LarynxTransitional. Control Speech, prevent Aspiration.
Single Cartilages of LarynxEpiglottis(Attaches to medical surf of Thyroid), Thyroid(ADAM’s Apple) sits cephalad to cricoid and gives Larynx triangular shape. Cricoid is a complete ring and singlet shaped.
Paired Cartilages of LarynxARYTENOIDS – vocal chords attached to vocal process@base, CORNICULATES – posterior wall of larynx on top arytenoids, CUNEIFORMS – anterior and lateral to corniculate
Conducting Airways UPPERNose, Mouth, Pharynx, Larynx
Conducting Airways LOWERTrachea 1, Mainstem 2, Lobar 5, Segmental 18/19, Subsegmental, bronchioles, Terminal bronchioles
Conducting Airways GAS EXCHANGEResp. Bronchioles, Alveolar Ducts, Alveolar Sacs, Alveoli
Airway LandmarksTrachea from C5-T5, cricoid to carina, Carina 21-23cm from lips, 11-13 cm long with 15-20 C shaped carts, 1.5-2.5 wide
A-C MembraneAlveolar epithelium, Alveolar Basement Membrane, Interstitium, Cap Base Membrane, Cap ENDOTHELIUM
Lobes and Segments RIGHTUPPER 3 – apical, posterior, anterior MIDDLE 2- Lateral and medial and LOWER 5 – Superior, Med. Basal, ant basal, lat basal, post basal
Lobes and Segments LEFTUPPER 4 – apical-post, anterior, Superior Lingular, Inferior Lingular. LOWER 4 – Superior, ant. medial, Lat medial, post medial
Passive Inspiration MusclesDiaphragm via Phrenic Nerve, External Intercostals
Accessory Muscles INSPIRATIONScalenes, sternocleidomastoid, Pectoralis major, trapezius
Accessory Muscles EXPIRATIONRectus AB, Transverse AB, External Oblique, Internal Oblique, Internal Intercostals
Normal Compliance Value0.2L/cmH2O
Normal Specific Compliance Value0.080
Normal Elastance Value5 cmH2O/L. Low indicates disease as emphysema
Low Compliance DiseasesPA, PE, Pulm Fib, Atelectasis
P-V curve HorizontalHorrible Compliance as in PA, PE, atelectasis, Pulm Fibrosis(Silicosis)…Little V for lots of P
P-V curve VerticalCompliance goes up like Emphysema…Lots of V for little P
Normal Airway Resistance (Raw) Value1-2 cmH2O/L/S High values indicate disease like ASTHMA, CHRONIC BRONCHITIS
Normal Conductance (Gaw) Value0.5-1.5 L/Sec/cmH2O LOW values indicate disease like ASTHMA, CHRONIC BRONCHITIS
Airway Resistance FactorsBronchospasm, Secretions, Mucosal Edema, Low Elastance, Artificial Airways
Poiseuille’s LAW – Laminar FlowPr to the 4th power P=pressure, r=radius…16 fold jump in P as r decreases 50%. Radius is biggest factors affecting FLOW
Reynold’s Number – Turbulence2rvd/n, r=radius, v=velocity, d=density, n=viscosity. >2000=turbulent flow.
Normal Time Constant Value (Kt)time for lung to empty 65% Vt.2 sec. Kt= compliance x Raw
SHORT Time Constant.1 = PA, IRDS, ARDS, Pulm Edema
Normal STROKE Volume60-130
STROKE VCO/HR, increase HR = decrease SV, increase SVR/PVR= decreased SV(BAD), Increase Ventrical Preload or Venous return = increase SV
Coronary CirculationOriginates at AORTIC SINUS @ base of aorta, terminates at CORONARY SINUS @ junction of SVC and R atrium
RIGHT Coronary CirculationThink RPM – RIGHT, POSTERIOR DESCENDING (serves R and L ventricles), and MARGINAL R atrium and ventricle
LEFT Coronary CirculationLEFT ANTERIOR DESCENDING (serves R and L Ventricles), CIRCUMFLEX ( L atrium and Vent)
SVR calculation[(MAP-CVP)/CO]x80
Normal SVR800-1500 dynes x sec x cm
Factors to INCREASE SVRVasoconstrictors – Dopamine, Norepi, Epi
Factors to DECREASE SVRVasodilators – Morphine, Nipride, Apresoline, Hyperstat
PVR Calculation[(Mean PAP- PCWP)/CO]x80
Normal PVR120-240 dynesxsec.xcm
Blood Chem of increased PVRACIDIC, Hypercapnic, Hypoxemia, fix w/PEEP CPAP, all due to constriction
Diseases assoc w increaed PVRPulm. Emboli, Emphysema, Interstitial Pulm fibrosis
Drugs to decrease PVRO2, Nitric Oxide, Aminophylline causes Alkalemia
Capillary Fluid BalanceHydrostatic Pressure (B/P) pushes out. Osmotic Pressure(electrolytes, Prteins, glucose, solutes) push in oin cell
Capillary Balance factors in Pulm EdemaIncreased Hydrostatic P(CHF), Decreased Osmotic P(Ca), Increased Cap Membrane Perm(ARDS)
High V/Q diseases >.8Pulmonary Emboli and Circulatory Shock = Deadspace. Responsive Hypoxemia. ABG = ALK, O2 above 100
Low V/Q diseases <.8Atelectasis, PA, Pulmonary Edema = SHUNT/Refractory Hypoxemia ABG = ACID, O2 – under 100
Fick’s LawDiffusion over A-C Membrane, directly proportional to SA, Press Gradient, and Diffusion Coefficient…INDIRECTLY to THICKNESS
OxyHb curve p50Normal 27
Decreased p50 LEFTLEFT=LOAD O2 is Easy in Lung and harder to unload in tissues
Increased p50 RIGHTRIGHT=RELEASE O2 in tissues but loading in Lung id harder
LEFT shift factorsLEFT-L-aLkalemia, decreased CO2, decreased 2,3,DPG, Hypothermia
RIGHT shift factorsACIDEMIA, increased CO2, Increased 2,3,DPG, HYPERTHERMIA/FEVER, since O2 is RELEASE in tissues, that’s why Fever is hot to touch
Total O2 delivery calculationCO x (CaO2x10) Normal is 5 x (20×10)=1000ml…if given dl, multiply by 10
O2 ConsumptionCO x [C(a-v)O2x10], normal = 250ml.min
Increased O2 consumption…common senseFEVER, Exercise, Seizures, Shivering all >250
Decreased O2 consumptionPeripheral shunting, bllod not reaching limbs, Cyanide poisoning-block mitochondria from processing O2, Hypothermia-MET rate goes down, ,250
Normal a-v gap20-15 = 5ml/min
Factors increased a-v gapExercise, Shivering, Fever, DECREASED CO, tissues are asking for more
Decreased a-v gapPeripheral shunting, cyanide poisoning, hypothermia, INCREASED CO
O2 Extraction RatioO2ER = (CaO2-CvO2)/CaO2 NORMAL is (20-15)/20= 25%
Shunt Calc (QS=shunted bl, QT=total bl flow, CCO2=content O2 in Pulm. Cap . Bed)QS/QT = (CCO2-CaO2)/(CCO2-CvO2)
Severity of shunt<10%=NORMAL, 10-20%=MILD, 20-30%=MODERATE, >30%= SEVERE
Control Centers for Ventilation – Cerebral CortexConscious Control like singing and speech
Control Center Vent. – DRG, VRGDRG maintain norm breathing, VRG when exercise
Control Center Vent – Apneustic CenterGASP, boosts INP effort, located in caudal PONS
Control Center Vent. – Pneumotaxic CenterPANTING, increase rate and decrease Vt, located in cePhaled PONS
Peripheral ChemoreceptorsLocated at Aortic Arch(VAGUS) and Carotid Sinus(glossopharyngeal), PaO2 <60 and LOW pH makes them go crazy
LOWEST Minute Ventilation (Ve)LOW CO2, HIGH PO2, HIGH pH
HIGHEST Minute Ventilation (Ve)HIGH CO2, LOW PO2, LOW pH
Vagal Reflexes 3Pulmonary Stretch Receptors, Irritant, and “J”
Pulmonary Stretch Receptorsin Smooth Muscle of Conducting Airway, respond to Increased Lung V, Decreased intrapleural P…Inhibit INSP, BROCHODILATE, INCREASED HR
Irritant ReceptorsBetween epithelial cells of large conducting airway. Respond to smoke, dust, chlorine, ammonia or froeign bodies. COUGH, HYPERNEA, BRONCOCONSTRICTION, EXP GRUNT
“J” Receptorsin Pulmonary interstitum, respond to interstital edema and pulmonary emboli. HYPONEA, TACHYPNEA, EXP GRUNT
Fetal shunts 3Ductus Venosus, Foramen Ovale, Ductus Arteriosis
Ductus VenosusUmbilical chord with IVC
Foramen OvaleFetal Atria ( R and L atrium) one way valve
Ductus ArteriosisPulmonry Artery with Descending Aorta
Effect of Exercise PulmonaryIncreases Ve, increases diffusion capacity x 3, increases alveolar Ventilation(up to 65% of Max breathing Cap)
Effect of Exercise CardioIncreased O2 consumption, Increase Extraction Ratio, Decreased SvO2, Increased a-v gap,
Normal Work of Breathing0.5 joules/L
Increased WOBINC Raw, LOW Gaw, LOW Compliance, LOW elastance
O2 costis the total O2 consumption of RESP muscles = less than 5%(12ml/min out of 250)
O2 cost increases withINC Raw, Decrease Gaw, Decrease Compliance, Decrease Elastance…Emphysema >120 ml/min
Tubular StructuresGlomerulus, Bowman’s Cap, Proximal Tubule, Loop of Henle, Distal Tubule, Collecting Duct
Monitor Renal FunctionCreatinine is best indicatorn 16mg/min
ADHsecreted by POST Pituitary Gland, infuenced by Serum Osmolarity, increased Osmolarity triggers ADH= decreased urine ourput=Water Retention
Plasma CationsNa -140, K-5, Ca-5
Plasma AnionsCl-105, HCO3-24
AldosteroneAdrenal hormone, releases in response to Hyponatremia, HyperKalemia, Hypovolemia, Decreaed CO…increases Na reabsorbtion and K secretion
What is differential count used for?Used to differentiate the category of infection; bacterial, viral, or parasitic
Your patient has a HR of 80 a RR 22 CO 5L and a blood pressure of 120/80′ what is his stroke volume?CO=SVxHR ; 5L = SVx80= 0.06L=60ml
Is the stroke volume of 60ml a normal stroke volume?Yes because a normal stroke volume is between 40-80mL
List 3 conditions that would lead to a decreased v/q ratio?Pulmonary shunting, decrease in ventilation, increase in perfusion! Obstructive lung disorders (emphysema, bronchitis, asthma)
Normal V/Q ratio is0.8
2 variables that affect the partial pressure of alveolar O2FiO2, PB, PaCO2
Explain diffusion limited gas flowAmnt of blood flow or the amnt of ventilation in the alveoli; something preventing oxygen from coming across
Define diastolic pressureBlood pressure in arteries prior to contraction
Define preloadAmnt of stretch prior to contraction
Passive mechanisms affecting vascular resistance?Blood volume, blood viscosity, lung volume, pul. Arterial press. Pg218
How long is the adult trachea?11-13 cm
Name four factors that are known to slow the rate of the mucocillary transportSmoking, dehydration, hypoxemia, general anasthetics
Describe the role of the gel layer in the mucous blanketTrap foreign particles
What bony structure on the X-ray could he use to help him identify wheather the abnormality is within the apex of the lung or above the lungThe first rib
Name the airways in which gas exchange takes placeAlveolar ducts, alveolar sacs, resp. Bronchioles,
Where is the carina locatedBifurnication (split) of the trachea
Define tidal volumeThe volume of air that normally moves into and out of the lungs in one quiet breath
What is the function of Clara cellsNot known
Normally an individuals tidal volume is about3-4 ml/pound
Which of the following forms the nasal septum?Ethmoid bone and vomer bone
Which of the following prevents the aspiration of food and liquids?Epiglottis
The canals of lambert are found inTerminal bronchials
The eustachian tubes are found in theNasopharynx
When shunted non deoxygenated blood mixes with reoxygenated blood distal to the alveoli (venous admixture) thePO2 of nonreoxygenated blood increases and the CaO2 of reoxygenated blood decreases
The lowest acceptable PaO2 for a 70 year old man is70 mmHg
In which of the following types of hypoxia is the oxygen pressure of the arterial blood normal?Anemic hypoxia, circulatory hypoxia, and histotoxic hypoxia
Assuming that everything else remains the same, when the individual’s cardiac output decreases theC(a-v)O2 increases and SvO2 decreases
The advantage of the polycythemia begin to offset by the increase in blood viscosity when the hematocrit reaches about55-60%
All of the following are characteristics of HbS ( sickle cell) exceptHbS has an increased oxygen carrying capacity
What level of shunt if considered to be life threatening for a patient who is cardiovascular compromised?Greater than 20%
Metabolic alkalosis can develop fromHypo kalmia and hypochloremia
Which he,oglobin has the greatest O2 carrot capacity?Hb F fetal hemoglobin
When does the chloride shift occurs?As excess HCO3 leaves the cell
Of the following HCO3 to H2C03 ratios reps18:1 and 12:1
During acut alveolar hyperventilation the bloodH2Co3 decreases
Which statement is not a characteristic of polycythemiaIt will decrease oxygen content
Which fthe following is believed to be responsible fr the basic rhythms of ventilationDorsal respiratory group
Which of the following are components f the pons?Pneumotaxic center and apneustic center
Stroke volume indexSVI=SV/BSA =mL/beat/m^2
What is the normal range for central venous pressure?0-8 mmHg
Value for right atrial pressure?0-8 mmHg
Normal range mean pulmonary artery pressure?9-18 mmHg
Normal range for pulmonary capillary wedge pressure?4-12 mmHg
Normal range for cardiac output?4-8 L/min
Normal range for stroke volume!60-130 mL
Normal range if cardiac index?2.5-4.2 L/min/m^2
Normal range for Stroke volume index?30-65 mL/beat/m^2
Normal range for pulmonary vascular resistance?20-120 dynes*sec*cm^-5
Normal range for systemic vascular resistance?800-1500 dynes* sec*cm^-5
Normal range for right ventricular stroke work index?7-12 g m/m^2
As an individual grows older what happens to his lung volumes?TLC stays the same; RV increases; ERV decreases;FRC increases; IC decreases; VC decreases; RV/TLC ratio increases;
Functional Residual Capacity(FRC) is the volume of air present in the lungs, specifically the parenchyma tissues, at the end of passive expiration. FRC=RV+ERV
At what age of growth and development of the lungs complete?20 years
As an individual grows older what happens to their forced flows?Decrease 20-30% of throughout avg adult life
At what age do lung function indices reach their maximum levelsbetween 20-25 years of age and then progressively decline
What happens to lung compliance with advancing age?The elastic recoil of the lungs decrease causing lung compliance to increase. the decrease in lung elasticiity develops bc the alveoli progressively deteriorate and enlarge after the age 30.
What happens to chest wall compliance with advancing age?with aging costal cartilage progressively calcify causing the ribs to slant downward. This causes the thorax to become less compliant
How do you estimate maximum heart rate?220-age
How much does diffusion capacity decrease with age?falls about 20% over an adult life
How much does cardiac output decrease with age?after age 20 it decreases about 1% per year. Between 30-80 cardiac output decreases about 40% in both men and women
What happens to blood pressure with increasing age?increase
What happens to stroke volume with increasing age?diminishes with age
What happens to cardiac output with increasing age?declines
What happens to heart work with increasing age?decreases approx 1% per year
What effect does aging have on acceptable PaO2?after age 45 the PaO2 declines. The minimum low of PaO2 should be greater than 75 mmHg no matter the age
What is the anaerobic threshold?the point at which anaerobic metabolism develops
How is increased alveolar ventilation during exercise mainly produced?Increase depth of ventilation (Vt) rather than increase rate of ventilation
What are the first 2 breathing stages during exercise?First Stage: increase in alveolar ventilation within seconds after onset of exercise. Second stage: slow gradual and further increase in alveolar ventilation during the first 3 mins. Alveolar Ventilation increases linearly with the amount of work.
What is the last breathing stage during exercise?Third stage: stabilizes
What changes do you see in arterial blood gases during exercise?during heaving exercise when lactic acidosis is present both pH and PaCO2 decline and PaO2 is constant
What happens to oxygen diffusion capacity during exercise?oxygen diffusion capacity increases linearly to increase oxygen consumption (VO2)
How do you calc maximum heart rate?220-age
How is increased stroke volume accomplished during exercise?Vasodilation in the working muscles increases venous return to the heart and then pumps more oxygenated blood to the working muscles
What percentage of muscle capillaries are dilated at rest?20-25%
What percentage of muscle capillaries are dilated during heavy exercise?all capillaries dilate to facilitate the distributions of blood.
What happens to overall peripheral vascular resistance during exercise?decreases
What is the limiting factor on maximal exercise and why?cardiovascular system; because there is more backup in the respiratory system
What are the symptoms of heat stroke?sweating, weakness, exhaustion,muscle cramping, circulatory collapse
How do you treat heat stroke?Spraying cool water on victims body; continually sponging victum with cool water; blowing air over the body with a strong fan or a combo of all 3
What is the Cardiopulmonary rehabilitation?a program to achieve and maintain the patient’s max level of independence and functioning in the community
What are the steps of cardio rehab?Phase 1: pretesting with a variety of test and patient is evaluated Phase 2: Patient and family education,exercises, and condition of cardiovascular system,graded Phase 3:follow up, care and long term maintenance
What would you expect the arterial blood gas of a patient with decreased renal function to look like and why?cause a metabolic alkalosis partly or fully compensated and loose the ability to hold on to the hydrogen ions
The renal system is used to regulate the concentration of which electrolytes?sodium, potassium, calcium, magnesium, phosphate
How is sodium ion concentration regulated?when amount of sodium increases the H2O levels increase by kidney. 1.secretion of ADH causes water retention 2.stimulation of thirst
List symptoms of decreased potassium ion concentrationmuscle weakness, metabolic alkalosis,diarrhea,tachycardia develop
Symptoms of increased potassium concentration?muscle weakness, metabolic acidosis, life-threatening arrythmias
The natural tendency is for thechest wall to move outward and the lungs to recoil inward
what is the normal tidal volume?7-9 ml/kg IDEAL body weight
which of the following is NOT an effect of stimulation of the parasympathetic nervous system?widening of the pupils
the cavity that contains organs and tissues in the center of the thoracic cage between the right and left lungs is known as themediastinum
closing of the larynx during exhalation is calledValsava’s maneuver
the absence of breathing is calledapnea
which of the following causes inspiration to seize at very high lung volumes?Hering-Bruer Inflation Reflex
A decreased systemic blood pressure causes the aortic and carotid sinus baroreceptors initiate reflexes that cause aincreased heart rate and increased ventilatory rate
Which of the following is in normal range for the central venous pressure?0-8 mmHg
The left stem bronchi angles off from the carina at what degree?40-60 degrees
The concha or turbinates are found in the?nose
the average lung compliance in a healthy adult at rest is?0.1 L/cm H2O
Which of the following are released when the parasympathetic nerve fibers are stimulated?Acetycholine
Which of the following are released when the sympathetic nerve fibers are stimulated?norepinephrine and epinephrine
The horizontal fissure separates the?the middle and upper lobes of the right lung
Cartilage is found in the following structures of the tracheobrochial tree?segmental bronchi
What condition is characterized by air in the pleural cavity?pneumothorax
when the lung compliance decreases the patient commonly hasdecreased tidal volume and increase ventilatory rate
Which of the following hemodynamic values are directly obtained by means of the pulmonary artery catheterCVP, RAP, PA,PCWP, CO
Which of the following do not contain cartlidge?Terminal Bronchiles & alveolar ducts
The process that exhanges gases between the external enviornment and the alveoli is ?Ventilation
The normal healthy adult produces how much mucus each day?100cc
Which of the following are causes of pulmonary surfactant deficiency?Pneumonia, ARDS, IRDS, Acidosis
Under normal circumstances in the healthy adult how much oxygen is consumed by the tissues in a minute and how much carbon dioxide is produced?O2= 250ml Co2=200ml
The PAO2 is determined by the balance between what 2 factors?The amount of oxygen entering the alveoli and the amount diffused across the capillaries
Which of the following gas laws states that in a mixture of gases the total pressure is equal to the sum of the partial pressure of each gas?Daltons Law
Two pulmonary disorders that increase V/Q ratio?Emphysema, pulmonary emboli
Which of the following states that the rate of gas diffusion is inversely proportional to the weight of the gas?Grahams Law
According to Frick’s Law gas diffusion is?directly proportional to the difference in partial pressure of the gas between two sides
What happens to systemic vascular resistance in response to increased blood volume?increased systemic vascular resistance
Two pharmacological agents that relax the pulmonary vessels?Oxygen & Calcium
If unrestrained which of the following causes a prolonged inspiration?Apneustic Center
Which of the following cause the central chemoreceptors to transmit signals to the respiratory components in the medulla?H+ (hydrogen)
When the blood PH decreases the oxygen dissociation curve shifts to?The right and P50increases
The tricupsid valve is located in the ?between the right atrium & right ventricle
What cartlidge is commonly called the adams apple?Thyroid cartlidge
Where is the majority of mucuos that forms the mucous blanket produced?submucosal glands
Which cartilaginous structure in the larynx covers the traches during swallowing?epligottis
Which of the following is not a major accessory muscles of inspiration?rectus abdominis muscles
Which of the following will readily diffuse across the blood brain barrier?CO2
Which of the following will cause a temporary cessation in breathing?sudden pain & sudden cold
An alveolus is ventilated but not profused with pulmonary blood this is the definition of?Alveolar dead space
The peripheral chemoreceptors are significantly activated when the PO2 decreases to about?60mmhg
When a patient is in-tubed the tip of the endotracheal tube should be located where?2cm ABOVE the carina
Beyond what point does air in the tracheal bronchial tree stop moving by flow and begin moving by molecular movement?terminal bronchiales
Stimulation of the peripheral chemoreceptors can cause which of the following?tachycardia, increased pulmonary vascular resistance, systemic arterial hypertension
What is the average surface area for gas exchange in an adult male lung?70square meters
The bony structures that make up the thorax include?ribs, sternum, manubrium sterni, thoracic vertebrae, xiphoid process
During relaxation the diaphragm ?becomes more curved and moves upward
How many pair of true ribs are there?7 true ribs
What is the major muscle of inspiration?diaphragm
Over the past two days your patients lung compliance has increased would you expect the lungs to accept a greater volume or lesser volume of gas per unit of pressure change?greater
What is the normal pressure in the left and right atrium?left=5mmhg right=2mmhg
How do you calculate Mean Arterial Pressure?MAP= SBP+2(DBP)/3 =mmhg
How is vascular resistance calculated?MAP/CO
What is the average partial pressure of oxygen in the pulmonary artery?40mmhg
When projected to a high alt for a prolonged period of time, an individual ‘sAlveolar ventilation increases, cardiac output decreases
When subjected to a high alt for a prolonged period of time, an individuals’spH becomes alkalotic
The best treatment for high alt pulmonary edemaRapid decent
At 99 feet below the water surface the pressure is4 atmospheres
Breathing a 100% o2 changes the carboxyhemoglobin half life to less than1 hour
Which of the following increases an individual’s cardiac outputEpinephrine, hyperthermia, dopamine,digitalis, dobutamine, isoproterenol,amrinome, septic shock,hyervolemia, decreased vascular resistance
An individuals systemic vascular resistance increases in response toEpinepherine,hypovolemia, dopamine, norepinephrine, phenylephrine, septic shock (late stages), decrease PCO2
The barometric pressure is about half the sea level value at an altitude of18000-19000 ft
The oxygen-diffusion capacity of high altitude natives is about20-25% greater than predicted
The oxygen diffusion capacity of high altitude natives as compared to low landers isHigher
Acute mountain sicknesses characterized byInsomnia,headache, dizziness,
You calc a heathy patients v/q ratio of 0.65 which zone where the measurements most likely taken?Zone 3
Percentage of red blood cell in relation to the total blood isHematocrit
Define intravascular pressureThe actual blood pressure in the lumen of any vessel at any point
Individual has a stroke volume of 50 mL and a heart rate of 90 beats per min, what it the cardiac output?50×90=4500 mL= 4.5 L/min
Equation for cardiac output?Stroke volume X heart rate= L/min
Define dead space ventilation?Venilation is taking place, but no gas exchange. NO Perfusion
Define shunted bloodBlood flow without ventilation; perfusion but no ventilation
If two gases had the same gram molecular weight gas A and gas B, gas A has a solubility coefficient of 48 and gas B has a solubility coefficient of 41, which gas would diffuse faster?Gas A ( higher solubility coefficient )
At sea level, the normal percent of nitrogen is?78%
What is the average partial pressure of oxygen in the aorta?100 mmHg
At sea level, the alveolar H20 is normally about?47 mmHg
Which of the following occur when the barorectors sense an increase in the arterial pressure?Venous dilation
How much faster does CO2 diffuse than O2?20 timesw
The difference between pressure in the lumen of a vessel and the pressure surrounding the vessel?Transmural pressure
The mitral valve lies between?Left atrium and left ventricle
When a patient is lying on his left side where is zone one?The portion of the lung closest to the right arm
In which zone of the lung does the alveolar pressure exceed that of the pulmonary artery pressure and these both exceed the Venus pressureZone 2
Which of the following cause blood clotting at a trauma cite?Thrombocytes
Drugs that will increase or decrease the force of myocardial contractions are referred to asInotropes
Compare to pulmonary circulation the pressure in the systemic is about?10 times the pressure
The force the ventricles must work against to pump blood is calledVentricular after load
An increase in the following is commonly seen in asthmatic patients?Eosinophils
In response to an increased alveolar oxygen pressure the pulmonary vascular systemRelaxes
In response to a decreased pc02 level, the pulmonary systemRelaxes
Under normal resting conditions the diffusion of CO2 and O2 is usually completed in about0.25 seconds
The normal transit time for blood through the alveolar capillary system is about how long0.75 seconds
Why will a penetrating chest would kill a buffalo quicker than it will kill a human being?a buffalo has a single plural lining so both lungs will collapse
Mixing of venous blood with arterial blood (a right to left shunt ) occurs normally because ofThebesian venous drainage
Which of the following mechanisms facilitate venous return to the heart?-skeletal muscle pumping-cardiac suction-sympathetic venous tone
the myocardium is the loose membranous sac that encloses the heart? T or FFalse muscular tissue of the heart
Parietal PericardiumLoose membranous sac that encloses the heart
The semilunar (pulmonary and aortic) valves separate the ventricles from their arterial outflow tracts. T or FTrue
Normal anatomic shunts account for approximately 2-3% of the total cardiac output. T or FTrue
Secondary Spontaneous Pneumothorax is one that occurs in a patient with underlying lung disease and results in a mortality of 43% in 5 years. T or FTrue
BOOP is an interstitial lung disease with the name of bronchiolitis obliterans with organizing pneumonia which can result in a secondary pneumothorax. T or FTrue
Most of the muscle mass of the heart is located in which chamber?Left ventricle (LV)
What is the ability of the myocardial tissue to propagate electrical impulses?automaticity
What are the first arteries to branch off the ascending aortacoronary
Which vessels in the body act like a faucet, controlling the flow of blood into the capillary beds?arterioles
What factor stimulates the carotid and aortic chemoreceptors?high carbon dioxide levels
What in essence is Frank-Starling’s Law of the Heart?the greater the stretch, the greater the tension it generates when contracted
Which portion of the nervous system is mainly responsible for the central control of the blood flow?sympathetic nervous system
The mitral (bicuspid) valve does which of the following?seprates the left atrium and the left ventricle
Which of the following formulas is used to calculate the total amount of blood pumped by the heart per minute or cardiac output?HR x SV
The second heart sound is associated with what mechanical event of the cardiac cycle?Semilunar valve closure
Opening of the semilunar valves occur when which of the following occurs?the pressures in the ventricles exceed those in the aorta and pulmonary arteries
Which of the following equations best protrays the factors determining mean arterial blood pressure?MAP = CO X SVR
Why are the vessels of the venous system, particularly the small venules and veins, termed the capacitance vessels?they can alter their capacity to maintain adequate perfusion
Which of the following represents the normal order of structures encountered by blood flowing from the vena cave to the aorta?RA, tricuspid valve, RV, pulmonary valve, pulmonary artery, pulmonary veins, LA, mitral valve, LV, aortic valve
The semilunar (pulmonary and aortic) valves do which of the following?separate the ventricles from their arterial outflow tracts
What are the major effects of peripheral chemoreceptors?vasoconstriction and increased heart rate
The first heart sound is associated with what mechanical even of the cardiac cycle?tricuspid valve closing
What is an appropriate normal resting cardiac output for a healthy adult?5000 mL/min
What method of chest tube removal has been associated with the lowest level of pneumothorax recurrance?Remove the chest tube 48 hours after the air leak resolves
When using a small-bore catheter with a one-way valve such as a Heimlich valve, how can you determine definitvely that there is or is not a small air leak?Connect to an underwater seal
A patient is suspected of having a pleural effusion. Which x-ray position is the most appropriate to confirm diagnosis?Lateral Decubitus chest film
A chest tube placed anteriorly between the second and third ribs. The tube is probably intended to treat a:pneumothorax
Immediately after insertion of a central line via subclavian vein, an intubated patient becomes dyspneic. The respiratory therapist should recommend which of the following diagnostics tests?Chest radiograph
All of the following would be useful in differentiating right main stem intubation from a left-sided pneumothorax except:Lung Compliance measurement
A patient has a heart rate of 70 bpm and a stroke volume of 60 mL with each heart beat. What is the approximate cardiac output in Lpm?4.2 Lpm
parietal pleuraMembrane covering the surface of the chest wall
HemothoraxBlood in the pleural space
Bronchopleural fistualAir leak from the lung to the pleural space
re-expansion Pulmonary EdemaOccurs when the lung is rapidly inflated after compression by plueral fluid
Viseral pleuraMembrane that lines the lung surface
tension pneumothoraxAir under pressure in the pleural space
empyemaPus filled pleural effusion
pleurodesisProcedure that fuses the pleura to prevent pneumothorax
automaticityAbility to initiate a spontaneous electrical pulse
preloadVentricular stretch provided by end -diastolic volume
afterloadForce against which the ventricle pumps
baroreceptorsbiological sensors that monitor arterial blood pressure
pericardiummembranous sac that surrounds the heart