Resp I Flashcards
conducting zone
anatomic dead space
no exchange
cartilage and goblet cell - to end of bronchi
pseudostratified ciliated columnar cell - to beginning of terminal bronchioles - then cuboidal
respiratory zone
gas exchange
cuboidal in resp bronchioles
simple squamous alveoli
cilia terminated resp bronchioles
type I pneumocte
line alveoli
- squamous
- gas echange
law of laplace
alveoli higher tendency to collapse as get smaller
type II pneumocyte
secrete surfactant
stem cells
cuboidal and clostered
surfactant maturity
lecithin to sphingomyelin ratio greater than 2
club cell
clara cell
noncilited - columnar/cuboidal
secretory granules
secrete component of surfactant
- degrade toxins
- reserve cells
lung lobes
left 3
left 2 and lingula - homolog right middle
right main stem bronchus - foreign object - wider and vertical
aspiration
upright - lower portion right inferior lobe
supine - superior right inferior lobe
diaphragm structures
I ate ten eggs at 12.
IVC - T8
esophagus - T10
aorta - T12
trachea bifurcation
T4
carotid birurcation
C4
aorta bifurcation
L4
lung volume
IRV - TV - ERV with normal breathing
RV - after max expiration
IC - IRV + TV
FRC - RV + ERV - all below tidal volume
VC - IRV + TV + ERV - max inspired and expired
total lung capacity - TLC
TLC = RV + ERV + TV + IRV
physiologic dead space
anatomic + alveolar dead space
apex - largest alveolar dead space
Vd = Vt x (PaCO2 - PECO2) / PaCO2
minute ventilation
volume gas enter lung per minute
at functional residual capacity
low end of tidal volume
system pressure is atmospheric
airway and alveolar P = zero
and intrapleural - is negative
compliance
change in volume with change in pressure
- decreased - pulm fibrosis, pneumonia, edema
- increased - emphysema, aging
fetal Hb
2a 2 gamma
HbA
2a 2B
taut - deox form - low affinity O2
R relaxed - high affinity for O2
Cl, H, CO2, 2,3 BPG, high temp
favor taut form over relaxed
shift dissociation curve right - more unloading
tx methemoglobin
methylene blue
methemoglobin
Fe3 - low O2 - affinity for cyanide - ferric
Fe2 - ferrous - high O2 affinity
tx cyanide poisoning
induce methemoglobin
-nitrite followed by thiosulfate
carboxyHb
bound CO
left shift O2 dissociation curve
-less unloading
tx - 100% O2
sigmoid dissociation O2 curve
bc 4 binding site
-higher affinity for each O2 bound
linear dissociation O2 curve
for myoglobin
-bc bas single O2 - monomeric
HbF
high affinity O2
-shift curve left
O2 content of blood
(O2 binding capacity x % saturation) + dissolved O2
CO poisoning O2 content
low O2 content
normal Hb
normal dissolved O2 - PaO2
low % sat Hb - CO compete with O2
anemia O2 content
low O2 content
low Hb
normal % O2 sat of Hb
normal PaO2
polycythemia O2 content
high O2 content
elevated Hb
normal % sat Hb
normal PaO2
pulmonary circulation regulation
hypoxia - low PAO2 - vasoconstriction
blood to well ventialted region o lung
perfusion limited
healthy O2, CO2, N2O
gas equilibrate early along length of capillary
diffusion increase increase if blood flow increase
diffusion limited
O2 - emphysema and fibrosis, CO
gas does not equilibrate by end of capillary
pulmonary wedge pressure
left atrium pressure
pulm vasc resistance
inverse to radius ~4
A-a gradient
normal - 10-15 mmHg
elevated - with hypoxemia - shunt, V/Q mismatch, fibrosis
hypoxemia
low PaO2
normal A-a gradient
-high altitude, hypoventilation
high A-a gradient
-V/Q mismatch, diffusion limitation, R to L shunt
hypoxia
low O2 to tissue
low CO
hypoxemia
anemia
CO poisoning
ischemia
low blood flow
low arterial flow
impaired vein drainage
