1,000 foot view Pulmonology Flashcards
what makes up the superior portion of the nose
cribriform plate and ethmoid
where does the air become turbulent
moved through conchae
what aids in the humidification of air
sinuses
what is the pharynx lined with
ciliated columnar cells that continue to make mucus and humidify the air
what areas are passage areas for both air and food/drink?
oropharynx and laryngopharynx
what does the laryngopharynx divide into
esophagus and trachea
what protects food from going into the trache
epiglottis
what is the connection between the upper nasal and oropharynx and the inferior respiratory centers
larynx
what encompasses the true vocal cords and false vocal cords
endolarynx
what controls the length of the vocal cords
laryngeal muscles
what connects the larynx to the lower airways
U shaped cartilage ringed structures
where does the trachea enter the lungs
at the hilum
what is the entry and exit point from the lung parenchyma
hilum
what is included within the hilum
primary bronchus
pulmonary artery
pulmonary veins
pulmonary nerve plexus
lymphatics
what are the layers of the bronchioles
epithelial lining - contains goblet-cells and cilia
smooth muscle layer
connective tissue layer
what is the carina
split off the trachea
what is the size of the bronchioles
1mm in diameter
what are the lobes of the lung
right lung - 3 lobs: superior, middle and inferior
left: superior and inferior
what are the lung fissures
left: horizontal and oblique fissure
right: oblique fissure
what makes up the alveoli
simple squamous epithelium
thin elastic basement membrane
capillary endothelium surround alveoli
what controls airway resistance
smooth muscles
what is the ‘search pattern’ for a chest x-ray
Airway
Bones
Cardiac and mediastinum
Diaphragm
Extras (lines, drains, wires, abdomen)
Fields
which ribs are false
8, 9 and 10
what ribs are floating
11 and 12
what way do the external intercostals pull the ribs
upward
push the sternum forward and expand thoracic cavity for inspiration
what intercostals help with expiration
internal intercostals - pull the ribs downward
where does the diaphragm originate
xiphoid process
what nerve innervates the diaphragm
phrenic nerve
when the thoracic cavity expands what occurs with the diaphragm
flattens when contracted
what portion of the diaphragm is higher riding on xray
right sided
what is the bottom of the lung where fluid can be trapped called
costophrenic angle
What is the barometric pressure
760 mmHg
what is the alveoli pressure
760 mmHg
what is the intrapleural pressure
750 mmHg
(-4–10mmHg)
if intrethoracic pressure increases what happens to the intrathoracic volume
the intrathoracic volume decreases
as the volume increases during inspiration what happens to the intra-alveolar pressure
it decreases
what is equaled out during inspiration
intra-alveloar and barometric pressure with the inflow of air
what does decreased thoracic volume do to thoracic pressure
decreased thoracic volume = increased thoracic pressure
what is the sequence of events for expiration
inspiratory muscles relex (diaphragm rises; rib cage descends due to recoil)
thoracic cavity volume decreases
elastic lungs recoil passively; intrapulmonary volume decreases
intrapulmonary pressure rises (to +1 mmHg)
air (gases) flows out of lungs down its pressure gradient until intrapulmonary pressure is 0
what is the sequence of events for inspiration
inspiratory muscles contract (diaphragm descends)
thoracic cavity volume increases
lungs stretched; intrapulmonary volume increases
intrapulmonary pressure drops (to -1 mmHg)
air (gases) flows into lungs down its pressure gradient until intrapulmonary is 0
what is the gas exchange unit
alveloi
what does Pores of Kohn allow for
the passage of air between the alveoli to share to air
what are the cell types within the alveoli
type 1: squamous cells. most common, provides structures
type 2: secrete surfactant
alveolar macrophages
what is surfactant
lipoprotein that coats the inner lining of the alveoli to prevent them from collapsing on themselves
reduces surface tension within the alveoli
what is the Law of Laplace
pressure between inner aspect and outside world of a sphere is inversely proportional to the radius so….
the smaller the alveoli get (expiration) the more pressure put on them increasing the likelihood of alveolar collapse
what is pulmonary compliance
how much the pulmonary cavity able to accommodate the changing thoracic volume during respiration
lung (mL) / Pressure (mmHg)
what is decreased compliance
decreased ability for the required pressure gradients to form
- pulmonary fibrosis, interstitial lung disease, pulmonary edema, obstructive lung disease, decreased surfactant, obesity, aging
what does hypoxia trigger
vasoconstriction in the lungs
what is the equation for ventilation
ventilatory rate x volume per breath
what is the oxyhemoglobin dissociation curve
how quickly the hemoglobin gets rid of the oxygen
Right shifted curve - Bohr effect
increased oxygen delivery to tissues caused by low pH, increased CO2, high temperature.. etc
what is a left shifted curve
haldane effect
reduced oxygen delivery to tissues - holds onto it
caused by: high pH, low temp, fetal Hb
what is dead space
volume of air that does not participate in gas exchange
what part of the respiratory system does not participate in gas exchange
conducting airways
what is alveloar dead space
non-perfused alveoli
what is anatomic dead space
conducting airways
what is Q
perfusion
Cardiac output = HR x SV
what is V
ventilation
tidal volume - dead space x RR
what is the ventilation and perfusion relationship
V/Q ratio
normal 0.8
optimal gas exchange
