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Respiratory (FA) Flashcards

1
Q

where do the lungs develop from? when?

A

respiratory diverticulum makes lung bud at wk 4

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2
Q

during which weeks is a TEF most possible?

A

wks 4-7 (the embryonic stage of lung devpt)

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3
Q

when is the fetus capable of respiration

A

wk 25

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4
Q

when are the lungs (finally) done developing?

A

wk 95,888,178

justtt kidding.. at 8 years!

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5
Q 
what develops at each stage?
embryonic (wk 4-7) 
pseudoglandular (wk 5-17)
Cannalicular ( wk 16-25) 
Saccular (26-birth) 
Alveolar (wk 36-8 yrs)
A 
embryonic phase (7wk)- 3iary bronchi
psuedoglandular phase (17 wk)- terminal bronchioles (w/ little capillaries) 
cannalicular phase (25 wk) - respiratory bronchi/alveolar ducts w/ prominent capillaries **baby can breathe!**
saccular phase (birth)- terminal sacs (1ary alveolar septae) 
alveolar phase (8yr) - adult alveoli
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6
Q

whats the change in pulmonary vascular resistance upon birth? why?

A

Pulmonary vascular resistance goes down because the baby is now breathing air not fluid, lower resistance.

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7
Q

pulmonary hypoplasia most commonly caused by what (2) things?

A

(1) congenital diaphragmatic hernia

(2) bilateral renal agenesis

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8
Q

club cells
type
actions

A

NONciliated, low columnar/cuboidal

(1) reserve cells
(2) secretory cells- secrete component of surfactant
(3) detox

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9
Q

type I pneumocyte
type
action

A

thin squamous cell

- line alveoli, permit gas exchange

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10
Q

type II pneumocyte
type
action

A

cuboidal

(1) secrete surfactant
(2) reserve cells – can become type I pneumocyte if needed, so proliferate during lung damage

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11
Q

what does surfactant do?

A

surfactant decreases alveolar surface tension

(1) increases compliance
(2) decreases lung recoil
(3) prevents collapse

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12
Q

what is surfactant made of?

A

lecithin mix, primarily DPPC (dipalmitoylphosphatidylcholine)

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13
Q

when does surfactant production BEGIN? when are there MATURE levels of surfactant?

A

wk 26 begins

wk 35 mature levels

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14
Q

what are risk factors for NRDS?

A
  • prematurity
  • c section
  • maternal diabetes (high fetal insulin)
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15
Q

what are the complications of NRDS?

A
  • PDA

- necrotizing enterocolitis

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16
Q

how do you treat NRDS?

how would you NOT treat NRDS and why?

A

treat: give mom steroids before/during birth, give baby surfactant
do NOT give baby O2. this will cause “ribs”= “retinopathy of premarity, intraventricular hemorrhage, bronchopulmonary dysplasia”

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17
Q

whats in the conducting zone of the lung?

A

nose/pharynx –> terminal bronchioles

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18
Q

what part of the respiratory tract has the lowest resistance? why?

A

terminal bronchioles

b/c there are MANY of them in parallel

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19
Q

what in the respiratory zone of the lung?

A

respiratory bronchioles—> alveoli

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20
Q

what kind of cells are in the trachea and bronchioles?

A 
ciliated, psuedostratified, columnar, 
goblet cells
club cells 
smooth muscle 
cartilage
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21
Q

what kind of cells are in the terminal bronchioles

A

transition from ciliated columnar cells to ciliated cuboidal cells
club cells
smooth muscle

22
Q

what kind of cells are in the respiratory bronchiles

A

cuboidal cells (notice, not ciliated)
club cells
smooth muscle

23
Q

what kind of cells are in the alveoli?

A 
squamous (type I) 
cuboidal (type 2) 
macrophages
capillaries 
(notice, no smooth muscle)
24
Q

when do the goblet cells and mucous glands stop being in the respiratory tract?

A

after the bronchioles (you wont find them in the terminal bronchioles)

25
Q

how many lobes:
R lung
L lung

A

3 lobes- right lung

2 lobes- left lung + lingula (+ space for heart)

26
Q

whats the pulmonary A’s relative position to the broncioles?

A

RALS

  • R pulm A is Anterior
  • L pulm A is Superior
27
Q

where is an inhaled foreign body likely to end up?

A
  • if upright– RLL

- if suping- RUL

28
Q

what passes the diaphragm at T8

A

IVC and phrenic N

“ I8 10eggs at12”

29
Q

what passes the diaphragm at T10

A

esopahgus, and vagus N (CNX)

“ I8 10eggs at12”

30
Q

what passes through the diaphragm at T12?

A

aorta, thoracic duct, azygous vein,
“red, white, and blue”
“ I8 10eggs at12”

31
Q

what bifurcates at
C4
T4
L4

A

C4- common carotid
T4: trachea
L4: abdominal aorta

32
Q

after a normal breath, how much more can you breathe in?

after a normal breath how much can you breathe out

A

IRV

ERV

33
Q

how much is breathed in while silently/quietly breathing?

and what is the amount?

A

TV (= 500 mL)

34
Q

what is the amount thats left in your lungs after a silent breath out?

A

FRC = ERV+ RV

35
Q

what is the total amount you can breathe out after a big breath in?

A

vital capacity

TV+ IRV+ ERV

36
Q

whats the total amount thats left in your lung after a big breath in

A

Total lung capacity

TV+ IRV+ ERV +RV

37
Q

what lung volumes cannot be measured? why?

A

FRC and TLC and RV

FRC and TLC both have RV in them which is not measurable

38
Q

how do you measure the physiologic dead space?

A

taco paco peco paco

Vd= VT * ((PaCO2- PECO2)/ (PaCO2) )

39
Q

how do you calculate minute ventilation?

A

VE= VT* RR

40
Q

how do you calculate alveolar ventilation?

A

Va= (VT- VD)*RR
or
Va= VE- VD

41
Q

a normal VD?

A

150 mL/breath

42
Q

a normal RR

A

12-20 breath/min

43
Q

what is methemoglobin

A

hemoglobin who has an Fe3+

44
Q

what can methemoglobin be caused by?

A

nitrites and benzocaine

45
Q

in what situation would you give someone nitrites and thiosulfate?

A

to MAKE methemoglobin. Why? because methemoglobin has high affinity for cyanide. in cases of cyanide poisoning it can sequested the cyanide

46
Q

what does methemoglobin poisoning look like? whats the cure?

A

cyanotic. chocolate colored blood.

give the patient Methylene Blue + vitamin C

47
Q

what is carboxyhemoglobin

A

hemoglobin thats bound to carbon monoxide

48
Q

what does carboxyhemoglobin poisoning look like? whats the cure?

A

it causes cherry red skin, headaches and dizziness
the cure is: 100% hyperbaric O2
(hint: fires, car exhaust, gas heater)

49
Q

how do you calculate O2 content of blood?

A

(1.34* Hb* SaO2) + (0.003PaO2)

50
Q

what gases are perfusion limited?

A

O2( good health, not emphysema or fibrosis), CO2, N2O

51
Q

what gases are diffusion limited?

A

CO

O2 (in emphysema and fibrosis)

52
Q

how do you calculate the diffusion capacity?

A

Velocity of gas= ADk ((P1-P2)/ T)
so increasing surface area, diffusion coefficient of the gas and pressure differences in the 2 chambers will cause more rapid diffusion
meanwhile increasing the thickness of the barrier will cause lower diffusion

need to knows (31 decks)

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