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(3) Cardio-Pulmo-Renal Rehabilitation > S1 L3.1: Functional Anatomy of the Lungs > Flashcards

S1 L3.1: Functional Anatomy of the Lungs Flashcards

1
Q

Composed of 12 ribs, thoracic vertebrae and sternum

A

Thoracic Cage

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2
Q

T/F: Ribs are inclined superiorly

A

False

Inclined inferiorly

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3
Q

What are the inspiratory muscles?

A

Diaphragm, SCM,
& scalenes

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4
Q

What are the expiratory muscles?

A

Abdominal muscles, internal intercostals

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5
Q

AIRWAYS: Anatomical Division

Nose, nasopharynx, larynx

A

Upper Airway

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6
Q

AIRWAYS: Anatomical Division

In the conducting zone, which generation is devoid of alveoli?

A

1-16th Generation

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7
Q

AIRWAYS: Anatomical Division

In the conducting zone, that is the generation with large or central airways?

A

1st-9th Generation

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8
Q

AIRWAYS: Anatomical Division

In the conducting zone, which generations have smal or peripheral airways?

A

10-16th Generation

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9
Q

AIRWAYS: Anatomical Division

Which generation has alveolar structure?

A

17th-23rd Generation

Also known as the Respiratory Zone

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10
Q

Statement 1: The anatomical dead space is the part where airways are devoid of alveoli.
Statement 2: These areas include the upper airways and the conducting zone

a. TF
b. FT
c. TT
d. FF

A

c. TT

No respiration occurs here

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11
Q

AIRWAYS: Histology

With mucosa and smooth muscle, no cartilage

Small or peripheral airways <1mm in diameter

A

Bronchioles

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12
Q

AIRWAYS: Histology

With mucosa, smooth
muscles, cartilage

Large or central airways >1mm in diameter

A

Bronchus

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13
Q

Lung Parenchyma

Structures distal to the terminal bronchioles

A

Respiratory Unit

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14
Q

Lung Parenchyma

Respiratory Organization
Respiratory unit → [?] → segments → [?] → lungs

A

Respiratory unit → Lobules → segments → Lobes → lungs

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15
Q

Blood Supply

Statement 1: The respiratory unit is supplied by the bronchial arteries
Statement 2: The conducting zone is supplied by pulmonary arteries

a. TF
b. FT
c. TT
d. FF

A

d. FF

Respiratory Unit: Pulmonary Arteries
Conducting Zone: Bronchial Arteries

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16
Q

Epithelial cells that line the peripheral gas exchange region of the lungs.

A

Pneumocytes

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17
Q

Comprise only 4% of the alveolar surface area but constitute 60% of alveolar epithelial cells and 10-15% of all lung cells

a. Type I (Flat) Pneumocyte
b. Type II (Cuboidal) Pneumocyte

A

b. Type II (Cuboidal) Pneumocyte

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18
Q

These cover more than 97% of the alveolar surface.

a. Type I (Flat) Pneumocyte
b. Type II (Cuboidal) Pneumocyte

A

a. Type I (Flat) Pneumocyte

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19
Q

Modulate the fluid composition surrounding the alveolar epithelium

a. Type I (Flat) Pneumocyte
b. Type II (Cuboidal) Pneumocyte

A

b. Type II (Cuboidal) Pneumocyte

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20
Q

Store lung surfactant intracellularly in organelles known as lamellar bodies

a. Type I (Flat) Pneumocyte
b. Type II (Cuboidal) Pneumocyte

A

b. Type II (Cuboidal) Pneumocyte

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21
Q

Complex branched cells with multiple cytoplasmic plates that represent the gas exchange surface in the alveolus of the lung

a. Type I (Flat) Pneumocyte
b. Type II (Cuboidal) Pneumocyte

A

a. Type I (Flat) Pneumocyte

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22
Q

Important Landmarks

Lung Apex

A

Protrudes 3-4 cm above the first rib anteriorly; same level posteriorly

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23
Q

Important Landmarks

Oblique Fissure

A

4th thoracic vertebra posteriorly to 6th chondrosternal junction; follows slope of 4th rib crossing the 5th rib.

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24
Q

Important Landmarks

Horizontal Fissure

A

4th rib parasternally extending laterally to meet the oblique fissure

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25
Q

Important Landmarks

Trachea

A

From C6 to T6-T7

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26
Q

Volumes and Ventilation

a. Tidal Volume
b. Inspiratory Reserve Volume (IRV)
c. Expiratory Reserve Volume (ERV)
d. Residual Volume (RV)
e. Vital Capacity (VC)
d. Inspiratory Capacity (IC)
f. Functional Residual Capacity (FRC)
g. Total Lung Capacity (TLC)

Maximum amount of air that can be inhaled from the end of a tidal volume

A

d. Inspiratory Capacity (IC)

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27
Q

Volumes and Ventilation

a. Tidal Volume
b. Inspiratory Reserve Volume (IRV)
c. Expiratory Reserve Volume (ERV)
d. Residual Volume (RV)
e. Vital Capacity (VC)
d. Inspiratory Capacity (IC)
f. Functional Residual Capacity (FRC)
g. Total Lung Capacity (TLC)

Volume of air remaining in the lungs at the end of maximum expiration

A

d. Residual Volume (RV)

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28
Q

Volumes and Ventilation

a. Tidal Volume
b. Inspiratory Reserve Volume (IRV)
c. Expiratory Reserve Volume (ERV)
d. Residual Volume (RV)
e. Vital Capacity (VC)
d. Inspiratory Capacity (IC)
f. Functional Residual Capacity (FRC)
g. Total Lung Capacity (TLC)

The maximum amount of air that can be inhaled after a normal tidal volume inspiration

A

b. Inspiratory Reserve Volume (IRV)

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29
Q

Volumes and Ventilation

a. Tidal Volume
b. Inspiratory Reserve Volume (IRV)
c. Expiratory Reserve Volume (ERV)
d. Residual Volume (RV)
e. Vital Capacity (VC)
d. Inspiratory Capacity (IC)
f. Functional Residual Capacity (FRC)
g. Total Lung Capacity (TLC)

Volume of air remaining in the lungs at the end of a TV expiration

A

f. Functional Residual Capacity (FRC)

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30
Q

Volumes and Ventilation

a. Tidal Volume
b. Inspiratory Reserve Volume (IRV)
c. Expiratory Reserve Volume (ERV)
d. Residual Volume (RV)
e. Vital Capacity (VC)
d. Inspiratory Capacity (IC)
f. Functional Residual Capacity (FRC)
g. Total Lung Capacity (TLC)

Volume of air that can be exhaled from the lungs after a maximum inspiration

A

e. Vital Capacity (VC)

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31
Q

Volumes and Ventilation

a. Tidal Volume
b. Inspiratory Reserve Volume (IRV)
c. Expiratory Reserve Volume (ERV)
d. Residual Volume (RV)
e. Vital Capacity (VC)
d. Inspiratory Capacity (IC)
f. Functional Residual Capacity (FRC)
g. Total Lung Capacity (TLC)

Volume of air in the lungs after a maximum inspiration

A

g. Total Lung Capacity (TLC)

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32
Q

Volumes and Ventilation

a. Tidal Volume
b. Inspiratory Reserve Volume (IRV)
c. Expiratory Reserve Volume (ERV)
d. Residual Volume (RV)
e. Vital Capacity (VC)
d. Inspiratory Capacity (IC)
f. Functional Residual Capacity (FRC)
g. Total Lung Capacity (TLC)

Volume of air inspired and expired during normal quiet breathing

A

a. Tidal Volume

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33
Q

Volumes and Ventilation

a. Tidal Volume
b. Inspiratory Reserve Volume (IRV)
c. Expiratory Reserve Volume (ERV)
d. Residual Volume (RV)
e. Vital Capacity (VC)
d. Inspiratory Capacity (IC)
f. Functional Residual Capacity (FRC)
g. Total Lung Capacity (TLC)

The maximum amount of air that can be exhaled from the resting expiratory level

A

c. Expiratory Reserve Volume (ERV)

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34
Q

Volumes and Ventilation

a. Tidal Volume
b. Inspiratory Reserve Volume (IRV)
c. Expiratory Reserve Volume (ERV)
d. Residual Volume (RV)
e. Vital Capacity (VC)
d. Inspiratory Capacity (IC)
f. Functional Residual Capacity (FRC)
g. Total Lung Capacity (TLC)

The elastic force of the chest wall is exactly balanced by the elastic force of the lungs

A

f. Functional Residual Capacity (FRC)

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35
Q

Volumes and Ventilation

a. Tidal Volume
b. Inspiratory Reserve Volume (IRV)
c. Expiratory Reserve Volume (ERV)
d. Residual Volume (RV)
e. Vital Capacity (VC)
d. Inspiratory Capacity (IC)
f. Functional Residual Capacity (FRC)
g. Total Lung Capacity (TLC)

TLC=IRV+TV+ERV+RV

A

g. Total Lung Capacity (TLC)

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36
Q

Volumes and Ventilation

a. Tidal Volume
b. Inspiratory Reserve Volume (IRV)
c. Expiratory Reserve Volume (ERV)
d. Residual Volume (RV)
e. Vital Capacity (VC)
d. Inspiratory Capacity (IC)
f. Functional Residual Capacity (FRC)
g. Total Lung Capacity (TLC)

3000 cc

A

b. Inspiratory Reserve Volume (IRV)

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37
Q

Volumes and Ventilation

a. Tidal Volume
b. Inspiratory Reserve Volume (IRV)
c. Expiratory Reserve Volume (ERV)
d. Residual Volume (RV)
e. Vital Capacity (VC)
d. Inspiratory Capacity (IC)
f. Functional Residual Capacity (FRC)
g. Total Lung Capacity (TLC)

500 cc

A

a. Tidal Volume

38
Q

Volumes and Ventilation

a. Tidal Volume
b. Inspiratory Reserve Volume (IRV)
c. Expiratory Reserve Volume (ERV)
d. Residual Volume (RV)
e. Vital Capacity (VC)
d. Inspiratory Capacity (IC)
f. Functional Residual Capacity (FRC)
g. Total Lung Capacity (TLC)

IRV+TV

A

d. Inspiratory Capacity (IC)

39
Q

Volumes and Ventilation

a. Tidal Volume
b. Inspiratory Reserve Volume (IRV)
c. Expiratory Reserve Volume (ERV)
d. Residual Volume (RV)
e. Vital Capacity (VC)
d. Inspiratory Capacity (IC)
f. Functional Residual Capacity (FRC)
g. Total Lung Capacity (TLC)

ERV+RV

A

f. Functional Residual Capacity (FRC)

40
Q

Volumes and Ventilation

a. Tidal Volume
b. Inspiratory Reserve Volume (IRV)
c. Expiratory Reserve Volume (ERV)
d. Residual Volume (RV)
e. Vital Capacity (VC)
d. Inspiratory Capacity (IC)
f. Functional Residual Capacity (FRC)
g. Total Lung Capacity (TLC)

1100 cc

A

c. Expiratory Reserve Volume (ERV)

41
Q

Volumes and Ventilation

a. Tidal Volume
b. Inspiratory Reserve Volume (IRV)
c. Expiratory Reserve Volume (ERV)
d. Residual Volume (RV)
e. Vital Capacity (VC)
d. Inspiratory Capacity (IC)
f. Functional Residual Capacity (FRC)
g. Total Lung Capacity (TLC)

Point at which the elastic forces of the lungs and chest wall equalize each other

A

f. Functional Residual Capacity (FRC)

42
Q

WHY and HOW does air move in and out of the lungs?

A

General Principle: Air moves from a greater to a lower
pressure.

43
Q

Usually same as atmospheric pressure

A

Mouth Opening Pressure

44
Q

Difference between the mouth opening pressure and alveolar pressure

A

Airway Pressure

45
Q

Difference between the alveolar and intrapleural pressure

A

Transpulmonary Pressure

46
Q

Statement 1: Lungs and chest wall have opposite elastic properties
Statement 2: Lungs have natural tendency to expand and the chest wall has natural tendency to collapse

a. TF
b. FT
c. TT
d. FF

A

a. TF

Lungs: collapse
Chest wall: expand

47
Q

Atmospheric Gas Composition

Nitrogen

48
Q

Atmospheric Gas Composition

H2O vapor

49
Q

Atmospheric Gas Composition

Oxygen

50
Q

Atmospheric Gas Composition

Carbon Dioxide

51
Q

Statement 1: In the anatomic dead space, oxygen added by airway mucosa dilutes other gasses
Statement 2: O2 concentration decreases in the alveoli due to diffusion from the alveoli into the pulmonary capillaries; reverse for CO2 is true

a. TF
b. FT
c. TT
d. FF

A

b. FT

H2O vapor added by airway mucosa dilutes other gasses

52
Q

Statement 1: In the AC Membrane, the Rate of diffusion is proportional with solubility and pressure difference
Statement 2: Rate of diffusion is inversely proportional with molecular weight

a. TF
b. FT
c. TT
d. FF

A

c. TT

AC Membrane: Alveolar-Capillary Membrane

53
Q

T/F: CO2 is heavier than O2 but 20x more soluble than O2

54
Q

Gas Tension

Because of the gas tension gradient, oxygen diffuses from the [?] into the [?] while CO2 diffuses out from the [?] into the [?]

A

Oxygen: Alveoli –> Pulmonary Capillary Blood
CO2: Pulmonary Capillary Blood –> Alveoli

55
Q

Transit time of blood pulmonary capillary transit (normal & during exercise)

A

Normal: 0.7sec
During Exercise: 0.3 sec

56
Q

T/F: Blood stays in the alveoli for more than enough time for adequate gas exchange

A

False: Blood stays in the capillaries for more than enough time for adequate gas exchange

57
Q

Statement 1: It takes 0.23 sec for CO2 to diffuse into the alveoli
Statement 2: It takes only 0.17 sec for O2 to diffuse into the alveoli

a. TF
b. FT
c. TT
d. FF

A

d. FF

0.23 sec for O2; 0.17 sec for CO2

58
Q

Blood-Gas Barrier

A
  1. Aqueous fluid layer (surfactants)
  2. Alveolar epithelium
  3. Epithelial basement membrane
  4. Intersitium
  5. Endothelium basement membrane
  6. Capillary endothelium
  7. Plasma
  8. Red cell membrane
  9. Intracellular fluid
59
Q

Relationship between respiratory unit’s ventilation (V) and perfusion or blood flow (Q)

A

V/Q Matching

60
Q

Statement 1: Ventilation and perfusion are greatest in more dependent portions of the lungs
Statement 2: V/Q is the best at the apex and the Effect of gravity: V < Q

a. TF
b. FT
c. TT
d. FF

A

a. TF

Effect of gravity: V > Q

61
Q

Types of VQ (MIS) MATCHING

a. Ideal, V = Q

b. Low V/Q, V < Q

c. No V but normal Q

d. High V/Q, V > Q

e. With V but not without Q

V/Q < 1

A

b. Low V/Q, V < Q

62
Q

Types of VQ (MIS) MATCHING

a. Ideal, V = Q

b. Low V/Q, V < Q

c. No V but normal Q

d. High V/Q, V > Q

e. With V but not without Q

V/Q > 1

A

d. High V/Q, V > Q

63
Q

Types of VQ (MIS) MATCHING

a. Ideal, V = Q

b. Low V/Q, V < Q

c. No V but normal Q

d. High V/Q, V > Q

e. With V but not without Q

V/Q = 1

A

a. Ideal, V = Q

64
Q

Types of VQ (MIS) MATCHING

a. Ideal, V = Q

b. Low V/Q, V < Q

c. No V but normal Q

d. High V/Q, V > Q

e. With V but not without Q

V/Q = 0

A

c. No V but normal Q

65
Q

Types of VQ (MIS) MATCHING

a. Ideal, V = Q

b. Low V/Q, V < Q

c. No V but normal Q

d. High V/Q, V > Q

e. With V but not without Q

V/Q Infinite

A

With V but not without Q

66
Q

Determinants of O2 Content

A
  1. Minute ventilation
  2. Dead space ventilation
  3. Alveolar ventilation
  4. O2 association/dissociation
  5. Hemoglobin level
67
Q

Statement 1: Bases are 6x better perfused than the apices
Statement 2: Bases are 3x better ventilated than the apices

a. TF
b. FT
c. TT
d. FF

A

b. FT

Bases are 8x better perfused than the apices

68
Q

V/Q Mismatch Patterns

Upper Lung

69
Q

V/Q Mismatch Patterns

Mid Lung

70
Q

V/Q Mismatch Patterns

Lower Lung

71
Q

Average V/Q of a normal upright lung

72
Q

2 Patterns of Breathing

Resides within the brainstem & influenced by the RAS

A

Metabolic (Autonomic) Control

73
Q

2 Patterns of Breathing

Concerned with coordinating breathing and can override spontaneous activity

A

Behavioral (Voluntary) Control

74
Q

2 Patterns of Breathing

Resides within the thalamus and cerebral cortex

A

Behavioral (Voluntary) Control

75
Q

2 Patterns of Breathing

Concerned with O2 delivery and acid-base balance

A

Metabolic (Autonomic) Control

76
Q

Respiratory Centers (Location)

a. Dorsal Respiratory Group
b. Ventral Respiratory Group
c. Pneumotaxic
d. Apneustic

Ventral medulla

A

b. Ventral Respiratory Group

77
Q

Respiratory Centers (Location)

a. Dorsal Respiratory Group
b. Ventral Respiratory Group
c. Pneumotaxic
d. Apneustic

Dorsal medulla

A

a. Dorsal Respiratory Group

78
Q

Respiratory Centers (Location)

a. Dorsal Respiratory Group
b. Ventral Respiratory Group
c. Pneumotaxic
d. Apneustic

Lower pons

A

d. Apneustic

79
Q

Respiratory Centers (Location)

a. Dorsal Respiratory Group
b. Ventral Respiratory Group
c. Pneumotaxic
d. Apneustic

Upper pons

A

c. Pneumotaxic

80
Q

Respiratory Centers (Effect)

a. Dorsal Respiratory Group
b. Ventral Respiratory Group
c. Pneumotaxic
d. Apneustic

Tends to terminate inspiration; contains both inspiratory and expiratory neurons

A

c. Pneumotaxic

81
Q

Respiratory Centers (Effect)

a. Dorsal Respiratory Group
b. Ventral Respiratory Group
c. Pneumotaxic
d. Apneustic

Active during inspiration; promotes inspiration; generated basic respiratory rhythm

A

a. Dorsal Respiratory Group

82
Q

Respiratory Centers (Effect)

a. Dorsal Respiratory Group
b. Ventral Respiratory Group
c. Pneumotaxic
d. Apneustic

Some neurons are active during all phases of cycle esp. during expiration

A

b. Ventral Respiratory Group

83
Q

Respiratory Centers (Effect)

a. Dorsal Respiratory Group
b. Ventral Respiratory Group
c. Pneumotaxic
d. Apneustic

Promotes inspiration

A

d. Apneustic

84
Q

Respiratory Centers (Purpose)

a. Dorsal Respiratory Group
b. Ventral Respiratory Group
c. Pneumotaxic
d. Apneustic

Inhibits the DRG. Primarily most active during the expiratory phase.

A

b. Ventral Respiratory Group

85
Q

Respiratory Centers (Purpose)

a. Dorsal Respiratory Group
b. Ventral Respiratory Group
c. Pneumotaxic
d. Apneustic

Drive the phrenic motor neurons and VRG cells when there is a need to increase respiratory rate (decrease expiratory phase)

A

a. Dorsal Respiratory Group

86
Q

Respiratory Centers (Purpose)

a. Dorsal Respiratory Group
b. Ventral Respiratory Group
c. Pneumotaxic
d. Apneustic

Transection increases TV and duration of inspiration resulting in slow, deep respiration with prolonged inspiratory hold (apneustic breathing)

A

c. Pneumotaxic

87
Q

Respiratory Centers (Purpose)

a. Dorsal Respiratory Group
b. Ventral Respiratory Group
c. Pneumotaxic
d. Apneustic

Most important, rhythm generator for respiration (Mostly inspiratory neurons)

A

a. Dorsal Respiratory Group

88
Q

Respiratory Centers (Purpose)

a. Dorsal Respiratory Group
b. Ventral Respiratory Group
c. Pneumotaxic
d. Apneustic

Inhibits the DRG. Shortens the inspiratory phase

A

c. Pneumotaxic

89
Q

Modulate the function of the respiratory controller

A

Cerebral Cortex

90
Q

Inhibits the DRG. Shortens the inspiratory phase

A

Vagus Nerve

91
Q

Statement 1: Vagus Nerve carries primarily inhibitory impulses from the
mechanoreceptors or proprioceptors and chemical receptors
Statement 2: Double vagotomy results in a more profound apneustic breathing

a. TF
b. FT
c. TT
d. FF

(3) Cardio-Pulmo-Renal Rehabilitation (34 decks)

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