10. Respiratory system

Question 1

anatomically how is respiratory tract is divided? Which organs belong to which?

Answer 1

divided into upper and lower respiratory tract…upper includes nose, pharynx, larynx….lower includes trachea, bronchi, bronchioles, alveolar duct, alveoli

Question 2

functionally how is the respiratory system separated? what is the function of each?

Answer 2

separated into two zones; conducting zones (nose to bronchioles) form a path for conduction of inhaled gases; respiratory zone (alveolar duct to alveoli) where gas exchange occurs

Question 3

Pharynx is a tube-like passage that connects the posterior nasal and oral cavities to _____ and _____. It is separated into ____pharynx, ___pharynx and _______pharynx

Answer 3

larynx and oesophagus; naso, oro, laryngo

Question 4

_____ is an inferior continuation of oropharynx. It extends from _____. It is commonly called the ____ box. why is it important?

Answer 4

larynx; epiglottis; voice; its important for breathing, vocalizing, prevent food getting stuck in trachea and cause choking

Question 5

Larynx is separated into which three sections?

Answer 5

supraglottic, glottis, infraglottic

Question 6

what are the two sets of vocal cords? how to produce falsetto?

Answer 6

vocal ligaments and vocal muscles; by relaxing muscles and vibrating ligaments

Question 7

Trachea extends from ____ (the level of ____) to ____ (the level of ____)

Answer 7

cricoid cartilage; C6; carina; T4-5

Question 8

the posterior tracheal wall lacks ___ and is supported by ______

Answer 8

cartilage; trachealis muscle

Question 9

what is the angle of tracheal bifurcation called?

Answer 9

carinal angle

Question 10

the trachea divides at ___ into right and left main bronchus

Answer 10

carina

Question 11

main bronchus divides into ____ bronchi, which then divides into _____ bronchi. The bronchi continue to divide into smaller and smaller bronchi up to ____ generations of divisions from main bronchus

Answer 11

lobar; segmental; 23

Question 12

How to distinguish bronchi and bronchioles?

Answer 12

no cartilaginous support, no cilia and mucous producing cells

Question 13

what is vital capacity? what is residual volume?

Answer 13

volume change of lung between full inspiration and maximal expiration; volume remaining in lungs after vital capacity breath to keep the lungs from collapsing

Question 14

what is tidal volume?

Answer 14

volume of air that is inspired or expired in a single breath during regular breathing

Question 15

what is minute ventilation?

Answer 15

total volume of gas in liters expelled from lungs per minute

Question 16

what is the movement of inspired gas into and exhaled gas out of lung called?

Answer 16

ventilation

Question 17

what is the normal volume of alveolar ventilation? similar to volume of blood flowing through lung

Answer 17

5 liters/min

Question 18

in normal healthy individuals, physiological dead space = anatomical dead space. what might increase physiological dead space?

Answer 18

pulmonary embolism (blockage in one of the pulmonary arteries in your lungs)/pulmonary fibrosis(lung disease that occurs when lung tissue becomes damaged and scarred)/pulmonary edema (condition caused by excess fluid in the lungs)

Question 19

what will happen to tidal volume , respiratory rate, respiratory muscle mass, elastic recoil and ventilation/perfusion matching with aging?

Answer 19

lower tidal volume, higher respiratory rate, reduced respiratory muscle mass, reduced elastic recoil, diminished ventilation/perfusion matching

Question 20

how much does residual volume increase/decrease per decade? will there be increase/decrease in vital capacity?

Answer 20

RV increase by 5-10%; decrease

Question 21

If the pressure in the pulmonary artery is greater than __ mm Hg and less than __ mm Hg, it is considered mild and is called pulmonary hypertension.

Answer 21

20-40

Question 22

how to approximate pulmonary artery systolic pressure? what does systolic PAP of 30mm Hg imply?

Answer 22

using tricuspid valve velocity; implies a mean PAP more than 20mm Hg = pulmonary hypertension

Question 23

poor asthma control leads to higher frequency of obesity. T or F

Answer 23

T

Question 24

what are the exercise prescriptions for asthma patients?

Answer 24

use of beta-agonist inhalers eg ventolin before and during exercise; cold air and low humidity can precipitate asthmatic attacks; try running indoor

Question 25

should swimming be recommended to asthma patients?

Answer 25

Yes: breathing in air near water surface that is warmer and more humid than normal air No: accidentally inhale water can trigger asthma symptoms

Question 26

Beta agonists may cause an initial increase/decrease in oxygen saturation because resultant bronchodilation can initially increase/decrease the ventilation/perfusion mismatch

Answer 26

decrease; increase

Question 27

ipratropium bromide is typically given twice. T or F

Answer 27

F, only once

Question 28

what is chronic obstructive pulmonary disease (COPD)? what is it often caused by? what are the two types of COPD? How to test it?

Answer 28

chronic inflammatory lung disease that causes obstructed airflow from lungs; smoking cigarette; emphysema (damage to the air sacs in the lungs) and chronic bronchitis (long-term inflammation of the airways); spirometry (measuring how much air you can breathe out in one forced breath)

Question 29

endurance training with strength training has become an established basic component of training therapy in chronic pulmonary disorders. T or F

Answer 29

T

Question 30

for patients with COPD, intensive interval training leads to higher/lesser degree of dynamic pulmonary hyperinflation, shorter/longer tolerated training period and higher/lower degree of exertional dyspnea

Answer 30

lesser; longer; lower

Question 31

why train lower limb strength for patients with COPD

Answer 31

this is where disease-related muscular atrophy usually most pronounced

Question 32

what training should be given to COPD patients to improve balance? what does it do?

Answer 32

whole body vibration training; above a specific vibration frequency, the stretch stimulus triggers a reflex that leads to an involuntary muscle contraction

Question 32

what training should be given to COPD patients to improve balance? what does it do?

Answer 32

whole body vibration training; above a specific vibration frequency, the stretch stimulus triggers a reflex that leads to an involuntary muscle contraction

Question 32

what training should be given to COPD patients to improve balance? what does it do?

Answer 32

whole body vibration training; above a specific vibration frequency, the stretch stimulus triggers a reflex that leads to an involuntary muscle contraction

Question 33

what will happen when flail chest occurs? how will flail segment move?

Answer 33

when three or more contiguous ribs are fractured in two or more places; it will move paradoxically >>> move posteriorly when inspiring and move anteriorly when expiring

Question 34

how to treat large flails?

Answer 34

endotracheal intubation

Question 35

what is tension pneumothorax? what is the consequence of tension pneumothorax?

Answer 35

Tension pneumothorax develops when a lung or chest wall injury is such that it allows air into the pleural space but not out of it; occluding (or obstructing) venous return to heart

Question 36

How does high altitude cause pulmonary edema?

Answer 36

vessels in the lungs narrow, causing increased pressure. This causes fluid to leak from the blood vessels to the lung tissues and eventually into the air sacs

Question 37

what are the symptoms of HAPE shown by chest radiographs and CT scans?

Answer 37

a patchy and sometimes peripheral distribution of edema

Question 38

what are the symptoms of HAPE shown by echocardiographic and pulmonary artery catheterisation studies?

Answer 38

marked pulmonary hypertension

Question 39

how to treat HAPE?

Answer 39

oxygen/portable hyperbaric chamber