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NPLEX I > Pulmonary System > Flashcards

Pulmonary System Flashcards

1
Q

Lungs

A

Right = 3 lobes
Left = 2 lobes (left lingular lobe = right middle lobe)
The apex of lung extends 4 cm above rib #1
Medial (hilar) surface:
1. pulmonary arteries veins
2. Bronchi
Pleura:
1. Visceral - adheres to lung
2. Parietal - adheres to thoracic cage
Pneumothorax is the loss of vacuum between the two.

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2
Q

Mediastinum

A

Anterior - Thymus gland
Middle - Heart and pericardium
Posterior - Esophagus, descending aorta, azygous veins, thoracic duct, sympathetic trunk
Superior - Aortic arch, brachiocephalic veins

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3
Q

How do we drain mucous out of the head?

A

CN1 - Olfactory - sensation
CN5 - Sensation

Sphenoid drains into ethmoid.
Both Frontal and ethmoid drain into the maxillary which then drains into the nasal cavity.

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4
Q

Tidal volume

A

Breathing in and out

Amount of air that moves in or out of the lungs with each respiratory cycle.

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5
Q

Inspiratory reserve volume

A

It is the amount of air that can be forcibly inhaled after a normal tidal volume.
Used during exercise.

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6
Q

Expiratory reserve volume

A

Your expiratory reserve volume is the amount of extra air — above-normal volume — exhaled during a forceful breath out

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7
Q

Residual volume

A

It is the volume that remains in the lungs after a maximal expiration

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8
Q

FEV 1

A

It is the volume that can be expired in 1 second after a maximal inspiration.
It is normally 80% of the forced vital capacity.
Good for checking COPDs

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9
Q

What does the phrenic nerve innervate?

A

The diaphragm

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10
Q

Medulla

respiration

A

Dorsal respiratory group
-Associated with inspiration

Ventral respiratory group

  • Associated with expiration
  • Only operates during active respiration as normal expiration is known to be passive.
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11
Q

Pons

respiration

A 
Apneustic Center (lower pons)
- Stimulates inspiration (gasp / Apneusis)
Pneumotaxic Center (upper pons)
- Inhibits inspiration (regulates rate and volume)
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12
Q

Remember

A

Carbon dioxide CO2 creates an acidic environment.

Bicarbonate creates a base environment.

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13
Q

Remember

A

Most of carbon dioxide is put away in bicarbonate buffer.

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14
Q

Rhinitis

A 
Rhin = nasal
-itis = inflammation
Inflammation of the nose
runny nose (rhinorrhea), nasal itching, nasal congestion, and sneezing
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15
Q

Allergic rhinitis

A 
Allergic rhinitis is inflammation of the nose caused by allergens such as hay, pollen, dust, animal hair, or mold spores.
Type 1 hypersensitivity reaction.
IgE mediated.
There are lots of mast cells that were activated by B-cells (which were activated by T cells) around the nose and mouth because both are portals of entry for infections
Symptoms:
- red itchy swollen eyes.
- nasal congestion.
- frequent bouts of sneezing
Treatment:
- antihistamine 
- nasal irrigation
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16
Q

Upper respiratory tract infection

A

An upper respiratory tract infection is any infection that involves the nasal cavity, paranasal sinuses, pharynx, or larynx, and it’s most often caused by an invading pathogen like a virus.

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17
Q

What is the larynx?

A

Below the pharynx
Commonly called voice box or glottis.
Passage for air between the pharynx above and the trachea below.

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18
Q

Tonsils

A

Lymphoid tissue
Acts as q first line of defense
Main function is to trap germs (bacteria and viruses)

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19
Q

What produces mucus?

A

Goblet cells and submucosal gland

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20
Q

Pus

A

Can form in the area where pathogens have invaded
Pathogens + immune cells + dead tissue + cytokines.
These cytokines get to the brain making the body increase temperature

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21
Q

Rhinitis

A 
Rhin = nose
-itis = inflammation
Infection of the nasal cavity
Bacterial or viral
Usually caused by viruses
Common Cold
Flu
VIRAL:
Rhinovirus (common cold)
Influenza virus
Respiratory syncytial virus (RSV)
Parainfluenza virus
Adenovirus
BACTERIAL:
Streptococcus pneumoniae
Haemophilus influenzae
Moraxella catarrahalis (causes otitis media in children)
Staphylococcus aureus
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22
Q

Chronic rhinitis

A

Post-nasal drip

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23
Q

Laryngitis

A 
Laryng = larynx 
-itis = inflammation
Inflammation of the larynx
Most common
Especially affects children
Chronic if it lasts more than 3 weeks
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24
Q

What does the pharynx split into?

A

Esophagus and larynx (and or trachea)

25
Q

Acute laryngitis

A 
Most common (usually due to upper respiratory tract infection)
Usually due to viruses:
- Rhinovirus
- Coronavirus
- Influenza virus
- Respiratory syncytial (RSV)
- Parainfluenza
Bacterial
- Group A streptococcus
- Streptococcus pneumonae
- Haemophilus influenzae
Super infection - bacterial infection with viral infection.

Goblet cells produce lots of mucus, immune cells migrate to the area (neutrophils and macrophages), they release chemicals that cause swelling and pain, vocal cords don’t vibrate smoothly, dysphonia occurs (hoarseness)

Symptoms:
3 D’s = Dysphonia, dyspnea, and dysphagia
Hoarse voice, cough, difficulty swallowing (dysphagia as the epiglottis may compress against the esophagus), SOB (in children due to smaller airways).

26
Q

Epiglottis

A

Sits on top of the larynx (voice box)

Keeps food and liquid going towards the esophagus and not going into the trachea

27
Q

Bacterial Epiglottitis

A

Inflammation of the epiglottis
Can be life-threatening as it can block the trachea not allowing for breathing
Mostly caused by Haemophilus influenzae
Group a streptococcus.

Pathogens get into the mouth or nose, deposit in the mucosa of the epiglottis, goblet cells produce mucus, immune cells migrate to that area and release cytokines which makes blood vessels more permeable to fluid, inflammation and swelling occurs, obstruction of airflow happens.
symptoms:
Fever, difficulty breathing, stridor

Lab:
Endoscope and x-ray

28
Q

Nasal Polyp

A

Nasal polyps develop when epithelial cells that line the respiratory region simply overgrow - a process called hyperplasia.
Non-cancerous
Blocks airflow and mucus drainage making pathogens lingering which cause infection causing swelling.

29
Q

Remember

A

Between the pulmonary and systemic circuit, if I am pumping into the aorta or systemic circuit I am pumping at 100 mmHg. I can not do this in the pulmonary circuit. We are going to have the same volume but lower pressure.

30
Q

Ventilation

A

The mass movement of air in and out of the lungs

31
Q

Perfusion

A

Movement of O2 and CO2 across the alveolar membrane

32
Q

Remember

A

Cartilaginous rings in the trachea and bronchi are C rings because, in the back of the C ring, there is smooth muscle that connects the two ends together.
Beta 1 goes to the heart and Beta 2 goes to the lungs

33
Q

Pulmonary Edema

A

Any factor that causes the pulmonary interstitial fluid pressure to rise from negative to positive
Causes:
Left heart disease
Pulmonary capillary membrane damage

34
Q

Emphysema

A

Pink puffers
Normal pCO2 - due to compensatory mechanism/response
PCO is normal because, unlike chronic bronchitis patients, they are never having a break from their emphysema. Chronic stimulation of erythropoietin (which comes from kidneys), then goes to bone marrow saying we need more red blood cells.
Permanent dilation of part or all the acinus with eventual destruction of alveolar walls
Cigarette smoking or def. serum alpha 1 protease inhibitor in non-smokers.
Barre-chest, pursed lips, slow forced expiration

35
Q

Chronic bronchitis

A

Increased pCO2
Persistent cough with sputum for at least 3 months in at least two consecutive years
Obese, corp pumonale, cyanotic
Do not retain hypercapnic drive to breathe

36
Q

How much erythrocyte is in total blood volume?

A

45% of total blood volume is made up of erythrocytes.

37
Q

What are erythrocytes?

What is the function of erythrocytes?

A

Red blood cells

Carry oxygen to tissues and carbon dioxide to lungs

38
Q

What is hematocrit?

A

The hematocrit is the proportion, by volume, of the blood that consists of red blood cells. The hematocrit (hct) is expressed as a percentage.

39
Q

What does hematopoietic stem rise give rise to?

A

It gives rise to red blood cells, white blood cells, and platelets.

40
Q

Polycythemia vera

A

refers to an increase in the number of red blood cells in the body.
The extra blood cells in the blood cause the blood to be thicker, increasing the risk of other health issues, such as blood clots.
90% of individuals with polycythemia have a mutation of the Janus Kinase 2 (JAK2) gene found in the hematopoietic stem cell which is responsible for making red blood cells.

Symptoms:
Fatigue
Dizziness
Increased sweating
Redness in the face
Blurred vision
Itchiness

complications:
Stroke, heart attack, DVT, Budd-Chiari syndrome (which is when liver veins are blocked by blood clot).

41
Q

What is erythropoietin?

A

It is a hormone that is produced predominantly by specialized cells in the kidney

42
Q

What normally makes erythropoietin (hormone) to be released?

A

Low oxygen

43
Q

Myelofibrosis

A

Secondary to polycythemia
Hematopoietic cells die out causes fibrosis within the bone.
Anemia, thrombocytopenia, and leukopenia are developed as the cells responsible for making RBCs, platelets, and WBCs die out.

44
Q

Reactive polycythemia

A

Caused by emphysema

45
Q

Pneumonia

Patchy area throughout the lung
Working hard to breathe
X-ray
Dullness to percussion
Tactile fremitus
A

Infection in the lungs is caused by microbes.
This infection brings fluid to the lungs making it harder to breathe.
It brings white blood cells, red blood cells, fluid, and proteins to the area of inflammation when microbes achieve colonization of an area(s) of the lung.
Symptoms:
Dyspnea, chest pain, productive cough

Caused by viruses, bacteria, and fungi

Most common viral cause:
Influenza (flue)

Most common bacterial cause:
Streptococcus pneumoniae
Haemophilus influenzae
Staphylococcus aureus

46
Q

Community-acquired pneumonia

A

Not in a hospital

47
Q

Hospital-acquired pneumonia

A

More serious because patients have weakened immune system

48
Q

Aspiration pneumonia

A

Occurs when something installs into the lungs from air tubes such as gastric juice, food, etc.

49
Q

Lobar pneumonia

A

A whole lobe is affected
Streptoccocus pneumoniae
Stages:
1. Congestion - days 1 and 2
Blood vessels and alveoli fill with excess fluid
2. Red hepatization - days 3 and 4
Exudate (RBCs, neutrophils and fibrin) fill airspaces making them more solid. Liver-like appearance
3. Gray hepatization - days 5 to 7. 4. Resolution - day 8 to 3 weeks
Exudate is digested, ingested and coughed up

50
Q

Atypical or interstitial pneumonia

A

Patchy areas concentrated in the perihilar region

51
Q

Lung abscess

A

In bronchial segment

Aspired microbe that causes abscess

52
Q

Tuberculosis

A

Mycobacterium tuberculosis
90-95% aren’t aware they are infected.
Aerobe!
Hard surface - survive on surfaces and inside of macrophages infecting them.
Transmitted via inhalation infecting the lung.
Upper lobes are affected the most
It can be in any organ, but it usually starts in the lung. If not cured, it invades other organs

53
Q

Hypersensitivity pneumonitis

A

farmer’s lung, pigeon breeders lung, air conditioner , interstitial pneumonia and fibrosis, non-caseating granulomas.
Body mistakenly thinks its pneumoniae

54
Q

bronchiectasis

A

Bronchi = bronchus
ectasis = dilation/expansion
Chronic inflammation make the bronchi and bronchioles get dilated
Obstructive lung disease - the infection makes mucus which obstructs airway.
secondary to ciliary dyskinesia - cilia don’t move normally.
Bacteria starts to multiply. Overtime after being damaged and having the elastin damaged/destroyed from the chronic inflammation, the airways dilate.

55
Q

Goodpasture’s syndrome

A

Autoimmune disorder
Goodpasture syndrome is a rare disorder in which your body mistakenly makes antibodies that attack the lungs and kidneys. It most often occurs in people ages 20 to 30 or older than age 60. It is more common in men. It can be fatal if not quickly diagnosed and treated.
Causes hemoptysis.
In kidneys: Hematuria - blood in the urine
Autoantibodies bind to specific of the alpha chain
type 2 hypersensitivity reaction

56
Q

What is the most abundant protein in the human body?

A

Collagen - triple helix, each chain is 1 of6 types.

57
Q

Basement membrane

A

sheet-like, made of protein (various), found in every organ system

58
Q

Asthma

A

It is small bronchi airway disease.
This causes two negative things: restriction or contraction of smooth muscle and over production of immune product - mucus
People die

59
Q

Pleural effusion

A

Wetness outside the lungs

Increased hydrostatic pressure/heart failure

NPLEX I (12 decks)

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