N240 Olol - Test 1 - A&p Respiratory- Test 1

Front 1

Lung Functions

Back 1

-Alveolar ventilation
-Gas diffusion
-Lung perfusion

Front 2

Structures- Lungs

Back 2

-Divided into left and right
-Left has two lobes
-Right has three lobes
-Between the lungs is the mediastinum that contains the heart, esophagus, and great vessels.
-Mucous in lungs traps bacteria and expels it by coughing.

Front 3

Structures - Airways

Back 3

-Upper airway includes the nose, nasalpharynx, oropharynx, and larynx.
-Nose warms, humidifies, and filters inspired air. By the time air reaches the alveoli it is 100% saturated with moisture.
-250 ml per day insensible water loss
-Larynx connects the upper and lower airway.
-Epiglottis closes off the larynx during swallowing.

Front 4

Lower airway

Back 4

-Trachea, bronchi, carina, bronchioles, and alveoli.
-Trachea divides into two mainstem bronchi at the level of the carina.
-Carina is sensitive and when stimulated will produce coughing.
-Right mainstem bronchus extends from the trachea more vertically than the left therefore there is a greater tendency to aspirate into the right lung.
-Right mainstem bronchus terminates into bronchioloes which terminate into alveoli.

Front 5

Structures - Gas Exchange

Back 5

-Bronchioles and alveoli are units of gas exchange.
-300 million alveoli that have a potential volume of 2500 ml.
-Everything above the terminal bronchioles and alveoli is anatomical dead space.
-Tidal volume is 500 ml, dead space 150 ml.

Front 6

Structure - Alveoli

Back 6

-Primary unit of gas exchange
-Contain two types of epithelial cells
-Type I provides structure
-Type II secrete surfactant
-Alveoli contain macrophages to ingest foreign material and remove it through the lymph system.

Front 7

Surfactant

Back 7

-A lipoprotein that coats the inside of the alveoli.
-Promotes expansion of alveoli during inspiration.
-Decreases the work of
---Breathing and
---Surface tension

Front 8

Pulmonary Circulation

Back 8

-Pulmonary artery divides into arterioles that follow the path of each bronchus and bronchiole.
-The capillary wall and alveolar wall are one cell thick, promoting gas exchange.
-If damaged can become permeable to plasma and blood entering the alveolar space.

Front 9

Chest wall and pleura

Back 9

-Chest wall consists of skin, ribs, and intercostal muscles that perform the work of breathing along with the diaphram.
-Pleural lining attached to the lungs is the visceral lining. This lining folds on itself and attaches to the chest wall as the parietal pleura.
-Pleural space – a potential space between the two linings that contains a thin layer of pleural fluid.

Front 10

Ventilation

Back 10

-The mechanical movement of gas into and out of the lungs.
-Breathing is usually involuntary with rate and depth of respiration controlled by the autonomic nervous system in response to changes in blood gas and pH levels.
-Can be voluntary during talking, eating, or holding our breath.

Front 11

Mechanics of inhalation

Back 11

-Diaphragm contracts and volume of the thoracic cavity increases.
-Negative pressure causes air to enter the lungs.
-Contraction of the external intercostals elevates the rib cage expanding the chest even more.
-Accessory muscles like the sternocleidomastoid and scalene also increase the volume of the chest.
-Expiration is passive.
-Most people sigh every 5-6 breaths. This causes surfactant to be secreted.

Front 12

Elastic recoil

Back 12

-Property of lungs which along with surface tension of water causes lungs to withdraw or collapse if they loose their relationship with the chest wall.
-It is the integrity of the pleural space that keeps lungs expanded.

Front 13

Compliance

Back 13

-A measure of the lung and chest wall distensibility.
-A decrease in compliance indicates a lung that is difficult to inflate.

Front 14

Gas Exchange

Back 14

-PaO2 is amount of oxygen dissolved in plasma.
-PAO2 is the amount of alveolar oxygen.
-SaO2 is the amount of oxygen bound to hemoglobin in comparison to the amount of oxygen hemoglobin can carry.
-Example 90% SaO2 means that 90% of hemoglobin's attachments for oxygen are bound with oxygen.

Front 15

Ventilation Perfusion Ratio

Back 15

-Segments of the lung ventilate and perfuse with differing efficiency.
-Apex of the lung ventilation exceeds perfusion.
-Base of the lung perfusion exceeds ventilation.
-Averages out to a V/Q ratio of 0.8
-Low ventilation to perfusion mucous plug
-High ventilation to perfusion PE

Front 16

Oxyhemoglobin Curve (shift to the left)

Back 16

-Shift to the left
-Hemoglobin has a greater attraction to oxygen.
-Alkalosis
-Hypocapnea
-Hypothermia

Front 17

Oxyhemoglobin Curve (shift to the right)

Back 17

-Shift to the right
-Hemoglobin has a decreased attraction for oxygen
-Acidosis
-Hypercapnea
-Hyperthermia

Front 18

Why is it so important to keep O2 Sats above 90%?

Back 18

-See GRAPH on lecture notes

Front 19

Why are we doing pulse oximetry?

Back 19

-Blood gases are expensive to perform too often

Front 20

Bohr Effect (shift to the right)

Back 20

- decreased pH
- increased Temperature
- increased PCO2
- increased 2,3-DPG

Front 21

2,3 DPG

Back 21

-found in red blood cells
-if low, then shift to the LEFT

Front 22

What is the Tidal Volume in a lung?

Dead space?

Back 22

500 ml

150 ml

Front 23

What type of epithelial cells produce surfactant?

Back 23

Type II

Type I provide structure

Front 24

How does Surfactant work?

Back 24

promotes expansion of the alveoli during inspiration

decreases work of breathing and surface tension

Front 25

It is the integrity of what that keeps lungs expanded?

Back 25

pleural space

Front 26

What is compliance?

Back 26

measure of lung and chest wall distensibility

Front 27

What is the avg V/Q ratio?

Back 27

0.8

Front 28

Hemoglobin has an attraction to what if there is a Oxyhemoglobin curve to the left?

Back 28

oxygen
causes
alkolosis
hypocapnea
hypothermia

Front 29

Hemoglobin has a decreased attraction to what if there is a Oxyhemoglobin curve to the left?

Back 29

oxygen causes
acidosis
hypercapnea
hyperthermia

Front 30

What is the name of a shift to the right on the Oxyhemoglobin scale>

Back 30

Bohr effect
decreased pH
increased: PCO2, temp, 2,3-DPG

Front 31

What in the world is 3-DPG?

Back 31

found in red bl. cells
if low then curve shifts to left