Ch.3

Question 1

Describe the function of the accessory muscles of inspiration?

Answer 1

Assist or replace the diaphragm in creating subatmospheric pressure in the pleural space during inspiration.

Question 2

Describe the function of the accessory muscles of expiration?

Answer 2

Often recruited when airway resistance becomes significantly elevated. When these muscles actively contract intrapleural pressure increases and offsets the increased airway resistance.

Question 3

What are the affects of purse-lip breathing?

Answer 3

Creates a positive pressure by retarding the airflow provides the airways with with some stability and an increased ability to resist surrounding intrapleural pressures. It offsets early airway collapse and air trapping during exhalation. Also slows the patients ventilatory rate and and generate a ventilatory pattern that is more affective in gas mixing.

Question 4

What is nasal flaring?

Answer 4

Facial reflex that that enhances the movement of gas into the TB tree. The dilator naris pulls the alae laterally and widens the nasal aperture providing a larger orifice for gas to enter the lungs during inspiration.

Question 5

What is splinting?

Answer 5

Severe resistance to taking a deep breath

Question 6

What is pleuritic chest pain?

Answer 6

A sudden, sharp, or stabbing pain in the chest. The pain generally intensifies during deep inspiration and coughing and diminishes during breath holding or splinting.

Question 7

What is nonpleuritic chest pain?

Answer 7

Constant pain that is usually located centrally. It is not generally worsened by deep inspiration. The pain also may radiate.

Question 8

List abnormal chest shapes and configurations?

Answer 8

•Kyphosis
• Scoliosis
• Kyphoscoliosis
• Pectus carinatum
• pectus excavatum
• barrel chest

Question 9

List abnormal extremity findings?

Answer 9

• Altered skin findings
• Presence or absence of digital clubbing
• Presence or absence of peripheral edema
• presence or absence of distended neck veins

Question 10

Describe normal and abnormal sputum production?

Answer 10

Normal: clear, thin, and odorless
Abnormal: yellow-green, opaque, thick, frothy, and pink

Question 11

Define hearing Breuer reflex?

Answer 11

A reduced stimulation of receptors rather than from stimulation of specific deflation receptors alone. They are located in the walls of the bronchi and bronchioles. When the receptors are stretched a reflex response is triggered to decreased the ventilatory rate.

Question 12

Define hysteresis?

Answer 12

The difference between the inflation and deflation pressure volume curve is a result of the variation in surface tension with changes in lung volume.

Question 13

Define I:E ratio?

Answer 13

The I:E ratio denotes the proportions of each breath cycle devoted to the inspiratory and expiratory phases. The duration of each phase will depend on this ratio in conjunction with the overall respiratory rate.
Normal I:E ratio is 1:2

Question 14

What is mMRC?

Answer 14

Method used to assess the pt’s breathlessness for those who can speak.

Question 15

Define mucociliary escalator?

Answer 15

The cough or mucociliary mechanism used to move secretions.

Question 16

What is nonpleuritic chest pain?

Answer 16

Constant pain that is usually located centrally. It is not generally worsened by deep inspiration. The pain also may radiate.

Question 17

What is pleural friction rub?

Answer 17

When a pt with pleurisy inhales and the lung expands irritating the inflamed parietal pleura and causing pain. On auscultation a squeaking or grating sound.

Question 18

What is pleuritic chest pain?

Answer 18

A sudden, sharp, or stabbing pain in the chest. The pain generally intensifies during deep inspiration and coughing and diminishes during breath holding or splinting.

Question 19

What is poiseuille’s law?

Answer 19

For pressure and flow even the slightest reduction in airway reduction in airway diameter can have a remarkable effect on the pt’s ability to move air in and out of the lungs.

Question 20

What is positional dyspnea?

Answer 20

A.k.a orthopnea which occurs when the patient is in the reclining position.

Question 21

What is renal dyspnea?

Answer 21

Difficulty breathing as a result of kidney disease.

Question 22

What is splinting?

Answer 22

Severe resistance to taking a deep breath is a symptom of pleuritic chest pain.

Question 23

What is tripod positioning?

Answer 23

Pts with advanced COPD may secure their arms to something stationary and use the pectoralis major muscles to increase the anteroposterior diameter of the chest.

Question 24

What is venous admixture?

Answer 24

A decreased arterial O2 level (hypoxemia).

Question 25

What is V/Q ratio?

Answer 25

A decreased arterial O2 level (hypoxemia).

Question 26

What is WOB?

Answer 26

Severely increased demand to breathe and dyspnea that occurs in the pt performing mild or moderate exercise with an abnormal capability to breathe because of a reduced cardiopulmonary function and reserve.