Notes in 23 Respiratory Physiology & Anesthesia

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Published	12/13/2023	The sum of the tidal volume plus the inspiratory reserve volume is known as {{c1::inspiratory capacity}}
Published	12/13/2023	The sum of the tidal volume, inspiratory reserve volume, and expiratory reserve volume is known as the {{c1::vital capac…
Published	12/13/2023	{{c2::Functional residual capacity}} = {{c1::Expiratory Reserve Volume}} + {{c1::Residual volume}}
Published	12/13/2023	What accessory muscles are recruited for labored inspiratory efforts?{{c1::Sternocleidomastoid}}{{c2::Scalene}}{{c3::Pectoralis}}
Published	12/13/2023	What muscles facilitate forceful exhalation?{{c1::Abdominal muscles}}{{c2::Internal}} intercostals
Published	12/13/2023	The trachea is approximately {{c1::10}}-{{c1::13}} cm long.
Published	12/13/2023	Which mainstem bronchi are you more likely to aspirate into? {{c1::Right}}
Published	12/13/2023	The cells of the mucosa of the airway transition from {{c1::ciliated columnar}} to {{c2::cuboidal}} to {{c3::flat alveolar epithelium}}.
Published	12/13/2023	In the alveoli, type {{c1::1}} pneumocytes form tight junctions.
Published	12/13/2023	Type {{c1::II}} pneumocytes secrete {{c2::surfactant}}, which are stored in intracellular {{c3::lamellar bodies}}.
Published	12/13/2023	Type {{c1::II}} pneumocytes can divide and form type {{c1::I}} pneumocytes.
Published	12/13/2023	What type of cells are present in the alveoli of smokers, and patients with pneumonia or acute lung injury?{{c1::Neutrophils }}
Published	12/13/2023	The diaphragm is innervated by the {{c2::phrenic}} nerves, which arise from {{c1::C3}}-{{c1::C5}}.
Published	12/13/2023	Sensory innervation of the tracheobronchial tree is provided by the {{c1::vagus}} nerve.
Published	12/13/2023	{{c1::Parasympathetic}} autonomic innervation of the lungs is provided by the {{c2::vagus}} nerve.
Published	12/13/2023	Parasympathetic (vagal) activity in the lungs causes:broncho{{c1::constriction}}{{c2::increased}} bronchial secretions
Published	12/13/2023	Sympathetic activity in the lungs causes:broncho{{c1::dilation}}{{c2::decreased}} secretions
Published	12/13/2023	At end inspiration and end expiration, flow is {{c1::zero}}.
Published	12/13/2023	At end inspiration and end expiration, alveolar pressure is equivalent to {{c1::atmospheric}} pressure.
Published	12/13/2023	At end-expiration, intrapleural pressure is {{c1::-5}} cm H2O.
Published	12/13/2023	During inspiration, chest expansion decreases intrapleural pressure to {{c1::-8}} - {{c1::-9}} cm H2O.
Published	12/13/2023	At end-expiration (aka the {{c3::functional residual capacity}}), the {{c1::outward}} elastic recoil of the {{c1::chest wall}} is balanced b…
Published	12/13/2023	Surface tension in the alevoli can be described with Laplace's law (Pressure = ):{{c1::}}
Published	12/13/2023	Pulmonary surfactant {{c1::decreases}} alveolar surface tension.
Published	12/13/2023	Distended alveoli {{c1::reduces}} surfactant concentration, leading to a {{c2::increase}} in surface tension.
Published	12/13/2023	FRC is {{c1::decreased}} when the patient is in a supine position.
Published	12/13/2023	Obese patients have {{c1::decreased}} FRC.
Published	12/13/2023	Closing capacity is the volume at which {{c1::small airways}} begin to close in {{c1::dependent}} areas of the lung.
Published	12/13/2023	In normal, young patients, the closing capacity is {{c1::less}} than the FRC.
Published	12/13/2023	In {{c2::elderly}} and {{c2::obese}} patients, the closing capacity is {{c1::more}} than the FRC.
Published	12/13/2023	Altering the {{c1::radius}} of a tube exhibits the greatest impact on flow.
Published	12/13/2023	A {{c1::low::high or low}} Reynolds number is associated with {{c2::laminar}} flow.
Published	12/13/2023	A {{c1::high::high or low}} Reynolds number is associated with {{c2::turbulent}} flow.
Published	12/13/2023	Where does laminar flow occur in the lungs?{{c1::Terminal bronchioles}}
Published	12/13/2023	Larger airways tend to have {{c1::turbulent}} flow.
Published	12/13/2023	HeliOx therapy is used in patients with severe {{c1::upper airway obstruction}}.
Published	12/13/2023	HeliOx therapy reduces {{c1::airway resistance}} when turbulent flow is present.
Published	12/13/2023	Most airway resistance comes from {{c1::medium}}-sized bronchi.
Published	12/13/2023	The point along the airways where dynamic compression occurs is called the {{c1::equal pressure point}}.
Published	12/13/2023	Patients with emphysema have increased {{c3::functional residual capacity}}, resulting in {{c1::air trapping}} and {{c2::auto-PEEP}}.
Published	12/13/2023	A normal FEV1/FVC is {{c1::80% or greater}}.
Published	12/13/2023	The {{c1::forced midexpiratory flow (FEF25-75%)}} is a better measurement of obstruction than the FEV1 because it is effort {{c2::independent}}.&…
Published	12/13/2023	Patients with reduced compliance tend to breathe {{c2::rapid/shallow}}.
Published	12/13/2023	In the supine position, the {{c1::dorsal}} part of the diaphgram moves cephalad.
Published	12/13/2023	Does general anesthesia increase airway resistance?{{c1::Not usually}}
Published	12/13/2023	{{c2::Physiologic dead space}} is the volume of gas that {{c1::does not participate in gas exchange}}.
Published	12/13/2023	Physiologic dead space is the sum of {{c1::anatomic}} dead space and {{c2::alveolar}} dead space.
Published	12/13/2023	Dead space from {{c2::conducting airways}} is known as {{c1::anatomic dead space}}.
Published	12/13/2023	Dead space from {{c2::nonperfused alveoli}} is known as {{c1::alveolar dead space}}.
Published	12/13/2023	Dead space can be estimated at {{c1::2 mL/kg}}.
Published	12/13/2023	Anticholinergic drugs {{c1::increase}} dead space via broncho{{c1::dilation}}.
Published	12/13/2023	The most common cause of increased dead space is {{c1::hypotension}}.
Published	12/13/2023	The {{c1::lower::upper or lower}} areas of the lung are better ventilated than the {{c1::upper::upper or lower}} areas.
Published	12/13/2023	What does hypoxia do to pulmonary vasculature?{{c1::Vasoconstricts}}
Published	12/13/2023	What physiological mechanism reduces intrapulmonary shunting and hypoxemia?{{c1::Hypoxic pulmonary vasoconstriction}}
Published	12/13/2023	What does hypocapnia do to the pulmonary vasculature?{{c1::Pulmonary vasodilation}}
Published	12/13/2023	{{c1::Dependent::dependent or nondependent}} areas of the lung receive greater blood flow than {{c1::nondependent::dependent or nondependent}} areas.&…
Published	12/13/2023	West zones:In zone 1, what is the relationship between PA, Pa, and Pv?{{c1::PA > Pa > Pv}}
Published	12/13/2023	West zones:In zone 2, what is the relationship between PA, Pa, and Pv?{{c1::Pa > PA > Pv}}
Published	12/13/2023	West zones:In zone 3, what is the relationship between PA, Pa, and Pv?{{c1::Pa > Pv > PA}}
Published	12/13/2023	Which West zone is alveolar dead space?{{c1::1}}
Published	12/13/2023	West zone 4 is due to {{c1::atelectasis}} and {{c2::interstitial pulmonary edema}}.
Published	12/13/2023	In West zone 4, blood flow is dependent on the differential between {{c1::Pa}} and {{c1::PIS}}.
Published	12/13/2023	The normal V/Q ratio is {{c1::0.8}}.
Published	12/13/2023	A V/Q ratio of 0 is also known as {{c1::intrapulmonary shunt}}.
Published	12/13/2023	A V/Q ratio of ∞ is also known as {{c1::dead space}}.
Published	12/13/2023	{{c1::Apical::apical or basal}} areas tend to have higher V/Q ratios than {{c1::basal::apical or basal}} areas.
Published	12/13/2023	Shunt is {{c1::perfusion}} without {{c1::ventilation}}.
Published	12/13/2023	Hypoxemia from an {{c2::absolute::absolute or relative}} shunt {{c1::cannot}} be corrected with 100% oxygen.
Published	12/13/2023	Normal physiologic shunts occur due to1. communication between {{c1::deep bronchial}} veins and {{c1::pulmonary}} veins2. small portion of {{c2::…
Published	12/13/2023	General anesthesia increases venous admixture because inhalational agents inhibit {{c1::hypoxic pulmonary vasoconstriction}}
Published	12/13/2023	Angiotensin-converting enzymes are found on the surface of the {{c1::pulmonary endothelium}}.
Published	12/13/2023	The inspired O2 tension (PIO2) is less than the partial pressure of atmospheric O2 because of {{c1::humidification}} in the upper …
Published	12/13/2023	Large increases in PaCO2 will produce {{c2::hypoxia}} when PIO2 is {{c1::at room air}}.
Published	12/13/2023	Gas transfer across the alveolar-capillary membrane is measured using the diffusing capacity of {{c1::carbon monoxide}}.
Published	12/13/2023	The A-a gradient is normally {{c1::<15}} mmHg.
Published	12/13/2023	The most common mechanism of hypoxemia is {{c1::increased A-a gradient}}.
Published	12/13/2023	Increased cardiac output {{c1::increases}} mixed venous O2 tension by inhibiting {{c2::hypoxic pulmonary vasoconstriction}}.
Published	12/13/2023	Mixed venous O2 samples must be obtained from a {{c1::pulmonary artery}} catheter.
Published	12/13/2023	The partial pressure of carbon dioxide in mixed venous blood (PvCO2) is normally approximately {{c1::45}} mmHg
Published	12/13/2023	PACO2 is primarily dependent on {{c1::alveolar ventilation}} and {{c1::CO2 production}}
Published	12/13/2023	The partial pressure of carbon dioxide in the alveolar air (PACO2) and arterial blood (PaCO2) is normally appr…
Published	12/13/2023	A normal PACO2 - PETCO2 gradient is less than {{c1::5}} mmHg.
Published	12/13/2023	{{c2::Henry's}} law: The amount of gas dissolved in solution is proportional to its {{c1::partial pressure}}.
Published	12/13/2023	O2 has a solubility coefficient of {{c1::0.003}} mL/dL/mmHg.
Published	12/13/2023	A normal hemoglobin molecule (hemoglobin A1) consists of two {{c1::α}} and two {{c1::β}} subunits.
Published	12/13/2023	One gram of hemoglobin can carry up to {{c1::1.34}} mL of O2.
Published	12/13/2023	What form of iron can bind O2? {{c1::Fe2+}}
Published	12/13/2023	{{c1::Bohr}} effect: An increase in {{c2::H+}} concentrations reduces O2 binding to hemoglobin.
Published	12/13/2023	2,3-DPG is a byproduct of {{c1::glycolysis}} that accumulates during {{c2::anaerobic}} metabolism.
Published	12/13/2023	Carbon monoxide (carboxyhemoglobin) shifts the O2-Hgb dissociation curve to the {{c1::left}}.
Published	12/13/2023	Carbon monoxide binds competitively to Hgb and with 200-300x {{c1::greater}} affinity than O2
Published	12/13/2023	Acquired methemoglobinemia comes from exposure to these oxidizing drug classes:{{c1::Nitrates}}{{c1::Sulfa drugs}}{{c1::Local anesthetics}}
Published	12/13/2023	Methemoglobinemia shifts the normal O2-Hgb dissociation curve to the {{c1::left}}.
Published	12/13/2023	Reduction of methemoglobin to normal hemoglobin is done using the drugs {{c1::methylene blue}} or {{c2::vitamin C}}.
Published	12/13/2023	O2 is transported in blood in two forms: {{c2::dissolved}} (2%) or {{c1::bound to hemoglobin}} (98%)
Published	12/13/2023	Low O2 delivery may be due to a low {{c1::PaO2}}, low {{c2::Hgb}}, or low {{c3::cardiac output}}.
Published	12/13/2023	A normal O2 extraction fraction is about {{c1::25}}%, or {{c2::5}} mL/dL.
Published	12/13/2023	During apneic periods, gas exchange is dependent on the {{c1::functional residual capacity}}.
Published	12/13/2023	Carbon dioxide is transported in blood in three forms:1. {{c3::dissolved in solution::7%}}2. {{c2::bicarbonate::70%}}3. {{c1::bound to protein (carbam…
Published	12/13/2023	The enzyme {{c1::carbonic anhydrase}} accelerates the conversion of carbon dioxide to bicarbonate.
Published	12/13/2023	{{c1::Acetazolamide}} impairs CO2 transport via inhibition of {{c2::carbonic anhydrase}}.
Published	12/13/2023	Most CO2 in blood is transported in the form of {{c1::bicarbonate}}.
Published	12/13/2023	At the {{c2::systemic venous}} capillaries, chloride ions are shifted {{c1::in to}} the cells in order to maintain electrical neutrality.
Published	12/13/2023	In {{c2::pulmonary}} capillaries, chloride ions are shifted {{c1::out of}} the cells.
Published	12/13/2023	{{c1::Hemoglobin}} in RBCs acts as a buffer at physiologic pH because of the high concentration of histidine.
Published	12/13/2023	O2-Hgb dissociation in capillaries shifts the CO2-bicarbonate equilibrium in favor of {{c1::bicarbonate}} formation.
Published	12/13/2023	O2-Hgb binding in lungs shifts the CO2-bicarbonate equilibrium in favor of {{c1::CO2}} formation.
Published	12/13/2023	The {{c1::dorsal}} respiratory group of neurons in the medulla is active during {{c2::inspiration}}.
Published	12/13/2023	The {{c1::ventral}} respiratory group is primarily responsible for {{c2::expiration}} and is not active during normal, q…
Published	12/13/2023	The {{c2::lower pontine (apneustic)}} center exhibits an {{c1::excitatory::excitatory or inhibitory}} effect on the dorsal medullary center.
Published	12/13/2023	The {{c2::upper pontine (pneumotaxic)}} center exhibits an {{c1::inhibitory::excitatory or inhibitory}} effect on the dorsal medullary center.
Published	12/13/2023	Central chemoreceptors lie on the {{c1::anterolateral}} surface of the {{c2::medulla}}.
Published	12/13/2023	Central chemoreceptors primarily respond to changes in {{c1::H+}} concentration in the {{c1::cerebrospinal fluid}}.
Published	12/13/2023	Central chemoreceptors regulates {{c3::PaCO2}} because the blood-brain barrier is permeable to {{c1::dissolved CO2}}, but not to {{c2::…
Published	12/13/2023	Activation of central chemoreceptors stimulates the adjacent {{c1::respiratory medullary}} centers to increase {{c2::alveolar ventilation}}.
Published	12/13/2023	Hypoxia depresses {{c1::central}} chemoreceptor activity (but not {{c1::peripheral}}).
Published	12/13/2023	The PaCO2  at which ventilation is zero is called the {{c1::apneic threshold}}.
Published	12/13/2023	The two sets of peripheral chemoreceptors include the {{c1::carotid bodies}} and the {{c2::aortic bodies}}.
Published	12/13/2023	The carotid bodies (peripheral chemoreceptors) lie at the {{c1::bifurcation of the common carotid arteries}}.
Published	12/13/2023	The carotid bodies (peripheral chemoreceptors) interact with the central respiratory centers via the {{c1::glossopharyngeal}} nerve.
Published	12/13/2023	{{c1::Decreases}} in arterial perfusion will {{c2::increase}} alveolar ventilation.
Published	12/13/2023	A {{c1::increase}} in [H+] will {{c2::increase}} alveolar ventilation.
Published	12/13/2023	{{c2::Peripheral}} chemoreceptors primarily respond to changes in {{c1::PaO2}}.
Published	12/13/2023	{{c1::Glomus}} cells in the carotid body (peripheral chemoreceptors) are inhibited by drugs such as {{c2::general anesthetics}} and {{c3::phenoth…
Published	12/13/2023	{{c1::Bilateral carotid}} surgery blunts the peripheral chemoreceptors and baroreceptors.
Published	12/13/2023	The Hering-Breuer inflation reflex inhibits {{c1::inspiration}} when the lung is {{c2::hyperinflated}}.
Published	12/13/2023	{{c1::Juxtacapillary}} receptors induce {{c2::dyspnea}} in response to pulmonary edema or embolism.
Published	12/13/2023	What is the effect of volatile anesthetics on the CO2 response curve?{{c1::Shift downwards and right}}
Published	12/13/2023	{{c1::Decreases}} in 2,3-DPG cause the O2-hemoglobin dissociation curve to shift to the {{c2::left}}
Published	12/13/2023	The {{c1::P50}} of the oxygen-Hgb dissociation curve is the Po2 at which hemoglobin is 50% saturated
Published	12/13/2023	The oxygen-Hgb dissociation curve is roughly flat when the Po2 is between {{c1::60}} and {{c1::100}} mmHg
Published	12/13/2023	Shifts of the O2-Hgb dissociation curve to the {{c1::right}} occur when there is {{c2::decreased}} affinity of hemoglobin for O2
Published	12/13/2023	Shifts of the O2-Hgb dissociation curve to the {{c1::right}} cause {{c2::increased}} unloading of O2 at tissues
Published	12/13/2023	{{c1::Increases}} in 2,3-DPG cause the O2-hemoglobin dissociation curve to shift to the {{c2::right}}
Published	12/13/2023	Shifts of the O2-Hgb dissociation curve to the {{c1::left}} occurs when there is {{c2::increased}} affinity of hemoglobin for O2
Published	12/13/2023	Shifts of the O2-Hgb dissociation curve to the {{c1::left}} cause {{c2::decreased}} unloading of O2 at tissues
Published	12/13/2023	{{c1::Decreases}} in temperature cause the O2-hemoglobin dissociation curve to shift to the {{c2::left}}
Published	12/13/2023	Hypoxic pulmonary vasoconstriction shunts blood toward {{c1::better}} ventilated alveoli.
Published	12/13/2023	The {{c1::lymphatic}} system in the lungs creates a {{c2::negative}} intrapleural pressure.
Published	12/13/2023	The transpulmonary pressure = {{c1::alveolar}} pressure - {{c1::intrapleural}} pressure
Published	12/13/2023	At rest, the transpulmonary pressure is {{c1::+5}} cm H2O.
Published	12/13/2023	Dependent alveoli have {{c1::lower::lower/higher}} transpulmonary pressures and are {{c2::more::less/more}} compliant.
Published	12/13/2023	Apical alveoli have {{c1::higher::lower/higher}} transpulmonary pressures and are {{c2::less::less/more}} compliant.
Published	12/13/2023	At the base of the lung, pleural pressure is {{c2::less::more/less}} negative, so the transpulmonary pressure is {{c1::smaller::bigger/smaller}}.
Published	12/13/2023	A normal P50 for the oxygen-Hgb dissociation curve is {{c1::26.6}} mmHg.
Published	12/13/2023	Fetal hemoglobin shifts the O2-Hgb dissociation curve to the {{c1::left}}.
Published	12/13/2023	Volatile anesthetics cause the O2-hemoglobin dissociation curve to shift to the {{c2::right}}
Published	12/13/2023	Peripheral chemoreceptor activity is {{c1::depressed}} by general anesthesia.
Published	12/13/2023	Aspiration pneumonitis causes destruction of the {{c1::lung parenchyma}}, which can lead to the formation of {{c2::pulmonary edema}}.
Published	12/13/2023	The first sign of aspiration is {{c1::hypoxemia}}.
Published	12/13/2023	{{c1::IV lidocaine (1.5 mg/kg)::drug + dose}} can be used as treatment for aspiration pneumonitis because it impairs {{c2::neutrophil aggregation}}.&n…
Published	12/13/2023	How do you calculate Reynold's number?{{c1::}}
Published	12/13/2023	Chemoreceptors in the medulla will gradually compensate for changes in PaCO2 over {{c1::24}}-{{c1::48}} hours.
Published	12/13/2023	The additional volume that can be inspired above tidal volume is the {{c1::inspiratory reserve volume}}
Published	12/13/2023	The additional volume that can be expired below tidal volume is the {{c1::expiratory reserve volume}}
Published	12/13/2023	The volume that remains in the lungs after maximal forced expiration is the {{c1::residual volume}}
Published	12/13/2023	What is the Bohr equation?{{c1::}}
Published	12/13/2023	The equal pressure point is found at the level of the {{c1::bronchioles}}, because no cartilage exists for support.
Published	12/13/2023	Gas exchange can only occur across {{c1::flat}} epithelium.
Published	12/13/2023	The equation to calculate alveolar ventilation based on PaCO2 is:{{c1::Alveolar ventilation = CO2 production / PaCO2}}
Published	12/13/2023	{{c1::Bicarbonate}} equilibration between the blood and the CSF occurs {{c2::slowly}}.
Published	12/13/2023	The Hering-Breuer inflation reflex occurs around {{c1::1500}} mL due to activation of {{c2::stretch}} receptors.
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