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Resp 2 Flashcards

1
Q

Equation for Law of Laplace

A

P = (2T)/r

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2
Q

Tendency to collapse on ______ as radius decreases

A

Expiration

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3
Q

______ alveoli have low collapsing pressure and are easy to keep open. ______ alveoli have high collapsing pressure and are more difficult to keep open.

A

Large; small

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4
Q

Surfactant is composed of:

A

Phospholipid, proteins, & Ca

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5
Q

Acts as surface tension reducer by disrupting the intermolecular forces (hydrogen bonds) b/w water molecules of liquid
Act like detergent

A

Surfactant

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6
Q

Reduction in surface tension _____ compliance

A

Increases

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7
Q

What lecithin-to-sphingomyelin (L/S) ratio in amniotic fluid indicates fetal lung maturity

A

> 2:1

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8
Q

Synthesis of surfactant starts when?

A

24 weeks of gestation; almost always present at week 35

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9
Q

Symptoms of neonatal respiratory distress syndrome d/t lack of surfactant

A

Atelectasis
Difficulty reinstating lungs (d/t decreased compliance)
Hypoxemia (d/t decreased V/Q)

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10
Q

Tx for neonatal respiratory distress syndrome

A

Maternal steroid shots before birth (speeds up formation of surfactant)
Artificial surfactant to infants by inhalation

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11
Q

Airflow (Q) =

A

Pressure gradient/ airway resistance (R)

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12
Q

Resistance to flow (R) =

A

(8 n L)/ pie r 4

8 (viscosity of inspired gas) x length of airway/ pie radius to the 4th power

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13
Q

Poiseuille’s equation says air flow is:

A

Directly proportional to the pressure gradient, and pie radius to the 4th power
Inversely proportional to 8 x the viscosity and Length

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14
Q

_____ lung volumes are associated w/ less radial traction and increased airway resistance

A

Low

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15
Q

_____ lung volumes are associated with greater radial traction and decreased airway resistance

A

High

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16
Q

Major site of airway resistance

A

In the medium-sized bronchi

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17
Q

Why do the smallest airways not offer the highest resistance?

A

B/c of their parallel arrangement

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18
Q

Work of inspiration:

A

Compliance work (50%)
Tissue resistance work
Airway resistance work

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19
Q

The volume inspired or expired with each normal breath

A

Tidal volume

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20
Q

the volume that can be inspired over and above the tidal volume (used during exercise)

A

Inspiration Reserve Volume

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21
Q

The volume that can be expired after the expiration of tidal volume

A

Expiratory Reserve Volume

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22
Q

The volume that remains in the lungs after a maximum expiration
Cannot be measured by spirometry

A

Residual Volume

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23
Q

How is residual volume measured?

A

Helium Dilution Method

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24
Q

The sum of tidal volume, inspiration reserve volume, & expiratory reserve volume
“Everything but the residual volume”

A

Vital capacity

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25
Inspiration capacity =
TV + IRV
26
The volume remaining in the lungs after a tidal volume is expired
Functional Residual Capacity
27
FREC =
ERV + RV
28
The volume in lungs after a maximum inspiration | The sum of all 4 volumes
Total lung capacity
29
prevents large SWINGS of PO2 by acting as a bufffer
FRC
30
FRC is reduced by:
Supine position Obesity Pregnancy Anesthesia
31
FRC increases by:
PEEP, CPAP | Increased airway resistance- asthma
32
Allows for more time (up to 10 min) for airway manipulation
Preoxygenation/Denitrogenation before anesthetic induction provides reservoir of O2 by filling FRC with 100 % O2
33
The volume of air that can be forcible expired as hard and as rapid as possible after taking maximum inspiration
Forced vital capacity (FVC)
34
Forced Expiratory Volume in 1st second/ Forced Vital Capacity
4/5 = 80%
35
In obstructive lung diseases such as asthma & COPD, the FEV1/FVC is ________
Decreased
36
In restrictive lung diseases such as pulmonary fibrosis, pneumothorax, scoliosis, myasthenia gravis, or ALS, FEV1/FVC is _______
Normal or increased
37
Poor lung expansion can be seen in _____ toxicity
Bleomycin (anti cancer)
38
Decreased BP and decreased PCWP =
Hypovolemic shock, give fluid
39
Decreased BP, increased PCWP =
Failing heart/cardiogenic shock, give inotropes
40
PCWP measures?
Left atrial pressure. Normally 10 mmHg
41
Right atrium pressure
< 5 mmHg
42
Right ventricle pressure
<25 / <5 mmHg
43
Left atrium pressure
< 12 mmHg
44
Left ventricle pressure
< 150/ 10 mmHg
45
Pulmonary trunk pressure
< 25/10 mmHg
46
Aortic pressure
< 150/90 mmHg
47
PCWP
< 12 mmHg
48
Pulmonary artery pressures
25/8 Mean = 15 Capillary = 7
49
In the pulmonary circulation, compliance is ______ and resistance is _______
Higher; lower
50
Why does alveolar hypoxia cause vasoconstriction in the lungs?
To divert blood away from poorly ventilated regions towards well-ventilated regions of lung. Decrease shunting of blood
51
Why is fetal pulmonary vascular resistance very high
D/t hypoxic vasoconstriction/ decreased blood flow
52
What happens with global hypoxia (breathing in thin air at high altitude)?
Vasoconstriction of entire lungs > pulmonary HTN > RVF
53
PVR =
((Pulm artery pressure - PCWP)/ CO ) x 80
54
PA > Pa > Pv
Zone I
55
Pa > PA > Pv
Zone II
56
Pa > Pv > PA
Zone III
57
Distribution of pulmonary blood flow is uneven d/t
Effect of gravity
58
When supine, pulmonary blood flow is
Nearly uniform throughout the lung
59
When standing, blood flow is lowest at _______ and highest at _____
Apex (zone 1); base (zone 3)
60
Factors that expand West Zone 1:
Decreased PA pressure (shock) pulm hypotension Increased Alveolar pressure (PEEP) Occlusion of blood vessel (pulmonary embolism)
61
Factors that reduce West Zone 1:
Increased PA pressure (pulm hypertension)
62
V/Q ratio is highest (3) at ____ and lowest (0.8) at ____
Apex; base
63
If the airways are completely blocked (ventilation 0), but blood flow is normal, the V/Q is? Which is called?
0; right-to-left shunt
64
If the blood flow is blocked, but the ventilation is normal, the V/Q is? Which is called?
Infinite; dead space
65
100% O2 will improve which type of V/Q mismatch?
Blood flow obstruction

Patho (13 decks)

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