Respiratory

Question 1

Nasal meatus

Answer 1

Spaces b/w turbinates - filter, warm and humidify air

Question 2

Turbinates

Answer 2

Projections w/in nose

Question 3

Conchae

Answer 3

Nasal bones that form turbinates

Question 4

Nares

Answer 4

Filter, warm and humidify air

Question 5

Mediastinum

Answer 5

Space b/w lungs

Trachea and heart sit w/in mediastinum

Question 6

Internal vs external intercostals

Answer 6

Internal = inspiration
External = expiration

Question 7

Pleura

Answer 7

Fluid-filled lining around lungs - visceral (lung-side) and parietal (rib-side)

Question 8

Hilum

Answer 8

Where veins, arteries, lymph and bronchi enter lungs

Question 9

Trace the respiratory tract

Answer 9

Nasopharynx–> oropharynx–> hypopharynx–> larynx (epiglottis, vocal cords, thyroid cartilage, crichoid cartilage)–> trachea–> lobar bronchi–> segmental–> subsegmental–> –> –> bronchioles–> alveoli

Question 10

Number of alveoli in children/adults

Answer 10

25/300 million

Question 11

Composition of bronchial walls

Answer 11

Goblet cells (musin)
Cilia
Phagocytes
Smooth muscle
Cartilage and collagen

Question 12

Pores of Kohn

Answer 12

Ports b/w alveoli

Question 13

Acinus

Answer 13

Cluster of alveoli

Question 14

Lung stretch receptors

Answer 14

Involved in reflex action - prevents over-inflation of lungs

Question 15

Tidal volume

Answer 15

Amount of air moved out of the lungs during normal respiration
Normal = 5-6 liters

Question 16

Accessory respiratory muscles

Answer 16

Accessory Inspiration - sternocleidomastoid, scalenes

Accessory Expiration - external and internal obliques, rectus abdominis, transversus abdominis

Question 17

Compliance

Answer 17

Ability to distend

Question 18

Functional residual capacity (FRC)

Answer 18

Amount left in lungs after a normal, passive expiration

Residual volume) + (expiratory reserve

Question 19

Alveolar and pleural pressures

Answer 19

Alveoli (PA) = -1 to +1

Pleural = -7.5 to -5

Question 20

Transpulmonary pressure

Answer 20

Difference b/w pleural and alveolar pressures
Pressure that the solid container is seeing
Positive - lung expands
Negative - lung contracts

Question 21

Total lung capacity

Answer 21

Maximum air lung can hold; approx. 7 liters

Question 22

Residual volume

Answer 22

Amount still left after a forceful exhalation

Question 23

Vital capacity

Answer 23

Total lung capacity minus residual volume

Question 24

Transmural pressure

Answer 24

Pressure across a wall - sum of the lung and chest wall pressures
Pressure that the solid container is seeing
Equals zero at resting, + at inspiration and - at expiration

Question 25

Types of cells in alveoli

Answer 25

Type I - structural Type II - surfactact J - unknown Phagocytes

Question 26

Partial pressures of O2 in alveoli and capillaries

Answer 26

PA02 - 104 mmHg | Venous mixed blood - 40 mmHg

Question 27

Respiratory rate

Answer 27

Breaths/minute | Normal = 12-16

Question 28

Minute ventilation

Answer 28

(Respiratory rate) x (tidal volume) = Volume of air moved per minute (Liters/minute) Normal = 5-8 L/min

Question 29

Hypoxemia vs Hypoxia

Answer 29

Low P02 in the blood vs an organ

Question 30

Hypoventilation

Answer 30

Inadequate to keep PCO2 from rising above normal

Question 31

V/Q

Answer 31

Ventilation/Perfusion Normal = .8 V/Q < .8 = inadequate ventilation, blood is shunted V/Q > .8 = ventilation of dead space

Question 32

Vital capacity

Answer 32

(Inspiratory reserve) + (tidal volume) + (expiratory reserve)

Question 33

Inspiratory capacity

Answer 33

(Tidal volume) + (inspiratory reserve)

Question 34

Total lung capacity

Answer 34

(Inspiratory reserve) + (tidal volume) + (expiratory reserve) + (residual volume)

Question 35

Functional residual capacity

Answer 35

(Expiratory reserve) + (residual volume)

Question 36

FEV1

Answer 36

Fraction of expired air exhaled in first second

Question 37

Normal (FEV1)/(FVC)

Answer 37

.8

Question 38

Obstrictive vs restrictive problems

Answer 38

``` Obstruction = bronchitis, asthma, emphysema; loss of recoil, loss of volume, increase in residual volume or decrease in airway radius Restriction = fibrosis, obesity, pulmonary edema; prevent lungs from expanding or filling; loss of compliance ```

Question 39

DRG/VRG

Answer 39

Dorsal respiratory group - auto rhythm, primary respiratory center, innervates diaphragm and inspiratory intercostals Ventral respiratory group - provides extra help for inspiration/expiration, innervates larynx and vocal cords

Question 40

How do obstructive problems look on Flow-volume and volume-time curves?

Answer 40

``` Flow-volume = bowl shaped Volume-time = takes longer to reach plateau ```

Question 41

How do restrictive problems look on flow-volume and volume-time curves?

Answer 41

``` Flow-volume = missile shaped Volume-time = plateaus like normal but w/lower volume ```

Question 42

Pressures in respiratory system

Answer 42

``` Pleura = -5 Alveoli = -1 to +1 ```

Question 43

Bohr effect

Answer 43

As H+, temp, CO2 and 2,3-BPG increase hemoglobin oxygen affinity decreases (right-shift)

Question 44

Oxygen hemoglobin affinity curve

Answer 44

``` Right-shift = decrease in affinity (acidic, hypercapnic, hyperthermic) Left-shift = increase in affinity (alkalosis, hypocapnic, hypothermic) ```

Question 45

Hyaline membrane disease

Answer 45

aka infant resp. distress syndrome - premies don't produce surfactant, alveoli collapse

Question 46

Right-to-left and left-to-right shunting

Answer 46

Right-to-left (septal defect) causes hypoxia; left-to-right (patent ductus arteriosus) doesn't

Question 47

p50

Answer 47

Partial pressure of oxygen at which hemoglobin is 50% saturated Increased p50 = right shift and decrease in affinity - requires higher PaO2 to become 50% saturated Decreased p50 = left shift and increase in affinity - requires lower Pa02 to become 50% saturated