Physiology Flashcards
Do the lungs recoil in inspiration or expiration?
Expriation
What is the nerve supply to the diaphragm?
Phrenic C3, C4, C5 keeps the diaphragm alive
When does the upper respiratory tract become the lower respiratory tract? At what vertebral level?
Larynx to trachea at C6
Where is the best place to auscultate the apex, middle lobe and lung base?
Apex: superior to medial 1/3 of the clavicle
Middle lobe: between ribs 4-6 in mid-axillary/mid-clavicular line
Base: scapular line at T11
Total lung capacity = X + X
Total lung capacity = residual volume + vital capacity
What is tidal volume?
Volume entering / leaving lungs in one breath
What is vital capacity?
Max volume breathed out in 1 breath
What is residual volume?
Minimum volume after expiration
What is FEV1?
Volume expired in 1st second of expiration
What is pulmonary compliance?
Effort to stretch lungs in inspiration
Does less pulmonary compliance = more or less work?
More work
Define ventilation and perfusion? What is shunting?
Ventilation rate of gas passing through lungs
Perfusion rate of blood passing through lungs
Shunting is perfusion but no ventilation
How is FVC, FEV1 and FEV1/FVC ratio effected in obstructive lung disease?
FVC: normal
FEV1: reduced
FEV1/FVC ratio: reduced
How is FVC, FEV1 and FEV1/FVC ratio effected in restrictive lung disease?
FVC: reduced
FEV1: reduced
FEV1/FVC ratio: normal
What is respiratory epithelium?
Psuedostratified ciliated columnar epithelium
Bicarbonate is produced by what enzyme in what cell?
Bicarbonate carries CO2 and is produced by carbonic anhydrase in RBCs
Define wheeze
Expiratory
High pitched whistling sound arising from smaller airways
(Polyphonic wheeze in inspiration + expiration, seen in severe COPD/ asthma)
Are crepitations inspiratory or expiratory
Inspiratory
Define stridor
Large airway obstruction
Inspiratory
First line investigation for stridor
Laryngoscopy
What is normal oxygen saturation targets? What are saturation targets in patients at risk of hypercapnic respiratory failure?
94-98%
88-92%
What patients are at risk of hypercapnic respiratory failure?
COPD
Opiate/benzo OD
What type of oxygen delivery should you use in COPD patients?
24-28% Venturi mask
carry a oxygen alert card
Name the 2 types of non-invasive ventilation NIV?
CPAP and BiPAP
What type of NIV is used for acute pulmonary edema?
CPAP
What type of NIV is used for type 2 respiratory failure?
BiPAP
What type of NIV is used for acute pulmonary edema?
CPAP
How do you assess that a CXR is properly inspired?
Anterior ends of at least 6 ribs visible
How do you assess that a CXR is properly penetrated?
Can see spinous processes behind the heart
How do you assess that a CXR is properly rotated?
Medial ends of clavicles equidistant from spinous processes of upper thoracic vertebrae
What % of oxygen delivery is high flow oxygen?
> 60%
double check this
What is the management of acute pulmonary edema?
High flow O2
Sit upright
IV furosemide
If remain hypotensive IV inotrope
