Anatomy, Physiology, Pathophysiology Flashcards
The upper airway is responsible for _______ and ________ incoming air.
Warming and Humidifying
How many liters of air are filtered, warmed, humidified, and exchanged each day
Approximately 10,000 liters
What is Kiesselbach’s plexus, where is is located, and what is it’s function.
It’s a rich supply of blood vessels in the lower nasal septum that warms inspired air.
The larynx is composed of three pairs of cartilage. Name them
thyroid (arytenoid)
cricoid (corniculate)
epiglottis (cuneiform)
The vocal cords and the space in between them are referred to as the ___________.
glottic opening
Approx how long is the treachea
10 cm
The right and left mainstem bronchi divide at this point.
Carina
The mainstem bronchi divide into the __________ (lobar) bronchi.
Secondary
The secondary bronchi divide into the __________ (segmental) bronchi.
Tertiary
The tertiary bronchi divide into the __________.
Bronchioles (small airways)
Approx 1 mm thick
After approx 22 divisions, the bronchioles become ___________.
Terminal bronchioles
The terminary bronchioles divide into the ________.
Respiratory bronchioles
Gas exchange in the lungs first begins at the level of the ______________
Respiratory bronchioles
The respiratory bronchioles divide into the _______.
Alveolar sacs.
This is where most of the gas exchange in the lungs take place
What is the purpose of surfactant?
Decrease surface tension of the alveoli, thus keeping them open for gas exchange.
How many lobes are in each lung?
3 lobes in the right
2 lobes in the left
Three important processes allow gas exchange to occur
Ventilation
Diffusion
Perfusion
As inspiration begins, the diaphragm (contracts/expands), the intercostal muscles (contract/expand). These 2 actions result in an expansion in chest volume, which produces an (increase/decrease) in the air pressure in the chest cavity.
contracts
contracts
decrease
Inspiration is dependent on 2 things.
Intact chest wall
Intact pleural cavity
During respiration, approx ______ mL of air move in and out of the lungs. This is referred to as the _____ volume.
500 mL
Tidal volume
Total lung capacity _____mL
6000 mL
Anatomical dead space is approx ______ ml
150 mL
Which part of the brainstem controls ventilation
Medulla
Describe the hypoxic drive
In COPD pt, the body becomes less responsive to changes in arterial PCO2. Instead, the major stimulus to breathe comes from the level of O2 detected in arterial blood by blood receptors in the aortic arch.
Measured PCO2 levels between 50-60 mmHg are not uncommon
Describe diffusion
Process by which gasses move between the alveoli and the pulmonary capillaries
Lung perfusion is dependent on three conditions
Adequate blood volume
Intact pulmonary capillaries
Efficient pumping of blood by the heart
What does hemoglobin do
It is the transport protein that carries oxygen in the blood
Hemoglobin with O2 bound is ________
Hemoglobin without O2 bound is _______
Oxyhemoglobin
Deoxyhemoglobin
What are some properties of hemoglobin
Made up of 4 iron containing heme molecules and a protein containing globin
O2 molecules bind to heme portion, which changes its striation allowing additional O2 molecules to bind more readily
Carbon dioxide is transported from the cells to the lungs in one of three ways. Name the three.
As bicarbonate ion (70%)
Bound to the globin portion of hemoglobin (23%)
Dissolved in plasma (7%)
Cheyne-Stokes respirations
Vent pattern with progressively increasing tidal volume, followed by a declining volume, separated by periods of apnea
Kussmaul’s respirations
Deep, rapid breaths that result as a corrective measure against conditions such as diabetic ketoacidosis (which produces metabolic acidosis)
Thick green or brown sputum is characteristic in which disease
bronchitis
Thin, yellow or pale, grey sputum is characteristic in which disease
Inflammation or an allergic reaction
What is tactile fremitus?
Vibrations felt in the chest during speaking
What is ARDS? What is affected by it?
Acute Resp Distress Syndrome
Affects gas exchange in the lungs. It is a form of pulmonary edema that is caused by fluid accumulation in the interstitial space within the lungs
Which disease ultimately causes pulmonary hypertension, which in turn leads to right sided heart failure (also knows as ______)
Emphysema (pink puffers)
Cor pulmonale
It is best to keep PEEP pressure at ___________
<10 cm/H20
What is pulsus paradoxes?
A drop in blood pressure of 10 mmHg or more with inspiration
Which disease will commonly present with chest pain, fever, tachypnea, tachycardia, and a cough. Auscultation will commonly demonstrate crackles (rales) in the involved lung segment
Pneumonia
What disease presents with sore throat, rhinorrhea, chills, rigors, myalgias, headache, and diarrhea.
SARS
Hemoglobin with carbon monoxide bound to is is referred to as __________
Carboxyhemoglobin
Carbon monoxide has an affinity for hemoglobin ______ to _______ times that of oxygen.
200 to 250 times
A pulmonary embolism is a _________ or some other particle that gets lodged in a __________.
Thrombus
Pulmonary artery
A ___________ ____________ is defined as a pneumothorax that occurs in the absence of blunt or penetrating trauma
Spontaneous Pneumo
Guillain-Barre
Caused by disfunction of nervous system. Myelin covering of nerve is damaged, causing loss of nerve impulse. Most pt will require ventilatory assistance.
Absence of breath sounds in trauma versus medical patient
Pneumothorax in medical
Hemothorax in trauma
Where do you auscultate
Right and Left Apex (right below clavicle)
Right and left midaxillary line (4th and 5th intercostal)
Right and left base (8th or 9th intercostal midclavicular line)
Also 6 locations on the posterior
