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Cardiopulm > respiratory system > Flashcards

respiratory system Flashcards

1
Q

nasopharynx

A

continuation of nasal cavity to the soft palate

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2
Q

oropharynx

A
  • soft palate to the upper border of epiglottis
  • at 2nd cervical vertebrae
  • passageway for food moving from mouth to esophagus and air from nasal cavity
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3
Q

laryngopharynx

A

extends from upper border of epiglottis to lower portion of the third, bodies of 4-5, upper portion of 6th vertebra

extends to esophagus

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4
Q

diaphragm origin

A
  • xiphoid process
  • costal margin
  • laterally ribs 6-12
  • posteriorly L1 and L2
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5
Q

diaphragm insertion

A
  • central tendon
  • thin but strong aponeurosis
  • located near center of diaphragm but more anterior than posterior
  • R and L hemidiaphragms
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6
Q

T/F: diaphragms separate different cavities w/different pressures

A

True

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7
Q

displacement of the diaphragm

A
  • quiet breathing: 2/3 inch

- max excursion: 2.5-4 in

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8
Q

what might limit diaphragm displacement?

A
  • obesity
  • pregnancy
  • size of various GI organs
  • ascites
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9
Q

supine effects on diaphragm

A
  • no effects of gravity
  • level of diaphragm rises; greater excursion
  • lung volumes low because of elevated position of abdominal organs
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10
Q

upright position effects on diaphragm

A
  • diaphragm pulled down because effects of gravity

- reduced excursion but lung volumes increased

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11
Q

SL effects on diaphragm

A
  • hemidiaphragms unequal
  • uppermost side drops to lower position and has less excursion than in sitting
  • higher but has less excursion
  • lowermost (dependent) side rises higher in thorax and has greater excursion
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12
Q

T/F: You should position a patient with an injured lung with the injured side up so the “good lung” has greater excursion

A

True

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13
Q

which intercostal is used for inspiration?

A

external

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14
Q

which intercostal is used for expiration

A

internal

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15
Q

T/F: inspiration is a passive process at rest and during exercise

A

False: Active

contraction of diaphragm and external intercostals

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16
Q

relaxed breathing

A
  • ribs drop

- diaphragm relaxes

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17
Q

elastic recoil

A

rebound of lungs after stretched by inhalation

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18
Q

why does elastic recoil occur?

A
  • elastin in CT of lungs

- surface tension of the film of fluid lining alveoli

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19
Q

what are the muscles for inspiration

A
  • external intercostals
  • SCM
  • scalenes
  • pec minor/major
  • upper trap
  • SA
  • rhomboids
  • serratus posterior superior
  • thoracic erector spinae
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20
Q

where is the apex of the lung located?

A
  • in the root of the neck

- highest point approx 1 inch above middle 1/3 of each clavicle

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21
Q

lobar bronchi

A

pass into a lobe of the lungs from R or L bronchus

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22
Q

segmental bronchi

A

pass through a segment of each lobe

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23
Q

bronchioles

A

smallest segments of bronchi

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24
Q

respiratory zone

A

gas exchange airways made up of:

  1. respiratory bronchioles
  2. alveolar ducts
  3. alveoli
25
Q

layers of the lungs?

A
  1. pleural space
  2. visceral pleura
  3. cervical parietal pleura
  4. costal parietal pleura
  5. mediastinal parietal pleura
  6. diaphragmatic parietal pleura
  7. costo-diaphragmatic recess
26
Q

subatmospheric pressure is also called

A

negative intrapulmonary pressure

27
Q

what causes air to flow into the lungs

A

difference in pressure between the atmosphere and alveoli. (high to low)

28
Q

Intrapulmonary pressure change during

  1. inspiration
  2. expiration
A
  1. -3

2. +3

29
Q

Intrapleural pressure change during

  1. inspiration
  2. expiration
A
  1. -6

2. -3

30
Q

Transpulmonary pressure change during

  1. inspiration
  2. expiration
A
  1. +3

2. +6

31
Q

how to measure static and dynamic lung volumes

A

spirometer

32
Q

resting TV

A

350-500 mLs

33
Q

minute ventilation

A
  • assessment of effective ventilation
  • L/min
  • calculated by multiplying RR x TV
  • rest: 5 L/min
  • max ex: 70-125 L/min
34
Q

Lung Compliance

A
  • lungs have capacity to expand and stretch
  • ease at which lungs can expand relative to pressure
  • speaks to distensability of lung tissue
  • stiffness of tissue
35
Q

Elasticity

A

ability of lungs to return to their initial size after being stretched

36
Q

T/F: emphysema has decreased compliance and are very difficult to inflate and have reduced capcity to recoil

A

False

  • easy to inflate
  • increased compliance
  • decreased capacity to recoil
37
Q

formula for lung compliance

A

ΔV/ΔP

38
Q

surface tension

A
  1. created by fluid secreted onto lining of alveoli
  2. resists lung expansion/distension
  3. acts to collapse alveolus and raises pressure of alveolar air
39
Q

surfactant

A

compound that reduces surface tension

40
Q

what happens in the absence of surface tension

A
  • recoil goes up
  • compliance goes down

lungs of a pre term baby

41
Q

Why don’t our lungs collapse when we aren’t actively breathing?

A
  1. because lungs are stuck to thoracic wall, always under elastic tension
  2. at functional residual capacity, elastic recoil of lung is balanced by elastic recoil of chest wall
42
Q

V/Q ratio

A

0.8

43
Q

distribution of pulmonary ventilation

A

2.5 x greater at base than apex

44
Q

distribution of pulmonary perfusion

A

6x greater at base than apex

45
Q

when does shunting occur

A

if perfusion occurs but very limited ventilation.

excess perfusion results in a R to L shunt

46
Q

dead space

A
  • if ventilation occurs w/limited perfusion
47
Q

excess of ventilation results in

A

physiologic dead space

48
Q

does a pulmonary embolism cause a shunt or dead space

A

shunt?

49
Q

defects in ventilation perfusion matching can lead to

A
  • hypoxia

- red oxygen delivery to peripheral tissue

50
Q

Ventilation / perfusion scar

A
  • test that measures air and blood flow in lungs
  • most often dx or rule out PE
  • involves radioactive albumin injected into blood and radionuclide into air breathed in
51
Q

Dalton’s Law

A
  • total pressure of gas mix is equal to sum of pressures of each gas in it
52
Q

partial pressure

A

pressure of an individual gas

multiply % of gas by total pressure

53
Q

CO2 transport in the blood

A
  1. CO2 dissolved in blood
  2. carried as bicarbonate ion
  3. carried combined w/hemoglobin
54
Q

Increased CO2 in the blood

A
  1. shift to the R increases CO3 and H
  2. reduces blood pH
  3. CO2 retention (hypercapnic)
  4. hypoventillation
  5. reduced exhalation volumes
55
Q

decreased CO2 in blood

A
  1. shift to L: decreased CO3 and H
  2. increases blood pH
  3. greater amounts of CO2 exhaled (hypocapnic)
  4. hyperventilation
  5. reduced exhalation volumes
56
Q

How much O2 is delivered through a nasal canula in adults

A

1-6 L/min

57
Q

what are some concerns using a nasal cannula

A

irritated and dried nasal mucosa

58
Q

FIO2

A

fraction of inspired air that’s oxygen = 21%

for every L/min, increases by 4%

Cardiopulm (20 decks)

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