Kopp Midterm Review 10/20/25

/Anatomy Questions Review

Introduction

• Overview of today's anatomy review session focusing on concepts from respiratory anatomy, gas laws, and basic physiology.

Key Topics Covered

1. Temperature and Heat Transfer

   • Discussed methods to convert Celsius to Fahrenheit.

   • Overview of mechanisms for protecting patient temperature.

2. Dalton's Law of Partial Pressures

   • Definition: Total pressure (T) equals the sum of the partial pressures of individual gases present in the mixture.
     $T = P<em>1 + P</em>2 + P<em>3 + … + P</em>n$

   • Necessary calculations include identifying known barometric pressure and calculating leftover pressure of unknown gases.

3. Anatomy Structure Walkthrough

   • List of anatomical structures in the upper and lower respiratory tract.

Upper Respiratory Tract

• Nasal Cavity:

  • Functions: Filtering, humidifying air.

• Pharynx:

  • Nasal Pharynx

  • Oral Pharynx

  • Laryngopharynx

• Epiglottis:

  • Part of the larynx, protects the trachea during swallowing.

Lower Respiratory Tract

• Larynx:

  • Houses vocal cords (true cords), composed of nine cartilages, thyroid cartilage (Adam's apple) being the most prominent.

• Trachea:

  • Contains 16 to 20 C-shaped cartilaginous rings.

  • Length: approximately 10 to 12 cm.

  • Function: Air passage.

• Carina:

  • Where the trachea bifurcates into right and left main stem bronchi.

• Bronchi and Bronchioles:

  • Includes lobar bronchi and segmental (tertiary) bronchi leading to terminal and respiratory bronchioles.

  • Discussion on bronchioles and terminologies related to small airways.

  • Highlighted bronchial tree structure including terminal bronchioles, respiratory bronchioles, and alveolar ducts/sacs.

• Alveoli:

  • Primary site of gas exchange; structure allows diffusion of gases.

  • Alveolar-capillary membrane is one cell thick allowing easy gas diffusion.

Blood Flow and Gas Exchange Process

1. Oxygen Movement

   • Movement path: Alveoli → Capillary membrane → Capillaries.

   • Transport: Oxygen binds to hemoglobin in red blood cells.

   • Process: Diffusion of oxygen into capillaries from alveoli, explained via principle of partial pressure difference.

2. Carbon Dioxide Transport

   • Main transport pathways:

     • Dissolved in plasma (small percentage)

     • Bound to hemoglobin (about 23%)

     • Converted to bicarbonate (70%) through the carbonic acid reaction.

   • The equation for the reaction:
     $CO<em>2 + H</em>2O <br>ightleftharpoons H<em>2CO</em>3 <br>ightleftharpoons H^+ + HCO_3^-$

Pathway of Blood Circulation

1. Oxygenated Blood

   • From lungs → Pulmonary veins → Left atrium → Mitral valve → Left ventricle → Aorta → Systemic circulation.

   • Discussed normal cardiac output: 4 to 8 L/min.

2. Deoxygenated Blood

   • From tissues → Venules → Veins → Superior/Inferior vena cava → Right atrium → Tricuspid valve → Right ventricle → Pulmonary arteries → Lungs.

Ventilation and Perfusion Ratio (VQ)

• Importance of VQ ratio in understanding lung mechanics.

• VQ mismatch influences blood and oxygen exchange in patients.

Anatomy of Lungs and Dead Space Concepts

1. Anatomical and Physiological Dead Space:

   • Anatomical dead space: Area where air cannot participate in gas exchange.

   • Formula:

     • $1 ext{ mL/lb} ext{ body weight or } 2 ext{mL/kg body weight}$

     • Ex: 75 kg patient → 150 mL anatomical dead space.

   • Physiological dead space includes both anatomical and alveolar dead space.

2. Respiratory volumes/capacity:

   • Specific volumes such as residual volume (RV), tidal volume (TV), vital capacity (VC), and functional residual capacity (FRC).

   • Key formulas and classification of lung volumes are crucial for understanding respiratory mechanics and pathologies.

Control of Breathing

1. Chemoreceptors

   • Types: Central (respond to CO2 and hydrogen ion levels) and Peripheral (respond to oxygen levels).

   • Operating mechanisms and importance in assessing lung function and patient management.

Summary of Important Terms and Concepts

• Mucous Production:

  • Goblet cells and bronchial glands produce mucous that humidifies and protects the airways.

  • Mucociliary Escalator: Mechanism that moves mucus out of the airways.

• Lung Compliance:

  • Different lung diseases impact compliance, with emphysema resulting in high compliance and fibrosis resulting in low compliance.

Final Notes

• Oxygen Content and Transport:

  • Oxygen binding to hemoglobin (1.34 mL O2/g Hb), significance of partial pressures, and associations.

• Summary of Lung Diseases:

  • Restrictive vs. obstructive lung disease characteristics and examples.