Lecture 8: Intro to Pulmonary (Exam II) Flashcards
During normal physiology, what is the intrathoracic pressure during inspiration and expiration?
- Inspiration: -7.5 cmH₂O
- Expiration: -5cmH₂O
How far up does the apex of the lung reach?
Above the clavicle
What structure separates the lungs?
Mediastinum
What type of muscle is the diaphragm?
Skeletal muscle
In the figure below, what structure is indicated by 1?
Parietal Pleura (mediastinal part)
In the figure below, what structure is indicated by 2?
Parietal Pleura (costal part)
In the figure below, what structure is indicated by 3?
Visceral Pleura covering the lung tissue
In the figure below, what structure is indicated by 5?
Parietal Pleura (diaphragmatic part)
In the figure below, what structure is indicated by 6?
Inferior Lobe
In the figure below, what structure is indicated by 7?
Middle Lobe
In the figure below, what structure is indicated by 9?
Superior Lobe
Which lung tends to have a little more volume? Why?
The right lung has more volume due to the heart being more in the left thoracic cavity.
What is indicated by the red circles in the figure below?
- Pulmonary Hilum (collections of the greater blood vessels and bronchi)
During inspiration, the rib cage ______ while the _________ drops.
elevates ; diaphragm
How much air is breathed in during a deep inspiration?
assume the person exhaled as much air as possible prior to inhaling.
4.5 L = Vital Capacity
The distance difference between the bottom of the lungs during inspiration and expiration is how much?
2cm
Do the lungs move anterior or posteriorly with inspiration?
- Anteriorly ( and inferiorly technically)
Where does the diaphragm insert at?
Three points:
- Xiphoid process
- Bottom of costal cage
- L-spine vertebral bodies.
What structure is indicated by 3 in the figure below?
Left dome of the diaphgram
What structure is indicated by 6 in the figure below?
Right dome of the diaphgram
What structure seals off the thoracic cavity from the abdominal cavity?
Diaphragm
What structure is indicated by 1 in the figure below?
Caval aperture (Vena Cavae)
What structure is indicated by 2 in the figure below?
Central tendon
What structure is indicated by 3 in the figure below?
Esophageal aperture
What structure is indicated by 4 in the figure below?
Aortic aperture
Name all the apertures from anterior to posterior.
Caval → esophageal → aortic
C-E-A
Why is it so risky to perform nerve blocks in the neck?
- Lots of important structures but especially the phrenic nerve. If blocked, then the diaphragm (at least one side) won’t be able to move.
We could survive one side not moving, but not both, especially in shitty lungs.
What nerve complex is very close to the phrenic nerve in the neck?
- Brachial plexus
When are the scalene muscles often noticed?
What is the purpose of the scalene muscles?
- If someone is using strong inspiratory effort.
- Scalene muscles prevent the diaphragm from pulling the thorax down.
What scalene muscle is noted by 5 in the figure below?
Where does it attach?
- Anterior Scalene
- Attaches to 1st rib and C3-C6
What scalene muscle is noted by 6 in the figure below?
Where does it attach?
- Middle Scalene
- Attaches to 1st rib and C3-C7
What scalene muscle is noted by 7 in the figure below?
Where does it attach?
- Posterior Scalene
- Attaches to 2nd rib and C5-C7
Most lung tissue is located anteriorly. T/F?
False. Most lung tissue is located posteriorly.
What position is the “lung-draining” position? Why is this?
- Prone: when prone, the heart doesn’t sit on the lungs and they can drain more effectively.
How many segments does the right bronchiole typically have?
10 segments
How many segments does the left bronchus have?
8 segments (bottom ones are typically fused)
What structure is indicated by 1 in the figure below?
Thyroid cartilage
What structure is indicated by 2 in the figure below?
What is the importance of this structure?
- Cricoid cartilage: connects the thyroid cartilage and the trachea.
What structure is indicated by 3 in the figure below?
Why is this structure important?
- Cricothyroid ligament (This is the location for an emergent cricothyrotomy airway)
What structure is indicated by 1 in the figure below?
What is the significance of this structure?
Hyoid bone: connects the jaw to the voicebox area.
What structure is indicated by 2 in the figure below?
Cricothyroid ligament
What structure is indicated by 1 in the figure below?
Epiglottic cartilage
What piece of anatomy moves down when swallowing?
What moves up to help prevent aspiration?
- Epiglottis
- Vocal folds
A fast vibration of the vocal ligament results in what kind of sound?
- Faster vibration = higher pitch (like a scream)
What are the vocal ligaments controlled by?
Skeletal muscles
How many conducting zones are there?
17
Zones 0 - 16
How many transitional and respiratory zones are there?
7
Zones 17 - 23
Is the trachea considered a part of the conducting zone?
Yes; the trachea is zone 0
How many structures are in Gen 1-3 total?
0-4 total?
1 to 3 = 2+4+8= 14
0 to 4 = 1+2+4+8+16= 31
The conducting zones are also known as what?
Anatomical dead space
How much respiratory surface area do the human lungs have?
70m2 (roughly tennis court sized)
Name the order of respiratory structures starting from the trachea all the way to the alveoli.
Conducting zone
- Trachea
- Bronchi
- Conducting bronchioles
- Terminal bronchioles
Respiratory zone
- Respiratory bronchioles
- Alveolar ducts
- Alveolar sacs
What is the technical criteria/definition for cyanosis?
- DeoxyHgb of > 5 GRAM/dL
Differentiate hypoxia and hypoxemia.
- Hypoxia: ↓O₂ at the tissue level.
- Hypoxemia: ↓O₂ in the blood.
What is orthopnea?
A change in breathing with bodily position change. (ex. prone to supine)
Differentiate hyperpnea and hyperventilation.
- Hyperpnea: more ventilation than normal
- Hyperventilation: ventilation greater than bodily needs.
