Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CardioPulm > Pulmonary Exam 1 > Flashcards

Pulmonary Exam 1 Flashcards

1
Q

anterior location of right horizontal fissure

A

between ribs 3-4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

anterior location of right oblique fissure

A

rib 6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

anterior location of lower lobe

A

lateral; this lobe is mostly posterior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

anterior location of left oblique fissure

A

about rib 6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

anterior location of lingula

A

left lobe; about ribs 4-6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

posterior location of left oblique fissure

A

about rib 4/root of spine of scapula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

posterior location of lower lobes

A

ribs 4-10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

generation at which cold; dry air fully conditioned

A

usually 12th gen; lower in subfreezing temps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

First level of respiratory division

A

respiratory bronchioles; then alveolar ducts; alveolar sacs; alveoli (generations 17-23)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

innervation of parietal pleura

A

intercostal nerves (against costal and lateral diaphragm surfaces); phrenic nerve (against superior medial diaphragm surface)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

symptom of diaphragmatic pleurisy

A

neck pain only when breathing (C3-4)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

test of pleurisy vs musculoskeletal pain

A

exhale and then move; if no movement (only breathing) produces pain; probably pleurisy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

when is pleurisy common?

A

after pnemonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Fissures in lungs

A

each lung has oblique fissure; only right has horizontal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

lung more likely to aspirate

A

Right; because the right mainstem bronchus is more vertical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the carina

A

where trachea splits into L and R bronchi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What defines a bronchopulomary segment

A

segmental bronchi (10 on R; 8 on L) and the lung it supplies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Right lower lobe segments

A

LAMPS (lateral; anterior; medial; posterior; superior)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Left lower lobe segments

A

ALPS (anterior; lateral; posterior; superior)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Trendeleburg position

A

head below pelvis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Lowest generation a cough can clear

A

upper 7 generations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Collateral ventilation

A

connection formed from one bronchiole to the next; can be created by deep breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Pores of Kohn

A

holes between alveoli; either for immune function or allows air to pass through

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

After 12th generation

A

no cartilage (so can easily change size or collapse); mucous cells; or cillia. Increase in Elastic fibers and smooth muscle cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

inspiration muscles

A

diaphragm; external intercostals; parasternal intercostals; SCM; scalenes; serratus anterior; pecs; traps; erector spinae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

expiration muscles

A

internal intercostals; abs (but mostly passive unless exercise or pathology)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Diaphragm % tidal volume when resting

A

2/3 when sitting; 3/4 when supine because more excursion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

function of pneumotaxic center

A

in pons; slows inspiration by inhibiting apneustic center

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

function of apneustic center

A

encourage inspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

fuction of vagal fibers; Hering-Breuer reflex

A

stretch receptors; used in fast breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Control of ventilation

A

CO2 level is main drive (PCO2 in CSF); central chemoreceptors in medulla. secondary drive from peripheral chemoreceptors in aortic arch which mainly monitors PO2; but if PCO2 is normal; PO2 must drop to 50mmHg before ventilation increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

properties of a CO2 retainer

A

peripheral chemoreceptors more controlling; common in COPD; depend more on PO2 level to control breathing rate; so if you give them more oxygen; their breath rate slows becuase the hypoxic drive to breathe is turned off. Treatment is to improve breathing pattern

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

autonomic input to lungs

A

sympathetic acts on beta 2 receptors; parasympathetic acts on cholinergic receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

effect of decreased PO2 in alveoli

A

vasoconstriction in pulmonary capillary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

restrictive disease hallmark

A

hard to get air in; comes out quickly; stiffness of lung itself or chest wall; lack of compliance; should take fast shallow breaths

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

obstructive disease hallmark

A

increased compliance ->increased work of breathing to overcome airflow resistance; can take big breath; hard to get all air out; should take deep slow breaths

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

surfactant functions

A

dec surface tension so the alveoli don’t collapse; increase alveolar compliance to decrease work of breathing (produced in type 2 cells)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

location of highest airflow resistance

A

beginning/larger airways; more turbulent flow; lower total cross section

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

PO2 levels (mmHg)

A

Environment: 160; Alveoli: 105; arteries: 100; Veins:40; mitochondria:

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

PCO2 levels (mmHg)

A

Environment: 0.3; alveoli: 40; arteries: 40; veins: 46

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

most diffusible gas

A

CO2 (more likely to be hypoxemic than hypercapnic)

42
Q

hyper/hypoventilation determined by

A

PCO2 levels

43
Q

dependent zone

A

lowest point in lung; dependent on body position; more compliant; Q>V; more air to dependent zone at normal tidal volumes

44
Q

independent zone

A

uppermost part of lung; alveoli more expanded; V>Q; at low tidal volume more air in independent zone

45
Q

functional residual capacity in different body postions

A

standing>sitting>supine (FRC is capacity when you stop breathing out at normal tidal volume)

46
Q

equal pressure point

A

where pressure in airway=pressure outside of it; beyond the EPP the airway can collapse if it doesn’t have carilage; huffing moves EPP more proximal compared to coughing

47
Q

closing capacity

A

closing volume+residual volume; volume at which the respiratory bronchioles start to collapse

48
Q

larynx location in neonates

A

high larynx; can breathe and swallow at the same time up to 3-4 months; obligitory nose breathers

49
Q

neonate alveolar surface

A

1/20 adult

50
Q

what contributes to upper airway obstruction in small infants?

A

enlarged lymphatic tissue

51
Q

effect of neonates having less collateral ventilation

A

more prone to atelectasis and infection

52
Q

neonate chest wall anatomy

A

circular rib cage (gravity pulls them down when they start to sit) and horizontal diaphragmatic angle of insertion; neonates are belly breathers but have low percent of type 1 fibers (25% in infant; 50% in adult); rib cage more cartilaginous so less efficient ventilation and more chest wall distortion

53
Q

Severity of obstructive disease in infants and young children

A

worse due to greater density of mucous glands vs the size of their bronchial surface

54
Q

age at which bronchiole smooth muscle develops

A

3-4 years

55
Q

air conductance increases at what age?

A

about 5 years

56
Q

pulmonary reserve in infants and children

A

less reserve to rely on when ill due to smaller lung volumes

57
Q

compliance in infants

A

decreased compliance in lungs and increased compliance in chest wall->increased work of breathing

58
Q

infant respiratory patterns

A

irregular

59
Q

neonate compensation for repiratory difficulties

A

increase rate rather than increasing depth

60
Q

change in work of breathing during REM

A

increased due to increased intercostal muscle tone

61
Q

cough reflex in infants

A

weak or absent

62
Q

PaO2 level at which cyanosis occurs

A

about 50 mmHg

63
Q

Apneustic breathing

A

slow rate; deep prolonged inspiration followed by apnea; associated with brainstem disorders

64
Q

kussmal’s breathing

A

fast rate; increased depth; regular rhythm; associated with metabolic acidosis; trying to blow off CO2; common in diabetes

65
Q

cheyne-stokes breathing

A

increasing then decreasing depth followed by apnea; very irregular pattern; associated with critical illness

66
Q

respiratory alternans

A

cyclic pattern of breathing alternating between abdominal and upper rib cage movement patterns; often sign of ventilatory muscle fatigue

67
Q

abdominal paradox; strong diaphragm with weak abdominals

A

abdomen rises excessively during inspiration and thorax is pulled inward; during exhalation abdomen falls and thorax moves outward

68
Q

abdominal paradox: weak or paralyzed diaphragm and normal upper accessory muscles

A

during inspiration abdominals pull inward and chest rises; during expiration abdomen rises and chest falls

69
Q

fremitus

A

vibrations normally felt over upper lobe when humming; if you feel it lower it suggests more solid less air, increased fremitus usually means solid, decreased is more air (pneumothorax)

70
Q

percussion

A

more air gives a more resonant tone

71
Q

inspiration/expiration time ratio

A

normal 1/2; when listening to breath sounds inspiration is louder and longer

72
Q

adventitious breath sounds

A

added sounds that may be due to airway narrowing; fluid in airway; secretions; atelectasis; or consolidation

73
Q

early inspiratory crackles

A

usually COPD; hearing larger airways snapping open

74
Q

late inspiratory crackles

A

restrictive disease (CHF or pulmonary fibrosis)

75
Q

wheezes

A

usually heard during expiration; sound produced by air passing through narrowed airway

76
Q

whispered pectoriloquy

A

spoken word muffled; will increase when fremitus increases

77
Q

bronchophany

A

spoken voice; should be muffled, voice sounds louder and more distinct with consolidation or increased density

78
Q

egophany

A

say E E E E; if it sounds like A A A A positive test; usually pleural effusion

79
Q

pulmonary function tests with “forced” in the name

A

people with obstructive disease will usually do poorly

80
Q

normal FEV1% (forced expiratory volume)

A

percent of total FVC (forced vital capacity) you can expel in 1sec; normal 75-85%; lower in obstructive disease; higher in restrictive

81
Q

forced expiratory flow (FEF)

A

average flow rate for 1L gas expired after the first 200 (or 500 or 1000 ml) during a FVC test; normal is about 5L/sec

82
Q

peak expiratory flow

A

pts with asthma may have home monitors; may be >10L/s in healthy males

83
Q

dead space definitions

A

anatomic: volume of air in conducting airways; physiologic: alveolar volume with poor V/Q; total dead space 1/3 of tidal volume

84
Q

MIP

A

max inspiratory pressure; greatest negative pressure that can be generated during inspiration against an occluded airway; usually 70-100 cm H2O; lower MIP means more ventilatory fatigue; drops in hyperinflated lungs; Higher MIP less breathlessness

85
Q

DLCO

A

diffusion of lung carbon monoxide;

86
Q

acid base status flowchart

A

first look at pH; then PaCO2 (acid) to determine if primary imbalance is respiratory; third look at HCO3- (base); lungs can compensate fast; kidneys slower

87
Q

normal pH

A

7.35-7.45

88
Q

normal PaO2

A

80-100 (lower for older adults; never

89
Q

normal PaCO2

A

35-45 mmHg (lower is hyperventilation; higher is hypo)

90
Q

normal HCO3-

A

22-26 mEq/L

91
Q

normal SaO2 (oxygen saturation of Hb)

A

95-98%; clinically want pts >90%; pulmonary pts >88%

92
Q

hyperventilation

A

lower PaCO2

93
Q

hypoventilation

A

high PaCO2

94
Q

approx FiO2 in nasal cannula

A

room air: 21%; 1L 24%; 4% increase for each L after (2L 28%)

95
Q

home oxygen concentrator

A

single unit with enough tubes to reach throughout house; probably a fall risk for some

96
Q

calculating PAO2

A

(713*FiO2)-PaCO2

97
Q

a/A ratio

A

PaO2/PAO2; percent of O2 getting across alveolar membrane into blood

98
Q

vesicular breath sounds

A

longer, louder inspiratory phase, expiration almost silent, normal for most of lung field

99
Q

bronchial breath sounds

A

short inspiratory phase, longer and louder expiration, loud and harsh, normally heard over trachea and manubrium, also heard over tumor, consolidation, or pleural effusion

100
Q

exam signs of emphysema

A

hyperresonant percussion, decreased fremitus, decreased breath sounds, early inspiratory crackles

101
Q

exam signs of pneumonia and atelectisis

A

increased fremitus, more clear/distinct voice sounds, E to A egophany, (atelectasis only will have tracheal shift)

CardioPulm (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions