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Anatomy 2 numbers > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

How many scalene muscles do we have?

A

6

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2
Q

We only need ___ phrenic nerve to survive if we are completely healthy

A

1

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3
Q

What generation is the trachea?

A

0

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4
Q

What generations are the bronchi?

A

1-3

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5
Q

What generations are the bronchioles?

A

4

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6
Q

What generations are the terminal bronchioles?

A

5-16

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7
Q

What generations are the respiratory bronchioles?

A

17-19

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8
Q

What generations are the alveolar ducts?
Alveolar sacs?

A

-Ducts: 20-22
-Sacs 23

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9
Q

What 4 things are in the conducting zones?

A
  1. Trachea
  2. Bronchi
  3. Bronchioles
  4. Terminal bronchioles
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10
Q

Diameter of the trachea

A

2 cm

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11
Q

Cyanosis is classified as a deoxyHB of…

A

> 5 gm/dL

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12
Q

1 mmHg = ? CmH2O

A

1.36 cmH2O

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13
Q

O2 consumption is _____ mL/min

A

250 mL/min

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14
Q

In between breaths, our pleural pressure should be ____ cmH2O

A

-5 cmH2O

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15
Q

At the end of inspiration, our intrapleural pressure is ____ cmH2O

A

-7.5 cmH2O

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16
Q

Peak inspiration occurs when alveolar pressure is at _____ cmH2O and airflow is at ____ L/s

A

-1 cmH2O
-0.5 L/s

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17
Q

Zone 1 equation

A

PA > Pa > Pv

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18
Q

Zone 2 equation

A

Pa > PA > Pv

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19
Q

Zone 3 equation

A

Pa > Pv > PA

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20
Q

Average blood flow through the lungs is

A

5L / min

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21
Q

Explain inspiration and expiration with pressure and what the diaphragm is doing… image from class

A
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22
Q

Alveolar pressure equation

A

PA = PIP + PER

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23
Q

ER pressure equation
aka
Transpulmonary pressure equation

A

PER=PA-PIP

or
PTP=PA-PIP

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24
Q

Active influences that increase pulmonary vascular resistance

A

PEA HATS Δ

-PGF2 alpha, PGE2
-Endothelin
-Angiotensin
-Histamine (pulmonary venoconstrictor)
-Acidosis (mixed venous)
-Thromboxane
-SNS / Epi / Norepi
- Change… Alveolar hypoxia / hypercapnia

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25
Q

Active influences that decrease pulmonary vascular resistance

A

-PGE1
-Beta-adrenergic agonists
-Stimulation of PSNS
-Nitric oxide
-Acetylcholine
-Prostacyclin (PGI2
-Bradykinin

(PB SNAP B)

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26
Q

Two most important passive forces that impact pulmonary vascular resistance

A
  1. Gravity!!!!
  2. Lung volumes
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27
Q

Passive things that impact pulmonary vascular resistance (9)

A

-Increased lung volume (above FRC)
-Decreased lung volume (below FRC)
-Increased CO
-Gravity / body position
-Increased (more +) interstitial pressure
-Increased blood viscosity
-Positive pressure ventilation
-Increased alveolar pressure
-Positive intrapleural pressure

(I dont care about very itchy ivy green plants)

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28
Q

Nitrogen DRY ATMOSPHERIC partial pressure? concentration?

A

Partial pressure: 600.3 mmHg
Concentration 79%

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29
Q

Oxygen DRY ATMOSPHERIC partial pressure? concentration?

A

Partial pressure: 159 mmHg
Concentration 21%

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30
Q

Partial pressure equation

A

Partial pressure = total pressure x [gas]

Example:
Partial pressure of oxygen:
760 x .21 = 159 mmHg

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31
Q

PIO2 in humidified gas

A

149 mmHg

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32
Q

PIN2 in humidified gas

A

564 mmHg

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33
Q

PIH2O

A

47 mmHg

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34
Q

How to find the PIO2?

A

PIO2 = FIO2 (PB - PH2O)

Example:
0.21 ( 760 - 47 ) = 149

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35
Q

Fresh air we breathe in has a PO2 of….
A PCO2 of…

A

PO2 of 150 (149 to be exact)
A PCO2 of 0

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36
Q

Alveolar PO2 and PCO2

A

PO2 of 100 (or 104 for *most *accurate)
A PCO2 of 40

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37
Q

How many mL of our tidal volume actually makes it all the way into the lungs for gas exchange?

38
Q

How many mL of our tidal volume is anatomical dead space?

39
Q

How to calculate anatomical dead space based on body weight

A

1 cc / lb of IBW

40
Q

PO2 and PCO2 of the pulmonary artery / systemic venous blood

A

PO2 of 40
A PCO2 of 45

41
Q

PO2 and PCO2 of the pulmonary vein / systemic arterial

A

PO2 of 100
A PCO2 of 40

Technically the pulmonary vein has a PO2 of 104 mmHg! Systemic arterial is diluted out with deoxygenated blood from pulmonary tissue circulatory system.

42
Q

The tissues of the lung have their own small circulatory system makes up about ___% of our cardiac output

43
Q

Alveolar gas at standard barometric pressure:
-PAO2
-PACO2
-PAN2
-PAH2O

A

-PAO2: 100 or 104 (most accurate)
-PACO2: 40
-PAN2: 569
-PAH2O: 47

all in mmHg!

44
Q

If I increase my ventilation, but leave pulmonary blood flow unchanged, how does this impact my alveolar O2 and CO2?

A

-Alveolar O2 would be higher
-Alveolar CO2 lower

45
Q

Typically, if I take in a 500 cc breath, the first ____cc will make it all the way into the lungs for gas exchange

46
Q

Typically, if I take in a 500 cc breath, the last ____cc will not make it deep enough into the lungs for gas exchange

47
Q

What makes up physiological dead space?

A

Alveolar dead space (bad) + anatomical dead space (normal)

48
Q

True or false: a 100 year old man in picture perfect health will have a significant amount of alveolar dead space in comparison to a 20 year old healthy adult

A

True! This is inescapable

49
Q

Minute ventilation equation

A

VT = VE = VT x BPM (n)

(First VT and VE would have dots over V! just can not do it in brainscapes!)

50
Q

VT equation

A

VT = VD + VA

51
Q

Alveolar ventilation equation using VT

A

(n)VA = (n)VT-(n)VD

52
Q

Alveolar ventilation equation using minute ventilation

A

VA = VE - VD
(all would have dots over V! just can not do it in brainscapes!)

53
Q

Normal minute ventilation and how you got it

A

6 L /min

VTx BPM
500 x 12 =6,000 mL

54
Q

Normal alveolar minute ventilation and how you got it

A

4.2 L/min

(12 x 500) - (12 x 150) = 4,200 mL
(n) VT - (n) VD

55
Q

Normal minute dead space ventilation and how you got it

A

1.8 L / min

VD(n)
150 x 12 = 1,800 mL

56
Q

Could I find total minute ventilation if I had minute dead space ventilation and minute alevolar ventilation? If so, how?

A

Yes!

Minute dead space ventilation + min alveolar ventilation = total minute ventilation

so…

1.8 L (dead space) + 4.2 L (alveolar ventilation) = 6L = total minute ventilation

57
Q

Pulmonary capillary starling forces:
PC
πpl

A

PC: 7 mmHg
πpl: 28 mmHg

58
Q

Pulmonary interstitium Starling forces:
Pis
πis

A

Pis: -8 mmHg
πis: 14 mmHg

59
Q

NFP of pulmonary capillary
How did you get it?

A

+1

7 + 14 + 8= 29
^ These favor filtration
29 - 28 (πcap; opposes filtration) = 1

**This is 3x the systemic NFP! (0.3 mmHg)

60
Q

In the graph, it shows that LAP can go all the way up to ___mmHg before it becomes a problem for pulmonary edema

61
Q

Two biggest risk factors for pulmonary edema formation

A

-Someone who has lost a lot of blood (and therefore proteins)
-Left heart failure

62
Q

Qf equation

63
Q

5 factors predisposing to pulmonary edema

General factors, not specific

A
  • Increased capillary permeability
  • Increased capillary hydrostatic pressure
  • Decreased interstitial hydrostatic pressure
  • Decreased colloid osmotic pressure
  • Insufficent pulmonary lymphatic drainage
  • Also unknown etiology… see image
64
Q

At FRC, the pleural pressures are:

Top of the lung:
Bottom of the lung:
Average:

A

Top of the lung: -8.5 cmH2O
Bottom of the lung: -1.5 cmH2O
Average: -5 cmH2O

65
Q

At RV, the pleural pressures are:

Top of the lung:
Bottom of the lung:
Average:

A

Top of the lung: -2.2 cmH2O
Bottom of the lung: +4.8 cmH2O
Average: +1.3 cmH2O

66
Q

At FRC, alveoli at the top of the lung are ___% full

A

60%

Note the slope is less steep, these alveoli are less compliant!

67
Q

At FRC, alveoli at the bottom of the lung are ___% full

A

25%

This is why they accept air easier! They are more compliant.

68
Q

Alveoli really can not be emptied more than to ____% of their capacity. Why?

A

20%
You push on the small airway and collapse it!

69
Q

At RV, alveoli at the bottom of the lung are ___% full

A

20%
as empty as they can be!

70
Q

At RV, alveoli at the apex of the lung are ___% full

71
Q

At RV, air prefers to go to the __ of the lung
At FRC, air prefers to go to the ___ of the lung

A

RV : top
FRC: base

72
Q

Why is the base of our lung noncompliant at RV?

A

We had to generate a really positive pleural pressure to breathe that air out! This collapsed the small airways. Slope of line is zero at a transpulmonary pressure of -4.8!

73
Q

At FRC the transpulmonary pressure is higher at the ___ of the lung. What does this mean?

A

Top of the lung!

The higher PTP keeps the alveolli more distended!

74
Q

All vascular smooth muscle constriction is mediated by _____

General anesthetics open ____ channels

A

Membrane potentials!
Potassium channels

75
Q

In a normal healthy adult, FRC goes down to ___ L in the supine position.

A

2L

We lose ERV due to the abdominal stuff pushing on diaphragm

ERV shrinks; IRV expands

76
Q

Possible indicator gases

A

-Helium
-Neon
-Argon
-Xenon

Maybe Radon…?

77
Q

This is the second leading cause of lung cancer, behind smoking

A

Radon gas!

78
Q

6 things that make up surfactant

A
  1. Surfactant protein A (hydrophilic)
  2. Surfactant protein D (hydrophilic)
  3. Surfactant protein B (hydrophobic)
  4. Surfactant protein C (hydrophobic)
  5. Dipalmitoylphosphatidylcholine
  6. Phosphatidylcholine
79
Q

Which surfactant proteins are water loving?

A

SP-A and SP-D

80
Q

Surfactant is: __% lipids and ___% proteins

A

90% lipids
10% proteins

81
Q

Dipalmitoylphosphatidylcholine makes up ___% of the surfactant

82
Q

Name the three cells that secrete surfactant

A
  1. Goblet cells (a little bit)
  2. Clara/club cells
  3. Type II alveolar cells
83
Q

Type I alveolar cells make up ___-___% of the gas exchange surface area

84
Q

Type II alveolar cells make up ___-___% of the gas exchange surface area

85
Q

Do we have more type I or type II alveolar cells?
How many more?

A

2x more type II alveolar cells

However, they do not take up as much real estatr as the type I

86
Q

How many alveoli do we have as young adults?

A

500 million

87
Q

Each of the alveoli could have as many as ____ capillaries attached to it

88
Q

A 20 year old healthy adult should have _____ m^2 of surface area for gas exchange

A

70 m^2

This is the size of a tennis court

89
Q

2/3 of our elastic recoil pressure is made up of….
1/3 is from…..

A

2/3: surface tension (of water)
1/3: tissue

90
Q

Small airway resistance is generally a ___ dependent thing.

Large airway resistance is a ___ dependent thing

A

Small: volume dependent!
Large: Traction / intrapleural pressure

We need a really low pleural pressure if we want a really high volume of air in our alveoli!

91
Q

The V/Q ratio is higher at the apex.
How does this impact PACO2 and PAO2?

A

PACO2 is lower at the apex, and PAO2 is higher at the apex.

This is in comparison to the base

92
Q

If I have a blood clot blocking blood flow to small group of alveoli. What will their PAO2 and PACO2 be?

A

PAO2: 149
PACO2: 0

They equilibrate with inspired air

Anatomy 2 numbers (4 decks)

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