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[OS 213] Pulmo Exam 1 Adre > Lec 01: Review of Normal Structure and Function > Flashcards

Lec 01: Review of Normal Structure and Function Flashcards

1
Q

What are the functions of the respiratory system?

A

gas exchange, ventilation, metabolic (conversion of angiotensin I -> angiotensin II, removal of amines and metabolites), mucociliary clearance, cough, acid-base balance

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2
Q

What is the spinal level of the larynx?

A

C4- C6

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3
Q

What are the anatomical landmarks of the trachea?

A

below the cricoid cartilage -> carina (bifurcation into main bronchi)

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4
Q

What is the spinal level of the carina

A

T5 at expiration, T6 at inspiration

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5
Q

Why does aspirated material more commonly pass through the right main bronchus?

A

right main bronchus is less sharply angled from the trachea

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6
Q

How many bronchopulmonary segments are there?

A

19 (9 left, 10 right)

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7
Q

What are the external anatomical landmarks of the lungs anteriorly?

A

clavicle -> 8th rib or 10th rib (laterally)

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8
Q

What are the external anatomical landmarks of the lungs posteriorly?

A

level of the clavicle -> T12

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9
Q

What is the anatomic division of the upper and lower respiratory tracts in adults?

A

vocal cords

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10
Q

What is the anatomic division of the upper and lower respiratory tracts in pediatric patients?

A

cricoid cartilage

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11
Q

When do the lungs start to develop in utero?

A

4th- 5th week AOG

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12
Q

What is the difference between anatomic and physiologic dead space?

A

ADS: region where gas exchange is not possible (conducting zone)
PDS: total volume that does not participate in ventilation

PDS = ADS + alveolar dead space (areas with ventilation and poor perfusion)

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13
Q

What is the effect of intubation on ADS?

A

ADS is increased

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14
Q

How are bronchi differentiated from bronchioles?

A

bronchi: conductive structures > 1mm, w/ glands, goblet cells and supporting cartilage plates
bronhioles: conductive structures < 1mm, glands, goblet cells and cartilage are absent, SM layer is thicker

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15
Q

What are the chief sites of greatest resistance in the conducting zone?

A

medium-sized bronchi (5th-7th generations)

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16
Q

What are Clara cells?

A

cuboidal, non-ciliated cells found in terminal bronchioles

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17
Q

What is the Reid index?

A

ratio between the thickness of SM glands and the thickness between epithelium and cartilage (normal 0.4)

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18
Q

What is the rationale of using B2-agonists as bronchodilators?

A

high concentration of B2 receptors in lower respiratory tract smooth muscles

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19
Q

What are the effector inflammatory cells in COPD and asthma?

A

COPD: neutrophils, airway macrophages, cytotoxic T-cells (less responsive to glucocorticoids)

Asthma: eosinophils, mast cells

20
Q

What is the difference between laminar and turbulent airflow?

A

laminar: linear, found in small airways, relatively quiet
turbulent: characterized by eddy currents; found in large airways and at bifurcations; breath sounds are low pitched and harsh

21
Q

What is the relationship of the rate of flow to resistance based on ohm’s law?

A

the greater the rate of flow, the greater the resistance

22
Q

What is the average volume of anatomic dead space?

A

150 mL

23
Q

(T/F) Central airways contribute a greater amount of resistance compared to peripheral airways

A

T

24
Q

What is Inspiratory Capacity(IC)?

A

maximum volume that can be inhaled from normal resting end-expiratory level (3500 mL); IC = TV (500 mL)+ IRV (3000 mL)

25
Q

What is Functional Residual Capacity(FRC)?

A

volume remaining in lungs during regular breathing; FRC= IRV(1100 mL)+ RV(1200 mL)

26
Q

What is Vital Capacity(VC)?

A

maximum volume that may be exhaled following a maximum inspiration; VC = IRV(3000 mL)+ TV(500 mL)+ ERV(1100 mL)

27
Q

What is normal pulmonary capillary blood flow?

A

70 mL

28
Q

What measurements of lung volume can’t be measured with a spirometer?

A

TLC, FRC, RV

29
Q

What is the composition of mucus?

A

95% water, 3% mucin, 1% lipids, <0.3% DNA

30
Q

What structures are targeted by mucolytic substances?

A

disulfide bridges

31
Q

What is the normal rate of ciliary beating?

A

12-15 bpm

32
Q

What separates the gel and sol layers in the airway?

A

surfactant

33
Q

What regulates liquid in the sol layer?

A

Na+ channel, cystic fibrosis transmembrane conductance regulator (Cl- extrusion)

34
Q

What test is used to confirm cystic fibrosis?

A

sweat test

35
Q

What is the difference between types I and II alveoli?

A

type I: extremely flattened (0.05 microns); 95% of alveolar wall

type II cuboidal, secrete surfactant w/ cytosomes

36
Q

How do surfactants stabilize lungs?

A

increase in surface area reduces surface tension

37
Q

What is the difference between emphysema and fibrosis in terms of compliance?

A

emphysema: increased compliance (decreased elastic recoil)
fibrosis: decreased compliance

38
Q

What is equal point pressure?

A

intrapleural pressure = airway pressure

39
Q

How does the airway remain patent during passive breathing?

A

There is a decrease in intrapleural pressure while elastic recoil remains the same. The net alveolar pressure is not matched anywhere on the airway.

40
Q

(T/F) Increasing effort during expiration (inc. intrapleural pressure) will change the location of the equal point pressure

A

F

41
Q

How does obstruction affect EPP?

A

intrapleural pressure is increased earlier and elastic recoil is decreased (lower Palv), EPP is moved upstream

42
Q

What is Fick’s Law of Diffusion?

A

diffusion is directly related to surface area and inversely related to membrane thickness

43
Q

What is the effect of exercise on gas exchange?

A

exercise causes hyperventilation and shortened transit time of blood

44
Q

What is the most potent vasoconstrictor of pulmonary blood vessels?

A

lack of oxygen

45
Q

When is 90% oxygen saturation achieved?

A

60 mm Hg PaO2

[OS 213] Pulmo Exam 1 Adre (4 decks)

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