Respiratory Physiology Flash Cards

Front 1

Clara cells have what function? Describe the cell type.

Back 1

Nonciliated columnar cell with secretory granules. These secretory granules secrete components of surfactant and also degrade toxins.
Clara cells act as reserve cells

Front 2

Oblique fissure on which lobe

Back 2

Right lobe

Front 3

Aspirate a peanut upright

Back 3

lower portion of right inferior lobe

Front 4

Aspirate a peanut supine

Back 4

Upper portion of right inferior lobe
(laying down, it doesnt go to the most bottom portion of the right inferior lobe)

Front 5

RALS

Back 5

Describes the location of the r/l BRONCHUS relative to the Pulmonary artery
Right Anterior
Left Superior

Front 6

Pnemonic Diaphragm structure

Back 6

I Ate Ten Eggs At 12
IVC T8
Esophagus T10
Aorta T12

Also, vagus (2trunks) at T10
T12 also has the thoracic duct and azygous vein

Front 7

Patient has trouble with passive breathing on inspiration. Where else might he have pain?

Back 7

Passive inspiration = diaphragm.

Referred pain in shoulder.

Front 8

Exercise - Inspiration. Muscles Used?

Back 8

External intercostal muscles
Scalene Muscles
Sternomastoids

Sternomastoid + scalene are located above the ribs.

Front 9

Pnemonic Diaphragm structure

Back 9

I Ate Ten Eggs At 12
IVC T8
Esophagus T10
Aorta T12

Also, vagus (2trunks) at T10
T12 also has the thoracic duct and azygous vein

Front 10

Exercise - Expiration. Muscles Used?

Back 10

Internal Intercostals
Internal and External Obliques
Transversus Abdominis
Rectus Abdominis

Front 11

Patient has trouble with passive breathing on inspiration. Where else might he have pain?

Back 11

Passive inspiration = diaphragm.

Referred pain in shoulder.

Front 12

Why doesn't left lung have middle lobe?

Back 12

The "middle lobe" space is occupied by the heart.

Front 13

Exercise - Inspiration. Muscles Used?

Back 13

External intercostal muscles
Scalene Muscles
Sternomastoids

Sternomastoid + scalene are located above the ribs.

Front 14

Exercise - Expiration. Muscles Used?

Back 14

Internal Intercostals
Internal and External Obliques
Transversus Abdominis
Rectus Abdominis

Front 15

Why doesn't left lung have middle lobe?

Back 15

The "middle lobe" space is occupied by the heart.

Front 16

Collapsing pressure eq.

Back 16

P = (2*Surface tension)/ Radius

Surfactant decreases surface tension thereby decreasing the collapsing pressure of the lungs.

Front 17

Law of Laplace implies what with respect to lung physioogy?

Back 17

As the radius decreases, there is a tendency to collapse. I.e. during expiration, there is a tendency for lungs to collapse.

Front 18

Kallikrein is a lung product. Effect?

Back 18

Activates bradykinin -causes cough and angioedema in the lungs.

Front 19

Ace is produced by lungs. What does Angiotensin II do in the heart?

Back 19

Inactivates bradykinin ; ACE inhibitors will thus increase bradykinin, leading to cough and angioedema.

Front 20

Cannot be measured on spirometry

Back 20

Residual volume

Front 21

Tidal volume typically

Back 21

500 ml

Front 22

Taco Paco Peco Paco

Back 22

The equation for determining Vd (Dead space)
Vd = Vt * (PaCo2-PeCo2)/(PaCo2)

PeCo2 = Expired Air PCO2

Front 23

What is the greatest Contributor of functional dead space?

Back 23

The APEX of the health lung

Anatomical Dead space is in the Conducting Zone
Functional Dead Space is the dead space in ALVEOLI

Front 24

Only areas of conducting zone with cartilage

Back 24

Trachea and Bronchi

Front 25

Fetal hemoglobin has what units

Back 25

2 Alpha and 2 Gamma

Front 26

Key difference between physiologic mechanisms of hemoglobin and myoglobin?

Back 26

Hemoglobin exhibits positive cooperativity and negative allostery.

Front 27

Factors favoring the Taut form over relaxed form in hemoglobin. Physiologic significance?

Back 27

Increase CL-, H+, Temperature, CO2, 2,3 BPG

H+ and CO2 go together since they both decrease pH]

Right shift on dissociation curve (O2 unloading)

Front 28

WHY does Fetal hemoglobin have a higher affinity for O2 than Adult hemoglobin?

Back 28

Has a lower affinity for 2,3BPG and hence a higher affinity for O2.

Front 29

Describe the chemical characteristics of Methemoglobin.

Back 29

Oxidized Hemoglobin (Iron in Fe3+) state. Decreased affinity for O2 and an increased affinity for CN-.

In

Front 30

Cyanide poisoning - describe tx ./ pathophys.

Back 30

Tx - Nitrite / Thiosulfate

Nitrite oxidizes hemoglobin to Methemoglobin which has high affinity for CN. Binding allows cytochrome oxidase to function. Use thiosulfate to bind to this cyanide - forms thiocyanate which is renally excreted.

Front 31

Carboxyhemoglobin has what two effects on hemoglobin.

Back 31

Carboxyhemoglobin = CO bound to hemoglobin. (The only thing with a "Carbox" bound to Hb is CO2)

1. O2 LEFT shift!!! thus leading to decreased unloading of O2.
i.e. CO actually increases the O2 affinity of Hb, but less O2 is bound because the affinity of CO is so darn high.
2. Decreased oxygen binding capacity because CO has 300x greater affinity (Hb greatly prefers CO)

Front 32

C-BEAT

Back 32

Right Shift HB curve
CO2
BPG
Exercise
Acid/Altitude
Temperature

INCREASING things (except pH) generally leads to a right shift. i.e. too much in the env. leads to Hb having less affinity

Front 33

Diffusion

Back 33

Vgas = A/T x Dk(P1-P2)
A= Area
T= Thickness
Dk(P1-P2) = Difference in partial pressures

Emphysema decreases A (amount of viable tissue is decreased)
Fibrosis increases T (Fibrosed tissue is thicker)

Front 34

Changes in pulmonary artery in PHTN

Back 34

Atherosclerosis, Medial Hypertrophy, Intimal Fibrosis of pulmonary arteries.

Front 35

Pulmonary circulation with respect to resistance and compliance

Back 35

Pulm circulation is low resistance, high compliance

Front 36

Pulmonary Hypertension is marked by what changes?

Back 36

Atherosclerosis, Medial Hypretrophy, Intimal Fibrosis.

Front 37

Pulm Hypertension definition based on lab results

Back 37

Normal Pulm Hypertension = 10-14 mmHg

> 25 mmHg = pulm hyp
or
>35 mmHg during exercise

Front 38

Primary pulm Hypertension = mutation in?

Back 38

BMPR2 . Inhibits smooth muscle vascular proliferation. Mutated in Primary pulm hypertension. ONLY this form is Primary. All other forms are secondary.

Front 39

PVR formula (Pulmonary vascular resistance(

Back 39

PVR = (Pressure(pulm artery)- Pressure(left atrium i.e. CWP))/ Cardiac Output

Front 40

Alveolar Gas equation

Back 40

PAO2 = PIO2 - (PaCO2/R)
Approximated as
PAO2 = 150 - (PaCO2/R)

PIO2 = inspired air

Front 41

Normal A-a Gradient?

Back 41

10-15 mmHg

Front 42

O2 content in blood - Formula?

Back 42

O2 Content = (O2 Binding Capacity * % saturation) + Dissolved O2

Front 43

Wasted ventilation occurs at

Back 43

The Apex (V/Q =3)

Front 44

Wasted Perfusion occurs at

Back 44

Base of lung (V/Q = .6)

Front 45

3 ways CO2

Back 45

1. Bicarbonate (95%)
2. CO2 bound to N terminus of globin on hemoglobin (referred to as Carbaminohemoglobin). CO2 binding favors the taut form (O2 releasE)
3. Dissolved CO2

Front 46

Exercise results in vasodialtion of which capillaries in the lungs?

Back 46

The Apical capillaries. There is normally a V/Q mismatch here (V/Q>3) such that it makes sense to selectively vasodilate this region to normalize the excess Ventilation.