Anderson Pulmonary

Question 1

What is the landmark for the apex of the lungs?

Answer 1

4cm above Rib 1

Question 2

Visceral or Parietal pleura:
adheres to lung
adheres to thoracic cage

Answer 2

Visceral

Parietal

Question 3

What occurs with the vacuum is lost between the visceral and parietal pleura?

Answer 3

Pneumothorax

Question 4

What nerves supply the lungs?

Answer 4

Vagus or thoracic ganglia

Question 5

What is the mediastinum? What is found in the anterior, middle, posterior, and superior?

Answer 5

The area around the heart. 
Ant: thymus gland
Mid: heart, pericardium
Post: esophagus, descending aorta, azygos veins, thoracic duct, sympathetic trunk
Sup: aortic arch, brachiocephalic veins

Question 6

At MCL, where does the lung extend? At Axillary line? Costal angle?

Answer 6

MCL - lung extends to 6th rib, pleura to 8th
Axilla - lung extends to 8th rib, pleura to 10th
Costal - lung extends to 10th rib, pleura to 12th

Question 7

Direction of sinus draining.

Answer 7

Sphenoid - ethmoid - maxillary - nasal cavity

Frontal - maxillary - nasal cavity

Question 8

Name the volume (PFT):
Inspired/expired in normal breath
Volume inspired above normal volume, exercise
Volume expired after normal volume
Volume remaining in lungs after max expiration
150ml, does not participate in gas exchange
Max expiration and inspiration combined

Answer 8

Tidal volume
Inspiratory reserve volume
Expiratory reserve volume
Residual volume
Dead space
Vital capacity

Question 9

Name the capacity:
Sum of tidal volume and IRV
Sum of ERV and residual volume
Sum of tidal volume IRV, and ERV
Volume of air expired in 1 sec after max inspiration
Volume of air expired after max inspiration

Answer 9

Inspiratory capacity
Functional residual capacity
Vital capacity
Forced expiratory volume
Forced expiratory capacity

Question 10

What is the normal FEV (1)/FVC?

Answer 10

80% or 0.8

Question 11

What are the two breathing areas in the medulla and what nerves are involved?

Answer 11

Dorsal Resp Grp (inspiration/rhythm) - input from CN9 and 10, output via the phrenic n. to diaphragm

Ventral Resp Gro (expiration) - only operates during active inspiration.

Question 12

What are the breathing areas in the pons?

Answer 12

Apneustic Center - stimulates inspiration (gasp)

Pneumotaxic Center - inhibits inspiration (reg rate/volume)

Question 13

Acid-base problems (CO2 or Bicarb):
Respiratory
Metabolic

Answer 13

CO2

Bicarb

Question 14

Acid or base: 
Decr CO2
Incr HCO3
Dec HCO3
Incr CO2

Answer 14

Basic
Basic
Acid
Acid

Question 15

T/F: Primary disturbance of increased CO2 results in a compensatory response of increased HCO3.

Answer 15

T

Question 16

T/F: Beta-2 autonomic nerve fibers are inhibitory.

Answer 16

T

Question 17

What is the PO2 of arterial blood? venous blood? What does this mean?

Answer 17

Arterial : 100 (10/10 hemoglobin saturated w/ O2)
Venous: 40 (4/10 hemoglobin saturated)

Question 18

What happens to PO2 with CO poisoning?

Answer 18

Your PO2 maxes out at 50 (not enough to be alive). Death.

Question 19

What is the enzyme that converts HCO3 to and from CO2 and water?

Answer 19

Carbonic anhydrase

Question 20

What is the mean pressure out of the heart on the right and left sides respectively?

Answer 20

Right: 15 mmHg
Left: 100 mmHg

Question 21

What is the difference between ventilation and perfusion?

Answer 21

Ventilation - Ability to fill lungs with air and expel it.

Ventilation - Ability of oxygen to get to the alveolar spaces.

Question 22

What condition is consistent with a “steeple sign” on xray?

Answer 22

Epiglottis or Laryngotracheobronchitis (Croup)

Question 23

What organisms are most likely to cause epiglottitis and what is the most serious sequelae?

Answer 23

H. influenza or beta-hemolytic strep

Death

Question 24

Name the lung pathology:
Left CHF, fluid overload - fluid fills lungs
Injury to type I pneumocytes/endothelial cells - acute
Sudden interruption in blood supply to lung
Increase pulmonary vascular resistance
Collapse or incomplete expansion of the lung

Answer 24

Pulmonary Edema
Adult Resp. Distress Syndrome/Shock Lung
Pulmonary Embolism/Infarction
Pulmonary HTN
Atelectasis

Question 25

Two types of pulmonary edema and causes?

Answer 25

Interstitial and alveolar (worse)

Left CHF, pulmonary capillary damage (toxic inhalant or pneumonia)

Question 26

What is compliance in lung physiology?

Answer 26

Distensibility of the lungs and chest wall.

Question 27

T/F:
Obstructive lung disease is the inability to get air in.
Restrictive lung disease is the inability to get air out.

Answer 27

F/F
Obstructive - can’t get air out.
Restrictive - can’t get air in.

Question 28

Emphysema vs. Bronchitis

Answer 28

Emphysema: normal PCO2, barrel chest, pursed lips
Bronchitis: increased PCO2, cough w/ sputum for at least 3mos/2yrs, cyanotic

Question 29

What are two main causes of emphysema?

Answer 29

Smoking or deficiency of serum alpha-1 protease inhibitor

Question 30

What are the stages of pneumonia?

Answer 30

Consolidation
Red hepatization
Gray hepatization
Resolution

Question 31

Name the pathology:
Chronic dilation of the bronchi from contraction of scar, usu lower lung
Small bronchi abnormally responsive to stimuli, type I hypersensitivity, IgE
Dust inhalation often in the upper lobes
Farmer’s lung, interstitial pneumonia and fibrosis
Ab agains basement membrane of lung/kidney, type II hypersensitivity

Answer 31

Bronchiectasis
Asthma
Pneumoconiosis
Hypersensitivity Pneumonitis
Goodpasture's Syndrome

Question 32

Name the lung tumor:
Benign, anywhere
In bronchi or near hilium, elevates serum Ca
Beneath the pleura, common in women
Anywhere in lung, rapid death
Pancoast tumor, early METS, often secrete hormones, rapid death

Answer 32

Bronchial Adenoma
SCC
Adenocarcinoma 
Large Cell Undifferentiated Carcinoma
Small/Oat Cell Undifferentiated Carcinoma