2.4 Ventilation/Perfusion

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Questions and Answers

What is the consequence of having high ventilation but low perfusion in the lung?

  • Increased gas exchange efficiency
  • No impact on gas exchange
  • Increased dead space (correct)
  • Increased shunt

Which of the following describes a reason for nonuniform ventilation of the alveoli?

  • High V/Q ratio throughout the lung
  • Different metabolic demands in different lung regions (correct)
  • Equal distribution of inspired gas
  • Uniform pulmonary blood flow

What is the purpose of the shunt equation in understanding pulmonary physiology?

  • To assess airway resistance
  • To calculate cardiac output
  • To quantify the amount of blood bypassing the lungs (correct)
  • To determine oxygen saturation

How does physiologic dead space affect gas exchange in the lungs?

<p>It decreases alveolar ventilation (A)</p> Signup and view all the answers

Which statement accurately summarizes regional differences in ventilation and perfusion?

<p>V/Q ratios vary across different lung regions (A)</p> Signup and view all the answers

How do V/Q ratios relate to gravity in the lungs?

<p>V/Q ratios are highest at the lung's apex due to gravity (B)</p> Signup and view all the answers

What influences mixed venous blood to bring CO2 into the lungs and take up alveolar O2?

<p>Both neural and humoral/chemical regulation (D)</p> Signup and view all the answers

Which of the following is a pulmonary vasoconstrictor that increases pulmonary vascular resistance (PVR)?

<p>Histamine (D)</p> Signup and view all the answers

What effect does sympathetic innervation have on pulmonary vascular resistance (PVR)?

<p>Increases PVR (D)</p> Signup and view all the answers

Which chemical is known to produce vasodilation in the pulmonary vasculature?

<p>Acetylcholine (D)</p> Signup and view all the answers

What intrinsic autoregulation mechanism produces vasoconstriction in the pulmonary vasculature?

<p>Hypoxic pulmonary vasoconstriction (A)</p> Signup and view all the answers

How does parasympathetic innervation affect the pulmonary vasculature?

<p>Causes vasodilation (C)</p> Signup and view all the answers

What is the impact on the V/Q ratio when the airway is occluded, preventing ventilation?

<p>V/Q = 0 (D)</p> Signup and view all the answers

What does a shunt in the context of gas exchange refer to?

<p>Allows blood to reach the arterial system without passing through ventilated lung regions (B)</p> Signup and view all the answers

How does a pulmonary embolus affect the V/Q ratio?

<p>V/Q increases (C)</p> Signup and view all the answers

What happens if there is matched ventilation and perfusion at the alveolar-capillary unit?

<p>Optimal gas exchange (D)</p> Signup and view all the answers

What is the impact of an intrapulmonary shunt on alveoli?

<p>Alveoli are underventilated or overperfused (B)</p> Signup and view all the answers

How are small shunts typically identified?

<p>By measuring partial pressures during 100% inspired oxygen (D)</p> Signup and view all the answers

What can cause nonuniform ventilation of the alveoli?

<p>Bronchoconstriction (B)</p> Signup and view all the answers

What is one cause of nonuniform ventilation due to obstruction according to the text?

<p>Decreased lumen (B)</p> Signup and view all the answers

How can one assess the distribution of inspired gas in the lungs?

<p>Lung scans after IV administration of dissolved Xe (B)</p> Signup and view all the answers

What may lead to nonuniform compliance in different lung regions?

<p>Regional variations in surfactant production (A)</p> Signup and view all the answers

What is the physiological shunt equal to?

<p>Physiological dead space (A)</p> Signup and view all the answers

What does a pathological right-to-left intracardiac shunt involve?

<p>An abnormal passage between the right and left sides of the heart (D)</p> Signup and view all the answers

What is the equation to calculate venous admixture in the context of shunting?

<p>Shunt equation (C)</p> Signup and view all the answers

Supplemental oxygen will not improve which type of shunt?

<p>Absolute intrapulmonary shunt (A)</p> Signup and view all the answers

Intrapulmonary shunts are associated with which of the following?

<p>Collapsed alveoli (D)</p> Signup and view all the answers

What does increased arterial-alveolar CO2 difference indicate?

<p>An increase in physiological dead space (D)</p> Signup and view all the answers

What is the primary cause of a normal (A-a) DO2?

<p>Ventilation-perfusion mismatch (A)</p> Signup and view all the answers

Which regions of the lung have high VA/Q ratios?

<p>&quot;Apical regions&quot; (A)</p> Signup and view all the answers

Absolute intrapulmonary shunts are also known as 'true shunts' and can be improved with supplemental oxygen.

<p>False (B)</p> Signup and view all the answers

Physiological shunt corresponds to anatomic dead space in the lungs.

<p>False (B)</p> Signup and view all the answers

Anatomic shunts include venous blood from bronchial, thebesian, and pleural veins entering the left ventricle without passing through pulmonary capillaries.

<p>True (A)</p> Signup and view all the answers

Absolute intrapulmonary shunts are associated with well-ventilated alveoli.

<p>False (B)</p> Signup and view all the answers

What is the key feature of an anatomic shunt?

<p>Blood from pleural veins entering the left ventricle without passing through pulmonary capillaries (D)</p> Signup and view all the answers

How do absolute intrapulmonary shunts differ from shunt-like states?

<p>Absolute shunts cannot be improved with supplemental oxygen, while shunt-like states can (A)</p> Signup and view all the answers

What does the shunt equation conceptually divide all alveolar-capillary units into?

<p>Well-ventilated and poorly ventilated units (B)</p> Signup and view all the answers

Which is a pathologic characteristic of the pulmonary vasculature that may contribute to nonuniform ventilation of the alveoli?

<p>Compression by tumors causing regional compliance issues (A)</p> Signup and view all the answers

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