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Flashcards in Section 5 Exam 2 Deck (83):
1

In this type of lung disease, both the FEV1 and FVC are reduced so the FEV1/FVC ratio is normal or even increased

restrictive

2

in this type of lung disease the FEV1 /F CV ratio is reduced:

obstructive lung disease

3

All restrictive lung diseases result in:

decreased TLC, increased work of breathing, inadequate ventilation and/or oxygenation and decreased FVC (restrict lung expansion)

4

Affect of the respiratory system on prostoglandins:

turns off

5

Affect of respiratory system on angiotensin II:

turns it on

6

inflammation of the pleural sac:

pleurisy

7

Does pressure increase or decrease with altitude?

decrease

8

Intra-alveoloar pressure is aka:

intrapulmonary pressure

9

intrapleural pressure is aka:

intrathoracic pressure

10

What is the intraplural/ thoracic pressure?

756 mm Hg

11

What 2 pressures push against intrapleural pressure?

atmospheric and intra-alveolar

12

Which gradient will be destroyed with a pneumothorax?

transmural

13

The diaphragm is responsible for __% of enlargement of thoracic cavity during inspiration.

75%

14

What 2 pressures are equal before inspiration/

intra-alveolar p. = atm. p.

15

Contraction of external intercostals enlarges cavity in what direction(s)?

lateral and AP (elevate ribs when contracting)]

16

True or False? Alveolar pressure is positive during inhalation and negative during expiration.

F. vice versa

17

What ensures that lungs will be fully expanded?

intrapleural pressure

18

Range of pressure in lungs during ventilation:

759 - 761 mm Hg

19

During forceful expiration, ___ pressure exceeds ___ pressure

intrapleural, atmospheric pressure (intra-alveolar increases too)

20

driving pressure is proportional to:

square of flow (V2)

21

What type of infections are patients with chronic bronchitis prone to?

bacterial

22

True or False? Airway lining thicken with chronic bronchitis.

T

23

Most common chronic childhood disease:

asthma

24

What can cause edema in asthmatic kids?

histamine

25

True or False? The breakdown of alveolar walls in emphysema is reversible.

F. irreversible

26

What causes the breakdown of alveolar walls in emphysema?

excessive trypsin from alveolar macrophages as defense against cigarette smoke irritants (lungs normally protected by α1-antitrypsin, but can be overwhelmed) OR genetic inability to produce α1-antitrypsin

27

Do asthma and emphysema start in small or large airways ?

small

28

Frictional resistance in airways accounts for __ % total R in the way to the alveoli.

80

29

Frictional resistance of the ______ makes up 20% total R on the way to the alveoli.

lungs and chest wall

30

Amount of air that gets to alveoli depends on:

muscle strength, airway resistance, elasticity/ compliance, and inertence (energy to set the system in motion)

31

Normal compliance is:

200 cm/ml H2O

32

This is a measure of the amount of change in volume for a given transmural pressure:

compliance

33

Why is compliance different for expiration/inspiration?

b/c of surfactant – hysteresis

34

How is static compliance measured?

without airflow

35

How does surfactant lower surface tension at the molecular level?

because water-surfactant attraction is not as strong as water-water

36

True or False? Surfactant reduces lung’s tendency to recoil

T

37

What does the inward-directed collapsing pressure of the alveolus depend upon?

2 times the surface tension divided by the radius of the alveolus

38

____ airways are more likely to collapse than ____ ones

smaller, larger

39

Why is surfactant more effective at lowering surface tension in smaller airways?

less spread out

40

Which are easier to stretch, saline-filled or air-filled lungs?

saline-filled

41

__% of total energy expended by body goes to breathing

3-5%, can increase 50-fold in exercise

42

How are intrapleural and intra-alveolar pressures affected by tidal volume increase?

intrapleural and intra-alveolar pressures decrease in direct proportion

43

Normal FEV1/ FVC %:

greater than 70%

44

What factors are normal restrictive lung diseases?

flow and resistance

45

What factors are decreased in restrictive lung diseases?

vital capacity, FEV1, and FVC

46

Causes of restrictive lung diseases:

leasions, obesity, pregnancy, ascite, interstitial lung disease

47

Lung volumes below ___% of predicted values are considered restrictive lung diseases.

80%

48

Can cause lung volumes to be smaller than predicted:

fibrosis, kyphoscoliosis (both increased elastic recoil) and pleural effusion (lung compression)

49

How does increased surface area affect DLCO?

reduces it

50

measurement of dissolved tensions of CO2 and O2 as well as pH of sample of arterial blood:

Arterial blood gas determination (ABGs)

51

How much can the respiratory (minute) ventilation increase with exercise?

25 times (to 150 L/min)

52

How many ml is used for gas exchange?

350ml

53

Can alveolar ventilation increase or decrease if respiratory ventilation remains the same?

Yes, breath slowly and deeply: alveolar ventilation increases; breath shallowly and rapidly: alveolar ventilation decreases

54

What prevents fluctuation in alveolar gas tensions with each tidal breath?

reservoir of gas ‘stored’ within alveoli

55

easy to fill lungs, hard to empty:

obstructive lung disease

56

most efficient way to increase alveolar ventilation:

Increase tidal volume

57

True or False? Increase respiratory rate and alveolar ventilation increases.

T

58

How is dead space affected with an increase in respiratory rate?

dead space increases

59

physiologic dead space calculation:

sum of anatomical & alveolar dead space

60

Is pleural pressure more negative at top or bottom of the lungs?

top

61

True or False? The larger alveoli are at the bottom of the lungs.

F. Top

62

Where is there a greater distending pressure for alveoli?

at top of lungs

63

Which regions of lung are better perfused, upper or lower?

lower

64

Why is the upper lungs less perfused than lower?

gravity, hydrostatic pressure gradient of 30 cm water

65

Pressure gradient in which a patient has hemorrhaged (BP, intravascular volume are low):

Alveolar > arterial, not in healthy patient

66

Pressure gradient for flow driven by difference between arterial/alveolar pressure; primary area of distension, recruitment of vessels during exercise:

arterial > alveolar > vein

67

In which zone does continuous forward flow through distended vessels occur?

Zone 3

68

What zone is this? Flow driven by difference between arterial/alveolar pressure; primary area of distension, recruitment of vessels during exercise

Zone 2

69

With airways obstruction, will FRC increase or decrease?

increase (premature airway closure)

70

What causes pulmonary edema?

left heart failure

71

Which form of oxygen in the blood is responsible for partial pressure?

dissolved

72

This is often given given post-surgery to boost blood oxygen content:

EPO

73

volumes percent of oxygen in blood:

20

74

What affect will blood doping have on blood viscosity?

increases it (increasing resistance)

75

Factors that would lead to a decreased P50:

decreased temperature, decreases CO2 pressure, decreased 2,3-DPG, increased pH

76

Does a decreased P50 correspond with an increased or decreased affinity?

increased

77

What shape is the CO2 dissociation curve/

linear

78

True or False? Oxygen and carbon dioxide bind the same site.

F. high oxygen reduces affinity

79

Parasympathetic affect on the lungs:

airway constriction, blood vessels dilation, glandular secretion

80

Does nonadrenergic noncholinergic activation lead to realization or stimulation?

stimulation

81

Does nonadrenergic noncholinergic inhibitory activation lead to relaxation or stimulation?

relaxation

82

In which direction will the Hb curve shift with a decrease in pH?

Right

83

True or False? Oxygen and CO2 bind the same site of hemoglobin.

F.