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92 Cards in this Set
- Front
- Back
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what is the only muscle the abducts (opens) the vocal cords?
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posterior cricoarytenoid
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what nerve innervates the larynx
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recurrent laryngeal n
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cricothyroid innervated by
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supoerior laryngeal n.
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which cartilidge in the larynx is the only fully circular one?
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cricoid
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where would you cut for choking victm
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cricoid cartilidge
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the recurrent laryngeal n loops under what structure on L and R
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L-aorta
R-subclavian |
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what type of cartilage is in epiglottis
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elasic
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epithelium of true vocal folds is
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stratified squamous nonkeratizined
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what is the difference between the take off of L adn R primary bronchi
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L is longer
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primary-
secondary- tertiary- |
lung
lobe segment |
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carina is
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bifurcation of trachea - if enlarged --> cancer staging
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cartilage ends with
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bronchioles
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goblet cells
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produce mucous
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brush cells
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sensory receptors (cough reflex)
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topography:
Angle of Lewis Horizontal fissure pleural space |
T4/5
4th/5th ICS 8-10ICS |
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relationship of L R pul a to bronchi
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L over
R in front |
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# of lobes on L?R?
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L-8 R-10
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at what level does cartilage dissapear
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bronchioles
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epithelium of false vc
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PSCC
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epithelium of true vc
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stratified squamous non-ker
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alveolar pores of Kohn do
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help with reexpansion and collateral ventilation
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major difference between L/R hila
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L-pul a in front
R-pul a on top |
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where does lower left lobe drain
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right superior tracheobronchial nodes
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what are the 5 stages of lung development
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embyronic
pseudoglandular cannalicular saccular alveolar |
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embryonic
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4-5 weeks
formation of lung bud |
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congenital abnormalities associated with embryonic period
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esophageal atresea, fistulas --> polyhydramnios
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Shh and Gli2/Gli3
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for lung formation in embryonic period
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Nkx2.1
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for branching in embryonic period
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pseudoglandular
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5-17 weeks (branching)
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steps of the mesenchymal-epithelial interactions
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1)epithelial cell proliferation and elongatoin FGF-10 indcuces BMP4 and epithelial cells grow
2) tips stop (Shh BMP4, TGF-b block FGF10) 3) branching new foci of FGF10 at edges allows branching |
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congenital abnormality associated with pseudoglandular phase
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congential cystic adenomatoid malformation (variable cysts in branchign)
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when does the diaphram develop
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4-12 weeks
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congenital abn associated with deve of diaphram
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congenital diaphragmatic hernia
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what happens in cannalicular phase?
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acinar formation, epithelial cell differenceiation, dev of capillary bed, thinning of mesenchyme
16-26 type 2 cells form |
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saccular phase
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24-36 weeks
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alveolar phase
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32-postnatal
secondary septation capillary remodeling |
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role of glucocorticoids in embryology
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decrease fibroblast proliferation and condense septal intersititum
ENHANCE SURFACTANT SYNTHESIS |
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Hyaline membrane disease
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ground-glass appearance
tachypnea, retraction, nasal flaring, grunting, cyanosis born 24-26 weeks (end of cannalciluar phase) |
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what is the composition of surfactant
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80% phospholipid DPPC
8% neutral lipids 12% protein |
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Fick's law
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V=(A/T) Dg (pA-pB)
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limits to diffusion effect o2 or co2 more
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o2 more
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perfusion limits o2 or co2 more
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o2 and co2
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ventilation limits o2 or co2 more
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co2
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alveolar ventilation eq
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VA=K*Vco2/pAco2
(pAco2 usually used interchangeably with paco2) |
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how will excercise and anemia affect calculated diffusing capacity in CO test
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exercise makes high and anemia makes low (increased flow and decreased RBCs)
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what causes a right shift in Hb saturation curve, what are the axis, and what happens to O2 affinity and P50
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decreased O2 affinity
increased p50 %hb sat. v. pO2 dec pH inc CO2 inc temp inc 2,3 DPG |
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how to calculate o2 content
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[Hb] * 1.34 * % sat + (0.003ml/dl/mmHg* pO2)
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carboxyHb is
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Hb with CO
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respiratory acidosis (acute and compen)
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inc pCO2 (above 40) low pH
inc pCO2 (above 40) compensated pH |
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Henderson-Hasselbach eq
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pH=6.1 + log [HCO3]/(0.03*pCO2)
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when A-a pO2 difference is > than --> abn
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20mmHg
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high V/Q
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top part of lungs
interferes most with CO2 acts like dead space |
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low V/Q
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bottom of lungs
interferes most with O2 acts like shunt |
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effect of shunt on pO2
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major drop bc the new oxygen content/O2 capacity --> percent saturation that --> low pO2
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calculations with blood mixtures use
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O2 content
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calculations with diffusions use
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partial pressure
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alveolar gas equation
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pAO2=FO2(pB-pH2O)-(PaCO2/R)
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percent shunt =
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(CiO2-CaO2)/(CiO2-CvO2)
CiO2 is using alveolar pO2 |
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physiological dead space eq:
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Vd/Vt=(pACO2-pECO2)/pACO2
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effects of cut below upper third of pons through vagus?
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long inspiratory spasms with brief expiratroy efforts (apneusis)
cut blocks an inhibitory influence on inspiration |
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effects of cut below the pons
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unstable rhythm that can give way to gasping with long expiratory pauses and brief inspirations
PONS important in STABILZATION AND COORDINATION |
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inspiratory neurons located
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rostral area of medulla
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expiratory neurons located
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caudal area of medulla
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restrictions --> breathing pattern
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shallow, frequent
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obstructions --> breathing patterns
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slow, deep
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Hering Breuer reflex
senses travels in |
senses stretch (extent and changes (some adapt, some dont)
runs in vagus limits respiratory excursion to safe size cut --> deeper, slower |
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Irrants -> breathing reflex
travels in |
vagus
cough, broncho-constriction, mucus secretion, fast shallow breathing |
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juxta-capillary receptors
travel in |
vagus
stimulated by certain substances --> slow or stoped breathing followed by fast and shallow breathing play role in dyspnea |
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how can 100% O2 --> apnea
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barbiturate poisoning or hypercapnia where O2 drive is only thing keeping respiration going
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which more potent central or peripheral
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central
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central respond to
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CO2
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peripheral respond to
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most, especially O2
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carotid receptors
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signal in CN IX and vagus
response time shorter than central key role to check O2 respond to nicotine |
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barbiturates and opiates depress breathing through
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central
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central
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sense CSF, CO2
slow adapts |
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cheyne stokes
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mild hypoxia --> deep breathes with intermittent pause
high altitudes sleep/kidney failure |
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biot's breathing
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more abrupt cheyne-stoeks, with brain damage, high CSF pressure
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Kussmaul
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metabolic acidosis with for ex, diabetes mellitus
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PAO2 (alveolar gas eq) relatd to PACO2
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PAO2 - PIO2 - PACO2/R
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high altitidue shift Hb curve?
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right bc of increased 23DPG
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p increase _ per 10m
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1 atm
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hypoxic hypoxia
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low pO2 of arterial blood
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anemic hypoxia
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low pO2 bc of decreased Hb
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stagnant hypoxia
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low pO2 bc of reduced blood flow
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histotoxic hypoxia
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cells cant make use of normal O2
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type II cells form in which phase
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canalicular
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alveoli first appear in which stage
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saccular
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functional type 1 and 2 in
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saccular
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what gene upregulates elastin, myofibroblast differentiation, and secondary septum formation in alveolar phase
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PDGF-A
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Bronchopulmonary dysplasia
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A disease of <1000g, 24-26 wk infants
results from inflammation and scarring of the lung often bc preme or mechanical ventilation |
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how does ERV IRV change from standing to supine?
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ERV goes down, IRV goes up
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how does FRC and VC change with restrictve? obstructive?
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r:both decrease
o: FRC up, VC down |
