Lung - Anatomy and Physio

Question 1

Conduction zone extends to?

Answer 1

Bronchioles and terminal bronchioles

Question 2

Cartilage ends where along respiratory tract?

Answer 2

Bronchi

Question 3

Goblet cells ends where along respiratory tract?

Answer 3

Bronchi

Question 4

Pseudostraticfied ciliated columnar epithelial cells end where along respiratory tract?

Answer 4

Terminal bronchioles

Question 5

SMCs end where along respiratory tract?

Answer 5

Terminal bronchioles

Question 6

Respiratory zone consists of?

Answer 6

respiratory bronchioles, alveolar ducts, and alveoli

Question 7

Cuboidal cells where? squamous?

Answer 7

respiratory bronchioles; alveolar ducts and alveoli

Question 8

Increase collapsing pressure by? When do alveoli have a tendency to collapse?

Answer 8

2*surface tension/radius
To increase collapsing pressure, Increase surface tension or decrease radius
Alveoli collapse during expiration

Question 9

Surfactant - made by? production begins when? Most important component? test of fetal lung maturity?

Answer 9

Type II cells starting around week 26. Dipalmitoylphosphatidylcholine. Lung mature when Lecithin:sphingomyelin ratio>2.0

Question 10

lung cells that make both Type I and Type II cells?

Answer 10

Type II cells

Question 11

Pneumocytes?

Answer 11

Type I, Type II and Clara cells

Question 12

Clara cells: histo? Function?

Answer 12

nonciliated columnar with secretory granules. Secrete component of surfactant and degrades toxins

Question 13

Inhale a foreign body - Goes into which lung?

If supine, which part of lung? If upright?

Answer 13

Right - wider and more verticle

Upper part of right inferior lobe
Lower part of right inferior lobe

Question 14

Right anterior, left superior describes?

Answer 14

Pulmonary artery to bronchus at lung hilus

Question 15

Structures perforating diaphragm?

Answer 15

I ate 10 eggs at 12

T8: IVC
T10: ESO, vagus
T12: Aorta, thoracic duct, Azygus vein

Question 16

Referred pain from the diaphragm?

Answer 16

shoulder (C5) and trapezius (C3,4)

Question 17

Inspiration muscles during exercise?

Answer 17

inSpiration - Scalene, SCMs, external intercostals

Question 18

expiration muscles during exercise?

Answer 18

rectus abdominus, internal/external obliques, transversus abdominis, internal intercostals

Question 19

Draw out lung volumes

Answer 19

p 546

Question 20

Calculation for anatomic dead space?

Answer 20

Vd = (PaCO2-PEco2)/PaCO2

Question 21

Largest contributor of dead space?

Answer 21

Apex of healthy lung

Question 22

When is inward pull pf lung balanced by outward pull of chest wall?

Answer 22

FRC (after a normal exhale)

Question 23

Hb - 2 forms?

Answer 23

Taut - low O2 affinity in tissues

Relaxed - high O2 affinity in lung

Question 24

Why does fetal Hb have higher O2 affinity?

Answer 24

Lower affinity for 2,3 BPG - prevents curve shift to the right

Question 25

Increased O2 unloading by? (mechs)

Answer 25

Increases in: Acid (binds to Heme and stabilizes unbound form) 2,3-BPG (Increased glycolysis in tissues makes more of this) CO2 Temperature increased Cl ions

Question 26

Carboxyhemoglobin?

Answer 26

Hb with CO bound. Shifts dissociated curve to the left

Question 27

low PAo2 in lungs vs other tissues?

Answer 27

vasoconstriction in lungs (shuts blood to better ventilated areas) vs vasodilation in tissues

Question 28

pt with healthy lungs: perfusion limited or diffusion limited circulation?

Answer 28

perfusion limited (gas always equilibriates by the time blood gets to end of pulmonary capillary)

Question 29

Diffusion formula? What is affected in amphysema? in Pulmonary fibrosis?

Answer 29

Area/thickness * difference in partial pressures decreased Area in emphysema. Increased thickness in fibrosis

Question 30

Pulmonary vascular resistance?

Answer 30

[P(pulmonary artery) - P (pulmonary vein)] / cardiac output

Question 31

O2 content equation?

Answer 31

(O2 binding capcity*saturation) + dissolved O2

Question 32

1 g Hb can hold how much O2? | How many grams of O2 normally in blood?

Answer 32

1.33 grams O2. 15 g/dl present normally.

Question 33

O2 binding capacity per dL blood?

Answer 33

20.1 ml O2/dL

Question 34

Decreased Hb. Affect on O2 saturation and PO2?

Answer 34

No effect

Question 35

Oxygen delivery to tissues equation?

Answer 35

Cardiac output* O2 content

Question 36

Alveolar gass equation?

Answer 36

PAo2 = PIo2 - Paco2/R PAo2 = 150 - Paco2/.08

Question 37

Hypoxemia with Increased Aa gradient? Normal Aa gradient?

Answer 37

hypoxemia, shunting, V/Q mismatch, diffusion hypoventilation, high altitude

Question 38

Hypoxemia vs hypoxia?

Answer 38

down Pao2 vs down O2 delivery

Question 39

Causes of hypoxia?

Answer 39

decreased O2 delivery to tissue. | Due to low Cardiac Output, Hypoxemia, anemia, CO poisoning

Question 40

V/Q at apex of lung? Base? changes in exercise?

Answer 40

3 vs .06 exercise - vasodilation - V/Q=1 at apex

Question 41

How is CO2 taken to lungs?

Answer 41

1) Bicarb (90%) 2) HbCO2 (carbaminoHb) 3) Dissolved

Question 42

Acute adjustment to high altitude?

Answer 42

increase ventilation

Question 43

Chronic adjustment to high altitude?

Answer 43

EPO, 2,3-BPG, increased mito, increased renal excretion of bicarbonate