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Front Back
Lungs

How many lobes and segments ?
Left- 2 lobes and 8 segments

Right-   3 lobes and 10 segments
Muscles of Respiration

  • diaphragm

  • External intercostals

  • Internal intercostals

List generations 1-25

  • #1 Mainstem Bronchi

  • #2 Lobar Bronchi

  • #3 Segmental Bronchi

  • #4-9 Subsegmental Bronchi

  • #10-15 Bronchioles

  • #16 Terminal Bronchioles

  • #17-19 Respiratory Bronchioles

  • #20-24 Alveolar Ducts

  • #25 Alveolar Sacs


 
Define main carina

  • The first seperation creating the left and right mainstem bronchi to the lungs.

Trachea

  • 4 inches long

  • 3/5 inches in diameter

  • size of pinkie finger

  • generation 0

Lower Airway
Everything below vocal cords
Upper airway
Everything above vocal cords
Glottis
Opening of larynx
Epiglottis
  • Leaf cover that moves freely in larynx
  • Covers trachea during swallowing
  • Prevents aspiration
Three functions of nose
  • Filtration- hair and mucus filter particles >5 microns at 100% effiecency
  • Warms air- air passing tissue heats gas to body temp
  • Humidifies- increased temp and vascular tissue increase humidity of gas
  • Body produces 1 liter of humidity/day 
Diaphragm

  • Major muscle of respiration

  • Innervated by phrenic nerve

Internal intercostals
  • pulls ribs down and in
  • found between ribs
  • go different directions than externals
  • posterior to externals
  • provide for active expiration
External intercostals

  • pull ribs up amd out

  • found between ribs

  • work with diaphragm during inspiration

Accessory muscles

  • Sternocleidomastoid

  • Scalene

Types of Pleura

  • Visceral - lining around lungs

  • Parietal- lining inner surface of rib cage

Alveolar/Capillary Membrane

  • A/C membrane

  • allows gas exchange between alveoli and capillaries

Saturation
  • Sat
  • the amount of O2 being carried on the hemoglobin compared to how much it is capable of carrying
  • Normal 95%-100%
  • venous normal 75%
Factors that have negative effect on A/C membrane
  • Decreased hemoglobin
  • Increased space between alveoli and capillary bed due to fluid
  • Decreased red blood cells
  • Deceased alveolar surface area due to scarring or disease
Surfactant
  • fluid that lines internal alveoler surface
  • decreases surface tension ( ST) so inspiration and expiration occur easily and smoothly
  • keeps alveoli from collapsing during expiration
  • decreases amount of negative pressure required to overcome surface tension
Oxygen

  • O2

  • colorless

  • odorless

  • tasteless

  • molecular weight 32 grams

  • constitutes 21% of air

  • supports combustion ( not explosive w/o source of ignition)

Partial Pressure
  • P
  • the pressure exerted by a single gas in a mixture
PaO2
Partial pressure of oxygen in arterial blood
PAO2
Partial pressure of O2 in the alveoli
PvO2
Partial pressure of O2 in venous blood
PaCO2
Partial pressure of CO2 in arterial blood
Bicarb
HCO3 bicarbonate produced by kidneys to help maintain normal body pH (7.35-7.45)
ABG
  • Arterial blood gas includes PaO2, PaCO2, pH, sat, bicarb
  • use radial artery
PvCO2
Partial pressure of CO2 in venous blood
PECO2
Partial pressure of exhaled CO2
FIO2

  • fractional concentration of inspired O2 expressed as a percentage

  • the percentage of a gas as compared to the entire mixture

  • FIO2 of room air (RA) 21%

Atmosphere
  • atm
  • 760 tor
  • 760mm Hg
  • local atm 747 tor
Barometer

  • used to measure barometric pressure 

  • barometric pressure (Pb) is atmospheric pressure adjusted to sea level

Calculation of PO2 in room air (O2 tension)
PO2=Pb x FIO2
Ventilation
  • air movement to aveoli
  • air is inspired and received in aveoli
Diffusion
O2 crosses the A/C membrane and is exchanged with exhaled air
Lung perfusion
Blood circulated throughout the lungs around aveoli
Diffusion at the tissue
  • O2 is transported in the blood
  • Blood reaches the body tissue
  • O2 is deposited into the mitochondria of the tissue cell
Respiration
The exchange of gases, O2 being inspired and CO2 being exhaled.

Internal- cellular level

External- avelor level
Functional residual capacity
  • FRC
  • Volume of gas maintained in the lungs at resting exhalation.
Airway Resistence
  • Raw
  • Resistence caused by narrowed lumen due to :
a) Bronchospasm

b) Mucosal edema

c) Partial obstruction   
 
Total lung capacity
  • TLC
  • Total amount of air in lung at full inspiration
Tidal volume
  • Vt
  • Amount of air moved by lungs during a normal inspiration
  • 500-700ml  Normal range
     
Respiratory rate
  • Breaths/minute B/M
  • Frequency F
  • RR
Minute volume
  • V
  • Ve exhaled minute volume
  • Volume of air drawn into lungs during a one minute interval
  • Usually 10L per minute
  • V=Vt x RR
Residual volume
  • RV
  • amount of gas remaining in the lungs after a forced exhalation
Cor-pulmonale
  • Right heart failure
  • Right ventricular hypertrophy (enlargement) caused by abnormalities of lung structure and function
Sequence of Cor-pulmonale
  • An increase in pulmonary disease results in hypoxemia (low oxygen) which causes constriction of the pulmonary capillary bed.
  • constriction causes increased blood pressure
  • Pulmonary hypertension causes the right side of heart to work harder
  • Pulmonary hypertension without treatment results in cor-pulmonale
  • Cor-pulmonale results in congestive heart failure (CHE)
Hyperventilation
  • Excessive breathing
  • Greater than Ve
  • Decreased PaCO2 (<35 mmHg)
  • Lightheadedness
  • Vasoconstriction
Lumen
The space of a tube such as a blood vessel or trachea
Cardiomegaly
Hypertrophy of the heart usually caused by hpertension
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