Chapter 1: Conducting Airways/ Respiratory System Flashcards
State the three primary functions of the nose
- Heating
- humidification
- filtering
Describe the functions of turbinates
To increase the surface area of the nasal passage to facilitate heating, humidifying, and filtering of inspired air
Describe the impact of intubation on inspired air
Intubation by-passes the upper airway including the nose so all the functions of the nose and upper airway are lost. When using an artificial airway we need to be prepared to assist in carrying out the functions of the upper airways
Name the structure that is the narrowest part of the upper airway (adults / babies).
• Adults - the glottis (space between the true vocal cords)
• neonates- cricoid cartilage
Label the structures of the upper airway
May be one on the exam
Describe the changes in the epithelium of the lower airway as it progresses down toward the bronchioles
The epithelial layer thins, moving from pseudo stratified columnar epithelial later to cuboidal, and finally savamous by the terminal bronchioles
In addition the cartilage disappears as do the submucosal glands
Name the alveolar cell types and functions
• Type l alveolar cells : these are very thin very simple cells whose purpose is to facilitate gas exchange
• Type 2 alveolar cells: produce surfactant (dppc) which helps stabilize the alveoli and serves as a source for new type I and type 2 cells following injury
• Type 3 alveolar cells: alveolar macrophages. They attack any foreign substance that makes it to the alveoli. They phagocytize it
Name the structure that covers the opening of the larynx to keep food from going into the lungs during swallowing
The epiglottis protects the entrance to the larynx and the lower airway
Explain why an endotracheal tube is move likely to be inserted into the right mainstream as opposed to the left mainstream
The angle at which the right mainstream bronchus comes off the carina is not very acute at 25 degrees. This provides almost a straight shot for aspirates or endotracheal tubes to enter the right mainstream bronchus
Differentiate between bronchi and bronchioles
• Bronchi: large, cartilaginous airways with normal respiratory epithelium and lots of submucosal glands
• Bronchioles: small airways lacking in cartilage, with cuboidal to squamous epithelium and diminishing to absent submucosal glands
Discuss what differentiates the conducting airways from the area of gas exchange
Alveoli. If alveoli are present then we are in the area of gas exchange
Describe how cilia function and their role in mucociliary clearance
They continuously sweep towards the laryngopharynx . They whip forward contacting the ger layer of the mucus, moving it and anything stuck to it towards the laryngopharynx.
Describe the interface at which gas exchange occurs.
- ACM
-alveolar epithelium
- alveolar basement membrane
- interstitial space
- capillary basement membrane
- capillary endothelium
- blood plasma
- RBC’s
Name the primary neurotransmitters in the sympathetic and parasympathetic nervous systems
SNS: catecholamines - epinephrine and norepinephrine
PNS: acetylcholine (ach)
Describe the typical effects of the sympathetic and parasympathetic nervous system stimulation
•SNS
Alpha 1 - vasoconstriction primarily of arterial smooth muscle
Beta 1 - increased heart rate and force of myocardial contraction
Beta 2 - causes bronchial smooth muscle relaxation leading to bronchodilation
• PNS
-relaxation of the arterial blood vessels
- slowing heart rate and force of constriction
- bronchoconstriction
Describe the effects of Beta 1 receptor stimulation
Increased heart rate and force of myocardial contraction
Describe the effects of Beta 2 receptor stimulation
Cause bronchial smooth muscle relaxation leading to bronchodilation
Define cAMP and describe its effect on bronchial smooth muscle
cAMP is a secondary messenger within cells. When the sympathetic nervous system is activated by epinephrine other catecholamine it binds at the receptors on the surface the cell and camp mediates the response.in the pulmonary system this results in brochodilation
Describe the effect a drug that inhibits phosphodiesterase would have on bronchial smooth muscle
By blocking the breakdown of camp there is a week bronchodialtory effect
Describe how atropine exerts its parasympathetic (anticholinergic) effect, as well as the effect it has on heart rate
-Atropine blocks parasympathetic receptors. As the parasympathetic system slows everything down and causes bronchoconstriction, blocking the parasympathetic nervous system results in bronchodilation, increased heart rate, and drying of secretions
-Atrovent (ipratropium bromide) is a pulmonary specific variant of atropine that minimizes the impact on heart rate but results in bronchodilation. Continues to cause reduced production of secretions
Be able to label structures of the thoracic cage
Anterior and posterior view
The primary muscle of inspiration/ventilation
Diaphragm
Name the accessory muscles of inspiration
-scalene muscles
-sternocleidomastoid
-pectoralis major muscles
- trapezius muscles
- external intercostal muscles
Name the primary accessory muscles of expiration
-rectus abdominis
-external abdominis
-internal abdominis
-transversus abdominis
-internal intercostal muscles
Name substances that are released when mast cells degranulate
Histamine
Heparin
Slow release substances of anaphylaxis
Platelet activating factor
Eosinophil chemotactic factor of anaphylaxis
