gary's ariways-2 Flashcards
What is your first line of defense in the upper airways?
Nasal haris
How much water is humidified per day?
650-1000 ml of H2O
What will suppress the gag reflex?
Sedation; a person who is deeply unconscious or someone who has damage to the cranial nerves
Name the 3 sections of the pharynx:
Nasopharynx
Oropharynx
Laryngopharynx
What is the function of the nasopharynx?
Gas conduction
Filtration of gases
Defense mechanism of the body (tonsils)
What are functions of the oropharynx?
Gas conduction
Food & fluid conduction
Filtration of inspired gases
Defense from micro-organism
What are the functions of laryngopharynx?
connection between upper & lower airway
food & fluid conduction
What are the functions of the Larynx?
Gas conduction
Phonation, production of sound
Sphintcer or glottic mechanism
What assists with the opening and closing of the glottis?
The paired cartilages
What anatomical structure determines the size of the et tube?
Vocal cords
What is the normal size of the glottis opening for females & males:
females: 7-8 mm
Males: 9-10 mm
For chest pt: patient lies flat on back; bed flat drains for what area?
Anterior segment of upper lobes; right & left
Patient is turned 1/4, left side up; what area is being drained?
Superior & inferior segment of lingual, left lobe
Patient is turned 1/2, on side, right side down, left side up, what area is being drained?
anterior segment of left lower lobes
patient is turned 3/4, right side down. what area is being drained
lateral segment of left lower lobe
patient is laying flat on stomach, bed is straight; what area is being drained?
superior segment of lower lobe
patient is lying flat on stomach, bed is tilted at foot what area is being drained?
Posterior segment of lower lobes
Patient is moved 1/4 from stomach position, left side is down, what segment is being drained.
Lateral & medial segment of right lower lobe
Patient is sitting upright, percuss at top below clavicle, what area is being drained?
Apical segment of upper lobe
Tracheal secretions tend to dry in intubated patient when inspired air has which of the following? I An AH of 30 mg/L II Water vapor of 47 torr III Dew point of 37 degrees C IV A relative humidity of 100% at 22 degrees C (71 F)--9-10 mg/L A. I, II, III B. I, II, III, IV C. I & IV D. III & IV
C. I & IV
What is the maximum amount of air that is exhaled at max inspiratory level called?
vital capacity
What are the boundaries of the upper airway?
The anterior nose to the true vocal cords
Where does the lower airway begin & end?
From the true vocal cords to the terminal air spaces or alveoli
What is another name for nose hairs?
vibrissae
What are the functions of the vibrissae
First line of defense of upper airway, they filter
Where is the olfactory region located?
In the nasal cavity; defined by superior concha laterally, nasal septal cartilage medially and roof of nasal cavity superiorily
Why is the sense of smell important to human health & survival?
protective mechanism against noxious gases
What is the function of the turbinates?
Heats, humidifies, & filters
Relate the importance of surface area to concha?
The turbulent flow that is produces by the concha ensures that gas molecules will come into contact with the surface area of nasal mucous membrane which allows for heating to body temp, humidifying and filtering.
How large is the surface area in the respiratory area of the upper airway?
160 cm2
How many ml o fwater per day can the respiratory region of the nose deliver?
650 - 1000 ml of H2O
What is the surface area of the respiratory region made of?
Pseudostratified ciliated columnar epithelium
How does inertial impaction help clean the air we breathe through the respiratory system of the nose?
It is the method used to trap and filter particles greater than 5 microns allow us to clear them before they are inhaled deeper
Which region of the nose is lined with cilia?
The columnar cells of the epithelial lining of the nasal cavity contains the cilia.
Which region of the nose is not lined with ciliary epithelium?
The vestibule
What are the mechanics of moving mucus?
Goble cells and submucosal glands produce mucus. The mucus will exist in 2 layers the sol and gel layers. The sol layer which is the bottom layer houses cilia and the gel layer is a viscous layer overlying the cilia that traps. The cilia will move in a coordinated wavelike action to move the mucus in one direction toward the oropharynx to transfer mucus up the respiratory tract.
Explain how the mucociliary escalator works in your nose?
It works in a coordinated fashion to remove mucus and debris. It is the lungs main method for removing microbes. Airway mucus and debris is moved in an upward fashion which is why it is referred to as an escalator. This movement is achieved because lays in a blanket fashion. The layers which include the sol is responsible for movement. The cilia move in a coordinated wavelike fashion to move mucus one direction up towards the pharynx. The visous gel layer traps the mucus and debris. At this level it can be expelled through the nose. The sneeze and cough mechanism will work to assist with this removal.
What are the component parts of the mucociliary escalator?
Goblet cells & ciliated epithelium
How does the mucus blanket move?
The mucus blanket moves unilaterally up the airway via a wavelike motion of the cilia.
What happens if the soluble layer loses too much moisture?
If moisture is not present the mucus becomes to thick which disrupts the mechanics of the action of the mucocilliary escalator. The cilia cannot effectively move mucus that is too thick. As a result the lung becomes less able to remove mucus and becomes susceptible to infection. Mucus plugging can also result.
Describe the cause and effect of nasograstric ET tube and inner ear infection?
The tubes can cause a blockage of the eustacian tube. This can prevent drainage and blocking of fluids causing infection of the inner ear.
Why are nasal sinuses present?
To lighten the head and produce resonance with speech
Why does mouth breathing cause a patient to have a dry throat?
When someone breaths from their mouth they lose the humidification mechanisms the nose provides as the nose is being completely bypassed.
What does the nose have that the mouth & pharynx does not when it comes to humidifying dry air?
The nose has 3 turbinates & a large surface area which create air resistance allowing for humidification, filter and warmth of the dry air entering the nose.
Does mouth breathing cause a humidity deficit?
No it will not cause a humidity deficit because the lower airway will compensate by working harder to overcome any initial deficit caused by mouth breathing.
How much airway resistance comes from breathing through your nose?
It creates 1/2 to 2/3 more airway resistance.
What is the function of the tonsils?
Defense mechanism, it fights infection
Why is the pharyngeal reflex so important?
It prevents something from entering the throat that shout not, can prevent aspiration.
How does the larynx function during coughing?
It works to seal closed the airway and releasing a high pressure in the lung
How is the cricoid cartilage different from thyroid cartilage?
Thyroid cartilage is the largest of the cartilages and encloses the main cavity of larynx anteriorily. Cricoid is small and is only cartilage to form complete ring of cartilage around airway. The cricoid can limit the size of et tube and can be used for an emergency airway
What is the name of the space between the true vocal cords?
rima glottides or glottis
Which direction to the vocal cords move during inhalation?
They will abduct or increase in size, they move apart
What direction do the vocal cords move during exhalation?
They will adduct or decrease in size, they move together
What is the function of the 3 paired cartilages?
to move vocal cords, tighten & relax them
What is the other name for the false vocal cords?
ventricular folds
What is the average transverse diameter of the glottis?
Female: 7-8 mm
Male: 9-10 mm
What are the dimensions of the trachea?
10-13 cm in length & 2 - 2 1/2 cm in diameter
What is the angle of the right mainstem bronchi?
20-30 degrees
What is the angle of the left mainstem bronchi?
40-55 degrees
How many segmental bronchi are within both lungs?
18
What is the diameter of the segmental bronchi?
4.5 - 13 mm
What is the diameter of the sub segmental bronchi?
1-6 mm
what is the diameter of bronchioles?
1 mm
What is the diameter of the terminal bronchioles?
1/2 mm
At what generation has the ciliary and mucus blanket disappeared?
Generation 16