Pulmonary A&P Flashcards
What involves the gas exchange pump? (conduction pathway)
Lung Tissue and airways
conducts airflow from outside –> alveoli and –> alveolar-capillary membrane
What involves the musculoskeletal ventilatory pump? what does is allow?
thoracic rib cage, cervical and thoracic spine, upper pelvic area and respiratory muscles
allow attachment for respiratory muscles and support/protection for lung
Where is the respiratory center located?
Medulla and Pons
what type of receptors respond to CO2 and pH in blood?
central chemoreceptors
What receptors can stimulate a change in RR?
central chemoreceptors
What is the primary stimulus in the control of ventilation? what is the secondary drive?
CO2 (CO2 and changes in pH)
O2 is secondary
What type of receptors in carotid and aortic arch respond to O2 and CO2
peripheral chemoreceptors
What is the pathway flow of air?
air in through nose or mouth
nasopharynx/oropharynx
trachea
carina (bifurcation) to many little airways
3 lobes of R or 2 lobes of L
lung tissue - parenchyma
alveoli
When we inhale the diaphragm ___
and the ___ muscle widens with the ribs
contracts and moves downward
external intercostals
The lower ribs do what kind of movements?
Lateral and A/P
bucket handle
The upper ribs do what kind of movements?
superior and outward elevation of thorax
pump handle
What is the function of the conducting zone? how many generation?
anything above bronchioles and alveoli sacs
warms and humidifies inspired air
filters and cleans
up to 16
How are particles trapped and taken out after breathing them in?
trapped in mucus
cilia moves it up and out to cough/blow nose
What is the function of the transitional and respiratory zone? how many generations?
includes respiratory bronchials and alveoli sacs
gas exchange b/w 1 alveoli and capillary
17+ generations
Where would you see turbulent flow in the airway?
trachea (big spaces)
Where would you expect to see laminar flow?
narrow airways (straight airways)
___: distensibility of tissues, promotes lung expansion, amount of pressure needed to expand tissues
compliance
decreased compliance = __ work = __ pressure to expand lungs
more work and more pressure
___: force which promotes return to normal, resistance to change
elastance
in an obstructive problem there is (increased or decreased) resistance?
increased
in obstructive you have decreased ___ making it harder to expand
estensibility? making it harder for airway to expand
in restrictive there is (increased or decreased) compliance?
decreased compliance
alveoli don’t want to open up
what happens to forces expiration in an obstructive disease?
airway starts to close down from pressure increase
What is closing volume?
What causes this?
while breathing the point which the airways begins to collapse
breathing hard causes closing
people with COPD what happens to the airway as they breath hard over time
airway closing happens closer to quiet breathing –> air trapping
someone with restrictive will have (increase or decrease) lung volume?
How is this related to compliance?
less volume
takes more pressure to get air in leading to smaller volume in lungs
What is the work of breathing?
What is the relationship with pressure and volume
work required to overcome airway and tissue resistance
Pressure X volume (proportinal)
What is normal work of breathing at rest?
<5%
What is the function of surfactant?
provide surface stability and prevents collapse of alveolar structures
surfactant:
increases __ of lung
__ work of breaking
promotes __ of alveoli
compliance
decreases
stability
surfactant:
secreted by ___
helps overcome __ to allow alveoli to expand
Type 2 alveolar cells
surface tension
When is surfactant start to be produced? When does fetus have sufficient amount for independent respiration?
24-28 weeks gestation
34-35 weeks
What kind of cells make up mucociliary transport and thier functions?
goblet cells: secrete mucus
Ciliated epithelial cells: move fluid
particulate matter stopped at multiple sites
What is someone mucociliary transport paralyzed, what are they at risk for?
anesthesia
pneumonia
___: air moving in/out of lungs for distribution to alveoli
ventilation
__: gas transported to/from lungs and cells in blood passing through pulm capillaries for gas exchange
Perfusion
___: air moving to cross alveolar capillary membrane
diffusion
When we sit upright where is ventilation highest? Where is perfusion highest?
upper lungs
weight of blood pushes down - lower lungs
when supine where is best ventilation and best perfusion?
ventilation: anterior
perfusion: posterior
When we are lying on L side, where is best ventilation and perfusion?
ventilation: R lung
perfusion: L lung
Where are you are greatest risk of pneumonia? (area of high ventilation or area of high perfusion)
area of higher perfusion because it is getting less ventilation
What position gives more opportunity for ventilation?
Prone
What is dead space? (blocked capillary)
Ventilation with no perfusion
What is shunt? (blocked airway)
perfusion with no ventilation
PEFR:
initial peak with max exhilation
FEV1:
What is is used to evaluate?
amount exhaled after 1 second - used to evaluate bronchodilator effectiveness
FEV25 -75:
what info?
middle 50% of exhalation
info about state of small - middle sized airways
FVC:
total volume expired with max effort
What is FEV1/FVC in normal, restrictive, and obstructive?
norm: 75%
restrictive: 83%
obstructive: 25%
What is DLCO?
What is it measuring?
What is the norm?
diffusion capacity of the lungs for carbon monoxide
overall function of the alveolar/capillary membrane
75-140% predicted
decreased surface ares or increased thickness of membrane will (increase or decrease) DCLO
decrease
What type of condition (4) will have decrease DLCO
emphysema
interstitial lung disease
pulmonary hypertension
smoking
What types of conditions (3) will have increased DLCO
exercise
asthma
supine position
why does exercise increase DLCO
recruitment of capillaries
why does supine position increase DLCO
increased pulmonary capillary blood volume
