1.330 Flashcards

1
Q

Primary function of the respiratory system?

A

Absorption of O2 and excretion of CO2

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2
Q

Level of respiration/ breathing

A

⬤ Breathing ( Pulmonary Ventilation): The way oxygen enters the lungs from the surrondings
⬤ External respiration: Gas exchange between the gas of the atmosphere and the lungs
⬤ Internal respiration: Gas exchange between tissue cells and systemic capillary blood
⬤ Cellular respiration: It is a series of chemical reactions that use O2 to break down food (glucose) to produce ATP(generate energy)

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3
Q

Function of the upper respiratory tract?
7 points

A

➢Conduction( Passageway for gas)
➢ Filtration
➢ Humidification
➢ Heater (warming of inhaled air)
➢Sense of small and taste (olfactory receptors)
➢Serves as a resonating chamber for speech
➢Protection of the lower airway

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4
Q

Definition of the URT?
What it’s composed of?

A

Defined as airways starting at the nose, extend to trachea

Composed of
➢Nasal cavities and sinuses
➢Oral cavity
➢ Pharynx
➢Larynx

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5
Q

Nasal cavity anatomical structure and their function?
5 points

A

⬤ External nares give entrance into cavities
⬤ Vestibules contain gross hairs working as filter (nasal cavity./septum)
⬤ Concha or turbinates: three shelflike bones projecting from lateral walls
Function: Increase surface area for filtering, warming, and humidifying inhaled gases
⬤ Contain olfactory cells providing sense of smell
⬤ Surface fluid is provided by goblet cells and submucosal glands in cavity and sinuses

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6
Q

Symptoms of diseases of the nose and paranasal sinuses?
8 points

A

❖ Nasal obstruction
❖Nasal discharge
❖Epistaxis
❖Hyposmia and anosmia
❖Headache
❖Snoring
❖Nasal septal deviation
❖Nasal polyps

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7
Q

What are sinuses, their sets, and function?

A

Def: Hollow spaces in the facial bones
Four sets of sinuses: Frontal, ethmoid, sphenoid, maxillary
Function of sinuses:
- Reduce weight of head
- Strengthen skull
- Modify voice during phonation

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8
Q

What is the oral cavity?
what is it composed of?
what does the posterior portion of the tongue has?

A

➢Forms common passage for air, food, and Fluids
➢Tip of soft palate, uvula, marks posterior aspect of cavity
➢Posterior portion of tongue has nerve endings triggering gag reflex to protect airway

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9
Q

Mallampati Score for intubation?

A

It measures how hard the intubation is from 1 to 4

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10
Q

Oral & nasal cavities open into the?

A

pharynx

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11
Q

The pharynx is composed of?

A

-Nasopharynx (from nasal cavity to uvula)
-Oropharynx (from uvula to tip of epiglottis)
Palatine tonsils (removed in tonsillectomy)
-Laryngopharynx (tip epiglottis to larynx)
Anatomic location where respiratory & digestive tracts divide

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12
Q

How many cartilages does the larynx has?
And their position

A

⬤ Contains nine cartilages
⮚ Thyroid (Adam’s apple)
⮚ Cricoid falls just below thyroid cartilage
⮚ Epiglottis attaches to thyroid cartilage
⮚ Three paired cartilages involved in phonation: Arytenoid, corniculate, cuneiform

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13
Q

What does the epiglottis do?
3 points

A

❖Closes laryngeal opening during swallowing, to create tight seal to prevent liquids and food from entering respiratory tract
❖Swallowing:
⮞ Muscular contractions resulting in early vocal cord closure and downward epiglottis movement
❖Folds connecting epiglottis and tongue form space called vallecula
⮞ Key landmark for oral intubation

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14
Q

Relative positions of oral cavity, pharynx, & larynx are major determinant of ………, particularly in ………….. patient

A

Relative positions of oral cavity, pharynx, & larynx are major determinant of patency, particularly in unconscious patient

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15
Q

How to keep patient upper airways open?

A

 Head tilts forward, partial or total occlusion can occur
 Extend head into “sniff position” to open airway & facilitate artificial airway insertion

(Correct is extended, flexed is the incorrect way)

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16
Q

What is the LRT?
What is it made of?

A

 Everything distal to larynx
 Made up of:
-Conducting airways⎯first 15 generations
-Purpose: convey gas from URT to area of gas exchange (lung parenchyma)
-Respiratory airways
-Microscopic airways distal to conducting zone
-Participate in gas exchange with blood

17
Q

Trachea extension, supported by, and the muscles

A

 Trachea: extends below cricoid cartilage to sternal angle
 Anterior & sides supported by 16 to 20 C-shaped cartilage
 Trachealis muscle connects tips of C-shaped cartilage & forms posterior wall

18
Q

Bronchi is bifurcated into…….. at ………?
The degree of each one?

A

 Right & left mainstem bronchi bifurcate at carina
 Right bronchus branches at 20- 30-degree angle
 Due to angle, most foreign aspirate goes to right lower lobe
 Left bronchus branches at 45- 55-degree angle

19
Q

Lobar and Segmental Pulmonary Anatomy of each lung

A

 Each lung is divided into lobes and segments
 Right lung has 3 lobes and 10 segments
 Left lung has 2 lobes and 8 or 10 segments

20
Q

Each segment of the lungs is supplied by?

These further divide numerous times until conducting airways end in ……………

A

Each segment is supplied by segmental bronchus.

These further divide numerous times until conducting airways end in terminal bronchioles

21
Q

All airway up to to terminal bronchioles constitute ………… and it is ………………………….. with the law of?

A

Dead space

~2 ml/kg of lean body weight, typically 150 ml

Deadspace to Tidal Volume Ratio (VD/VT)**
(VD/VT) = (PaCO2 –PECO2) / PaCO2

22
Q

The wall of the conducting airways (trachea to bronchioles) made of 3 layers

A

 Inner layer ( a mucous membrane) called a mucosa
- Composed of epithelia
- Pseudostratified, ciliated, columnar epithelia⎯most numerous cell type
 Submucosa⎯composed of connective tissue, bronchial glands & smooth fibers wrap around airway
 Adventitia⎯outer covering of connective tissue, cartilaginous rings

23
Q

The conducting airways has basal cells that?
3 points

A

 Contribute to appearance of pseudostratified cellular layer
 Mature into pseudostratified cells
 Thought to play role in repair of mucous membrane following diseases

24
Q

The conducting airways has Neuroendocrine cells that?
5 points

A

 Connected to vagus nerve
 Are thought to function during lung development
 Hypoxia & stress-strain sensors
 Secrete bioactive chemicals (e.g., serotonin, calcitonin, & gastrin releasing peptide)
 Mixed with lymphocytes & thought to be migratory in nature

25
Q

Respiratory bronchioles arise from terminal bronchioles & have 2 functions

A
  1. Conduct gas deeper into respiratory zone
  2. Participate in gas exchange: Bronchiole walls sprout alveoli
26
Q

All structures distal to one terminal bronchiole form primary lobule or acinus, each composed of:

A

➢ Respiratory bronchioles, alveolar ducts, alveolar sacs, & about 10,000 alveoli

27
Q

Alveoli are ? 4 points

A

 saclike growths that sprout on walls of respiratory bronchioles, alveolar ducts, & alveolar sacs
 Primary function is gas exchange
 Around 270 – 790 million of alveoli in adults, (increase with individual’s heights),
 The diameter of the alveoli in the apical regions are greater then in the basal regions of the lungs! Q

28
Q

Alveoli types 1 cells and macrophages?

A

Type I pneumocytes: very flat & cover about 93% of alveolar surface
 Very thin facilitating gas exchange
 Form very tight joints, which limits movement of materials into alveolar space

Alveolar macrophages provide defense

29
Q

Alveoli types 2 cells?

A

Type II pneumocytes are cuboidal
 Twice as many as type I cells
 Manufacture & storage of surfactant
-It is a mixture of several phospholipids, proteins, and ions.
-Reduces surface tension & alveolar tendency to collapse
-Increases compliance & decreases work of breathing
-In humans, surfactant appears at about week 28 (a full-term pregnancy is 40 weeks).
-Deficiency of surfactant → Respiratory Distress Syndrome (RDS).
 Have “Stem” cell like action
-Can differentiate into type I cells, so as to repopulate & repair damaged alveolar surface

30
Q

Blood-gas barrier

O2 & CO2 diffuse from alveoli through: 7 points

A

A/C membrane provides area for gas exchange (typically about 140 m^2 and 1 µm thick)

 O2 & CO2 diffuse from alveoli through:
- Surfactant layer
- Type I cell
- Basement membrane
- Interstitial space containing basement membrane, elastin & collagen fibers, & capillaries
- Capillary endothelial cells
- Plasma
- Finally, into erythrocytes (RBCs)