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Intro to Respiratory Medicine > Cardio/Pulmonary A&P Week 1-13 > Flashcards

Cardio/Pulmonary A&P Week 1-13 Flashcards

Weeks 1-13

1
Q

Pleural Cavity

What does it do?
What does it Contain?

A

Allows the pleura to slide during inspiration & Exhalation.

During Inspiration it keeps the lungs attached to the thorax

It Contains Serous Fluid

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2
Q

What are the 2 Pleural Membranes

A
  1. Visceral= attached to the lungs and into the fissures
  2. Parietal= Lines the thoracic wall, surface of the diaphragm and lateral mediatstinum
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3
Q

What does the Lymphatic System do?

A

Fluid Balance, absorption of fats & fat-soluble nutrients and transports Lymph Fluid

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4
Q

What are the Segments of Each Lung & Lobes

A

Right Lung= 10 Segments (Upper, Middle, Lower)
- Upper= Apical, Anterior, Posterior
- Middle= Lateral Medial
- Lower= Superior, Anterior Basal, Medial Basal, Lateral Basal, Posterior Basal

Left Lung= 8 Segments (Upper & Lower)
- Upper= Upper Division, Apical/Posterior, Anterior
- Lower= Superior, Anterior Basal, Medial Basal, Lateral Basal, Posterior Basal

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5
Q

Condition: Tracheomalacia

A

Weakness of the Trachea
(congenital or acquired)
Can be healed on it’s own or fixed with surgical stent

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6
Q

What is Bronchial Circulation?

Where does the blood supply come from?

A

Blood supply to lung tissue comes from Aorta.

Blood moves along tracheobronchial tree to terminal bronchioles then merges with pulmonary arteries and capillaries

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7
Q

Bronchiolitis vs. Bronchiectasis

A

Bronchiolitis= infection involving bronchioles. Common in Children

Bronchiectasis= Chronic. Bronchi walls become thick

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8
Q

Leukocytes (WBC)

What do they do?
How many are there?

A

Protect the body against Bacteria, viruses, parasites, toxins and tumors

5k-9k per mm3

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9
Q

What are the 5 Leukocyte breakdowns

A
  1. Neutrophils= First responders
  2. Lymphocytes= T Cells, makes antibodies
  3. Monocytes= Largest-Macrophages
  4. Eosinophils= Allergic Reaction- High in Asthma
  5. Basophils= Release Histamine and Heparin
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10
Q

Erythrocytes (RBC)

What do they do?
How many are made and die?
What is it made of and where is it made in?
Lifespan?

A
  • Transports CO2 and O2
  • 4.2-6.2 million per mm3 are made every 2 seconds and are destroyed ever 2 second by liver and spleen
  • Majority is made of Hemoglobin (Hb), comes from red bone marrow in cranial, vertebral, ribs sternum, humerus & Femur
  • 120 day lifespan
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11
Q

What is Blood Plasma?
How much of the blood is Plasma?
What is it made of?

A
  • Liquid portion of the blood
  • 55% of the blood is plasma
  • Proteins, Electrocytes, Food substances, Respiratory Gases, Hormones, Waste Products
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12
Q

Veins vs. Arteries

A

Veins= Deoxygenated blood to the heart (Except Pulmonary Veins-Oxygenated)
- Thinner, collapsable, more shallow and has valves

Arteries= Oxygenated blood away from the heart (Except Pulmonary Artery-deoxygenated)
- Thicker and Deeper

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13
Q

What is normal Cardiac Output (Qt)

A

4-8 L/min

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14
Q

What are the 3 formed elements of the blood?

A

Erythrocytes (RBC)
Leukocytes (WBC)
Platelets

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15
Q

Condition: Pharyngeal Reflex

A

Gag Reflex

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16
Q

Cricoid Cartilage

What is it’s shape?
Where is it located?

A
  • Full Ring Shaped
  • Sits below Thyroid cartilage. Makes up a large portion of the back of the Larynx and the bottom is attached to the Trachea
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17
Q

Thyroid Cartilage

What is it shape?
Where is it located?
Nickname?

A
  • Butterfly Shaped
  • In front of the Larynx
  • ‘Adams Apple’
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18
Q

Cricothyroid Ligament

What is this known for?
Where is it located?

A
  • The site for trach incision
  • Sits between the bottom of the thyroid cartilage and top of the Cricoid Cartilage
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19
Q

Trachea vs. Esophagus

What are the two used for?
What does the Trachea contain?

A
  • Trachea is Anterior airway, Esophagus is posterior for food and liquid.
  • Trachea has Vocal Cords, Epiglottis, Vestibule, Vallecula
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20
Q

Condition: Epiglottitis

A

Inflammation of the epiglottis.
(For RTs, pt may need to be Trached)

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21
Q

Condition: Croup
AKA Laryngotracheabronchitis

How to identify?

A

Inflammation below the Glottis

Identified by Steeply Sign on Xray, loud barking cough

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22
Q

Where are the Following?
- Nasopharynx
- Oropharynx
- Laryngopharynx

A

Nasopharynx= Sits Above Uvula

Oropharynx= Back of throat, below Uvula

Laryngopharynx= Lower bottom of throat, Right above the Larynx

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23
Q

What is in the Oral Cavity?

A

Anterior 2/3 of tongue, Vestibules (gums), Hard Palate, Soft Palate, Teeth

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24
Q

Condition: Epistaxis

A

Nosebleeds

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25
Q

Mucous

  • How much is made?
  • What’s in it?
A

100 mL per day, made up mostly of water (95%) and 5% is glycoproteins, carbs, lipids, DNA and Debris

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26
Q

What are the 2 layers of Mucous and what do they do?

A

Gel= Top Layer, next to laminar surface.

Sol= Bottom Layer, next to epithelial lining. Known as the Mucociliary Escalator (up & out)

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27
Q

What are the Canals of Lambert?

A

The areas between terminal bronchioles and Alveoli

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28
Q

Condition: Tracheal Agenesis vs. Tracheal Atresia

A

Agenesis= Congenital, Born without a Trachea (poor outcome)

Atresia= Congenital, underdeveloped Trachea (poor outcome)

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29
Q

Condition: Dysphagia

A

Difficulty Swallowing

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30
Q

Condition: Tracheoesophageal Fistula

A

An opening between the trachea and esophagus
- Can be corrected by surgery

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31
Q

Condition: Tracheal Stenosis

A

Narrowing of airway. Congenital or acquired
- Required surgical repair

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32
Q

Where is the intercostal space?
What does it contain?
Where do nerves/vessels run?

A
  • Space between the ribs
  • Contains Blood vessels, nerves and muscles
  • Vessels and nerves run inferior to the Rib
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33
Q

How many Ribs do we have?
False vs. True vs. Floating

A

12 Ribs
1-7= True Ribs
8-10= False Ribs
11 & 12= Floating Ribs

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34
Q

Pleural Effusion vs. Pneumothorax

A

Pleural Effusion= Fluid buildup in the pleural space- removed with needle

Pneumothorax= Air in the pleural space- removed with chest tube

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35
Q

Name the Right Lung Fissures

A
  1. Horizontal- between upper & middle lobe
  2. Oblique- between middle and lower lobe
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36
Q

Name the Left Lung Fissures

A
  1. Oblique- between the upper and lower lobe
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37
Q

Mediastinum vs. Hilum

A

Mediastinum= Space between Right and Left lungs. Houses organs and vessels

Hilum= Opening in middle of each lung where bronchi, veins, arteries enter the lungs

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38
Q

What is blood made of?

A

55% Plasma & 45% formed elements

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39
Q

What is the Respiratory Zone and it’s secondary name?

A

The site for gas exchange.
AKA. Parenchyma, Primary Lobule or Acinus

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40
Q

Alveoli
How many are there?
What do they do?

A
  • 500 million in an adult
  • Gas exchange units
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41
Q

Alveoli
What are the two main types?
What type of cells is it made of?

A

Type I= 95% surface. Major site for gas exchange
Type II= 5% of Surface. Produces Surfactant which reduces surface tension.

Made of Alveolar Epithelium

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42
Q

What does Interstitum Do and what is it made of?

A

Gives Alveolar capillary clusters support, made of gel like substance with collagen fibers

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43
Q

What are the two types of interstitum spaces and what do each do?

A

Tight & Loose
- Tight= Most gas exchange. Between the alveolar epithelium & pulmonary capillary endothelium

  • Loose= Contains lymphatic vessels and neural fibers with collagen
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44
Q

What are the 3 parts of the Tracheobronchial Tree

A
  1. Epithelial Lining= Pseudostratified ciliated mucous glands. Separated from the Lamina Propria by a basement membrane. Covered in mucous blanket (95% water)
  2. Lamina Propria= Submucosal layer. Has tiny blood vessel and lymphatic vessels. Branches to the vagus nerve. Has smooth muscle fibers that go counterclockwise and clockwise to constrict
  3. Cartilaginous Layer= outer layer of tree, Called the conducting zone
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45
Q

Path of Blood through the heart

A

Blood enters the Right Atrium from the Inferior and Superior Vena Cava, moves through the Tricuspid Valve to the Right Ventricle, through the pulmonary valve to the pulmonary artery with deoxygenated blood to the Lungs. Picks up oxygen and go to the Pulmonary veins into the Left Atrium, down through the bicuspid valve into the Left Ventricle, Through the aortic valve to the aorta, to the rest of the body and back into the Right Atrium.

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46
Q

The Upper Airways

What are they?
Their function?
What cells make them up?

A

Nose, Oral cavity, pharynx and Larynx

Conducts gases to and from the lungs. Conditions, humidifies and filters air. The 1st defense mechanism for the lungs. Area for speech and smell.

Stratified squamous epithelium

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47
Q

What are the 4 types of cells

A
  1. Stratified Squamous epithelium
    - Flat simple cells, lay on top of each other
    - Upper Airways
  2. Pseudostratified ciliated columnar epithelium
    - Columns of cells with cilia
    - tracheobronchial tree
  3. Simpe Cuboidal Epithelium
    - cubes or donut shaped
    - lines the airways
  4. Simple Squamous epithelium
    - grout or cobble stone
    - alveolar walls and capillaries
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48
Q

Thrombocyte (Platelets)

How many are there?
What do they do?

A

150k-450k per mm3

Prevents blood loss by clotting, seals small tears

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49
Q

What are the two subsets of COPD

A

Emphysema & Chronic Bronchitis

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50
Q

What is emphysema

A

Subset of COPD, alveolar wall destruction

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51
Q

What are the Pores of Kahn

A

Small holes in alveolar walls. Allows gas exchange between adjacent alveoli

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52
Q

Lower Airways

What makes them up?
What is their function?

A
  • Airway below Larynx consisting of Trachea, Bronchioles, bronchi
  • A passageway for air to enter and leave. Site for gas exchange
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53
Q

What 3 cells make up the lower airways?

A
  1. Pseudostratified ciliated columnar Epithelium (Tracheobronchial Tree)
  2. Simple Cuboidal Epithelium (Bronchioles)
  3. Simple Squamous Epithelium (Alveolar walls)
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54
Q

What is the Nose 3 main functions?

A
  1. Filter
  2. Humidify
  3. Condition
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55
Q

What is nasal flaring and why do we see it?

A

Respiratory Distress due to pneumonia, asthma or airway obstruction

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56
Q

What is the Conducting Airway

A

Passageway between Ambient Air & Alveoli

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57
Q

What is Sinusitis (rhinitis) and what causes it?

A

Inflammation of mucous membranes in the sinus/nasal cavity

Causes: URI, dental infection, atmospheric pressure change, artificial airway in nose, nasal cavity defects

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58
Q

What are the 7 Tracheobronchial tree levels

A

Trachea (15-20 cartilage rings)

(1st Gen.) Main Stem R. & L. Bronchi. - Has Carina Split

(2nd Gen.) Lobar Bronchi- R. has 3 lobes L. has 2 lobes

(3rd Gen.) Segmental Bronchi - R.=10 L.=8

(4th-9th Gen.) Subsegmental Bronchi - Last area of cartilage

(10th-15th Gen.) Bronchioles- No Cartilage. More likely to collapse

(16th-19th Gen.) Terminal Bronchioles. Canals of Lambert and Clara Cells

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59
Q

What are the 9 structures of the Thorax

A
  1. 12 Thoracic Vertebrae
  2. 12 Ribs
  3. Sternum
  4. Costal Cartilage
  5. Muscles
  6. Mediastinal Structures
  7. Heart
  8. Lungs
  9. Pleura
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60
Q

What are the 4 types of Retractions?

A
  1. Subcostal- Under the sternum
  2. Substernal- Sternum pulls inward
  3. Suprasternal- center of neck pulls in and down
  4. Supraclavicular- above clavicles pulls in and down
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61
Q

Where does the Diaphragm connect

A

Lumbar vertebrae, costal margin, Xiphoid Process

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62
Q

Peripheral Nervous System (PNS)
What does it include?
What are the 3 sub-systems

A
  • All the nerves outside of the brain and spinal column. (12 cranial & 31 spinal pairs)
  1. Somatic= Voluntary- reflex away from heat
  2. Autonomic= Regulates HR, RR, Pupils, Urine
    • Sympathetic (Increased HR&RR)= Fight/Flight/Freeze
    • Parasympathetic (Decreased HR&RR)= Rest
      & Digest
  3. Enteric= Gastrointestinal
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63
Q

What is the difference between an Agonist and Antagonist medication?

A

Agonist= Medication or Chemical simulates binding

Antagonist= Medication or chemical blocks binding

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64
Q

Which Receptor do we prefer the most and is it Adrenergic or Cholingeric?

A

Adrenergic- Beta 2. Bronchodilation of smooth muscles in airways

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65
Q

What is VPAC1

A

Vasodilation by Nitic Oxide

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66
Q

Histamine Receptors come from where and why?

A

Hypothalmus in response to injury, inflammation or irritation

The Lungs: Comes from Mast Cells and causes Bronchoconstriction

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67
Q

Condition: Asthma vs. COPD

A

Asthma- Airway inflammation. Has reversable airflow limitation- meaning medication can help.

COPD- Nonreversible or limited reversible airflow limitations (meds do not help)

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68
Q

What do Goblet Cells produce and when?

A

Mucous in times of infection or irritation

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69
Q

What does the mucous blanket contain?

A

Gel & Sol Layer and Cilia

70
Q

Condition: Pneumoconiosis

A

Group of diseases casued by inhaling particles that affect the Parenchyma

i.e. Coal Dust

71
Q

What does Boyle’s Law state?
What is the equation?

A

When Temp Remains constant, pressure will vary inversely with volume

P1V1=P2V2

72
Q

What does Henry’s Law state?
What’s an example?

A

The amount of gas dissolved in a liquid is proportionate to the amount of gas above the surface at a certain temperature.

i.e. Carbonated Soda

73
Q

What does Charle’s law State?
What is an exmaple?

A

If pressure and mass stay constant, the volume is proportionate to temperature

i.e. Heat sensitive thermometer or a Turkey

74
Q

What does Ficks law state?
What are the 3 important things to remember?

A

The rate of diffusion depends on the concentration gradient of the substance and the thickness of the membrane

  1. More surface area=better diffusion
  2. Bigger difference in Partial Pressures= better diffusion
  3. Thinner the membrane=better diffusion
75
Q

How long does it take for blood to travel through the pulmonary capillaries and how does exercise aide in this?

A

Normal Diffusion= .25 seconds
Pulmonary Diffusion= .75 Seconds

When exercising, blood moves faster so diffusion is quicker. In Healthy lungs this is ok, in unhealthy lungs this is not ok

76
Q

What does the Diaphragm do during inspiration and expiration

A

Inspiration= Diaphragm contracts downward, creating a negative pressure and increasing volume in the lungs for air to flow in and equalize the pressure.

Expiration= Diaphragm relaxes moving back up, which makes the thoracic cavity smaller, increasing the pressure so air flows out of lungs.

77
Q

How many pieces of the Diaphragm is there?
What enters the Diaphragm?
What main nerve controls it?

A
  • 2 Hemidiaphragms join in the middle
  • Esophagus, aorta, Inferior vena cava, nerves
  • Phrenic Nerve
78
Q

Procedure: Thoracentesis
Why do we do it?
What’s important to remember?

A

Needle inserted in pleural space to remove excess fluid.
Important: Needle must be superior to Rib to avoid vessels and nerves

79
Q

Diffusion: why does O2 leave alveoli and go to capillaries and why does CO2 leave capillaries and go to alveoli’s

A

Diffusion goes from high to Low

Blood= High pressure
Alveoli= Low pressure

80
Q

Minute Ventilation equation (VE)

A

VE= Vt x f

81
Q

Alveolar Ventilation Equation (VA)

A

VA= Vt - Vd x f

82
Q

How do you calculate deadspace?

A

1/2 of the air remaining in the airway does not get to the lungs.

Average deadspace= 150 mL

83
Q

What does Dalton’s Law state?
What is the air made up of?

A

in a mixture of gases, the total pressure is equal to the sun of Partial Pressure of each sperate gas. (mmHg)

  • 78% Nitrogen
  • 21% Oxygen
  • .03% Carbon Dioxide
  • .93% other
84
Q

Alveolar Air Equation (PAO2)(mmHg)

A

(Pb-PH20)FIO2-PaCo2(1.25)

Pb= atmospheric Pressure always 760 unless otherwise noted

PH20= Water Pressure always 47

85
Q

What are the 4 Position a patient can be in

A
  1. Fowlers= Upright
  2. Semi Fowlers= Reclining
  3. Trendelenburg= Head down, Feet up
  4. Reverse Trendelenburg= Feet down, Head up
86
Q

Condition: Hypersensitivity Pneumonitis

A

Pneumonia due to Fungal spores

i.e. Moldy Hay, Bird Poop

87
Q

Condition: Byssinosis

A

Inhaling cottong, hemp or flax seed

88
Q

Condition: Asbestosis and Mesothelioma

A

Asbestosis: Inhaling Asbestosis

Mesothelioma: Cancer caused by inhaling asbestosis. Latency 20-50 years

89
Q

Condition: Silicosis

What happens in the lungs?

A

Inhaling Silica.

Macrophages engulf and form nodules, can be seen on Xray

90
Q

What are the 3-particle sizes and their locations in the lungs?

A
  1. Greater than 5 Microns= Oro/Nasopharynx
  2. 1-5 Microns= Trachea & Conducting airways
  3. Less that 1 micron= Peripheral airway and alveoli (macrophages collect and break particle down by phagocytosis
91
Q

What is the Mucociliary Escalator

A

Process of moving foreign debris up and out of the airway (the SOL layer)

92
Q

What are the 3 parts and 4 lobes of the Brain

A

Parts:
1. Cerebrum=Right controls the left and vice versa
2. Cerebellum= Base of Skull- Voluntary muscle movement- posture & balance
3. Brainstem= Eye movement, involuntary functions: HR, RR, Temp, Digestion

Lobes:
1. Frontal= Personality, Emotion, Judgement
2. Temporal= Hearing, Visual, memories
3. Parietal= Touch, Temp, Paid
4. Occipital= Visual info center

93
Q

Central Nervous System (CNS)
What does it include and what are the 3 layers?

A

Incudes the Brain stem and Spinal Cord. Protected by the Dura Mater, Arachnoid Mater and Pia Mater

94
Q

Where is Cerebrospinal Fluid found and what does it contain?

A

Found between the Arachnoid and Pia Mater in CNS.

Contains, nutrients, removes waste product and acts as a cushion

95
Q

What is a sniff test?

A

Assess the diaphraghm movement to determine paralysis

96
Q

What is Paralysis of the Diaphragm

A

Damage to the Phrenic nerve, can be bilateral or unilateral. Determined by performing ‘sniff test’

97
Q

What is a Hiatal Hernia?

A

Portion of the stomach pushing through the esophageal hiatus

98
Q

What is a diaphragmatic hernia?

A

abnormal opening allowing abdominal contents to enter the thoracic cavity

99
Q

What are the 4 parts of the sternum?

A
  1. Manubrium
  2. Gladiolus= Body
  3. Xiphoid Process
  4. Manubriosternal Join. AKA. Angle of Louis
100
Q

What are the 3 intercostal Muscles?

A
  1. External= Contract on inspiration (rib cage opens)
  2. Internal= Contract on expiration (rib cage pulls in)
  3. Transverse= Work with internal
101
Q

what do Oxygen Consumption (VO2) & Oxygen Extraction Ration (O2ER) mean?

A

Out of the 1000 mL of o2 being delivered to our tissues only 250 mL gets used (VO2) and/or we use only 25% of the delivered O2 (O2ER)

102
Q

Blood Oxygen Content Equation (CaO2)(Vol%)

A

(PaO2 c .003) + (1.34 x Hbg% x SaO2)

103
Q

What does Poiseuille’s Law state?
(Think: Driving force/Radius)

A

To maintain constant flow the driving pressure must vary inversely with the radius

Decreased Radius= more pressure and less gas flow

Increase Radius= less pressure and more gas flow

104
Q

How to calculate the Total Flow for a device (3 parts)

A
  1. Magic Box
  2. Total parts
  3. Total parts x O2 input flow
    **Must know the pt demand to determine if device is adequate
105
Q

Total O2 Delivery in Blood equation (D02)(mL)

A

Qt x (CaO2 x 10)

106
Q

% of O2 in air equation (FIO2) (%)

A

(Airflow x 21) + (O2 flow x 100)
___________________________
Total Flow

Total flow= Airflow + O2 Flow

107
Q

What does Laplace’s Law State?
What does this mean in reference to a bubble (alveoli)

(Think: Blowing up a balloon)

A

As surface tension increases the pressure needed decreases, vice versa

When the Radius of a bubble increases the pressure decreases

108
Q

Condition: Hypoxemia vs. Hypoxia

A

Hypoxemia= Low O2 in the arteries (PaO2)

Hypoxia= Low tissue oxygenation

Hypoxemia leads to Hypoxia

109
Q

Condition= Polycythemia

What is it?
When do we see it?
Why is it bad?

A
  • Abnormally high RBCs.
  • Due to chronically low O2. Pt will have high hematocrit and Hb
  • It’s bad because the blood thickens, making the heart work harder, leading to heart failure and harder oxygenation, the body ends up making more RBCs due to the low O2 and therefore the cycle repeats
110
Q

What is Driving Pressure?

A

The difference between two ends of a tube (airway)

111
Q

What is Transrespiratory & Transthoracic pressures

A

They are ideally the same.

Transrespiratory= the difference between atmospheric pressure and alveolar pressure

Transthoracic= the difference between the alveolar pressure and body surface pressure

AKA. Pressure needed to inflate the lungs

112
Q

What is Transpulmonary Pressure

A

Difference between alveolar pressure and pleural pressure

AKA. Pressure need to keep alveoli open

113
Q

What is compliance?
What do High and Low mean?

A

How easily the lungs accept air. When compliance increases the lungs accepts more air. When compliance decreases the lungs take less air.

More Compliant= Floppy Lung: GOOD
Less Compliant= Stiff Lung: BAD

114
Q

In Poiseuille’s Law, what is turbulent air vs. Laminar Air?

A

Turbulent= Random flow, resistance from the sides and molecules.

Laminer= Smooth flow

115
Q

Surfactant
Where is it made?
What is it make of?
How does it work?

A
  • Made in alveolar type II cells.
  • Made of 90% phosphilid & 10% Protein
  • Forms a thin film between liquid and air in alveolus. It decreases surface tension by decreasing the H20 Molecule attraction.
116
Q

What happens when there is decreased Surfactant?

A

Acidosis, Hypoxia, Atelectasis, Pulmonary vascular congestion

117
Q

What are the 4 types of Hypoxia

A
  1. Hypoxic Hypoxia= Low O2 at tissue due to low PaO2
  2. Anemic Hypoxia= Low Hb, normal PaO2. Hb struggles to carry O2
  3. Circulatory Hypoxia= Normal PaO2, slow blood flow, decreased cardia output
  4. Histotoxic Hypoxia= cells cannot use the O2 correctly, normal PaO2. Cyanide poisoning.
118
Q

Where are the Peripheral Chemoreceptors located and what do they sense?

A

Carotid arteries and aortic arch.

They sense low O2, body reacts by increasing ventilation.

119
Q

How is CO2 transported?

A

A small portion is dissolved in the plasma, but majority is carried via bicarbonate.

CO2 attached to H20 and turns into Bicarbonate

120
Q

What are the 4 levels of Hypoxemia?

A
  1. Normal= 80-100 mmHg
  2. Mild= 60-80 mmHg
  3. Moderate= 40-60 mmHg
  4. Severe= Less than 40 mmHg
121
Q

What happens during a Left and Right Shift on the Dissociation Curve?

A

Left= Increased affinity of Hb and O2. O2 unloading is harder at the tissue level.

Right= Decreased affinity of Hb and O2. O2 unloads easily at the tissue level

122
Q

What is Pulmonary Shunting?
What are the two types?

A

Blood moving from Right to Left of the heart without O2.
- Absolute and Relative

Absolute= Anatomic and Capillary does not respond to O2 therapy

Absolute/Anatomic= Congenital Heart Disease, Intrapulmonary Fistula, Vascular Lung Tumors

Absolute/Capillary= Caused by atelectasis, fluid or consolidation

Relative= Does respond to O2 Therapy. Perfusion is greater than ventilation

123
Q

Which was does gas flow with the Pressure Gradient?

A

High to Low

124
Q

Where are the Central Chemoreceptors located and what do they sense?

A

Cerebrospinal fluid and they sense Hydrogen, when low it increases ventilation

125
Q

Air to O2 Ration (Magic Box) & Total Parts equation

A
  1. Make a box
  2. Center= O2 %
  3. Top Left Corner= 20
  4. Bottom Left corner= 100
  5. Subtract Diagonally (20-center=Bottom right corner…100-center=Top right corner)
  6. Divide the top Right from Bottom Right to get the left side of the Ratio. The right side of the ratio=1.

Total Parts= Left side of ratio + Right side of Ratio

126
Q

What is Flow Demand Equation? (L/min)

A

VE x 3

127
Q

Condition: Oxyhemoglobin vs. Deoxyhemoglobin

A

Oxyhemoglobin= Hb bound with O2

Deoxyhemoglobin= Hb not bound with O2

128
Q

What does Hooke’s law state?

(Think: rubber bands)

A

Responds directly to force and returns to original resting shape.

1 unit of force=1 unit of stretch.

There is a breaking point

129
Q

What are the 2 mechanisms of oxygen content and what is the equation?

A

O2 dissolved in the plasma= PaO2 x .003

O2 combined with Hb= 1.34 x Hbg% x SaO2

130
Q

What is Hemoglobin (Hb) and what are the 2 kinds?

A
  • Each RBC contains 280 million Hb molecules
  • Each Hb holds 4 O2

Two Type= Adult and Fetal
Adult= HbA Males: 14-16, Females: 12-15

Fetal= HbF. Increased affinity for O2, Facilitate transfer of O2 at the placenta. Gradually replaced within first year of life

131
Q

What is the treatment for Carboxyhemoglobin?

A
  • Breathing room air= 5 hours to remove 1/2 the CO
  • Breathing 100% O2 cuts time to 1-1.5 Hours
  • Hyperbaric Chamber cuts time to 23 minutes -
132
Q

What is Carboxyhemoglobin?

A

Carbon Monoxide (CO) poisoning

133
Q

What are the 3 types of abnormal Hemoglobin?

A
  1. Met Hb= Iron in Heme. Blood is thick and rusty brown. Nitrate Poisoning. Treated with methylene blue or ascorbic acid.
  2. Sickle Cell= Congenital. Crescent shaped, O2 Transport impaired
  3. Carboxyhemoglobin= CO Poisoning. CO bound to Hb. 1%-2% normal. 5%-10% cigarette smokers
134
Q

What all are appropriate in relation to Alveoli?
- Contains Surfactant
- Contains Cilia
- Surrounded by capillaries
- approximately 2 million in an adult
- only 1 cell thick

A
  • Contains surfactant
  • surrounded by capillaries
  • only 1 cell thick
135
Q

What is the first place we start to see gas exchange in the lungs?

A

Respiratory Brochioles

136
Q

What is the last point we see cartilage in the tracheobronchial tree?

A

Bronchioles

137
Q

What is the purpose of the nasal turbinate’s (concha)?

A

They create more surface area allowing for better warming and humidification

138
Q

What is an advantage of nasal topical agents?

A

Less or no systemic absorption- localized effect

139
Q

Is the lower portion of nose made up primarily of bone?

A

No, cartilage

140
Q

The autonomic nervous system is part of the peripheral nervous system True or False?

A

True

141
Q

The movement of gases from an area of high concentration to one of lower concentration is called?

A

Diffusion

142
Q

Does surfactant increases work of breathing or decrease?

A

Decreases

143
Q

What is increased alveolar Ventilation that decreases PaCO2?

A

Hyperventilation

144
Q

What is the complete absence of spontaneous breathing?

A

Apnea

145
Q

What is a increased depth of breathing with or without an increased frequency?

A

Hyperapnea

146
Q

What is 10-30 seconds of apnea followed by increase then decrease in tidal volume?

A

Cheyne Stokes

147
Q

What is normal spontaneous breathing called?

A

Eupnea

148
Q

What is rapid breathing called?

A

Tachypnea

149
Q

What is decreased alveolar ventilation that increases CO2?

A

Hypoventilation

150
Q

What is the feeling of shortness of breath?

A

Dyspnea

151
Q

What is one reason the alveolar capillary membrane may be thicker than normal?

A

Pulmonary Fibrosis

152
Q

Which pleural membrane is firmly attached to the outer surface of each lung? Visceral or Pariental?

A

Visceral

153
Q

Blood passes through the lungs in about how long?

A

.75 seconds

154
Q

Diffusion of O2 from alveoli to the blood plasms is completed in about how long?

A

.25 seconds

155
Q

Which gas law best relates to the composition of atmospheric gases?

A

Daltons Law

156
Q

According to Ficks Law, diffusion will increase if the surface area increases true or false?

A

True

157
Q

During exercise the time available for gas diffusion increases or decreases?

A

decreases

158
Q

When is an alveolus ventilated but not perfused you have what?

A

Dead Space

159
Q

What is another name for nasal hairs?

A

Vibrissae

160
Q

What is Paroxysmal adduction of the vocal cords, often misdiagnosed as asthma?

A

Vocal Cord Dysfunction

161
Q

What is a spasm or contraction of the vocal cords called?

A

Laryngospasm

162
Q

What is an infection of the palatine tonsils that form an abscess?

A

peritonsillar abscess

163
Q

What is inflammation of the larynx called?

A

laryngitis

164
Q

What is an infection of the palatine tonsils called?

A

Tonsillitis

165
Q

What is an ear infection called?

A

otitis media

166
Q

Is the alveolar duct a cartilagenous airway?

A

No

167
Q

Is a Transesophageal echocardiogram invasive?

A

yes

168
Q

What is high pressure in the pulmonary circulation called?

A

Pulmonary Hypertension

169
Q

What is a blood clot in the lungs called

A

Pulmonary embolus

170
Q

What is low red blood cell count called

A

Anemia

171
Q

What is blood cancer called

A

Lymphoma

172
Q

What is it called when clotting factors are missing leading to ineffective clotting

A

hemophilia

Intro to Respiratory Medicine (2 decks)

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