> For the complete documentation index, see [llms.txt](https://thisispiggy.gitbook.io/my-wiki/llms.txt). Markdown versions of documentation pages are available by appending `.md` to page URLs; this page is available as [Markdown](https://thisispiggy.gitbook.io/my-wiki/01-step-1/pulmonary/01-pulmonary-anatomy.md).

# 01 Pulmonary Anatomy

## Lobes

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Pulmonary/lobes%20of%20lungs/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/x1Jl0zW.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/mddYzSs.jpg)

* RLL pneumonia

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Pulmonary/aspiration%20is,%20which%20side,%20upright%20vs%20lying%20down/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/kdNIaqI.jpg)

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

![](https://f001.backblazeb2.com/file/wikiFiles/gXdDAHZ.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/6HeQrrh.jpg)

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

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Pulmonary/pulmonary%20artery,%20bronchus%20relationship/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/Jk9BB5s.jpg)

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

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Pulmonary/diaphragm%20openings/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/F4nIaJ4.jpg)

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

![](https://f001.backblazeb2.com/file/wikiFiles/sbENCmW.jpg)

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Pulmonary/diaphragm%20innervation,%20pain%20referred%20where,%20cause.%20What%20is%20paradoxical%20movement,%20diagnosis%20how)..

![](https://f001.backblazeb2.com/file/wikiFiles/5rkAv4P.jpg)

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

## Respiration

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Pulmonary/quiet%20vs%20exercise%20breathing%20muscles/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/wHu2o1G.jpg)

* quiet: diaphragm sole muscle

![](https://f001.backblazeb2.com/file/wikiFiles/XcXkP8s.jpg)

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

## Respiratory tract

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Pulmonary/respiratory%20tract%20components%20and%20zones/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/4ktiubg.jpg)

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

![](https://f001.backblazeb2.com/file/wikiFiles/QpzWl3c.jpg)

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Pulmonary/mucous%20components,%20made%20by%20what%20cell,%20function,%20degraded%20how/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/fTjLcqa.jpg)

* barrier to infection

## Alveoli

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Pulmonary/alveoli%20cell%20types,%20function/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/cIMw5wk.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/CgMCqV8.jpg)

* clara: not in alveoli, in terminal bronchioles

## Surfactant

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Pulmonary/surfactant%20secreted%20how,%20component,%20function,%20mechanism/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/hmthSIW.jpg)

* surfactant: alveoli stay open when exhale

![](https://f001.backblazeb2.com/file/wikiFiles/JXsrWDV.jpg)

* 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

![](https://f001.backblazeb2.com/file/wikiFiles/tnt5nQL.jpg)

## NRDS

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Pulmonary/fetal%20lung%20mature%20when,%20definition,%20drug%20used%20if%20not%20mature.%20Disease%20if%20not%20mature)..

![](https://f001.backblazeb2.com/file/wikiFiles/GgMr3vv.jpg)

* NRDS if not mature

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Pulmonary/NRDS%20is,%20result,%20risk%20factors,%20complications/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/E8PYkcB.jpg)

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

![](https://f001.backblazeb2.com/file/wikiFiles/a5HYJO8.jpg)

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

![](https://f001.backblazeb2.com/file/wikiFiles/tt6nfpX.jpg)

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