Pulmonary Overview Flashcards
Name how many lobes each lung has
3 - Right lung: upper, middle, and lower lobes
2 - Left lung: upper and lower lobes
The trachea bifurcates into its mainstem bronchi at the levels of the ____ anteriorly and the _____ posteriorly
sternal angle
T4 spinous process
What are serous membranes that cover the outer surface of
each lung?
The pleurae
the pleura that cover the outer surface of each lung
visceral pleura
the pleura that cover the inner rib cage and upper surface of the diaphragm
parietal pleura
The main buffer system utilized by the body is the what?
bicarbonate buffer system
What is the major Respiratory Component because it depends upon the rate of respiration?
pCO2
The bicarbonate buffer system is unique because why?
It has a huge buffering capacity because it communicates with air – it is an open system
What is the major Metabolic Component because its plasma concentration is maintained by the kidney, and is affected by amount of nonvolatile acids made?
HCO3
Increase in pCO2 (and decrease in pH) results in what?
increase in respiratory rate
Receptors in carotid bodies and in the aortic arch are sensitive to what?
arterial pO2 (the partial pressure of oxygen)
Decrease in pO2 level of what then results in the respiratory rate increasing?
pO2 < 60mmHg
Central chemoreceptors in the Medulla are sensitive to what?
pCO2 and pH
On pulse oximetry, a level less than what requires oxygen?
Less than 88%,
Pulmonary function testing measures what?
how well you are breathing
Pulmonary function testing provides objective data on what four factors?
Type of disease
Severity of disease
Changes in the disease
Response to treatment
Pulmonary function testing will give what three categories of information?
Lung volumes
Flow rates
Diffusing capacity
Volume of gas in the lungs at the end of maximum inspiration/amount of air contained in the fully expanded lung
Total lung capacity
The amount of air breathed in (inspired) or out (expired) during normal respiration (spontaneous breath)
Tidal volume
The additional air that can be inhaled after a normal tidal breath in
Inspiratory reserve volume
The amount of air left in the lung at end of normal breathing exhalation
Functional residual capacity
The amount of air that can be forced out of the lungs after a maximal inspiration
Vital capacity
The amount of air left in the lung after a maximal exhalation (never expired)
Residual volume
The volume that can be inhaled after a tidal breath – out
Inspiratory capacity
The amount of additional air that can be breathed out after normal expiration
Expiratory reserve volume
How much air you can blow out (very important)
Forced vital capacity
If someone had fluid in their lungs for example, this would be reduced
Forced vital capacity
During a forced vital capacity, the amount exhaled in the first second of a forced expiration
Forced expiratory volume 1 second
Normal lungs can get about what percentage of our FVC out in the first second?
80%
Extremely important to determine if they have obstructive disease (can’t get the air out)
Forced expiratory volume 1 second
Indicates both large and small airway function
Forced expiratory volume 1 second
Measures flow generated during the mid-portion of the forced expiratory maneuver
Forced expiratory flow
Indicates large airway patency
Measures the highest flow that can be generated by the patient forcefully blowing after fully inflating the lungs
PEP
The ratio of FEV1 and FVC is an indication of what?
obstruction to air flow
What is the most important parameter to use?
FEV1/FVC
Tests airflow rates and lung volumes
Ability of lungs to transfer gas across the alveolar-capillary membrane
Can be used to diagnose lung disease
Spirometry
In interpreting PFTs, “normal” is considered anything ____ of predicted
based on age? (what percentage)
> 79%
ABGs look at which two categories?
oxygenation and acid/base balance
It is necessary for the body to maintain the blood pH within a very narrow range of what?
7.35-7.45
pH < 7.35
Acidosis
pH >7.45
Alkalosis
What are the four major components of the ABG?
pH
PaO2
PaCO2
HCO3⁻
What is a measure of the respiratory component of ABGs?
PaCO2
What is a measure of the metabolic component of ABGs?
HCO3-
What are the four types of Acid-Base abnormalities?
Metabolic Acidosis – decrease in plasma HCO3⁻
Metabolic Alkalosis– increase in plasma HCO3⁻
Respiratory Acidosis – increase in pCO2
Respiratory Alkalosis – decrease in pCO2
If pCO2 is cause = respiratory
If HCO3 is cause = metabolic
Caused by any process which decreases the ability of lungs to exchange CO2 for O2
pH decreases; pCO2 increases; hyperkalemia
Respiratory Acidosis
Caused by any process which increases respiratory rate
pH increases; pCO2 decreases; hypokalemia
Respiratory Alkalosis
Caused by any process that decreases acid or increases bicarbonate
Metabolic alkalosis
Caused by any process that increases accumulation of acids or decreases amount of bicarbonate
Metabolic acidosis
Compensation is by adjusting respiratory rate and pCO2 (occurs over
minutes/hours)
Metabolic acidosis = decrease in pCO2
Metabolic alkalosis = increase in pCO2
This is normally <15 mm Hg but will increase with age
Alveolar-Arterial Oxygen Gradient
What is 20x more soluble in plasma than oxygen?
CO2
The greater the oxygenation of hemoglobin in the capillaries the ____
ability to bind CO2
less
CO2 is carried in the blood as? (3 answers)
HCO3⁻
CO2 dissolved in plasma
Carbaminohemoglobin
