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SF3- EXAM 2 > Anatomical- Clinical Correlates of the Respiratory System > Flashcards

Anatomical- Clinical Correlates of the Respiratory System Flashcards

1
Q

The rib cage provides a space in which the lungs inflate. What can a clinician logically infer from this statement?

A

Deformities of the thoracic wall directly impact upon the inflation of the lungs. Deformities of the vertebral column reduce the volyme of the pleural cavity and inflation of the lungs.

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2
Q

What factors are important in increasing vascular resistance of the lungs?

A
  • Reduced inflation of the lungs
  • Hypoxia

NOTE: Hypoxia is a potent stimulus for vasoconstriction

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3
Q

Kyphoscolosis may result in a significant __________ (increase/ decrease) in resistance and pressure in pulmonary circulation.

A

Increase

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4
Q

In the fetus, pressure is higher in the pulmonary vessels than systemic vessels thuse there is right-left shunting of blood through the __________.

A

Foramen ovale

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5
Q

When the lungs are fully inflated, resistance to pulmonary blood flow _________________ (increases/ decreases/ remains the same).

A

Increases

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6
Q

When the lungs are fully expanded, pulmonary resistance goes up because of compression of the _____________.

A

Pulmonary capillaries

NOTE: This is due to the ballooning alveoli

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7
Q

What are possible consequences of an increase in pulmonary resistance?

A
  • Dilation of the right heart
  • Dilation of the pulmonary artery
  • Pulmonary hypertension

NOTE: In extreme cases, cardiorespiratory failure and death may result

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8
Q

Cor pulmonali

A

abnormal enlargement of the right side of the heart as a result of disease of the lungs or the pulmonary blood vessels.

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9
Q

What are the symptoms of cor pulmonali?

A
  • Ascites
  • Enlarged liver
  • Hypertrophy of the right ventricle
  • Distention of the external jugular vein
  • Edema around the ankles

NOTE: Pulmonary congestion is NOT a symptom of cor pumonali

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10
Q

Anything that reduces blood flow through the right heart results in __________ congestion.

A

Systemic

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11
Q

What are the symptoms of right heart failure and systemic congestion?

A
  1. Engorgement of jugular veins
  2. Elevated venous pressure
  3. Ascites
  4. Enlarged and tender liver
  5. Cyanosis
  6. Edema
  7. Dilation of right heart

REMEMBER: Engorgement of jugular veins and edema are NOT symptoms of cor pulmonali

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12
Q

Cor Pulmonale image

A
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13
Q

Hepatojugular reflux

A

The distension of the neck veins precipitated by the maneuver of firm pressure over the liver.

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14
Q

During inspiration, air pressure is lowest in what areas?

A

Alveoli

Bronchi

Trachea

Pleural cavity

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15
Q

Contraction flattens the diaphragm and increases the volume of the _____________ and decreases volume of ___________.

A

thoracic cavity; abdomen

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16
Q

What is required for the lungs to be fully inflated?

A
  • Thoracic wall must be structurally sound
  • Pleural cavities must remain empty (potential space)
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17
Q

Flail chest

A

Multiple fractures resulting in a “floating” and unstable portion of the thoracic wall

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18
Q

What hapens to the flail wall during inspiration and expiration?

A
  • Inspiration
    • ​Flail wall moves in, opposite in direction to the expanding chest
  • Expiration
    • ​The flail wall moves outward in the opposite direction

*This is due to the ambient pressure in comparison to the pressure inside the lungs. This is called paradoxical breathing.

19
Q

What occurs during inspiration and expiration, in a blowing pneumothorax?

A

Inspiration

  • Air is “sucked” into the pleural cavity, collapsing the lung

Expiration

  • Air is “blown” out of the pleural cavity
20
Q

Symptoms of an open pneumothorax

A

Cyanosis

Severe respiratory distress

Shock

NOTE: It is imperative to close the wound with gauze or a hand

21
Q

In cases of an open pneumothorax, a _____________ promotes re-expansion of the collapsed lung.

A

Thoracostomy tube

22
Q

In cases of a tension pneumothorax, what occurs during inspiration and expiration?

A

Inspiration

  • Air enters the pleural cavity through a valve-like opening

Expiration

  • The tissue valve closes preventing air from escaping
23
Q

In cases of pneumothorax, the pressure continues to increases. What are the results of this?

A
  • Trachea is shifted
  • Contralateral lung is compressed and ventilation is impaired
  • Diaphragm is depressed
  • Venous return to the heart is impaired
24
Q

What are the clinical manifestions of tension pneumothorax?

A
  • Respiratory distress
  • Cyanosis
  • Tracheal deviation
  • Chest pain
  • Hyper-resonance
25
Q

Spontaneous pneumothorax

A

Air-filled blisters on the surface of an emphysemic lung can rupture releasing air into the pleural cavity and producting a pneumothorax

NOTE: This is the most common type of pneumothorax

26
Q

Chyle

A

A milky fluid consisting of fat droplets and lymph. It drains from the lacteals of the small intestine into the lymphatic system during digestion.

NOTE: This substance can fill the pleural cavity, known as a chylothorax

27
Q

Embolism

A

Obstruction of a blood vessel by a transported clot, mass of bacteria or foreign bacteria.

28
Q

What are predisposing factors for pulmonary embolism?

A
  • Venous stasis
  • Coagulation disorders
  • Trauma
  • Post-operative or post-partum
29
Q

What are the most common sources of pulmonary emboli?

A
  • External iliac vein
  • Femoral vein
  • Deep femoral vein
  • Popliteal vein
  • Posterior tibial veins
  • Soleal plexus of veins
30
Q

Following the flow of blood from the lesser saphenous vein, at what point do vessels first begin to get smaller?

A

After the pulmonary artery

31
Q

What are the cardinal signs of a massive pulmonary embolism?

A

Sudden onset of dyspnea

Tachycardia (in predisposed individuals)

32
Q

What are the symptoms of a pulmonary infarction?

A

Pleural pain

Breathlessness

33
Q

Emphysema

A

Enlargement of alveoli because of the deterioration of alveolar septi and walls

34
Q

__________ results in decreased elasticity, making expiration difficult.

A

Fibrosis

*Air becmes trapped in the alveoli during expiration

35
Q

Centriacinar emphysema

A

Dsitended respiratory bronchioles of all orders communication with one another

36
Q

Panacinar emphysema

A

All airways and alveoli involved with breakdown of diving walls

37
Q

Signs of chronic obstuctive pulmonary disease

A
  1. Exertional dyspnea
  2. Trachypnea
  3. Hyper-resonance
  4. Asthenic body build
  5. Use of respiratory muscles
  6. Sternal lift
  7. Diaphragm is flattened, inactive, and atrophied
38
Q

What are the anatomical consequences of lung cancer?

A
  • Metastasis to hilar and carinal nodes
  • Distortion of trachea
  • Collapse of right upper lobe due to compression of lobar bronchus
  • Superior vena cava syndrome
39
Q

Signs of superior vena cava syndrome

A
  • Edema and rubor of face, neck, and chest
  • Distention of superficial veins
  • Arm veins fail to drain on elevation
40
Q

When is superior vena cava syndome most serious?

A

When the superior vena cava is obstructed inferior to the entrance of the azygos vein.

NOTE: They azygos vein and its tributaries provide an import collateral by which blood may return to the heart if the superior vena cava is obstructed.

41
Q

Symptoms of Pancost syndrome

A
  1. Horner’s syndrome
  2. Parathesia and paresis of arm and hand
  3. Superior vena cava syndrome
  4. Dyspnea
  5. Dysphonia
  6. Dysphargia
  7. Paralysis of 1/2 of the diaphragm
42
Q

A tumor of the thoracic inlet in also known as _________.

A

Pancoast’s Syndrome

NOTE: CN X, the brachial plexus, and phrenic nerve are found in this area

43
Q

______________ is the most common cause of a positive pressure pneumothorax.

A

Emphysema

SF3- EXAM 2 (11 decks)

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