Respiratory - Anatomy + Physiology

Front 1

Conducting zone of respiratory tree

Back 1

From nose to terminal bronchioles

Front 2

Anatomic dead space is equal to

Back 2

Conducting zone of respiratory tree (from nose to terminal bronchioles)

Front 3

Cartilage and goblet cells are found in conducting zone until which level?

Back 3

End of bronchi

Front 4

Pseudostratified ciliated columnar cells, smooth muscle cells extend to which level of conducting zone?

Back 4

Terminal bronchioles

Front 5

Respiratory zone consists of

Back 5

Respiratory bronchioles, alveolar ducts, alveoli

Front 6

Epithelial cell type in respiratory bronchioles

Back 6

Cuboidal cells

Front 7

Type I pneumocytes function

Back 7

Squamous cells lining alveoli: gas exchange

Front 8

Type II pneumocytes function

Back 8

Secrete pulmonary surfactant to prevent atelectasis
Precursor to type I cells
Proliferate during lung damage

Front 9

Clara cells function

Back 9

Secretes surfactant component, degrades toxins, acts as reserve cells

Front 10

Collapsing pressure formula

Back 10

P = 2(surface tension)/radium

Front 11

Law of Laplace

Back 11

Alveoli tend to collapse with expiration as radius decreases

Front 12

Components of surfactant

Back 12

Lecithins - dipalmitoylphosphatidylcholine

Front 13

When does surfactant synthesis begin in fetus?

Back 13

Week 26; mature levels reached at week 35

Front 14

Lung gross anatomy

Back 14

Right lung: 3 lobes
Left lung: 2 Lobes + Lingula

Front 15

Relation of pulmonary artery to bronchus in R and L hilus

Back 15

RALS
R: artery anterior to hilus
L: artery superior to hilus

Front 16

Structures passing through diaphragm at T8, T10, T12

Back 16

T8: IVC
T10: esophagus, vagus
T12: aorta, thoracic duct, azygos vein

Front 17

Nerve innervating diaphragm

Back 17

Phrenic - C3, C4, C5

Front 18

Location of diaphragmatic referred pain

Back 18

Shoulder (C5), trapezius ridge (C3, 4)

Front 19

Forced inspiration: which muscles are used

Back 19

External intercostals, scalene muscles, sternocleidomastoid

Front 20

Forced expiration: which muscles are used

Back 20

Rectus abdominis, internal and external obliques, transversus abdominis, internal intercostals

Front 21

Inspiratory reserve volume

Back 21

Air that can be breathed in after normal inspiration

Front 22

Tidal volume: typical amount

Back 22

500 mL

Front 23

Expiratory reserve volume

Back 23

Air that can be breathed out following normal expiration

Front 24

Residual volume

Back 24

Air that is remaining in lungs after maximal expiration
*Cannot be measured on spirometry*

Front 25

Inspiratory capacity

Back 25

Tidal volume + Inspiratory reserve volume

Front 26

Functional residual capacity

Back 26

Volume of air in lungs after normal expiration

Front 27

Vital capacity

Back 27

TV + IRV + ERV; maximal amount of air expired after maximal inspiration

Front 28

Total lung capacity - amount

Back 28

6L

Front 29

Largest contributor of functional dead space in lung

Back 29

Apex

Front 30

Lung & chest wall elastic tendencies

Back 30

Lung: collapse inward
Chest wall: expand outwards

Front 31

Lung-chest wall system pressure at FRC

Back 31

Atmospheric; tendencies of lung and chest wall are balanced

Front 32

Lung compliance is decreased in which conditions?

Back 32

Pulmonary fibrosis, pneumonia, pulmonary edema

Front 33

Lung compliance increased in which conditions?

Back 33

Emphysema, normal aging

Front 34

HbA subunits

Back 34

2a2b

Front 35

HbF subunits

Back 35

2a2y

Front 36

Methemoglobin

Back 36

Oxidized form of Hb (ferric) with increased cyanide affinity

Front 37

Treatment of methemoglobinemia

Back 37

Methylene blue

Front 38

Drug that forms methemoglobin

Back 38

Nitrites

Front 39

Carboxyhemoglobin

Back 39

Hb-CO: decrease in O2 binding capacity, decreased O2 unloading in tissues

Front 40

Factors causing right shift in O2-Hb curve

Back 40

CADET:
CO2
Altitude/Acid
2,3-DPG
Exercise
Temperature

Front 41

Partial pressure of O2 at which Hb is 50% saturated

Back 41

26 mmHg

Front 42

Decrease in PAO2 causes what change in pulmonary vessels?

Back 42

Hypoxic vasoCONSTRICTION

Front 43

Diffusion equation

Back 43

Vgas = Area/Thickness x Dk(P1-P2)
Dk(P1-P2) = pressure difference

Front 44

Perfusion limited circulation - when does gas equilibrate?

Back 44

Early along length of pulm capillary (normal health)

Front 45

Diffusion limited circulation seen in which conditions?

Back 45

Emphysema, fibrosis

Front 46

Normal pulmonary artery pressure

Back 46

10-14 mmHg

Front 47

Pulmonary HTN value

Back 47

> 25 mmHg

Front 48

Pulmonary HTN histological changes

Back 48

Arteriosclerosis, medial hypertrophy, intimal fibrosis of pulm arteries

Front 49

Cause of primary pulmonary HTN

Back 49

BMPR2 gene mutation - loss of inhibition of vascular smooth muscle proliferation

Front 50

Cause of secondary pulmonary HTN

Back 50

COPD, mitral stenosis, recurrent thromboemboli, autoimmune disease, left-to-right shunt, sleep apnea, high altitude

Front 51

Pulmonary vascular resistance formulas

Back 51

PVR = [ P(pulm artery) - P (L atrium)] / CO
PVR = [Qx8nl]/[COx3.14r^4]

Front 52

O2 content of blood calculation

Back 52

O2 content = (O2 binding capacity x % sat) + dissolved O2

Front 53

How much O2 is bound to 1 g Hb?

Back 53

1 g Hb = 1.34 mL O2

Front 54

Normal Hb amount in blood

Back 54

15 g/dL

Front 55

O2 binding capacity of blood

Back 55

20.1 mL O2/dL

Front 56

When does cyanosis result in relation to amount of deoxyHb?

Back 56

When deoxygenated Hb > 5 g/dL

Front 57

Oxygen delivery to blood calculation

Back 57

O2 delivery = CO x O2 content of blood

Front 58

Alveolar gas equation

Back 58

PAO2 = PIO2 - [PaCO2/R]
which is equal to
PAO2 = 150 - PaCO2/0.8

Front 59

Normal A-a oxygen gradient

Back 59

= PAO2 - PaO2 = 10-15 mmHg

Front 60

Hypoxemia, hypoxia, ischemia definitions

Back 60

Hypoxemia: Decrease in PaO2 (arterial)
Hypoxia: decreased O2 delivery
Ischemia: loss of blood flow

Front 61

Hypoxemia causes if A-a gradient is normal

Back 61

High altitude
Hypoventilation

Front 62

Hypoxemia causes if A-a gradient is increased

Back 62

V/Q mismatch
Diffusion limited
R --> L shunts

Front 63

Hypoxia causes

Back 63

Decreased CO
Hypoxemia
Anemia
CO poisoning

Front 64

V/Q values at apex vs. lung base

Back 64

Apex: V/Q = 3 (more ventilation than perfusion)
Lung base: V/Q = 0.6 (more perfusion than ventilation)

Front 65

Ventilation and perfusion at apex vs. lung base

Back 65

More ventilation and perfusion take place in lung base than in apex

Front 66

V/Q = 0 indicates what?

Back 66

No ventilation (ie. airway obstruction)

Front 67

V/Q = infinity indicates what?

Back 67

No perfusion (eg. pulm embolus); physiological dead space

Front 68

Carbaminohemoglobin

Back 68

HbCO2 - CO2 bound to N terminus of globin, favours O2 unloading

Front 69

Haldane effect + location of activity

Back 69

Oxygenated Hb --> H+ dissociation from Hb --> favours CO2 release from RBCs; lungs

Front 70

Bohr effect + location of activity

Back 70

Increased H+ from tissues --> unloading of O2 from Hb; periphery

Front 71

Physiological response to high altitudes

Back 71

Hyperventilation
Increase in - EPO (rise in Hct, Hb), 2,3-DPG
Increase renal HCO3- excretion (compensate for respiratory alkalosis)
Hypoxic vasoconstriction

Front 72

Physiological response to exercise

Back 72

Hyperventilation
Uniform V/Q ration in all lung fields
Decrease in pH, increase in 2,3-DPG
NO changes in PaO2 and PaCO2