1,000 foot view Pulmonology

Question 1

what makes up the superior portion of the nose

Answer 1

cribriform plate and ethmoid

Question 2

where does the air become turbulent

Answer 2

moved through conchae

Question 3

what aids in the humidification of air

Answer 3

sinuses

Question 4

what is the pharynx lined with

Answer 4

ciliated columnar cells that continue to make mucus and humidify the air

Question 5

what areas are passage areas for both air and food/drink?

Answer 5

oropharynx and laryngopharynx

Question 6

what does the laryngopharynx divide into

Answer 6

esophagus and trachea

Question 7

what protects food from going into the trache

Answer 7

epiglottis

Question 8

what is the connection between the upper nasal and oropharynx and the inferior respiratory centers

Answer 8

larynx

Question 9

what encompasses the true vocal cords and false vocal cords

Answer 9

endolarynx

Question 10

what controls the length of the vocal cords

Answer 10

laryngeal muscles

Question 11

what connects the larynx to the lower airways

Answer 11

U shaped cartilage ringed structures

Question 12

where does the trachea enter the lungs

Answer 12

at the hilum

Question 13

what is the entry and exit point from the lung parenchyma

Answer 13

hilum

Question 14

what is included within the hilum

Answer 14

primary bronchus
pulmonary artery
pulmonary veins
pulmonary nerve plexus
lymphatics

Question 15

what are the layers of the bronchioles

Answer 15

epithelial lining - contains goblet-cells and cilia
smooth muscle layer
connective tissue layer

Question 16

what is the carina

Answer 16

split off the trachea

Question 17

what is the size of the bronchioles

Answer 17

1mm in diameter

Question 18

what are the lobes of the lung

Answer 18

right lung - 3 lobs: superior, middle and inferior
left: superior and inferior

Question 19

what are the lung fissures

Answer 19

left: horizontal and oblique fissure
right: oblique fissure

Question 20

what makes up the alveoli

Answer 20

simple squamous epithelium
thin elastic basement membrane
capillary endothelium surround alveoli

Question 21

what controls airway resistance

Answer 21

smooth muscles

Question 22

what is the ‘search pattern’ for a chest x-ray

Answer 22

Airway
Bones
Cardiac and mediastinum
Diaphragm
Extras (lines, drains, wires, abdomen)
Fields

Question 23

which ribs are false

Answer 23

8, 9 and 10

Question 24

what ribs are floating

Answer 24

11 and 12

Question 25

what way do the external intercostals pull the ribs

Answer 25

upward push the sternum forward and expand thoracic cavity for inspiration

Question 26

what intercostals help with expiration

Answer 26

internal intercostals - pull the ribs downward

Question 27

where does the diaphragm originate

Answer 27

xiphoid process

Question 28

what nerve innervates the diaphragm

Answer 28

phrenic nerve

Question 29

when the thoracic cavity expands what occurs with the diaphragm

Answer 29

flattens when contracted

Question 30

what portion of the diaphragm is higher riding on xray

Answer 30

right sided

Question 31

what is the bottom of the lung where fluid can be trapped called

Answer 31

costophrenic angle

Question 32

What is the barometric pressure

Answer 32

760 mmHg

Question 33

what is the alveoli pressure

Answer 33

760 mmHg

Question 34

what is the intrapleural pressure

Answer 34

750 mmHg (-4--10mmHg)

Question 35

if intrethoracic pressure increases what happens to the intrathoracic volume

Answer 35

the intrathoracic volume decreases

Question 36

as the volume increases during inspiration what happens to the intra-alveolar pressure

Answer 36

it decreases

Question 37

what is equaled out during inspiration

Answer 37

intra-alveloar and barometric pressure with the inflow of air

Question 38

what does decreased thoracic volume do to thoracic pressure

Answer 38

decreased thoracic volume = increased thoracic pressure

Question 39

what is the sequence of events for expiration

Answer 39

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

Question 40

what is the sequence of events for inspiration

Answer 40

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

Question 41

what is the gas exchange unit

Answer 41

alveloi

Question 42

what does Pores of Kohn allow for

Answer 42

the passage of air between the alveoli to share to air

Question 43

what are the cell types within the alveoli

Answer 43

type 1: squamous cells. most common, provides structures type 2: secrete surfactant alveolar macrophages

Question 44

what is surfactant

Answer 44

lipoprotein that coats the inner lining of the alveoli to prevent them from collapsing on themselves reduces surface tension within the alveoli

Question 45

what is the Law of Laplace

Answer 45

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

Question 46

what is pulmonary compliance

Answer 46

how much the pulmonary cavity able to accommodate the changing thoracic volume during respiration lung (mL) / Pressure (mmHg)

Question 47

what is decreased compliance

Answer 47

decreased ability for the required pressure gradients to form - pulmonary fibrosis, interstitial lung disease, pulmonary edema, obstructive lung disease, decreased surfactant, obesity, aging

Question 48

what does hypoxia trigger

Answer 48

vasoconstriction in the lungs

Question 49

what is the equation for ventilation

Answer 49

ventilatory rate x volume per breath

Question 50

what is the oxyhemoglobin dissociation curve

Answer 50

how quickly the hemoglobin gets rid of the oxygen

Question 51

Right shifted curve - Bohr effect

Answer 51

increased oxygen delivery to tissues caused by low pH, increased CO2, high temperature.. etc

Question 52

what is a left shifted curve

Answer 52

haldane effect reduced oxygen delivery to tissues - holds onto it caused by: high pH, low temp, fetal Hb

Question 53

what is dead space

Answer 53

volume of air that does not participate in gas exchange

Question 54

what part of the respiratory system does not participate in gas exchange

Answer 54

conducting airways

Question 55

what is alveloar dead space

Answer 55

non-perfused alveoli

Question 56

what is anatomic dead space

Answer 56

conducting airways

Question 57

what is Q

Answer 57

perfusion Cardiac output = HR x SV

Question 58

what is V

Answer 58

ventilation tidal volume - dead space x RR

Question 59

what is the ventilation and perfusion relationship

Answer 59

V/Q ratio normal 0.8 optimal gas exchange