Chapter 32 Pulmonology

define intrinsic risk factors

from within the patient, genetic predisposition

what does pleural fluid do?

serves as lubricant for the lungs to move during respiration

how does the lungs get blood?

through the pulmonary vessels and bronchial vessels

define extrinsic risk factors

external to the patient

examples: smoking and/or environmental pollutants

what is the function of the upper airway

warming an humidifying incoming air

during blank, air drawn into lungs

inspiration

4 parts of the upper airway

-nasal cavity

-oropharynx

-nasopharynx

-laryngopharynx

during blank, air leaves the lungs

expiration

lateral wall of the nasal cavity marked by thre bony prominences are called the

turbinates

is inspiration an active or passive process?

active, it requires energy

between each set of turbinates is a passageway/meatus that leads to the blank

paranasal sinuses

define lung compliance

ease with chest expanding and stretch

is expiration an active or passive process?

passive, does not require energy 

what is cilia?

thin, fingerlike projections that have the ability to contract in a single direction. help trap particles before they get into your lower airway

a rich supply of blood vessels referred to as blank, in the lower nasal septum warms inspired air

kiessselbach’s plexus

what cranial nerve is important for our sense of smell

first cranial nerve, the olfactory nerve

what is the pharynx?

funnel shaped structure that connects the nose and mouth to the larynx. has three divisions… nasopharynx, oropharynx and laryngopharynx

your larynx is composed of three pairs of cartilage… what are they?

thyroid cartilage, cricoid cartilage and epiglottis

another name for false vocal cords

vestibular folds

when you smoke cigarettes, it leads to the destruction of your cilia. what is your only mechanism left?

impairs the lungs ability to clear mucus, dirt and germs (because that jobs of your cilia) leading to increase respiratory infections, chronic inflammation and long term lung disease

define tidal volume

air moving in and out of the lungs

the more airway resistance…

the less air flows into the chest cavity

bronchi contain smooth muscle that are very sensitive to input from the sympathetic nervous system. this is why…

sympathetic stimulates (like epinephrine) or parasympathetic blocking agents (atropine, ipratropium bromide) are useful for treatment of asthma

at the blank, the trachea divides into the right and left main stem bronchi.

carina

define inspiratory reserve volume

lungs draw in additional volume of air beyond volume inspired during normal respirations

pneumonia is more common in the R lung due to…

because the right mainstream bronchus is more straight and the left angles more to the left. food is more likely to go straight down into the right lung.

define expiratory reserve volume

amount of air that can be forcibly expired out of the lungs after a normal breath

order of divisions of the bronchi

bronchi → secondary bronchi → tertiary bronchi → bronchioles → alveolar ducts → alveolar sacs

define residual volume 

air remaining in the lungs at all times 

most gas exchange (oxygen and carbon dioxide) takes place in the blank

alveoli

define inspiratory capacity 

sum of tidal volume and inspiratory reserve volume 

what do pulmonary capillaries do?

carey carbon dioxide-rich blood from the heart into the lungs and oxygen-rich blood away from the lungs for return to the heart

define functional residual capacity

sum of expiratory reserve and residual volume

what makes up the respiratory membrane?

alveolar linings, supportive tissue and capillaries

define total lung capacity

total volume of air in the lungs

define vital capacity

amount of air that is measured from a full inspiration to a full expiration 

the alveoli are moistened and kept open because of the presence of an important chemical called

surfactant

not all of the alveoli remain open during gas exchange, a small percentage of blood passes through the alveoli without exchanging oxygen and carbon dioxide

physiologic shunt

define minute respiratory volume 

amount of air moved in and out of the lungs during 1 minute

your right lung has blank lobes while your left lung has blank lobes

3 and 2

the lungs are covered by connective tissue called

pleural

define minute alveolar volume 

volume of air moving through the alveolar in 1 minute

what does the visceral pleura cover?

the lungs, also does not have nerve fibers

define forced expiratory volume (FEV)

volume of air exhaled over a measured period of time

what covers the thoracic cavity and does contain nerve fibers?

parietal pleura

define peak flow

measures maximum rate of airflow during forced expiration 

one function of the pulmonary artery

transport deoxygenated, carbon dioxide blood away from the heart and to the lungs.

*remember Artery, Away (away from the heart)

define anatomical dead space 

air rest in the trachea, mainstem bronchi and bronchioles. unable for gas exchange 

one function of the pulmonary vein

transport oxygenated blood from the lungs to the heart

*vacation to the heart

define alveolar dead space

some alveoli unavailable for gas exchange 

3 important processes allowing gas exchange to occur are…

-ventilation

-diffusion

-perfusion

define ventilation

mechanical process of moving air in and out of the lungs

what is the organ regulates/controls ventilation 

medulla 

define diffusion

processed by which gases move between the alveoli and the pulmonary capillaries

how does the medulla know when to tell your body to inhale and exhale?

CO2 goes up → chemoreceptors/stretch receptors sense this and send it to the → phrenic nerve, the phrenic nerve then tells your diaphragm to move

each set of ribs is connected by a thick array of muscles called

the intercostal muscles

the hering-breuer reflex does what?

prevent overinflation of the lungs

define perfusion

circulation of blood through the body

perfusion works under three conditions, what are they?

-adequate blood volume (fluid)

-intact pulmonary capillaries (container)

-efficient pumping of blood by the heart (pump)

what does hemoglobin do?

transporting protein that carries oxygen in the blood

oxygen is transported two ways… what are they?

-dissolved in the plasma

-bounded to hemoglobin

difference between oxyhemoglobin and deoxyhemoglobin

oxyhemoglobin is hemoglobin with oxygen bound while deoxyhemoglobin is hemoglobin without oxygen

carbon dioxide is transported from the cells to the lungs in three ways… what are they?

-formed as bicarbonate ion

-bound to globin portion of the hemoglobin molecule 

-dissolved in plasma

hemoglobin with carbon dioxide bound is called

carbaminohemoglobin

define respiration

exchange of gases between a living organism and its environment

where does pulmonary respiration take place?

in the lungs

where does cellular respiration take place?

peripheral capillaries 

define pulmonary shunting

area of lungs tissue ventilated, no perfusion occurs, oxygen is not moved to the circulatory system

is a pulse ox accurate when someone has potentially carbon monoxide poision?

no, pulse ox only measures the saturation of hemoglobin without seeing what is actually attached to the hemoglobin

carbon monoxide has an affinity for hemoglobin that is how many more times than higher than oxygen?

200-250

car pedal spams, seen in hyperventilation, are due to

hypocalcemia

blank resistance and blank compliance govern the amount of air that flows into the lungs

airway, lung

amount of air that is measured from a full inspiration to a full expiration

vital capacity

located on the visceral pleural and on the walls of the bronchi and bronchioles, the blank provide input into the medullas respiratory center

stretch receptors

exchanges of gases between a living organism and its environment is

respiration

when an area of lung tissue is approximately ventilated but no capillary perfusion officers, available oxygen is not moved into the circulatory system. this is known as

pulmonary shunting

blank provides a noninvasive measure of CO2 levels

capnometry