Finalll!!! Flashcards
(170 cards)
1
Q
As an individual ages, the A. Vital capacity decreases B. Functional residual capacity decreases C. Expiratory reserve volume increases D. Residual Volume Decreases
A
A. Vital Capacity Decreases
2
Q
During Exercise, the oxygen consumption (VO2), of the skeletal muscles may account for more than A.65% of the total VO2 B. 75% of the total VO2 C. 85% of the total VO2 D. 95% of the total VO2
A
D. 95% of the total VO2
3
Q
The concentration of myoglobin in skeletal muscle is increased with high altitude natives
A
A. True
4
Q
The max heart rate of a 55 year old person is
A
165 bpm
5
Q
Most of the lung funtion indices reach their max level between
A
20-25 years of age
6
Q
Acute mountain sickness is characterized by
A
Sleep disorders, Headaches, Dizziness, palpitation, Loss of appetite
7
Q
At the onset of exercise, sympathetic discharge causes the
A
HR to increase, Peripheral vascular system to constrict, heart to increase its strength of contraction, blood vessels of the working muscles to dilate (all of the above)
8
Q
During max exercise, the O2 diffusion capacity may
A
increase. (as much as 3 fold)
9
Q
The O2 diffusion capacity of high altitude natives is about
A
20-25% greater. GREATER
10
Q
The half life of carboxyhemoglobin when a victim is breathing room air at 1 atm is approx
A
5 hours
11
Q
During exercise, an increase in heart rate accounts for a greater proportion of the increased CO than the increase in SV T/F
A
true
12
Q
If a patient has a SaCO level of 20% how long will it take to reduce the level to 10% if he is breathing 100% oxygen
A
B. 5 hours
13
Q
During pulmonary rehabilitation programs, the patient is evaluated by a variety of tests, such as PFTs, ambulatory oximetry studies, and nutritional, pyschological, lifestyle, etc... needs. this is done during what phase of the program A. Phase 1 B. Phase 2 C. Phase 3 D. Phase 4
A
A. Phase 1
14
Q
Length and intensity of exercise is primarily limited by
A
Cardiac function
15
Q
Indications of hyperbaric oxygenation might include
A
All of the above- Decompression sickness, Thermal burns, Clostridial gangrene, Carbon monoxide poisoning
16
Q
A person in a high altitude situation develops crackles in the bases, pink frothy sputum and shortness of breath; which of the following lung conditions is occurring
A
Pulmonary edema
17
Q
at the start of exercise, what is the FIRST physiologic response
A
Increased HR
18
Q
The epithelial lining of the tracheobronchial tree is primarily composed of
A
pseudostratified ciliated columnar epithelium
19
Q
Most of the mucus that lines the lumen of the tracheobronchial tree is produced by
A
Submucosal glands
20
Q
Type II cells produce
A
Surfactant
21
Q
Mast cells produce
A
Histamine
22
Q
The first 19 generations of the lower airways are called the
A
Conducting zone and deadspace (where no gas exchange occurs)
23
Q
Respiratory zone
A
last 4 generations
24
Q
The visceral pleura lines the
A
lungs
25
The parietal lines the
thorax
26
The right and left main stem bronchi, blood vessels and nerves enter and exit the lungs through the
hilum
27
The phrenic nerve originates from what point of the spinal cord
Cervical 3-5
28
This opens and closes over the glottis to prevent aspiration of fluids/ solids during inspiration and expiration
Epiglottis
29
```
Which of the following have an important function in the immunologic response of pt with asthma
A. Goblet Cells
B. Type 1 cells
C. Beta 2 cells
D. Mast Cells
```
Mast cells- create histamine= bronchospasm (allergic reaction)
30
Anteriorly, the base of the lungs extends to about the level of which of the following ribs
6th
31
Ribs eight, nine, and ten are referred to as the
False ribs
32
True ribs
1-7
33
The area between the base of the tongue and the epiglottis is called
Vallecula
34
What function do the lympathic vessels in the lung perform
Fluid removal
35
```
Which one of the following would facilitate mucocillary transport and sputum clearance
A. Dehydration (8hrs)
B. Cig smoking
C. Humidity
D. Hypoxia
```
C. Humidity
36
The primary muscles of relaxed breathing are the
hemidiaphragms
37
The submucosal glands empty their contents when which of the following occurs?
A. The sympathetic nerve send a signal
B. The parasympathetic nerves send a signal
C. The voluntary motor nerves send a signal
D. Type II cells are stim
B. The parasympathetic nerves send a signal
38
The surfactant that is produced by the Type II cells in the alveoli main function is to
Reduce surface tension
39
The primary innervations of the hemidiaphragms is provided by the
Phrenic nerve
40
Stimulation of the heart by the parasympathetic nervous system will result in
The heart rate decreasing
41
Stimulation of the heart by the sympathetic nervous system will result in
The heart rate increasing
42
Muscles of inspiration
Pectoralis Major, Scalene, Sternocleidomastoids, Trapezius
43
Muscles of Expiration
Transverse abdominis, Internal intercostals, Rectus abdomonis, External intercostals
44
The point at which the trachea bifurcates into the right and left main stem bronchi is called the
carina
45
All the arteries in the body carry oxygenated blood to their destination T/F
False
46
In infants, this is the narrowest point of the upper airway
Cricoid cartilage
47
When lung compliance decreases
Ventilatory rate increases, Tidal volume decreases
48
Normal Tidal volume range is about
3-4 ml/lb
49
Deadspace
Ventilation without perfusion
50
Shunt
Perfusion without ventilation
51
Physiologic deadspace combination of
alveolar and anatomical deadspace
52
Surfactant is produced by which type of cells
Alveolar type II
53
Which of the following plays the greater role in causing Vent rate to increase in response to a dec PaO2
A. Carotid bodies
B. Aortic bodies
A. Carotid bodies
54
Alveoli falls below the critical closing pressure =
the alveoli will collapse
55
Apnea
Complete absense of spontaneous ventilation
56
Normal breathing
Eupnea
57
Cheyne-Stokes breathing
fast to slow to apnea breathing
58
Hypoventilation breathing
shallow/ slow
59
Increased alveolar ventilation
Hyperventilation
60
Biots breathing
Short episodes of rapid, uniformly deep inspirations, followed by 10-30 seconds of apnea
61
Rapid rate of breathing is called
tachypnea
62
Anatomical deadspace is estimated by using which equation
1ml/lb
63
Decreased alveolar ventilation
Hypoventilation
64
Cervical vertebrae 3-5
Where phrenic nerve originates from
65
```
Auto PEEP can cause
A. Alveoli to collapse
B. Air trapping and alveolar hyperinflation
C. Increased lung compliance
D. Decreased Raw
```
B. Air trapping and alveolar hyperinflation
66
Ten to thirty sec of apnea, followed by a gradual increase in 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
67
Normal Vd/Vt ratio is
25%-35%
68
The first 19 generation of the tracheobronchial airways are termed
Conduction zone
69
What readily diffuses the blood brain barrier
CO2
70
Type of breathing increases both the depth and rate of breathing to lower the PaCO2 and is commonly associated with diabetic ketoacidosis
Kussmauls breathing
71
A condition in which an indiv is able to breath most comfortably only in an upright position and commonly associated with severe COPD
Orthopnea
72
The peripheral chemoreceptors are significantly activated when the PaO2 decreases to about
60mmHg (hypoxic drive kicks in)
73
Which of the following centers control inspiration during normal breathing
Ventral
74
This area senses decreased O2 levels in the arterial blood and sends impulses to the resp center to increase ventilation
Peripheral Chemoreceptors
75
When airway resistance becomes high, to offset the increased work of breathing, pts vent. patterns is generally
Decreased RR and increased Vt
76
When you increase the I:E ration, you are doing what
prolonging the expiratory phase
77
If you have a COPD pt that is breathing at a RR=12bpm, with an I:E ratio of 1:3
Breath Cycle= 60/12= 5, Inspiratory 5/4= 1.25, Expiratory rate= 5-1.25= 3.75
78
Tidal volume
W x 1-5lb
79
Minute ventilation
RR x Vt
80
Ventilation deadspace
W x RR
81
Valv
Ve- Vd
82
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
83
The peripheral chemoreceptors are special oxygen sensitive cells that react to reduction in
oxygen levels in the arterial blood
84
Whats the normal pressure of carbon dioxide found in the mixed venous blood of the pulmonary arteries (PvCO2)
46 mmHg
85
What would be a norm pressure of carbon dioxide found in the arterial blood (PaCO2) on an adult
40 mmHg
86
What would be a norm pressure of O2 found in the arterial blood (PaO2) on an adult
80-100 mmHg
87
```
Which of the following is NOT an ex of a clinical condition that decreases the rate of gas diffusion
A. emphysema
B. Asthma
C. Pulmonary Edema
D. Pneumonia
```
B. Asthma
88
```
Carbon dioxide diffuses
A. at the same rate then O2
B. Twice as fast as O2
C. Half as fast as O2
D. 20x faster then O2
```
D. 20x faster then O2
89
```
The first 19 generations of the lower airways are termed the:
I. Conductive Zone
II. Respiratory Zone
III. Anatomic Deadspace
IV. Alveolar Deadspace
```
I. Conductive Zone and III. Anatomic Deadspace
90
Whats the ventilation to perfusion relationship in the upright lung, upper lung region (apex)
V>Q
91
V
Middle lobes
92
V=Q
Lower lobes
93
What is internal respiration
Gas exchange between the blood and the tissues (cells)
94
In the upright lung, blood flow is greatest through
lower lobes (gravity)
95
Blood flow and ventilation is best matched in what area of the lung
Middle lobe
96
Normal O2 consumption is equal to
250ml/min
97
Whats the partial pressure of H20 at 37 degree C
47 mmHg
98
What does the stimulated sympathetic nervous system cause to occur in the bronchial smooth muscle
bronchodilation
99
Which of the following causes blood to clot after an injury
Thrombocytes
100
A pt has a HR of 75 and a SV of 80ml what is their CO
6000mL= 6.0L/min
101
Normal CVP
0-8mmhg
102
Which of the following are most active in response to a bacterial infection
Neutrophils
103
Normal systemic arterial blood pressure is
120/80
104
If the meal arterial pressure falls below this value, there is inadequate perfusion to the brain and kidneys
60mmHg
105
```
Which of the following does NOT affect SV
A. Preload
B. Afterload
C. Contractility
D. Cardiac Index
```
D. Cardiac index
106
Cardiac Index equation
CO/BSA
107
Normal pulmonary artery pressure is
25/8 mmHg
108
An increase in which WBC indicates an allergic response such as asthma
Eosinophils
109
Inner lining of the heart is the
Endocardium
110
These vessels are referred to as resistance vessels and have the most influence on systemic blood pressure
Arterioles
111
60% of the total vascular blood volume is located in the
veins
112
The degree that the myocardial fiber is stretched prior to contraction best describes
Ventricular Preload
113
When the vascular resistance increases, the blood pressure
increases
114
This portion of the serous pericardium is on the surface of the heart
Visceral pericardium
115
Blood circulation through the heart
Superior and Inferior Vena Cava, Right Atrium, Tricuspid Valve, Right Ventricle, Pulmonary Valve, Pulmonary Artery, Pulmonary capillaries, Pulmonary vein, left atrium, mitral valve, left ventricle, aortic valve, aorta
116
Mean arterial pressure equation
Systolic+ diastolic x 2 divided by 3
117
CO divided by BSA
Cardiac index
118
The testing done to obtain volume and flow rate parameters, such as the FVC, FEV1, and FEF25-75
Spirometry
119
Flow is made up of what two components
Volume and time
120
Test to measure ability of gas diffusion across the alveolar capillary membrane is
DLCO
121
With norm lungs, comparing the SVC to the FVC should show that
A. The volumes are essentially the same
B. the flows are essentially the same
C. The FVC volume is larger then the SVC volume
D. The SVC flow is faster then the FVC
The volumes are essentially the same
122
```
Following the FVC maneuver that prod a flow/time curve tracing, you should be able to calculate the following measurements
I. FVC
II. FEV1
III. MVV
IV.FEF 25-75
V. FEV1/FVC ratio
VI.DLCO
```
I. FVC
II. FEV1
IV. FEF 25-75
V. FEV1/ FVC ratio
123
The volume of the FEV1 should be what % of the FVC volume
80%
124
What affects the prediction of normal lung volumes and flow rates
Age Height and gender
125
The reading is a good indicator of the patency of large airways
FEF 200-1200
126
MIP and MEP measure
muscle strength
127
What forced expiratory measurements reflects the status of the medium and small airways
FEF 25-75
128
The FEV1
The volume of air exhaled in the first 1 second of the FVC maneuver
129
In obstructive lung disease, the FEV1 and FEV1.FVC ratio are
decreased
130
Tests that can be performed to measure TLC
Helium Dilution, Nitrogen washout, and body plethysmography
131
Which portion of a FVC maneuver is referred to as "effort dependent"
first 30%
132
```
If a pt develops air trapping bc of obstructive disease, what volume will increase because of air trapping
A. RV
B. VT
C. IC
D. VC
```
A. RV
133
Restrictive lung disease will show up on a PFT as
low volumes
134
As a person norm ages , lung volumes and flow rates
decrease
135
Body pleth uses a modification of whos law to indirectly measure gases volumes in the lungs
Boyles law
136
The peak exp flow rate is the
fastest flow point in which air is forcefully exhaled
137
CaO2 formula
((Hbg x 1.34) x SaO2) + (PaO2 x 0.003)
138
CvO2 formula
((Hgb x 1.34) x SvO2) + (PvO2 x 0.003)
139
CcO2 Formula
(Hgb x 1.34 x1) + (PAO2 x 0.003)
140
Arterial Venous content formula
CaO2-CvO2
141
O2 ER
CaO2-CvO2/ CaO2
142
Oxygen Delivery (DO2)
CO x (CaO2 x 10)
143
O2 consumption formula (VO2)
CO x ((CaO2-CvO2) x 10)
144
Qs/ Qt (shunt)
CcO2-CaO2/ CcO2 - CvO2
145
Alveolar minute ventilation
Vt- Vd x RR
146
Normal CaO2 range is approx
18-20 vol %
147
CaO2- CvO2 is indicative of
Tissue uptake of oxygen
148
Which shift in the oxyhemoglobin dissociative curve is normally more clinically harmful to the pt
Left shift
149
```
A pt with a Hgb of 8.7 may potential have what type of hypoxia
A. Hypoxic Hypoxia
B. Anemic Hypoxia
C. Circulatory hypoxia
D. Histotoxic hypoxia
```
B. anemic hypoxia (not enough hgb to carry)
150
Each gram of hemoglobin can carry how much oxygen
1.34 ml
151
The normal antomical shunt is about
2-5%
152
Each heme group of a RBC can carr how many molecules oxygen
4
153
You have a post op pt that is sedated and sleeping. You note that their SaO2 is 89% on 1 lpm NC. You increase the liter flow to 5lpm and the SaO2 increases to 95%. this is an ex of
Shunt-like effect due to hypoventilation
154
A pt with a core body temp of 101.3 degrees F, will have a shift in the oxyhemoglobin dissociation curve to the
right
155
Metabolizing tissue cells consume approx___ of O2 produce approx ___ of CO2 at rest
250ml/min and 200ml/min
156
89% of the CO2 transport is provided by
RBC transport system
157
The single biggest carrier (63%) of CO2 is the
bicarbonate in the RBCs
158
an substance that dissociates completely into H+ and an anion is a
strong acid
159
Chemicals that neutralize acids and bases effect on the pH are called
buffers
160
pH normal range
7.35-7.45
161
PaCO2 normal range
35-45
162
HCO3 normal range
21-26
163
PaO2 normal range
80-100
164
Respiratory compensation can occur much quicker than metabolic (renal) compensation T/F
True
165
Common causes of Metabolic Acidosis might include
Lactic acidosis, Diarrhea, Ketoacidosis
166
The PaCO2 level increases with both acute and chronic hypoventilation. How can you tell the difference
A. The pH is within the norm range, and the HCO3 is increased , with chronic
B. The pH is low, and the HCO3 is norm, with acute
C. the pH is low, and the HCO3 is low, with acute
D. A and B
D. A and B
167
the pH of the human body is actually slightly
alkaloid
168
Hypoventilation acidic or alk?
Acidic
169
Hyperventilation acid or alk?
Alk
170
Respiratory compensation usually occurs in how much time when the pH begins to fall?
instantly
