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cardio & pulm system > pulmonary anatomy & physiology > Flashcards

pulmonary anatomy & physiology Flashcards

week 3 (63 cards)

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1
Q

ventilation

A

act of breating - inspiration and expiration

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2
Q

respiration

A

gas and fluid exchange

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3
Q

perfusion

A

flow of blood to alveolar capillaries

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4
Q

nasal cavity

A

air condution, filter system, humidifier, temp control
- moist, sticky environment (submucosal galnds, goblet cells)

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5
Q

pharynx

A

pathway between nasal cavity (posterioly) and esophagus
- naso oro and laryngo pahrynx

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6
Q

larynx

A

bifurcates off pharynx, connecting with the trachea
- prevents aspiration; salling, ventilation and volcalization

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7
Q

when some one is swalling and aspirating what are we worrying about anatomically?

A

the trachea - anterior to esophagus and posterior to arch of aorta

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8
Q

lower: diffusion
what is acinar units?

A

Terminal respiratory
- respiratory bronchioles
- alveolar ducts
- alveiol (epithelial cells)
- gas exchange
- surfactant (type II cells)

surfactant - not present until week 24, manages surface tension, prevents alveolar collapse
24 weeks is signifcant bc this is the point where if the baby is born they will try to keep it alive

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9
Q

arterial blood gases

what is normal pH range

A

7.35-7.45

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10
Q

arterial blood gases
normal PaO2 value range

A

80-100 mmHg

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11
Q

arterial blood gases
PaCO2 normal value range

A

35mmHg-45mmHg

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12
Q

arterial blood gases

SaO2 normal percentages

A

95%-100%

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13
Q

arterial blood gases
normal HCO3 value range

A

22-26 mEq/L

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14
Q

what is bicarbonate (HCO3)

A

form of carbon dioxide in the blood
- by product of the body’s metabolism
- carried to the lungs via blood
- regulation is aided by the kidneys
- exhales as CO2

HCO3 = kidneys = metabolic

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15
Q

what are the ABG general rules?

3 things

A
  1. if pH/PaCO2 move in opposite directions from normal vlues , it is likely a respiratory problem
  2. if pH/HCO2 move in same direction from normal value, likely metabolic problem
  3. determining if pH is uncompensated, partially compensated or fully compensated
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16
Q

compensated=
partilaly compensated=
uncompensated =

A

compensated= normal pH; abnormal PaCo/HCO3
partilaly compensated= all values will be outsdie the normal range
uncompensated = abnoraml pH

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17
Q

draw uncompensated pH table

A
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18
Q

perfusion

A

capillary blood flow throughthe pumonary circulation
- necessary for gas exchange (tissue oxygenation, CO2 release)

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19
Q

perfusion
V/Q match =

A

balance between airflow and blood flow within lungs

V = ventilation Q = perfusion

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20
Q

what is the optimal V/Q ratio?

A

.8 (4V:5Q)

any varitions could lead to airway collapse and capillary vasoconstriction

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21
Q

lung properties:

surface tension

A

surfactant (complex material made of lipids and proteins)

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22
Q

lung properties
compliance

A

distensibility of the lung tissue

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23
Q

what happens when there is an imbalance with compliance

A

imbalance –> tissuestiffness, decreased lung expansion

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24
Q

lung properties:
elasticity

A

lung recoil during expiration

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25
lung properties airflow resistance
1* the turbulent upper airway
26
what are the 4 basic lung sounds
tracheal - 1:1-2 loud, hollow bronchial - 1:2 loud, manubrium, between scapula bronchovesicular - 1:1 less loud, sternal region vesicular - 2-3:1 low ptich, periphery ## Footnote first numeric indicates inspiration, second indicates expiration (ex: 1:2 = inspir:expir)
27
why do we want to test lung auscultation
- if the patient sounds bad you can auscultate quick and easy
27
abnormal lung sounds: tactile fremitus bronchophony
patient is instructed to say "99" during lung auscultation (+) if there is increased clarity instead of the normal muffled sound ## Footnote you can listen to it or feel it as they in/ex
28
abnormal lung sounds: tactile fremitus egophony
patient is instructed to say "E" during lung auscultation (+) if a clear "A" is heartd instead
29
abnormal lung sounds: tactile fremitus whispering pectoriloquy
have patient whisper a phrase like "1,2,3" (+) if heard clearly on auscultation - meaning pathologic moving throug fluid ## Footnote should normally hear nothing
30
adventitious sounds: friciton rub
pleural creaking (inspiration) can be painful (parietal)
31
adventitious sounds: crackles (rales)
- can have a fine or course sound quality (can occur during inspiration or expiration) - air moving through secretions/fluid
32
adventitious sounds: rhonchi
- low pitched, snoring (inspiration or ex) - obstruction of large airways ## Footnote can possibly have something on their neck
33
adventitious sounds: wheezes
high pitch, musical (1* expiration; overtime becomes I/E)
34
pleura
the serous memebrane, containing 2 essential coverings parietal: lines the chest wall, diaphragm, mediastinum visceral: lining the outer surface of each lung - separated by the pleural cavity
35
# respiration inspiratory muscles
- diaphragm (C3-5) - external intercostals (T1-T12)
36
# respiration compensatory/secondary inspiratory muscles
- accessory muscles - SCM - scalenes - pec minor
37
# respiration expiratory muscles
passive - none active - internal intercostal (T1-T12), abdominal muscles (T7-L1)
38
which hemisphere of the diaphragm is stronger?
R- protected and strengthenedby the liver L- weaker; more susceptible to rupture and herniation
39
what are the 3 crucial openings of the diaphragm
- vena caval - esophageal - aortic
40
Diaphragm inspiration = expiration =
- flattened diaphragm (descension) - elevated diaphragm (return to resting)
41
what is a normal amount of thoracic excursion
3-5 cm - positional and respiration dependent ## Footnote supine = improved diaphragm movement; however, abdominal cavity shifts --> decreased lung vol...supine is not ideal for ascites, pregnancy, obesity
42
what is the oxyhemoglobin curve
- how well oxygen is binding to Hgb (hemoglobin)
43
what is a hypercapnic state
its a decrease in pH on the oxyhemoglobin curve --> acidotic environment --> R shift there is an increase 2,3 diphosphoglycerate which bind to Hgb --> decreased affinity for O2 --> decreases oxygen to the tissues (exercise) simply put: condition characterized by abnormally elevated levels of carbon dioxide (CO2) in the blood, often caused by hypoventilation or impaired CO2 removal from the lungs
44
what is a hypocapnic state
increase in pH on the oxyhemoglobin curve --> alkalotic environment --> LEFT shift (>7.4 pH) there is an increased Hgb affinity for O2 --> hypothermic state aka decreased O2 to tissues simply put: condition characterized by reduced carbon dioxide in the blood, often resulting from hyperventilation (rapid or deep breathing)
45
if PaO2 is <80mmHg, small SaO2 changes lead to major?
hypoxemic changes within the blood ## Footnote pg. 95 in textbook for more info
46
describe what is occuring during inspiration/expiration at the diaphragm
inhalation: diaphragm contracts (moves down), rib cage expands as rub muscles contract exhalation: diaphragm relaxes (moves up), rib cage gets smaller as rib muscles relax
47
muscles that are involved in expiration
- internal intercostal muscles - rectus abdominis - transversus abdominis - internal obliques - external obliques ## Footnote remember quiet expiration is passive
48
we are negative pressure breathers - what is pulmonic pressure
pressure in the alveoli is lower than atmospheric pressure (thorax expansion)
49
pulmonic pressure - inspiration occurs when
- inspiratory muscle contraction expands thoracic cavity and increase lung volumes - reduces pressure in the lungs (intrapulmonic pressure) that is below atmospheric pressure (creating a negative space --> air flow into lungs)
50
pulmonic pressure - expiration occurs when
- INCREASED intrapulmonary pressure that is greater than atmospheric pressure - lung recoil + expulsion of air
51
what is pleuritic pressure ? why does pleura stick together?
- necessary balance between oppositional forces - maintaining lungs in close proximity to chest wall - allowing changes in lung vol - normal thoraicic excursion (allows lungs to move in the space) - intrapleural pressure is lower than intrapulmonic pressure
52
what is the movement of the ribs during respiration
pump handle movement - increase antero-posterior diameter of thoracic cavity bucket handle movement - elevation of ribs increase in lateral diameter of thoracic cavity
53
what is a cuirass shirt
type of negative pressure breathing apparatus that allows better accessibility to the patient and requires an airtight seal
54
draw the inspiration/expiration lung volume chart what is: - inspiratory reserve volume - maximum voluntary expiration - expiratory reserve volume - residual volume - vital capcity - functional residual capacity - inspiratory capactiy - total lung capacity - tidal volume
55
describe the neurological regulation of ventilation
- noraml breathing occurs w/out conscious awareness - automatic and involuntary (1st from medullary function, secondary from pons
56
where does conscious breathing occur in the brain?
motor cortex of frontal lobe - bypassing the brainstem, communicating directly with spinal cord ## Footnote review neural receptors from week 1 to aid in this concept
57
the medulla oblongata has what responsibility in respiratory center?
- controls automotic ventilation - responsible for rhythmicity of breathing
58
pons responsibilty in respiration
controls automatic ventilation - responsible for rate and depth of breathing
59
what part of the brain controls voluntary ventilation
cerebral cortex
60
what is the right atrial chamber pressure
0-8 mmHg ## Footnote lower than left atrial chamber
61
what is the left atrial chamber pressure
4-12 mmHg
62
what are the two parts of rubor of dependency
1. potential onset of ischemia during limb elecation 2. positive rubor after >30 seconds during limb dependency

cardio & pulm system (13 decks)

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