Pulmonary Anatomy and Physiology Review Flashcards
Ventilation: What is it
breathing, mechanical process that moves air into and out of lungs
Gas Exchange: What is it?
exchange b/w blood and alveoli
exchange b/w blood and tissues
Gas delivery to tissue is simply called __ flow.
blood
____use oxygen to make ATP (cellular respiration).
tissues
Gases return from ___ to the ___. Then exhalation occurs.
tissues to lungs
External Respiration?
ventilation and gas exchange in lungs
Internal Respiration?
oxygen utilization and gas exchange in tissues
What can limit diaphragm displacement (4)?
SOAP pneumonic
Size of various GI organs, (esp. liver that lays inf. to diaphragm)
Obesity
Ascites
Pregnancy
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.
False, we’re talking supine here.
The resting position of the diaphragm is determined by what?
body position
Upper resp. tract consist of … (4)
Frontal Sinus
Nasal Conchae
Nose
Larynx
Nose functions to conduct, __, & __ air. Then air goes into ___ which extends from base of skull to esophagus.
1&2) filtrate & humidify
3) pharynx
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?
1) Oropharynx
2) Laryngopharynx
The central tendon/insertion of the diaphragm is a thin but strong __, located near the __ of the diaphragm but more anterior than posterior.
1) aponeurosis
2) center
also know your diaphragm is separated into R/L hemidiaphragms
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).
1) contracts/flatten
2) relaxes/makes dome shape
3) 2/3s of an in.
4) 2.5-4 inches
In supine the lung volumes are __ b/c abd. organs are elevated. Whereas lung volumes are __ in the upright position b/c of gravity.
1) low + greater excursion during breathing
2) high + less excursion during breathing
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.
1&2) higher lung volume & less excursion
3&4) lower lung volume & more excursion
The external intercoastal is a muscle of __. Muscle fibers go in a ___ direction and contraction makes the lower rib __.
1) inspiration
2) inferomedial
3) elevate
during inspiration, lungs go EXTERNAL/outward, ribs go up (rib elevation)
The internal intercoastal is a muscle of __. Muscle fibers go in a ___ direction and contraction pulls the ribs __. The __ muscles are also muscles of __.
1&5) expiration
2) posterior, inferomedial
3) downward/depression
4) abdominal
during expiration, lungs go INTERNAL/recoil, ribs go down (rib depression)
___ 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.
1) Inspiration
2) Expiration
3) rebound
4&5) surface tension
FORCED EXPIRATION IS ACTIVE
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.
1) Bucket handle
2) Pump handle
The RIGHT lung has __ lobes, separated by _ fissures. What are the names of the lobes & fissures? How does ea. fissure separate the lobes?
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
The R lung lobes are separated into 10 segments total. How many segments belong to ea. lobe? What are these segment names?
RUL has 3 = superior (apical/apex), anterior, posterior
RML has 2 = medial, lateral
RLL has 5 = superior, medial/middle, lateral, anterior basal, posterior basal
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?
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
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.
1) lobar
2) segmental
3) bronchioles
The __ zone is where gas-exchange occurs. It’s made up of __ __, alveolar __, and the __.
1) respiratory
2) respiratory bronchioles
3) alveolar ducts
4) alveoli
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.
1) increase
2) decrease
3) negative
4) into
At rest (no inspiration or expiration), intrapulmonary pressure is __ to atmospheric pressure.
equal to
no airflow
T/F: If intrapleural pressure was ever more positive than intrapulmonary pressure or transpulmonary pressure, our lungs would collapse.
TRUE AF
For expiration, intrapulmonary pressure becomes more __ than atmospheric pressure. Intrapleural pressure remains __.
1) positive
2) negative
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
1&2) 350-500
3&4) Minute ventilation; one minute
5) effectiveness
6&7) TV x RR
Loss of __ reduces recoiling capacity in diseases like Emphysema. The lungs can easily inflate with increased/excessive __ but reduced __
1) elastin
2) compliance
3) elasticity
The capacity/ease of the lungs to expand and stretch is lung __. The ability of the lungs to recoil after being stretched is __.
1) compliance
2) elasticity
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.
1) volume
2) pressure
3) resistance
4) parenchyma
5) low
Elasticity/recoil of thoracic wall is created by the elasticity of tissue in the __ wall. Recoiling of this favors __ of the thoracic cavity.
1) chest wall
2) expansion
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.
1) Surface tension
2) Recoiling
__ reduces surface tension. Without it, recoil __ and compliance __, like in the lung of a pre-term baby.
1) Surfactant
2) increases
3) decreases
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.
1) expansion
2) inward
3) stuck
T/F: Pulmonary ventilation and perfusion are distributed equally throughout the lung.
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)
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.
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
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.
1) more
2) less
3) greater
remember Q is gravity dependent though
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.
1) 0.8
2) shunt
3) dead space
What is one condition that can cause a shunt? What about a dead space?
Shunt: mucus, COVID, pulmonary obstruction
Dead Space: PE
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.
1) constrict
2) dilate
__ __ __ 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.
1) Ventilation Perfusion Scan
2) PE
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.
1) equal to
2) Partial
REMEMBER: O2 makes up 21% of the atmosphere, so partial pressure of O2 = 760 X 21% = 159 mmHg.
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
1) PaO2 > PaCO2
2) PaO2 > PaCO2
3) PaO2 > PaCO2
4) PaO2 slightly < PaCO2
5) PaO2 slightly < PaCO2
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.
1) more
2) increase
3) decreases
4) decreasing
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.
1) decrease
2) acidic
3) hypoventilation
4) exhalation
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.
1) increase
2) alkalitic
3) hyperventilation
4) exhalation
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 _%.
1) inhaled
2) 21%
3) 4%
