lung exam

Question 1

nasal cavity`

Answer 1

warm and moisten air

Question 2

nasopharynx

Answer 2

back of nose and throat; leads to larynx

Question 3

larynx

Answer 3

cartilage, contains vocal folds

Question 4

trachea

Answer 4

midline, non-paired conducting airway

Question 5

bronchi

Answer 5

branching airways with variable cartilage

Question 6

bronchioles

Answer 6

branching airways, no cartilage, surrounded by smooth muscle

Question 7

alveoli

Answer 7

balloons, site of gas exchange (pulmonary microvasculature)

Question 8

right vs left lung lobes

Answer 8

right: 3 lobes; superior, middle, inferior

left: 2 lobes, superior and inferior

Question 9

cardiac notch

Answer 9

space in left lung for the heart

Question 10

what type of airway/zone is ventilation?

Answer 10

conduction zone/ airway

Question 11

what type of airway/zone is diffusion?

Answer 11

respiratory or change zone / exhaling airways

Question 12

what moves the gas in ventilation/ conducting airway

Answer 12

pressure gradients

Question 13

what moves the gas in diffusion/ exchange airway

Answer 13

concentration gradients

Question 14

ventilation; what’s happening in the pressure gradients

Answer 14

skeletal muscles change volume of thoracic cavity –> pressure changes –> air movement through conducting airways

Question 15

which structures are for ventilation

Answer 15

nasopharyngeal –> terminal bronchiole

Question 16

which structures are for diffusion

Answer 16

respiratory bronchiole –> alveoli

Question 17

diffusion; what’s happening in the concentration gradients

Answer 17

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

Question 18

lung volume after quiet inspiration?

Answer 18

volume after quiet inspiration = 3L

Question 19

muscles for ventilation

Answer 19

-chest wall muscles; intercostals, scalenes, SCM
-diaphram

–> muscles change volume of chest wall/ thoracic space
-volume changes –> pressure changes in lung

Question 20

lungs and chest wall

Answer 20

lungs; conducting and exchanging airways- pleural space

Question 21

the pleura; what does is connect?

Answer 21

-“connects” lungs to diaphragm and chest wall
-movements of chest wall and diaphragm are ‘tied’ to it

Question 22

pleural cavity

Answer 22

-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

Question 23

what happens during inspiration

Answer 23

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

Question 24

what happens during expiration

Answer 24

-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

Question 25

diaphragm contracts with inspiration or expiration? what happens when it contracts; up or down?

Answer 25

inspiration, down

Question 26

diaphragm relaxes with inspiration or expiration? what happens when it relaxes; up or down?

Answer 26

expiration, up

Question 27

volume and pressure during inspiration

Answer 27

volume of thoracic cavity increases and pressure decreases

Question 28

volume and pressure during expiration

Answer 28

volume of thoracic cavity decreases and pressure increases

Question 29

where does the trachea bifurcate (branch)?

Answer 29

bifurcation of the trachea is located under the sternum close to the joint of the 3rd rib

Question 30

where is the fissure that divides the superior lobe from the middle lobe, anteriorly

Answer 30

the 4th rib - 4th intercostal space

Question 31

posteriorly; where does the lung go from and to during deep inspiration

Answer 31

inferior lobe airspaces descend from the 10th rib posteriorly to the 12th on deep inspiration

Question 32

larynx

Answer 32

phonation (speaking) and protect airway from foods/liquids

Question 33

pulmonary disease- pleural effusion

Answer 33

-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

Question 34

pulmonary disease- consolidation

Answer 34

-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

Question 35

fluid in small airways

Answer 35

-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

Question 36

wheeze

Answer 36

-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)

Question 37

stidor

Answer 37

-when large airway is narrowed or constricted -louder, harsher sound on inspiration and sometimes on expiration

Question 38

pleural effusion vs consolidation

Answer 38

pleural effusion: fluid in pleural space consolidation: gunk in larger airways and alveoli

Question 39

stidor vs wheeze

Answer 39

wheeze: small airway narrowed or constricted stidor: large airway narrowed or constricted

Question 40

fine crackles vs coarse crackles

Answer 40

fine crackles when fluid in small airways coarse crackles when consolidation

Question 41

hear bronchophony in consolidation

Answer 41

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.