Pulmonary Part 1 (Exam 3)

Question 1

functions of the lungs

Answer 1

perfuse body tissue with oxygen required for metabolism
remove CO2 from blood
maintain normal ranges of PaO2 and PaCO2

Question 2

the lung filter about ___________ liters of air per day at rest

Answer 2

7500

Question 3

every cardiac cycle, the entire volume of blood in the body must pass through the

Answer 3

pulmonary circulation

Question 4

norma respiratory rate

Answer 4

15 breaths per minute

Question 5

breath

Answer 5

inflation and deflation of the lungs
occurs in response to pressure in the pleural space

Question 6

pressure in the pleural space is controlled by

Answer 6

the striated diaphragm

Question 7

ventilation must match

Answer 7

perfusion

Question 8

gas exchange occurs via

Answer 8

simple diffusion

Question 9

pressure gradient

Answer 9

increase in volume of the lung leads to a decrease in pressure in intra alveolar space

Question 10

in order to inhale air, the diaphragm must overcome

Answer 10

the force of elastic recoil

airflow resistance

Question 11

equation for pressure in alveoli

Answer 11

P = 2T/r

Question 12

surfactant

Answer 12

reduces surface tension on alveoli so they don’t crush each other

Question 13

pulmonary arteries

Answer 13

receive deoxygenated blood from right ventricle

Question 14

pulmonary veins

Answer 14

send newly oxygenated blood from alveolar capillaries to left atrium

Question 15

bronchial circulation receives ____________ from ____________________ in order to perfuse ______________

Answer 15

oxygenated blood
left ventricle
all lung structures

Question 16

does the lymphatic system continue into alveolar space?

Answer 16

No!

fluid must move to terminal bronchioles to drain

Question 17

FEV1

Answer 17

forced expiratory volume in the first second of expiration

Question 18

FVC

Answer 18

forced vital capacity

total amount of air that can be exhaled during a forced expiration

Question 19

obstructive lung disease

Answer 19

inability to get air out of the lungs
FEV1/FVC less than 70-75%
increase of FEV1 greater than 12% after bronchodilator

Question 20

restrictive lung disease

Answer 20

inability to get enough air into the lungs
all expiratory volumes reduced

Question 21

COPD

Answer 21

reduced diffusing capacity of the lungs for carbon monoxide

Question 22

nonspecific defenses of the lung

Answer 22

cough/mucociliary transport
ciliated epithelium
secretions
cellular defenses (lung epithelium, monocytes, alveolar macrophages)
protease inhibitors and antioxidants

Question 23

specific defenses of the lung

Answer 23

B cell antibody
antigen presentation to lymphocytes
T cell mediated via cytokines
Non-lymphocyte cellular response (mast cells/eosinophils)

Question 24

in respiratory acidosis pH is __________
the primary disturbance is ___________
the innate compensatory response is ________________

Answer 24

decreased

increased PaCO2

Increased HCO3

Question 25

compensation for metabolic disturbance can be accomplished _________ by ___________________ but metabolic compensation of a respiratory disturbance occurs ____________

Answer 25

rapidly alteration in breathing slowly

Question 26

acute respiratory acidosis

Answer 26

hypoxemia and hypercapnia can be fatal

Question 27

chronic respiratory acidosis

Answer 27

persistent increase in PaCO2 and decrease in PaO2

Question 28

Asthma risk factors

Answer 28

atopy genetics smoking previous viral respiratory infection obesity

Question 29

Main abnormality of Asthma

Answer 29

heightened reactivity of airway to potentially harmless stimuli

Question 30

3 effects caused by Asthma

Answer 30

luminal obstruction airway inflammation bronchoconstriction

Question 31

airway inflammation leads to

Answer 31

an increase in airflow resistance

Question 32

in asthma, does ventilation match perfusion?

Answer 32

NO leads to hypoxemia

Question 33

hyper inflammatory response of asthma can lead to

Answer 33

increase mucous secretion damage to epithelium and airway walls alter in muscle tone and ability

Question 34

what is activated after inhalation of allergens in asthma?

Answer 34

mast cells and eosinophils

Question 35

in asthma, inflammatory cells are produced by epithelial cells that drive

Answer 35

airway fibrosis and tissue remodeling

Question 36

signs and symptoms of asthma

Answer 36

SOB fewer breaths per minute due to inc work of breathing tachycardia wheezing/cough chest tightness hypoxemia hypercapnia reduced pulmonary function tests

Question 37

In obstructive disorders, the FEV1/FVC ratio is

Answer 37

decreased

Question 38

pharmacotherapeutics for asthma

Answer 38

bronchodilators inhaled corticosteroids monoclonal antibodies (block inflammatory mediators)

Question 39

two types of COPD

Answer 39

bronchitis emphysema

Question 40

difference between bronchitis and emphysema

Answer 40

bronchitis - inflammation in airways, reversible emphysema - destruction of alveoli, not reversible

Question 41

difference between bronchitis and asthma

Answer 41

causes are different! asthma - allergens bronchitis - gases, smoking, etc.

Question 42

chronic inflammation of COPD is caused by

Answer 42

noxious particles or gas

Question 43

Chronic bronchitis

Answer 43

chronic obstruction in airways impairment in clearing of secretions

Question 44

in which COPD is the ventilation/perfusion ratio impacted?

Answer 44

bronchitis more likely to have hypoxemia

Question 45

signs and symptoms of chronic bronchitis

Answer 45

thick, purulent cough wheezing ronchi in expiration/inhalation hypoxemia at rest polycythemia (inc hematocrit) reduced pulmonary function tests

Question 46

if patient is chronically hypoxemic in chronic bronchitis, this can cause

Answer 46

tachycardia and pulmonary hypertension

Question 47

cardiac effects due to chronic bronchitis

Answer 47

right heart enlargement/failure elevated jugular pressure on cardiac exam

Question 48

emphysema

Answer 48

loss of alveolar capillary bed loss of supporting structures destruction of terminal respiratory units

Question 49

In emphysema __________ are destroyed by ________________

Answer 49

lung parenchyma endogenous or exogenous oxidants

Question 50

in emphysema, ______________ inhibit __________________ function which allows for a abnormal amount of circulating protease and continuous irreversible damage to _________________

Answer 50

oxidants protease inhibitors elastin and collagen fibers

Question 51

deficiency of alpha 1 antitrypsin

Answer 51

in smokers can increase the chance of developing emphysema

Question 52

in emphysema, there is increased

Answer 52

lung compliance

Question 53

sign and symptoms of emphysema

Answer 53

decreased breath sounds hyperinflations and increased chest diameter pulmonary HTN reduced pulmonary function tests polycythemia

Question 54

in emphysema, there are decreased breaths sounds due to

Answer 54

decreased breath flow and hyperinflation of lungs

Question 55

is the ventilation/perfusion ratio impacted in emphysema?

Answer 55

only initially one will exhibit respiratory acidosis and PO2/PCO2 levels will appear normal initially