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ESA 3 - Recap > Resp > Flashcards

Resp Flashcards

1
Q

State the order of the respiratory tract and its associated epithelia

A
  1. Bronchus - Ps C Go
  2. Lobar bronchi
  3. Segmental Bronchi
  4. Subsegmental Bronchi - Ps C Go
  5. Bronchioles - SC C Cl
  6. Terminal Bronchioles
  7. Alveolar ducts - SC C Cl
  8. Alveoli - Simple Squamous

Ps C Go - Pseudostratified ciliated columnar with goblet cells

SC C Cl - Simple Cuboidal Ciliated with Clara Cells

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2
Q

What are 4 common flora of resp tract?

A

Viridans streptococci

Neisseria

Anaerobes

Candida Albicans

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3
Q

What are 3 uncommon flora of the resp tract

A

Strep pneumonia

Strep pyogenes

H influenzae

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4
Q

What would a CXR if sarcoidosis reveal?

A

Miliary and nodule shadowing and diffuse fibrosis

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5
Q

State the CXR of bronchopneumonia. What are the symptoms of bronchopneumonia?

A

Patchy consolidation. Not confined to lobes.

Aspiration of gastric contents, cardiac failure, COPD

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6
Q

What antibiotic would you give for:

a) community acquired pneumonia
b) hospital acquired pneumonia

A

a) penicillin
b) co-amoxiclav

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7
Q

What is saturated vapour pressure

A

equilibrium between water molecules entering and leaving the water

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8
Q

Define content of a liquid

A

content = solubility x tension

amount of gas dissolved in a liquid.

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9
Q

which ribs are true ribs? which are false? which are floating?

A

true = 1-7

flase = 8-12

floating = 11 and 12

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10
Q

describe the features of ribs 1 and 2

A

rib 1 - 1 articulating head. short and wide. grooves for subclavian arteries

rib 2 - rough area for serratus anterior attachment

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11
Q

state the intercostal muscles and what direction they run

A

external - inferior and anteriorly

innermost and internal - inferior and posteriorly

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12
Q

Define inspiratory capacity and give avg value

A

quiet expiration to maximal inspiration

3L

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13
Q

define serial, physiological and distributive dead space

A

physiological = distributive + serial

serial = airways

distributive = non airways

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14
Q

how does the lung get around laplace’s law?

A

surface tension rises and surfactant less efficient with bigger alveoli therefore pressure is increased

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15
Q

What is resp distresss syndorme? how would you treat?

A

not enough surfactant produced in lungs of newborn

steroids

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16
Q

How is compliance measured?

A

volume change of lungs per unit of pressure change

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17
Q

What is helium dilution used for? explain process

A

used to measure residual volume

  1. helium insoluble in blood
  2. patient added to closed system
  3. change in helium concentration calculated and can be used to work out functional residual volume
  4. FRC = RV + ERV
  5. ERV calculated from spirometer
18
Q

What is nitrogen washout used for? how does it work?

A

used to calculate serial deadspace

  1. patient takes in 100% oxygen
  2. patient breathes out through valve measuring nitrogen content
  3. middle of curve = dead space
19
Q

How does Hb have a buffering capacity?

A

when not bound to oxygen can bind to H+ from co2 + h2o

H+ binds to water and breathed out in lungs

20
Q

Whats the normal arterial and venous content of co2 per liter?

A

arterial - 22mmol

venous - 24mmol

21
Q

Give 3 ways that type 1 resp failure can occur and examples

A
  1. thickening of alveolar membrane - fibrotic lung disease
  2. Decrease in alveolar SA - emphysema
  3. Increase in pleural fluid - pulmonary oedema
22
Q

Give 3 ways type 2 resp failure acan occur and examples

A
  1. paralysis of resp muscles - MND
  2. Chest wall abnormalities - scoliosis
  3. Difficulty ventilating lungs - COPD / asthma
23
Q

What are the symptoms of asthma?

A

breathlessnes, polyphonic wheeze, tight chest, dry cough

24
Q

Symptoms of COPD?

A

cough and sputum, breathlessness

25
Q

How would a COPD patient present?

A

cyanosis, barrel chest, wheezing, co2 retention

26
Q

What causes lobar pneumonia?

A

strep pneumoniae

27
Q

What happens in interstitial pneumonia?

A

progressive scarring of lungs

28
Q

Give 2 organisms that cause acute community acquired pneumonia

A

s pneumoniae

h influenzae

29
Q

Give 2 organsism that cuase acute hospital acquired pneumonia

A

MRSA

legionella pneumophilae

30
Q

What symptoms are associated with pneumonia?

A

cough with sputum (purulent, or rusty)

Breathlessness

Fever

Pleuritic chest pain (pain worse on inspiration)

31
Q

What can be heard on auscultation of pneumonia patient?

A

bronchia breath sounds

crackling

wheeze

dullness to percussion

32
Q

How do you assess the severity of pneumonia?

A

CURB65

C - confusion

U - Urea >7mmol/l

R - Resp rate >20

B - Blood pressure systolic

65 - over 65?

33
Q

Describe infection by TB

A
  1. MTB enters airways
  2. Macrophages unable to kill them as MTB blocks fusion of phagosome with lysosomes
  3. Granuloma forms with caseous necrosis centre - primary focus
  4. primary focus TB can drain into hilar lymph nodes = primary complex
  5. Primary infection heals with or without calcification
  6. Latent TB
34
Q

What happens in fibrosing alveolitis? WHat would a CXR show? what does a lung function test show?

A

activation of immune system results in lung damage due to proteases and ROS. Fibrosis occcurs. Idiopathic

CXR - small lungs, micronodular shadowing

Lung function - reduced compliance and gas transfer

35
Q

define a transudate and an exudate

A

transudate -

exudate - >30 g protein per liter

36
Q

give 3 factors that result in transudate pleural effusion

A

increase in hydrostatic pressure

decrease in oncotic presure

increased capillary permeability

37
Q

give 3 factors that result in exudate pleural effusion

A

Neoplasma

infeciton

Immune disease

38
Q

4 symptoms of pleuritis?

A

pain when coughing

pain on inspiration

referred pain to shoulder due to diaphragmatic pleura

Plerual rub - creaking noise heard on ausculation with resp movements

39
Q

What disease process affects:

a) air
b) air to airways
c) airways

A

a) low oxygen
b) scoliosis
c) COPD

40
Q

What disease would affect

a) arterial blood
b) arterial blood to regional arteries
c) regional arteries

A

a) anaemia
b) shock
c) peripheral artery disease

ESA 3 - Recap (6 decks)

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