Pulmonary Physiology & Pathology E3

Systemic circulation moves ___ blood from the heart through the ___

*oxygenated* *body*

What prevents atelectasis?

*preventing alveolar collapse via surfactant*

What is the purpose of the film of mucus that is secreted by the mucosa?

*protect underlying cells*

respiratory alkalosis

Arise in blood pH due to hyperventilation resulting w/ a decrease in CO2.

Hemataemeis

active bleed in GI, bloody vomit

Which of the following is consistent w/ atelectasis? Select all that apply: compression d/t physical force N2 washout too much surfactant too little surfactant

*compression d/t physical force* *N2 washout* *too little surfactant*

What treatment options are available for ARDS?

*cortical steroids to calm vessel inflammation* *ventilator d/t diaphragm no longer contracting* *difficulty inhalation*

What are the functions of surfactant? Select all that apply: increase surface tension decrease surface tension inhibits pathogens attracts h2o repels h2o prevents alveolar collapse

*decrease surface tension* *inhibits pathogens* *repels h2o* *prevents alveolar collapse*

Respiratory pathologies ___ ventilation resulting in a ___ v/q and triggering ___

*decrease* *decreased v/q* *shunting*

Cardio pathologies ___ perfusion resulting in a ___ v/q

*decrease* *increased*

Pulmonary circulation is the flow of ___ blood from the ___ to the ___ and back to the heart.

*deoxygenated* *heart to the lungs*

What organ is used with inspiration?

*diaphragm*

Successful CPR results in ___ d/t instability in a portion of the ___ ___. This is also known as "Paradoxical Breathing" failed chest/chest wall fixed chest/chest wall flail chest/chest wall mobile chest/chest wall

*flail chest* *chest wall*

*Bronchiolitis* is an ___ obstruction in small airways. The main concern is pulmonary impairment d/t ___ ___ inflammation

*inflammation* *smooth muscle*

Which part of breathing requires the most effort? Why?

*inspiration* *need to use diaphragm*

Pulmonary circulation has a ___ pressure than the systemic circulation. Why? higher lower equal

*lower pressure* *shorter distance to travel*

Pt has inhaled a chicken nugget & it is now obstructed in the trachea. Is this an upper or lower obstruction?

*lower*

Does the brain or lungs receive air first?

*lungs*

Pip must remain ___ , otherwise the lung will ___ causing a ___

*negative* *collapse* *pneumothorax*

Which muscles are used with forced expiration?

*rectus abdominus*

Hypercapnia in the alveolar sacs leads to ____ ___

*respiratory acidosis* *excessive CO2 (basic) in the blood*

If a pt starts choking, which bronchi is most likely to become obstructed? Why?

*right bronchi, more vertical, larger (3 lobes)*

What protective reflex is triggered by decreased O2 at the alveoli?

*shunting*

Diverting blood away from a bad alveoli to a good alveoli is called ___ which results in ___ O2/CO2 exchange and overall ___ SpO2

*shunting* *increasedO2/CO2* *increased SpO2*

Chronic asthma can lead to obstruction and ___ ___ which is a medical emergency. Why is this a medical emergency?

*status asthmaticus* *constricted airways for @ least 15 mins*

Upon damage to the lungs, which cells are sacrificed first ? Why?

*type II pneumocytes/alveoli* *type I is needed for gas exchange ABCs*

Pt has a sinus infection and laryngitis. Are these considered an upper or lower infections?

*upper*

What is the disadvantage of shunting?

*vasoconstriction resulting in pulmonary HTN*

What are the 4 steps of fxn in the pulmonary system? How does this differ from CO2 diffusion?

*ventilation - moving gas* *diffusion - moving gas at a cellular level, O2 onto RBC* * perfusion - moving blood to tissues* * diffusion - from RBC to tissue* *CO2 diffusion occurs in opposite order*

Bronchitis vs. Bronchiolitis

- Bronchitis = rhonchi - Bronchiolitis = runny nose and wheezy

Dyspnea

difficulty breathing

Orthopnea

difficulty breathing when lying down

Pulmonary edema leads to ___, leading to ___ ->___->___

hypoxia shunting increased capillary hydrostatic pressure

Alveolar ventialation

moving gas @ alveoli

Decreased v/q indicates ___ ___

*respiratory pathology*

Serous membranes are found in: Heart Lungs GI All of the above

all of the above

Which structure of the conducting airways contain smooth muscle and are considered the primary reactive airway?

*bronchioles*

Increased v/q indicates ___ ____

*cardio pathology*

What type of pathology is shunting?

*cardio*

Oxygen is transported via ____ or by ___ in plasma

*97% oxyhemoglobin (RBCs)* *3% dissolved*

What is the primary method of CO2 transport? Why?

*Bicarbonate HCO3* *prevents pH changes*

Why does CO2 want to leave the body?

*CO2 is high in tissues, low outside of the body* *gases move from high to low*

Which of the following do the peripheral chemoreceptors (lungs) detect? Select all that apply: CO2 H+ O2

*CO2* *H+* *O2*

What substances do the chemoreceptors in the medulla of brain detect in the blood?

*CO2* *H+* h2o (h2o + co2 = H+)

What occurs after emphysema, chronic bronchitis, & chronic asthma?

*COPD*

Anaphylactic shock would warrant what treatment? Epi pen Cut hole in the trachea Apply O2 mask All of the above

*Epi pen* to vasodilate bronchioles

T/F: Cardio pathologies can trigger shunting to occur

*False*

What are your ideal lung properties? Select all that apply: High recoil Low recoil High resistance Low resistance Increased compliance Decreased compliance

*High recoil* *Low recoil* *Increased compliance*

Which muscles are used during regular *expiration*? Rectus Abdominus Diaphragm External Intercostals Internal Intercostals None of the above

*None, passive*

Why does O2 want to move into tissue?

*O2 is lower in the tissue, wants to spread* *gases move from high to low*

What is the correct order of *pressures* of the lungs upon *exhalation*? Select all that apply Pa > Pb > Pip Pb > Pa > Pip Pip < Pb < Pa Pip < Pa < Pb

*Pa > Pb > Pip* *Pip < Pb < Pa*

What is the correct order of *pressures* of the lungs upon *inhalation*? Select all that apply Pb > Pa > Pip Pip < Pa < Pb Pa < Pb < Pip Pip > Pb > Pa

*Pb > Pa > Pip* *Pip < Pa < Pb*

What is the primary method of oxygen transport in the body?

*RBCs*

Ventilation-Perfusion ratio is a reflection of ___.

*SpO2*

Hemoptysis indicates an ___ ___ in the ___ tract

*active bleed* *@resp tract*

Allergies that cause inflammation at the alveolar sac is called ___, which is the same as ___

*allergic alveolitis* * type I hypersensitivity pneumonitis*

Pneumocytes are also called ___

*alveoli*

Gas exchange occurs across the ___ membrane which is formed by ____ epithelium

*alveolocapillary* *simple squamous*