pulm a

• transversus thoracis
• xiphoid --> 2nd-6th costal cartilages
• helps w forceful exp

• the amount of air that is under volitional control
• inspiratory reserve volume + tidal volume _ expiratory reserve volume
• aka forced expiratory vital capacity (FVC)

• air in lung after tidal expiration
• expiratory reserve volume plus residual volume

IRV + TV + ERV + RV

RV = residual volume (vol of gase in lungs after ERV has been exhaled)

• FEV1: amount of air exhaled in first second of forced exhalation (forced exp vital cap FVC) - should be at least 70% of the FVC
• FEF: forced expiratory flow rate -- flow rate btwn 25-75% of forced exhalation -- shows changes in smaller airways, and changes more w disease than FEV1 does

• 55 mmHg
• or SaO2 is below 88%

• as CO2 increases, pH decreases
• as bicarbonate increases, pH increases

• it's screwy
• heart: apex is on the bottom, base is on the top
• lung: apex is on top, base is on the bottom
• the base is the wider part

• ventilation perfusion ratio
• at the apex (top) of lung it's high
• middle of lung about 1
• and in base it's low

thing is, the blood flow (perfusion) is gravity dependant, so the Q will be greatest in the region closest to the floor

• well ventilated but no gas exchange
• Could be because it's just a conducting airway or bc of a disease
• (gravity indep area)

• blood is traveling thru but no gas exchange bc of a ventilation abnormality
• (gravity dependent area)

120 bpm

75/50

• 75-80
• 24-54

• 500 ml
• 20 ml

• normal
• soft rustling heart throughout insp and at start of exp

hollow, echoing, normally only heard over superior R ant thorax (over the R main stem bronchus)

• crackling sound
• during insp
• 2/2 atelectasis, fibrosis, pulm edema

• during exp
• 2/2 obstruction (asthma, COPD, foreign body)
• can be heard on insp if severe enough

• E sounds like A
• 2/2 fluid filled areas, cavitation lesions, plural effusions, consolidation

intense clear sound during auscultation even at lung bases 2/2 fluid-filled areas of consolidation, cavitation lesions, or pleural effusions

whispered sounds heard clearly during auscultation 2/2 fluid-filled areas of consolidation, cavitation lesions, or pleural effusions

continuous x-ray beam allows observation of diaphragmatic excursion

4,000-11,000

• resp alk: alveolar hypervent
• resp acidosis: alveolar hypoven

• alkalosis: dizy, tingly, numb, tetany
• acidosis: anxiety, HA, dyspnea, confusion, coma

• alk: vomiting, diuretics, steroids, adrenal disease, bicarb ingestion
• acid: diabetic, lactic, or uremic acidosis diarrhea

• restrictive: IRV and ERV decrease
• obstructive: ERV decreases and RV increases

falls more than 20 mmHg or gets lower than 55 mmHg

increases > 10 mmHg or gets above 65 mmHg

• chronic congenital or acquired
• abnormal dilation of bronchi
• excessive sputum production

• hyaline membrane disease
• alveolar collapse in premature infant

enlargement and failure of the right ventricle of the heart as a response to increased vascular resistance or high blood pressure in the lung

• obstructive 
• seen in premies 2/2 high pressures of mechanical vent 2/2 resp distress syndrome

both will be low, but can get hypercapnea as it  gets more severe

abnormally increased concentration of hemoglobin in the blood, through either reduction of plasma volume or increase in red cell numbers

• force: enough to make pt's voice quiver
• duration: depends on pt's needs and improvement, but 3-5 min

• inhibit the parasymp nervous system -- increase HR, BP, bronchodilation
• side effects: lack of sweating, dry mouth, delusions

• smooth muslce relaxation
• side effects: increased BP, HR, arrythmias, GI problems, ...

• block the leukotrienes (tied with inflammation) released in allergic reactions
• inhibit airway edema and smooth muscle contraction
• anti-inflam
• ex: montelukast / singulair

• antiallergic drug
• prevents release of mast cells (histamine) after contact w allergens
• can prevent exercise-induced bronchospasm and asthma