Anatomy and Physiology

Question 1

Lateral borders of the trachea run ___ into the ___

Answer 1

perpendicular into the suprasternal notch

Question 2

The sternal angle AKA angle of Louis the point where what attaches

Answer 2

The point of anterior attachment of the 2nd rib and the tracheal bifurcation

Question 3

True ribs

Answer 3

1 to 6 - AKA costosternal ribs - they have a single anterior costchondral attachment to the sternum

Question 4

False ribs

Answer 4

7-10 - AKA costochondral ribs - they share costochondral attachments before attaching anteriorly to the sternum

Question 5

Ribs 11 and 12

Answer 5

Floating ribs - or costovertebral ribs

They have no anterior attachment

Question 6

Posterior border of the sternum

Answer 6

vertebral column from T1 to T12

Question 7

Upper airway consists of what

Answer 7

Nose or mouth
Pharynx (used for both resp. and dig)
Larynx (connects pharynx to trachea)

Question 8

Lower airways

Answer 8

Conducting airways = trachea to terminal bronchioles (transport air ONLY)
Respiratory unit = resp bronchioles, alveolar ducts, alveolar sacs, alveoli - diffusion of gas occurs through all of these!

Question 9

Right lung divides into

Answer 9

3 lobes by oblique and horizontal fissure lines
Each lobe divides into segments
10 segments total

Question 10

Left lung divides into

Answer 10

two lobes by single oblique fissure line
Each lobe is divided into segments
8 segments total

Question 11

Parietal pleura covers

Answer 11

Inner surface of thoracic cage, diaphragm, and mediastinal border of the lung

Question 12

Visceral pleura covers

Answer 12

Wraps outer surface of the lung including the fissure lines

Question 13

Intrapleural space is what

Answer 13

the potential space between the two pleura that maintains the approximation of the rib cage and the lugs allowing forces to be transmitted from one structures to another

Question 14

Primary muscle of inspiration

Answer 14

diaphragm

Question 15

When the diaphragm is at rest the hemidiaphragm is where

Answer 15

arched high into the thorax

Question 16

When the diaphragm contracts what happens

Answer 16

the central tendon is pulled downward - flattening the dome

The result is protrusion of the abdominal wall during inhalation

Question 17

Additional primary muscles of inhalation besides diaphragm include

Answer 17

portions of the intercostals

Question 18

Accessory muscles of inspiration are used when

Answer 18

when a more rapid or deeper inhalation is required or with disease states

Question 19

Accessory muscles of inspiration include what

Answer 19

Upper two ribs raised by SCM
Rest of ribs raised by levator costarum and serratus
With fixed shoulder girdle, trap, pectorals, and serratus can be mm of inspiration

Question 20

Expiratory muscles of ventilation - Resting exhalation results from what

Answer 20

a passive relaxation of the inspiratory muscles and the elastic recoil tendency of the lung

Question 21

Expiratory muscles are used when

Answer 21

a quicker and/or fuller expiration is desired, as in exercise or disease states

Question 22

Expiratory muscles include

Answer 22

quadratus lumborum, portions of intercostals, muscles of abdomen and triangularis sterni

Question 23

Pts who lack abdominal musculature (like SCI) tend to have what resting position of diaphragm

Answer 23

a lower resting position

decreasing inspiratory reserve

Question 24

The more upright the body position, the ___ the diaphragm and ___ the inspiratory capacity

Answer 24

The lower the diaphragm

Lower inspiratory capacity

Question 25

The more supine the body position the more ____the diaphragm

Answer 25

the more adventitious the position of the diaphragm

Question 26

Mechanics of breathing -

Answer 26

Elastic recoil of lung parenchyma pulls lungs and pleura and thorax into position of exhalation (inward pull) Bony thorax pulls thorax and pleura and lungs into position of inspiration (outward pull)

Question 27

Resting end expiratory pressure (REEP) is what

Answer 27

the point of equilibrium where the forces in mechanics of breathing are balanced Occurs at end tidal expiration

Question 28

Tidal volume

Answer 28

volume of gas inhaled (or exhaled) during a normal resting breath

Question 29

Inspiratory reserve volume

Answer 29

volume of gas that can be inhaled beyond a normal resting tidal inhalation

Question 30

Expiratory reserve volume

Answer 30

volume of gas that can be exhaled beyond a normal resting tidal exhalation

Question 31

Residual volume

Answer 31

volume of gas that remains in the lungs after ERV has been exhaled

Question 32

Inspiratory capacity

Answer 32

(IRV + TV) | The amount of air that can be inhaled from REEP

Question 33

Vital capacity

Answer 33

(IRV + TV + ERV) the amount of air that is under volitional control measured as forced expiratory vital capacity (FVC)

Question 34

Functional residual capacity

Answer 34

(ERV + RV) | the amount of air that resides in the lungs after normal resting tidal exhalation

Question 35

Total lung capacity

Answer 35

(IRV + TV + ERV + RV) | the total amount fo air that is contained within the thorax during a maximum inspiratory effect

Question 36

Flow rates - FEV1 (forced expiratory volume in 1 second)

Answer 36

The mount of air exhaled during the first second of FVC | In healthy, at least 70% of FVC is exhaled in first second

Question 37

Forced expiratory flow rate (FEF)

Answer 37

the slope of a line drawn between the points 25% and 75% exhaled volume on a forced vital capacity exhalation curve

Question 38

FEF vs. FEV1

Answer 38

FEF is more specific to smaller airways and shows more dramatic change with disease than FEV1

Question 39

Arterial oxygenation is what

Answer 39

The ability of arterial blood to carry oxygen

Question 40

Arterial oxygenation - Partial pressure of oxygen in the arterial blood (PaO2) depends on

Answer 40

the integrity of the pulmonary system, the circulatory system and the Pa)2

Question 41

Arterial oxygenation - PaO2 at room air is

Answer 41

95-100 mm Hg

Question 42

Arterial oxygenation - Mild hypoxemia is what (number)

Answer 42

Less than 90 mm Hg PaO2

Question 43

Arterial oxygenation - Hyperoxemia is what (number)

Answer 43

Over 100 for PaO2

Question 44

Arterial oxygenation - Fraction of oxygen in the inspired air (FiO2) is what

Answer 44

percentage of oxygen in air based on a total of 1.00

Question 45

Arterial oxygenation - FiO2 at room air is what

Answer 45

21% oxygen - usually written as 0.21

Question 46

Arterial oxygenation - Supplemental oxygen is usually given when PaO2 falls below

Answer 46

55mm Hg

Question 47

Alveolar ventilation is what

Answer 47

ability to remove carbon dioxide from pulmonary circulation and maintain pH

Question 48

Alveolar ventilation - pH indicates what

Answer 48

the concentration of free floating hydrogen ions within the body

Question 49

Alveolar ventilation - pH norm

Answer 49

7.35-7.45

Question 50

Alveolar ventilation - PaCO2 is what

Answer 50

Partial pressure of carbon dioxide within the arterial blood

Question 51

Alveolar ventilation - PaCO2 norm

Answer 51

35-45 mm Hg

Question 52

Alveolar ventilation - Hypercapnea is what (number) and Hypocapnea is what (number)

Answer 52

Hyper is over 45 | Hypo is less than 35

Question 53

Alveolar ventilation - an increase in PaCO2 does what to pH

Answer 53

Decreases it

Question 54

Alveolar ventilation - HCO3 is what

Answer 54

amount of bicarbonate ions within the arterial blood

Question 55

Alveolar ventilation - HCO3 norm

Answer 55

22-28 mEq/L

Question 56

Alveolar ventilation - HCO3 removal or retention changes pH how

Answer 56

direct relationship | more you have, the higher the pH

Question 57

Optimal respiration occurs when

Answer 57

ventilation and perfusion are matched

Question 58

Dead space is what

Answer 58

a space that is well ventilated but in which no respiration (gas exchange) occurs

Question 59

Shunt

Answer 59

No respiration occurs because of a ventilation abnormality Complete atelectasis of a respiratory unit allows the blood to travel through the pulmonary capillary without gas diffusion

Question 60

Effect of body position on ventilation perfusion relationship - upright position

Answer 60

Perfusion is gravity dependent In upright, more pulmonary blood is found at the base of the lung Ventilation - at static the apical alveoli are fuller but with inspiration the base gets air

Question 61

Ventilation perfusion ratio (V/Q) -

Answer 61

the ratio of pulmonary alveolar ventilation to pulmonary capillary perfusion

Question 62

Effect of body position on ventilation perfusion relationship - upright position - V/Q ratio

Answer 62

apices are gravity independent with the lowest blood flow (Q) in upright position There is more air than blood though so you have a high V/Q ratio `

Question 63

Effect of body position on ventilation perfusion relationship - upright position - other positions

Answer 63

all positions will give you three zones - gravity independent, middle, gravity dependent The gravity ind area of the lung acts as dead space The gravity dep area of the lung acts as a shunt