Ex 3: 3 Apr 3 Apr Pulmonary Function and Airway Management Overview Flashcards
What is the typical partial pressure of oxygen (PAO2) in the lungs between breaths?
About 100 millimeters of mercury
How much fresh air is added to the lungs with one breath?
350 cc’s of fresh air
What is the effect of adding 350 cc’s of fresh air on the PA CO2 in the lungs?
Reduces PA CO2 by about four millimeters of mercury
What is the concentration of oxygen in the lungs calculated from a total pressure of 760 mmHg and a partial pressure of 100 mmHg?
About 13.16% O2
What is the average volume of oxygen in the lungs when healthy and resting?
About 395 mls of oxygen
What is the typical oxygen consumption per minute in a healthy individual?
About 250 cc’s of oxygen
True or False: The left lung has three lobes.
False
How many lobes does the right lung have?
Three lobes
How many bronchopulmonary segments are typically found in the right lung?
About 10 bronchopulmonary segments
How many bronchopulmonary segments are typically found in the left lung?
Usually 8 bronchopulmonary segments
What is the name of the connective tissue lining the outside of the lungs?
Visceral pleura
What is the name of the connective tissue lining the inside of the chest?
Parietal pleura
What is the purpose of the fluid in the pleural space?
Allows lungs to move freely within the chest
What is the costodiaphragmatic recess?
An opening or space between the diaphragm and rib cage
What shape does the diaphragm take during breathing?
It moves up and down
What happens to the lung volume when a person is paralyzed?
It can drop below residual volume, below about one liter
What anatomical feature does the left lung have to accommodate the heart?
Carved out space in the lung
What is the significance of pre-oxygenation in a paralyzed patient?
It helps to buy time in case of airway management difficulties
Fill in the blank: The _______ muscle connects at a centralized location called the central tendon.
Diaphragm
What is a typical issue that can arise from a lung infection affecting the pleura?
Painful breathing due to friction
What happens to the concentration of O2 when breathing in humidified air?
It decreases slightly, typically to 19-20%
What is the central tendon in relation to the diaphragm?
The central tendon is the centralized location where the diaphragm connects, typically where the heart sits.
Why is the left lung taller than the right lung?
The left lung is taller because the heart depresses the left side of the diaphragm more than the right side.
What are the major anchoring points for the diaphragm?
The diaphragm is anchored to the lumbar spine and the central tendon.
What is the primary function of the diaphragm during quiet breathing?
The diaphragm contracts and relaxes to facilitate air movement in and out of the lungs.
What role do the scalene muscles play in breathing?
The scalene muscles stabilize the top of the thorax while the diaphragm drops during inspiration.
What is the function of the sternocleidomastoid muscle in breathing?
The sternocleidomastoid muscle helps prevent the rib cage from being pulled down during deep inspiration.
What are the two sets of intercostal muscles and their functions?
The two sets are:
* External intercostal muscles - aid with inspiration
* Internal intercostal muscles - aid with forced expiration.
How do abdominal muscles contribute to breathing?
Abdominal muscles help push air out of the lungs by compressing the abdominal cavity.
What muscles are referred to as ‘pec muscles’?
Pec major and pec minor are referred to as ‘pec muscles’ and help stabilize the thorax during inspiration.
What is the pharynx and how is it divided?
The pharynx is divided into three parts:
* Nasopharynx - top part
* Oropharynx - middle part
* Laryngopharynx - bottom part.
What is the primary role of the upper airway?
The upper airway filters, heats, and humidifies inspired air.
What are the bony projections in the nose called?
The bony projections in the nose are called conchae, which include superior, middle, and inferior conchae.
Fill in the blank: The internal intercostal muscles are primarily used for _______.
[forced expiration]
True or False: The diaphragm is the only muscle used for breathing.
False
What happens to the tongue and floor muscles during paralysis?
They become flaccid and can block the airway when the person is supine.
Why are the bones of the nose porous?
The bones are porous to allow blood vessels to aid in heating and humidifying inspired air.
What happens if the air is not humidified as it enters the upper respiratory system?
The larynx and trachea can dry out, leading to potential problems.
What are the three types of concave projections in the nose called?
Superior concave, middle concave, inferior concave
These projections play a role in the filtration of air as it passes through the nasal cavity.
What is the primary function of the curved bony projections in the nose?
Generate turbulence to filter air
The turbulence helps trap particulates in mucus on the nasal walls.
What is another term used for the bony projections in the nose?
Turbinates
Turbinates are shaped like turbines and help spin the air for better filtration.
What is the ethmoid bone’s significance in the nasal structure?
It supports the superior and middle turbinates
The ethmoid bone is fragile and located in the middle of the face behind the nasal opening.
What bone do the inferior concave projections of the nose come from?
Maxillary bone
The maxillary bone forms the upper jaw and supports the inferior turbinates.
True or False: The ethmoid bone can withstand significant trauma without fracturing.
False
The ethmoid bone is delicate and can fracture easily if impacted.
What is the primary risk when performing nasal intubation?
Breaking the bony structures of the nose
Fractures can lead to significant bleeding and airway complications.
Fill in the blank: The __________ is the upper projection of the ethmoid bone that serves as an attachment point for the falx cerebri.
Crista galli
The crista galli is a midline structure that helps separate the cerebral hemispheres.
What cranial nerve is primarily responsible for sensory function in the face?
Trigeminal nerve (Cranial Nerve V)
The trigeminal nerve has three branches that supply different regions of the face.
What are the three divisions of the trigeminal nerve?
Ophthalmic, maxillary, mandibular
Each division innervates specific areas of the face.
What causes an ice cream headache?
Cold stimuli affecting the trigeminal nerve
The brain misinterprets the cold sensation from the roof of the mouth as pain in the forehead.
What is the function of the cribriform plate of the ethmoid bone?
Allows olfactory neurons to pass through
These neurons are responsible for the sense of smell.
True or False: The nasal cavity is not a good site for drug absorption.
False
The nose is highly vascular, making it effective for drug absorption.
Which cranial nerves primarily innervate parts of the pharynx?
Cranial nerves IX and X
Cranial nerve IX is the glossopharyngeal nerve, and cranial nerve X is the vagus nerve.
What is primarily responsible for innervating the oral pharynx?
Trigeminal nerve
The trigeminal nerve is cranial nerve V.
Which cranial nerves are primarily responsible for sensory function in the rest of the pharynx?
Cranial nerves IX (glossopharyngeal) and X (vagus)
Cranial nerve IX is responsible for the back of the mouth, while cranial nerve X (vagus) covers the oropharynx and larynx.
What does the vagus nerve innervate in the respiratory system?
Back of the oropharynx, larynx, trachea, and epiglottis
The vagus nerve plays a crucial role in sensory function throughout the upper respiratory system.
What is the role of the epiglottis?
Closes off the airway during swallowing
The epiglottis prevents food from entering the larynx and trachea.
Which cranial nerve is responsible for taste sensation in the back third of the tongue?
Glossopharyngeal nerve (cranial nerve IX)
This nerve also provides basic sensory function for the area.
Which cranial nerve handles taste sensation for the front two-thirds of the tongue?
Facial nerve (cranial nerve VII)
This nerve is distinct from the glossopharyngeal nerve.
What structures are included in the tonsils?
- Palatine tonsils
- Pharyngeal tonsils
- Lingual tonsils
These tonsils are located at various positions in the mouth and throat.
What can cause the soft palate to obstruct the airway?
Enlarged pharyngeal tonsils
Enlarged tonsils can push the soft palate forward, complicating breathing.
What are the two sets of salivary glands mentioned?
- Sublingual glands
- Submandibular glands
The parotid gland is also mentioned as an additional salivary gland.
What can occur if the parotid gland is damaged?
It can swell to enormous sizes
This can happen due to trauma, such as a punch to the side of the face.
What is the purpose of the vallecula during intubation?
It serves as a notch for the intubation blade to access the airway
The vallecula is located between the tongue and the epiglottis.
How does the larynx move during swallowing?
It moves upward to cover the airway
This movement can either pull the epiglottis back or raise the larynx.
What is the function of mucus in the airway?
Cleans the larynx and traps debris
Mucus helps clear the airway by trapping and moving particles out.
What is the hyoid bone?
A floating bone located underneath the tongue
It supports the tongue and is involved in swallowing.
Fill in the blank: The _______ nerve is cranial nerve V and is responsible for sensory function in the anterior two-thirds of the tongue.
Trigeminal
This division is specifically the mandibular division (V3) of the trigeminal nerve.
True or False: The soft palate is a hard structure that assists in breathing.
False
The soft palate is made of soft tissue and can obstruct the airway if too floppy.
What is the function of the epiglottis?
The epiglottis prevents food from entering the trachea during swallowing.
What is the hyoid bone?
A floating bone located underneath the mouth, serving as an attachment point for muscles and cartilage in the larynx.
What is the thyroid cartilage?
The largest piece of cartilage in the larynx, serving as an attachment point for the hyoid bone and the trachea.
What is the cricothyroid joint?
The joint that allows the thyroid cartilage to pivot down.
What is the cricoid cartilage?
A ringed piece of cartilage at the bottom of the larynx, continuous and circular.
What is the laryngeal prominence?
The front projection of the thyroid cartilage, commonly referred to as the Adam’s apple.
Why do men’s voices tend to be lower pitched than women’s?
Men typically have a larger laryngeal prominence, which results in longer vocal cords.
What are arytenoid cartilages?
Diamond-shaped pieces of cartilage that the vocal cords attach to.
What is the role of the cricothyroid muscle?
It fastens the cricoid cartilage to the thyroid cartilage and helps pivot the thyroid cartilage down.
Fill in the blank: The most narrow point of the upper airway in adults is the _______.
transglottic space
What are retinoid cartilages?
Small pieces of cartilage that attach to the cricoid cartilage and the vocal cords.
What happens to the cricoid cartilage as a person ages from birth to 10 years?
It is typically the most narrow portion of the upper airway in children under 10.
What are the projections of the thyroid cartilage called?
Horns or superior horns.
What is the function of the vocal cords?
To produce sound by vibrating as air passes through them.
What is a facet in the context of cartilage?
A divot or groove that serves as a pivot point between two pieces of cartilage.
True or False: The thyroid cartilage is an unpaired cartilage in the larynx.
True
What type of muscle are the laryngeal muscles?
Skeletal muscles.
What is the significance of the length of vocal cords?
Longer vocal cords produce lower pitched sounds, while shorter vocal cords produce higher pitched sounds.
What happens to the cricoid cartilage after age 10?
It widens and is no longer the narrowest part of the upper airway.
What is the role of the muscles attached to the arytenoid cartilages?
To control the movement and tension of the vocal cords.
Fill in the blank: The sides of the thyroid cartilage are called _______.
laminae
What connects the thyroid cartilage to the cricoid cartilage?
The inferior horns of the thyroid cartilage.
What is the corniculate cartilage?
A small piece of cartilage fused to the arytenoid cartilage.
What is the narrowest point in the adult upper airway?
The space between the vocal cords.
In patients 10 years or younger, what is the most narrow point of the upper airway?
The cricoid cartilage.
What happens to the cricoid cartilage around age 10?
It widens and is no longer the most narrow part of the upper airway.
What structure covers the opening of the larynx when swallowing?
The epiglottis.
What is the role of the glottis during swallowing?
It closes to ensure food goes down the esophagus.
What is aspiration?
The entry of stomach contents into the airway.
What technique is used to prevent aspiration during procedures?
Cricoid pressure.
How is cricoid pressure applied?
By pushing on the front of the cricoid cartilage.
What does cricoid pressure aim to do?
Close off the esophagus to prevent gastric contents from entering the airway.
What risk is associated with cricoid pressure if the patient is awake?
It can cause damage to the esophageal sphincter.
What can high abdominal pressure lead to when using cricoid pressure?
Blowing out the esophageal sphincter.
What anatomical feature separates the esophagus from the stomach?
The esophageal sphincter.
What is the typical pressure experienced by the esophageal sphincter?
It is not subject to high amounts of pressure.
What can excessive pressure on the esophageal sphincter result in?
Permanent damage.
What muscle assists with deep breathing when the arms are stabilized?
Pectoralis minor.
What does the pectoralis minor muscle connect to?
The coracoid process of the scapula and ribs 3 through 5.
How does posture indicate a patient’s respiratory health?
Leaning over or supporting themselves may indicate breathing difficulties.
What behavior might suggest poor pulmonary health in a patient?
Struggling to breathe and leaning on objects.
What should be observed during pre-operative assessments?
Small behaviors that indicate a patient’s respiratory condition.
What is a common observation for someone with lung problems?
They may appear to be struggling to breathe.
