Test Bank For Integrated Cardiopulmonary Pharmacology 5th Edition By Bruce Colbert, Luis Gonzalez 9781517805067 Chapter 1-15 Complete Guide .2

Unitc2
● Describechowcnormalcinspirationcandcexpirationcoccurs
○ Normalcinspiration
■ Diaphragm
● Maincmusclecofcrespiration
● Ascthecdiaphragmccontracts,citcdecreasescthecintrathoracicc
pressure,cpullingcaircintoctheclungs
■ Intercostals
● Contractctocelevatecribs
○ Normalcexpiration
■ Passivecprocess
● Relaxationcofcthecdiaphragmcandcintercostals
■ Forcedcexpiration
● Abdominalcmuscles
● Explaincthecimportancecofcforcedcexpirationcandcmusclescinvolvedcincperforming
○ Abdominalsccontractcduringcforcedcexpiration
■ Providecanteriorcsupportctocabdomencandcprovidecgoodclengthctensioncr
elationshipcforcdiaphragm
■ Forcecdiaphragmcbackcupwards
■ COPDcpatientscusecabdominalsctocforcecaircout
■ Coughingciscaidedcbycabdominalcmusclescforcacgoodceffectiveccough
○ Intercostalscaidcincforcedcexpiration
● Explaincthecprocesscofcgascexchange,cincludingcthecrolecofcpartialcpressurescandcfactorsca
ffectingcdiffusion
○ Partialcpressure
■ Partialcpressure:cpressurecofceachcgascincacgascmixture
● Thecsumcofcallcpartialcpressuresciscequalctocthectotalcpressurecofct
hecsystem
● Ancincreasecincpartialcpressureciscancincreasecincmovement
■ Partialcpressurecofcacgasciscdependentcon
● Totalcbarometriccpressure
● Fractionalccomponentcofcthatcgas
■ Normativecvalues
● PaO2c=c80-100cmmcHg
● PaCO2c=c40cmmcHg
● PvO2c=c40cmmcHg
● PvCO2c=c46cmmcHg
○ Diffusion
■ ProcesscwherebycO2candcCO2cmovecincandcoutcofcthecalveolicandcc
apillaries
● Qc=cCAD/X
● Qc=cnetcratecofcdiffusion

, ● Cc=cconcentrationcgradientcorcpartialcpressurecgradient
● Ac=csurfacecarea
● Dc=cdiffusionccoefficient
● Xc=cdistancecorcthicknessctocbeccrossed
○ Factorscaffectingcdiffusion
■ Partialcpressurecgradient
■ Sizecofcthecpathway
● Edemacandcfibrosiscmakecdiffusioncharder
■ Surfacecarea
● Numbercofcalveolicthatcarecopenc(ventilation)
● Numbercofccapillariescopencgoingctocthecalveolic(perfusion)
■ Diffusionccapacity
● Amountcofcgascthatcdiffusescpercmlcperc1cmmcHgcdifference
● Thecgreatercthecnumber,ctheceasiercgasescmove
○ Trainingcincreasescthiscnumbercatcrestcwithcexercise
● Explaincthecprocesscofcgasctransport,cincludingcthecfactorscinvolvedcinctransportingc
oxygenctocthectissuescandccarboncdioxidectoctheclungs
○ O2ctransport
■ Dissolvescincblood
● ThecamountcofcO2cdissolvedcincbloodc=cPO2cxcCs
● Linearcfunctioncatcacconstantctemperature
○ Tempcincrease,csolubilitycdecreases
○ Hbctransport
■ Hbciscacproteincwithc4cironcmoleculescattached
■ EachchemeccanccarryconecO2cmolecule
■ Averagecvalues
● Females:c14
● Males:c16
■ ActualcamountcthatcbindsctocHbcdependsconcPPcofcO2cincthecbloodcandcisca
boutc19.6cmlcO2
● Explainchowcthecoxyhemoglobincdissociationccurvecdescribescthecabilitycforcoxygenctoc
bindctochemoglobinx
○ O2csatscneedctocbecatc90-100%cincorderctochavec60-100cPO2
○ Anythingclessciscabnormal
○ IncreasedcO2csatcandcPO2cincreasescthecabilitycofcthecbodyctocdrivecO2cintocthecti
ssues
● ExplaincthecrolecofcpH,ccarboncdioxidec(BohrcEffect),c2,3,cDPG,ctemperature,candch
emoglobinclevelsconcthecoxyhemoglobinccurve
○ Shiftctocthecrightc(increasedcabilityctocdrivecO2cintocthectissues)
■ DecreasedcpH
■ IncreasedcCO2
■ Increasedc2c3cDPGc(increasedcanaerobiccexercise)
■ Increasedctemperature

, ■ Hemoglobinclevels?
● Describeca-VO2cdifferencecandcwhatcitcmeans
○ RepresentscthecamountcofcO2cextractedcbycthectissues
■ NormallycPaO2caboutc95%csatcorc19.6cvol%
■ NormallycPvO2caboutc75%csatcorc15cvol%
○ ExercisescdecreasescPvO2ctocbelowc45%csat
■ Increasesca-VO2cdifference
■ MorecO2ciscbeingcpushedctocthectissues
○ AbilitycforcthecbodyctocextractcO2cincreasescwithctraining
● Describechowctheccarboncdissociationccurvecdescribescthecabilitycforccarboncdioxidectocb
indctochemoglobin
○ Haldeneceffect
● Explainchowcoxygenclevelscaffectctheccarboncdissociationccurvec(HaldanecEffect)
○ AscthecPPcofcO2cincreases,ctheccurvecshiftsclower
○ OxygenationcofcHbcdecreasescthecabilitycofcCO2ctocbindctocHb
● Describecthecstructurescinvolvedcinctheccontrolcofcbreathingcandcthecrolecofceach
○ Respiratoryccenter
■ LocatedcincthecMEDULLA
■ DorsalcRespiratorycGroup
● NTS
● Thoughtctochavecpacemakerccellscthatcfunctioncandchavecacbasalcr
atecofcfiring
● Outputcgoesctocdiaphragmcviacphreniccnervecandcexternalci
ntercostals
● Signalchascslow,cramp-
likecincreasecinctensioncandcgradualcincreasecincthoraciccvol
umec(overcaccoursecofc2cseconds)
● Expirationcduectocabsencecofcstimulusc(3cseconds)
■ VentralcRespiratorycGroup
● Nucleuscambiguousc(NA)candcnucleuscretroambiguous
● Importantconlycduringcforcefulcexhalationcbycsendingcsignalsctocthec
abdominalscandcinternalcintercostals
■ PneumotaxiccCenter
● Incthecpons
● Influencescthecrate/frequencycofcbreathing
○ Increasedcfiringccausescacdecreasecinclengthcofcinspirationc
andcincreasedcrespiratorycrate
○ Decreasedcfiringccausescancincreasecinclengthcofcinspirationc
andcslowercrespiratorycrate
■ ApneusticcCenter
● Locatedcincthecpons
● Workscoppositecthecpneumotaxicccentercincthatcitcpreventsctheci
nspiratorycneuronscfromcswitchingcoff
● Differentiatecthecfunctioncofcthecperipheralcandccentralcchemoreceptors

, ○ Centralcchemoreceptors
■ Locatedcincthecmedulla
■ Mostcimportantcregulatorcofcminutectocminutecventilationcandcrespondctoc
changescinchydrogen
● IndirectcresponsectocancincreasecincCO2cbecausechydrogenccannotc
crosscthecbloodcbraincbarrier
○ Peripheralcchemoreceptors
■ Locatedcincthecaorticcandccarotidcbodies
■ Relaycsignalsctocthecrespiratoryccenterscviacthecvaguscnervec(aorticc
bodies)candcthecglossopharyngealcnervec(carotidcbodies)
■ RespondctocincreasecincCO2candcincreasedchydrogen
● CarotidcbodiescalsocrespondctochighcKcandclowcO2
■ Firingcofcthesecleadsctocincreasecincventilation
● Explainchowctheccentralcchemoreceptorscarecablectocincreasecventilationcincresponsectoci
ncreasedccarboncdioxideclevels
○ AscthecbodycincreasescitscCO2cconcentration,cincreasedcamountscofcCO2cdiffusecf
romcthecbloodstreamcintocthecmedullarycinterstitialcspace
○ CO2ciscconvertedctochydrogencandcbicarbonate
○ ThiscbuildupcofcH+cionsciscsensedcbycthecchemoreceptors
○ Signalscsentctocrespiratoryccentercproducecincreasedcventilationcthatcblowscoffcthec
CO2creturningcthecpHctocnormal
● Explainchowcthesecstructurescworkctogetherctocincreasecventilationcduringcexercise
● Differentiatecthecprimarycfactorcinccontrollingcventilationcduringcsubmaximalcandcmaximalc
exercise
○ Submaxcexercise
■ Primarycdrivecoriginatescfromchighercbrainccenters
■ Modulatedcbychumoralcchemoreceptorscandcmusclecafferentsctocfinectunec
breathingctocregularcbloodcPCO2clevels
○ Maxcexercise
■ H+clevelscincreasecincbloodciscproportionalctocincreasecincventilation
■ K+clevelscincbloodcincreasecproportionalctocincreasecincventilation
■ Musclecafferentscincreasedcascacresultcofcincreasedcmotorcunitcrecruitmentc
neededctocperformcmaxcexercise
■ Increasedctemperature
■ Increasedclevelscofcbloodccatecholamines
● Listcthectwocfactorscdeterminingccardiaccoutput
○ StrokecVolume
○ HeartcRate
● Describecthecintrinsiccandcextrinsicccontrolsctocheartcrate
○ Intrinsic
■ Heartccellscarecautorhythmic
● CreatecowncAPs
● Cellscnevercrest