Exam II- Spring 2024 Flashcards

1
Q

Identify the 5 anatomical structures

A
  1. Central Tendon
  2. Esophageal Aperture
  3. Lumbar Spine- where diaphragm anchors itself to
  4. Aortic Aperture
  5. Caval Aperture

*alternate view

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2
Q

Identify the 5 anatomical structures

A
  1. Epiglottis
  2. Thyrohyoid Membrane and Hyoid Bone
  3. Thyroid Cartilage
  4. Cricoid Cartilage
  5. Laryngeal Prominence (Adam’s Apple)
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3
Q

Identify the 7 Anatomical Structures

A
  1. Epiglottis
  2. Cricoid Cartliages
  3. Vocal Folds (vocal cords)
  4. Thyroid Cartilage
  5. Thyrohyoid Ligament
  6. Hyoid Bone
  7. Tracheal Cartilage
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4
Q

Identify the 2 anatomical structures

A
  1. Colliculus
  2. Thyroid Cartilage

lateral view

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5
Q

What type of muscles are in the vocal folds and what innervates them?

A
  • Skeletal muscles
  • Recurrent laryngeal nerve
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6
Q

What is the formula to calculate Transpulmonary Pressures (PTP)? What other pressure does this formula work for?

A
  • PTP= Aveolar Pressure (PA) - Pleural Pressure (PIP)
  • Elastic Pressure (PEL)
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7
Q

What is the formula for Tidal Volume?
What is the formula in minute ventilation?
What are the normal values for each?

A
  • VT= VDS + VA
  • Minute Vent= VT x (RR)
  • Resp. Rate= 12 bpm
  • Tidal Volume= 500 mL; 6 L/min
  • Dead Space Volume= 150 mL; 1.8 L/ min
  • Aveolar Volume= 350 mL; 4.2 L/ min
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8
Q

What are the normal volumes for:

Tidal Volume
Residual Volume
Expiratory Reserve Volume
Inspiratory Reserve Volume

A
  • TV= 500 mL
  • RV= 1.5 L
  • ERV= 1.5 L
  • IRV= 2.5 L
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9
Q

Which volumes make up the following capacities and their normal values:

Total Lung Capacity
Inspiratory Capacity
Functional Residual Capacity
Working/ Vital Capacity

A
  • TLC= 6 L
  • IC= IRV+VT= 3.0 L
  • FRC= ERV+RV= 3.0 L
  • VC= IRV+VT+ERV= 4.5 L
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10
Q

definitions: P, C, a, A, V

A

A: alveolar
a: arterial
C: content
P: pressure
V: ventilation

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11
Q

1 atm =?

A

760mmHg

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12
Q

PA>Pv>Pa

A
  • West Perfusion Zone 1
  • no blood flow
  • In a healthy lung, there should not be a zone 1
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13
Q

Pa>PA>Pv

A
  • West Perfusion Zone 2
  • Pulsatile flow; “In between”
  • Pulsatile blood flow during higer pressures times of the cardiac cycle and tapers off with a lower pulm blood pressure
  • top portions of the lung
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14
Q

Pa>Pv>PA

A
  • West Perfusion Zone 3
  • Continuous flow; “always on”
  • Normally in the bottom 1/2 of the lung
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15
Q

The effects of the weight of the lung on blood flow at the very base of the lung that sites on the diaphragm

A
  • West Perfusion Zone 4
  • A subset of Zone 3; reduces the amount of blood flow in the very bottom portion of the base
  • the weight of the lungs compress the easily collapsable pulm vein and arteries
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16
Q

Primary muscle for inpiration and ventilation

A

Diaphragm

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17
Q

Supportive muscles that aid in inspiration? Expiration?

A
  • Intercostal and scalene muscles
  • Only intercostal muscles
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18
Q

How many scalene muscles are there and where are the attachment points?

A
  • 3 Scalene Muscles
  • 5: Anterior; C3-C6 and attach to Rib 1
  • 6: Middle; C3-C7 and attach to Rib 1
  • 7: Posterior; C5-C7 and attach to Rib 2
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19
Q

Describe the diaphragm, innervation, and where is it attached?

A
  • Dome-shaped striated skeletal muscle that is thought of as two leaflets or domes
  • Phrenic nerve
  • Anchored into the L-spine bodies
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20
Q

What are the three openings and their orientation in the body?

A
  • Caval Aperture- most anterior
  • Aortic Aperture- most posterior
  • Esphogeal Aperture- between the two
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21
Q

Which aperture is most anterior and which is most posterior?

A
  • Caval Aperture is most anterior
  • Aortic Aperture is most posterior
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22
Q

What is the largest cartilaginous part of the larynx (voice box)?

A
  • Thyroid Cartilage
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23
Q

During growth and development, _____ segments in the ______ lung fuse together.

A

4; left

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24
Q

Generation 0-16 is known as the ______.
Generation 0 is the ______.

A
  • Conducting Zone
  • Trachea
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25
Q

What are airways with no cartilage?

A

Bronchioles

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26
Q

Starting from the trachea, list the path of air during inspiration.

A

Trachea> bronchi> bronchioles> terminal bronchioles> respiratory bronchioles> alveolar ducts> alveolar sacs

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27
Q

Vocal cords are fastened anteriorly at the ______.

A

Thyroid cartilage

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28
Q

The larynx is innervated by what nerve?

A

Recurrent laryngeal nerve

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29
Q

Generations 17-23 are known as ?

A

Transitional and Respiratory Zones

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30
Q

starting generation point for alveoli to show up

A

generation 17

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31
Q

How many generations total do we have?

A

24; trachea is zero

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32
Q

All the surface area of all the alveoli of the lungs equals ________.

A

70 m^2

33
Q

how many alveoli sacs are there?

A

8x10^6

34
Q

The lungs have _______ more capacity for gas exchange if it needs it.

A

3x

35
Q

When does cyanosis occur as it pertains to deoxyhemoglobin?

A

When deoxyhemoglobin >5 g/ dL

36
Q

What is the Fick Equation?

A

CO= O2 absorbed per min (mL/ min)/ Arteriovenous O2 difference (ml/ L)

37
Q

What volumes make up the vital capacity?

A

Expiratory Reserve Volume (ERV), Tidal Volume (TV), and Inspiratory Reserve Volume (IRV)

38
Q

What volumes make up functional residual capacity (FRC)?

A

ERV , RV

39
Q

(+) air flow value

A

expiratory follow,

(-) is inspiratory

40
Q

lowest/highest airflow and at what time marks

A

1 second: -0.5L/s
3 second: +0.5L/s

41
Q

highest alveolar pressure and at what time marks

A

1 second: -1 cm H2O
3 second: +1 cm H2O

42
Q

Alveolar capillaries resistance gets higher as ___ , it gets lower as ___

A

Alveolar resistance gets higher as lung volumes get higher , gets lower as lung volume gets lower

43
Q

Higher the pulmonary blood flow, the lower?

A

PVR

44
Q

the two ways that our body uses to reduce pulmonary vascular resistance when cardiac output increases.

A

recruitment and distension

45
Q

effect on PVR from increased lung volume

A

increase

46
Q

effect on PVR from decreased lung volume

A

increase

47
Q

effect on PVR from increased pulmonary artery pressure

A

decrease

48
Q

effect on PVR from increased left atrial pressure

A

decrease

49
Q

In gravity dependent regions of the lungs, PVR increase or decrease

A

decreases

50
Q

effect on PVR from positive pressure ventilation

A

increases

51
Q

% of gases in atmosphere

A

N2: 79%
O2: 21%
CO2: 0.04%

52
Q

water vapor pressure during humidification

A

47 mmHg

53
Q

the alveolar gasses should be the same as ?

A

the alveolar gasses should be the same as our pulmonary venous gasses or our systemic arterial gasses.

54
Q

in deoxygenated venous blood PO2 =

A

40 mmHg

55
Q

venous PCO2 =

A

45 mmHg

56
Q

arterial blood PaO2 = ?

A

100 mmHg

57
Q

arterial blood PaCO2 =

A

40 mmHg

58
Q

pulmonary capillary pressures

A
59
Q

HPV is primarily done thru sensing which gas?

A

O2
secondary : CO2

60
Q

greater intravascular pressures
more recruitment, distention
lower resistance
greater blood flow

A

perfusion of bottom lung

61
Q

intrapleural pressure less negative
smaller transmural pressure gradient
alveoli smaller, more compliant
more ventilation

A

ventilation of bottom lung

62
Q

top of lung doesnt get emptier than ?
bottom lung doesn’t get emptier than ?

A

top: 30%
bottom: 20%

63
Q

FRC intrapleural pressure:
RV intrapleural pressure:

A

FRC: -5 cm H2O
RV: +2 cm H2O

64
Q

noble gas used for PFT

A

Xenon

65
Q

noble gas thats 2nd leading cause of lung cancer

A

Radon

66
Q

makes up 62% of all surfactant’s phospholipids

A

phosphatidylcholine and dipalmitoyl phosphatidylcholine

67
Q

hydrophobic surfactant protein

A

SP-B and SP-C

68
Q

surfactant make up % between protein and lipids

A

90% lipid, 10% protein

69
Q

functions of club cells

A

produces surfactant at much lower rate than alveoli

progenitor cell for damaged areas of lung

70
Q

elastic recoil pressure components

A

1/3 is d/t tissue recoil
2/3 is d/t surface tension

71
Q

type 1 vs type 2 alveolar cell surface area percentage

A

type 1: 90-95% of alveolar surface area
type 2: 5-10% of alveolar surface area

72
Q

Not only does COPD not have enough elastic tissue in alveoli and airways, it also has less?

A

traction

73
Q

increasing lung volume does what to airway resistance?

A

decreases

74
Q

FRC volumes standing vs supine

A

standing: 3L
supine: 2L

75
Q

what happens to FRC as head of bed is tilted down

A

decreases

76
Q

FRC drops in supine pt because of?

A

reduction in ERV

“diaphragm is getting pushed up from all the mass of the stuff that’s in your abdomen. So the volume that gets squeezed out is the ERV. “

77
Q

compliance value for lungs

A

200 mL/ per cm H2O

78
Q

__ % of expired air should be CO2

A

5%

79
Q

at what transpulmonary pressure will lung be typically full

A

25-30