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
2
Q
What are the 2 Pleural Membranes
A
- Visceral= attached to the lungs and into the fissures
- Parietal= Lines the thoracic wall, surface of the diaphragm and lateral mediatstinum
3
Q
What does the Lymphatic System do?
A
Fluid Balance, absorption of fats & fat-soluble nutrients and transports Lymph Fluid
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
5
Q
Condition: Tracheomalacia
A
Weakness of the Trachea
(congenital or acquired)
Can be healed on it’s own or fixed with surgical stent
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
7
Q
Bronchiolitis vs. Bronchiectasis
A
Bronchiolitis= infection involving bronchioles. Common in Children
Bronchiectasis= Chronic. Bronchi walls become thick
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
9
Q
What are the 5 Leukocyte breakdowns
A
- Neutrophils= First responders
- Lymphocytes= T Cells, makes antibodies
- Monocytes= Largest-Macrophages
- Eosinophils= Allergic Reaction- High in Asthma
- Basophils= Release Histamine and Heparin
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
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
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
13
Q
What is normal Cardiac Output (Qt)
A
4-8 L/min
14
Q
What are the 3 formed elements of the blood?
A
Erythrocytes (RBC)
Leukocytes (WBC)
Platelets
15
Q
Condition: Pharyngeal Reflex
A
Gag Reflex
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
17
Q
Thyroid Cartilage
What is it shape?
Where is it located?
Nickname?
A
- Butterfly Shaped
- In front of the Larynx
- ‘Adams Apple’
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
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
20
Q
Condition: Epiglottitis
A
Inflammation of the epiglottis.
(For RTs, pt may need to be Trached)
21
Q
Condition: Croup
AKA Laryngotracheabronchitis
How to identify?
A
Inflammation below the Glottis
Identified by Steeply Sign on Xray, loud barking cough
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
23
Q
What is in the Oral Cavity?
A
Anterior 2/3 of tongue, Vestibules (gums), Hard Palate, Soft Palate, Teeth
24
Q
Condition: Epistaxis
A
Nosebleeds
25
Mucous
- How much is made?
- What's in it?
100 mL per day, made up mostly of water (95%) and 5% is glycoproteins, carbs, lipids, DNA and Debris
26
What are the 2 layers of Mucous and what do they do?
Gel= Top Layer, next to laminar surface.
Sol= Bottom Layer, next to epithelial lining. Known as the Mucociliary Escalator (up & out)
27
What are the Canals of Lambert?
The areas between terminal bronchioles and Alveoli
28
Condition: Tracheal Agenesis vs. Tracheal Atresia
Agenesis= Congenital, Born without a Trachea (poor outcome)
Atresia= Congenital, underdeveloped Trachea (poor outcome)
29
Condition: Dysphagia
Difficulty Swallowing
30
Condition: Tracheoesophageal Fistula
An opening between the trachea and esophagus
- Can be corrected by surgery
31
Condition: Tracheal Stenosis
Narrowing of airway. Congenital or acquired
- Required surgical repair
32
Where is the intercostal space?
What does it contain?
Where do nerves/vessels run?
- Space between the ribs
- Contains Blood vessels, nerves and muscles
- Vessels and nerves run inferior to the Rib
33
How many Ribs do we have?
False vs. True vs. Floating
12 Ribs
1-7= True Ribs
8-10= False Ribs
11 & 12= Floating Ribs
34
Pleural Effusion vs. Pneumothorax
Pleural Effusion= Fluid buildup in the pleural space- removed with needle
Pneumothorax= Air in the pleural space- removed with chest tube
35
Name the Right Lung Fissures
1. Horizontal- between upper & middle lobe
2. Oblique- between middle and lower lobe
36
Name the Left Lung Fissures
1. Oblique- between the upper and lower lobe
37
Mediastinum vs. Hilum
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
38
What is blood made of?
55% Plasma & 45% formed elements
39
What is the Respiratory Zone and it's secondary name?
The site for gas exchange.
AKA. Parenchyma, Primary Lobule or Acinus
40
Alveoli
How many are there?
What do they do?
- 500 million in an adult
- Gas exchange units
41
Alveoli
What are the two main types?
What type of cells is it made of?
Type I= 95% surface. Major site for gas exchange
Type II= 5% of Surface. Produces Surfactant which reduces surface tension.
Made of Alveolar Epithelium
42
What does Interstitum Do and what is it made of?
Gives Alveolar capillary clusters support, made of gel like substance with collagen fibers
43
What are the two types of interstitum spaces and what do each do?
Tight & Loose
- Tight= Most gas exchange. Between the alveolar epithelium & pulmonary capillary endothelium
- Loose= Contains lymphatic vessels and neural fibers with collagen
44
What are the 3 parts of the Tracheobronchial Tree
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
45
Path of Blood through the heart
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.
46
The Upper Airways
What are they?
Their function?
What cells make them up?
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
47
What are the 4 types of cells
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
48
Thrombocyte (Platelets)
How many are there?
What do they do?
150k-450k per mm3
Prevents blood loss by clotting, seals small tears
49
What are the two subsets of COPD
Emphysema & Chronic Bronchitis
50
What is emphysema
Subset of COPD, alveolar wall destruction
51
What are the Pores of Kahn
Small holes in alveolar walls. Allows gas exchange between adjacent alveoli
52
Lower Airways
What makes them up?
What is their function?
- Airway below Larynx consisting of Trachea, Bronchioles, bronchi
- A passageway for air to enter and leave. Site for gas exchange
53
What 3 cells make up the lower airways?
1. Pseudostratified ciliated columnar Epithelium (Tracheobronchial Tree)
2. Simple Cuboidal Epithelium (Bronchioles)
3. Simple Squamous Epithelium (Alveolar walls)
54
What is the Nose 3 main functions?
1. Filter
2. Humidify
3. Condition
55
What is nasal flaring and why do we see it?
Respiratory Distress due to pneumonia, asthma or airway obstruction
56
What is the Conducting Airway
Passageway between Ambient Air & Alveoli
57
What is Sinusitis (rhinitis) and what causes it?
Inflammation of mucous membranes in the sinus/nasal cavity
Causes: URI, dental infection, atmospheric pressure change, artificial airway in nose, nasal cavity defects
58
What are the 7 Tracheobronchial tree levels
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
59
What are the 9 structures of the Thorax
1. 12 Thoracic Vertebrae
2. 12 Ribs
3. Sternum
4. Costal Cartilage
5. Muscles
6. Mediastinal Structures
7. Heart
8. Lungs
9. Pleura
60
What are the 4 types of Retractions?
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
61
Where does the Diaphragm connect
Lumbar vertebrae, costal margin, Xiphoid Process
62
Peripheral Nervous System (PNS)
What does it include?
What are the 3 sub-systems
- 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
63
What is the difference between an Agonist and Antagonist medication?
Agonist= Medication or Chemical simulates binding
Antagonist= Medication or chemical blocks binding
64
Which Receptor do we prefer the most and is it Adrenergic or Cholingeric?
Adrenergic- Beta 2. Bronchodilation of smooth muscles in airways
65
What is VPAC1
Vasodilation by Nitic Oxide
66
Histamine Receptors come from where and why?
Hypothalmus in response to injury, inflammation or irritation
The Lungs: Comes from Mast Cells and causes Bronchoconstriction
67
Condition: Asthma vs. COPD
Asthma- Airway inflammation. Has reversable airflow limitation- meaning medication can help.
COPD- Nonreversible or limited reversible airflow limitations (meds do not help)
68
What do Goblet Cells produce and when?
Mucous in times of infection or irritation
69
What does the mucous blanket contain?
Gel & Sol Layer and Cilia
70
Condition: Pneumoconiosis
Group of diseases casued by inhaling particles that affect the Parenchyma
i.e. Coal Dust
71
What does Boyle's Law state?
What is the equation?
When Temp Remains constant, pressure will vary inversely with volume
P1V1=P2V2
72
What does Henry's Law state?
What's an example?
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
What does Charle's law State?
What is an exmaple?
If pressure and mass stay constant, the volume is proportionate to temperature
i.e. Heat sensitive thermometer or a Turkey
74
What does Ficks law state?
What are the 3 important things to remember?
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
How long does it take for blood to travel through the pulmonary capillaries and how does exercise aide in this?
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
What does the Diaphragm do during inspiration and expiration
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
How many pieces of the Diaphragm is there?
What enters the Diaphragm?
What main nerve controls it?
- 2 Hemidiaphragms join in the middle
- Esophagus, aorta, Inferior vena cava, nerves
- Phrenic Nerve
78
Procedure: Thoracentesis
Why do we do it?
What's important to remember?
Needle inserted in pleural space to remove excess fluid.
Important: Needle must be superior to Rib to avoid vessels and nerves
79
Diffusion: why does O2 leave alveoli and go to capillaries and why does CO2 leave capillaries and go to alveoli's
Diffusion goes from high to Low
Blood= High pressure
Alveoli= Low pressure
80
Minute Ventilation equation (VE)
VE= Vt x f
81
Alveolar Ventilation Equation (VA)
VA= Vt - Vd x f
82
How do you calculate deadspace?
1/2 of the air remaining in the airway does not get to the lungs.
Average deadspace= 150 mL
83
What does Dalton's Law state?
What is the air made up of?
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
Alveolar Air Equation (PAO2)(mmHg)
(Pb-PH20)FIO2-PaCo2(1.25)
Pb= atmospheric Pressure always 760 unless otherwise noted
PH20= Water Pressure always 47
85
What are the 4 Position a patient can be in
1. Fowlers= Upright
2. Semi Fowlers= Reclining
3. Trendelenburg= Head down, Feet up
4. Reverse Trendelenburg= Feet down, Head up
86
Condition: Hypersensitivity Pneumonitis
Pneumonia due to Fungal spores
i.e. Moldy Hay, Bird Poop
87
Condition: Byssinosis
Inhaling cottong, hemp or flax seed
88
Condition: Asbestosis and Mesothelioma
Asbestosis: Inhaling Asbestosis
Mesothelioma: Cancer caused by inhaling asbestosis. Latency 20-50 years
89
Condition: Silicosis
What happens in the lungs?
Inhaling Silica.
Macrophages engulf and form nodules, can be seen on Xray
90
What are the 3-particle sizes and their locations in the lungs?
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
What is the Mucociliary Escalator
Process of moving foreign debris up and out of the airway (the SOL layer)
92
What are the 3 parts and 4 lobes of the Brain
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
Central Nervous System (CNS)
What does it include and what are the 3 layers?
Incudes the Brain stem and Spinal Cord. Protected by the Dura Mater, Arachnoid Mater and Pia Mater
94
Where is Cerebrospinal Fluid found and what does it contain?
Found between the Arachnoid and Pia Mater in CNS.
Contains, nutrients, removes waste product and acts as a cushion
95
What is a sniff test?
Assess the diaphraghm movement to determine paralysis
96
What is Paralysis of the Diaphragm
Damage to the Phrenic nerve, can be bilateral or unilateral. Determined by performing 'sniff test'
97
What is a Hiatal Hernia?
Portion of the stomach pushing through the esophageal hiatus
98
What is a diaphragmatic hernia?
abnormal opening allowing abdominal contents to enter the thoracic cavity
99
What are the 4 parts of the sternum?
1. Manubrium
2. Gladiolus= Body
3. Xiphoid Process
4. Manubriosternal Join. AKA. Angle of Louis
100
What are the 3 intercostal Muscles?
1. External= Contract on inspiration (rib cage opens)
2. Internal= Contract on expiration (rib cage pulls in)
3. Transverse= Work with internal
101
what do Oxygen Consumption (VO2) & Oxygen Extraction Ration (O2ER) mean?
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
Blood Oxygen Content Equation (CaO2)(Vol%)
(PaO2 c .003) + (1.34 x Hbg% x SaO2)
103
What does Poiseuille's Law state?
(Think: Driving force/Radius)
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
How to calculate the Total Flow for a device (3 parts)
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
Total O2 Delivery in Blood equation (D02)(mL)
Qt x (CaO2 x 10)
106
% of O2 in air equation (FIO2) (%)
(Airflow x 21) + (O2 flow x 100)
___________________________
Total Flow
Total flow= Airflow + O2 Flow
107
What does Laplace's Law State?
What does this mean in reference to a bubble (alveoli)
(Think: Blowing up a balloon)
As surface tension increases the pressure needed decreases, vice versa
When the Radius of a bubble increases the pressure decreases
108
Condition: Hypoxemia vs. Hypoxia
Hypoxemia= Low O2 in the arteries (PaO2)
Hypoxia= Low tissue oxygenation
Hypoxemia leads to Hypoxia
109
Condition= Polycythemia
What is it?
When do we see it?
Why is it bad?
- 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
What is Driving Pressure?
The difference between two ends of a tube (airway)
111
What is Transrespiratory & Transthoracic pressures
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
What is Transpulmonary Pressure
Difference between alveolar pressure and pleural pressure
AKA. Pressure need to keep alveoli open
113
What is compliance?
What do High and Low mean?
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
In Poiseuille's Law, what is turbulent air vs. Laminar Air?
Turbulent= Random flow, resistance from the sides and molecules.
Laminer= Smooth flow
115
Surfactant
Where is it made?
What is it make of?
How does it work?
- 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
What happens when there is decreased Surfactant?
Acidosis, Hypoxia, Atelectasis, Pulmonary vascular congestion
117
What are the 4 types of Hypoxia
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
Where are the Peripheral Chemoreceptors located and what do they sense?
Carotid arteries and aortic arch.
They sense low O2, body reacts by increasing ventilation.
119
How is CO2 transported?
A small portion is dissolved in the plasma, but majority is carried via bicarbonate.
CO2 attached to H20 and turns into Bicarbonate
120
What are the 4 levels of Hypoxemia?
1. Normal= 80-100 mmHg
2. Mild= 60-80 mmHg
3. Moderate= 40-60 mmHg
4. Severe= Less than 40 mmHg
121
What happens during a Left and Right Shift on the Dissociation Curve?
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
What is Pulmonary Shunting?
What are the two types?
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
Which was does gas flow with the Pressure Gradient?
High to Low
124
Where are the Central Chemoreceptors located and what do they sense?
Cerebrospinal fluid and they sense Hydrogen, when low it increases ventilation
125
Air to O2 Ration (Magic Box) & Total Parts equation
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
What is Flow Demand Equation? (L/min)
VE x 3
127
Condition: Oxyhemoglobin vs. Deoxyhemoglobin
Oxyhemoglobin= Hb bound with O2
Deoxyhemoglobin= Hb not bound with O2
128
What does Hooke's law state?
(Think: rubber bands)
Responds directly to force and returns to original resting shape.
1 unit of force=1 unit of stretch.
There is a breaking point
129
What are the 2 mechanisms of oxygen content and what is the equation?
O2 dissolved in the plasma= PaO2 x .003
O2 combined with Hb= 1.34 x Hbg% x SaO2
130
What is Hemoglobin (Hb) and what are the 2 kinds?
- 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
What is the treatment for Carboxyhemoglobin?
- 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
What is Carboxyhemoglobin?
Carbon Monoxide (CO) poisoning
133
What are the 3 types of abnormal Hemoglobin?
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
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
- Contains surfactant
- surrounded by capillaries
- only 1 cell thick
135
What is the first place we start to see gas exchange in the lungs?
Respiratory Brochioles
136
What is the last point we see cartilage in the tracheobronchial tree?
Bronchioles
137
What is the purpose of the nasal turbinate's (concha)?
They create more surface area allowing for better warming and humidification
138
What is an advantage of nasal topical agents?
Less or no systemic absorption- localized effect
139
Is the lower portion of nose made up primarily of bone?
No, cartilage
140
The autonomic nervous system is part of the peripheral nervous system True or False?
True
141
The movement of gases from an area of high concentration to one of lower concentration is called?
Diffusion
142
Does surfactant increases work of breathing or decrease?
Decreases
143
What is increased alveolar Ventilation that decreases PaCO2?
Hyperventilation
144
What is the complete absence of spontaneous breathing?
Apnea
145
What is a increased depth of breathing with or without an increased frequency?
Hyperapnea
146
What is 10-30 seconds of apnea followed by increase then decrease in tidal volume?
Cheyne Stokes
147
What is normal spontaneous breathing called?
Eupnea
148
What is rapid breathing called?
Tachypnea
149
What is decreased alveolar ventilation that increases CO2?
Hypoventilation
150
What is the feeling of shortness of breath?
Dyspnea
151
What is one reason the alveolar capillary membrane may be thicker than normal?
Pulmonary Fibrosis
152
Which pleural membrane is firmly attached to the outer surface of each lung? Visceral or Pariental?
Visceral
153
Blood passes through the lungs in about how long?
.75 seconds
154
Diffusion of O2 from alveoli to the blood plasms is completed in about how long?
.25 seconds
155
Which gas law best relates to the composition of atmospheric gases?
Daltons Law
156
According to Ficks Law, diffusion will increase if the surface area increases true or false?
True
157
During exercise the time available for gas diffusion increases or decreases?
decreases
158
When is an alveolus ventilated but not perfused you have what?
Dead Space
159
What is another name for nasal hairs?
Vibrissae
160
What is Paroxysmal adduction of the vocal cords, often misdiagnosed as asthma?
Vocal Cord Dysfunction
161
What is a spasm or contraction of the vocal cords called?
Laryngospasm
162
What is an infection of the palatine tonsils that form an abscess?
peritonsillar abscess
163
What is inflammation of the larynx called?
laryngitis
164
What is an infection of the palatine tonsils called?
Tonsillitis
165
What is an ear infection called?
otitis media
166
Is the alveolar duct a cartilagenous airway?
No
167
Is a Transesophageal echocardiogram invasive?
yes
168
What is high pressure in the pulmonary circulation called?
Pulmonary Hypertension
169
What is a blood clot in the lungs called
Pulmonary embolus
170
What is low red blood cell count called
Anemia
171
What is blood cancer called
Lymphoma
172
What is it called when clotting factors are missing leading to ineffective clotting
hemophilia
