Lecture 1 Flashcards
what are the primary functions of the lungs ?
providing O2 to the skin
remove CO2
explain the respiraotyr passage chronologically
trachea - bifurcation at 4-5T or sternal angle
bronchi
bronchioles
alveoli
explain the anatomy of the right lung
2 fissures - oblique and horisontal
3 lobes - upper, middle, lower
larger and shorter than left lung
explain the anatomy of the left lung
only one fissure - oblique
2 lobes - upper and lower
a cardiac notch
which is the functional part of the alveolar?
Acinus
what are the parts of Acinus?
respiraotry bronchioles
Alveolar ducts
Alveoli
enumirate the cells of airway epithelium
basal cells
club cells
ciliated cells
Goblet cells
explain the role of basle cells ?
principle stem cells, facilitating epithelial regeneration
explain the role of club cells
secerte anti-inflammatory protein
explain the role of ciliated cells
ensure effective mucociliary clearance
explain the role of goblet cells
chief mucus producing cells
what do all these cells do?
they protect the lungs by:
filtering
sense danger
alerts immune system
maintains balance
which disease are disfunctining basle cells related to ?
COPD and lung cancer
which disease are disfunctioning Club cells associated with ?
asthma
which condition is associated with abnormal ciliated cells ?
PCD, making it harder to clear mucus
Goblet cells ?
chronic bronchitis
where does the pulmonary trunk split at?
left to the sternal angle
how many veins are there ?
4 delivering oxynated blood from 5 total lobes
right upper and middle lobes veins merge before exiting the lung
explain the specifics of the right pulmonary artery
is longer and wider than the left one
most travle lunger to reach the right lung
passes under the aortic arch before entering the lung
explain the specific of the left pulmonary artery
short and enters the left lung directly
which part of the respiratory cycle is passive ?
expiration unless being forced
what do static lung functions target?
volumes and capacities
what do dynamic lung fucntion tests target ?
volumes and velocity
what is the purpose of static lung volumes ?
provides a snapshot of the amount of air in the lungs at a specific point during the breahing
what diseases can be detected by static lung volumes ?
restrictive lung dieases
what is TCL (total lung capacity)?
the total amiunt of air in the lungs can hold after taking the deepest possible breath
what is FRC (functional residual capacity)?
the amiunt of air left in your lungs after normal exhalation
what is RV (residual volume)?
the air left in the lungs after forced exhalation.
this air helps keeping your lungs from collapsing
what is vital capcity (VC) ?
maxium amount of air that you can exhale after the deepest breath possible
accurate diagnosis of static lung volumes ?
they help differentiate between resrictive and obstructive disease
assess serverity
they can show how severe a restrictive disease is
what is the purpose of dinamic lung volume tests ?
assess how quick air moves in and out the lung during breahing.
what diseases can dynamic lung volume tests help assessing?
obstructive lung disease
explain peak expiratory flow (PEF)
how quick you can exhale air
explain what forced expiratory volume (FEV)
the amount of air exhaled forcefully in a specficifc time - 1 second
what is forced vital capacity (FVC)
the total amount of air exhaled forcefully after a deep breath
what is relaxed vital capacity (RVC) ?
total amount of air exhaled gently after a deep breath
which lung volumes can be measured by spirometry ?
- Tidal volume Vt
- Inspiratory reserve volume IRV
- Expiratory reserve Volume ERV
- Inspiratory Capacity IC
Vital capacity VC
which lung volumes can not be measured by spirometry ?
- Residual volume RV
- Functional residual capacity FRC
Total lung capacity TLC
- Functional residual capacity FRC
what is the FEV1/FVC ratio?
the per centage of yout FVC that you exhale in the fiirst second.
helps diff between obstructive and restrictive disease
what is the obstructive pattern of FEV1/FVC ratio?
A lower ratio (less than 70-80% depending on age) suggests an obstructive problem, where you have difficulty exhaling
what is the restrictrive pattern in FEV1/FVC ratio ?
A normal or higher ratio with a reduced FVC suggests a restrictive problem, where your lungs can’t fully expand.
what is FEV6?
- What it measures: Similar to FEV1, but it measures the amount of air exhaled in 6 seconds.
Why it’s important: FEV6 is sometimes used as an alternative to FVC, especially when patients have difficulty exhaling forcefully for a longer duration.
FEF25-75% (Forced Expiratory Flow over the middle one half of the FVC)
- What it measures: This assesses the airflow during the middle portion of your exhalation. It provides information about the smaller airways in your lungs.
Why it’s important: FEF25-75% can be helpful in detecting early signs of obstructive lung diseases, even before FEV1 is significantly affected.
MVV (Maximal Voluntary Ventilation)
- What it measures: This assesses your maximum breathing capacity by measuring how much air you can breathe in and out during a specific time period (usually 12-15 seconds).
Why it’s important: MVV reflects the overall function of your respiratory muscles and lungs.
what is the normal FEV1/FVC ratio
At least 70% of the total air exhaled (FVC) should be expelled in the first second (FEV1). This means a normal FEV1/FVC ratio is between 0.75 and 0.85 (75-85%).
how is lung function in obstructive lung disease ?
reduction of FEV1
FVC lower than RVC
longer exhalation time more than 6 s
Lower FEV1/FVC ratio
how is lung function in restrictive lung disease ?
reduced FVC
normal or high FEV1/FVC ratio
smaller airway obstruction in lung function
- Reduced FEF25-75%: Conditions affecting the smaller airways, like bronchiectasis, primarily affect airflow during the middle of exhalation, leading to a reduced FEF25-75%.
how is TLC in restrictive disorders
reduced in any restrictive
whether the problem is within the lungs (intrapulmonary) or outside the lungs (extrapulmonary). Examples include pulmonary fibrosis (intrapulmonary) and obesity (extrapulmonary).
how is TLC in COPD?
increaed due to air trapping
how is FRC in obstructive diseases ?
increased. due to air getting trapped
FRC in restrictive diseases?
FRC, along with RV, helps differentiate between different types of restrictive lung diseases.
RV in restrictive disease ?
RV, along with FRC, helps differentiate between different types of restrictive lung diseases.
how is restrictive conditions differentiated ?
- Parenchymal lung diseases: In conditions affecting the lung tissue itself (parenchyma), such as pulmonary fibrosis, both RV and FRC are decreased. This is because the lungs are stiff and cannot expand fully, leaving less air in the lungs even after a normal exhale.
Respiratory muscle weakness and obesity: In conditions where the respiratory muscles are weak or the chest wall is restricted (e.g., obesity), RV is reduced, but FRC remains normal. This is because the lungs themselves are normal, but the ability to fully exhale is impaired.
where is the most sensitive sites of cough ?
larynx/carina/points of bronchial branches
where are the extrapulmonary receptors for cough ?
esophagus/diaphragm/stomach
