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CardioPulm > Pulmonary Anatomy and Physiology Review > Flashcards

Pulmonary Anatomy and Physiology Review Flashcards

1
Q

Ventilation: What is it

A

breathing, mechanical process that moves air into and out of lungs

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2
Q

Gas Exchange: What is it?

A

exchange b/w blood and alveoli
exchange b/w blood and tissues

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3
Q

Gas delivery to tissue is simply called __ flow.

A

blood

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4
Q

____use oxygen to make ATP (cellular respiration).

A

tissues

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5
Q

Gases return from ___ to the ___. Then exhalation occurs.

A

tissues to lungs

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6
Q

External Respiration?

A

ventilation and gas exchange in lungs

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7
Q

Internal Respiration?

A

oxygen utilization and gas exchange in tissues

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8
Q

What can limit diaphragm displacement (4)?
SOAP pneumonic

A

Size of various GI organs, (esp. liver that lays inf. to diaphragm)
Obesity
Ascites
Pregnancy

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9
Q

T/F: Pts will have a greater excursion in the upright position than lying in supine due to the level of the diaphragm is rising.

A

False, we’re talking supine here.

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10
Q

The resting position of the diaphragm is determined by what?

A

body position

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11
Q

Upper resp. tract consist of … (4)

A

Frontal Sinus
Nasal Conchae
Nose
Larynx

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12
Q

Nose functions to conduct, __, & __ air. Then air goes into ___ which extends from base of skull to esophagus.

A

1&2) filtrate & humidify
3) pharynx

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13
Q

1) What part of the pharynx serves as a passageway for food to the esophagus AND for air moving to/from the nasal cavity?
2) What about from the epiglottis to the esophagus at the level of C6?

A

1) Oropharynx
2) Laryngopharynx

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14
Q

The central tendon/insertion of the diaphragm is a thin but strong __, located near the __ of the diaphragm but more anterior than posterior.

A

1) aponeurosis
2) center
also know your diaphragm is separated into R/L hemidiaphragms

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15
Q

The diaphragm __ when we inhale and __ when we exhale. Displacement of the diaphragm during quiet breathing is __ of an in. and max excursion is __ inch(es).

A

1) contracts/flatten
2) relaxes/makes dome shape
3) 2/3s of an in.
4) 2.5-4 inches

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16
Q

In supine the lung volumes are __ b/c abd. organs are elevated. Whereas lung volumes are __ in the upright position b/c of gravity.

A

1) low + greater excursion during breathing
2) high + less excursion during breathing

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17
Q

In SL, hemidiaphragms are unequal. The uppermost side drops to a lower position leading to __ lung volume & __ excursion than in sitting position. The lower side rises higher than the thorax leading to __ lung volume & __ excursion than in sitting position.

A

1&2) higher lung volume & less excursion
3&4) lower lung volume & more excursion

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18
Q

The external intercoastal is a muscle of __. Muscle fibers go in a ___ direction and contraction makes the lower rib __.

A

1) inspiration
2) inferomedial
3) elevate
during inspiration, lungs go EXTERNAL/outward, ribs go up (rib elevation)

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19
Q

The internal intercoastal is a muscle of __. Muscle fibers go in a ___ direction and contraction pulls the ribs __. The __ muscles are also muscles of __.

A

1&5) expiration
2) posterior, inferomedial
3) downward/depression
4) abdominal
during expiration, lungs go INTERNAL/recoil, ribs go down (rib depression)

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20
Q

___ is an active process at rest & during exercise. __ at rest of a passive process achieved through elastic recoil of the lung. Elastic recoil is the ___ of the lungs after inhalation d/t elastin in lung conn. tissue & __ __ of fluid that lines alveoli.

A

1) Inspiration
2) Expiration
3) rebound
4&5) surface tension
FORCED EXPIRATION IS ACTIVE

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21
Q

The __ handle refers anterior portion of ribs moving fwd when they are elevated d/t ant. end being lower than the posterior end of the rib.
The __ handle refer to costovertebral joints 2-6 moving on a side-to-side axis resulting in raising & lowering of the sternal end of the rib.

A

1) Bucket handle
2) Pump handle

22
Q

The RIGHT lung has __ lobes, separated by _ fissures. What are the names of the lobes & fissures? How does ea. fissure separate the lobes?

A

1) 3 lobes: RUL, RML, RLL
2) 2 fissures:
the oblique MAJOR fissure separates RLL from RML & RUL
the horizontal MINOR fissure separates RML from RUL

23
Q

The R lung lobes are separated into 10 segments total. How many segments belong to ea. lobe? What are these segment names?

A

RUL has 3 = superior (apical/apex), anterior, posterior
RML has 2 = medial, lateral
RLL has 5 = superior, medial/middle, lateral, anterior basal, posterior basal

24
Q

Left lung is __ than R lung in size. L lung has __ lobes (also name them) with the __ fissure separating them. How many segments does the lung have total and w/in. ea. lobe? What are the segments names?

A

1) smaller
2) 2
3) Oblique
4) 9 total, LUL = 5, LLL = 4
5) -LUL segments = anterior, apico-posterior (some consider this 2 diff segments), superior lingular, inferior lingular
-LLL segments = superior (apical), anterior, posterior, lateral

25
Q

Our lungs have R and L main bronchi. Then they become __ bronchi when passing through a lobe of the lung and __ bronchi when passing through a segment of ea. lobe. The __ are the smallest segments of your bronchi.

A

1) lobar
2) segmental
3) bronchioles

26
Q

The __ zone is where gas-exchange occurs. It’s made up of __ __, alveolar __, and the __.

A

1) respiratory
2) respiratory bronchioles
3) alveolar ducts
4) alveoli

27
Q

During inspiration there is a __ in lung/thoracic cavity volume and a __ in intrapulmonary pressure (w/in the lung/alveoli). This brings about a (positive/negative) (subatmospheric) intrapulmonary pressure leading to air flow __ lungs.

A

1) increase
2) decrease
3) negative
4) into

28
Q

At rest (no inspiration or expiration), intrapulmonary pressure is __ to atmospheric pressure.

A

equal to
no airflow

29
Q

T/F: If intrapleural pressure was ever more positive than intrapulmonary pressure or transpulmonary pressure, our lungs would collapse.

A

TRUE AF

30
Q

For expiration, intrapulmonary pressure becomes more __ than atmospheric pressure. Intrapleural pressure remains __.

A

1) positive
2) negative

31
Q

Resting TV is __ to __ mLs.
__ ventilation is the total volume of air inhaled OR exhaled in __. It also assesses the ___ of ventilation. To calculate it, multiply __ by __.
At rest = 5 L/min
Max ex = 70-125 L/min

A

1&2) 350-500
3&4) Minute ventilation; one minute
5) effectiveness
6&7) TV x RR

32
Q

Loss of __ reduces recoiling capacity in diseases like Emphysema. The lungs can easily inflate with increased/excessive __ but reduced __

A

1) elastin
2) compliance
3) elasticity

33
Q

The capacity/ease of the lungs to expand and stretch is lung __. The ability of the lungs to recoil after being stretched is __.

A

1) compliance
2) elasticity

34
Q

Lung compliance is defined as change in lung __ over change in transpulmonary __. Compliance can be affected by factors that produce __ to distention like infiltration of conn. tissue into lung __ causing fibrosis.
Fibrosis can be correlated with __ compliance of a lung.

A

1) volume
2) pressure
3) resistance
4) parenchyma
5) low

35
Q

Elasticity/recoil of thoracic wall is created by the elasticity of tissue in the __ wall. Recoiling of this favors __ of the thoracic cavity.

A

1) chest wall
2) expansion

36
Q

Created by the fluid secreted on the lining of alveoli, __ __ is the tendency of liquids to acquire the least surface area possible & favoring the __ of lungs inward/resisting lung expansion. This helps to determine lung compliance.

A

1) Surface tension
2) Recoiling

37
Q

__ reduces surface tension. Without it, recoil __ and compliance __, like in the lung of a pre-term baby.

A

1) Surfactant
2) increases
3) decreases

38
Q

Our lungs don’t collapse when we are not actively breathing due to recoiling of chest wall outwardly causing (expansion/compression). Our lungs tend to recoil (outward/inward), but because they are __ to the thoracic wall they are always under a balance of elastic tension.

A

1) expansion
2) inward
3) stuck

39
Q

T/F: Pulmonary ventilation and perfusion are distributed equally throughout the lung.

A

FALSE
Ventilation (V) = 50%> at the base than the apex (more at the apex)
Perfusion (Q) = dependent on body position in response to gravity (more at the base)

40
Q

At to APEX of the lung: the alveoli are (larger/smaller) and (more/less) compliant, the intrapleural pressure is more (negative/positive), leading to (more/less) ventilation.

A

1) larger
2) less
3) negative
4) less
If intrapleural pressure is more negative, this usually means the lung is INSPIRING air in b/c the pressure MUST be subatmospheric

41
Q

At to BASE of the lung: there (more/less) vascular pressure, more recruitment/distention, and (more/less) resistance to blood flow, leading to (greater/less) blood flow/perfusion.

A

1) more
2) less
3) greater
remember Q is gravity dependent though

42
Q

A normal V/Q ratio is __. If perfusion occurs with very limited ventilation, this results in a __, where blood leaves the lung deoxygenated. If ventilation occurs with very limited perfusion, this results in physiologic __ __. where a portion of the lung is NOT perfused.

A

1) 0.8
2) shunt
3) dead space

43
Q

What is one condition that can cause a shunt? What about a dead space?

A

Shunt: mucus, COVID, pulmonary obstruction
Dead Space: PE

44
Q

To compensate for a shunt, the pulmonary arterioles __ causing reduced ventilation and perfusion. To compensate for a dead space, the pulmonary arterioles __ causing enhanced ventilation and perfusion.

A

1) constrict
2) dilate

45
Q

__ __ __ is a test that measures V/Q in your lungs. It most often used to dx or rule out a __ ___. Radioactive albumin is injected into blood and xenon or technetium (radionuclides) are inhaled in by the pt.

A

1) Ventilation Perfusion Scan
2) PE

46
Q

Dalton’s law is the total pressure of a gas mix is ___ the sum of pressure of each gas in it. __ pressure is the pressure of an individual gas that can be measured by multiplying the gas % by the total pressure.

A

1) equal to
2) Partial
REMEMBER: O2 makes up 21% of the atmosphere, so partial pressure of O2 = 760 X 21% = 159 mmHg.

47
Q

Describe the amount of PaO2 & PaCO2 the following parts of the path air takes through the body:
1) Atmosphere
2) Alveolar air after external respiration
3) Oxygenated blood to L atrium of the heart
4) Systemic tissue cells after internal respiration
5) Deoxy blood to R atrium
6) For this step, just know blood goes from R atrium to lungs for exhalation

A

1) PaO2 > PaCO2
2) PaO2 > PaCO2
3) PaO2 > PaCO2
4) PaO2 slightly < PaCO2
5) PaO2 slightly < PaCO2

48
Q

Oxygen Dissociation Curve:
As (more/less) oxygen becomes available in the blood (PaO2), Hb binding affinity for O2 increases leading to a (incr/decr) in oxy saturation (SaO2). As PaO2 (incr/decr) in environments like the veins so does SaO2, d/t Hb binding affinity for O2 (incr/decr) as well.

A

1) more
2) increase
3) decreases
4) decreasing

49
Q

As CO2 increases in the blood, blood pH levels __(incr/decr)_ and become more (acidic/alkalitic). This is caused by __ventilation (decr. RR) and reduced (inhalation/exhalation) volumes.

A

1) decrease
2) acidic
3) hypoventilation
4) exhalation

50
Q

As CO2 decreases in the blood, blood pH levels __(incr/decr)_ and become more (acidic/alkalitic). This is caused by __ventilation (incr. RR) and reduced (inhalation/exhalation) volumes.

A

1) increase
2) alkalitic
3) hyperventilation
4) exhalation

51
Q

FIO2 is the fraction of (inhaled/exhaled) air that is oxygen. Normal values is __%. For every liter of supplemental oxygen via a nasal cannula, the FIO2 increases by _%.

A

1) inhaled
2) 21%
3) 4%

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