Procedures I: Pulmonary

The Respiratory system includes

thoracic cavity, airways leading to the lungs, and the lungs

everything in the thoracic cavity is protected by

the rib cage

the thoracic cavity runs from

clavicle to the diagragm

what seperates the thoracic and abd cavities

diaphragm

mediastinum

space between lungs that includes the heart, great vessels, trachea, esophagus, thymus, lymphatics, nerves, fibrous tissue and fat

what is included in the upper respiratory tract

nose, nasal cavity, and pharynx

nose

primary passageway of air

nasal cavity

large air-filled space that includes the superior, middle, and inferior nasal conchae

pharynx

connects the mouth (oropharynx), nose (nasopharynx) and throat (laryngopharynx) and is also shared by the digestive system

what does the lower respiratory tract consist of

larynx, trachea, lungs (bronchi, bronchioles and alveoli)

parts of larynx

voice box, thyroid cartilage, cricoid cartilage, epliglottis

voice box

involved in breathing, swallowing, and talking

thyroid cartilage

protects voicebox

cricoid cartilage

structural support, keeps airway open

epiglottis

composed of elastic cartilage and is a valve that covers the entry of larynx to prevent food from entering trachea

opens when inhale, closed when swallow

trachea

windpipe, tough flexible tube that begins around c7 and ends at T5

trachea is ____ to esophagus

anterior

tracheal ligaments are attached to

cricoid cartilage

bronchial tree anatomy

trachea → bronchi→bronchioles

where does trachea bifurcate into L and R main bronchi

carina

Rt bronchus is ___ and _______ than Lt

wider and more vertical

bronchi have ____ in their walls while bronchioles don’t

cartilage

primary bronchi branch into

secondary bronchi and tertiary, then bronchioles, respiratory bronchioles, alveolar ducts, and alveolar sacs

bronchial epithelium is lined by cilia and goblet cells that secretes mucus to make sure

lungs don’t stick together

alveoli are present in

respiratory bronchioles but most numerous in alveolar sacs

Alveoli

where oxygen and carbon dioxide are exchanged

Type 1 alveolar cells

very thin and spread over surface of alveoli (covers 95% of alveolar surface), main role is gas exchange b/w alveoli and pulmonary capillaries

Type 2 alveolar cells

make surfactant and macrophages; more spreadable

what does surfactant do

a chemical that reduces the surface tension of a liquid making it more spreadable, mix of fat and proteins and helps prevent alveolar collapse and lungs sticking together

alveolar macrophages

WBCS that help remove particulate matter

type 2 cells and turn into type 1

during lung injury

lobes of the lungs

rt:3 lobes (upper, middle, lower)

lt lung: 2 lobes (upper lower)

fissures

deep groves or clefts that separate lobes of the lungs

2 in rt (horizontal, oblique)

1 in lt (oblique)

hilum of lung

depression in the mediastinal surface

hilium of lung acommodates

bronchi, pulmonary blood vessels, lymphatic vessels, and nerves

visceral pleura

double-layered serous membrane that adheres to the surface of the lungs, including fissures that separate the lobes

the visceral pleura provides

lubrication and facilitates movement of the lungs during breathing

parietal pleura

outer layer of the pleura and adheres to thoracic wall, mediastinum, and diaphragm

pleural cavity

space b/w the parietal and visceral pleura

pleural cavity contains pleural fluid which allows for

lubrication and smooth breathing

lungs are suppiled with lymphatic vessels that travel toward

hilium of the lungs w/ airways and blood vessels raching lymph nodes and cont into mediastinum

Pulmonary arteries pathway

pulmonary artery —> form R and L pulmonary arteries and follows bronchial tree —> follow bronchi and bronchioles, dividing with them until they reach the alveoli

each alveolus is supplied by

a terminal arteriole, which gives rise to approx. 1000 capillaries per alveolus

the pulmonary capillaries drain into what and form into

pulmonary veins; left atrium

order of blood flow

1) deoxygenated blood is brought to the RA through vena cava

2) deoxygenated blood from RA moves to RV and pumped to pulmonary arteries

3) blood becomes oxygenated

4) oxygenated blood from the lungs is carried by the pulmonary veins from lung to LA

5) the oxygenated blood from LA moves to LV and is pumped to body tissues via aorta

lungs recieve blood from aorta through

bronchial arteries

anastomoses

connection b/w 2 passageways

tidal volume

volume of air breathed out in a normal breath

functional residual capacity

volume of air in the lungs at the end of a normal breath

total lung capacity

volume of air in the lungs after you inhale as much as possible

residual volume

volume of air left in lungs after a complete forceful exhalation

compliance

change in volume or change in pressure of air in the lungs

closing capacity

volume of air in the lungs when closure begins bronchioles collapse

perfusion and ventilation are not evenly distributed in the lungs, so its different

in upright and supine position

V/Q in upright position

V of lower portion of lungs is 150% that of the apex

Q- 3-5x more blood flow in the base of the lungs

important b/c injection can sink to the bottom (create an ombre)

V/Q in suine position

V is more uniform top to bottom but there is a gradient from front to back

ventilation exceeds blood flow by how much in upper zones, and what is going on in middle and lower zoons?

upper zones= exceeds by 2:1 to 3:1 in upper zones

middle zones= more closley matched

lower zones: blood flow exceeds ventilation

how large are capillaries

7-10 micrometers in diamter

injecting MMA= blocks less than 0.1% of capillaries so this why its safer