CABS: 1,000 ft View Pulmonology Flashcards
External canal leads to the
nasopharynx
Turbulence in the nasal cavity helps
keep the air warm
superiorly in the nasal cavity
cribriform plate
inferiorly in the nasal cavity is
hard palate
as air moves through the conchae it becomes
turbulent
hair filters the ____ in the nasal cavity
air
mucosa in the nasal cavity helps
with warmth and humidification
paranasal sinuses help with
humidification of air and contains mucus (traps foreign particles)
Pharynx is lined with ________ cells that continue to make ______ to humidify air
ciliated columnar cells
mucus
Nasopharynx is just for
air
Septum divides the _____
nairs
Oropharynx and laryngopharynx are the passage areas for
food and drink
uvula and soft palate of the oropharynx protect upper passages from backflow of
fluids
laryngopharynx will divide inferiorly into the
esophagus and trachea
Epiglottis will ________ so that food does not go into the _______
separate
trachea
Upper and lower respiratory tract is seperated by
cricoid cartilage
Tracheobronchial tree is _____ shaped cartilage ______ structure
U
ringed
Is U shaped for
movement and swallowing of food
Air enters the lungs at the
hilum
Hilum is
the entry and exit point from the lung parenchyma to attach to other structure
Respiratory tract is lined by
cilia
Cilia in the resp tract help
to push FB and microorganisms out (cough)
Goblet cells are
modified epithelial cells to produce mucin which will lubricate airways, trap molecules and humidify the inhaled air
Things mostly go down the right side of the carina into the right lung because it is
straighter
Bronchioles have 3 tissue layers
epithelial lining (containing goblet cells and cilia)
smooth muscle layer
connective tissue layer
Smooth muscle in the bronchioles are responsible for
bronchoconstriction
bronchodilation
Nasal cavity has
turbinates (to warm and humidify)
cilia
Carina splits ______ in two
trachea into right and left main bronchi
Bronchi keep branching and branching into
alveoli
alveoli are
thin elastic basement membrane to allow for good diffusion
smooth muscle around alveoli controls
airway resistance
Lung lobes
upper
lower
right middle
Search pattern on CXR (ABCDEF)
Airway (trachea, carina, bronchi)
Bones (clavicles, scapula, humeri, ribs, vertebra)
Cardiac and mediastinum
Diaphragm (symmetry, pleura)
Extras (lines, drains, wires, abdomen)
Fields (opacity, density)
CXR fluffy, patchy
alveolus +/- bronchiole
CXR linear
interstitium
CXR Blunted costophrenic angles, meniscus sign
Pleura
Ribs are attached to what part of your spine
Thoracic spine (makes less mobile)
Ribs protect
lungs, pleura, trachea, esophagus, heart, diaphragm, part of the liver, and kidneys
ribs are a flat bone: what happens in flat bones as an adult
hematopoiesis
Neurovascular bundle in placed where in comparison to the ribs
inferiorly (in costal groove)
Expand thoracic cavity for
inspiration
internal intercostals pulls ribs inward to help with
expiration
Diaphragm originates at _______ around rib ______ inner surface
xiphoid
7-12
Diaphragm inserts at
L1-L3
What nerve innervates the Diaphragm
Phrenic nerve
Diaphragm is a _____ shape muscle, when its contracted (expanding) it
dome
flattens
Diaphragm is important for
physical exertion and speech/singing
Right side of the costophrenic angle is naturally higher because of the
liver
blunted costophrenic angle =
fluid
Pleural layers of the lung
visceral pleura
interpleural space
parietal pleura
Inhalation diaphragm
contracts, moves down
Exhalation diaphragm
relaxes, moves up
Intra alveoli pressure =
0 mmHg
Barometric pressure =
0 mmHg
Intrapleural pressure =
-4 - -10 mmHg
increasing intrathoracic pressure will _______ intrathoracic volume
decrease
Thoracic volume ________ as the diaphragm flattens, external intercostals pull ribs ______ and _____
increases
up and out
the net negative will cause air to be pulled _____ to the alveoli to equal out the pressure
in
as volume increases, intra-alveolar pressure will
decrease (which gives net negative compared to barometric pressure)
During expiration inspiratory muscles are ______ and ______ of lung and chest wall
relaxed
recoil
As chest wall expands and lung/alveoli expands pressure will decrease causing air to
come in
Alveoli is a
gas exchanging unit
pores of kohn allow for
passage of air between the alveoli to share to air
Two types of cell types in the alveoli
type 1 - squamous cells, provides structure
type 2 - secretes surfactant
what is surfactant
lipoprotein that coats the inner lining of the alveoli to prevent them from collapsing on themselves
who doesn’t have surfactant
premies
What immune cell is in the alveoli?
alveolar macrophages
When alveoli are damaged there’s a
decrease in surfactant (closes alveoli) and they are restructured (inflammation and scar tissue)
the smaller the alveoli get the more likely they are to
collapse
at ____ weeks is when we start making type 2 alveolar cells in prep for birth
20 weeks
Pulmonary compliance is how
elastic the lung are (need good expansion and recoil to have good movement of air)
Compliance = _______ / _________
lung volume / pressure
Compliance will allow _______ movement/ volume of the thoracic cavity
increase
Decreased compliance = decreased ability to
have the correct pressure gradients
Hypoxia will trigger
vasoconstriction, allowing for blood to be shunted to more aerated areas within the lung
if the entire lung is vasoconstricted it will result in
pulm HTN
Ventilation = ________ * __________
ventilatory rate * volume per breath
O2 is used for
Cellular metabolism –> ATP production
Alveolocapillary membrane is where
gas exchange happens (abutting cappilary bed and alveolus)
Oxyhemoglobin dissociation curve
how fast we want to get rid of O2
Oxyhemoglobin dissociation curve: Right shift (what O2 is doing)
Heme gets rid of O2 faster and gives it to tissues
Oxyhemoglobin dissociation curve: Left shift (what O2 is doing)
Heme hold onto O2 longer
Right shift is called
Bohr effect
Left shift is called
Haldane effect
What is Dead space
the conducting airways (doesn’t participate in gas exchange)
What is alveolar dead space
non-perfused alveoli
V =
ventilation (air flow)
Q =
perfusion (blood flow)
Ventilation =
air within the alveoli (how much air is participating in gas exchange)
tidal volume - dead space * RR
Perfusion =
Cardiac output = HR * SV
V/Q is a ratio that tells us
about air intake or blood flow for gas exchange
