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Advance Anesthesia II > Pulmonary Anatomy PPT I > Flashcards

Pulmonary Anatomy PPT I Flashcards

First PPT of Pulmonary Anatomy

1
Q

In which bronchial level does gas exchange occur?

A

Level 17

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2
Q

What percentage of the adult complement of alveoli does a newborn’s lung have?

A

6-15%

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3
Q

At what age is full complement of alveoli is develop?

A

about 2 years after birth

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4
Q

Complement alveoli microvascular development continues between what age?

A

2-5 years after birth

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5
Q

The nasal cavity lateral wall have projections called?

A

Conchae

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6
Q

Conchae Functions

A
  • Increase surface area
  • Increase turbulance within the nasal cavity
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7
Q

The nasal cavity is separated from the oral cavity by:

A

The palate

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8
Q

Palate is further divide to:

A
  1. Anterior hard palate (bone)
  2. Posterior soft palate (muscle)
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9
Q

The Pharynx?

A

Muscular passage from the nasal cavity to the larynx

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10
Q

Three regions of the Pharynx:

A
  1. Nasopharynx (superior region behind the nasal cavity)
  2. Oropharynx ( middle region behind mouth)
  3. Laryngopharynx ( inferior region attached to larynx)
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11
Q

The oropharynx and Laryngopharynx are comomon passage for:

A

Air and Food

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12
Q

Tonsils of the Pharynx

A
  1. Pharyngeal tonsil (adenoids) in the nasopharynx
  2. Palatine tonsils in the oropharynx
  3. Lingual tonsils at the base of the tongue
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13
Q

The lungs:

A
  • Occupy most the thoracic cavity
  • Apex is near the clavicle (superior portion)
  • Each lung is divided into lobes by fissures
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14
Q

How many lobes are in the Right and Left lung?

A
  • Right lung 3 lobes
  • Left lung 2 lobes
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15
Q

Covering of the Lungs:

A
  • Pulmonary (visceral) pleura covers the lung surface
  • Parietal pleura lines the walls of the thoracic cavity
  • Pleural fluid fills the area between layers of pleura to allow gliding
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16
Q

Respiratory Tree Divisions:

A
  • Primary bronchi
  • Secondary bronchi
  • Tertiary bronchi
  • Bronchioli
  • Terminal bronchioli
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17
Q

How many division are in the Airway?

A

24 divisions

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18
Q

How many bronchioles division are in the Airway?

A

1-23 divisions

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19
Q

Muscles involved in Inspiration:

A
  1. Diaphragm
  2. External intercostals
  3. Sternocleidomastoid
  4. Scalenes
  5. Pectoralis minor
  6. Serratus posterior superior
  7. Erector spinae
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20
Q

Muscles involved in Quiet breathing?

A
  • Diaphragm
  • External Intercostals
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21
Q

Muscles involved in Forced Inspiration:

A
  1. Sternoclediomastoid
  2. Scalenes
  3. Pectoralis minor
  4. Serratus posterior superior
  5. Erector spinae
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22
Q

Muscles involved in Forced Expiration:

A
  1. Internal Intercostals
  2. Abdominal muscles
  3. Transversuss thoracis
  4. Serratus posterior inferior
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23
Q

During Inspiration:

A
  • Diaphragm and Intercostal muscle contract
  • Thoracic cavity increases
  • External air is pulled into the lungs
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24
Q

During full Inspiration the diaphragm moves:

A

inferiorly during contraction

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25
During Expiration the diapragm moves:
Superiorly as it relaxes
26
Explain Expiration cycle:
* Passive process dependent up on natural lung elasticity * Air is pushed out the lungs * Forced expiration occur
27
Normal pressure within the pleural space is always:
Negative ( intrapleural pressure)
28
Differences in lung and pleural space pressures keep lungs from:
Collapsing
29
What is the relationship between the pleural sac and the lung?
Respiratory system
30
Dalton's Law
* The total pressure of a mixture of gases is the sum of the pressure of the individual gases
31
Gases, singly or in a mixture, move from areas of:
Higher pressure to areas of lower concentration
32
Boyle's Law
If the volume of a container of gas changes, the pressure of the gas will change in an **inverse manner**
33
Partial pressure gas formula
Pgas = Patm x % of gas in atmosphere
34
Nitrogen % in Air
78%
35
Oxygen % in Air
21%
36
CO2 % in Air
0.033%
37
Nitrogen Pgas in dry 25 deg C at 760 mmHg
593 mmHg
38
Oxygen Pgas in dry 25 deg C at 760 mmHg
160 mmHg
39
CO2 Pgas in dry 25 deg C at 760 mmHg
0.25 mmHg
40
Water vapor Pgas in dry 25 deg C at 760 mmHg
0 mmHg
41
Mention the four lung volumes:
1. Tidal volume (TV) 2. Inspiratory reserve volume (IRV) 3. Expiratory reserve volume (ERV) 4. Residual volume (RV)
42
Lung capacities components:
1. FRC 2. Vital capacity 3. Total lung capacity 4. Inspiratory capacity
43
FRC is composed of:
ERV + RV
44
Vital capacity is composed of:
IRV + TV + ERV
45
Total lung capacity is made of:
TV + IRV + ERV + RV
46
Inspiratory capacity is made of:
TV + IRV
47
Lungs with high complaince
Strech easily
48
Lungs with low complaince
* Requires more force * Restrictive lung disease
49
What's Restrictive lung disease?
Inadequate surfactant production
50
What's Lung compliance?
Change in lung volume for each unit change in transpulmonary pressure
51
What is Transpulmonary Pressure?
Difference in pressure between alveolar pressure and pleural pressure
52
What are the two compliance curve Phases of Respiration?
1. Inspiratory compliance curve 2. Expiratory compliance curve
53
The compliance diagram of lungs shows:
Capacity of the lung to "adapt" to small changes of transpulmonary pressure
54
Compliance of lungs occurs due to:
Elastic forces A & B
55
**Elastic forces A** are composed of:
Elastin + Collagen fibers
56
Elastic forces B:
Provided by surfactant
57
Surfactant is present inside the walls of:
Alveoli
58
Pulmonary Surfactant:
- **Synthesized by type II alveolar cells** - Decreases surface tension - Prevents bacterial invasion - Cleans alveoli surface
59
Pulmonary surfactant prevent alveolar collapse during:
Expiration
60
Pulmonary surfactan consist of:
* Hypophase (protein) * Phospholipid (dipalmitoylphosphatidylcholine) * Calcium ions
61
Laplaces Law Formula:
| * **High Radius = low pressure to collapse**
62
Smaller alveoli have a greater tendency to
collapse
63
How much fresh air is the **Dead Space** filled with?
150 mL
64
How much air leaves the alveoli during the first exhalation?
350 mL
65
Total pulmonary ventilation formula:
(Ventilation rate) x (Tidal volume)
66
Local control of Arterioles and Bronchioles Table
67
Most CO2 in the blood is transported as:
Bicarbonate ions in the plama
68
What are the two circulations in the Lungs?
1. Pulmonary circulation 2. Bronchial circulation
69
Pulmonary circulation:
* Arises from RV * Receives 100% of blood flow * In series with systemic circulation * Receives 100% of CO ( 3.5 L/min/m2)
70
Surface area of gas exchange is:
50-100 m2
71
Bronchial Circulation:
* Arises from the Aorta * Part of systemic circulation * Receives ~ 2% of LV output
72
What's the MEAN of Pulmonary Artery?
15
73
What's the MEAN of sytemic artery?
100
74
Which lung zone occurs major ventilation?
Zone 3
75
How many zones are in the lung?
3
76
In healthy people there is
No zone 1
77
Lung Zone 1
PA > Pa > Pv ## Footnote Pa = arterial, PA = Alveolar, PV = Venous
78
Lung Zone 2:
Pa > PA > Pv ## Footnote Pa = arterial, PA = Alveolar, PV = Venous
79
Lung Zone 3:
Pa > Pv > PA ## Footnote Pa = arterial, PA = Alveolar, PV = Venous
80
General hypoxemia (high altitude or hypoventilation) can cause:
Extensive pulmonary artery vasoconstriction
81
The Respiratory Center is composed of neurons located bilaterally in:
* Medulla Oblangota * PONS
82
Respiratory Center is divided in 3 major groups:
1. Dorsal respiratory 2. Ventral respiratory 3. Pneumotaxic center
83
Dorsal respiratory group (medulla) is responsible for:
Inspiration
84
Ventral respiratory group (medulla) is responsible for:
Expiration & Inspiration
85
Pneumotaxic respiratory group (PONS) is responsible for:
Rate & pattern of breathing
86
What's the most fundamental role in ventilation control?
Rate & Pattern of breathing
87
In Chemoreceptors (CTZ) Oxygen is a large reservoir attached to:
Hemoglobin
88
Chemoreceptors are more sensitive to changes in:
Pco2 ( sense through pH changes)
89
Chemoreceptors Ventilation is adjusted to maintain:
Arterial PCo2 of 40 mmHg
90
Chemoreceptor (CTZ) are located:
* Through the body * In the Brain and Arteries
91
Activity of respiratory muscle is transmitted to the brain by:
The phrenic and intercostal nerves
92
**Neural centers** that control rate and depth are located in:
The medulla
93
The PONS appears to smooth out:
Respiratory rate
94
Normal Respiratory Rate (eupnea) is:
12-15 bpm
95
What is Hypernia?
Increase of respiratory rate due to oxygen needs
96
Factors that influence the Respiratory rate and Depth:
1. Level of Co2 2. Increase Co2 3. Chemical factors
97
# [](http://) Change in Oxygen concentration in the blood are detected by:
* **Chemoreceptors** * In the aorta and carotid artery
98
Obstructive Pulmonary Disorders are a broad spectrum of pathologies characterized by:
* Decrease FEV1/ FVC with normal FVC
99
Spirometry Volume loops graphic
100
Bronchospasm symptoms:
- Chest tightness - Tachypnea - Tachycardia - Wheezing - Dyspnea - Cough - Thick, tenacious sputum - Prolonged expiratory phase - Used of accessory muscles - Intercostal & supraclavicular retractions - Pulsus paradoxus - Silent chest - Agitation - Confusion - Somnolence - Cyanosis
101
CODP is classified as:
* Chronic bronchitis (histology) * Pulmonary emphysema (Clinically)
102
Chronic Bronchitis Anatomic Pathology:
- Increase size & number of mucous glands in airway mucosa - Mucus accumulation & airway obstruction - Decrease small airway diameter
103
Chronic Bronchitis Pathology:
- Bronchospasm - Airway inflammation - Abundant secretions - Recurrent infections - Cigarette smoking - Environmental contamination
104
Pure Emphysema features:
- Rarely infectious - Minimal secretions - Increased V/Q mismatch - Smoking - Pulmonary cripple - Irreversible
105
Emphysema Pathology
* Destructive loss of alveolar walls within the acinus * Without accompanying fibrosis
106
Other causes of COPD:
- Marphan syndrome - HIV - Malnutrition - Bullous sarcoidosis - Salla disease - Meckel syndrome
107
Obstructive Sleep Apnea (OSA):
- **Intermittent cessation of airflow** at the nose and mouth during sleep - **Apneas of at least 10 seconds duration** - Most cases apneas last 20-30 sec - Can last 2-3 min - Is a leading cause of daytime sleepiness - Contributes to CVS disorders - 2% in middle-aged women - 4% in middle-aged men
108
Sleep apneas are divided into:
1. Central sleep apnea 2. Obstructive sleep apnea
109
Central sleep apnea:
Neutral drive to all respiratory muscle is abolished
110
Pathogenesis of OSA:
- Occlusion of the oropharyngeal airway - Results in progressive asphyxia - Brief arousal from sleep - The patient returns to sleep and the process is repeated up to 300-400 /night - Sleep becomes fragmented
111
Mallanpati Class I
Complete visualization of soft palate
112
Mallanpati class II
Complete visualization of the Uvula
113
Mallanpati Class III
Visualization of only the base of the Uvula
114
Mallanpati Class IV
Soft palate is not visible

Advance Anesthesia II (7 decks)

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