lung exam Flashcards
nasal cavity`
warm and moisten air
nasopharynx
back of nose and throat; leads to larynx
larynx
cartilage, contains vocal folds
trachea
midline, non-paired conducting airway
bronchi
branching airways with variable cartilage
bronchioles
branching airways, no cartilage, surrounded by smooth muscle
alveoli
balloons, site of gas exchange (pulmonary microvasculature)
right vs left lung lobes
right: 3 lobes; superior, middle, inferior
left: 2 lobes, superior and inferior
cardiac notch
space in left lung for the heart
what type of airway/zone is ventilation?
conduction zone/ airway
what type of airway/zone is diffusion?
respiratory or change zone / exhaling airways
what moves the gas in ventilation/ conducting airway
pressure gradients
what moves the gas in diffusion/ exchange airway
concentration gradients
ventilation; what’s happening in the pressure gradients
skeletal muscles change volume of thoracic cavity –> pressure changes –> air movement through conducting airways
which structures are for ventilation
nasopharyngeal –> terminal bronchiole
which structures are for diffusion
respiratory bronchiole –> alveoli
diffusion; what’s happening in the concentration gradients
pressure changes ‘mix’ the air, but distances are small enough that diffusion is effective in gas movement
-many small structures on lung that occupy majority of lung volume
-volume after quiet inspiration = 3L
-closely associated with pulmonary microvascualture
lung volume after quiet inspiration?
volume after quiet inspiration = 3L
muscles for ventilation
-chest wall muscles; intercostals, scalenes, SCM
-diaphram
–> muscles change volume of chest wall/ thoracic space
-volume changes –> pressure changes in lung
lungs and chest wall
lungs; conducting and exchanging airways- pleural space
the pleura; what does is connect?
-“connects” lungs to diaphragm and chest wall
-movements of chest wall and diaphragm are ‘tied’ to it
pleural cavity
-small amounts of fluid; 10-20mL
-fluid “connects” chest wall to alveoli
-movements of thoracic cage and diaphragm –> changes in pleural cavity pressure –> changes in alveolar pressure
what happens during inspiration
external intercostals and diaphragm contract
–> external intercostals: ribs move up and out
–> diaphragm: descends with contraction
-volume of thoracic cavity increases and the intrathoracic pressure decreases
-drop in intrathoracic pressure –> drop in pressure of the airspaces of the lungs –> movements of air from the atmosphere to the lungs
what happens during expiration
-diaphragm and external intercostals relax
–> external intercostals: relax and ribs move down and in
–> diaphragm: rises on relaation
-volume of thoracic cavity increases –> an increase in intrathroacic pressure
-increase in intrathoracic pressure –> airspace of lungs increases pressure –> movement of air from lungs back to the atmosphere
diaphragm contracts with inspiration or expiration? what happens when it contracts; up or down?
inspiration, down
diaphragm relaxes with inspiration or expiration? what happens when it relaxes; up or down?
expiration, up
volume and pressure during inspiration
volume of thoracic cavity increases and pressure decreases
volume and pressure during expiration
volume of thoracic cavity decreases and pressure increases
where does the trachea bifurcate (branch)?
bifurcation of the trachea is located under the sternum close to the joint of the 3rd rib
where is the fissure that divides the superior lobe from the middle lobe, anteriorly
the 4th rib - 4th intercostal space
posteriorly; where does the lung go from and to during deep inspiration
inferior lobe airspaces descend from the 10th rib posteriorly to the 12th on deep inspiration
larynx
phonation (speaking) and protect airway from foods/liquids
pulmonary disease- pleural effusion
-fluid in pleural space
-difficult to hear breath sounds, difficult for airspaces to expand
-lungs are dull to percussion
-fluid is in the way of auscultation and the echo from percussion
-causes of unilateral: cancer, infection (i.e. pneumonia), trauma
-causes of bilateral: congestion due to heart failure, bilateral infection, inflammation
pulmonary disease- consolidation
-gunk in the larger airways and alveoili
-mostly infectious causes
–> pneumonia and chronic obstructive pulmonary disease
-or if airway obstructed by tumor, other growth, or foreign body then gunk collects and cant be cleared
-collpase of that region of lung or pneumonia often develop
i.e. coarse crackles, bronchophony, decreased breath sounds and dullness to percussion would be found more superior in the lung
fluid in small airways
-when fluid or secretions are mostly in small airways you get fine crackles
-common in pulmonary edema due to infection of congestive heart failure
-fine crackles can also occur when small airways “snap” during some types of COPD
wheeze
-small airway is narrowed or constricted
-high-pitched, musical sound on expiration
-common in obstructive diseases: asthma, COPD, pulmonary edema (when fluid collects in the respiratory and terminal bronchioles)
stidor
-when large airway is narrowed or constricted
-louder, harsher sound on inspiration and sometimes on expiration
pleural effusion vs consolidation
pleural effusion: fluid in pleural space
consolidation: gunk in larger airways and alveoli
stidor vs wheeze
wheeze: small airway narrowed or constricted
stidor: large airway narrowed or constricted
fine crackles vs coarse crackles
fine crackles when fluid in small airways
coarse crackles when consolidation
hear bronchophony in consolidation
Bronchophony: which is when voice transmission through lung structures is heard with a higher resonance. In particular, bronchophony refers to an atypical increase in the intensity and clarity of the individual’s spoken voice heard when auscultating the lungs with a stethoscope.
