Pathophysiology 1 Exam 3

1. What are the structures of the upper airway?

Nasopharynx, oropharynx, laryngopharynx.

2. What are the structures of the lower airway?

Larynx, trachea, bronchi, bronchioles, alveoli.

3. What does the nasal cavity function in?

Conducts gases to and from the lungs; filters, warms, and humidifies the air; heat exchange system.

4. What is ciliary function impaired by?

Smoking, alcohol, hypothermia, hyperthermia, cold air, low humidity, starvation, anesthetic, corticosteroids, noxious gases, the common cold, increase mucus production.

5. Where is the eustachian tube located?

Tube between the middle ear and the posterior nasopharynx.

6. True or False: Gas exchange occurs in the conducting airways.

False, no gas exchange occurs in the conducting airways.

7. What are the conducting airways?

Trachea, bronchi, and bronchioles.

8. What do the conducting airways help assist in?

The passage of gases to the alveoli where gas exchange occurs.

9. Alveolar macrophages do what?

Phagocytize foreign particles.

10. True or False: Type II alveolar cells produce surfactant.

True.

11. What are the partial pressures of gases in alveoli?

PAO2 for oxygen and PACO2 for carbon dioxide.

12. What are the partial pressures of gases in the blood?

PaO2 and PaCO2.

13. Blood supply to the lungs comes from where?

Bronchial arteries and pulmonary arteries.

14. What is the function of the bronchial arteries?

Supply small amount of oxygenated blood to pleura and lung tissues.

15. What is the function of the pulmonary arteries?

Provide a vast network of capillaries that allow for gas exchange.

16. What happens once blood leaves the right ventricle?

Blood from the right ventricle goes to the pulmonary arteries (unoxygenated) and then to pulmonary arterioles to the capillary membrane for gas exchange.

17. True or False: The respiratory system in children is significantly different from that of adults which makes children more susceptible to obstruction, aspiration and infection.

True.

18. True or False: Vital capacity is the volume of gas that can be exhaled during maximal expiration.

True.

19. What does surfactant function in?

Decreases surface tension, allowing the alveoli to open easily with each breath.

20. What happens during inspiration?

The chest wall muscles contract, elevating the ribs as the diaphragm moves downward creating a negative intrapleural pressure.

21. What happens during expiration?

Lung deflates passively because of elastic recoil and relaxation of the diaphragm.

22. Airway resistance is provided from?

Radius of airways, elastic fibers, surface tension in the alveoli.

23. True or False: Chemoreceptors respond to changes in arterial CO2 and pH.

True.

24. Normal perfusion, but low alveolar ventilation causes?

Collapsed lung, pneumonia, ARDS.

25. True or False: Thickening of the alveolar-capillary membrane cannot cause impaired diffusion.

False, it can.

26. Hypoxemia is defined as?

Deficient blood oxygen as measured by low arterial O2 and low hemoglobin saturation.

27. Hypoxia is defined as?

A decrease in tissue oxygenation.

28. Acute Respiratory Failure (ARF) results in?

State of disturbed gas exchange results in: low PaO2, high PaCO2 greater than 50 mmHg, pH less than 7.30.

29. What are the three mechanisms of secondary pulmonary HTN?

Increased pulmonary blood flow, increased resistance to blood flow (usually due to hypoxic vasoconstriction), increased left atrial pressures.

30. What is one way to diagnose pulmonary hypertension?

ECG (there are more!).

31. Describe a pulmonary embolism?

An undissolved detached material (blood clot, fat emboli, amniotic fluid, air, tumor, foreign bodies, septic, parasites) that occludes blood vessels.

32. What are the 3 factors that Virchow said cause thrombus formation?

Venous stasis/sluggish blood flow, hypercoagulability, damage to the venous wall (intimal injury).

33. What are the four major types of pulmonary malignancies?

Large cell carcinoma, small cell carcinoma, squamous cell carcinoma, adenocarcinoma.

34. True or False: Obstructive lung diseases are manifested by increased resistance to airflow.

True.

35. What is asthma characterized by?

Airway obstruction that is reversible (not completely in all patients), airway inflammation, increased airway responsiveness to a variety of stimuli.

36. What are the two types of asthma?

Intrinsic (non-allergic), extrinsic (allergic).

37. Which immunoglobulin mediates extrinsic asthma most commonly?

IgE.

38. What are some inflammatory mediators?

Histamine, leukotrienes (anaphylactic), cytokines (released by T cells).

39. What is the pathogenesis of asthma?

Normal respiratory epithelium replaced by goblet (mucus-producing) cells resulting in mucosal edema, inflammatory exudates, hyperresponsiveness of the airway.

40. What is acute bronchitis?

Acute inflammation of the trachea and bronchi.

41. What is the distinct hallmark of acute bronchitis?

Recent onset of cough.

42. True or False: Inhaled short-acting B2 agonists is given to cause bronchodilation for patients with chronic bronchitis.

True.

43. What is the etiology of emphysema?

Destructive changes of the alveolar walls without fibrosis, abnormal enlargement of the distal air sacs, and the damage is irreversible.

44. True or False: Radial traction is normally used to hold the airway open.

True.

45. Bronchiectasis is defined as?

Obstruction of bronchi due to inflammation, infection, and dilation of the bronchial wall of medium-sized bronchi and bronchioles.

46. Bronchiolitis is defined as?

Widespread inflammation of bronchioles as a result of infectious agents.

47. The etiology of croup syndrome is from?

A number of acute, viral inflammatory diseases of the larynx, trachea, and bronchi.

48. What do restrictive pulmonary diseases result from?

Decreased lung expansion.

49. What is interstitial lung disease characterized by?

Thickening of alveolar interstitium.

50. Persistent alveolitis leads to?

Obliteration of alveolar capillaries, reorganization of lung parenchyma, irreversible fibrosis.

51. In interstitial pulmonary fibrosis, lung tissue becomes infiltrated by?

Lymphocytes, macrophages, and plasma B cells.

52. Sarcoidosis is defined as?

A restrictive disorder associated with abnormal protein deposits in the lung.

53. True or False: In hypersensitivity pneumonitis, antibodies are produced in response to inhaled particles.

True.

54. True or False: Occupational lung disease results from chronic inhalation of gases and inert particles.

True.

55. What is pneumoconiosis made up of?

Coal, silica, asbestos.

56. Acute Respiratory Distress syndrome, is a consequence of?

Widespread pulmonary inflammation damaging the alveolar-capillary membrane leading to 3 major pathophysiologic processes.

57. What is a pulmonary edema shown as on a chest radiograph?

Evident as diffuse 'whiteout'.

58. Infant Respiratory Stress Syndrome (IRDS) occurs most commonly in?

Premature infants born before development of surfactant-producing cells (less than 32 weeks of gestation).

59. True or False: Accumulation of air in the pleural space is called pneumothorax and can’t resist lung expansion.

False, it can restrict lung expansion.

60. Which type of pneumonia produces exudate?

Bacterial.

61. What is the manifestation of bacterial pneumonia?

Includes fever, chills, cough, and purulent sputum.

62. What causes respiratory syndrome?

COVID-19 coronavirus.

63. What causes Pulmonary Tuberculosis?

Mycobacterium tuberculosis.

64. True or False: Ankylosing spondylitis is a nonprogressive inflammatory disease.

False, it is progressive and leads to immobility of vertebral joints and fixation of the ribs.

65. Where does body fluid flow in?

In arteries, veins, and lymph vessels.

66. What are the locations of extracellular fluid?

Interstitial (between cells), vascular (blood vessels), in dense connective tissue and bone, and transcellular fluid (synovial, cerebrospinal, and GI fluids).

67. How would you describe the roles of fluid homeostasis?

Fluid intake, fluid absorption, fluid distribution, and fluid excretion.

68. Thirst is triggered by?

Increased concentration of extracellular fluid, decreased circulating blood volume, dryness of the mucous membrane.

69. By which pressures force the fluid from the vascular compartment to go in between the cells?

Capillary hydrostatic pressure (outward pushing vascular fluid against vessel wall) and interstitial fluid colloid osmotic pressure (inward-pulling force of the particles in the interstitial fluid).

70. True or False: Capillary forces move fluid from the interstitial compartment into capillaries.

True.

71. True or False: Water moves in and out of the cells by passive diffusion.

False, water moves in and out of the cell by osmosis.

72. Does water move to the lower osmolarity?

No, moves to higher.

73. What are the two components that indicate body fluid balance?

Urine volume and concentration.

74. ADH causes the kidney to?

Retain water (not salt).

75. What are the two major categories of fluid imbalances?

Saline imbalances (imbalance of amount of ECF) and water imbalance (imbalance concentration of ECF).

76. EC volume deficit presents itself as?

Fluid loss from vascular and interstitial areas can result in sudden weight loss, BP decrease with a concurrent HR increase, flat neck veins, dizziness, etc.

77. What are the causes of EC volume excess?

1) Caused by addition or retention of isotonic saline; 2) Excessive secretion of aldosterone causes kidneys to retain too much saline.

78. True or False: Imbalances are disorders of concentration and not the amount of ECF.

True.

79. What are primary causes that cause hyponatremia?

A gain of relatively more water than salt, and a loss of relatively more salt than water.

80. Do cells shrivel in hypernatremia?

Yes.

81. How would you classify an edema?

Excess fluid in the interstitial compartment.

82. Cells contain higher concentrations of?

Potassium, magnesium, and phosphate ions.

83. Extracellular fluid contains higher concentration of?

Sodium, chloride, calcium, and bicarbonate ions.

84. When is electrolyte absorption beneficial?

Absorption is essential if the electrolyte is to be useful metabolically.

85. Hormones, such as Epinephrine, Insulin, and Parathyroid hormone cause?

Mobilization of electrolyte into the bloodstream.

86. Where does electrolyte excretion?

Occurs through urine, feces, and sweat.

87. Electrolyte deficit imbalance may be caused by what factors?

Decreased intake, decreased absorption, shift into electrolyte pools, increased excretion, and loss through abnormal route.

88. True or False: Potassium is mostly inside the cell.

True.

89. Name the clinical manifestations of hypokalemia?

Altered smooth, skeletal, cardiac muscle function due to changes in the resting membrane potential.

90. True or False: Only free (unbound) ionized calcium is physiologically active.

True.

91. What does hypocalcemia present as?

Decreases the threshold potential causing hyperexcitability of neuromuscular cells.

92. What is the clinical manifestation of hypermagnesemia?

Depression of neuromuscular function related to decreased release of acetylcholine at the neuromuscular junction.

93. Manifestations of calcium imbalance (hypocalcemia and hypercalcemia) are attributed to?

Altered excitability of neuromuscular cells.

94. True or False: Normal cellular metabolism continually releases acids.

True.

95. What does the pH of a fluid reflect?

Its degree of acidity or alkalinity.

96. What type of ions do acids release?

Hydrogen ions (H+).

97. Death can occur if?

pH falls below 6.9 and pH rises above 7.8.

98. What are the three major mechanisms to regulate the acid-base status?

Buffers, respiratory system, and renal system.

99. Bicarbonate ion is an indicator of?

The renal (metabolic) component of the acid-base balance.

100. True or False: Buffers take awhile to defend against any pH changes in all body fluids.

False, buffers are the first line of defense against pH changes in all body fluids.