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Pulm > Pulmonary Anatomy and Physiology > Flashcards

Pulmonary Anatomy and Physiology Flashcards

1
Q

Vertebrae

A

Provide stability

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2
Q

Ribs

A

Protect thoracic organs

Provide dynamic bone lever system for ventilation

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3
Q

Ribs 1-7

A

True ribs

Most stable

Directly attach to sternum via costocartilage

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4
Q

Ribs 8-10

A

False ribs

Insert to the sternum through the costal cartilage of rib 7

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5
Q

Ribs 11-12

A

Floating ribs

Do not articulate with the sternum

Designed for mobility at the expense of stability

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6
Q

Sternum

A

Provides mobility

Manubrium - articulates with clavicles and ribs 1 and 2

Body - ribs 3-7

Xiphoid - most inferior portion (hyaline cartilage); fully ossifies by age 40

Sternal angle - horizontal ridge at level of 2nd rib, level of the carina (T5)
-Allows pump handle motion

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7
Q

Pump handle

A

Anterior and superior motion of the sternum and upper rib cage

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8
Q

Bucket handle

A

Lateral and superior motion of the ribs

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9
Q

Chest mobility increases as you move…

A

Inferiorly and anteriorly

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10
Q

Chest mobility decreases as you move…

A

Superiorly and posteriorly

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11
Q

Sequence of normal breathing

A
  1. Diaphragm rise
  2. Lateral costal expansion of lower chest
  3. Gentle rise of upper chest superiorly and anteriorly
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12
Q

Mm of larynx and pharynx

A

Act as valves that help regulate airflow

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13
Q

Diaphragm

A

Primary mm of inspiration

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14
Q

External intercostals

A

Elevate ribs and increase thoracic volume

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15
Q

Internal intercostals

A

Lower the ribs and decrease thoracic volume

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16
Q

Simultaneous intercostal contraction

A

Elevates the ribs

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17
Q

Quiet breathing exhalation

A

Passive recoil of lungs and ribs

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18
Q

Forceful exhalation

A

Use abdominal mm to depress lower ribs and compress abdominal contents to push against the diaphragm and help to actively exhale

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19
Q

Diaphragm resting

A

Supine - rests higher, has a larger excursion

Sitting and standing - rest lower

Side lying - dependent side of diaphragm has larger inspiratory excursion

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20
Q

Breathing INN

A

Phrenic nerve

C 3 4 5

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21
Q

Abdominal mm

A

Stabilize rib cage and provide visceral support

Provide positive pressure for diaphragm

Provide increased intrathoracic pressure for effective cough, BM, venous return, etc

INN T6-L1

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22
Q

Paradoxical breathing pattern

A

Complete opposite of the way the diaphragm is supposed to contract

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23
Q

CONCENTRIC diaphragm cx

A

Quiet, forceful inhalation

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24
Q

ECCENTRIC diaphragm cx

A

Controlled exhalation or speech

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25
Q

Intercostal fx

A

Stabilize rib cage during inhalation and prevent chest wall from moving inward toward the negative pressure

INN T1 - T12

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26
Q

Erector spinae fx

A

Stabilize thorax posteriorly

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27
Q

Pectoralis fx

A

Can stabilize the ribs

Used in reverse, can assist with ant and lat chest wall expansion

Forced exhalation when chest moves into flexion

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28
Q

SA fx

A

Only insp mm paired with trunk flexion

Post expansion with fixed UE

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29
Q

SCM fx

A

Superior and anterior expansion

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30
Q

Trapezius fx

A

Superior expansion

LEAST energy efficient accessory mm

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31
Q

Newborn breathing

A

Triangle shape

Diaphragmatic breathers

No functional accessory mm

No pulmonary reserves

Stability more important than mobility in newborn thorax

Ribs horizontally aligned

Not a lot of neck presentation

Respiration > 40 (high)

Low tidal volume

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32
Q

3-6 mo breathing

A

Rectangular-shaped chest

Mostly diaphragmatic with some upper chest movement

You will see a bigger breath going in and a slowing down of respiration rate

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33
Q

6-12 mo breathing

A

MOST SIGNIFICANT STAGE OF NORMAL CHEST DEVELOPMENT

Elliptical and rectangular shape

All mm now available

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34
Q

Intra-abdominal pressure

A

Always reported as positive

Fluctuates with breathing

Increases with inhalation

Decreases with exhalation

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35
Q

Intrathoracic pressure

A

Lower to draw air in inhalation and higher with exhalation

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36
Q

As we age…

A

Decreased lung compliance
Decreased chest wall compliance
Lung volumes and expiratory flow rates decrease

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37
Q

Upper airways

A

Nasal and oral orifices to the false vocal cords in the larynx

Conducting airways filter warm, conduct air to the respiratory units

Nose
Nasal cavity
Pharynx
Nasopharynx
Oropharynx
Laryngopharynx
Larynx
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38
Q

Pharynx

A

Shared thoroughfare for digestive and respiratory system

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39
Q

Larynx

A

Prevents food and other things from entering airways

40
Q

Lower airways

A

True vocal folds to the alveoli

Conducting airways function to filter, warm, and conduct the air to the respiratory units

41
Q

Respiratory units…

A

where gas exchange occurs

42
Q

Trachea

A

12 cm long

Carina - where it divides into R and L main stem bronchi

Cartilaginous rings

R main stem bronchus is more vertical, shorter, and wider than L
***More prone to aspirate to R side than L

43
Q

Resp unit organs

A

Trachea
Bronchi
Bronchioles
Terminal bronchioles

44
Q

Terminal respiratory units

A

Where gas exchange occurs

Alv ducts and sacs

Alv epithelium

Alv capillary septum (membrane) - where O2 gets from lung to capillary

45
Q

Coughing only gets us to…

A

7th generation

46
Q

Alveolus

A

Cup-shaped out pouching lined by simple squamous epithelium and supported by a thin elastic membrane

47
Q

Alveolar sac

A

2+ alveoli that share a common opening

48
Q

Type I Alveolar Cells

A

Simple squamous

Form a continuous lining of the wall

MAIN SITE FOR GAS EXCHANGE

Macrophages - phagocytes that help remove dust particles and other debris

49
Q

Type II Alveolar Cells

A

Septal cells

Secrete alveolar fluid, which includes SURFACTANT

50
Q

Cilia

A

Helps move secretions

Needs ATP and appropriate ionic conditions of Ca++ and Magnesium

51
Q

Parenchyma

A

Spongy, porous material that the lungs are made of

52
Q

Apex of lung

A

About 1 in about clavicle

53
Q

Hilus/hilum

A 
Principal bronchus
Pulmonary artery
Pulmonary veins
Bronchial arteries and veins
Pulmonary nerve plexus
Lymph vessels
54
Q

Purposes of thorax

A

Attachment for mm of ventilation

Houses lungs and mediastinum

55
Q

Lung blood supply

A

L and R bronchial arteries and veins

56
Q

Lung INN

A

Lungs, trachea, bronchi INN by SNS and PNS

57
Q

L lung 10% smaller than R lung…

A

Cardiac notch

58
Q

Oblique fissures

A

Upper and middle lobe

from

Lower lobe

59
Q

Horizontal fissure

A

R lung only

Separates upper lob and middle lobe

60
Q

Right lung

A

3 lobes

RUL
RML
RLL

61
Q

Left lung

A

2 lobes

LUL
LLL

Lingula (incorporated into LUL)

62
Q

Lobules

A

Contain lymph vessel, arteriole, venule, and branch from a terminal bronchiole

63
Q

Pleurae

A

Membranous serous sac covers each lung

Visceral and parietal

Somatosensory nn hit this so if you hit a parietal pleura, you could feel this pain in the thoracic or abdominal walls or neck and shoulders

64
Q

Pleural space

A

Potential space

65
Q

Pleuritis

A

Inflammation of membranes

Build up of fluid possible

66
Q

Thoracocentesis

A

Tx - around 7th IC space and suck the fluid out

67
Q

SURFACTANT

A

Week 28

68
Q

Ventilation

A

Movement of gas to and from the alveoli

69
Q

Diffusion

A

Passage of O2 and CO2 across the alveolar membrane

70
Q

Perfusion

A

Transport dissolved and bound gases to/from lungs and cells in blood

71
Q

Respiration

A

O2 consumption at cell level and production of CO2 in use of metabolic substrates

72
Q

O2 transport

A

Delivery of fully oxygenated blood to peripheral tissues, cellular uptake of O2, use of O2 in tissues, and return of desaturated blood to the lungs

73
Q

DO2

A

Oxygen delivery

74
Q

VO2

A

Oxygen consumption

75
Q

OER

A

Oxygen Extraction Ratio

VO2/DO2

@ rest, we extract 23%

76
Q

Steps in O2 Transport Pathway

A
  1. Inspired O2 and quality of ambient air
  2. Airways
  3. Lungs and chest wall
  4. Diffusion
  5. Perfusion
77
Q

Upper respiratory tissue type

A

More cartilage

78
Q

Lower respiratory tissue type

A

More smooth mm and cilia

79
Q

75% inspiration

A

Caused by contraction of diaphragm and intercostals

80
Q

Pulmonary circulation

A

Delivery of DEoxygenated blood and return of oxygenated blood to the heart

81
Q

Bronchial circulation

A

Bronchial arteries from the aorta deliver oxygenated blood to the lungs

Accounts for 1-2% of CO

82
Q

Pulmonary veins drain from…

A

Capillaries

83
Q

Anatomic Dead Space

A

Does not participate in gas exchange

84
Q

Respiratory membrane

A

0.5 micrometers thick

Allows for rapid gas diffusion

85
Q

Partial pressure

A

The pressure exerted by each component of a gas mixture

86
Q

Poor ventilation

A

Shunt

87
Q

Poor perfusion

A

Physiologic dead space

88
Q

Factors Affecting O2 Concentration in the Blood

A

Decreased hemoglobin concentration

Inadequate alveolar ventilation

Decreased diffusion across the pulmonary membrane when diffusion distance increases the pulmonary membrane changes

V/Q mismatch occurs when a portion of the alveoli collapses

89
Q

Medullary rhythmicity

A

Inhale:exhale 2:3
Inspiratory neurons
Expiratory neurons

90
Q

Pneumotaxic area in the pons

A

Maintains normal pattern of respiration

Inhibitory impulse shortens inhalation, increases RR

91
Q

Apneustic area in the pons

A

Impulses activate/prolong inspiration

92
Q

Hering-Breuer reflex

A

When smooth mm receptors are stretched too much, it sends message to brain to prevent over expansion of lung

Not involved in normal breathing

Labored breathing from exercise

93
Q

How does baby learn to breathe?

A

Ventilation is initiated quickly due to hypoxia and hypercapnia

Once placenta is disturbed during delivery, chemoreceptors in baby’s brain make them take a breath

94
Q

Avg lung can hold…

A

6 L of air

95
Q

Surface tension

A

Surfactant lowers wall tension in relation to size to maintain proper wall tension so alveoli do not collapse

96
Q

If lung collapses…

A

Your chest can expand more

97
Q

CO2 transport

A

Dissolved in plasma
Bound to proteins
Bicarbonate

Pulm (10 decks)

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