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107 Cards in this Set
- Front
- Back
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Egophonia
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(increased resonance of voice on auscultation) say "e" and sounds like "a"
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Cor pulmonale
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hypertrophy (increase in size) of the right side of the heart with or without HF, resulting in pulmonary hypertension
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Hyperresonance
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loud, lower-pitched sound over areas that normally produce a resonant sound during percussion of chest. Could mean lung hyperinflation (COPD), lung collapse (pneumothorax), or air trapping (asthma).
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(CO2) Narcosis
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There are two chemoreceptors in the respiratory center that control breathing. Normally, CO2 is the main stimulant. With COPD patients, they develop a tolerance for high CO2 over time. Theoretically, now O2 (hypoxemia) becomes the main driving force. Therefore, caution must be used when administering O2 to these types of patients because they may stop breathing. According to the book, the concern should not all be on breathing, but instead on not providing adequate O2 to these patients. O2 should be titrated to the lowest effective dose with careful, ongoing assessment.
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Pursed-lip breathing
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purpose is to prolong exhalation to prevent bronchiolar collapse and air trapping. Exhalation should be about 3 times as long as inhalation. The patient is taught to inhale slowly through the nose and exhaling slowing through pursed lips, like whistling.
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Forced vital capacity (FVC)
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This is the total amount of air that can forcibly be blown out after full inspiration, measured in liters.
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Forced expiratory volume (FEV)
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# This is the amount of air that you can forcibly blow out in one second, measured in liters
# . Along with FVC it is considered one of the primary indicators of lung function. |
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Total lung capacity
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The volume of air contained in the lung at the end of maximal inspiration.
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Pulmonary fibrosis
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scarring throughout the lungs. Pulmonary fibrosis can be caused by many conditions including chronic inflammatory processes (sarcoidosis, Wegener's granulomatosis ), infections, environmental agents (asbestos, silica, exposure to certain gases), exposure to ionizing radiation (such as radiation therapy to treat tumors of the chest), chronic conditions (lupus, rheumatoid arthritis), and certain medications.
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Sarcoidosis
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is a multisystem disorder characterized by non-caseating granulomas (small inflammatory nodules). It most commonly arises in young adults. The cause of the disease is still unknown. Virtually any organ can be affected; however, granulomas most often appear in the lungs or the lymph nodes. Symptoms usually appear gradually but can occasionally appear suddenly. The clinical course generally varies and ranges from asymptomatic disease to a debilitating chronic condition that may lead to death.
Sarcoidosis most often manifests as a restrictive disease of the lungs, causing a decrease in lung volume and decreased compliance (the ability to stretch). The disease typically limits the amount of air drawn into the lungs, but produces higher than normal expiratory flow ratios. The vital capacity (full breath in, to full breath out) is decreased, and most of this air can be blown out in the first second. This means the FEV1/FVC ratio is increased from the normal of about 80%, to 90%. Obstructive lung changes, causi |
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Kyphosis
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also called "hunch back" or "hunchbackism" or "hunchbackedness", in general terms, is a common condition of a curvature of the upper (thoracic) spine. It can be either the result of bad posture (slouching) or a structural, muscular abnormality in the spine.
In the sense of a deformity, it is the pathological curving of the spine, where parts of the spinal column lose some or all of their lordotic profile. This causes a bowing of the back, seen as a slouching back and breathing difficulties. Severe cases can cause great discomfort and even lead to death. |
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Duchene Muscular Dystrophy
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One of nine types of muscular dystrophy, a group of genetic, degenerative diseases primarily affecting voluntary muscles.
Cause - An absence of dystrophin, a protein that helps keep muscle cells intact. Onset - Early childhood - about 2 to 6 year Symptoms - Generalized weakness and muscle wasting first affecting the muscles of the hips, pelvic area, thighs and shoulders. Calves are often enlarged. Progression - DMD eventually affects all voluntary muscles, and the heart and breathing muscles. Survival is rare beyond the early 30s. A less severe variant is Becker muscular dystrophy. Inheritance - X-linked recessive. DMD primarily affects boys, who inherit the disease through their mothers. Women can be carriers of DMD but usually exhibit no symptoms. |
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Atopy
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a type I (IgE antibodies) hypersensitivity or allergic reaction for which there is a genetic predisposition.
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Bronchodilation
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increase in diameter or airway caused by dilation of smooth muscles encircling the bronchioles
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Bronchospasm
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increased smooth muscle tone with closure of small airways.
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Paroxysmal
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occurring repeatedly and without warning
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Peak expiratory flow
Peak flow meter |
measures the maximum flow of air that can be forcefully exhaled in 1 second.
PEDMs measure amount of air that is exhaled. The reading that should be used is the largest of three tries. |
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Status asthmaticus
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severe, life-threatening asthma attack that is refractory (resistant) to usual treatment and places the patient at risk for developing respiratory failure.
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Empyema
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a pleural effusion that contains pus. It’s caused by conditions like pneumonia, TB, lung abscess and infection of surgical wound of the chest.
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Flail chest
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results from multiple rib fractures, causing instability of the chest wall. The chest wall cannot provide the bony structure necessary to maintain bellows action and ventilation. During inspiration, the affected (flail) portion gets sucked in, and during expiration it bulges out. This prevents adequate ventilation of the lung in the injured area.
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Hemoptysis
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coughing up blood that came from the nasopharynx, larynx, trachea, bronchi, or lungs
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Kussmaul's respirations
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regular, rapid and deep respirations
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Lung restriction
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decreased compliance of the lungs or chest wall or both.
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Pleural effusion
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collection of fluid in the pleural space. It is not a disease but a serious sign of disease.
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Pleurisy
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inflammation of the pleura. Most common causes are pneumonia, TB, chest trauma, pulmonary infarctions, and neoplasms (tumor or growth). Can cause pleural effusions.
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Pneumonectomy
Lobectomy Sternotomy Thoracotomy |
removal of one entire lung
removal of one or more lobes of the lung cutting through the sternum surgical opening into the thoracic cavity |
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Thoracentesis
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a procedure done to remove fluid from the pleural space
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Mediastinal shift
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deviation in the mediastinum (area between the lungs). Example: trachea shifted to the left
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Surfactant
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a lipoprotein that lowers the surface tension in the alveoli, reduces the amount of pressure needed to inflate the alveoli and decreases the tendency of the alveoli to collapse.
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Mixed venous blood gas
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patients with impaired cardiac output or hemodynamic instability may have inadequate tissue oxygen delivery or abnormal oxygen consumption. The amount of oxygen delivered to the tissues or consumed can be calculated.
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Lactate
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Any salt derived from lactic acid. Lactic acid is a chemical made by your muscle when there is not enough oxygen getting to your muscle. Lactic acid builds up and makes the muscle feel like it is "burning" and the muscle tires faster. You have to breathe harder to get oxygen to your muscles so they can get rid of the lactic acid. When your muscles make less lactic acid, your breathing is easier.
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Insensible fluid loss
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Part of metabolic fluid balance. Some fluid is lost through perspiration and as water vapor in expired air. This is part of the body's temperature control mechanism and is termed "insensible loss": it cannot be easily measured. Some sources say it accounts for a daily loss 500 to 650 milliliters of water
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Intercostal retractions
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sinking in of soft tissues relative to the cartilaginous and bony thorax during breathing. In disease states (particularly in severe airway obstruction), retractions becomes extreme.
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Hypercyanotic episode (Tet spell)
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Hypercyanotic episodes are characterized by paroxysms of hyperpnea, prolonged crying, intense cyanosis, and decreased intensity of the murmur of pulmonic stenosis. Mechanism - Secondary to infundibular spasm and/or decreased SVR with increased right-to-left shunting at the VSD, resulting in diminished pulmonary blood flow
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Elastance
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The tendency of a material or body tissue to return to its original form after having been stretched or deformed (syn: compliance)
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Dyspnea
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air hunger resulting in labored or difficult breathing
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Compliance
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(distensibility) measure of the elasticity of the lungs and thorax. With decreased compliance, the lungs become harder to inflate.
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Clubbing
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an increase in the angle between the base of the nail and the fingernail to 180 degrees or more, usually accompanied by an increase in the depth, bulk, and sponginess of the end of the finger.
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Atelectasis
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collapsed, airless alveoli. Most common cause is airway obstruction that results from retained exudates and secretions.
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Arterial blood gas
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used to determine oxygenation status and acid-base balance. Analysis includes measurement of the PaO2, PaCO2, acidity (pH), and bicarbonate (HCO3-) in arterial blood. SaO2 is measured or calculation during the process also.
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Apnea
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cessation of spontaneous respirations
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Accessory muscles
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muscles recruited to increase ventilation by patients with labored breathing.
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which lung do you put down?
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good lung.
you want the maximum perfusion (lower lung) to be where the max ventilation is (good lung). |
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v/q test
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ventilation/perfusion
-used to diagnose pulmonary embolus |
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Pneumothorax in R lower lobe you would expect to hear?
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absent lung sounds
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Acute asthma attack in 8-yr-old kid, what would demonstrate maximum effort to breathe?
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bulging neck muscles
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what is an indication of ventilation?
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PaCO2
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Emphysema w/hyperresonance would mean...
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trapped air in alveoli
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late signs of respiratory distress
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cyanosis & retractions
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C2 SCI 's affect on resp fxn?
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total dependence-- diaphragm and intercostals would be affected.
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Pursed lip breathing
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aids in elongating expiration, decrease trapping of CO2, prevent airway collapse.
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Wheezing during assessment
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beta agonist agent
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resp acidosis
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lo pH, hi PaCO2 (acid), normal HCO3 (base)
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resp alkalosis
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hi pH, lo PaCO2 (acid), normal HCO3 (base)
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met acidosis
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lo pH, normal PaCO2 (acid), lo HCO3 (base)
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met alkalosis
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hi pH, normal PaCO2 (acid), hi HCO3 (base)
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normal pH=
HCO3= PaCO2= |
7.4
24 40 |
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compensated resp acidosis
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lo pH, hi PaCO3 (acid), HI HCO3 (base)
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compensated resp alkalosis
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hi pH, lo PaCO3 (acid), LO HCO3 (base)
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compensated met acidosis
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lo everything.
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compensated met alkalosis
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hi everything
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nasal cannula
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24-40% FiO2
1-6L/min convenient, comfortable, popular not for hi needs pts. |
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simple mask
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35-50% FiO2
5-8L/min higher rate, short period closterphobic, not used often. |
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non-rebreather mask
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60-90% FiO2
15+ L/min lots of O2, CO2 not rebreathed -for seriously ill pts bag should not collapse. |
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venturi mask
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24-50% FiO2
hi flow, very precise % -not affected by how pt is breathing -for COPD |
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T-bar mask
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for those with trach tubes
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crackles
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-fine crackles, rales
-@ base of lungs, sm airways -fluid in lungs, atelectasis -tx: diuretics (fluid), deep breathing (atelectasis) |
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rhonchi
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-coarse crackles
-lg airways -obstruction of mucous hi up. -tx: cough up, suction |
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wheeze
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-whistle-y
-r/t asthma, constricted airway -tx: bronchodilator (neb or inahler) -usually on expiration? |
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stridor
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-high, whistle-y, turbulent, accordion sound w/o auscultation.
-r/t croup, increased WOB -heard on inspiration |
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diminished breath sounds
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-can't hear anything
-r/t consolidation, pneumonia, pleural effusion |
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elderly & oxygenation
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-decreased elasticity & contractability
-COPD: barrel chest -bad at coughing: decreased mm tone & less cilia. -cannot compensate for hypoxia and hypercapnia |
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acute asthma attack stats=
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early: hi pH, lo paCO2 & PaO2
late: lo pH, hi paCO2, lo PaO2 |
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(asthma questions)
P A W S |
Planned visits: dr visits often?
Albuterol: how often? Wheezing: what makes you? Spirometry: test results? |
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(4 pillars of asthma mgmt)
R M E T |
R-Regular visits to PCP
M-medication mgmt (enough $, difference btwn rescue and controller) E-education & support (how to use action plan, ER location) T-decrease triggers (cold air, allergens, emotions, exercise) |
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Acute Respiratory Distress Syndrome (ARDS)
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more quickly progressing form of acute respiratory failure when the alveolar capillary membrane becomes damaged and more permeable. Because of this damage, intravascular fluid fills the alveoli of the lungs quickly thereby preventing gas exchange between the lungs and the blood. Severe dyspnea, hypoxemia (due to lack of O2), and reduced lung compliance result. Common conditions that cause ARDS: aspiration, pneumonia, chest trauma, sepsis, embolism, and many more. Mortality rate is between 50-70%!
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Acute Respiratory Failure
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Not a a disease, but a condition which occurs as the result of one or more diseases involving the lungs or other body systems such as the central nervous system.
2 types: hypoxic & hypercapnic |
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Ventilation-Perfusion (V/Q) mismatch
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In normal lungs, the volume of blood perfusing (4-5L/min) is almost equal to the amount of fresh gas reaching the alveoli (4-5L/min). This is expressed as a V/Q ratio of 1:1. Many diseases cause mismatch. The most common ones are those with increased secretions in airways (COPD), alveoli (pneumonia) or with bronchospasm (asthma). V/Q mismatch can also be caused by atelactasis (alveolar collapse) and by pain. Unrelieved pain interferes with chest and abdominal wall movement which compromises ventilation. All of these conditions compromise airflow. The perfusion portion of V/Q can be compromised by a pulmonary embolus
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Shunt
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occurs when blood leaves the heart without participating in gas exchange. It can be seen as extreme V/Q mismatch. A shunt can be anatomic or intrapulmonary. Anatomic shunt is when blood passes through a channel like a ventricular septal defect and skips the lungs. In intrapulmonary shunt blood passes through the lungs without exchanging gas. You see this when the alveoli is filled with fluid in conditions like ARDS, pneumonia, and pulmonary edema. Shunt causes more severe hypoxemia than V/Q mismatch.
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Diffusion limitation
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Occurs when gas exchange across the alveolar-capillary membrane is compromised by a process that thickens or destroys the membrane
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Alveolar hypoventilation
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Generalized decrease in ventilation as a result of restrictive lung disease, CNS problems, chest wall dysfunction, or neuromuscular disease.
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Hypercapnia
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defined as an increase in arterial CO2 tension (PaCO2). Hypercapnic respiratory failure is often defined as a PaCO2 greater than 45 mm Hg in combination with acidemia (arterial pH of less than 7.35). The acidemia shows the body’s inability to compensate and any further pH decreases would indicate a serious acid-base imbalance. When ventilatory demand does exceed ventilatory supply. The PaCO2 can no longer be supported and hypercapnia results. The course can be acute or chronic. Four types of diseases can cause this problem:
1.Airways and alveoli: Asthma, emphysema, chronic bronchitis, and cystic fibrosis can put patients at risk of hypercapnic resp. failure due to airflow obstruction and air trapping. 2.CNS: common example is respiratory depression brought by an overdose of opiates. Also seen with brainstem infarction. 3. Chest wall: a variety of conditions prevent normal chest wall movements. Some examples are chest trauma, kyphscoliosis, and massive obesity. 4. Neuromuscular conditions: Guilla |
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Anemia
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Altered oxygen transport. A deficiency in the number of erythrocytes (RBCs), the quantity of hemoglobin, and/or the volume of packed RBCs (hematocrit).
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Bronchiectasis
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characterized by permanent, abnormal dilation of one or more large bronchi. There are two pathologic types: saccular and cylindric. Saccular bronchiectasis occurs mainly in large bronchi and is characterized by cavity-like dilations. Cylindric bronchiectasis involves medium-sized bronchi that are mildly to moderately dilated
bacterial infections cause the bronchial walls to weaken, and pockets of infection begin to form. When the walls of the bronchial system are injured, the mucociliary mechanism is damaged, allowing bacteria and mucus to accumulate within the pockets resulting in bronchiectasis. |
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Bronchiolitis
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An acute viral infection that rarely occurs after the age of 2 years. Respiratory Syncytial Virus (RSV) causes 80% of cases; outbreaks tend to occur in rainy seasons (mostly winter and spring);
RSV affects the ciliated epithelial cells of the respiratory tract causing them to swell and lose their cilia; RSV causes membranes of infected cells to fuse with neighboring cells to make a giant cell; the bronchioles fill with mucus and exudate as well as inflammatory cells and dead epithelial cells causing them to be obstructed, esp. during expiration; obstruction leads to hyperinflation, obstructive emphysema, and areas of atelectasis; RSV is transmitted thru direct contact with respiratory secretions; in young infants, disease may require hospitalization. |
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Bronchitis
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Inflammation of the mucous membranes of the bronchial airways (lower respiratory tract) caused by infection, irritation, or both. This can produce partial obstruction of bronchi by secretions or constrictions
can be acute or chronic. |
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Bronchopulmonary Dysplasia (BPD)
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chronic lung disease that develops primarily in very low birth weight infants with respiratory distress syndrome. The immature lung undergoes an initial injury leading to a chronic inflammatory process that results in recurrent injury and abnormal healing. Pulmonary changes include interstitial edema and epithelial swelling followed by thickening and fibrotic proliferation of the alveolar walls and squamous metaplasia of the bronchiolar epithelium. Ciliary activity is paralyzed which leads to aggravation of airways and atelectasis as well as diminished ability to clear lung of mucus. Altered diffusion/surface area, impaired ventilation, problem w/ lung compliance. When the healing process begins, the process is altered by continuous high oxygenation, poor nutrition or vitamin E deficiency resulting in decreased surface for O2 and CO2 exchange.
Administration of surfactant and using the lowest peak inspiratory pressure and level of O2 necessary are preventative measures in infants who may be prone to BPD |
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COPD
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Chronic obstructive pulmonary disease is a disease state characterized by presence of airflow obstruction caused by chronic bronchitis or emphysema. Asthma was formerly defined w/ COPD, but is now defined as separate because inflammation has been found to be the distinguishing feature. Airflow obstruction is generally progressive, may be accompanied by airway hyperactivity and may be partially reversible. Chronic bronchitis is the presence of chronic productive cough for three months in each of two successive years in a patient in whom other causes of chronic cough have been excluded. Emphysema is an abnormal permanent enlargement of the airspaces distal to the terminal bronchioles, accompanied by destruction of their walls and without obvious fibrosis. There is usually some overlap between chronic bronchitis and emphysema. Primary cause of COPD is exposure to tobacco smoke. Recurring respiratory infections, heredity and aging are also causes.
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croup
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Croup is breathing difficulty accompanied by a "barking" cough. Croup, which is swelling around the vocal cords, is common in infants and children and can have a variety of causes
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Cystic fibrosis
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An autosomal recessive, multisystem disease characterized by altered function of the exocrine glands involving primarily the lungs, pancreas, and sweat glands. Abnormally thick, abundant secretions from mucous glands can lead to a chronic, diffuse, obstructive pulmonary disorder in almost all patients. Exocrine pancreatic insufficiency is associated with most cases of CF. Sweat glands excrete increased amounts of sodium and chloride. Usually begins in infancy primarily in white and black populations.
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Emphysema
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A chronic pulmonary disease marked by an abnormal increase in the size of air spaces distal to the terminal bronchiole, with destruction of the alveolar walls. These changes result in a loss of the normal elastic properties of the lungs. Smoking is the most common cause along with exposure to environmental dust, smoke, or pollution. Very small percent of people acquire from genetic illnesses in which there is inadequate protection against destructive enzyme activity in the lung.
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Diaphragmatic Hernia, congenital (CDH)
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Primarily the result of incomplete development of the transverse septum and pleuroperitoneal folds, which means they can’t properly form the diaphragm. This allows abdominal contents to protrude through the diaphragm and into the thoracic cavity. CDH can be diagnosed in fetus as early as the first trimester (by polyhydramnios, mediastinal shift, and bowels in chest) and usually presents as moderate to severe respiratory distress at birth (see Janelle’s patho). As the baby transitions to extrauterine life, air that enters the intestines actually compromises respirations. A baby with CDH may be dyspneic and cyanotic and have a scaphoid abdomen (due to abdominal contents filling the chest…like liver and loops of intestines). As the abdominal organs/structures fill into the thoracic cavity, they compress the lung/s. This prevents the lung/s from being able to grow and respiration is further compromised by hypoplasia and compression of the lung (airways and blood vessels). Cardiac output is impaire
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Epiglottitis
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This is an inflammation of the epiglottis after infection. The severe swelling that occurs may obstruct air flow and can cause death. This is an emergency and must be treated stat!!! Usually occurs in children 2-5 as a result of a bacterial infection. (It can be seen in adults but rare).
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Hemothorax
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an accumulation of blood in the intra-pleural space. Can be caused by chest trauma, lung malignancy, pulmonary embolus, complications of anticoagulant therapy, and tearing of pleural adhesions.
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Infant respiratory distress syndrome (IRDS)
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Primarily a disease related to developmental delay in lung maturation. Responsible for more infant deaths than any other disease and carries the highest risk in terms of long-term respiratory and neurologic complications. Seen almost exclusively in preterm infants. A baby with RDS tries to cry and breathe at birth, but within minutes to hours he starts working hard to breathe because his lungs tend to collapse with each breath.
baby with RDS breathes faster than 60 breaths a minute, makes a grunting sound when he breathes out, pulls in the chest wall and the spaces between the ribs when he tries to breathe (these movements during breathing are called retractions), has flaring of the nostrils. has a bluish color around the lips, which means that he needs more oxygen. Patho: Preterm infants are born before lungs are fully prepared to serve as efficient organs for gas exchange. In third trimester, preterm infants born with many underdeveloped, uninflatable alveoli. Also, limited pulmonary blood flow (from po |
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Primary Pulmonary Hypertension (PPH)
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This is a rare disease whose exact cause is unknown. Characterized by hypertension in the pulmonary arteries, mean pulmonary arterial pressure greater than 25 mmHg at rest or greater than 30 mmHg with activity (without a obvious cause). Poor prognosis as there is no definitive therapy. PPH more common in women and may have a genetic link. Key mechanism involves a deficient release of vasodilator mediators from pulmonary epithelium with a cascade of injury. Secondary Pulmonary Hypertension: This occurs when there is a primary disease causing the PH. The primary disease may result in anatomic changes causing increased vascular resistance (loss of capillaries from alveolar wall damage in COPD, stiffening of pulmonary Vasculature, obstruction of blood flow) or may results in vascular changes.
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Sleep apnea
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A condition characterized by partial or complete upper airway obstruction during sleep, causing apnea and hypopnea. Apnea is the cessation of spontaneous respirations. Hypopnea is abnormally shallow and slow respirations. Airflow obstruction occurs when the tongue and the soft palate fall backward and partially or completely obstruct the pharynx. May last from 15-90 sec. During apneic period, the patient may experience severe hypoxemia (decreased PaO2) and hypercapnia (increased PaCO2). These changes are ventilatory stimulants and cause the patient to partially awaken with a general startle response, snort, and gasps, which causes the tongue and soft palate to move forward and the airway to open. Apnea and arousal cycles occur repeatedly, as many as 200 to 400 times during 6-8 hours of sleep. Occurs in 2-10% of population. More common in men than women.
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SARS
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severe acute respiratory syndrome. Caused by a coronavirus. Spread via droplets in the air or possibly through contact with objects that have been contaminated. Signs and symptoms include fever greater than 38°C, headache, overall feeling of discomfort, muscle aches, and mild respiratory symptoms. A dry cough and trouble breathing develops after 2-7 days. Sore throat, facial swelling, drooling, HA, high fever, leukocytosis, chills. Lung-related complications: Pneumonia, pleural effusion, airway obstruction
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Tracheoesophogeal Fistula (TEF)
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TEF is a rare congenital malformation when the esophagus does not attach to the stomach and the trachea and esophagus do not develop as separate and distinct structures. In the most common malformation (80-95% of cases) the proximal esophagus develops as a blind pouch that never reaches the stomach, and the distal segment is connected to the trachea or primary bronchus by a short fistula at or near the tracheal bifurcation. This malformation causes a lot of problems with eating, breathing and nearly inevitable aspiration pneumonia. Luckily, it can be discovered early, antibiotic therapy can be started in time, and the malformation can be surgically corrected.
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Tuberculosis
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infectious disease caused by Mycobacterium tuberculosis that usually affects the lungs, but may occur in larynx, kidneys, bones, adrenal glands, lymph nodes, male & female genital tracts, meninges, & cerebral cortex. TB kills more people worldwide than any other infectious disease. # cases has increased in recent yrs d/t epidemic levels of TB among HIV infected pts and the emergence of multidrug-resistant (MDR) strains of M. tuberculosis. MDR strains have developed d/t poor compliance to treatment regimens.
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rare cold sx
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fever, headache, weakness, bed-ridden
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7th leading cause of death in US
(5th among elderly) |
influenza
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Linoleic acid (LA)- omega 6?
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is a polyunsaturated fatty acid used in the biosynthesis of arachidonic acid (AA) and thus some prostaglandins. It is found in the lipids of cell membranes. It is abundant in many vegetable oils, especially poppy seed, safflower and sunflower oils.
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Hypoxia
Hypoxemia |
Inadequate supply of O2 to tissues
Inadequate supply of O2 in the blood |
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EARLY Evidence of Inadequate Oxygenation
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Apprehensive, restless, irritable
Tachypnea, dyspnea w/ activity Tachycardia |
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LATE Evidence of Inadequate Oxygenation
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Combative, coma
Dyspnea at rest, pausing to breath , Cyanosis, cool clammy skin |
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Pores of Kohn
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are pores between adjacent alveoli, or interalveolar connections. They function as a means of collateral ventilation; that is, if the lung is partially deflated, ventilation can occur to some extent through these pores. The pores also allow the passage of other materials such as fluid and bacteria
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