Quiz 3

• muscles of inspiration are the external intercostals and diaphragm
• accessory muscles of inspiration are SCM, scalenes, SA, pecs, traps, and erector spinae
• Supine is the worst position

  • diaphragm sits higher so lungs can't expand
• Sidelying

  • upper side drops lower and has less excursion
  • lower side rises higher and has more excursion
• Muscles of forced expiration are abdominals and internal intercostals
• visceral pleura covers the outer surface of each lung
• parietal pleura covers the inner surface of the chest wall and the diaphragm
• R lung has 3 lobes
• L lung has 2 lobes and lingula
• Conduction airways has no gas exchange

  • trachea
  • bronchi
  • bronchioles
• Respiratory Airways

  • respiratory bronchioles
  • alveolar ducts
  • alveoli
• Total lung capacity is the total amount of air the lungs can accomodate
• vital capacity is the total amount of air exhaled after maximal inhalation
• inspiratory capacity is the maximal amount of air that can be inhaled after a resting state
• functional residual capacity is the amount of air remaining in the lungs after a normal exhalation
• tidal volume is the amount of air that moves in or out of the lungs with each respiratory cycle
• inspiratory reserve volume is the amount of air that can be forcibly inhaled after a normal tidal volume
• expiratory reserve volume is the volume of air that can be forcibly exhaled after exhaling
• residual volume is volume of air remaining in the lungs after maximal exhalation
• Obstructive lung disease is difficulty getting air out due to damage to lungs or narrowing of airways
• Obstructive lung disease causes

  • COPD
  • asthma
  • bronchiectasis
• Obstructive risk factor are smoking, lung irritants, and genetics
• Signs of obstructive

  • lung hyperinflation
  • elevated shoulder girdle
  • horizontal ribs
  • barrel-shaped thorax
  • low, flat diaphragm
• COPD is chronic obstructive pulmonary disease

  • not reversible
  • abnormal inflammatory response to noxious particles
  • Emphysema or chronic bronchitis
• Emphysema is damage to the alveoli

  • irreversible
  • accumulation of air in the tissues
  • smoking
• Chronic Bronchitis is the presence of chronic productive cough for 3 months

  • hyper secretion of mucus
  • smoking
• Emphysema

  • SOB
  • thin
  • dry cough
  • use of accessory muscles
  • pursed lip
  • barrel chest and low and flat diaphragm
• Chronic Bronchitis

  • chronic productive cough
  • overweight
  • cor pulmonale
  • R ventricle hypertrophy
  • cyanotic
  • peripheral edema
• Spriometry is the gold standard for dx COPD
• Asthma is reversible

  • chronic inflammatory disorder
  • recurrent episodes of wheezing, dyspnea, chest tightness, and coughing
• Bronchiectasis

  • progressive form of obstructive lung disease
  • dilation of airways is associated with chronic bacterial infections
  • localized is dilation caused by tumor or inhaled foreign object
  • diffuse needs systemic testing to determine cause
• Sx of bronchiectasis

  • blood streaked sputum
  • elevate HOB and sidelying on suspected bleed down
• Restrictive Lung Disease is difficulty getting air in

  • restriction of expansion of chest wall or lungs
• Signs of restrictive lung disease

  • tachypnea
  • hypoxemia
  • crackles
  • decreased lung volumes and capacity
  • cor pulmonale
• Atelectasis is when a portion of the lung collapsed from collapse of alveoli

  • mediastinum is shifted towards the affected side
• Acute Respiratory Distress Syndrome (ARDS)

  • from a disease that causes inflammation
• Sx of ARDS:

  • dyspnea at rest and activity
  • tachypnea
  • cyanotic
  • impaired mental status
• Tx for ARDS

  • early mobilization to prevent muscle wasting
  • prone positioning
• Interstitial Lung Disease is a large group of disorders that affect the lungs and can cause shortness of breath

  • most common is idiopathic pulmonary fibrosis
• Scleroderma is an autoimmune disease of CT

  • progressive systemic sclerosis