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31 Cards in this Set

  • Front
  • Back
Lung Functions
-Alveolar ventilation
-Gas diffusion
-Lung perfusion
Structures- Lungs
-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.
Structures - Airways
-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.
Lower airway
-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.
Structures - Gas Exchange
-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.
Structure - Alveoli
-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.
Surfactant
-A lipoprotein that coats the inside of the alveoli.
-Promotes expansion of alveoli during inspiration.
-Decreases the work of
---Breathing and
---Surface tension
Pulmonary Circulation
-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.
Chest wall and pleura
-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.
Ventilation
-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.
Mechanics of inhalation
-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.
Elastic recoil
-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.
Compliance
-A measure of the lung and chest wall distensibility.
-A decrease in compliance indicates a lung that is difficult to inflate.
Gas Exchange
-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.
Ventilation Perfusion Ratio
-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
Oxyhemoglobin Curve (shift to the left)
-Shift to the left
-Hemoglobin has a greater attraction to oxygen.
-Alkalosis
-Hypocapnea
-Hypothermia
Oxyhemoglobin Curve (shift to the right)
-Shift to the right
-Hemoglobin has a decreased attraction for oxygen
-Acidosis
-Hypercapnea
-Hyperthermia
Why is it so important to keep O2 Sats above 90%?
-See GRAPH on lecture notes
Why are we doing pulse oximetry?
-Blood gases are expensive to perform too often
Bohr Effect (shift to the right)
- decreased pH
- increased Temperature
- increased PCO2
- increased 2,3-DPG
2,3 DPG
-found in red blood cells
-if low, then shift to the LEFT
What is the Tidal Volume in a lung?

Dead space?
500 ml

150 ml
What type of epithelial cells produce surfactant?
Type II

Type I provide structure
How does Surfactant work?
promotes expansion of the alveoli during inspiration

decreases work of breathing and surface tension
It is the integrity of what that keeps lungs expanded?
pleural space
What is compliance?
measure of lung and chest wall distensibility
What is the avg V/Q ratio?
0.8
Hemoglobin has an attraction to what if there is a Oxyhemoglobin curve to the left?
oxygen
causes
alkolosis
hypocapnea
hypothermia
Hemoglobin has a decreased attraction to what if there is a Oxyhemoglobin curve to the left?
oxygen causes
acidosis
hypercapnea
hyperthermia
What is the name of a shift to the right on the Oxyhemoglobin scale>
Bohr effect
decreased pH
increased: PCO2, temp, 2,3-DPG
What in the world is 3-DPG?
found in red bl. cells
if low then curve shifts to left