Lungs Flashcards
Kartagener Syndrome
Nonfunctional cilia d/t defective dynein
Respiratory tract sinuses eustachian tubes fallopian tubes falgella of sperm
chornic infections d/t poor mucus clearance
infertility
hearing loss
50% have situs inversus
Tracheoesophageal fistulas types A-E
Type A: esophageal atresia w/o fistula - upper and lower not connected
Type B: Upper esophagus connects w/ trachea
Type C: lower esophagus connects w/ trachea - MC 85%
–> air in stomach - gastric bubble on XR
Type D: upper and lower connect w/ trachea
Type: connects w/ trachea but no atresia - “H” type
Smoking effect on trachea
trachea lined with ciliated columnar epithelium
Smoking –> metaplasia to squamous epithelium
-can’t move mucus –> chronic bronchitis
Congenital diaphragmatic hernia
abdominal contents in pleural cavity –> lung hypoplasia d/t compression
usually left side
assoc w/ polyhydramnios
Severe: flattened abdomen, cyanosis, inability to breathe normally
Sliding hital hernia
most common
GE junction displaced upward
Hour glass stomach
Paraesophageal hernia
fundus move into thorax
GE junction not moved
Innervation of diaphragm
Phrenic - C3, 4, 5
Growing diaphragm drags phrenic from cervical region down
irritation of diaphragm presents as neck and shoulder pain
Lecithin-Sphingomyelin ratio
amniotic fluid sample
ratio give estimate of lung maturity in preterm fetus
> 2.0 fetal lung mature
less than 2.0 not mature, type 2 pneumocytes not making enough surfactant
give corticosteroids to mom to help mature type 2 pneumocytes
Pulmonary circulation
decrease of alveolar O2 –> vasoconstriction to shunt blood away from parts not ventilating well to those with higher O2
COPD –> cor pulmonale
Low alveolar O2 –> chronic vasoconstriction –> pulmonary htn –> cor pulmonale –> right ventricular failure
Gas exchange limiting factors
normal lung: perfusion - how much blood in the area
Diffusion - how quickly gas moves in and out of blood
Pulmonary vascular resistance equations
delta P = QR
-Pressure, Q: perfusion, Resistance
Resistance = 8(viscosity)(Length of vessel)/pi r^4
Bronchoconstriction causes
anaphylaxis
bronchospasm
asthma
parasympathetic stimulation
decreases radius, increases resistance
Beta 2 stimulation effect on resistance
increases radius of bronchioles –> decreased resistance to air flow
FRC changes in emphysema vs pulmonary fibrosis
FRC increases in emphysema
-lungs more compliant - doesn’t resist chest wall pull
–> barrel chest
chest wall winning
FRC decreases in pulmonary fibrosis (as well as pulmonary edema, premie w/ low surfactant)
-total lung volume reduced as lungs are winning
