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A_First Aid Random Memorizing > Pulm > Flashcards

Pulm Flashcards

1
Q

when and from where does lung development come from

A

distal end of respiratory diverticulum during week 4

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2
Q

errors in which stage of development can lead to tracheoesophageal fistula

A 
embryonic stage (week 4-7)
this is because trachea, mainstem bronchi, and lobar/segmental bronchi develop
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3
Q

when do terminal bronchioles develop

A

pseudoglandular (week 5-17)

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4
Q

when is respiration capable

A

25 weeks

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5
Q

when do alveolar ducts and prominent capillary network develop

A

cannalicular (week 16-25)

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6
Q

What stage do pneumocytes and SURFACTANT start

A

saccular (week 26-birth)…mature levels of surfactant not there until 36 weeks

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7
Q

how long does it take for all adult alveoli to develop

A

8 years (300-400 million alveoli)

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8
Q

congenital diaphragmatic hernia and bilateral renal agenesis assocaited with…

A

pulmonary hypoplasia

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9
Q

recurent respiratory infections, airway compression, discrete round sharply defined fluid filled densities on CXR

A

bronchogenic cysts (abnormal budding of foregut and dilation of terminal/large bronchi

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10
Q

purpose of club cells

A

secrete component of surfactantm degrade toxins, act as reserve cells

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11
Q

what type of pneumocytes make up 97% of alveolar surface

A

type I, thin and optimal for gas diffusion

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12
Q

components of surfactant

A

mix of lecithins (most important one is dipalmitoylphsphatidylcholine - DPPC)

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13
Q

formula for collapsing pressure

A

(2 x surface tension)/radius
so decrease collapsing pressureby decreasing surface tension
alveoli more likely to collapse during EXPIRATION

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14
Q

these cells secrete surfactant from lamellar bodies, are cuboidal and clustered and are precursors to type I and type II cells

A

type II pneumocytes

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15
Q

how does surfactant affect lung recoil and compliance

A

decrease recoil, increase compliance

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16
Q

which cells proliferate during lung damage

A

type II pneumocytes

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17
Q

prenatal screening has decreased Lecithin/sphingomyelin ratio in amniotic fluid (<1.5)…risk for….

A

neontal respiratory distress syndrome (NRDS) (surfactant deficiency leading to increasd surface tension and alveolar collapse)

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18
Q

what cardiac complication is NRDS prone to

A

PDA (due to persistantly low O2 tension)

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19
Q

gi complication of NRDS

A

NEC

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20
Q

risk of giving O2 in NRDS

A

RIB

retinopathy of prematurity, intraventricular hemorrhage, bronchopulmonary displasia

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21
Q

components of large airways

A

nose, pharynx, larynx, trachea, bronchi

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22
Q

components of small airways

A

bronchioles and terminal bronchioles (least airway resistance here due to largely parallel orientaiton)

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23
Q

large and small airways are called “anatomic dead space” why?

A

do not participate in gas exchange

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24
Q

cellular make up of conducting zone

A

cartilage and goblet cells extend to end of bronchi

psuedostratified clilated columnar in bronchus which transition to cuboidal as you leave terminal bronchioles

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25
where to airway smooth muscle cells extend
until the end of terminal bronchioles
26
What makes up the respiratory zone
respiratory bronchioles, alveolar ducts, alveoli (all participate in gas exchange)
27
Cellular make up of respiratory zone
mostly cuboidal in respiratory bronchioles then transition into simple squamous cells in alveoli
28
where to cilia terminate
repistoary bronchioles
29
where to cartilage and goblet cells extend to
end of bronchi
30
what cell type is found in brochioles, terminal bronchioles, and respitaory bronchioles
club cells! "clara cells"
31
which lung has the lingula
left lobe
32
What is the relation of carina to ascending and descending aorta
carina (split of right and left bronchus) is posterior to ascending aorta and anteromedial to descending aorta
33
Which side does aspirations tend to occur more and why
right side because mainstem bronchus is more wide,shorter, and more vertical than the left
34
where do things aspirate when you're supine vs standing
supine - upper right lobe, posterior | standing - basal segment of right lower lobe (preferentially)
35
What does RALS mean
refers to relation of pulmonary artery to bronchus in right lung, pulmonary artery is right of bronchus in left lung, pulmary artery is superior to bronchus
36
What penetrates diaphragm at T8
IVC, right phrenic nerve
37
What penetrates diaphragm at T10
esophagus, vagus nerve (CN 10, 2 trunks)
38
What penetrates diaphragm at T12
aorta (red), thoracic duct (white), azygos vein (blue)
39
whre does the common carotid bifurcate
C4
40
where does the abdominal aorta bifurcate
L4
41
where does the trachea bifurcate
T4
42
where can pain from diaphragm radiate
shoulder (C5) and trapezius ridge (C 3,4)
43
lung volume that can't be measured by spirometry
any measurement that includes RESIDUAL VOLUME
44
air that can be inhaled after normal exhalation
inspiratory capacity
45
air that can still be breathed in after normal inspiration
inspiratory reserve volume
46
air that can be breathed out after normal expieration
expiratory reserve volume
47
how to calculate inspiratory capacity
IRV + TV
48
how to calculate vital capacity
TV + IRV + ERV....volume of air that can be exhaled after MAXIMAL respiration
49
how to calculate volume of physiologic dead space
``` (Taco) x (Peco - Paco)/Paco Vt X ([Peco-Paco)/Paco) ```
50
How to calculate FRC (functional residual capacity(
volume of air left in lungs after normal expiration
51
chest tube placement at 5th intercostal space at mid axilarry line pierces what muscle
serratus anterior
52
how do high altitudes affect blood pH, PaO2, PaCO2, and plasma HCO3 when you're there for more than 2 days
high altitude = less PaO2 = trigger hyperventilation = less PaCO2 (respiratory alkalosis) = 2 days later compensation for respiratory alk by lowering HCO3
53
normal pO2 room air/trachea normal pO2 expiratory in alveoli normal pCO2 expiratory in alveoli
breathed in air has pO2 160 which will decrease to arteries during expiration will increase PVR due to less radial 150 mmhg in trachea...as it gets to alveoli it will equilibrate to about 104 mmhg...meanwhile blood being brought into alveoli for gas exchange will bring about pCO2 of 40 mmhg if there is a perfusion defect, PE for example, tracheal pO2 and alveolar pO2 would equilibrate at 145 and pCO2 would be low
54
when is PVR the lowest
fucntional residual capacity (volume after normal expiration) at max inspiration and max expiration, high lung volumes will stretch due to expanding alveoli and extra alveolar
55
how does interstitial lung disease affect lung volume, elastic recoil, and radial traction on airways
decreases lung volume due to fibrosis fibrotic tissue will increase elastic recoil because fibrotic tissue will have INCREASED radial traction on airways this will decrease FVC which will increase FEV1/FVC ratio
56
patient prior hx of TB that was treated in the past develops hemoptysis with no fevers night sweats or weight loss...imaging shows old cavities filled with new round mass
aspergillus colonization
57
what nerve to stimulate in OSA with loud snoring/gasping rspirations
hypoglossal....this will move tongue forards and increase anteroposterior diameter of airway reducing number of apneic events by holding airway open
58
SOB with normal PaO2, nml Sa02, lowered O2 conent
anemia
59
nml PaO2, nml Sa02 and increased O2 content
polycythemiaa
60
decreased PaO2, decreased Sao2, decreased O2 content
high altitiude
61
SOB with nml PaO2, SaO2, and oxygen content
cyanide poising
62
major virulence factor causing epiglottitis in Hflu
``` polysaccaride capsule (PRP, polyribosylribitol phosphate) Hib vaccine is composed of PRP conjugated to tetanus toxoid) ```
63
piriform recess in larynx houses what nerve
``` internal laryngeal nerve (branch of superior laryngeal nerve CNX)....carries only sensory fibers if damged (i.e. foreign body)...lose cough reflex ```
64
which cardiac anomaly is associated with increased risk of circle of willis abnormalities, intracerebral hemorrhage, and AVMs?
coarctation of aorta
65
what pattern of breathing is favored (decreased work o fbreathing) for diseases with increased elastic resistance vs obstructive disease
elastic resistance - quick shallow breaths, work o fbreathing goes down as RR goes up obstructive - deep long breaths...work of breath goes up the faster you breathe
66
how long do you have to be vegetarian to become vitb12 deficiency and get anemia
years!!!!!!!!!!!! | if you get a lil hoe who's only been vegetarian for a few months, she mostly likely got IDA from her period yo
67
most common predisposing condition to native valve endocarditis in developing and non developing nations
MVP - developed | rheumatic heart dx - nondeveloped
68
malignant cells often show decreased binding of integrin with....
fibronectin, colagen, and laminin | all components of normal extracellular matrix
69
composition of benign lung hamartomas
native tissue to lung but disorganized cartilage, fibrous and adipose tissue NOT ALVEOLAR TISSUE (bronchioalveolar carcinoma)
70
How far to epithelial cilia reach
terminal bronchioles | goblet cells, glands, cartilage only go up to respitary bronchioles
71
what does left heart failure do to lung compliance
backed up fluid accumulation into lungs WILL INCREASE lung compliance
72
MOA of vareniciline
partial agonist to nicotine (a4B2 nicotininc) receptor so will reduce withdrawal cravings while slightly inducing some weak reward effects of normal nicotine
73
MOA of succinylcholine
deploarizing block prevents repolarizing of motor end plate....has two phases first decreases but maintains constant stimulation in phase I in phase II there is a fading of response across multiple stimulations
74
MOA of vecuronium
NONdepolarizing nmj block....depolarizes ....progressive reduction of train of four stimulation immediately by competitively inhibiting post synaptic
75
pancytopenia, bone marrow biopsy empty fat cells, no LAD or splenomegaly
mcc idiopathic aplastic anemia
76
what changes are seen 0-4 hours after post MI in myocardium
NONE BITCH | takes 4 hours to see changes
77
asian male smoker with painful foot ulcers and exertional calf pain demonstrates hypersensitivity to intradermal injected tobacco extract
buerger's disease segmental thrombosing vasculitis that extends into contiguous veins and nerves affects medium sized vessles priniipally tibila and radial arteries
78
BRCA1BRCA2 responsbile for
tumor suppressor genes involved in DNA repair

A_First Aid Random Memorizing (17 decks)

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