Chapter 17 Assessment of Respiratory Function Flashcards
What is the upper respiratory tract consist of?
Nose, paranasal sinuses, pharynx, tonsils, adenoids, larynx, and trachea
What is the purpose of the nose?
To filter, warm, and humidfy the air
How many passageways does each nasal cavity have?
3
Superior turbinate
Middle turbinate
Inferior turbinate
What is the 4 bony cavities of the paranasal sinuses lined with?
Nasal mucosa and ciliated pseudostratified columnar epithelium
Where is a common site for infections in upper respiratory tract?
Paranasal Sinuses
What prominent function does the sinuses do?
serves as a resonating chamber in speech
What are the names of the 4 sinuses?
Named after their locations
Frontal
Ethmoid
Spenoid
Maxillary
what are the three regions of pharynx (throat)?
Nasal
Oral
Laryngeal
Where is the faucial (palatine) and tonsils located?
Housed in the oropharynx
What is the passageway for the respiratory and digestive tracts?
The pharynx
Are adenoids and tonsils part of the lymphatic system?
True
What does the larynx connect?
Pharynx and trachea
What is the main function of the larynx?
Vocalization
What is part of the larynx?
Epiglottis
Glottis (opening between the vocal cords)
Thyroid cartilage (largest cartilage structure and forms part of the Adamās apple)
Cricoid cartilage
Arytenoid cartilages (used in vocal cord movement with the thyroid cartilage)
Vocal Cords(located in the lumen of the larynx)
Why is the larynx considered the watch dog of the lungs?
It protects lower airways from foreign substances and helps with coughing.
What is the trachea (windpipe) composed of?
Smooth muscle with C-shaped rings of cartilage, to prevent the wall of the trachea from collapsing.
What connects the larynx to the right and left main stem bronchi?
Trachea
What does the lower respiratory tract consist of?
The lungs
Which contain the bronchial and alveolar structures
What covers the lungs and thoracic cavity?
Visceral pleura covers the lungs
Parietal pleura lines the thoracic cavity, lateral wall of the mediastinum, diaphragm, and inner aspects of the ribs.
What does the mediastinum contain?
The lungs, heart, thymus, aorta, vena cava, and esophagus
Where does oxygen and carbon dioxide exchange take place?
Alveoli
Where is surfactant produced and what does it do?
Produced by type 2 alveolar cells and it reduces surface tension in the lungs
What may alter bronchial diameter and affects airway resistance?
Asthma, chronic bronchitis, obstruction(mucus, tumor, foreign body), emphysema (loss of lung elasticity, keepings airways open),
What conditions are associated with decreased compliance?
Severe obesity, pneumothorax, hemothorax, pleural effusion, pulmonary edema, atelectasis, pulmonary fibrosis, and acute respiratory distress syndrome
What is tidal volume?
The volume of air inhaled and exhaled with each breath
normal value 500ml or 5-10ml/kg
does not vary even with severe disease
What is inspiratory reserve volume (IRV)?
The max volume of air that can be inhaled after a normal inhalation
Normal value is 3000mL
What is expiratory reserve volume (ERV)?
The max volume of air that can be exhaled forcibly after normal exhalation
Normal value is 1100mL
is decreased with restrictive conditons such as obesity, ascites, & pregnancy
What is the equation for vital capacity?
VC=TV+IRV+ERV
Normal value 4600mL
decrease may be found in neuromuscular disease, generalized fatigue. atelectasis, pulmonary edema, COPD, and obsesity
What is the equation for vital capacity?
VC=TV+IRV+ERV
Normal value 4600mL
decrease may be found in neuromuscular disease, generalized fatigue. atelectasis, pulmonary edema, COPD, and obesity
What is the equation for inspiratory capacity?
IC=TV+IRV
normal value is 3500mL
decrease may indicate restrictive disease and obesity
What is the equation for functional residual capacity?
FRC=ERV+RV
Normal value is 2300mL
may be increased with COPD, ARDS, & obesity
What is hypoxia?
Low level of cellular oxygen
What is a shunt?
blood bypasses the alveoli without gas exchange occuring
seem with pneumonia, atelectasis, tumor, or a mucus plug
Main cause of hypoxia after thoracic or abdominal surgery and most type of respiratory failure
Explain dead space.
When ventilation exceeds perfusion
The alveoli do not have enough blood supply for gas exchange to occur
characteristic of pulmonary emboli, pulmonary infraction, and cardiogenic shock
Explain silent unit.
Absence of limited ventilation and perfusion
Seen in pneumothorax and servere acute repiratory distress syndrome (ARDS)
What controls the inspiratory and expiratory rate and depth of ventilation?
Medulla oblongata and pons
What causes reflex hypoventilation or hyperventilation?
Baroreceptors (located in aortic and caotid bodies) respond to an increase or decrease in arterial blood pressure.
What are major signs or respiratory disease?
Dyspnea, cough, sputum production, chest pain, wheezing, and hemoptysis
What could sudden dyspnea in a healthy person indicate?
pneumothorax (air in pleural cavity), acute respiratory obstruction, allergic reaction, or MI
What are common causes of a cough?
Asthma, GERD, infection, and side effects of meds such are ACE inhibitors.
What could pink-tinged mucoid sputum suggest?
Lung tumor
What could be the cause of profuse, frothy, pink material sputum suggest?
Pulmonary edema
What could be the cause of foul-smelling sputum and bad breath suggest?
Lung abscess, bronchiectasis, or an infection cause by fusospirochetal or other anaerobic organism
What could be associated with chest pain or discomfort?
Pulmonary, cardiac, gastrointestinal, musculoskeletal disease, or anxiety.
What does chest pain feel like if it is a pulmonary condition?
sharp, stabbing, and intermittent; or dull, aching, and persistent
What is hemoptysis?
It is blood coming from the respiratory tract.
Always needs futher investigation and the onset is usaually sudden.
What are the most common causes of hemoptysis?
Pulmonary infection
Carcinoma of the lung
Abnormalities of the heart or blood vessels
Pulmonary artery or vein abnormalities
PE or infraction
What is the pH of blood from the lungs?
Above 7 (alkaline)
and is usually bright red
What is the pH of blood from the stomach?
less than 7 (acidic)
and is usually darker red
What is clubbing of the fingers a sign of?
Lung disease
chronic hypoxic conditions
chronic lung infections
malignancies of the lung
congenital heart disease
endocarditis
IBS
Hispanics are more likely to be diagnosed with asthma than any other race. T/F
False
What does funnel chest (pectus excavatum) and pigeon chest (Perctus Carinatum) associated with?
Rickets or Marfan syndrome
Bronchial and bronchovesicular sounds what are heard anywhere else but the main bronchus in the lung could signify what?
Pneumonia and heart failure
must be furthur evaluated
Which abnormal sound needs emergent attention?
Stridor-high pitched musical sounds heard in the neck
What is bronchophony and egophony?
Bronchophony is vocal resonance that is more intense and clearer than normal
Egophony is voice sounds that are distorted E sounds like A
What is associated with general crackles, coarse crackles, and fine crackles?
General-heart failure and pulmonary fibrosis
Coarse-obstructive pulmonary disease
Fine- interstitial pneumonia, restrictive pulmonary disease, bronchitis
What is associated with wheezes and Rhonchi?
Wheezes-chronic bronchitis or bronchiectasis
Rhonchi- secretions or tumor
What is the vital capacity that a patient will be unable to sustain spontaneous ventilation and will requre respiratory assistance?
Less that 10mL/kg
What is used to measure inspiratory force?
Manometer
What are potential complications when obtaining ABGs?
Pain, infection, hematoma, and hemorrhage
What do VBG levels reflect?
The balance between the amount of oxygen used by tissues and organs and the amount of oxygen returning to the right side of the heart in the blood
What is the % that OSA effects?
26% ages 30-70
4-9% of woman
9-24% of men
90% are not diagnosed
What are the 3sā of OSA?
Snoring
sleepiness
significant other report of sleep apnea episodes
What is hypersomnolence?
Daytime sleepiness
What is the daily dose of modafinil that shows improvement to OSA?
200-400mg
What medication can be given to patients with OSA?
Modafinil
armodafinil
protiptyline
medroxyprogesterone acetate
acetazolamide
