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123 Cards in this Set
- Front
- Back
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What type of neurons are found in the olfactory mucosa?
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Bipolar
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What do the olfactory glands secrete?
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Mucus and odorant binding protein
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What is the oropharynx?
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The body's common pathway for food and air
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What cellular connections maintain polarity?
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Zonula occludens or Tight junctions--actin/IM filaments attach here
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What lines the anterior portion of the epiglottis? What lines the posterier?
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Anterior is lined with stratified squamous and the posterior is lined with respiratory epithelium
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What does the somatic layer form?
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Parietal pleura
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What does the splanchnic layer form?
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Visceral pleura
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What two structures do some cool movin and groovin during cranial/caudal folding?
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Heart and septum transversum are both anterior before the great folding
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What separates the pericardium from the pleural space?
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Pleural pericardial folds come in from MESODERM and ultimately partition off the pericardium from the pleural space
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What forms the diaphragm central tendon?
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The septum transversum
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Where does most of the musculature of the diaphragm come from?
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The pleuroperitoneal membrane
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What forms the crux of the diaphragm?
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The esophageal mesoderm
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What are the lungs at the start of their development?
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They are respiratory diverticuli that bud off the pharynx
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What is the most common cause of oligohydramnion and what malformation occurs as a result?
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Lack of amniotic fluid due to RENAL AGENISIS--this in turn results in prevention of formation of lungs and chest
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Where do you puncture for an thoracocentesis?
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Over the top of the rib because that is where the smaller vessels run
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What are the landmarks for the positions of the lungs?
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Midclavicular 6
Midaxillary 8 Midscapular 10 |
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How do the pulmonary arteries on the right and left side appear in the hilus?
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Left side: pulmonary artery is SUPERIOR to bronchus
Right side: pulmonary artery is off to the side |
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Which brachiocephalic vein crosses over the medial plane of the body and what consequences does this have?
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The LEFT brachiocephalic vein
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Where do the phrenic nerves run?
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Over the subclavian artery and under the brachiocepahlic vein--then both run ANTERIOR to the root of the lung
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The intraembryonic coelom gives rise to what?
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The Body Cavities
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What will splanchnic mesoderm ultimately give rise to?
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Connective tissue and lung smooth muscle
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What willline the larynx/trachea/alveoli?
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Endoderm will line it as epithelium
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What is the precursor to somatic and splanchnic mesoderm?
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Lateral Plate Mesoderm
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What do the mesenteries consist of?
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A double layer of peritoneum due to the joining of layers
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What is the difference between intraperitoneal organs and retroperitoneal organs?
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Intra--continue to suspend from the mesentery(e.g. small intestine)
Retro--lie on Body Wall and are covered in peritoneum(Secondarily retro lose their mesentery completely like the colon!) |
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What does the septum transversum divide?
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Divides the intraembryonic coelom into the pericardial cavity and the peritoneal cavity
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What joins the pericardial cavity to the peritoneal cavity?
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The PERICARDIAL CANALS
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What do the pleuropericardial folds consist of?
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Serous membrane(parietal layer of serous pericardium) + body wall mesenchyme(fibrous pericardium) + serous membrane(parietal pleura)
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What nervous system structure will the PP folds eventually hold?
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The phrenic nerve
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What forms the outer rim of muscle of the diaphragm?
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The paraxial mesoderm
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What forms the esophageal mesenchyme of the diaphragm?
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Right and left crura
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How are the costodiaphragmatic recesses formed?
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body wall tissue is added peripherally to the diaphragm
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Why does the phrenic nerve arise from C3/4/5?
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Because at 4 weeks the septum transversum is at the same level as those vertebrae
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What forms from the respiratory diverticulum?
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Bronchial buds
Primary = R/L Lung Secondary = Lung LOBES Tertiary = Bronchopulmonary Segments |
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True/False: The lung contains all three layers of tissue.
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FALSE--the lung contains only ENDODERM AND MESODERM
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True/False: The pleural cavities are completely separate due to the intercostal pleura.
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FALSE--they are separate because of the visceral pleura
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How do the lungs grow?
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They increase the number of respiratory bronchioles and alveoli
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What is the order of maturation stages of the lungs?
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Pseudoglandular--canalicular--terminal sac--alveolar
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What can cause pulmonary hypoplasia?
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Congenital diaphragmatic hernia and Eventration of the Diaphragm
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What is pulmonary hypoplasia?
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Underdeveloped lungs due to mesenchymal interaction dysfunction
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What are the three stimuli for respiration?
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Increased pCO2, decreased pO2, or decreased pH
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The last bronchiole without an alveolus is called a what?
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Terminal bronchiole
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What does the anatomical dead space consist of?
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The airways down to the terminal bronchioles
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What is unique about the capillary and alveolar basement membranes?
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They are FUSED to allow for easy diffusion
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Pulmonary arteries follow ______ and are _______. Pulmonary veins follow ________ and are ______.
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Pulmonary arteries follow airways and are vertical--Pulmonary veins follow interstitial connective tissue are horizontal
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What is transpulmonary pressure?
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The difference in pressure between the alveoli and the pleural cavity
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Is lung compliance a static property or a dynamic property? What is a static property?
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A static property is a measurement made when AIR ISN'T MOVING
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What are two DYNAMIC properties?
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Airway resistance and FEV1
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Historesis describes what?
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At every volume the pressure is lower with expiration
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How is FRC mainly measured?
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With gas dilution
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What does compliance equal? What is the opposite of compliance?
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It equals the change in volume over the change in pressure
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What would happen if tension were not variable in alveoli due to surfactant?
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Alveoli would tend to empty into more slowly emptying neighbors
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As alveolar radius decreases..what hapens to surface tension?
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It decreases
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Particles larger than 10 microns get how far?
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Not past the glottis
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Particles less than 0.5 microns do what?
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Are exhaled
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Particles that are 2-10 microns do what?
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Are trapped in the trachea/bronchioles
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What are the 4 effects of smoking?
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Increased amount of mucous, increased viscosity of mucous, reduction in ciliary movement, and alveolar macrophage dysfunction
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True/False: the compressive and expulsive phases occur more than once for a given inspiration during coughing.
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True
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What are some facts about alveolar macrophages?
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Amoeba like and migrate upward--monocyte linneage--move upward via mucociliary elevator--smokers have 2-3X more alveolar macrophages than normal
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What is transpulmonary pressure?
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Alveolar pressure minus pleural pressure
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What is the minimal volume of the lungs and when does this state occur?
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When the transpulmonary volume is zero--stab wound that introduces air into the chest wall
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Fibrosis causes a increase or decrease in compliance?
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DECREASE
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What happens to lung volumes in the case of fibrosis?
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They all go DOWN
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True/False: Smoking causes an increase in proteolytic enzymes
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TRUE
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What lung volumes change for a smoker?
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FRC and RV increase but VC decreases due to the residual volume increasing more than total lung capacity
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Why do we use plateau pressure to measure compliance?
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Because compliance is a static measurement and should be recorded with no air moving
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True/False: If the lungs are inflated then the transpulmonary pressure is always negative
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FALSE--it is always POSITIVE
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What effect does a higher lung volume have on resistance?
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It decreases lung resistance
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With a forced expiration curve, what is above the x-axis and what is below?
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Inhalation is below and expiration is above
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What does poor elastic recoil mean for patients with respect to airway crimping?
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The crimping of airways due to pleural pressure exceeding airway pressure can occur even earlier than normal(elastic recoil pressure is the only pressure keeping the airway pressure above that of the pleural space)
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What are the three parts of the work of inspiration?
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1. overcome static compliance
2. overcome airway resistance 3. overcome tissue resistance |
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The top of the lungs exhibit _____ compliance and _____ ventilation. The bottom of the lungs exhibit ____ ventilation and _____compliance.
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The top of the lungs exhibit decreased ventilation and decreased compliance and the bottom of the lungs exhibit increased ventilation and increased compliance
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What does the functional reserve capacity do for the lungs?
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It mutes the pulsatile effects of breathing on partial pressures
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What three factors affect alveolar PO2?
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PO2 of oxygen entering the alveoli, removal of O2 in exchange for CO2, and the entry of CO2 into the alveolus
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Will pushing more O2 have any effect on CO2 levels?
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YES--if the CO2 levels are too high then give 100% oxygen
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Is CO2 elimination perfusion limited or diffusion limited?
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PERFUSION
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A decrease in alveolar SA causes a what in diffusion?
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DECREASE in diffusing capacity
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What effect does increasing arterial and venous pressure have on PVR? Why?
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they both decrease resistance, although arterial increase decreases it more dramatically--this effect is due to RECRUITMENT/DISTRIBUTION
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What effect does lung volume have on PVR? Why?
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Decrease at first and then dramatic increase--this is due to the alveolar and extra alveolar vessels operating like two distinct populations
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What is the driving force for hypoxic vasoconstriction?
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ALVEOLAR PO2--hypoxia affects K+ conductance in the smooth muscle to cause vasoconstriction
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What factors can reduce DLCO?
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Reduced uptake by RBC's due to anemia or hemorrhage, Decreased alveolar capillary SA from emphysema, and Thickened alveolar capillary membrane from pulmonary fibrosis
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What are some scenarios that cause restriction?
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Lung fibrosis, obesity, chest wall abnormalities, lung resection
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What are the afferent inputs for respiration?
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Receptors(stretch in smooth muscle of lung, irritant receptors that cause bronchoconstriction, and juxtacapillary receptors stimulated by pulmonary edema to cause SOB and shallow breathing/tachypnea), Muscle spindles, and chemoreceptors in the aortic and carotid bodies
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What is the breathing pacemaker and what takes over for exercise?
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Dorsal respiratory group--ventral respiratory group
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What do the pontine respiratory centers do?
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Pneumotaxic center shuts off inspiration and apneaustic center prolongs inspiration
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Should you give a patient with bad COPD 100% oxygen?
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NO--they have CO2 insensitivity and so will stop breathing
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What happens during non-REM sleep?
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Decreased chemosensitivity, apnea, and EEG slowing
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What happens to PaCO2 during exercise?
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It DROPS OFF TO BUFFER decreasing pH
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What is the Haldane effect?
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Oxygen causing CO2 to be unloaded into the alveoli or out of tissues because OXYHb is a stronger acid than DeoxyHb
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True/False: Fetal hemoglobin contains extra 2,3 DPG
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FALSE--also has no beta chains
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If you suspected a person of having CO intoxication, would a pulse oximeter be able to read that?
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NO--you need to take a cooximeter to read the % of oxyHb vs. other Hb types
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How should you treat CO2 intoxication?
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Give 100% oxygen
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True/False: PO2 in the bloodstream will rise significantly with hyperventilation
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False--hyperventilation has much more of an effect on CO2 levels than O2
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What are the vocal folds lined with?
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Pseduostratified columnar epithelium and patches of stratified squamous
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What type of cartilage is found in the trachea? Is it surrounded by anything?
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It is hyaline cartilage and it is surrounded by perichondrium
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The respiratory epithelium is what cell type?
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Pseudostrat. squamous
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How is odorant sensed?
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GPCR receptors that increase cAMP
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What is found in the mucosa? The submucosa?
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Epithelium and loose lamina propria--mixed glands and mucous/serous glands
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Do bronchioles contain glands? Cartilage?
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No--No
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What are Clara cells?
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Non-ciliated secretory cells with rounded apical surface projections that secrete surfactant components and detox
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What lines the terminal bronchioles?
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Simple cuboidal epithelium
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What do brush cells do?
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Sense air quality
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Where are alveolar macrophages found?
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In the alveolar septum
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What forms most of the musculature of the diaphragm?
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The pleuroperitoneal membranes
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Where is the last place you will find glands in the lungs?
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In the terminal bronchioles
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At what level does the vena cava pierce? The Oesophagus? The aortic hiatus?
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8-10-12
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Where is the tip of the scapula?
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Between 7 or 8
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Where is the horizontal fizzier anatomically?
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around T4
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What are the parasymp. and symp. supplies to the lungs and what do they cause?
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Parasymp = vagus--causes bronchoconstriction, vasodilation of pulmonary vessels, and increased secretions
Symp = pulmonary plexus--causes bronchodilation, vasoconstriction, and decreased secretion |
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What do the recurrents branch off of?
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The vagus
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Where does the phrenic run on the left and right side?
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R side--under brachiocephalic vein and over brachiocephalic artery
Left Side--between subclavian and internal carotid |
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Where does the vagus run?
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Over the artery and under the vein on the right and then posterior instead of anterior to the root of the lung--almost same course as phrenic
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What does LARP mean?
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Left anterior right posterior is the vagus service to the esophagus
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What is the course of the thoracic duct?
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Angle between internal jugular and left subclavian vein
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What transition occurs when moving through the alveolar ducts?
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Cuboidal to simple squamous epithelium
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What is the difference between a closed and open pneumothorax?
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Open--mediastinum will shift and push against heart with inspiration but will return to normal position on expiration
Closed--mediastinum stays shifted |
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Does the mediastinum contain the lungs?
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NO
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What veins connect the SVC to IVC? What veins drain into them?
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Azygous and Hemiazygous and the intercostal veins drain into them
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What veins drain into the azygous?
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posterior intercostals
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What are the order of arteries coming off the arch of the aorta?
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1. Right brachiocephalic trunk 2. Left common carotid artery 3. Left subclavian artery
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What is the most common variation of the aortic arch?
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Left common carotid coming off the brachiocephalic trunk
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The aortic hiatus is found at with thoracic vertebra?
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T12
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What does the thoracic duct not drain?
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The right superior quadrant
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