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respiratory Flashcards

1
Q

trachea deviated to normal lung

A

pneumothorax/ pleural effusion

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2
Q

trachea deviated to collapsed lung

A

atelectasis/fibrosis

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3
Q

how many segments in each lung

A

R)=10
L)=8

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4
Q

what is each bronchopulmonary segment supplied by

A

tertiary artery/tertiary bronchus

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5
Q

which bronchus is wider shorter and more vertical and what does this mean

A

right
this means aspirated material is more likely to enter right bronchus thus the right lung

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6
Q

what segment is aspirated material more likely to go into if a patient is erect

A

posterior basal segment(right inferior lobe)

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7
Q

what segment is aspirated material more likely to go into if a patient is supine

A

superior segment (right inferior lobe)

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8
Q

what segment is aspirated material more likely to go into if a patient is laying on right side

A

posterior segment(right upper lobe)

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9
Q

what is in the conducting zone

A

trachea-bronchi-bronchioles-terminal bronchioles

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10
Q

what is in the transitional and respiratory zones

A

respiratory bronchioles-alveolar ducts-alveolar sacs

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11
Q

what does the pleura do

A

-helps protect and cushion the lungs
-facilitate optimal contraction/expansion of the lungs during breathing

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12
Q

2 layers of pleura

A

-visceral
-parietal
(PIC VOO)

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13
Q

what is the pleural cavity

A

space between the visceral and parietal pleura containing pleural fluid

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14
Q

what does the pleural cavity do

A

allows the layers of pleura to slide against each other to facilitate respiration

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15
Q

what happens if air enters the pleural cavity

A

because the surface tension of the pleural fluid keeps the lungs in contact with the thoracic wall, if air enters, the lung will detach from the thoracic wall, collapsing and leading to a pneumothorax

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16
Q

what is the cervical pleura innervated by

A

T1 intercostal nerve (pain is referred to medial arm)

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17
Q

what is the costal pleura innervated by

A

T2-10 intercostal nerves (pain is referred to chest)

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18
Q

mediastinal pleura innervation

A

phrenic nerve(pain referred to jaw/neck/arm/shoulder)

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19
Q

diaphragmatic pleura innervation

A

follows phrenic or intercostal nerve portion

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20
Q

what is a pneumothorax

A

collection of air outside the lung but within the pleural cavity

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21
Q

types of pneumothorax

A

-spontaneous(primary) pneumothorax
-non-spontaneous(secondary)
-tension
-non-tension
-trauma
-iatrogenic

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22
Q

causes of spontaneous pneumothorax

A

no clear cause but may be a result of risk factors

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23
Q

causes of non spontaneous pneumothorax

A

underlying lung pathology such as COPD asthma tuberculosis cystic fibrosis whooping cough etc

24
Q

causes of trauma pneumothorax

A

trauma to lungs e.g stab or injury

25
causes of iatrogenic pneumothorax
medical trauma i.e accidental puncture during surgery
26
causes of tension pneumothorax
breach in visceral pleura/lung surface which will admit air into pleural cavity during inspiration -air cannot come back during expiration as it acts as a one way valve -this leads to excessive pressure accumulation in pleural cavity -leads to lung collapse
27
causes of non tension pneumothorax
no ongoing accumulation of air=no increased pressure= no severe
28
Tx of tension pneumothorax
decompression needle inserted above 3rd rib, along mid clavicular line
29
Sx of pneumothorax
-sudden CP -dyspnoea -tachycardia -tachypnoea -dry cough -fatigue -hypotension -signs of respirator distress(nasal flaring, anxiety, accessor muscle use)
30
Dx of pneumothorax
absent breath sounds on auscultation
31
what is a hilum
area on the mediastinal surface where key structures pass through
32
trachea epithelium
pseudostratified columnar epithelium(ciliated)
33
bronchi epithelial histology
pseudostratified columnar epithelium(ciliated)
34
bronchioles epithelial histology
simple columnar epithelium & simple cuboidal epithelium
35
alveoli epithelial histology
simple squamous epithelium
36
what do type 1 pneumocytes do
responsible for gas exchange
37
what do type 2 pneumocytes do
production and secretion of surfactant
38
which way does air move
high pressure to low pressure
39
what is the intrapulmonary pressure
-the pressure of air in lungs -at rest 0mmHg
40
what is the intrapleural pressure
-pressure in pleural space -at rest -4mmHg(negative pressure helps adhere lung to chest wall)
41
what is the transpulmonary pressure
pressure difference between intrapulmonary and intrapleural pressures
42
process of inspiration and expiration
1. chest expands 2. intrapulmonary/alveolar and intrapleural pressures decrease 3. Gases rush into lungs to equalise pressure to 0mmHg(inspiration) 4. as diaphragm relaxes along with the chest, lung volume decreases 5. intrapulmonary/alveolar pressure increases to roughly 4mmHg 6. gases rush out of lungs to equalise pressure to 0mmHg(expiration)
43
what is lung compliance
how easy it is for the lung to inflate
44
what influences lung compliance
-lung elasticity -muscles vs resistance -surfactant surface tension
45
what is lung elasticity
stretching of parenchyma of lungs
46
what is muscles vs resistance
ability of the inspiratory muscles to overcome the resistance of chest wall, lung tissues and airways in order to inflate lungs
47
surfactant surface tension
surfactant decreases surface tension by 7-40% preventing alveoli from collapsing
48
what is bronchomotor tone established by
-vagal efferent nerves(bronchoconstriction) -inhaled stimuli like dust(reflex bronchoconstriction) -sympathetic nerve supply(bronchodilation) -circulating catecholamines e.g NA dopamine epinephrine(bronchodilation)
49
types of ventilation control
-neural control -chemical control
50
neural control
1. Pre-Botzinger complex in the ventral ventral respiratory group(VRG) in the medulla regulates unconscious breathing(pacemaker control) -modulated by carotid bodies, stretch receptors, chemo/mechanoreceptors -suppressed by opiates causes respiratory arrest 2. signals from dorsal respiratory group(GRP) go to diaphragm, signalling it to inspire -DRG also innervates external intercostals -VRG innervates internal intercostals 3. cessation of breaching comes from the pons in the pneumotaxic area(It is thought that the apneustic area stimulates inspiration
51
chemical control types
-central chemoreceptors -peripheral chemoreceptors
52
central chemoreceptors
-located in medulla -monitor CO2 via H+ concentrations -slower speed but greater effect(minutes) -These are pH receptors not CO2 receptors
53
peripheral chemoreceptors
-located in carotid bodies and aortic arch -monitors 02,CO2 and H+ -faster speed but smaller effect
54
are central or peripheral chemoreceptors slower
central responds slower to a rise in CO2, but has a larger effect(70%)
55
factors affecting diffusion
-partial pressure of gases on either side of membrane -thickness of alveoli epithelium -area of lungs for diffusion -solubility of the gas -matching of ventilation and perfusion
56

med 2100 (5 decks)

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