A&p Test #1 Review

Front 1

Upon leaving the bronchial walls of the capillary bed, O2 poor blood can go 2 ways(1) 25-33% drains thru true bronchial veins & into the right atrium and (2) the remaining 64-75% drains directly into the pulmonary veins. (2) does what to the pulmonary venous blood?

Back 1

mixes poor O2 blood with well oxygenated blood

Front 2

Normal anatomic shunting makes it so that systemic arterial blood can never have the same partial pressure of O2 as _____.

Back 2

alveolar gas

Front 3

Define anatomical shunting

Back 3

The mixing of unoxygenated blood with oxygenated blood.

Front 4

The ___ connections between bronchial & pulmonary circulation causes anatomical shunting( also called bronchopulmonary-arterial anastomoses).

Back 4

vascular

Front 5

Pulmonary venous blood is normally identical to ____ blood.

Back 5

arterial

Front 6

The _____ is the source of innervation for the lung airways.

Back 6

autonomic nervous system(autonomic sensory & motor nerves)

Front 7

Skeletal muscles of chest wall & diaphragm are innervated by the ___.

Back 7

somatic nervous system

Front 8

The ____ &___ are divisions of the autonomic system that control most of the body's visceral functions(soft organs of the thoracic & abdominal cavities).

Back 8

sympathetic & parasympathetic

Front 9

The paired ___ nerves supply motor inervation to the diaphragm. they originate from right and left cervical nervous plexus as branches of c3-c5.

Back 9

phrenic

Front 10

The ___ nerves are spinal nerves that innervate muscles between ribs & intercostal muscles.

Back 10

intercostal

Front 11

____ is the transmitter used in sympathetic innervation of the lungs.

Back 11

norepinephrine

Front 12

___ is the transmitter used in the parasympathetic innervation of the lungs.

Back 12

acetylcholine

Front 13

The external landmark for tracheal division into mainstem bronchi is the ___.

Back 13

sternal angle(aka angle of louis)

Front 14

This external angle marks where you must NOT go down to when doing compressions.

Back 14

xiphoid process

Front 15

The primary muscles for respiration are the ___ &___.

Back 15

diaphragm & intercostals

Front 16

The primary muscles for inspiration are the _____.

Back 16

accessory muscles

Front 17

The accessory muscles are ___ & ___.

Back 17

Scalene & sternocleidomastoid

Front 18

Movement of the ____ & _____ are responsible for pleural pressure changes.

Back 18

lungs& chest

Front 19

What is the (normal) pleural pressure value ?

Back 19

755 mm Hg(negative under normal quiet breathing)

Front 20

What is the (normal)pleural pressure value for inspiration & expiration?

Back 20

-8 & -6

Front 21

___(or distensibility) is the measure of the lung's opposition to inflation.

Back 21

Compliance

Front 22

What is the normal value for compliance?

Back 22

.2L/cm H2O

Front 23

____/_____ is the change in pressure required to produce a unit of volume change cm H2O/L. It is the mathematical reciprocal of compliance.

Back 23

Resistance/elastance

Front 24

Another term for airway resistance is RAW. ____ is the normal RAW in adults.

Back 24

05-1.5 cm H2O/L/second

Front 25

Surfactant forms a mono molecular layer over pulmonary alveolar surfaces, preventing alveolar collapse at lower lung volumes by ______.

Back 25

reducing alveolar surface tension

Front 26

Where is surfactant formed/produced by _____ and stored in lamellated bodies to be secreted onto the alveolar surface.

Back 26

type II pneumocytes

Front 27

Exchange of O2 with CO2 across capillary membranes by simple diffusion is called ___.

Back 27

internal respiration

Front 28

Exchange of gases from outside with the lungs(into the body) is called ___.

Back 28

external respiration

Front 29

How does a normal diaphragm move during inspiration (directional)?

Back 29

down

Front 30

How does a normal diaphragm move during expiration(directional)?

Back 30

up

Front 31

How much does a normal diapram move (distance)?

Back 31

1-2cm(10 with max)

Front 32

How does a floppy diaphragm move during inspiration & expiration?

Back 32

the diaphragm decreases the AP diameter of the thoracic cavity on inspiration & moves very little on expiration( check expiration part again)

Front 33

What diseases would cause problems with innervation of the diaphragm?

Back 33

neuromuscular diseases and trauma

Front 34

A huge part of clearance is the _______. The ciliated epithelial cells move in a forward motion, causing the trapping of foreign matter. The forward motion also moves the mucus upward & hopefully outward(this is mucokinesis)!

Back 34

mucociliary escalator

Front 35

The top layer of the airway tissue mucus is a ____ blanket, the next layer is the ___(water)layer where the tips of the ciliated epithelial cells "do the wave".

Back 35

gel, sol

Front 36

What does the upper airway consist of?

Back 36

nose, oral cavity, pharynx and larynx

Front 37

What are the functions of the nose ?

Back 37

Air conditioning, filtering, warming and humidifying

Front 38

What is another name for conchae?

Back 38

turbinates

Front 39

The function of the conchae or turbinates is to ______.

Back 39

increase surface area

Front 40

What types of cells are in the mucous of the lung?

Back 40

immungolobiulins and inflammatory cells

Front 41

The larynx marks the transition between what to areas?

Back 41

the upper and lower airways

Front 42

Inspired gas abruptly changes direction of flow at the ____point of the nasopharnyx.

Back 42

posterior

Front 43

The oropharynx and the laryngopharnyx are lined with what type of cells?

Back 43

non-cilitated stratifed squamous ephthelium

Front 44

The larynx is a cartilaginous cylindrical structure that acts as a valve on top of the trachea used for speech and to_____

Back 44

stop aspiration of soilids and liquides during swallowing and breathing

Front 45

The opeaning of the trachea is?

Back 45

The glottis

Front 46

The thyroid cartilage is also called the____.

Back 46

adams apple

Front 47

What is the eppiglottis shaped like?

Back 47

Thin flat leaf shaped

Front 48

What land mark is used intubation?

Back 48

vallecula

Front 49

Were does the vallecula?

Back 49

between the epiglottis and the tongue

Front 50

What part of the upper airway in infants is the narrowest?

Back 50

the cricoid

Front 51

What part of the upper airway is the narrowest in the adults?

Back 51

The glottis

Front 52

eppiglottitis is

Back 52

inflamation or swollen eppiglottis

Front 53

eppiglottitis is caused by?

Back 53

infection (croup) or trauma

Front 54

What kind of breath sound does eppiglottis make?

Back 54

stridor

Front 55

A tracheostomy is done were?

Back 55

1-3 cm below the cricoid cartlage

Front 56

Paralysis and edema caused by what?

Back 56

increased resistance to airway resistance

Front 57

larynospam occures when what enters the trachea?

Back 57

anything except air

Front 58

anatomical dead space is what?

Back 58

the conducting airways from the mouth and nose down to the terminal brochioles were no gas is exchanged

Front 59

Wasted ventilation is_____

Back 59

anatomical dead space

Front 60

emphysema cause what?

Back 60

more anatomical dead space

Front 61

how much anatomical dead space do we have?

Back 61

1 pound per ideal body weight or 2.2kg

Front 62

How do we figure out anatomical dead space for women?

Back 62

100 pounds for a 5ft women and add 5 pounds for every inch

Front 63

how do we fined the ideal body weight in men

Back 63

for a 5 ft man is 106 and then you add 6lbs for every inch after that

Front 64

were dose gas exchange occure?

Back 64

in the acinus

Front 65

What type of cells do the aalveoli have?

Back 65

type 1 and 2

Front 66

What do type one cells look like?

Back 66

flat

Front 67

What do type 2 cells look like?

Back 67

compacted polygonal shaped

Front 68

When is the diaphragm inactive?

Back 68

during quiet exhalation

Front 69

the fibers of the diaphram orginates from the lower ribs, sternum and the lower end of the __________

Back 69

sternum

Front 70

crural fibers originate from the _------- and the ________ of the lumbar vertabre.

Back 70

1st and 3rd

Front 71

The maxiumum that the diaphram can move down is

Back 71

6-10cm

Front 72

the diaphram moves how much durring normal breathing?

Back 72

1-2cm

Front 73

What side of the diaphram is higher the rt or the lft?

Back 73

the right

Front 74

Why is the rt side of the diaphram higher than the lft side?

Back 74

to allow the liver to be tucked under the bottom edge of the rib case

Front 75

The left side of the lung is lower because

Back 75

it allows room for the heart

Front 76

What are costophrinic angels?

Back 76

were the ribs meets the diaphram

Front 77

What are the two types of pleural effusion?

Back 77

Transudative and exudative

Front 78

What causes transudative pleural effusion?

Back 78

fluid leaking into pleural space, increased pressure or low protein

Front 79

What causes exudative effusion?

Back 79

blocked blood vessels inflamation injury or drug reaction

Front 80

What is pleural effusion?

Back 80

excess fluild in the pleural space that can impare breathing

Front 81

Alveorlar epithelium are highly permeable to gas but not to_

Back 81

liquid

Front 82

The spaces inbetween the membrain in the alveolar are?

Back 82

the interstium space

Front 83

What type of cell makes surfactant?

Back 83

Type 2 cells

Front 84

What is the purpose of the pressure gradients?

Back 84

Causes air to move in and out of the lungs and are responsible for keeping the lungs in an inflated state.

Front 85

What are the 3 important pressure gradients in ventilation?

Back 85

transpulmonary (PL)
transthoracic (Pw)
transrespiratory (Prs)

Front 86

What is the transpulmonary gradient (PL)?

Back 86

The difference between the pressure in the alveoli and the pleural space, and is responsible for maintaining alveolar inflation (PL = PA - Ppl)

Front 87

What is the transrespiratory gradient (Prs)?

Back 87

The difference between the atmosphere and the alveoli, and is responsible for the actual flow of gas into and out of the alveoli during breathing (Prs = Pl + Pw)

Front 88

What is the transthoracic gradient (Pw)?

Back 88

The difference between the pressure in the pleural space and the pressure at the body surface, and represents the total pressure required to expand or contract the lungs and chest wall. (Pw = Ppl - Pbs)

Front 89

What is a spirometer?

Back 89

The device used to measure volumes of air moving in and out of the lungs

Front 90

Residual volume RV

Back 90

Volume of air remaining in the lung after a maximal-effort expiration

Front 91

Expiratory reserve volume ERV

Back 91

Volume of air that can be exhaled with maximal effort from a resting (tidal) end-expiratory level

Front 92

Tidal volume TV or Vt

Back 92

volume of air normally inhaled or exhaled with each breath during resting, quiet breathing

Front 93

Inspiratory reserve volume IRV

Back 93

volume of air that can be inhaled with maximal effort from the tidal end-inspiratory level

Front 94

Total lung capacity TLC

Back 94

Volume of air in the lung after a maximal-effort inspiration; the sum of all volumes

Front 95

Inspiratory capacity IC

Back 95

Volume of air that can be inhaled with maximal effort from a resting (tidal) end-expiratory level; the sum of TV and IRV

Front 96

Vital capacity VC

Back 96

Maximum volume of air that can be exhaled after a maximal-effort inspiration; sum of IRV, TV, and ERV

Front 97

Functional residual capacity FRC

Back 97

Volume of gas remaining in the lung at the end of a normal tidal exhalation (relaxed ventilatory muscles); sum of
ERV and RV

Front 98

Volume

Back 98

The amount of gas in a given lung "compartment" (one section)

Front 99

Capacity

Back 99

Two or more volumes

Front 100

Resistance

Back 100

recoil, elastance

Front 101

Compliance

Back 101

inflatable, distensible

Front 102

What is the main weaning parameter from a ventilator?

Back 102

RSBI - Rapid Shallow Breathing Index f(rr)/Vt
If it is >100 you usually do not pull tube

Front 103

Cost of Breathing

Back 103

1 ml of O2/L of Vent
COPD 10 times as much O2