Pulmonary Flashcards by HM Beyea

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

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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

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What are the muscles needed to breathe in?

Innermost intercostals (C/L chest wall)
External intercostals (I/L chest wall)
Diaphragm

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What are the muscles needed to force air in?

Scalenes
SCM
Trapezius
Pectoralis major/minor

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What are the muscles needed to breathe out?

Passive (recoil)

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What are the muscles needed to force air out?

Internal/external oblique
Rectus abdominus
Transverse abdominus
Quadratus lumborum

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What is the difference between a carotid body and a carotid sinus?

Carotid body: chemoreceptor
Carotid sinus: baroreceptor

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What color is air on x-ray?

Black
(Radiolucent)

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What color is fluid/solid on x-ray?

White
(Radiopaque)

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What disease has a steeple sign on neck film?

Croup

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What disease has a thumb sign on neck film?

Epiglottitis

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What is a “blue bloater”?

Bronchitis (chronic)

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What is a “pink puffer”?

Emphysema

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What diseases have pulmonary eosinophilia?

Aspergillosis
Strongyloides

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What drugs cause pulmonary eosinophilia?

Nitrofurantoin
Sulfonamides

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What are the risk factors for lung cancer?

Smoking
Radon
2nd hand smoke
Pneumoconiosis (except anthracosis)

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What diseases have hemoptysis?

Bronchiectasis
Bronchitis
Pneumonia
TB
Lung cancer

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Where is a Bokdalek hernia?

Back of diaphragm

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Where is a Morgagni hernia?

Middle of diaphragm

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What diseases have respiratory alkalosis?

Restrictive lung diseases
Anxiety
Pregnancy
Gram neg sepsis
Pulmonary embolism

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What diseases have respiratory acidosis?

Obstructive lung disease

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What diseases have metabolic alkalosis?

Low volume state
Vomiting
Diuretics
GI blood loss

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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

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What is the obstructive pattern of blood gases?

Elevated pCO2 -> decr pH
Elevated RR -> decr pO2

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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