Pulmonary Flashcards
List 4 types of cells in the lungs
Goblet: Mucus production
Type I pneumocyte: macrophages (95%)
Type II pneumocyte: produce surfactant
Clara/dust cells (macrophages): ingest dust particles
What is the histology of the trachea?
Top 1/3: stratified squamous epithelium (protects against abrasion)
Middle 1/3: mixture
Lower 1/3: tall columnar pseudo-stratified ciliated epithelium
What are the muscles needed to breathe in?
Innermost intercostals (C/L chest wall)
External intercostals (I/L chest wall)
Diaphragm
What are the muscles needed to force air in?
Scalenes
SCM
Trapezius
Pectoralis major/minor
What are the muscles needed to breathe out?
Passive (recoil)
What are the muscles needed to force air out?
Internal/external oblique
Rectus abdominus
Transverse abdominus
Quadratus lumborum
What is the difference between a carotid body and a carotid sinus?
Carotid body: chemoreceptor
Carotid sinus: baroreceptor
What color is air on x-ray?
Black
(Radiolucent)
What color is fluid/solid on x-ray?
White
(Radiopaque)
What disease has a steeple sign on neck film?
Croup
What disease has a thumb sign on neck film?
Epiglottitis
What is a “blue bloater”?
Bronchitis (chronic)
What is a “pink puffer”?
Emphysema
What diseases have pulmonary eosinophilia?
Aspergillosis
Strongyloides
What drugs cause pulmonary eosinophilia?
Nitrofurantoin
Sulfonamides
What are the risk factors for lung cancer?
Smoking
Radon
2nd hand smoke
Pneumoconiosis (except anthracosis)
What diseases have hemoptysis?
Bronchiectasis
Bronchitis
Pneumonia
TB
Lung cancer
Where is a Bokdalek hernia?
Back of diaphragm
Where is a Morgagni hernia?
Middle of diaphragm
What diseases have respiratory alkalosis?
Restrictive lung diseases
Anxiety
Pregnancy
Gram neg sepsis
Pulmonary embolism
What diseases have respiratory acidosis?
Obstructive lung disease
What diseases have metabolic alkalosis?
Low volume state
Vomiting
Diuretics
GI blood loss
What diseases have metabolic acidosis?
Acid production
RTA II
DKA
Diarrhea
MUDPILES (high anion gap)
- methanol
- uremia
- DKA
- paraldehyde
- iron
- lactic acidosis
- ethylene glycol
- salicylates
What is the obstructive pattern of blood gases?
Elevated pCO2 -> decr pH
Elevated RR -> decr pO2
What does stridor tell you?
Extrathoracic narrowing
=> narrows when breathing in
=> neck x-ray
What does wheezing tell you?
Intrathoracic narrowing
=> narrows when breathing in
=> chest x-ray
What does rhonchi tell you?
Mucus in airway
=> obstructive lung disease
What does grunting tell you?
Blows collapsed alveoli open
=> restrictive lung disease
What does dull percussion tell you?
Something b/w airspace and chest wall absorbing sound (fluid or solid)
What does hyperresonance tell you?
Lungs hyperinflated with air
What does tracheal deviation tell you?
Away from pneumothorax OR toward atelectasis
“Air-phobic”
What does fremitus & egophony indicate?
Consolidation
=> pathognomonic for pneumonia
What is restrictive lung disease?
Small stiff lungs
Trouble breathing in
What is obstructive lung disease?
Big mucus-filled lungs
Trouble breathing out
What is epiglottitis?
X-ray thumb sign
Drooling
What is croup?
X-ray steeple sign
Barking cough
What is tracheitis?
Look toxic
Grey pseudomembrane
Leukocytosis
What is asthma?
Wheeze on expiration
IgE
Eosinophils
What is bronchiolitis?
Asthma in kids <2 yo
What is maxillary sinusitis?
Teeth pain worse with bending forward
What is bronchiectasis?
Bad breath
Purulent sputum
Hemoptysis
What is chronic bronchitis?
Lots of sputum
“Blue bloater”
What is emphysema?
Restrictive to obstructive pattern
“Pink puffer”
What is laryngomalacia?
Epiglottis roll in from side-to-side
What is pneumonia?
Consolidation of airway
What is pneumothorax?
Air outside of lungs
Hyperresonance on same side
How do you detect a pulmonary embolus?
Tachypnea
Increased V/Q scan
EKG
S1Q3T3
What is tamponade?
Decreased breath sounds/BP
Increased JVD
Fluid in pericardial sac
What is tracheomalacia?
Soft cartilage
Stridor since birth
What is cystic fibrosis?
Meconium ileus
Steatorrhea
Bronchiectasis
What is aspergillosis?
Allergy to mold, dead plants, compost piles
Who gets asbestosis?
Shipyard workers
pipe fitters
brake mechanics
insulation installers
Who gets silicosis?
Sandblasters
Glassblowers
What gets byssinosis?
Cotton workers
Who gets beryliosis?
Radio/TV welders
Those working with bulbs
Who gets anthracosis?
What is main feature of anthracosis?
- coal workers
- massive fibrosis
What is sarcoidosis?
Non-caseating granulomas
Eggshell calcification of lymph nodes
What are manifestations of carcinoid syndrome?
Flushing
Wheezing
Diarrhea
What are manifestations of small cell carcinoma of the lung?
At carina
Malignant
Cushing’s
SIADH
SVC syndrome
What are manifestations of large cell carcinoma of the lung?
Large stuff
What are manifestations of squamous cell carcinoma of the lung?
Smoker
High PTH
High Calcium
What are manifestations of bronchoalveolar carcinoma?
Looks like pneumonia
Due to pneumoconiosis
