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AP (2) > Exam 3 Lecture 19 (4-11-23) Airway Anatomy > Flashcards

Exam 3 Lecture 19 (4-11-23) Airway Anatomy Flashcards

1
Q

All of the neurological control of breathing happens in the _________.

A

Brainstem

(11:44)

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2
Q

Name the 3 parts of the brainstem

A
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3
Q

What is another name for the midbrain?

A

Mesencephalon

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4
Q

Which part of the brainstem will predominantly regulate the control of respiration?

A

Medulla

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5
Q

What does PRG stand for?

A

Pontine Respiratory Group

PRG regulates respiration.

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6
Q

What are the two main parts of the medulla?

A
  • Ventral Respiratory Group (Front)
  • Dorsal Respiratory Group (Back)

(14:10)

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7
Q

Where are the Botzinger (BOT) and Pre-Botzinger Complex (Pre-BOT) located?

How does the Botzinger and Pre-Botzinger Complex contribute to respiration?

A

VRG of the medulla.

Pace the respiratory rate.

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8
Q

Where is the Apneustic Center located?

What does the Apneustic Center stimulate?

What is the result of overstimulation of the Apneustic center?

A

Lower Pons

Apneustic Center stimulates the inspiratory neurons of the DRG in the medulla.

Overstimulation of the Apneustic Center will result in a prolonged inspiration and brief expiration.

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9
Q

What are two factors that Dr. Schmidt mentioned will control our respiratory drive?

A
  • Planned movement
  • Feedback from sensors and blood gas-related products

(18:00)

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10
Q

An increase or decrease in the following blood gas products will result in an increase in respiratory drive.
______ CO2
______ H+
______ O2
______ pH

A
  • ↑ CO2
  • ↑ H+
  • ↓ O2
  • ↓ pH

All these factors will increase respiratory drive.

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11
Q

An increase or decrease in the following blood gas products will result in a decrease in respiratory drive.
______ CO2
______ H+
______ O2
______ pH

A
  • ↓ CO2
  • ↓ H+
  • ↑ O2
  • ↑ pH

All these factors will reduce respiratory drive.

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12
Q

Where are the locations of our chemoreceptor?

A
  • Central (brainstem)
  • Periphery
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13
Q

The central chemoreceptors in the brainstem will typically respond to ________, _________, and _______.

A
  • Protons
  • CO2
  • pH
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14
Q

The central chemoreceptors in the brainstem will typically not respond to changes in ______.

A
  • Oxygen
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15
Q

Where are peripheral chemoreceptors located?

A
  • Carotid Body (one on each side of the neck)
  • Aortic Bodies (3 or 4 spread across the aortic arch)
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16
Q

Where are the baroreceptors located?

A
  • Carotid Sinus

Chemoreceptors are in the bodies

(20:40)

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17
Q

How do chemoreceptors work?

A

Blood gas changes drive chemoreceptors (CO2, O2, H+, pH) to either increase or decrease respiratory drive.

When PAO2 drops below normal (100 mmHg), carotid body nerve impulses will increase, increasing respiratory drive.

High blood flow through the carotid bodies allows them to “see” changes in the body and make adjustments fairly quickly.

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18
Q

What is the primary driver of the peripheral chemoreceptors?

A

PCO2

↑ PCO2 ,↑ Respiratory Drive
↓ PCO2, ↓ Respiratory Drive

(23:00)

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19
Q

↑ PCO2 will _______ MAP.

A

increase MAP

Short-term response

(23:30)

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20
Q

How do the aortic bodies relay information back to the medulla?

A

Vagus Nerve (X)

This will be the same route as the baroreceptors

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21
Q

What pathway does the carotid body take to get back into the brainstem?

A

Carotid body → Hering’s nerve → Glossopharyngeal Nerve (IX) → Medulla (Nucleus Tractus Solitarius)

(24:30)

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22
Q

The trachea extends from the base of the ________ down to the bifurcation and splitting of the left/right bronchi.

A

larynx

(25:00)

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23
Q

What is the length of a typical trachea (range)?

By tilting the head back, how much can the trachea elongate?

A

11 to 13 cm

+2 cm (elongation)

(25:40)

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24
Q

What will happen to the internal diameter of the trachea if there is elongation?

A

Decreased internal diameter of the trachea.

(26:00)

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25
Q

The width of the trachea is similar to the width of what body part, according to Dr. James Schmidt?

A

Index Finger

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26
Q

What is the circular structure at the bottom of the larynx attached to the trachea?

A

Cricoid Cartilage

27
Q

What cartilages make up the larynx?

How many cartilages make up the larynx?

A
  • Thyroid Cartilage (largest cartilage)
  • Epiglottis (large cartilage)
  • Cricoid Cartilage (large cartilage)
  • Ayrentoids Cartilage (2)
  • Cuneiform Cartilage (2)
  • Corniculate Cartilage (2)

9 cartilages make up the larynx

28
Q

What is the length of the right main stem bronchus?
What is the length of the left main stem bronchus?

A

2 cm (right)

5 cm (left)

29
Q

Which mainstem is more vertical?

Which mainstem is more horizontal?

A

The right mainstem is more vertical.

The left mainstem is more horizontal.

(27:30)

30
Q

How many split points are in each bronchus?

A
  • The right bronchus has 3 split points.
  • The left bronchus has 2 splits points.
31
Q

How many total airway segments are there in the right lung?

How many total airway segments are there in the left lung?

A
  • 10 air segments on the right lung
  • 8 airway segments on the left lung

The picture shows 10 airway segments for the left lung, but some segments are fused together.

32
Q

What type of muscle sits between the tracheal rings?

A

Smooth Muscle

33
Q

What cartilage will prevent food from entering the lungs?

A

Epiglottis

34
Q

What is the largest piece of cartilage in the larynx?

A

Thyroid Cartilage

35
Q

What cartilage is a continuous ring in the larynx?

A

Cricoid Cartilage

36
Q

The vocal cords are attached to what two cartilage?

A
  • Thyroid Cartilage (Thyroid Notch)
  • Arytenoid Cartilage
37
Q

In pediatric patients (<10 yrs), their narrowest upper airway point is going to be the ________.

A

Cricoid Cartilage

Section III (red) in the picture.
(33:00)

38
Q

In adult patients, their narrowest upper airway point is going to be the ________.

A

Level of the Vocal Cards

Section II (green) in the picture.

39
Q

What is the region of the blue circle called?

40
Q

What are the regions of the pharynx?

A
  • Nasopharynx
  • Oropharynx
  • Hypopharynx (Laryngopharynx)
41
Q

What are the two components that make up the roof of the mouth?

A
  • Hard palate (bone)
  • Soft palate (flesh)
42
Q

Label A, B, C, and D.

A

A. Pharyngeal Tonsil
B. Lingual Tonsil
C. Hard Palate
D. Soft Palate

43
Q

Label A, B, C, and D

A

A. Hard Palate
B. Soft Palate
C. Uvula
D. Palatine Tonsil

44
Q

The tongue is a ________ muscle.

45
Q

What is the region in the green triangle called?

A

Vallecula

This is where the tip of our Mac Blade goes.

46
Q

Label the Question Mark.

A

Eustachian canal or Pharyngotympanic Tube

This helps control equilibrium and maintains pressure in the ear drums.

(42:15)

47
Q

What is the specialized bone that makes up the nose?

A

Ethmoid Bone

48
Q

What part of the ethmoid bone serves as an attachment for the meninges of the brain?

A

Crista galli

49
Q

Label A, B, C, D, and E.

50
Q

Where is the best place to try to keep your nasal airway?

A

On the floor of the nasal cavity (the palatine process of the maxilla).

You want to avoid the conchae; they are very fragile.

51
Q

What is another name for concha?

A

Turbinates

52
Q

What is the dividing septum between the two sides of the nose?

53
Q

Why are the conchae porous?

A

To house blood vessels and humidify the inspired air.

54
Q

What two arteries supply the nasal vasculature?

A
  • Internal Carotid Artery (roof of the nose)
  • External Carotid Artery
55
Q

Which artery provides circulation to the scalp, according to Dr. Schmidt?

A

Internal Carotid Artery

56
Q

How many sets of salivary glands do we have? Name them.

A
  • Parotid Gland
  • Submandibular Gland
  • Sublingual Gland
57
Q

What is the largest cranial nerve in your head?

A
  • Trigeminal Nerve (V)

Takes care of sensory innervation for almost the entire face.

58
Q

What are the three divisions of the Trigeminal Nerve?

A
  • Ophthalmic Branch / V1 (forehead)
  • Maxillary Branch/ V2 (front of the face)
  • Mandibular Branch/ V3 (lower jaw)
59
Q

What nerve innervates the movement and taste of the back one-third of the tongue?

A
  • Glossopharyngeal Nerve (IX)
60
Q

What nerve is responsible for the taste in the front two-thirds of the tongue?

What nerve innervates the movement of the front two air two-thirds

A

Facial Nerve (VII)

Mandibular Branch (V3) of Trigeminal Nerve

61
Q

What is the sensory nerve for the larynx?

A
  • Vagus Nerve (X)
62
Q

What nerve innervates the hard palate?

A

The greater palatine nerve of the maxillary branch of the trigeminal nerve.

63
Q

What division of the trigeminal nerve is responsible for our ice cream headache/brain freeze?

A

Maxillary branch (V2) of the Trigeminal Nerve

AP (2) (5 decks)

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