Which of the following changes in the lungs occurs under the influence of general anesthesia? I. decreased chest wall elastance II. increased pleural pressure III. decreased muscle tone IV. decreased chest wall compliance

A. I only
B. II, III only
C. I, II, III only
D. II, III, IV only


?ANS: B
A. Incorrect response: See explanation B.
B. Correct response: The effect of general anesthesia or mechanical ventilation on regional pleural pressure in humans is not well described, though it is known that muscle tone decreases during anesthesia, increasing chest wall elastance and thus increasing pleural pressure. This effect helps explain the diminished FRC and eventual development of atelectasis in the dependent regions of normal subjects undergoing prolonged mechanical ventilation for elective surgery.
C. Incorrect response: See explanation B.
D. Incorrect response: See explanation B.

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