Pulmonary - Exam 2

Question 1

adequate gas exchange needs adequate (4 things)

Answer 1

1. ventilation
2. perfusion
3. distribution of ventilation
4. ability for diffusion of CO2 and O2 across alveolar-capillary membrane

Question 2

normal lung function depends on the maintenance of these 3 things

Answer 2

1. PO2
2. PCO2
3. arterial pH
   WITHOUT EXCESSIVE CARDIAC OR PULMONARY WORK

Question 3

lung structure is comprised of

Answer 3

airway and alveoli

Question 4

airways are categorized into

Answer 4

23 generations

Question 5

conducting airways are numbers __-___ and have no

Answer 5

0-16, have no gas exchange

Question 6

conducting airways are made up of (3)

Answer 6

1. trachea - 0
2. segmental bronchi - 1-3
3. bronchioles (non-respiratory) - 4-16

Question 7

respiratory bronchioles are where ___ takes place and are __-___

Answer 7

gas exchange, 16-23

Question 8

respiratory bronchioles are broken down into (2)

Answer 8

1. resp. bronchioles - 17-20

2. alveolar ducts - 21-23

Question 9

alveoli function to INC

Answer 9

SA in lungs

Question 10

alveoli are the site of

Answer 10

gas exchange

Question 11

we have about ___ alveoli in the adult lung

Answer 11

300-500 million

Question 12

O2-CO2 exchange occurs via ____ across the alveolar capillary membrane

Answer 12

diffusion

Question 13

alveoli have THIN (.5-1.0 micrometer) membranes in order to ensure

Answer 13

distribution of O2 to RBC

Question 14

V/Q =

Answer 14

ventilation/perfusion ratio, the ratio of ventilation to blood flow

Question 15

what determines gas exchange in lungs

Answer 15

V/Q ratio

Question 16

we can inc PO2 by giving O2, NOT by INC ___ to parts of the lung

Answer 16

ventilation

Question 17

normal V/Q

Answer 17

1, PO2 = 100, PCO2 = 40

Question 18

V/Q <1 (what we see clinically) has ___ ventilation and ___ perfusion

Answer 18

DEC ventilation, normal perfusion

Question 19

V/Q >1 (less common) has ____ ventilation and ____ perfusion

Answer 19

normal ventilation, DEC perfusion (O2 is there, not able to attach to RBC)

Question 20

with R-L shunt V/Q is

Answer 20

zero (alveoli filled with fluid)

Question 21

examples of V/Q = 0

Answer 21

PNA, palm edema

Question 22

with V/Q = 0, R-L shunt, PO2 doesn’t respond to

Answer 22

oxygen

Question 23

dead space is ventilated but NOT

Answer 23

perfused

Question 24

with INC dead space you have more air to clear from conducting airways and thus less

Answer 24

alveolar ventilation (less air to participate in gas exchange)

Question 25

4 causes of hypoxemia

Answer 25

1. V/Q <1 2. hypoventilation (INC CO2) 3. R-L shunt 4. diffusion defect (thick alveoli)

Question 26

hypercapnia is

Answer 26

INC CO2

Question 27

2 causes of hypercapnia

Answer 27

1. hypoventilation | 2. dec V/Q

Question 28

2 things that affect distribution of ventilation

Answer 28

1. dec distensability (dec compliance, inc stiffness) | 2. airway obstruction

Question 29

compliance formula

Answer 29

change in volume/change in pressure

Question 30

with restrictive disorders compliance

Answer 30

DEC (stiffer)

Question 31

resistance formula

Answer 31

change in pressure/flow

Question 32

extrathoracic upper airway obstructions are __ issues

Answer 32

inspiratory (stridor)

Question 33

inhaling through a straw is like a ____ obstruction

Answer 33

extra thoracic upper airway

Question 34

intrapulmonary airway obstruction is obstruction in the

Answer 34

lower lungs, bronchioles

Question 35

with intrapulmonary airway obstruction air can flow in but

Answer 35

airway above obstruction collapses on expiration (expiratory wheezes)

Question 36

ex of intrapulmonary airway obstruction

Answer 36

asthma/COPD

Question 37

atelectasis is the collapse of

Answer 37

alveoli (sever obstruction that collapses lungs)

Question 38

example of intrapulmonary airway obstruction is _____ in emphysema

Answer 38

hyperinflation (OVERCOMPLIANT tissue stretches permanently, IPA obstruction so bad you can hardly exhale)

Question 39

increased airway resistance is from ____ and ____

Answer 39

bronchospasm and inflammation

Question 40

increased airway resistance is common in (3) diseases

Answer 40

CF, asthma, chronic bronchitis

Question 41

restrictive lung diseases are characterized by (5)

Answer 41

1. dec compliance 2. stuff lungs 3. small lung vol 4. difficult to INFLATE 5. INC work of breathing

Question 42

list the 6 restrictive lung diseases

Answer 42

1. PNA 2. aspiration PNA 3. influenza PNA 4. TB 5. pulmonary fibrosis 6. pulmonary edema

Question 43

_____ is infection of the lung, filled with infected material (causes R-L shunt and dec V/Q)

Answer 43

PNA

Question 44

PNA may also cause _____ and _____ leading to ____

Answer 44

bronchospasm and INC pulmonary capillary permeability leading to pulmonary edema

Question 45

recurrent PNA is not normal, points to

Answer 45

underlying disorder like chronic lung disease (asthma, CF, immunocompromised)

Question 46

aspiration PNA is

Answer 46

inhaled foods or gastric material in the lungs which fills alveoli

Question 47

aspiration PNA is most common in those with

Answer 47

swallowing dysfunction (elderly, peds, neuro, GERD)

Question 48

____ is a common site of aspiration PNA

Answer 48

RML

Question 49

pulmonary fibrosis is caused by

Answer 49

multiple types of injury

Question 50

clubbing is a sign of which restrictive lung disease

Answer 50

pulmonary fibrosis

Question 51

pulmonary fibrosis is when

Answer 51

alveolar tissue is scarred leading to DEC lung vol and DEC compliance

Question 52

untreated ____ leads to pulmonary fibrosis

Answer 52

interstitial pneumonitis

Question 53

with pulmonary edema the fluid is in

Answer 53

the alveoli, not the capillary

Question 54

obstructive lung diseases are characterized by

Answer 54

1. INC resistance 2. airway obstruction 3. narrow airways 4. DEC expiratory flow 5. INC effort of breathing

Question 55

list the 6 obstructive lung diseases

Answer 55

1. asthma 2. chronic bronchitis 3. emphysema 4. bronchiectasis 5. CF 6. pulmonary embolism

Question 56

____ is the most common chronic lung disease

Answer 56

asthma

Question 57

asthma is the

Answer 57

episodic narrowing of airways from inflammation and bronchospasm

Question 58

primary problem in asthma is

Answer 58

airway mucosal inflammation causes swelling of airway lining and mucous secretion (release of cytokines and leukotrienes)

Question 59

_____ is the primary physiologic abnormality in asthma

Answer 59

bronchoconstriction

Question 60

with chronic bronchitis there is chronic ____ and _____ of ____

Answer 60

chronic infection and inflammation of bronchi and bronchioles

Question 61

emphysema involves destruction of

Answer 61

alveolar walls (dec SA for gas exchange, dec elastic support of airways, airway obstruction, severe hyperinflation)

Question 62

_____ is when airways lose cartilaginous support, collecting infectious materials, there is an abnormal dilation of bronchi

Answer 62

bronhiectasis

Question 63

bronchiectasis is always due to

Answer 63

underlying disease

Question 64

with bronchiectasis there is a massive risk of

Answer 64

hemoptysis

Question 65

CF is autosomal

Answer 65

recessive

Question 66

with CF multiple systems are involved by the most serious clinical problem and cause of death is

Answer 66

CF lung disease

Question 67

GF gene is

Answer 67

CFTR protein (cystic fibrosis transmembrane conductance regulator protein)

Question 68

in CF the ____ in exocrine cells does not work

Answer 68

chloride channel (cilia do not work, mucus with bacteria is stuck)

Question 69

___ is a common cause of pulmonary embolism

Answer 69

DVT in femoral veins

Question 70

a massive PE can occlude all or most of the pulmonary outflow tract leading to

Answer 70

sudden RHF and death