Embryology, Anatomy, Physiology Flashcards
Bronchogenic cysts Caused by
► Diagnostic criteria
abnormal budding of the foregut and dilation of terminal or large bronchi
►Cartilage in wall
Club cells
►Location
►Function
► Located in bronchioles.
►Degrade toxins b CYP 450; secrete component of surfactant; act as reserve cells.
Law of laplace
Collapsing pressure (P) = 2 (surface tension) / radius
Alveolar proteinases
- Elastase
- Matrix metalloproteinase
- 0Cathepsin G
Anti-proteinases
- A1AT
- TIMP (Tissue inhibitor of metalloproteinases)
- Alpha-2 microglobulin
Screening tests for fetal lung maturity:
- lecithin sphingomyelin (L/S) ratio in amniotic fluid (≥2 is healthy; < 1.5 predictive of NRDS),
- foam stability index,
- surfactant-albumin ratio
Albumin and total proteins in amniotic fluid normally _________from early gestation to term
decreases by 50%
in lungs, _____ levels remain constant
sphingomyelin
Therapeutic supplemental O2 can result in
(RIB).
Retinopathy of prematurity,
Intraventricular hemorrhage,
Bronchopulmonary dysplasia
Neonatal respiratory distress syndrome
Risk factors:
- prematurity,
- maternal diabetes (due to fetal insulin),
- C-section delivery
Common iliac veins merge into IVC at ____ level
L5
IVC is ____ to descending part of duodenum
medial
IVC passes through the ____ of central tendon of diaphragm at ___ level
Right
T8
Thoracocentesis for pleural effusion
area 1 or 2 intercostal spaces below the fluid level and 5-10 cm lateral to the spine or midscapular line.
Needle positioning for tension pneumothorax
2nd intercostal space, midclavicular line
Cartilage and goblet cells end at
bronchi
Airway smooth muscle cells extend to
end of terminal bronchioles
Pseudostratified ciliated columnar cells primarily make up epithelium of bronchus and extend to
beginning of terminal bronchioles
Mostly cuboidal cells in ______, then simple squamous cells ________
respiratory bronchioles
up to alveoli
Cilia terminate in
respiratory bronchioles
________ cannot be measured by spirometry
RV and any lung capacity that includes RV
Hysteresis: Lung inflation follows a different pressure volume curve than lung deflation due to
need to overcome surface tension forces in inflation
At ____, airway and alveolar pressures equal atmospheric pressure (called zero), and intrapleural pressure is ______
FRC
Negative
Hb exhibits ____ cooperativity and ______ allostery
positive
positive
Myoglobin has ____ affinity for oxygen than Hb
higher
Transpulmonary pressure:
positive
negative
Alveolar pressure - Intrapleural pressure
positive: holds airway open
negative: Airway collapse
Equal pressure point in healthy lungs occurs in
cartilaginous airways
Deoxygenated form of Hb has ___ affinity for oxygen
lower
CO poisoning Classically associated with ______ lesions on MRI
bilateral globus pallidus
CO poisoning OD curve
Left shift in curve →↑affinity for O2 →↓O2 unloading in tissues.
In cyanide poisoning everything is normal except, ____ is increased and ____ is decreased
↑ venous O2 content
↓ arterial-venous O2 gradiant
Cyanide binds iron in ____ form
Fe3+
P50 for Hb and myoglobin is ____
Hb: 26mmHg
Myoglobin: 1mmHg
If P50 is decreased, ODC will shift towards
left
Hemoglomin M disease is a congenital cause of ______ due to mutation in ____
methemoglobinemia
heme-binding pocket
At what point in ODC, compensatory erythropoeisis will occur?
left shift → ↓O2 unloading → renal hypoxia → ↑EPO production
Alveolar gas equation
PAO2 = PIo2 - Paco2 / R
150 - Paco2/0.8
R = respiratory quotient =
CO2 produced / O2 consumed
In normal lung
ventilation is max at
perfusion is max at
V/Q ratio is max at
base
base
apex
CO2 bound to Hb at
N-terminus of globin (not heme).
Haldane effect
In lungs, oxygenation of Hb promotes dissociation of H+ from Hb. This shifts equilibrium toward CO2 formation; therefore, CO2 is released from RBCs
Bohr effect
In peripheral tissue, H+ from tissue metabolism shifts curve to right, unloading O2
High altitude sickness long tern complication
Chronic hypoxic pulmonary vasoconstriction results in pulmonary hypertension and RVH.
H+ binds to Hb to
end of globin chain (not heme)
Exercise: partial pressure of O2 and CO2 in blood
Arterial PaO2 and PaCO2 are normal
Venous O2↓ and CO2↑
