01 Pulmonary Anatomy

• RLL pneumonia

• left: sharp angle
• vomit and then pneumonia: usually right sided

• supine: superior portion of right inferior lobe or posterior portion of right upper lobe

• right PA: anterior to right bronchus
• left PA: superior to left bronchus

• caval foramen: IVC
• esophageal hiatus: esophagus
• aortic hiatus

• dyspnea: can't contract diaphragm to breath
• other side move down, push affected side up

Respiration

• quiet: diaphragm sole muscle

• accessory muscles: in hospital, see pts contract neck/abd when breathing = respiratory distress

Respiratory tract

• URI: does not involve lower respiratory tract (sinusitis, pharyngitis, etc.)

• barrier to infection

Alveoli

• clara: not in alveoli, in terminal bronchioles

Surfactant

• surfactant: alveoli stay open when exhale

• Laplace law
• if pressure in sphere below distending pressure, alveoli collapse
• low sphere: small radius, distending pressure high, takes more pressure to keep small sphere open, also more likely to collapse
• when inhale, alveoli gets large; when exhale, gets smaller
• result: when alveoli need the air to keep open, air leaves, distending pressure gets high
• surfactant shrinks surface tension as radius falls during exhalation
• when exhale, surfactant molecules gets closer, concentration higher, reduce surface tension
• falling radius and surface tension offsets one another

NRDS

• NRDS if not mature

• hyaline: glass like, what alveoli looks like
• give O2: all goes to healthy alveoli, sick ones collapsed (shunting)

• high glucose from mother stimulate baby's pancreas to make insulin

• all related to O2
• bronchopulmonary dysplasia: hyperplasia and fibrosis of airways (exposing premature lung to high O2 concentration, O2 toxicity)