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First Aid 2014 > RESPIRATORY: 594 - 596 > Flashcards

RESPIRATORY: 594 - 596 Flashcards

1
Q

What are the two parts of the respiratory tree?

A

Conducting zone and respiratory zone

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2
Q

What makes up the conducting zone?

A
  1. Large airways: nose, pharynx, larynx, trachea, and bronchi
  2. Small airways: bronchioles and terminal bronchioles
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3
Q

How are the terminal bronchioles arranged and why?

A

Large numbers in parallel giving minimal airway resistance

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4
Q

What is the function of the conducting zone?

A

Warms, humidifies, and filters air

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5
Q

What does it mean that the conducting zone is “anatomic dead space”?

A

Does NOT participate in gas exchange

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6
Q

How far do the cartilage and goblet cells extend in the conducting zone?

A

To the end of the bronchi

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7
Q

Describe the epithelia in the conducting zone.

A

Pseudostratified ciliated columnar cells extend to the beginning of the terminal bronchioles, then transition to cuboidal cells

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8
Q

In general, how far do the airway smooth muscles extend?

A

To the end of the terminal bronchioles

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9
Q

What makes up the respiratory zone?

A

Lung parenchyma: respiratory bronchioles, alveolar ducts, alveoli

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10
Q

Why is most of the epithelia in the conducting zone ciliated?

A

To beat mucus up and out of the lungs

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11
Q

What is the function of the respiratory zone?

A

Gas exchange

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12
Q

Describe the epithelia in the respiratory zone.

A

Mostly cuboidal cells in the respiratory bronchioles then simple squamous cells up to alveoli

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13
Q

Is the epithelia in the respiratory zone ciliated?

A

No

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14
Q

What do alveolar macrophages do?

A

Clear debris and participate in immune response

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15
Q

What are the three types of pneumocytes?

A
  1. Type I
  2. Type II
  3. Club (Clara) cells
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16
Q

What is the main function of Type I vs. Type II pneumocytes?

A

Type I - Line the alveolar surfaces and allow for gas diffusion

Type II - Secrete pulmonary surfactant, also serve as precursors to Type I and Type II cells

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17
Q

How are type I pneumocytes optimized for gas diffusion?

A

Squamous cells that are thin

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18
Q

What is pulmonary surfactant made of?

A

Complex mix of lecithins - most important of which is dipalmitoylphosphatidylcholine

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19
Q

What is the term for alveolar collapse?

A

Atelectasis

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20
Q

Explain the Law of Laplace.

A

Alveoli have an increased tendency to collapse on expiration as the radius decreases

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21
Q

Why do we need pulmonary surfactant?

A

Decreases alveolar surface tension and prevents alveolar collapse

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22
Q

Which cells proliferate during lung damage?

A

Type II

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23
Q

When does surfactant synthesis begin?

A

Around week 26 of gestation, but mature levels are not achieved until around week 35

24
Q

What is an indicator of fetal lung maturity?

A

Lecithin-to-sphingomyelin ratio > 2.0 in amniotic fluid

25
Q

Describe club/clara cells.

A

Nonciliated, low-columnar/cuboidal with secretory granules

26
Q

What are 3 functions of club cells?

A
  1. Secrete component of surfactant
  2. Degrade toxins
  3. Act as reserve cells
27
Q

How many lobes does each lung have?

A

Right - 3

Left - 2

28
Q

What is the homologue of the right middle lobe?

A

Lingula - it is a projection of the upper lobe of the left lung

29
Q

Why is the right lung a more common site for inhaled foreign body?

A

Right main stem bronchus is wider and more vertical than the left

30
Q

Describe the difference in location of where an aspirated item will likely end up while a person is upright vs. supine.

A

Will tend to end up regardless in the right inferior lobe

Upright - lower portion
Supine - superior portion

31
Q

Describe the relationship between the location of the pulmonary artery to the bronchus on each side.

A

RALS -
Right anterior
Left superior

32
Q

At what levels do the IVC, esophagus, and aorta pass through the diaphragm?

A

Mnemonic: I (IVC) ate (8) ten (10) eggs (esophagus) at twelve (12).

IVC - T8
Esophagus - T10
Aorta - T12

33
Q

What nerve innervates the diaphragm and what are its roots?

A

Phrenic nerve - C3, 4, 5

Mnemonic: C3, 4, 5 keep the diaphragm alive

34
Q

Where can pain from diaphragm irritation be referred to?

A

Shoulder (C5) and the trapezius ridge (C3, 4)

35
Q

What is inspiratory reserve volume (IRV)?

A

Air that can still be breathed in after normal inspiration

36
Q

What is tidal volume (TV)?

A

Air that moves into lung with each quiet inspiration

37
Q

What is the normal value for tidal volume?

A

Around 500 mL

38
Q

What is expiratory reserve volume (ERV)?

A

Air that can still be breathed out after normal expiration

39
Q

What is residual volume?

A

Air in lung after maximal expiration

40
Q

Which lung volume cannot be measured on spirometry?

A

Residual volume

41
Q

What is the difference between volume and capacity?

A

Capacity - made up of 2 or more volumes

42
Q

What are the components of inspiratory capacity (IC)?

A

IRV + TV

43
Q

What is functional residual capacity (FRC)?

A

Volume in lungs after normal expiration

44
Q

What are the components of FRC?

A

RV + ERV

45
Q

What is vital capacity (VC)?

A

Maximum volume of gas that can be expired after a maximal inspiration

46
Q

What are the components of VC?

A

TV + IRV + ERV

47
Q

What is total lung capacity (TLC)?

A

Volume of gas present in lungs after a maximal inspiration

48
Q

What are the components of TLC?

A

IRV + TV + ERV + RV

49
Q

What makes up physiologic dead space (VD) in the respiratory system?

A

Anatomic dead space of conducting airways plus functional dead space in alveoli (volume of inspired air that does not take part in gas exchange

50
Q

What is the largest contributor of functional dead space?

A

Apex of healthy lung

51
Q

How do we calculate VD?

A

VD = VT x (PaCO2 - PECO2) / (PaCO2)

PaCO2 = arterial PCO2
PECO2 = expired air PCO2

Mnemonic: Taco, Paco, Peco, Paco

52
Q

What are two measures of ventilation?

A
  1. Minute ventilation

2. Alveolar ventilation

53
Q

What is minute ventilation?

A

Total volume of gas entering the lungs per minute

54
Q

How do we calculate minute ventilation?

A

VE = VT x respiratory rate (RR)

55
Q

What is alveolar ventilation?

A

Volume of gas per unit time that reaches the alveoli

56
Q

How do we calculate alveolar ventilation?

A

VA = (VT - VD) x RR

First Aid 2014 (24 decks)

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