Pulmonary Anatomy and Physiology ppt Flashcards Preview

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1

Just a quick reveiw of some anatomy, he said it is just info but I thought it would be good to know your BASIC anatomy prior to becoming a lung master!!!!

what makes up the thoracic cage?

what is the thoracic cage for?

 

-12 thoracic vertebral bodies, the ribs, and the sternum

protection and pliability

2

Just a quick reveiw of some anatomy, he said it is just info but I thought it would be good to know your BASIC anatomy prior to becoming a lung master!!!!

  1. what is a useful landmark b/c it corresponds to the mid portion of the trachea? (which as we all know is the desirable location for the distal tip of the tracheal tube)
  2. the trachea is fibromuscular. how long is it? and what is it's diameter?
  3. the trachea beagins at what vertebra?
  4. it bifurcates where? (name and location)
  5. the right main stem bronchus extends approx ____cm before it's initial division into the bronchus to the right, upper and missle lobes?
  6. The left mainstem bronchus extends approx ____ cm before its initial division.
  7. 1/250-1/50 people have and anomalous what?

  1. the 2nd thoracic vertebra
  2. 10-12 cm long, 20 mm diameter
  3. 6th cervical vertebra
  4. at the carina, 5th thoracic vertebra
  5. 2.3 cm
  6. 5 cm
  7. RUL bronchus above the carina

3

what degree do the bronchus take off at?

right?

left?

right-250

left- 450

 

4

do the bronchioles have cartilage like the bronchi??

no that would be silly

5

 The "air" transfers from the bronchi to the bronchioles then divide to transitional resp bronchioles. during all of this what happens to caliber and total airway area?

the caliber decreases and the total airway area increases!

(sounds confusing but this is what i found when I looked it up...so basicaly we are going from a Large diameter (caliber) bronchi to the smaller bronchioles. althought the diameter or caliber gets smaller teh actual surface area is larger, b/c there are more bronchials kind of like the alveoli have a huge surface area dispite being smaller than a freckel on an ants pecker)

6

what is between the visceral and parietal pleura and why?

a thin layer of fluid to allow the lungs to move in a smooth motion

(visceral is toward the organ (lung) and the parietal pleura is toward the rib cage)

7

what occurs with negative pressure in the lungs?

the lungs expand and the layers are approximated

 

8

Note position of lungs

anterior

9

Note position of lungs

right side

10

Note position of lungs

left side

11

As stated previously notice the different bronchi and see the 250 right vs the 450 left and the cm difference between the first branches

 

12

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what do we do if a pt gets over constriction? like an analphalaxis response or a recative airway?

we either want to  OVERDRIVE the sympathetic side (our beta agonist) or give epinephrine

or we want to KNOCK OUT the parasympathetic side- atropine, glycopyrrolate, atrovent (anticholinergics)

side note- the reason we do this is because this is b/c when they are having a airway issuse that is causing the lungs to constrict is it PNS not SNS so we need to stop it or overcome it

13

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as the last slide stated if we are having a constrictive airway problem we are having a PNS response. This slide will tie in with it and show why the smooth muscle is PNS controlled 

So what are the 4 ways that airway smooth muscle is controlled (basically what controlls the resistance in the airway smooth muscle)

  1. Humeral and neural influances
  2. Rich PARASYMPATHETIC innervation (ACh)
  3. ß2 receptors- smaller airways
  4. NANC receptors (NonAdrenergic NonCholinergic)- histamine H1 and H2, substance P

14

  1. Increases in lung volumes are accompanied by increases in what?
  2. As lung volumes decrease below FRC significant increases in what occurs?

  1. airway diameter

B/c the airways are tethered by the surrunding lung parenchyma.

       2.  airway resistance

15

pharmacological blockade of the PNS pathways or surgical transection of the vagus nerves can cause what in the lungs?

bronchodilation

(remember what i said earlier, to overcome the airway resistance you must increase SNS or block PNS)

16

the NANC stimulation of the airway smooth muscle realeases H1 and H2. what do each do? and which one prevales?

H1 receptors -bronchoconstriction

H2 receptors- Bronchodilation

but regardless the predominant effect is bronchoconstriction

 

17

Inhaled gases are warmed, filtered and humidified by what?

the nasal vascular mucosa (your god damn nose)

18

the nose can heat the filtered air within __0C of body temp.

(i found this kinda of crazy. the nose is kind of like an instant warmer)

10C

33.8oF

19

The nose humidifies the air to almost _____%

100%

20

What in the nose is for mucous and particle removal? 

Nasal cilia

21

what can supress the cough reflex? and what can this lead to?

the administration of

general anesthesia

local anesthesia to the airway

opiods

benzodiazepines

-leads to the impaired clearance of secretions and foreign material from the airway

 

22

the cough reflex is mediated by what? and from where? so it is controlled by what part of the ANS?

vagus mediated

from the medulla

PNS

 

23

What actually occurs with a cough? or the basic 3 steps in a cough reaction

deep inspiration ⇒ glottic closure ⇒ forceful expiration (a cough0

24

the Sneeze relex (or nose cough as I like to call it) is similar to a cough with what exception!!!

this is a gimme come on you know it!!!

it facilitates the clearance of secretions from the nasal passageway, rather than the passageway below the nose

25

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what is the chief muscle of breathing?

The diaphragm

26

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the diaphragm accounts for approximately __% of the air that enters the lungs during spontaneous inspiration.

75%

27

how does the diaphragm cause gas to flow into the chest?

by decreasing intrathoracic pressure to less than atmospheric pressure

28

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the diaphragm does what to abdominal contents during inspiration?

downward and forward

29

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what is the usual (average/normal) diaphragm excursion?

1-10cm

30

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what in the spinal cord is the diaphragm controlled? and by what nerve?

 

cervical roots 3-5

the phrenic nerve

** a way to remember 3,4,5  keeps the lungs alive**