Anderson Pulmonary Flashcards
What is the landmark for the apex of the lungs?
4cm above Rib 1
Visceral or Parietal pleura:
adheres to lung
adheres to thoracic cage
Visceral
Parietal
What occurs with the vacuum is lost between the visceral and parietal pleura?
Pneumothorax
What nerves supply the lungs?
Vagus or thoracic ganglia
What is the mediastinum? What is found in the anterior, middle, posterior, and superior?
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
At MCL, where does the lung extend? At Axillary line? Costal angle?
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
Direction of sinus draining.
Sphenoid - ethmoid - maxillary - nasal cavity
Frontal - maxillary - nasal cavity
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
Tidal volume Inspiratory reserve volume Expiratory reserve volume Residual volume Dead space Vital capacity
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
Inspiratory capacity Functional residual capacity Vital capacity Forced expiratory volume Forced expiratory capacity
What is the normal FEV (1)/FVC?
80% or 0.8
What are the two breathing areas in the medulla and what nerves are involved?
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.
What are the breathing areas in the pons?
Apneustic Center - stimulates inspiration (gasp)
Pneumotaxic Center - inhibits inspiration (reg rate/volume)
Acid-base problems (CO2 or Bicarb):
Respiratory
Metabolic
CO2
Bicarb
Acid or base: Decr CO2 Incr HCO3 Dec HCO3 Incr CO2
Basic
Basic
Acid
Acid
T/F: Primary disturbance of increased CO2 results in a compensatory response of increased HCO3.
T
T/F: Beta-2 autonomic nerve fibers are inhibitory.
T
What is the PO2 of arterial blood? venous blood? What does this mean?
Arterial : 100 (10/10 hemoglobin saturated w/ O2)
Venous: 40 (4/10 hemoglobin saturated)
What happens to PO2 with CO poisoning?
Your PO2 maxes out at 50 (not enough to be alive). Death.
What is the enzyme that converts HCO3 to and from CO2 and water?
Carbonic anhydrase
What is the mean pressure out of the heart on the right and left sides respectively?
Right: 15 mmHg
Left: 100 mmHg
What is the difference between ventilation and perfusion?
Ventilation - Ability to fill lungs with air and expel it.
Ventilation - Ability of oxygen to get to the alveolar spaces.
What condition is consistent with a “steeple sign” on xray?
Epiglottis or Laryngotracheobronchitis (Croup)
What organisms are most likely to cause epiglottitis and what is the most serious sequelae?
H. influenza or beta-hemolytic strep
Death
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
Pulmonary Edema Adult Resp. Distress Syndrome/Shock Lung Pulmonary Embolism/Infarction Pulmonary HTN Atelectasis
Two types of pulmonary edema and causes?
Interstitial and alveolar (worse)
Left CHF, pulmonary capillary damage (toxic inhalant or pneumonia)
What is compliance in lung physiology?
Distensibility of the lungs and chest wall.
T/F:
Obstructive lung disease is the inability to get air in.
Restrictive lung disease is the inability to get air out.
F/F
Obstructive - can’t get air out.
Restrictive - can’t get air in.
Emphysema vs. Bronchitis
Emphysema: normal PCO2, barrel chest, pursed lips
Bronchitis: increased PCO2, cough w/ sputum for at least 3mos/2yrs, cyanotic
What are two main causes of emphysema?
Smoking or deficiency of serum alpha-1 protease inhibitor
What are the stages of pneumonia?
Consolidation
Red hepatization
Gray hepatization
Resolution
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
Bronchiectasis Asthma Pneumoconiosis Hypersensitivity Pneumonitis Goodpasture's Syndrome
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
Bronchial Adenoma SCC Adenocarcinoma Large Cell Undifferentiated Carcinoma Small/Oat Cell Undifferentiated Carcinoma
