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Flashcards in Resp A&P High Yield Deck (70):
1

What makes up the anatomic dead space in the lungs?

Conducting zone

2

Which can be found further down the conducting zone...goblet cells or pseudostratified ciliated columnar cells? Why is this important?

pseudostratified ciliated columnar cells--> because it help to "beat up" the mucus produced

3

What comprises the respiratory zone of the resp tree?

resp bronchioles, alveolar ducts, and alveoli

4

Describe the histology of the lining of the respiratory zone?

Cuboidal cells

5

What do Type I pneumocytes look like?

Squamous (thin for optimal gas diffusion

6

What do type II pneumocytes look like?

Cuboidal

7

What are the 2 functions of Type II pneumocytes?

1- Precursors for type I
2- secretion of surfactant

8

When do alveoli have a tendancy to collapse (insp or exp)? Why is this?

Collapse in expiration due to decreased radius

9

What is the most important component of surfactant?

Dipalmitoylposphatidylcholine

10

When does surfactant synthesis begin? When are the levels high enough?

Begin @ 26 weeks

Mature @ 35 weeks

11

What cells secrete the proteinaceous component of surfactant?

club/ clara cells

12

If you were to aspirate while upright where would the aspirate go?

Lower portion of right inferior lobe

13

If you were to aspirate while supine where would the aspirate go?

Superior portion of the right inferior lobe

14

What type of fissure is found in BOTH lungs?

Oblique

15

What level does the IVC go through the diaphragm?

T8

16

What level does the Esophagus go through the diaphragm?

T10

17

What level does the vagus go through the diaphragm?

T10

18

What level does the aorta go through the diaphragm?

T12

19

What level does the throacic duct go through the diaphragm?

T12

20

What level does the azygos vein go through the diaphragm?

T12

21

What nerve (and nerve roots) innervates the diaphragm?

Phrenic nerve--> C3- C5

22

Where does diaphragm irritation refer to?

Shoulder (C5)

23

What level does the common carotid bifurcate?

C4

24

What level does the trachea bifurcate?

T4

25

What level does the abdominal aorta bifurcate?

L4

26

"air that can still be breathed in after normal inspiration"

Inspiratory reserve volume

27

"air that moves into lung with each quiet inspiration"

tidal volume

28

"air in lung that can still be breathed out after normal expiration"

Expiratory reserve volume

29

"air in lung after maximal expiration; cannot be measured on spirometry

reserve volume

30

"IRV + TV"

Inspiratory capacity

31

"RV + ERV"

FRC

32

"TV +IRV + ERV"

Vital capacity

33

"IRV + TV + ERV + RV"

TLC

34

What balances the inward pull of the lungs at FRC?

Outward pull of the chest wall

35

What are airway and alveolar pressures at FRC?

Zero!

36

What are intrapleural pressures ar FRC?

Negative

37

What conditions are associated with decreased compliance?

Pulmonary fibrosis
Pneumonia
Pulmonary edema

38

What conditions are associated with increased compliance?

Emphysema
Normal Aging

39

Which form of Hemoglobin has a low affinity for O2... T or R?

T

40

What factors favor the T form (deoxygenated) of Hb? Which way does the curve shift?

Shifts to the RIGHT with:

Increased Cl-

Increased H+

Increased CO2

Increased 2,3- BPG

Increased Temp

41

Hb is a buffer for...

H+ ions

42

Methemoglobin has an increased affinity for what molecule?

Cyanide

43

How is methemoglobin treated?

Methylene blue

44

What is a method for inducing methemoglobinemia?

Nitrates followed by thiosulfate

45

What is carboxy Hb?

Hb bound to CO in place of O2

46

Which way does the O2 binding curve shift in CO poisoning?

To the LEFT

47

Why is myoglobin curve not sigmoidal?

Because there is no coopertive binding due to its monomeric nature

48

A decreased affinity is indicated by a ____ shift in the curve.

Right shift

49

Which Hb curve is further to the left...HbF of HbA?

HbF

50

How is O2 content defined?

(O2 binding capacity X % saturation) - dissolved O2

51

How much O2 can 1g Hb bind/.

1.34 mL O2

52

Which is decreased when there is decreased Hb?

O2 content
O2 saturation
Arterial PO2

O2 content decreases

The others stay the same

53

What occurs in a decreaesd PAo2?

Hypoxic vasoconstriction that shifts blood away from poorly ventilated regions of lung to well ventilated regions of lung to well ventilated regions of lung

54

What gases are typically perfusion limited?

O2, CO2, N2O

55

"gas equilibrates early along the length of the capillary"

Perfusion limited

56

"gas does not equilibrate by the time blood reaches the end of the capillary"

Diffusion limited

57

What gases are diffusion limited?

O2 in emphysema or fibrosis

CO

58

What can cause hypoxemia (decreased PaO2) with a normal A-a gradient?

High altitude


Hypoventilation

59

What can cause hypoxemia (decreased PaO2) with an increased A-a gradient?

V/Q mismatch

Diffusion limitatino

Right-to- left shunt

60

What is hypoxia?

decreased O2 delivery to tissue

61

What is V/Q at the apex of the lung?

3

62

What is the V/Q at the base of the lung?

0.6

63

Where are ventilation and perfusion BOTH greater...base or apex of the lung?

Base

64

During exercise what happens to the V/Q ratio at the base of the lungs?

It increases! Approaches 1

65

How is the majority of CO2 transported in the blood?

As HCO3- (with H+ bound to Hb)

66

Where can CO2 bind Hb?

N terminus of globin chain

67

What is the mechanism through which HCO3 leaves RBCs?

Cl-/ HCO3 - antiporter

68

What happens to 2,3 BPG levels in high altitudes?

They increase...in an effort to derease Oxygen binding affinity--> to allow for oxygen to be unloaded in the tissues

69

How does the body compensate for the respiratory alkalosis created by hyperventiation in response to altitude?

Increased renal excretion of HCO3

70

Why does the pH decrease during strenuous exercise?

Due to lactic acidosis--> aids in Oxygen unloading!

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