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A Review Flashcard > Pulmonology A&P > Flashcards

Pulmonology A&P Flashcards

1
Q

What divides the upper and lower respiratory tract?

A

the larynx (below the vocal cords is lower respiratory tract)

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2
Q

Conducting Zone vs Respiratory Zone

A
  • conducting zone: transfers air to and from the lungs
    • nose, pharynx, larynx, trachea, bronchi, to terminal bronchioles
  • Respiratory Zone: site of gas exchange at alveoli
    • respiratory bronchioles, alveolar ducts, alveoli
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3
Q

Where is the trachea located

A

anterior to esophagus, extends from larynx to ~T5

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4
Q

What is located in the mediastinum?

A

heart, esophagus, trachea, great vessels

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5
Q

Location of Oblique fissures and Horizontal fissure (R lung)

A
  • oblique fissures: T3 spinous process to 6th rib mid-clavicular
  • Horizontal fissure (R lung): 4th rib anteriorly, to 5th rib at mid axillary line
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6
Q

Parietal pleura has what type of sensation?

A

pain sensation in response to injury or inflammation: Phrenic nerve (refers pain C3,C4, C5)

  • phrenic nerve also innervates mediastinal and diaphragmatic part
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7
Q

Visceral Pleura and lung tissue have what type of sensation?

A
  • have visceral sensory reflexes but no pain sensation
  • have parasympathetic innervation from Vagus nerve CNX
  • also innervated by sympathetic fibers from the sympathetic trunks
  • will have visceral reflexes such as cough and stretch reflexes
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8
Q

Type I Alveolar Cells

A

simple squamous epithelium supported by elastic basement membrane

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9
Q

Type II Alveolar Cells

A

secrete surfactant

  • surfactant: lipoproteins
    • coats the alveoli to reduce surface tension to prevent collapse of alveoli
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10
Q

Alveolar Macrophages

A

aka dust cells, mononuclear phagocytes

  • engulf debris and prepare it for removal via lymph nodes
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11
Q

Inspiration

A
  • passive (resting): diaphragm contracts
    • external intercostals contracts
  • active (forced or strained):
    • sternocleidomastoid and scalenes contract
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12
Q

Expiration

A
  • passive (resting:
    • diaphragm relaxes
  • active (forced, strained):
    • internal intercostals
    • abdominal muscles
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13
Q

Transmural Pressure Gradient

A

the difference in pressure between the pleural cavity and the atmosphere or alveoli

  • approx -4mmHg
  • normal atmospheric pressure: 760mmHg
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14
Q

High Compliance vs Low Compliance

A
  • high compliance: loose, easy inflation
    • typically destruction of airspace or decreased elasticity
      • ex: emphysema
  • Low compliance: stiff, hard to inflate
    • typically connective tissue changes or fluid build up
      • ex: fibrosis, edema, ARDS
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15
Q

PO2 deoxygenated vs oxygenated

A

Po2 deoxygenated = 40mmHg

PO2 oxygenated = 100mmHg

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16
Q

PCO2 at the tissues versus the alveoli

A

PCO2 at tissue = 46mmHg

PCO2 at alveoli = 40mmHg

17
Q

V/Q ratio

A
  • V= airflow (ventilation)
  • Q = blood flow (perfusion)
  • normal V/Q (ventilation/perfusion) ratio on average ~0.8
  • ***highest ventilation and perfusion are both highest at the base of the lungs***
18
Q

What causes high V/Q?

A

ventilation > perfusion

blockage of blood flow → no gas exchange

19
Q

What causes low V/Q?

A

ventilation

  • blockage of airway → diverted away from non-ventilated alveoli to areas of better ventilation → SHUNT
20
Q

What causes decreased hemoglobin saturation and increased oxygen unloading?

A
  • increased temp
  • increased CO2
  • increased H+ levels
  • shifts the hemoglobin saturation curve to the Right
21
Q

What causes increased saturation of the hgb and decreased oxygen unloading?

A

decreased temperature

decreased CO2 levels (ph> 7.6)

22
Q

Chloride Shift

A

HCO3- is returned to the plasma through HCO3- channels that swap Cl- for HCO3-

23
Q

When CO2 enters the blood via diffusion gradients at tissue what happens to it?

A
  • slow reaction, converts to HCO3- when it interacts with water in the plasma
  • fast reaction, converts to HCO3- quickly in RBCs due to enzyme carbonic anhydrase
  • the HCO3- rxn reverses at the lungs to release CO2 and CO2 is transported out of the plasma into the alveoli
24
Q

Central Chemoreceptors and Breathing

A
  • sense pH changes in the CSF
  • CO2 enters the CSF through the BBB
  • pH decreases when CO2 = high
  • low CSF pH = increased breathing rate
  • Note: become insensitive to chronically high levels of CO2
25
Q

Peripheral Chemoreceptors

A
  • directly detect pH, CO2, and O2 in the arterial circulation
    • low pH and high arterial CO2 = increased breathing rate
    • low O2 (only very low <60mmHg) = increased breathing rate
26
Q

Bronchiolitis obliterans

A

fibrotic changes permanently scar the lungs, occlude airways

27
Q

Atelectasis

A

collapse of lung tissue that occurs due to a variety of conditions

  • compression atelectasis: external pressure on lungs due to tumors, pneumothorax, abdominal torsion
  • absorption atelectasis: obstructed or hypoventilated alveoli from inhalation of concentrated O2 or anasthesia
  • Surfactant Impairment: decreased production in premature infants, ARDS, anesthesia, mechanical ventilation
  • ***post surgical care = deep breathing, ambulation, position changes***
28
Q

Parenchyma

A

the functional tissue of an organ, excluding the connective tissue and the supportive tissue

29
Q

First line medication for smoking cessation

A

varenicline (chantix)

  • varenicline use with nicotine replacement products should generally be avoided → can cause n/v, headaches, dizziness, GI upset
30
Q

Smoking Cessation Options

A
  1. varenicline (Chantix)
  2. nicotine replacement products
  3. antidepressants
    1. bupropion
    2. nortriptyline
31
Q

Nicotine Withdrawal

A

a theory says that a drop in dopamine release in the brain after long periods of exposure to nicotine leads to mood disorders, cravings for tobacco, and other sxs

32
Q

Cystic Fibrosis and Genetics

A

mutation in the CFTR gene

autosomal recessive

33
Q

Asthma and Genetics

A
  • asthma runs in families
  • polygenic, multifactorial disorder
  • ADAM33, filigrin and other genes associated with atopy are associated with asthma
34
Q

Alpha-1-antitrypsin deficiency

A

inherited disorder that may lead to lung and liver disease

  • this deficiency causes neutrophil elastase to destroy alveoli and cause lung disease (like emphysema/COPD)
  • the abnormal alpha-1 antitrypsin can also accumulate in the liver and cause damage
  • Environmental Factors: tobacco smoke, chemicals and dust can also impact the severity of this deficiency
  • autosomal dominant with codominance features
35
Q

Sarcoidosis and genetics

A

both environmental and genetic factors

  • siblings of patients with sarcoidosis are 5x as likely of developing sarcoidosis
  • HLA (human leukocyte antigen) alleles have been consistently associated with sarcoidosis susceptibility

A Review Flashcard (27 decks)

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