Pulmonary System Review

Question 0

Substance that dissociates into ions and gives up a hydrogen to the solution

Answer 0

ACID

Question 1

What are the three common causes of metabolic alkalosis?

Answer 1

1. Use of diuretics
2. Excessive vomiting
3. Ingestion of alkaline drugs

Question 2

What are the two types of acid that are formed in the body? Define each.

Answer 2

Volatile acids - can be eliminated in gaseous form via the lungs.

Non-volatile acids - excreted by kidneys

Question 3

Main sources of volatile acids

Answer 3

Metabolism of glucose and fat

Question 4

Sources if non-volatile acids

Answer 4

Anaerobic glycolysis, amino acid metabolism, phosphoprotein metabolism

Question 5

What are the body’s three main defense mechanisms against acid-base balance disruption?

Answer 5

Buffering,
Increasing alveolar ventilation,
Increasing hydrogen ion elimination and increasing bicarbonate reabsorption

Question 6

What happens if buffering does not correct the acid-base imbalance?

Answer 6

The respiratory system will take-over.

Question 7

What is the body’s immediate defensive response to acid-base imbalance?

Answer 7

BUFFERING

Question 8

What is the major volatile acid in the body?

Answer 8

CARBONIC ACID

Question 9

On a ventilated patient, what can be done to correct respiratory acidosis?

Answer 9

Increase RR to decrease PaCO2

Increase the tidal volume

Question 10

What are some causes of respiratory alkalosis?

Answer 10

Hyperventilation, restrictive ling disease, agitation, pain, anxiety

Question 11

On a ventilated patient, how can respiratory alkalosis be corrected?

Answer 11

Decrease RR, decrease TV

Question 12

What medications can be given if the pH is more than 7.55?

Answer 12

Acetazolamide (Diamox)
Ammonium chloride
HCl
KCl

Question 13

What are te causes of metabolic acidosis?

Answer 13

Inc. pdx’n of lactic acid, ketoacidosis, loss of bicarb (diarrhea, vomiting), accumulation of endogenous acids (d/t renal failure)

Question 14

Why does renal failure lead to metabolic acidosis?

Answer 14

In renal failure, excretion and buffering of acid compounds are limited.

Question 15

What are three major factors that control ventilation?

Answer 15

Neural, central chemical, peripheral chemical

Question 16

Which part of the brain is the respiratory center located at?

Answer 16

Medulla oblongata

Question 17

Which center in the pons acts to prevent the interruption of the impulses for breathing?

Answer 17

APNEUSTIC CENTER

Question 18

Which center fire impulses to limit inspiration?

Answer 18

Pneumotaxic center

Question 19

What is the feedback mechanism that prevents the hyper-inflation of the lungs through the use of stretch receptors on the bronchi and bronchioles?

Answer 19

The HERING-BREUER REFLEX

Question 20

Summarize the CENTRAL CHEMICAL CONTROL of ventilation

Answer 20

Physical activity -> Inc. CO2 pdx’n
-> inc. PaCO2. -> inc. H+ in CSF
-> inc. pH in CSF -> inc. stumulation of resp. center.
(Dec. of H+ ions or alkalosis decrease the stimulation of resp. ctr. )

Question 21

Explain the peripheral chemical control of ventilation.

Answer 21

Chemoreceptors (in carotid arteries, aorta) are stimulated by any decrease in O2 supply (eg ^pH, dec. perfusion, dec. hgb), resulting to tachycardia, ^RR, etc.

Question 22

Explain how hi-flow O2 may suppress the hypoxic drive in CO2 retainers.

Answer 22

CO2 retainers constantly have elevated PaCO2. Chemoreceptors in the brain are not as sensitive to H+ ion concentration changes.
The decrease in PaO2 is what stimulates their breathing. If oxygen is increased, the stimulus to breath will be gone.

Question 23

What are the four phases of respiration?

Answer 23

I. Ventilation
II. Diffusion of O2 and CO2 into alveoli
III. Delivery of O2 and removal of CO2 from cells.
IV. Regulation of ventilation

Question 24

Average pulmonary artery pressure

Answer 24

25/10 mm Hg

Question 25

What is the amount of pressure needed to move the blood from the right to the left heart?

Answer 25

8-12 mm Hg

Question 26

True or false: The pulmonary capillary wedge pressure must be higher than the pulmonary artery pressure to move blood from the right heart to the left heart.

Answer 26

False

Question 27

What is the function of pulmonary surfactant?

Answer 27

It reduces surface tension in the alveoli.

Question 28

What are two pathologic states that result due to insufficient / absent surfactant:

Answer 28

HYALINE MEMBRANE DSE, ARDS

Question 29

What term refers to the distensibility of the lungs and thorax

Answer 29

COMPLIANCE

Question 30

The unit of measurement for compliance

Answer 30

L/cm H2O

Question 31

What are the two types of compliance?

Answer 31

STATIC, DYNAMIC

Question 32

A pattern of breathing. Regular, rapid, shallow, with irregular abrupt periods of apnea

Answer 32

BIOT RESPS

Question 33

Regular, rapid, deep breathing pattern with no apneic episodes

Answer 33

Central neurogenic hyperventilation

Question 34

Progressive inc. in rate and depth followed by progressive dec. in rate and depth, then apnea.

Answer 34

Cheyne-Stokes

Question 35

Tachypnea pattern of labored, deep breaths

Answer 35

Kussmaul

Question 36

Which pattern of breathing is assoc. with metabolic acidosis?

Answer 36

Kussmaul breathing

Question 37

Breathing pattern caused by alterations in acid-base status, neuro-cerebral insult, and an underlying metabolic problem

Answer 37

Cheyne-Stokes respiration

Question 38

Dosage of hydrocortisone (for pulmonary issues)

Answer 38

20 to 240 mg/day

Question 39

Dosage of prednisone for treating pulmonary problems

Answer 39

5 to 60 mg/day

Question 40

What is the major side effect of inhaled steroids

Answer 40

Infection with oral Candida albicans