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NPLEX > Pulmonary > Flashcards

Pulmonary Flashcards

1
Q

how many lobes on ea lung?

A

2 on left

3 on right

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2
Q

the only artery w deoxygenated blood is?

A

pulmonary artery … to R side of HT

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3
Q

the only vein w oxygenated blood is?

A

pulmonary vein

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4
Q

what CN constricts bronchioles?

A

CN 10

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5
Q

What organs are located in the Middle, Anterior, Posterior, and Superior regions of the MEDIASTINUM?

A

Middle: HT
Anterior: Thymus
Posterior: Esoph, descending aorta, azygos V.
Superior: aortic arch, brachiocephalic vein

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6
Q

Rib level at MCL on expiration and inspiration?

A

inspiration: 8 - pleura
expiration: 6 - LU
* * JUST REMEMBER 6-LU MCL (then for Axilla 8,10 and Costal Angle -10,12)

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7
Q

Sphenoid sinus drains to?

A

Sphenoid -> Ethmoid -> Maxillary -> Nasal Cavity

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8
Q

Frontal sinus drains to?

A

Maxillary -> Nasal Cavity

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9
Q

Larynx does what and is innervated by?

A

CN 10

- vocalization

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10
Q

What is Tidal Volume, TV?

A

what I’m doing now breathing

- the extra is “reserve vol”

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11
Q

What is “Dead Space”?

A

vol. of LU that does not participate in gas exchange
- anatomical vs physiologic
- – anatomical is 150ml - think dead person
- – physiological - Bohr’s Method Vd = …

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12
Q

What is FEV1?

A

Forced Expiratory Vol in 1 Sec! after max inspiration

  • see that 1 there
  • vs FVC, same thing wo time limit
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13
Q

FEV1 is usu what percentage of FVC?

A

80%

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14
Q

Can Residual Vol be measured?

A

NO

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15
Q

VC =

A

TV + IRV + ERV

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16
Q

TLC, Total Lung Capacity includes what?

*Increased TLC is indicative of?

A

VC (TV + IRV + ERV) + RESIDUAL VOLUME that cannot be measured
- (COPD, along w increased RV)

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17
Q

Medulla and LU

A

mediates INSPIRATION & EXPIRATION

  • RHYTHM
  • input from vagus and glossopharyngeal
  • output via phrenic to diaphragm
  • cerebral cortex overrides
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18
Q

Voluntary Control of breathing regulated by?

A

Cortex

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19
Q

Apneustic Center is located where and responsible for what?

A

Pons - lower

  • Gasp
  • stimulates inspiration
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20
Q

Pneumotaxic Center is located where and responsible for what?

A

upper Pons

- inhibits inspiration, regulates Rate & Vol.

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21
Q

What part of the brain is responsible for hyper/hypo - ventilation

A

Cortex

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22
Q

Where is the Central Chemoreceptor and what does it sense?

A

Medulla

pH and CO2

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23
Q

Where is the Peripheral Chemoreceptor and what does it sense?

A

CAROTID BODIES & AORTIC BODIES

pH and CO2

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24
Q

Respiratory vs Metabolic Acidosis/Alkalosis

A

Respiratory: think PCO2
Metabolic: think HCO3-

25
Q

P50 means…

A

At 50% saturation of Hgb …

- Pressure of 02 (which is 25mmHg)

26
Q

What is a Chloride Shift?

A

HCO3- leaves RBC in exchange for Cl-

- this happens when HCO3 is transported to LU to change back into CO2 and breathed out

27
Q

when in RBC, H2CO3 dissociates into H+ + HCO3- … the protons are buffered by?

A

Deoxyhemoglobin

28
Q

Epiglottitis

  • Eti
  • pop.
  • what happens?
A

H. flu or Beta Hemolytic Strep INFX
in children
bc trachea is small, epiglottis swells and obstructs airway - head will be tilted and child will drool
- on XRAY see steeple sign (usu w Croup?)
- “THUMB PRINT SIGN”

29
Q

Pulmonary Edema usu caused by?

  • but can also be caused by?
  • 2 types
  • sequalae
A

L-sided HT Failure!

  • also can be caused by pulmonary capillary membrane damage
  • 2 types are Interstitial and Alveolar
  • sequelae —> LU infx
30
Q

Is Emphysema COPD or Restrictive? What happens to the LU?

A

OBSTRUCTIVE

  • LU hyper-inflates but doesn’t let the air out (bc damaged alveolar septae and decreased elastic recoil)
  • increased COMPLIANCE
31
Q

In emphysema you will see normal Pressure of CO2 because?

A

the body compensates w rbc’s

32
Q

In chronic bronchitis the pressure of CO2….

A

INCREASES
COPD
think “blue bloater”

33
Q

Dx criteria Chronic Bronchitis?

A

cough + sputum for at least 3mo in 2 consecutive yrs

emphysema and bronchitis often together

34
Q

Lobar Pneumonia:
ETI:
usu starts where?

A

LOBAR = intra-alveolar

  • Strep pneumoniae diplococci gram+
  • –> rust brown sputum
  • Klebsiella gram- in ALCOHOLICS
  • –> see hepatization (gray or red)

USU STARTS IN LOWER LU THEN MOVES UP

35
Q

What is Bronchiectasis?

  • sputum?
  • where in LU?
  • Eti?
A

dilation of bronchi - COPD
secondary to INFX (dilation bc damage to bronchial wall)
- usu lower LU
- foul sputum in AM (a lot of sputum)… mb hemoptysis

36
Q

Is Bronchial Adenoma malignant or benign?

A

either

37
Q

What CA of the LU is deadly?

Which has the worst prognosis?

A

Large Cell Undifferentiated Carcinoma

—> worst! —>Small/Oat Cell Undifferentiated Carcinoma

38
Q

Pancoast Tumor is what kind?

- usu causes what?

A

small cell carcinoma

- Horner’s Syndrome

39
Q

Which CA of the LU produce hormones?

A
  • SCC, SQUAMOUS CELL CARCINOMA is malignant and produces parathyroid leading to an increase in Ca2+ in plasma
  • located CENTRAL LU
40
Q

Small Cell (oat cell) CA has a _____ prognosis and is assoc. w smoking and what hormone production?

A

Poor prognosis

  • ectopic ACTH and ADH secretion
  • located CENTRAL LU
41
Q

Where is Large Cell Undiff Carcinoma of the LU located? METS?

A

PERIPHERAL

  • mets to BRAIN
  • POOR prognosis
42
Q

MC carcinoma of LU?

where in LU located?

A

ADENOCARCINOMA

located in PERIPHERY

43
Q

The common cold is accurately called?

A

RHINITIS

44
Q

anti-glomerular basement antibody disease that affects LU and KD … commonly causes hemoptysis.

A

Goodpasture’s Syndrome

  • AI Dz
  • type ll hypersensitivity (Abs)
  • middle aged men
45
Q

Sarcoidosis vs TB

what type of granulomas?

A 
TB = CASEATING
Sarcoidosis = NONCASEATING
46
Q

FEV1/FVC ratio: COPD vs Restrictive

A

Restrictive- they both decrease so remains the same

COPD: ratio DECREASES

47
Q

What is Wegener Granulomatosis

A

in the name.. think granulomas of upper and lower LU

  • vasculitis
  • unknown eti
48
Q

What are HEART FAILURE CELLS?

A

hemosiderin-laden M0

seen when you have pulmonary edema caused by heart failure

49
Q

MC LU CA

A

METS

50
Q

Unilateral vs Bilateral blunting of costophrenic angle?

A

unilateral -> pleural effusion, hemathorax

bilateral -> obstructive LU Dz

51
Q

LR located beneath what ribs?
SP?
HT?

A

LR 6-11
SP 9-11
HT 3-5

52
Q

blood supply to mammary glands?

A

Internal Thoracic A.

53
Q

see a Widened Mediastinum on Xray

ddx:

A

esoph rupture, aortic rupture, aortic dissection, mediastinal mass (thyroid, thymoma, teratoma, lymphoma, trauma)

54
Q

Which way the trachea deviate w Atelectasis?

A

same side

- vs pneumothorax.. think balloon

55
Q

Myasthenia Gravis assoc w enlarged ___.

A

thymus

56
Q

Hilar LA - think…

A

TB, Sarcoidosis, Lymphoma

57
Q

Blood supply to LU from…

A

R and L Bronchial A

58
Q

fremitus means…

A

consolidation

NPLEX (24 decks)

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