Pulmonary Flashcards
(156 cards)
Alveolar Gas equation
PAO2=
PIO2 - (PaCO2/R)
Can be approximated PAO2= 150 - PaCO2/0.8***
A-a gradient
PAO2-PaO2 = 10-15 mmHG
increased indicates underlying lung pathology
Air in the stomach on CXR in an infant be concerned w/
Early warning in the mother?
Trachealoesophageal fistula and esphageal atresa
Polyhydrominos
Most common type of tracheal esophageal fistula
C type w/ esophageal atresia and distal fistula
Type E (or H type) is the just a fistula
Diaphragm is made by the joining of what 4 structures?
Failure leads to?
septum transversum (from the cranial aspect) fuses w/ pueroperitonela folds, abdominal walls, and esophageal mesentery
Failure congenitally leads to herniation and lung hypoplasia (usually the L) polyhydraminos associated
Presentation of congenital diaphragm heniation
polyhydraminos in utero
hypoplastic lung -> cyanosis and inability to breath
flattened stomach
5 structures perforating the diaphragm and at what level?
T8 - IVC
T10 - esophagus
T12 - aorta, azygos vein, thoracic duct
innervation of the diaphragm
Phrenic C3-5
leads to referred pain to the shoulder (spleen and cholecysitis)
Aspiration pneumonia is more likely going to be found in what lobe?
R lobe due to wider and more vertical
Peanut inspiration the same but if lying down will be in the superior portion od the right inferior lobe while standing up it will be inferior portion of R inferior lobe
Importance of bronchopulmonary segments? Contains?
separated by connective tissue - has a bronchus, and 2 arteries per segment, veins are in the periphery
Spepaerates out the right 3 lobes and the L 2 lobes further
Smokers will see what transformation in their trachea
columnar ciliated cells -> stratified squamous through metaplasia
Chronic sinusitis, infertility and situs inversis?
Cause?
Kartagener syndrome
Due to dyenin not functioning leading to cilia defects all over
Important measure of fetal lung maturity
lecithen:Springomyelin ratio being greater than 2.0
See if enough dipalmitolphasphatidylcholine is being made
Product of type II pneumocytes?
dipalmitolphasphatidylcholine
other type II and I pneumocytes during injury
Role of type I pneumocytes?
gas diffusion - very thin
muscles of inspiration
- quiet
- exercise(3)
diaphragm
Sternocleidomastoid, scalenes, external intercostals
muscles of expiration
- quiet
- exercise
quiet is passive
exercise - internal intercostals, transverse abdominus, rectus abdominus, internal and external obliques
TLC is the combination of?
Functional Residual capacity and Inspiratory capacity or
Inspiratory reserve volume and Tidal volume and experatory reserve volume and residual volume
Inspiratory capacity is a combination of?
Tidal volume and inspiratory reserve volume
Vital capacity is a comination of
expiratory reserve capacity, tidal volume and inspiratory reserve capacity
Functional reserve capacity
residual volume and expiratory reserve volume
Determining the physiologic dead space formula
Dead space
= Tidal volume x [(PaCO2 - PeCO2)]/PaCO2
a= arterial
e expired air
Functional residual capacity (FRC) what is the relationship between chest wall and lungs
how does it change in emphysema?
How does it change in fibrosis?
they are balanced in their pull - airway and alveolar pressure are 0 and the intrapleural pressure is negative
in emphasymia there is increased compliance so the FRC is increased. More volume at given pressure
in fibrosis there is decreased compliance so less volume at a given pressure
Diffusion limited gases are?(2)
what does that mean?
CO and O2 (in diseased state: emphysema/fibrosis)
means that the partial pressure of the arterial will not be saturated upon leaving the lung - amount of gas carried limited by the diffusion