Final Flashcards
(333 cards)
1
Q
When lung compliance decreases the patient commonly has I. An increased ventilatory rate 2. A decreased Tidal Volume 3. an Increased tidal volume 4. A decreased Vent Rate
A
- An increased ventilatory rate 2. A decreased tidal volume
2
Q
Normal Tidal volume range is about
A
3-5 ml/lb
3
Q
What is the normal I:E ratio
A
1:2
4
Q
Physiologic deadspace is a combination of
A
Alveolar and anatomical deadspace
5
Q
The excursion of the diaphragm during normal breathing is approx
A
1.5cm
6
Q
what will happen if the volume of gas in the alveoli falls below the critical closing pressure
A
the alveoli will collapse
7
Q
which of the following terms describes straigh even air flow
A
Laminar
8
Q
What is used to determine minute ventilation
A
Vt x RR
9
Q
The difference between the alveolar pressure and the mouth pressure is the
A
transairway pressure
10
Q
if the radius of the airways with a driving pressure of 10cm H20 is decreased by 16% because of bronchospasm, the new driving pressure would have to be ___ to maintain the same flow of air
A
20cmH20
11
Q
With the transairway pressure, if the mouth pressure is 759 mmHg and alveolar pressure is 755 mmHg, the driving pressure would equal
A
+4 mmHg
12
Q
When airway resistance becomes high, to offset the increased work of breathing, patients ventilatory pattern is generally
A
increased RR and decreased Vt
13
Q
The point at which the trachea bifurcates into the right and left main stem bronchi is
A
carina
14
Q
List three primary functions of the nose
A
humidify air, cool/warm air, filter air
15
Q
the epithelial lining of the traceobranchial tree is primarily composed of
A
pseudostratified ciliated columnar epithelium
16
Q
Most of the mucus that lines the lumen of the tracheobronchial tree is produced by the
A
Submucosal glands
17
Q
the length of the trachea is about
A
11-13 cm
18
Q
Which of the following structures make up the respiratory zone
- alveoli
- respiratory bronchioles
- segmental bronchi
- alveolar savs
A
1, 2, 4
19
Q
The first 19 generations of the lower airways are called the
A
Conducting Zone, Deadspace
20
Q
Terminal bronchioles permit gas to enter in adjacent alveoli via the
A
channels of lambert
21
Q
the visceral pleura lines
A
the lungs
22
Q
The right and left stem bronchi blood vessels and nerves enter and exit the lungs through the
A
hilum
23
Q
Small holes in the walls of the interalveolar septa are called the
A
pores of kohn
24
Q
The phrenic nerve originates from what point of the spinal cord
A
Cervical 3-5
25
This opens and closes over the glottis to prevent aspiration of fluids/ solids during inspiration and expiration
epiglottis
26
the intercostals spaces including veins, arteries, and nerves. how are they located in relationship to the ribs
inferior
27
which of the following have an important function in the immunologic response of patients with asthma
Mast Cells
28
The conchae (turbinates) aid in what process
Warm and humidify inspired air
29
Which of the following is the largest cartilage on the larynx
Thyroid
30
Which of the following represents a correct sequence of the trachelbronchial tree, starting at the mouth and ending at the alveoli
Bronchioles, segmental bronchi, respiratory bronchioles, and alveolar ducts
31
About what percentage of the total alveolar surface is composed of Type I
95%
32
Anteriorly, the base of the lungs extends to about the level of which of the following ribs
6th
33
Ribs eight, nine, and ten are referred to as the
false ribs
34
The area between the base of the tongue and the epiglottis is callled
Vallecula
35
What function do the lympathic vessels in the lung perform
fluid remove
36
Which of the following is associated with sympathetic nervous system
1. Epinephrine
2. Beta 2 receptors
3. Norepinephrine
4. Alpha 1 Receptors
all of the above
37
The pharyngeal tonsils are located in the
Oropharynx
38
Croup in normally viral infection causing subglottic swelling of the airway and is characterized by
inspiratory stridor
39
What would facilitate mucocillary transport and sputum clearance
Humidity
40
Type I cells are actually
simple squamous epithelium
41
The angle of the left main stem bronchi in an adult is approx
40-60 ddegrees
42
False ribs get their term because
they connect indirectly to the sternum by cartilage
43
Lymphatic vessles
Start in the region of the alveolar ducts and flow towards the hilum, are more numberous over the left lower lobe as compared to the right lower lobe
44
The primary muscles of relaxed breathing are the
Hemidiaphragms
45
The alveoli are protected from infection by the
macrophages
46
which of the following are part of the sternum
1. Oblique fissure
2. Xiphoid process
3. floating ribs
4. manubrium
2. xiphoid process 4. manubrium
47
The submucosal glands empty their contents when which of the following occurs
the parasympathetic nerves send a signal
48
the surfactant that is produced by the type II cells in the alveolis main function is to
reduce surface tension
49
The primary innervations of the hemidiaphragms is provided by the
phrenic nerve
50
the stimulation of the heart by the parasympathetic nervous system will result in
the heart rate decreasing
51
Which of the following are called "Capacitance vessels"
Veins
52
Cartilage is absent in which of the following structures of the tracheobronchial tree
Bronchioles and terminal bronchi
53
4 things found in the mediastinum
part of esophagus, heart, larynx, some arteries and veins going to/ from heart
54
Ciliated cells disappear at which level of the tracheobronchial tree
Respiratory bronchioles
55
Muscles of Inspiration
Pectoralis major, Scalene, Sternocleidomastoids, Trapezius
56
Muscles of Expiration
Transverse Abdominis, Internal Intercostals, Rectus abdomonis, External intercostals
57
The palatine and pharyngeal tonsils are thought to by types of lymphoid tissue T/F
True
58
The Eustachian tubes serve to equalize pressure in the middle of the ear T/F
True
59
Visceral pleura is attached to the inner surface of the chest T/F
False
60
the lungs have a natural tendency to want to expand T/F
False
61
The thorax has a natural tendency to want to
expand
62
The point at which the trachea bifurcates into the right and left main stem bronchi is called
the carina
63
What does the stimulation by the sympathetic nervous system cause to occur to the bronchial smooth muscle
Bronchodilation
64
Air moves in and out of the conductive airways because of
pressure changes
65
in infants this is the narrowest point of the upper airway
cricoids cartilage
66
How many lobes in right lung
3
67
The potential space between the parietal and visceral pleura is called the
pleural space
68
if an endotracheal tube is inserted too far into the trachea, it will most likely enter the
right lung
69
When the ___ receptor sites in the bronchial smooth muscle are stimulated, bronchodilation occurs
Beta2
70
Gases move back and forth from the alveoli and capillaries by means of
diffusion
71
what structure moves in an upward direction to close off the nasopharynx from the oropharynx during swallowing
soft palate
72
the pharyngotympanic tubes (eustachian tubes) are found in the
nasopharynx
73
Nasotracheal suction causing nose bleed, termed as
Epitaxis
74
This structure lies posterior of the trachea and descends down to the cardiac sphincter, through the diaphragm , and into the stomach
Esophagus
75
The introduction of gas/ air into the pleural cavity through an opening in the chest wall or a rupture of the lung is referred to as
pneumothroax
76
Thoracentesis, she noted that the physician introduces the needle where to the rib
over the top of the rip (superior)
77
Stimulation of this area causes a profound cough
carina
78
how many pair of ribs are there
12
79
As an indiv ages, the
a. Vital capacity decreases
b. functional residual capacity decreases
c. expiratory reserve volume increases
d. residual volume decreases
a. vital capacity decreases
80
During exercise, the oxygen consumption (VO2), of the skeletal muscles may account for more than
95% of the total VO2
81
During very heavy exercise, the
1. Increased pH
2. Decreased PaCO2
3. Constant PaO2
4. Decreased pH
5. Increased PaCO2
2, 3, and 4
82
When an individual is subjected to a high altitude for a prolonged period of time, which of the following is seen?
An increased RBC production, A decreased PaCO2, A decreased alveolar ventilation
83
Between 20 and 60 years of age, the RV/TLC ration increases from 20%
35%
84
With advancing age, the
PaO2 decreases, C(a-v)O2 decreases
85
The concentration of myoglobin in skeletal muscle is increased with high altitude natives T/F
true
86
The maximum heart rate of a 55 year old person is
175 bpm
87
Most of the lung function indices reach their maximum levels between
20-25 years of age
88
Acute mountain sickness is characterized by
Sleep disorders, headaches, dizziness, palpitations, loss of appetite
89
During exercise, the P(A-a)O2 begins to increase then the oxygen consumption reaches about what % of its maximum
40%
90
The so called PCO2 respiratory drive breaking point during a dive is about 55mmHg T/F
true
91
Natives who have been at high altitudes for generations commonly demonstrate a
Mild respiratory alkalosis
92
At the onset of exercise, sympathetic discharge causes the
1. HR to increase
2. Peripheral vascular system to constrict
3. Heart to increase its strength of contraction
4. blood vessels of the working muscles to dilate
All of the above
93
With advancing age, the
1. Stroke Volume Decreases
2. Heart work decreases
3. Cardiac output increase
4. Blood pressure increase
1. Stroke Volume Decreases
2. Heart work decreases
4. Blood Pressure Increase
94
The maximum alveolar ventilation generated during heavy exercise under normal conditions is about what % of the MVV
30-40%
95
As an individual ages, the
1. FVC increases
2. PEFR decreases
3. FEV1 increases
4. MVV increases
c. 2 & 4
96
during exercise, heat production may increase as much as
20 fold
97
With advancing age, the
1. Lung compliance decreases
2. Chest wall compliance increases
3. Lung compliance increases
4. Chest wall compliance decreases
3. Lung compliance and 4. Chest wall compliance decreases
98
During Exercise, the stroke volume reaches its peak when the cardiac output is at about what % of its maximum
50%
99
Between 30 and 80 years of age, the CO decreases by about
40%
100
During maximum exercise, the oxygen diffusion capacity may increase as much as
3 fold
101
When exercising in hot, humid conditions, the body temp can rise to 106-108 degree F. As much as 5-10 pounds of body fluid can be lost in one hour! T/F
True
102
The oxygen diffusion capacity of high-altitude natives is about
20-25% greater than predicted
103
over the course of life, the diffusion capacity decreases by about
20%
104
During strenuous exercise, and adults alveolar ventilation can increase
20 fold
105
the half life of COHb when a victim is breathing room air at 1 atm is approx
5 hours
106
During exercise, an increase in HR accounts for a greater proportion of the increased CO than the
increase in SV
107
If a patient has a SaCO level 20% how long will it take to reduce the level to 10% if he is breathing 100% oxygen
5 hours
108
During pulmonary rehabilitation programs, the patient is elvaluated by a variety of tests, such as PFTs, ambulatory oximetry studies, and nutritional, psychological, lifestyle, ect... needs. this done during what phase of the program
Phase 1
109
Length and intensity of exercise is primarily limited by
cardiac function
110
Cardiac output is calculated from which two valves
Heart Rate, Stroke Volume
111
a patient has a SaCO level of 20%, what is the patients max SaCO
80%
112
Indications of Hyperbaric Oxygenation might include
Decompression sickness, thermal burns, Clostridial gangrene, Carbon Monoxide poisoning
113
If a CO poisoning patient was in the ER and a hyperbaric chamber was not available what would be best treatment for this patient
non-rebreather mask at 15 lpm
114
A person in a high altitude situation develops crackels in the bases, pink frothy sputum and shortness of breath; which of the following lung conditions is occuring
pulmonary edema
115
what is the best way to treat the patient in pulmonary edema in high altitude
Rapid decent of altitude
116
with time, one of the physiologic changes that occurs with living at a high altitude is an increase in the production of RBC, this condition is termed as
polycythemia
117
Max. heart is calculated by
220-age
118
At the start of exercise, what is the first physiologic response
increase heart rate
119
Acclimation occurs after being exposed to a high altitude after what length of time
4 days
120
Small holes in the walls of the interalveolar septa are called
pores of Kohn
121
Terminal bronchioles permit air/gases to enter adjacent ares via the
Canals of Lambert
122
What is the function of type II cells in alveoli
Produce surfactant to reduce alveolar surface tension
123
What would slow the rate of mucocillary transport
Cigarette smoking, hypoxia (low blood oxygen level), Dehydration
124
What does the sympathetic nervous system stimulation cause to occur in the bronchial smooth muscle
Vasodilation
125
If you reduce the radius of the tube a gas is flowing through, how will this affect flow, if all else remains stable?
flow will decrease
126
When lung compliance decreases, the patient commonly has
An increased Ventilatory rate, a decrease tidal volume
127
At rest, the normal intrapleural pressure change during quiet (tidal) breathing is about
2-4 mmHg
128
Normal tidal volume range is about
3-4 ml/lb
129
what is the normal I:E ratio
1:2
130
Define deadspace
perfusion without gas exchange
131
Shunt
gas exchange without perfusion
132
Physiologic deadspace is a combination of
alveolar and anatomical deadspace
133
Surfactant is produced by which type of cells
alveolar type II
134
The excursion of the diaphragm during normal breathing is approx
1.5cm
135
Which of the following plays the greater role in causing ventilator rate to increase in response to a decreased PaO2? Carotid bodies or Aortic bodies
Carotid bodies
136
What will happen if the volume of gas in the alveoli falls below the critical closing pressure
The alveoli will collapse
137
Complete absence of spontaneous ventilation is called
Apnea
138
Increased alveolar ventilation (produced by any ventilatory patter that causes the PaCO2 decrease)
Hyperventilation
139
Static compliance assesses which of the following
a. lung compliance
b. airway resistance
c. stiffness of the lung
d. Both A & B
Lung compliance
140
Short episodes of rapid, uniformly deep inspirations, followed by 10-30 seconds of apnea is called
Biots breathing
141
Which of the following terms describes straight even air flow
Laminar
142
Which of the follow is used to determine minute ventilation
Vt x RR
143
Chemical reaction that occurs when CO2 moves into the cerebrospinal fluid and results in a decreased pH
CO2 + H2O H2CO3 HCO3 + H
144
A rapid rate of breathing is called
Tachypnea
145
Ventilation is
The movement of air in and out of the lungs
146
Surfactant is chemically a
Phospholipid
147
The difference between the alveolar pressure and the mouth pressure is the
transairway pressure
148
decreased alveolar ventilation (produced by any ventilatory pattern that causes the PaCO2 to increase), is called
hypoventilation
149
Anatomical deadspace is estimated by using which equation
1ml/lb
150
Ten to thirty seconds of apnea, followed by a gradual increase in the volume and frequency of breathing, followed by a gradual decrease in the volume of breathing, until another period of apnea occurs is called
Cheyne-stokes breathing
151
Normal airway resistance is equal to approx
0.5-1.5 cmH20/L/Sec
152
When alveoli or particularly large numbers of alveoli collapse it is termed
atelectasis
153
If the radius of the airways with a driving pressure of 10cm H2O is decreased by 16% because of bronchospasm, the new driving pressure would have to be __ to maintain the same flow of air
20cmH2O
154
Phrenic nerve originates from the spinal column at the level of
Cervical vertebrae 3-5
155
This type of breathing increases both the depth and rate of breathing to lower PaCO2 and is commonly associated with diabetic ketoacidosis
Kussmauls breathing
156
Raw is commonly high in patients with
COPD
157
Auto-PEEP can cause
Air trapping and alveolar hyperinflation
158
normal Vd/Vt ratio is
5-10%
159
A condition in which an indiv is able to breath most comfortably only in an upright position and commonly associated with servere COPD
Orthopnea
160
Which of the following readily diffuses the blood brain barrier
CO2
161
Which of the following cause the inspiration to cease at very high volumes
hering-breur reflec
162
Failure of the medulla can be from all the following except
a. Increased ICP (intracranial pressure)
b. Poliomyelitis
c. CNS Depressants
d. Caffeine
D. caffeine
163
What has the most powerful effect on the respiratory components of the medulla
Increased H+
164
A patients subjective report that they are having difficulty breathing is
dyspnea
165
The peripheral chemoreceptors are significantly activated when the PaO2 decreases to about
60mmHg
166
If unchecked what center will cause strong gasping inspiratory efforts
Apneustic
167
Which of the following centers controls inspiration during normal breathing
Ventral
168
The conduction zone of the tracheobronchial airway is essential
The anatomical deadspace
169
This area senses decreased oxygen levels in the arterial blood and sense impulse to the respiratory center to increase ventilation
peripheral chemoreceptors
170
```
In addition to a low PaO2 , the peripheral chemoreceptors are also sensitive to a/an
I.Decreased pH
II. Increased PaO2
III. Decreased pH
IV. Increased temp
```
I, II, and III
171
with the transairway pressure, if the mouth pressure is 759 mmHg and the alveolar pressure is 755 mmHg, the driving pressure would equal
+4mmHg
172
The point at which the trachea bifurcates into the right and left main stem bronchi is
carina
173
During high levels of exercise, the diaphragmetic excursion can increase to
6-10cm
174
Which of the following protects the lungs from excessive inflation
Hering-breuer reflex
175
Which of the following will readily diffuse across the blood brain barrier
CO2
176
Suppression of the peripheral chemoreceptors begin when the PaO2 falls below
30mmHg
177
The molecular cohesive force at the liquid gas interface is called
Surface tension
178
When airway resistance becomes high, to offset the increased work of breathing, patients ventilatory pattern is generally
Increased RR and Decreased Vt
179
A rapid and shallow ventilatory pattern is called
tachypnea
180
In the normal individual in the upright position
I. The negative intrapleural pressure is greater in the upper lung regions
II. The alveoli in the lower lung regions are larger than the alvioli in the upper lung regions
IV. The intrapleural pressure is always below atmospheric pressure during a normal ventilatory cycle
181
The difference between the alveolar pressure and the pleural pressure is called the
transpulmonary pressure
182
In the healthy lung, when the alveolus decreases in size during a normal exhalation the
Surface tension decreases and Surfactant to alveolar surface area increases
183
if the pressure at the mouth is 756mmHg and at the lungs it is 756 mmHg, this would represent
End inspiration, End-Expiration
184
The resp components of the PONS consists of
Apneustic center, Pneumotoxic center
185
You give the patient an Albuterol neb. Treatment to relieve the bronchospasm, by dilating the smooth muscle of the airways, the medication is targeting the
Beta 2 Receptors
186
To correct auto-PEEP you could
Increased I:E ratio
187
Which would
Prolong the expiratory phase
188
Define diffusion
Movement of gas from high concentration to an area of low concentration
189
In normal lungs, what is the amount of time needed for oxygen and carbon dioxide to reach equilibrium between the alveoli and the pulmonary capillaries
0.25 seconds
190
What is the normal oxygen level found in the mixed venous blood of the pulmonary arteries (PvO2)
40 mmHg
191
The peripheral chemoreceptors are special O2-sensitive cells that react to reduction in
Oxygen levels in the arterial blood
192
What is the normal pressure of Carbon dioxide found in the mixed venous blood of the pulmonary arteries (PvCO2)
46 mmHg
193
Which of the following structures make up the respiratory zone
I. Alveoli
II. Respiratory Bronchioles
IV. Alveolar Sacs
194
What would be a normal pressure of carbon dioxide found in the arterial blood (PaCO2) on an adult
40mmHg
195
The right and left main stem bronchi, blood vessels, and nerves enter and exit the lungs through the
hilum
196
What would be a normal pressure of oxygen found in the arterial blood (PaO2) on an adult
80-100 mmHg
197
Which of the following is NOT an example of a clinical condition where perfusion limits the movement of O2 into the blood from alveoli
A. Anemia
B. Atelectasis
C. Decreased Cardiac Output
B. Atelectasis
198
```
Which of the following is NOT an example of a clinical condition that decreases the rate of gas diffusion
A. Emphysema
B. Asthma
C. Pulmonary Edema
D. Pneumonia
```
Asthma
199
Alveolar Air Equation
FiO2 (Pb-47) - (PaCO2 x 1.25)
200
Oxygen moving from the alveoli to the capillaries can be
Perfusion and diffusion limited
201
Carbon Dioxide diffuses
20x faster then oxygen
202
Cardiopulmonary disorders that result in an increased V/Q (V>Q) ratio includes all EXCEPT which of the following
a. hypoventilation
b. Decreased cardiac output
c. Pulmonary emboli
d. hyperventilation
A. hypoventialtion
203
The first 19 generations of the lower airways are termed the
Conductive Zone, anatomic deadspace
204
What is the ventilation to perfusion relationship in the upright lung, upper lung region (apex)
V>Q
205
What is internal respiration
Gas exchange between the blood and the tissue (cells)
206
In the upright lung, blood flow is greatest through
the lower lobes
207
Blood flow and ventilation is best matched in what area of lungs
Middle lobe
208
What is the overall, average ventilation to perfusion ratio of the lungs (V/Q ratio)?
4:5 or 0.8
209
When lung compliance decreases the patient commonly
Increases respiratory rate, Decreases tidal volume
210
Normal Oxygen consumption is equal to
250 ml/ min
211
Daltons law
the sum of partial pressures of each gas will equal the total pressure of that mixture of gases
212
The primary muscles of relaxed breathing are the
hemidiaphragms
213
what is the barometric pressure at sea level
760mmHg
214
What is the partial pressure of H20 at 37 degree C
47 mmHg
215
What does the stimulated sympathetic nervous system cause to occur in the bronchial smooth muscle
Bronchodilation
216
What function do the lymphatic vessels in the lung perform
Fluid removal
217
Which of the following is believed to be responsible for the basic rhythm of ventilation
dorsal resp group
218
The area between the base of the tongue and the epiglottis is called
Vallecula
219
Where are the peripheral chemoreceptors located?
In the carotid arteries, Aortic arch
220
The amount of O2 dissolved in the plasma is equal to how many mls per mmHg of the PAO2/100 mls of blood
0.003ml
221
If a patient has a SaO2 of 97% on RA, by putting them on 100% NRB mask will dramatically increase the amount of O2 delivered to the tissues T/F
True
222
Each gram of hemoglobin carries this amount of O2
1.34ml
223
A SaO2 of 90% on the Oxyhemoglobin Dissociation curve is equal to
a PaO2 of 60mmHg
224
Normal Male Hemoglobin is
14-16g/ 100ml of blood
225
An abnormally high RBC count is known as
Polycythemia
226
The testing is done to obtain volume and flow rate parameters, such as the FVC, FEV1, and FEF25-75, is called
Spirometry
227
When lung compliance decreases, the pt commonly has
Increased ventilatory rate, a decreased tidal volume
228
The visceral pleura lines the
Lungs
229
Flow is made up of what two components
Volume and time
230
The best defines functional residual capacity
The volume of air remaining in the lungs after a normal exhalation
231
Normal tidal volume range is about
3-4 ml/lb
232
In normal lungs, what is the amount of time needed for O2 and carbon dioxide to reach equillibrium between the alveoli and the pulmonary capillaries
0.25 seconds
233
The test to measure the ability of gas diffusion across the alveolar-capillary membrane is
DLCO
234
Expiratory wheezing throughout the lung fields. The patient says they are having a difficult time exhaling. What physiologic mechanism explains this situation?
Static compression of the small airways
235
In normal lungs the residual Volume (RV) makes up how much of the total lung capacity?
20%
236
With normal lungs, comparing the SVC to the FVC should show that
the volumes are essentially the same
237
The volume of the FEV1 should be what % of the FVC volume
80%
238
Which of the following does affect the prediction of normal lung volumes and flow rates
Age, Height, and gender
239
Which of the following causes blood to clot after an injury
Thrombocytes
240
MIP and MEP measure
muscle strength
241
What best defines the inspiratory reserve volume (IRV)
The max volume of air that can be inhaled after a normal Vt inhalation
242
Which of the following forced expiratory measurements reflects the status of medium and small airways
FEF 25-75
243
The FEV1 is
the volume of air exhaled in the first 1 sec of the FVC maneuver
244
What best defines the expiratory reserve volume
The max amount of gas that can be exhaled after anormal Vt exhaled
245
The parameter is a reflective of the emptying of the small-medium airways during a FVC maneuver
FEF 25-75
246
In obstructive lung disease, the FEV1 and FEV1/FVC ratio are
decreased
247
A DLCO study on a pt with emphysema shows that their measured DLCO is only 55% of predicted. with this pt, you would suspect that the diffusion impairment is probably due to
loss of surface area
248
A pt has a HR of 75 and SV of 80ml, what is their CO
6.0 L/min
249
Tests that can be performed to measure TLC are
Helium dilution, Nitrogen Washout, Body plethysmography
250
Surfactant is produced by which type of cells
Alveolar type II
251
Which portion of a FVC maneuver is referred to as "effort dependent"
First 30%
252
In restrictive lung disease, the FVC and FEV1 are decreased. the FEV1/FVC ratio is
Generally normal
253
Vt+ERV+IRV equals which of the following
VC
254
What would be anormal pressure of carbon dioxide found in the arterial blood (PaCO2) on an adult
40mmHg
255
if a patient develops air trapping because of obstructive disease, what volume will increase because of air trapping
RV
256
In a patient with obstructive lung disease such as asthma, which of the following is usually found
Expiratory flows are decreased
257
Restrictive lung disease will show up on a PFT as
Low Volumes
258
As a person normally ages, lung volumes and flow rates
Decrease
259
The amount of air that is needed for normal ventilation with tidal breathing is what percentage of the TLC
7-10%
260
What function do to the lymphatic vessels in the lung perform
Fluid remove
261
Body plethysmography uses a modification of whos law to indirectly measure gas volumes in the lungs
Boyles Law
262
The peak expiratory flow rate is the
Fastest flow point in which air is forcefully exhaled
263
Tidal volumes in obstructive disease tend to increase. this is probably due to
Increased airway resistance
264
The largest volume of air that can be breathed voluntarily in and out of the lungs in 1 minute is known as the
MVV
265
Complete absence of spontaneous ventilation is called
apnea
266
Nebulizers target what cells in the airway and cause what type of response
Beta 2 cells and smooth muscle relaxation
267
The best defines tidal volume
The volume of air that moves in and out of the lungs during quiet breathing
268
The surfactant that is produced by the Type II cells in the alveolis main function is to
reduce surface sension
269
Normal Cardiac Index (CI) range
2.5 to 4.0 L/min/m2
270
What is most active in responsding to tissue destruction by bacteria
Neutrophils
271
Normal hematocrit for an adult %
45%
272
This lines the inner surface of the heart chambers
endocardium
273
Approx what % of the bodys blood is contained within the venous system
60%
274
The sympathetic nervous system regulates systemic blood pressure by either dilation of contriction of
Arterioles
275
The maximum pressure generated during ventricular contraction is the
Systolic pressure
276
Compared to the pulmonary pressures, the systemic pressures are
ten times as much
277
The degree that the myocardial fiber is stretched prior to contraction is the definition of
Ventricular preload
278
in general, when the contractility of the heart decreases, the CO
Decreases
279
The coronary arteries originate from the
Aorta
280
During contraction of the ventricles, if blood flows back into the atrium , it is termed
regurgitation
281
Normal central venous pressure (CVP) of an adult be
0-8mmHg
282
Pulmonary Vascular Resistance could be a result of
Pulmonary emboli , Emphysema, and positive end expiratory pressure from a ventilator
283
The average, normal systemic arterial blood pressure is
120/80mmHg
284
If the mean arterial pressure falls below this value, theres inadequate perfusion to the brain and kidneys
60mmhg
285
Force against which the ventricles must work to pump blood best describes
Ventricular afterload
286
What affects stroke volume
Preload, afterload, contractility
287
Pulmonary artery carries deoxygenated oxygen T/F
TRUEEE
288
Which of the following pulmonary capillary wedge pressures is within normal limits
4-12 mmHg
289
Normal pulmonary artery pressure is
25/8
290
An increase in which WBC indicates an allergic response such as asthma
Eosinophils
291
What is the max pressure generated during ventricular contraction called
systolic
292
While assisting the insertion of a pulmonary artery catheter, what pressure reading would indicate that the tip of the catheter is in the right ventricle
25/0
293
Granulocyte
Neutrophil, Eosinophil, Basophil
294
The coronary artery travels towards the apex of the heart and supplies blood to both anterior walls of the ventricular and the interventricular septum
Anterior Interventricular branch
295
60% of the total vascular blood volume is located in the
veins
296
PVR reflects the
afterload of the right ventricular
297
PVR increases in response to
Acidemia, Mechanical ventilation, Epinephrine
298
An increased myocardial contractility is called
positive inotropism
299
This has the greatest influence on how blood flows through all the different lung regions
gravity
300
When the arterial pressure falls, the baroreceptors cause the
Heart rate to increase, arterioles to constrict, and heart to contract more forcefully
301
If the MAP is less than 60mmHg the result is
low perfusion to the brain and kidneys
302
Which coronary artery supplies blood to the lateral walls of the right atrium
Marginal
303
The pulmonary and systemic arterioles are under control of which nervous system
Sympathetic
304
CO divided by the body surface area equals
The cardiac index
305
The ideal behind optimal PEEP is to
Improve oxygenation by increasing diffusion surface area, not compromise vascular blood flow
306
The normal CaO2 range is approximately
18-20 vol %
307
The normal hgb range for adult males and females is
males: 14-16g% and females 12-15g%
308
CaO2-CvO2 is indicative of
tissue uptake of oxygen
309
Hemoglobin not bound with oxygen is called
reduced hemoglobin
310
Clincally, aggressive cardiopulmonary supportive measures are usually required when the pulmonary shunting is greater than
20%
311
Which shift in the oxyhemoglobin dissociation curve is normally more clinically harmful to the patient
left shift
312
A pt with a hgb of 8.7 may potential have what type of hypoxia
Anemic hypoxia
313
Ventilation without perfusion is termed
dead space
314
each gram of hemoglobin can carry how much O2
1.34 ml
315
Normal anatomical shunt is about
2-5%
316
Under normal conditions, the O2ER is about
25%
317
Total oxygen delivery depends on
Oxygenation of the blood, Hemoglobin amount, Cardiac output
318
Total number of RBCs in relation to the volume of blood is the
Hematocrit
319
Pt with a core body temp over 101.3 degrees F will have a shift in the oxyhemoglobin dissociation curve to the
right
320
Metabolizing tissue cells consume approx__ of oxygen produce approximately__ of CO2 at rest
250ml/min and 200 ml/min
321
CO2 is transported from the tissues to the alveolie via
Plasma and RBCs
322
89% of the CO2 transport is provided by
RBC transport system
323
I:E ratio, RR 20bpm
1:2, Inspiratory Cycle= 1, Expiratory cycle=2 sec, Breath cycle= 3 sec
324
RR 10bpm, I:E 1:2
60/10= 6 breaths (breath cycle), 1:2.. 1+2=3... 6/3=2 Inspiratory breath cycle, 6-2=4 Expiratory cycle
325
Tidal volume norm
3-5 ml/lb
326
Deadspace norm
1/lb
327
Lung compliance
increase ventilatory rate, Decrease tidal volume
328
Deadspace
ventilation without perfusion
329
Shun
Perfusion without ventilation (pneumonia)
330
Vt formula
weight x 3-5 ml
331
Minute ventilation
Vt x RR (Lpm)
332
Vd
Weight x 1ml (lpm) x RR
333
Valv
Ve - Vd
