Forced Expiratory Vol in 1 Sec! after max inspiration - see that 1 there - vs FVC, same thing wo time limit

mediates INSPIRATION & EXPIRATION - RHYTHM - input from vagus and glossopharyngeal - output via phrenic to diaphragm - cerebral cortex overrides

Pulmonary Flashcards by Katherine Souza

how many lobes on ea lung?

2 on left

3 on right

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the only artery w deoxygenated blood is?

pulmonary artery … to R side of HT

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the only vein w oxygenated blood is?

pulmonary vein

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what CN constricts bronchioles?

CN 10

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

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

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Rib level at MCL on expiration and inspiration?

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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Sphenoid sinus drains to?

Sphenoid -> Ethmoid -> Maxillary -> Nasal Cavity

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Frontal sinus drains to?

Maxillary -> Nasal Cavity

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Larynx does what and is innervated by?

CN 10

- vocalization

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What is Tidal Volume, TV?

what I’m doing now breathing

- the extra is “reserve vol”

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What is “Dead Space”?

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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What is FEV1?

Forced Expiratory Vol in 1 Sec! after max inspiration

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

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FEV1 is usu what percentage of FVC?

80%

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Can Residual Vol be measured?

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VC =

TV + IRV + ERV

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TLC, Total Lung Capacity includes what?

*Increased TLC is indicative of?

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

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Medulla and LU

mediates INSPIRATION & EXPIRATION

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

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Voluntary Control of breathing regulated by?

Cortex

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Apneustic Center is located where and responsible for what?

Pons - lower

Gasp
stimulates inspiration

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Pneumotaxic Center is located where and responsible for what?

upper Pons

- inhibits inspiration, regulates Rate & Vol.

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

Cortex

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Where is the Central Chemoreceptor and what does it sense?

Medulla

pH and CO2

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Where is the Peripheral Chemoreceptor and what does it sense?

CAROTID BODIES & AORTIC BODIES

pH and CO2

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Respiratory vs Metabolic Acidosis/Alkalosis

Respiratory: think PCO2
Metabolic: think HCO3-

P50 means...

At 50% saturation of Hgb ... | - Pressure of 02 (which is 25mmHg)

What is a Chloride Shift?

HCO3- leaves RBC in exchange for Cl- | - this happens when HCO3 is transported to LU to change back into CO2 and breathed out

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

Deoxyhemoglobin

Epiglottitis - Eti - pop. - what happens?

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"

Pulmonary Edema usu caused by? - but can also be caused by? - 2 types - sequalae

L-sided HT Failure! - also can be caused by pulmonary capillary membrane damage - 2 types are Interstitial and Alveolar - sequelae ---> LU infx

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

OBSTRUCTIVE - LU hyper-inflates but doesn't let the air out (bc damaged alveolar septae and decreased elastic recoil) - increased COMPLIANCE

In emphysema you will see normal Pressure of CO2 because?

the body compensates w rbc's

In chronic bronchitis the pressure of CO2....

INCREASES COPD think "blue bloater"

Dx criteria Chronic Bronchitis?

cough + sputum for at least 3mo in 2 consecutive yrs | emphysema and bronchitis often together

Lobar Pneumonia: ETI: usu starts where?

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

What is Bronchiectasis? - sputum? - where in LU? - Eti?

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

Is Bronchial Adenoma malignant or benign?

either

What CA of the LU is deadly? | Which has the worst prognosis?

Large Cell Undifferentiated Carcinoma | ---> worst! --->Small/Oat Cell Undifferentiated Carcinoma

Pancoast Tumor is what kind? | - usu causes what?

small cell carcinoma | - Horner's Syndrome

Which CA of the LU produce hormones?

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

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

Poor prognosis - ectopic ACTH and ADH secretion - located CENTRAL LU

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

PERIPHERAL - mets to BRAIN - POOR prognosis

MC carcinoma of LU? | where in LU located?

ADENOCARCINOMA | located in PERIPHERY

The common cold is accurately called?

RHINITIS

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

Goodpasture's Syndrome - AI Dz - type ll hypersensitivity (Abs) - middle aged men

Sarcoidosis vs TB | what type of granulomas?

``` TB = CASEATING Sarcoidosis = NONCASEATING ```

FEV1/FVC ratio: COPD vs Restrictive

Restrictive- they both decrease so remains the same | COPD: ratio DECREASES

What is Wegener Granulomatosis

in the name.. think granulomas of upper and lower LU - vasculitis - unknown eti

What are HEART FAILURE CELLS?

hemosiderin-laden M0 | seen when you have pulmonary edema caused by heart failure

MC LU CA

METS

Unilateral vs Bilateral blunting of costophrenic angle?

unilateral -> pleural effusion, hemathorax | bilateral -> obstructive LU Dz

LR located beneath what ribs? SP? HT?

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

blood supply to mammary glands?

Internal Thoracic A.

see a Widened Mediastinum on Xray | ddx:

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

Which way the trachea deviate w Atelectasis?

same side | - vs pneumothorax.. think balloon

Myasthenia Gravis assoc w enlarged ___.

thymus

Hilar LA - think...

TB, Sarcoidosis, Lymphoma

Blood supply to LU from...

R and L Bronchial A

fremitus means...

consolidation