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Respiratory Physiology > Quiz 1- Respiratory System > Flashcards

Quiz 1- Respiratory System Flashcards

1
Q

2 goals the respiratory system achieves?

A

1- oxygenation

2- ventilation

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2
Q

Purpose of epiglottis

A

Positioned upright, covers the larynx to prevent food from entering trachea/lungs

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3
Q

What are conchae/ their purpose?

A

folds in nasal cavity that increase the surface area to warm

and humidify air to body temp/ 95% water vapor saturation

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4
Q

3 Functions of the nose

A

1- Warm & humidify air
2- Filter & obstruct foreign particles from entering lungs with nasal hair and ciliated epithelium
3- Assist phonation & sensation of smell (CN1)

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5
Q

Vallecula?

A

Space anterior to the epiglottis at root of tongue that the MAC blade slides into.

Pressure on hyoepiglottic ligament lifts epiglottis

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6
Q

Palatine Tonsils Location & Function

A
  • b/l tonsils in pharynx

- Defense against infectious pathogens

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7
Q

What is Waldeyer’s Ring?

A
  • Ring of Tonsils/lymphoid tissue in pharynx.

- includes palatine tonsil (what we normally think of tonsils) and lingual tonsil (at back of tongue)

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8
Q

MP Class 1

A

full uvula, tonsillar pillars, soft palate

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9
Q

MP Class 2

A

partial view uvula/tonsils, soft palate

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10
Q

MP Class 3

A

soft palate only

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11
Q

MP Class 4

A

hard palate only

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12
Q

Glossoptosis

A

collapse of oropharynx

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13
Q

macroglossia

A

large tongue

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14
Q

micrognathia

A

small jaw, mandible

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15
Q

prognathism

A

protrouding jaw, mandible

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16
Q

microgenia

A

small chin

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17
Q

microstomia

A

small mouth

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18
Q

malocclusion

A

upper protrusion (buck teeth)/ overbite

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19
Q

Location of larynx- adult

A

C3-6

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20
Q

Location of larynx- birth

A

C3-4

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21
Q

Normal atlas- occiput extension

A

35 degrees

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22
Q

5 Functions of Larynx

A 
1- protective airway sphincter
2- seals off airway during swallow
3- supports vocal cords
4- modulates speech
5- provides autoPEEP
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23
Q

Rima glottidis

A

space between cords

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24
Q

What is the narrowest portion of the upper airway in adults?

A

Rima glottidis

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25
Q

What is the narrowest portion of the upper airway in children?

A

Cricoid cartilage until age 5

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26
Q

Cartilages of Larynx

A 
9 Total:
3 Unpaired
     Epiglottis 
     Thyroid
     Cricoid
3 Paired: 
     Arytenoid
     Corniculate 
     Cuneiform
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27
Q

Purpose of Hyoid bone

A

to suspend the larynx

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28
Q

Function of Arytenoids

A

Rotate to open and close vocal cords

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29
Q

Extrinsic muscles of larynx- where/function?

A
  • They attach to bone or pharynx

- move larynx during swallowing

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30
Q

Intrinsic muscles of larynx- 2 functions

A

2 sets, different fx:
1- alter shape and size of larynx
2- move vocal cords

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31
Q

Larynx muscles that alter size and shape- names

A

Aryepiglottic
Thyroepiglottic
Oblique Arytenoid

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32
Q

Larynx muscles that move the vocal cords

A 
Cricothyroid
Thyroarytenoid
Lateral Cricoarytenoid
Posterior Cricoarytenoid
Traverse Arytenoid
Vocalis
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33
Q

What nerve innervates the muscles of the larynx?

Motor/Sensory?

A

Recurrent Laryngeal Nerve - motor for all EXCEPT Cricothyroid (external SLN)

Superior Laryngeal Nerve

  • Internal SNL= Sensory to infraglottis
  • External SNL= Motor to Cricothyroid muscle
34
Q

What nerve innervates the cricothyroid muscle and what does it do?

A

Tenses vocal cords, innervated by the External Superior Laryngeal Nerve

35
Q

What are the 3 compartments of the larynx?

A 
Supraglottis Compartment: above cords
  -epiglottis
  -false vocal cords
Glottis (ventricle): at cords
  -true vocal folds
  -rima glottidis
  -arytenoids
Infraglottis Compartment: below cords
  -cricoid cartilage
  -trachea
36
Q

What happens to the epiglottis and larynx during swallowing?

A

epiglottis moves down to cover glottis

larynx moves upward by muscles

epiglottis pressed downward by base of tongue

37
Q

3 important laryngeal membranes?

A 
1- Thyrohyoid membrane
2- Quadrangular Membrane
3- Cricothyroid Membrane**
- inferior to true VC
-emergency airway for cric
38
Q

Where do the Recurrent Laryngeal Nerve and Superior Layrngeal Nerve stem from?

A

The Vagus Nerve branch (CNX)

39
Q

What does stimulation to the RLN do?

A

abduction of vocal cords

40
Q

What does damage to the RLN cause?

A

VC adduction

41
Q

What structure does the left RLN pass?

A

Aortic arch

42
Q

What are the 2 branches of the SLN and what do they do?

A

1- Internal SLN: sensory

2- External SLN: motor

43
Q

What is the Sphenopalatine Ganglion and what does it innervate?

A
  • middle division of CN V (trigeminal)

- nasal mucosa, superior pharynx, uvula, tonsils

44
Q

What is the Glossopharyngeal nerve and what does it innervate?

A
  • CN IX

- lingual back 1/3, pharyngeal, tonsillar nerves, (oral pharynx, supraglottic region)

45
Q

What does the Internal branch of the Superior Lyrangeal Nerve innervate?
Where does this nerve stem from?
What happens when this nerve is stimulated?

A

Sensory nerve: mucous membrane of supraglottis and glottis
Stimulation causes laryngospasm- reflex to protect airway

Stems from CN X

46
Q

What does the External branch of the Superior Lyrangeal Nerve innervate?
Where does this nerve stem from?

A

External SLN: motor innervation of cricothyroid muscle- tenses VC

Stems from CN X

47
Q

What does the RLN innervate?

A

trachea below VC’s:

innervates muscles of the larynx that move the true VCs (except cricothyroid) and those that move the larynx itself

48
Q

What makes up the glottis?

A

The vocal folds: 2 pairs of horizontal membrane folds
1- False vocal cords
- upper vestibular folds that close during swallowing

2- True vocal cords: produce vocal sound
-vocal ligament within, mobile elastic fibers

49
Q

Direct Laryngoscopy (DL) Grade 1

A

full view of vocal cords, glottis

50
Q

This is the only abductor muscle of the vocal cords

A

Posterior Cricoarytenoid

Innervated by RLN

51
Q

Direct Laryngoscopy (DL) Grade 2

A

partial view of VC, arytenoid and corniculate cartilages

52
Q

Direct Laryngoscopy (DL) Grade 3

A

only epiglottis

53
Q

Direct Laryngoscopy (DL) Grade 4

A

only soft palate

54
Q

VC abduction- muscles and nerves?

A

ONLY the Posterior Cricoarytenoid Muscle

via stimulation of the RLN

55
Q

VC adduction- muscles and nerves?

A

Intrinsic muscles close & tense VCs:
Close- RLN via Intrinsic muscles
Tense- External SLN via cricothyroid muscle

56
Q

How is sound produced via VCs? What is VC position?

A

1-air forced between closed cords- causes vibration
2- vibratory sound waves formed to words by upper airway movement
3- sound modification by upper airway structures (pharynx, oral cavity, tongue, lips)

57
Q

How is pitch of VC sound determined?

A

By VC tension:
more tension= higher sound
less tension= lower sound

58
Q

What is the cricoid cartilage?

A

Cartilage ring located below larynx and thyroid cartilage

Between cricothyroid membrane & trachea

59
Q

What is a Sellick Maneuver?

A
  • aka cricoid pressure

- Pressure on the cricoid posteriorly to close the esophagus

60
Q

When do you use a Sellick Maneuver?

A
  • during RSI, trauma, full stomach, GERD, obesity, pregnancy, gastroparesis (DM), SBO, pyloric stenosis, etc…
  • prevent gastric regurgitation into trachea
  • Aligns glottic opening during intubation
  • Prevents ventilation of air into stomach
61
Q

What are the 2 differences in upper airways between adults and children?

A 
1- level and shape of larynx:
  adults: C3-6, cylinder
  children: C3-4, cone shape (why we use uncuffed ETT in peds)
2- narrowest portion of airway
  -adults= rima glottidis
  -children= cricoid ring
62
Q

What is the level of the carina?

A

T5-7

25cm from teeth*

63
Q

What is the trachea and where does it extend?

A

Flexible cylindrical tube supported by 20-25 C-shaped cartilages
extends from C6 to T5

64
Q

Functions of the bronchial tree

A
  • distribute air to alveoli
  • warm & humidify air
  • filter & transport particles from lungs, ciliated
65
Q

As bronchial divisions occur, what happens to airway resistance?

A

Airway resistance decrease because the overall cross-sectional area increases (even though the airway diameter decreases with branching)

66
Q

What is the purpose of conducting airways?

A

Ventilation, but NO perfusion as they do not participate in gas exchange

67
Q

Anatomical Dead Space? How much % of each breath?

A

-A portion of each breath is wasted ventilation- 30%

68
Q

What does an ETT reduce dead space to?

A

-ETT bypasses upper airway and reduces dead space to 100mL

69
Q

Estimate of dead space

A

2cc’s/Kg

70
Q

What is an acinus?

A

The gas exchange segment that includes all respiratory structures:

  • respiratory bronchiole
  • alveolar ducts & sacs
  • alveoli
71
Q

Where does gas exchange start to occur?

A

respiratory bronchiole

72
Q

By what means does gas exchange occur?

A

simple diffusion allows gaseous exchange between airspace & pulmonary capillaries

73
Q

What are PS-CC and where are they found?

A

Pseudostratified Ciliated Columnar Epithelium- found from larynx to bronchi (mucociliary elevator)

74
Q

What does smoke do to PS-CC?

A

Stuns/disables them and disrupts mucociliary elevator)

75
Q

What are goblet cells & 3 functions?

A

Cells that release mucous into the airway (mucous blanket)

  • moisten inspired air
  • prevent drying of airway
  • traps particles
76
Q

Where & what are Clara Cells? 2 functions?

A

Clara cells are located in bronchioles (which lack goblet cells) & produce a mucus-poor, watery proteinaceous material that combines with surfactant & mucus.

Functions:

  • assist with cleaning small airways
  • reduce surface tension in bronchioles
77
Q

What are Type I Pneumocytes?

A

Squamous epithelial cell is
flat & thin designed to increase alveolar surface area to facilitate gas exchange

They control fluid movement between interstitium & airspace

78
Q

What are Type II Pneumocytes?

A

Cuboidal cells that repair alveolar epithelium after injury & secrete surfactant

79
Q

What is surfactant?

A
  • Mix of proteins, phospholipids, & ions
  • decreases cohesiveness of water molecules= reduces surface tension/ force necessary to inflate alveoli
  • preventions alveolar collapse during expiraton
80
Q

What type of alveolar cell is unable to regenerate self?

A

Type I pneumocyte, but Type II pneumocytes can regenerate as type I

Respiratory Physiology (11 decks)

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