CO2 sensor ## Footnote A disconnected sensor will not record CO2 levels, leading to a flat waveform.
76
What is the expected CO2 waveform pattern after a tourniquet is released?
Transient increase in CO2 ## Footnote The sudden perfusion after ischemia leads to increased CO2 production.
77
What is the impact of alveolar dead space on CO2 levels?
Decreases CO2 concentration in exhaled air ## Footnote Ventilation of non-perfused alveoli dilutes CO2 in the gas sample.
78
Fill in the blank: An abrupt increase in cardiac output typically results in a _______ of CO2 from the patient.
spike
79
What happens to average CO2 when combining a normal CO2 alveolar area with a low CO2 area?
It drops the average CO2 in that gas sample.
80
Is arterial CO2 always equal to or higher than alveolar CO2?
Yes.
81
What can reduce the CO2 in alveolar air?
Significant alveolar dead space emptying at the same time as good alveolar.
82
What is the relationship between alveolar and arterial O2?
Alveolar O2 is always equal to or higher than arterial O2.
83
True or False: Alveolar gas can be concentrated in the lungs.
False.
84
What happens to alveolar gas as it becomes systemic arterial gas?
It is diluted out.
85
What can occur if the esophagus is intubated?
You might get breaths of CO2-rich air, but it quickly disappears.
86
Why are anesthetized, paralyzed, intubated, and ventilated patients not in normal conditions?
Their respiratory centers aren't as active, and they have low lung volumes.
87
What effect does being supine have on lung volume?
Lung volume drops significantly.
88
What pleural pressure gradient is typically seen at low lung volumes?
The anterior pleural pressure is lower than the posterior pleural pressure.
89
Where does ventilation primarily occur in an empty lung when air is added?
At the top or apex of the lung.
90
What does V/Q matching refer to?
The matching of ventilation to perfusion in the lungs.
91
How can higher lung volumes improve V/Q matching?
More air is directed towards the posterior part of the lung.
92
What is PEEP and why is it used?
Positive End-Expiratory Pressure; it helps keep airways open and prevents atelectasis.
93
What is a downside of using PEEP?
It increases the workload for the right heart.
94
What happens to lung volume when a patient is awake and spontaneously breathing?
Lung volume is generally higher compared to when paralyzed.
95
What does Boyle's law state?
Gases are compressible.
96
What is one method to determine hidden lung volumes like RV?
Helium dilution or full body plethysmography.
97
Fill in the blank: To assess lung volumes, we can use _______ law.
Boyle's
98
What is the effect of abdominal contents on lung volume when supine?
They push up against the diaphragm, reducing lung volume.
99
What is the relationship between V/Q matching and lung volume?
Lower lung volumes can lead to poor V/Q matching.
100
What is the common gas mixture used in the OR to address low lung volumes?
30% O2 with balanced nitrous or another gas.
101
What happens to lung volume if a patient is moderately sedated?
It does not drop to extremely low levels as in full paralysis.
102
What happens to the anterior and posterior parts of the lung during ventilation at low lung volumes?
Fresh air is directed towards the anterior part, while the posterior part has more blood flow.
103
What is the typical lung volume for a patient lying supine?
About 2 liters.
104
What is Dalton's law?
The partial pressure of a gas is equal to the concentration of the gas times the total pressure. ## Footnote Dalton's law states that the pressure exerted by a particular gas in a mixture is independent of the other gases present.
105
What does Graham's law state?
The movement of gases with similar solubility is dictated by the size of the gas molecules; smaller gases move faster than larger gases. ## Footnote Graham's law uses the square root of the molecular weight to compare the rates of movement of different gases.
106
Fill in the blank: The pressure that one gas exerts is probably going to be independent of what the gases in the mixture are doing, according to _______.
Dalton's law.
107
What is the relationship between molecular weight and gas movement according to Graham's law?
The smaller gas moves faster than the larger gas when comparing gases of identical solubility. ## Footnote This is calculated using the ratio of the square roots of their molecular weights.
108
What law is used to describe flow, resistance, pressures, or voltages?
Ohm's law.
109
What does the fixed law of diffusion relate to?
It determines how fast a gas will diffuse across a barrier based on various variables.
110
True or False: Boyle's law was used frequently throughout the course.
False.
111
What can be found in the appendix of the pulmonary textbook?
A few gas laws and brief descriptions of them.
112
What is the significance of understanding these gas laws in the context of the course?
They are foundational concepts that will be useful in other classes.

A&P2 Spring 25’ (26 decks)

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