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JM Exam I/Adult 3
Text sect 5& 12/ppts pg 1-4
| Question | Answer |
|---|---|
| What is the function of the cardiopulmonary system? | Gas exchange;delivery of O2, removal of CO2 waste; synthesis of surfactant and other chemicals, metabolism & detoxification of drugs &toxins & defense against infection. |
| What is housed in the thorax? | Lungs & mediastinum (heart &major vessels);sternum; 12 pairs of ribs;1st 7 ribs “true ribs” attached to vertebral column &sternum;ribs8-10 “false”attach to rib above;11-12 “floating” no anterior attachment. |
| What is the costal angle? | Angle between xiphoid process of the sternum & costal cartilages |
| Diaphragm? | Major muscle of respiration (separates thoracic cavity from abdominal cavity. |
| What are the muscles of the thoracic wall? What do they do? | External intercostals muscles elevate ribs;inspiration. |
| What are the internal intercostals muscles? Their use? | Accessory muscles of expiration. |
| Discuss shape of right lung. | Spongy, cone-shaped; thicker,wider, shorter (because of height of liver, 3 lobes;upper,middle, lower; lobes subdivide into 10 segments. |
| Discuss shape of left lung. | Spongy, cone-shaped;longer, narrow((because of mediastinum;2 lobes-upper lower. Lobes subdivided into 8 segments |
| Define lingual. | Refers to area between left upper & lower lobes. |
| What is the apex of the lungs? | The upper/rounded part of each lung (plural: apexes or apices). aPEX: SOMETHING COMES TO A POINT-NOT NECESSARILY @ TOP! |
| What are the lungs covered with? | 2 thin/tough layers of serous membrane. |
| What is the inner layer of serous membrane on the lungs? | Visceral pleura. |
| What is the outer layer of serous membrane on the lungs? | Parietal pleura-lines thoracic wall covers the diaphragm Y mediastinal structures. |
| How much lubricant is between pleural layers, why, and what is it called? | 5-15 mls to allow sliding, no friction;pleural space |
| When is the ONLY time we see the pleural space? | When air (pneumothorax or fluid/blood (hemothorax) collects in it. |
| Where is the pleural space? | Extends from nose to terminal bronchioles; divided into 2 principle parts (upper and lower airways). |
| What constitutes the upper airway? | Includes nasal cavity, sinuses, mouth, pharynx, and larynx. |
| What is the primary function of the nasal cavity? | Warm/cool, filter, humidify inspired air. |
| What % of the atmospheric air is made up of O2? Nitrogen? | Ox=21% and Nitrogen = 78% plus other trace gases. |
| Dexcribe anatomy of pharynx. | divided3 sects:Nasopharynx (adenoids & openings of Eustachian tubes:connect pharynx to middle ear); oropharynx (tongue, throat);laryngopharynnx or hypopharynx (larynx, epiglottis) which closes over larynx during swallowing. |
| What constitutes the lower airways? | Trachea, bronchi & bronchioles. |
| Where is the trachea located? | Directly in front of esophagus. |
| What is the trachea made up of? | 16-20 C-shaped cartilage (open to posterior) |
| Discuss the bronchi anatomy. | At level of 2nd or 3rd intercostals space (ICS) ; splits at carina; rt main-stem (shorter, wider, straighter angle);main-stem bronchi divide into lobar bronchi to segmental then subsegmental bronchi. |
| Where does aspirated material usually go? Why? | To right lung due to it being shorter, wider, straighter angle. |
| What is the tracheobronchial tree? | Conducting airways that continue to divide further and further: bronchioles (less than 2mm in diameter);terminal airways (last of the conducting airways). |
| What is anatomical deadspace? Where is it? | Lower airways, normal portion of pulmonary system where NO GAS EXCHANGE OCCURS; NO PULMONARY CAPILLARIES>nose to conducting airways |
| What is alveolar deadspace? | Areas in alveoli where gas exchange does not occur, ie: mucous. |
| What is physiologic deadspace? | Anatomic + alveolar. |
| What is the mucociliary escalator? | Specialized mucous membrane lining the lower respiratory tract. |
| What is pulmonary mucosa compsed of: Pseudostratified columnar epithelium. | |
| What is the lower airway lined with? | Cilia |
| How do cilia work? | Layer of mucous sits on top, traps dirt & debris as ciia beat in constant upward motion & transport the mucous to pharynx. |
| How can cilia be paralyzed? | Smoke, pollutants, alcohol, anesthesia, HIG O2, DEHYDRATION |
| What do bronchioles mark? | Transition to respiratory zone which includes-terminal bronchioles, alveolar ducts,sacs & alveoli(this is where gas exchange occurs). |
| How many alveoli does an adult have? | 300 million. |
| What surround alveoli? | Pulmonary capillaries. |
| Where are pulmonary capillaries located? | Surrounding alveoli. |
| What types of cells does the alveolar epithelium consist of? | Type I pneumocytes line most of the alveolar surface;type II pneumocytes produce surfactant (reduces surface tension&prevents collapse);alveoloar macrophages phagocytic cells (bacteria & foreign particle). |
| What does the interstitium consist of? Where is it located? | Between alveoli; capillaries, lymphatic channels, nerves & elastic tissue which gives the lungs their elastic recoil. |
| What two special properties do the lungs have? | Recoil (elastance)ability to return to resting position after stretching and Compliance-enables lung to expand |
| What does emphysema result in? | Results in loss of recoil due to alveolar wall breakdown resulting in hyperinflation. |
| What is pulmonary fibrosis? | Connective tissue replaced with scar tissue resulting in stiff, noncompliant lungs. |
| What is ventilation? | The movement of air in & out of the repiratory tract. |
| What must be present in order to have effective ventilation? A patent airway;thoracic cage, lung, & muscles of respiration must be intact & functioning. | |
| What is repisration? | The exchange of gases-Internal respiration (tissue level) and external respiration ( lungs). |
| What is the atmospheric pressure? | About 760 mmHg |
| What is intrathoracic & intrapleural pressure? | Always slightly below atmospheric pressure. |
| What is inspiration? | Active phase of ventilation. |
| What does diaphragmatic contraction result in? | Flattening downward & out movement expanding thoracic cage. |
| What is Boyle’s Law? | As volume in chest increases, the pressure in thoracic cavity decreases. |
| What part of the brain controls ventilation? Medulla (resp centers);sensitive to CO2 & H+ ions in CSF, slight increases in either stimulates ventilation. | |
| What is the primary arterial stimulus for ventilation? | CO2 |
| Discuss stimulus for ventilation other than arterial CO2. | Decreased O2; peripheral chemoreceptors located in carotid & aortic bodies falls below normal of 100 mmHg; maximal response with PO2 below 50-60mmHg. |
| What is diffusion? | Movement of substance from higher concentration or pressure to lower (internal & external respiration. |
| What is alveolar partial pressure? | About 100 mmHg. |
| What is venous partial pressure? | About 40 mm Hg. |
| Why does O2 move from alveoli to pulmonary capillary bed and CO2 move out? | Because the alveolar partial pressure is about 100 mmHg and venous partial pressure is about 40 mmHg: DIFFUSION! |
| What does gas exchange depend on besides diffusion? | ventilation/perfusion matching: imperative to have adequate blood flow Y ventilation for optimal gas exchange;ventilation present w/o perfusion: NO GAS EXCHANGE CAN OCCUR (DEAD SPACE) |
| What is anatomic dead space? | Normal portion of pulmonary system where no gas exchange occurs (no pulmonary capillaries)> nose to conducting airways. |
| Give examples of increased dead space? | Emphysema & pulmonary embolism. |
| Give examples of shunting (blood flow but NO ventilation). | Pneumonia, atelectasis, ARDS. |
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