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NPTE Pulmonary PT > Anatomy and Physiology > Flashcards

Anatomy and Physiology Flashcards

1
Q

Lateral borders of the trachea run ___ into the ___

A

perpendicular into the suprasternal notch

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2
Q

The sternal angle AKA angle of Louis the point where what attaches

A

The point of anterior attachment of the 2nd rib and the tracheal bifurcation

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3
Q

True ribs

A

1 to 6 - AKA costosternal ribs - they have a single anterior costchondral attachment to the sternum

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4
Q

False ribs

A

7-10 - AKA costochondral ribs - they share costochondral attachments before attaching anteriorly to the sternum

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5
Q

Ribs 11 and 12

A

Floating ribs - or costovertebral ribs

They have no anterior attachment

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6
Q

Posterior border of the sternum

A

vertebral column from T1 to T12

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7
Q

Upper airway consists of what

A

Nose or mouth
Pharynx (used for both resp. and dig)
Larynx (connects pharynx to trachea)

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8
Q

Lower airways

A

Conducting airways = trachea to terminal bronchioles (transport air ONLY)
Respiratory unit = resp bronchioles, alveolar ducts, alveolar sacs, alveoli - diffusion of gas occurs through all of these!

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9
Q

Right lung divides into

A

3 lobes by oblique and horizontal fissure lines
Each lobe divides into segments
10 segments total

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10
Q

Left lung divides into

A

two lobes by single oblique fissure line
Each lobe is divided into segments
8 segments total

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11
Q

Parietal pleura covers

A

Inner surface of thoracic cage, diaphragm, and mediastinal border of the lung

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12
Q

Visceral pleura covers

A

Wraps outer surface of the lung including the fissure lines

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13
Q

Intrapleural space is what

A

the potential space between the two pleura that maintains the approximation of the rib cage and the lugs allowing forces to be transmitted from one structures to another

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14
Q

Primary muscle of inspiration

A

diaphragm

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15
Q

When the diaphragm is at rest the hemidiaphragm is where

A

arched high into the thorax

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16
Q

When the diaphragm contracts what happens

A

the central tendon is pulled downward - flattening the dome

The result is protrusion of the abdominal wall during inhalation

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17
Q

Additional primary muscles of inhalation besides diaphragm include

A

portions of the intercostals

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18
Q

Accessory muscles of inspiration are used when

A

when a more rapid or deeper inhalation is required or with disease states

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19
Q

Accessory muscles of inspiration include what

A

Upper two ribs raised by SCM
Rest of ribs raised by levator costarum and serratus
With fixed shoulder girdle, trap, pectorals, and serratus can be mm of inspiration

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20
Q

Expiratory muscles of ventilation - Resting exhalation results from what

A

a passive relaxation of the inspiratory muscles and the elastic recoil tendency of the lung

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21
Q

Expiratory muscles are used when

A

a quicker and/or fuller expiration is desired, as in exercise or disease states

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22
Q

Expiratory muscles include

A

quadratus lumborum, portions of intercostals, muscles of abdomen and triangularis sterni

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23
Q

Pts who lack abdominal musculature (like SCI) tend to have what resting position of diaphragm

A

a lower resting position

decreasing inspiratory reserve

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24
Q

The more upright the body position, the ___ the diaphragm and ___ the inspiratory capacity

A

The lower the diaphragm

Lower inspiratory capacity

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25
Q

The more supine the body position the more ____the diaphragm

A

the more adventitious the position of the diaphragm

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26
Q

Mechanics of breathing -

A

Elastic recoil of lung parenchyma pulls lungs and pleura and thorax into position of exhalation (inward pull)
Bony thorax pulls thorax and pleura and lungs into position of inspiration (outward pull)

27
Q

Resting end expiratory pressure (REEP) is what

A

the point of equilibrium where the forces in mechanics of breathing are balanced
Occurs at end tidal expiration

28
Q

Tidal volume

A

volume of gas inhaled (or exhaled) during a normal resting breath

29
Q

Inspiratory reserve volume

A

volume of gas that can be inhaled beyond a normal resting tidal inhalation

30
Q

Expiratory reserve volume

A

volume of gas that can be exhaled beyond a normal resting tidal exhalation

31
Q

Residual volume

A

volume of gas that remains in the lungs after ERV has been exhaled

32
Q

Inspiratory capacity

A

(IRV + TV)

The amount of air that can be inhaled from REEP

33
Q

Vital capacity

A

(IRV + TV + ERV)
the amount of air that is under volitional control
measured as forced expiratory vital capacity (FVC)

34
Q

Functional residual capacity

A

(ERV + RV)

the amount of air that resides in the lungs after normal resting tidal exhalation

35
Q

Total lung capacity

A

(IRV + TV + ERV + RV)

the total amount fo air that is contained within the thorax during a maximum inspiratory effect

36
Q

Flow rates - FEV1 (forced expiratory volume in 1 second)

A

The mount of air exhaled during the first second of FVC

In healthy, at least 70% of FVC is exhaled in first second

37
Q

Forced expiratory flow rate (FEF)

A

the slope of a line drawn between the points 25% and 75% exhaled volume on a forced vital capacity exhalation curve

38
Q

FEF vs. FEV1

A

FEF is more specific to smaller airways and shows more dramatic change with disease than FEV1

39
Q

Arterial oxygenation is what

A

The ability of arterial blood to carry oxygen

40
Q

Arterial oxygenation - Partial pressure of oxygen in the arterial blood (PaO2) depends on

A

the integrity of the pulmonary system, the circulatory system and the Pa)2

41
Q

Arterial oxygenation - PaO2 at room air is

A

95-100 mm Hg

42
Q

Arterial oxygenation - Mild hypoxemia is what (number)

A

Less than 90 mm Hg PaO2

43
Q

Arterial oxygenation - Hyperoxemia is what (number)

A

Over 100 for PaO2

44
Q

Arterial oxygenation - Fraction of oxygen in the inspired air (FiO2) is what

A

percentage of oxygen in air based on a total of 1.00

45
Q

Arterial oxygenation - FiO2 at room air is what

A

21% oxygen - usually written as 0.21

46
Q

Arterial oxygenation - Supplemental oxygen is usually given when PaO2 falls below

A

55mm Hg

47
Q

Alveolar ventilation is what

A

ability to remove carbon dioxide from pulmonary circulation and maintain pH

48
Q

Alveolar ventilation - pH indicates what

A

the concentration of free floating hydrogen ions within the body

49
Q

Alveolar ventilation - pH norm

A

7.35-7.45

50
Q

Alveolar ventilation - PaCO2 is what

A

Partial pressure of carbon dioxide within the arterial blood

51
Q

Alveolar ventilation - PaCO2 norm

A

35-45 mm Hg

52
Q

Alveolar ventilation - Hypercapnea is what (number) and Hypocapnea is what (number)

A

Hyper is over 45

Hypo is less than 35

53
Q

Alveolar ventilation - an increase in PaCO2 does what to pH

A

Decreases it

54
Q

Alveolar ventilation - HCO3 is what

A

amount of bicarbonate ions within the arterial blood

55
Q

Alveolar ventilation - HCO3 norm

A

22-28 mEq/L

56
Q

Alveolar ventilation - HCO3 removal or retention changes pH how

A

direct relationship

more you have, the higher the pH

57
Q

Optimal respiration occurs when

A

ventilation and perfusion are matched

58
Q

Dead space is what

A

a space that is well ventilated but in which no respiration (gas exchange) occurs

59
Q

Shunt

A

No respiration occurs because of a ventilation abnormality
Complete atelectasis of a respiratory unit allows the blood to travel through the pulmonary capillary without gas diffusion

60
Q

Effect of body position on ventilation perfusion relationship - upright position

A

Perfusion is gravity dependent
In upright, more pulmonary blood is found at the base of the lung
Ventilation - at static the apical alveoli are fuller but with inspiration the base gets air

61
Q

Ventilation perfusion ratio (V/Q) -

A

the ratio of pulmonary alveolar ventilation to pulmonary capillary perfusion

62
Q

Effect of body position on ventilation perfusion relationship - upright position - V/Q ratio

A

apices are gravity independent with the lowest blood flow (Q) in upright position
There is more air than blood though so you have a high V/Q ratio `

63
Q

Effect of body position on ventilation perfusion relationship - upright position - other positions

A

all positions will give you three zones - gravity independent, middle, gravity dependent
The gravity ind area of the lung acts as dead space
The gravity dep area of the lung acts as a shunt

NPTE Pulmonary PT (5 decks)

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