Respiratory Flashcards
Which side of the lungs is the patient more likely to aspirate and why?
Right side
Bronchus is more vertical and wider
What are the primary muscles of inspiration?
Diaphragm - 40% relaxed breathing
Scalenes
Parasternal Inercostals
What are the accessory muscles of inspiration and when are they used?
With increased demand
External intercostals
SCM
Upper traps
Pec Minor
Expiration is usually passive and due to elastic recall of chest wall adjusting pressure gradient. When needed (due to demand or reduced chest well elasticity) which muscles help with elastic expiration?
Transverse abdominals
Internal and external Obliques
Rectus Abdominals
Internal intercostals
Key note - expiration = internal intercostals
Inspiration inspiration = external intercostals
Lung anatomy:
Which lung has 3 lobes and what are the fissures?
Right lung
Horizontal and oblique
Left lung only has oblique fissure
Which pleura covers the lungs: parietal or visceral?
Visceral
How many Bronchopulmonary segments does the Right lobe have?
A - 10
B - 8
C - 3
D - 6
10
Check out the Lung Volumes/capacity chart and LABEL ALL SEGMENTS
Why is the dependent area of the lung better ventilated?
Dependent area bears weight which reduced alveolar volume which means higher compliance (ability to stretch/expand)
This means more expiration from these (air out) so they are preferentially ventilated on inspiration (greatest amount of air in as empty at the start) in healthy lungs
Which region of the lung would be dependent aka preferentially ventilated in each position?
Standing - bases
Supine - posterior
Sidelying - ipsilateral (lung lying on)
Which is the word for low V/Q ratio/mismatch:
A - Shunt
B - Deadspace
And is ventilation or perfusion affected?
Shunt
Ventilation reduced
What is the difference between anatomical and physiological deadspace?
Anatomical is volume of air in spaces without gas exchange aka bronchus/bronchioles/trache.
Physiological is anatomical plus alveolar dead space (alveoli where no gas exchange occurs). This should be negligible in healthy adults
Identify the zones of the lung by V/Q mismatch:
V/Q >1 ventilation > perfusion (both low)
V/Q = 1 optimal
V/Q <1 perfusion >ventilation (both high)
V/Q > 1 apex
V/Q = 1 mid zone (3rd rib)
V/Q <1 base
In a patient with Right sided pneumonia which side should the patient lie on to preferentially ventilate the right lung
Unhealthy lung tissue preferentially ventilated on non-dependent lung
Healthy lung tissue preferentially ventilated on dependent side
So lie on left side (right side up)
