Week 1 Pulmonary

Question 1

what is the sternal angle?

Answer 1

-formed by articulation of manubrium with the body of the sternum
-the point from which all costal cartilages and ribs are counted
-marks the level of bifurcation of the trachea into the right and left main stem bronchi

Question 2

where does the sternal angle lie?

Answer 2

-at the level of 2nd costal cartilage
-opposite the intervertebral disc between T4&T5

Question 3

which ribs are true, false, and floating?

Answer 3

1-7 = true (vertebrosternal connection)
8-10 = false (have vertebrochondral connection)
11-12 = floating (only vertebral connection)

Question 4

what is ventilation?

Answer 4

the process of moving air in and out of the lungs

Question 5

what is the purpose of the respiratory system?

Answer 5

maximize gas exchange

Question 6

what is happening during inspiration?

Answer 6

-the diaphragm contracts and flattens elevating the lower ribs and pushing the upper ribs and sternum up and out
-chest cavity elongates and enlarges
-intrapulmonic pressure decreases allowing air to follow the pressure gradient and come in

Question 7

is expiration passive or active?

Answer 7

usually passive except during strenuous exercise (internal intercostals and abdominal muscles are used)

Question 8

what is the valsalva maneuver?

Answer 8

-the closing of the glottis following a full inspiration while maximally activating the expiratory muscles
-results in an increase in intrathoracic pressure helping stabilize the chest during lifting

Question 9

what are the types of pleuritis or pleuritic pain?

Answer 9

hemothorax (blood), pneumothorax (air), empyema (pus), and pleural effusion (swelling)

Question 9

what is pleura?

Answer 9

two membranes surrounding the lungs

Question 9

what is the hilus?

Answer 9

the point at which the nerves, vessels, and primary bronchi penetrate the parenchyma

Question 10

what is the difference between the right and left lung?

Answer 10

no middle long on the left

Question 11

where is a tracheostomy tube placed?

Answer 11

between the second and third tracheal rings

Question 12

where is gas exchanged allowing oxygen to enter into the bloodstream and carbon dioxide to leave?

Answer 12

bronchioles and alveoli

Question 13

what is fick’s law?

Answer 13

if surface area decreases or thickness increases then gas diffusion decreases
-gas diffuses through the tissue at a rate proportional to the surface area and inversely proportional to its thickness

Question 14

what is surfactant and why is it important?

Answer 14

-lipoprotein lubricant mix of phospholipids, proteins, and calcium produced by the alveolar epithelial cells
-without it our lungs would stretching out on inspiration and collapse on expiration (balloon)
-keeps surface tension on alveoli

Question 15

what is the conducting zone of the airway?

Answer 15

(dead space)
trachea, primary bronchus, bronchus, bronchi, bronchioles

Question 16

what is the transitional and respiratory zone of the airway?

Answer 16

(where gas exchange takes place)
respiratory bronchioles, alveolar ducts, alveolar sacs

Question 17

what is the difference between ventilation and respiration?

Answer 17

respiration = exchange of gases
ventilation = moving air in and out of lungs

Question 18

what is tidal volume?

Answer 18

normal breathing at rest
= between 0.4 and 1 liter per breath

Question 19

what is inspiratory reserve volume?

Answer 19

the amount of space you have above tidal volume to increase inspiratory breath at rest
= about 2.5-3.5 liters

Question 20

what is expiratory reserve volume?

Answer 20

the amount of space you have below tidal volume to breathe out

Question 21

what is force vital capacity?

Answer 21

the summation of IRV + TV + ERV
= about 3-5 liters
decreases with age or if not utilized

Question 22

what is residual lung volume?

Answer 22

the dead space you can’t breathe out
= about 0.8-1.4 liters
increases with age

Question 23

what is total lung capacity?

Answer 23

the summation of FVC + RLV

Question 24

during exercise what happens to IRV, ERV and TV?

Answer 24

IRV + ERV decrease
TV increases

Question 25

what does the amount of air ventilated depend on?

Answer 25

the maximal force vital capacity of the lungs and the velocity of flow (influenced by lung compliance)

Question 26

what is FEV1/FVC?

Answer 26

pulmonary airflow capacity
= ~85% of FVC in 1 second
obstructive diseases result in significant lower FEV1/FVC

Question 27

what does training do to lung volumes?

Answer 27

increases lung volumes except for tidal volume

Question 28

what is the purpose of the pulmonary system?

Answer 28

to maximize gas exchange
to increase exchange

Question 29

what is the most common obstructive lung condition? what is it caused by?

Answer 29

asthma
caused by irritation of the lining of the bronchioles that decreases the airway size

Question 30

what does the oxygen pressure difference do?

Answer 30

drive the movement of oxygen towards the tissues and carbon dioxide towards the atmosphere

Question 31

what is henry’s law?

Answer 31

gases diffuse from high pressure to low pressure

Question 32

what does gas diffusion rate depend on?

Answer 32

pressure differential and the solubility of the gas in the fluid

Question 33

what happens to the gas transfer capacity in pulmonary disease?

Answer 33

may be impaired by the thickening of membrane and a reduction in surface area

Question 34

what is the average arterial blood gas levels? PO2 and PCO2

Answer 34

PO2 = 100 mmHg
PCO2 = 40 mmHg

Question 35

what are the two mechanisms for O2 transport?

Answer 35

dissolved in plasms (for carotid sensors) and combined with hemoglobin

Question 36

when normal Hb level exist each dL of blood contains about how much O2?

Answer 36

20 mL

Question 37

what is happening with the blood oxygen when a person has iron deficiency anemia?

Answer 37

they have reduced oxygen carrying capacity up to half as much )2 can be carried. as a result the heart rate will increase.

Question 38

what is the oxyhemoglobin dissociation curve?

Answer 38

-illustrates the saturation of hemoglobin with oxygen at various PO2 or partial pressures of oxygen
-as the partial pressure goes up the saturation of hemoglobin goes up.

Question 39

what are the 3 methods of CO2 transport?

Answer 39

1. dissolved CO2 establishes the partial pressure of carbon dioxide in the blood (5%)
2. plasma bicarbonate in solution: carbon dioxide combines with water to form carbonic acid (60-80%). helps with buffering acids during exercise
3. bound to hemoglobin directly (20%)

Question 40

what is the haldane effect?

Answer 40

Hb interaction with O2 reduces its ability to combine with CO2. this aids in releasing CO2 in the lungs

Question 41

why does the rate and depth of breathing matter?

Answer 41

shallow breathing: only going in and out of dead space. will decrease the pressure differences and slow gas exchange at the alveolar level

Question 42

how does rate and depth of breathing affect alveolar ventilation?

Answer 42

increases

Question 43

during increased demand (exercise) what happens to rate and depth of breathing?

Answer 43

initially larger increases in depth occur, followed by increases in both rate and depth

Question 44

what is alkalosis?

Answer 44

increased pH - lungs rid of CO2

Question 45

what is acidosis?

Answer 45

decreased pH - kidneys rid bicarbonate

Question 46

what three mechanisms help regulate internal pH?

Answer 46

chemical buffers, pulmonary ventilation, renal function

Question 47

how does acid-base regulation occur?

Answer 47

takes place using chemical buffering in the blood
the renal system: becomes more basic and removes bicarbonate
the lungs remove CO2 when the blood becomes more acidic by increasing ventilation