Physio Exam

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  1. What is Daltons Law of Partial Pressures (the equation)?
    Partial Pressure = Total Pressure x Fractional Gas Coefficient
  2. What factors affect the diffusion of gases according to Fick's Law?
    The diffusion of gases is directly proportional to: 1) The driving force 2) A diffusion coefficient 3) Surface area available for diffusion

    The diffusion of gases is inversely proportional to:  1) Thickness of the membrane
  3. What does Lung Diffusion Capacity (DL) take into account? How is it measured?
    DL combines the diffusion coefficient of the gases, the surface area of the membrane, and the thickness of the membrane. It also takes into account the time required for the gas to combine with proteins in the pulmonary capillary blood 

    DL can be measured with carbon monoxide as CO transfer cross the alveolar/pulmonary capillary barrier is limited exclusively by the diffusion process
  4. How does Lung Diffusion Capacity change in response to the following conditions?
    1) Emphysema
    2) Fibrosis or Pulmonary Edema
    3) Anemia
    4) Rigorous Exercise
    • 1) DL Decreases due to destruction of the alveoli resulting in decreased surface area for gas exchange
    • 2) DL decreases because the diffusion distance increases (either by increased membrane thickness or increases interstitial volume)
    • 3) DL decreases because the amount of hemoglobin in RBCs is reduced 
    • 4) DL increases because additional capillaries are perfused with the blood, which increases the surface area for gas exchange
  5. The diffusion rate of O2 and CO2 depend on ______ and _____
    The diffusion rate of O2 and CO2 depend on the partial pressure differences across the membrane and the area available for diffusion 
  6. How is Diffusion-Limited Exchange effected in conditions such as:
    1) Fibrosis
    2) Emphysema
    • 1) The diffusion of O2 is restricted due to thickening of the alveolar membrane increasing the diffusion distance 
    • 2) Diffusion of O2 is decreased due to the surface area available for gas diffusion is decreased
  7. Define: Tidal Volume
    Volume inspired or expired with each normal breath
  8. Define: Inspiratory Reserve Volume (IRV)
    The volume that can be inspired over and above the TV and is used during exercise
  9. Define: Expiratory Reserve Volume
    The volume that can be expired after the expiration of a Tidal Volume
  10. Define: Residual Volume
    The volume that remains in the lungs after a maximal expiration. It cannot be measured by spirometry
  11. Define: Inspiratory Capacity
    The sum of TV and IRV
  12. Define: Functional Residual Capacity
    • The sum of ERV and RV
    • It is the volume remaining in the lungs after a TV is expired
    • It includes the RV, and thus cannot be measured by spirometry
  13. Define: Vital Capacity (or Forced Vital Capacity)
    • The sum of TV, IRV, and ERV
    • It is the volume of air that can be forcible expired after a maximal inspiration
  14. Define: Total Lung Capactiy
    • The sum of all four lung volumes (IRV, TV, ERV, and RV)
    • It is the volume in the lungs after a maximal inspiration
    • As it includes RV, it cannot be measured by spirometry
  15. What is the Forced Expiratory Volume (FEV1)?
    • It is the volume of air that can be expired in the first second of a forced maximal expiration 
    • It is normally 80% if FVC, and expressed as (FEV1/FVC = 0.8)
  16. In obstructive lung disease (such as ______), FEV1 is ____ more than FVC so that FEV1/FVC is _____.
    In obstructive lung disease (such as Asthma), FEV1 is reduced more than FVC so that FEV1/FVC is decreased.
  17. In restrictive lung disease (such as ______), both FEV1 and FVC are _____.
    In restrictive lung disease (such as Fibrosis), both FEV1 and FVC are reduced
  18. When the diaphragm contracts, the abdominal contents are pushed ______ and the ribs are _______, thus causing the volume of the thoracic cavity to ______.
    When the diaphragm contracts, the abdominal contents are pushed downward and the ribs are lifted upward, thus causing the volume of the thoracic cavity to increase.
  19. True or False: The external intercostals and accessory respiratory muscles are often used during normal quiet breathing
    FALSE: Neither groups of muscles are actively participating in Inspiration during normal quiet breathing, they only play a role during exercise or when airway resistance is increased due to disease (e.g., Asthma)
  20. What effect to the Abdominal Muscles and Internal Intercostal Muscles have?
    Abdominal Muscles: Compress the abdominal cavity, push the diaphragm up, and push air out of the lungs

    Internal Intercostals: Pull the ribs down and inward
  21. An FEV1 that is significantly less that 80% of FVC suggests the presence of an ______ disease
    An FEV1 that is significantly less that 80% of FVC suggests the presence of an obstructive pulmonary disease (such as Asthma, where VC is usually normal but expiration is more difficult and takes longer because bronchoconstriction increases the resistance to air flow)
  22. Explain the Surface Tension of Alveoli (what it results from, what it creates, how it relates to Large and Small Alveoli)
    The Surface Tension of Alveoli is the result from attractive forces between molecules of liquid lining the alveoli. This creates a collapsing pressure that is directly proportional to surface tension, and indirectly proportional to Alveolar Radius 

    Pressure to keep Alveoli Open = (SurfaceTension/AlveoliRadius) 

    • Large Alveoli = low collapsing pressure; easy to keep open
    • Small Alveoli = high collapsing pressure; more difficult to keep open
  23. Define: Atelectasis
    The condition characterized by small alveolar collapse in the absence of surfactant to reduce surface tension
  24. Airflow is directly proportional to ______, and inversely proportional to _____.
    Airflow is directly proportional to the pressure difference between the mouth (or nose) and the alveoli, and inversely proportional to airway resistance.

    Airflow = (PressureGradient/AirwayResistance)
  25. Briefly describe Asthma
    1) Condition
    2) Caused by
    3) Symptoms
    4) Treatment
    Condition: Obstructive lung disease where expiration is impaired; Airway occasionally constricts, inflamed, lined with excess mucus

    Caused By: Environmental stimulants or allergens such as cold or warm air, exertion, emotional stress, pollens, etc.. .In children most common trigger is viral illnesses (common cold).

    Symptoms: Wheezing, shortness of breath, chest tightness, coughing 

    Treatment: Bronchodialators; Beta2 Antagonist such as Albuterol
  26. Briefly describe COPD
    1) Condition
    2) Caused by
    3) Symptoms
    4) Treatment
    Condition: Combination of Chronic Bronchitis and Emphysema; An obstructive lung disease where expiration is impaired

    Caused by:

    Symptoms: Decreased FEV1 and FVC, Barrel-shaped chest

    Treatment:
  27. Describe Pink-Puffers and Blue-Bloaters as they relate to COPD
    Pink Puffers: Have primarily emphysema; present with mild hypoexmia, and due to maintained alveolar ventilation have normocapnia (normal CO2 partial pressure)

    Blue Bloaters: Primarily have Bronchitis, severe hypoxemia with Cyanosis (blue-ish discoloration of skin), due to inability to maintain alveolar ventilation will present with Hypercapnia (increased CO2 partial pressure). May lead to Right Ventricular Failure and Systemic Edema
  28. Breifly describe Firbosis
    A restrictive disease in which inspiration is impaired

    Characterized by a decrease in all lung volumes

    FEV1 is actually decreased less than FVC, thus FEV1/FVC may end up increasing or presenting as normal.
  29. How is most CO2 carried in the blood?
    As HCO3-
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Physio Exam
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Physio Exam
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