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Schmidtty Final > (Recap/chemoreceptors/Anatomy) > Flashcards

(Recap/chemoreceptors/Anatomy) Flashcards

1
Q

What does the FEF 25-75 measure?
What is another term for the FEF 25-75?

A
  • Looking at the rate of airflow when the middle half of the VC is being expired

Forced Mid expiratory Flow

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2
Q

What would the FEF test show if there was an airway obstruction?

A

Prolonged 25-75 = lower number which signifies a worse test result

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3
Q

Acceptable FEF 25-75 reading for an asthma patient?

A

500-1000 mls/sec

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4
Q

Whats the purpose using the FEF test compared to the FEV1/FVC Ratio test?

A
  • Thought to be a more sensitive test than FEV1/FVC for medium and small airway obstruction inside the chest
  • Not as sensitive as the Closing volume/capacity tests which are the most sensitive
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5
Q

If there was less inward recoil by the lungs, the chest wall could…?

A

the chest wall could pull out further than normal = leads to higher lung volumes and a more positive Pleural pressure

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6
Q

When laying supine, do we have higher/lower lung volumes and higher/lower chest recoil?
Why?

A

We have lower lung volumes and lower chest recoil. The tissue above the chest wall is pushing down, opposing chest recoil outwards.
Higher BMI = Less chest recoil

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7
Q

Which set of muscles resting tone contribute to outward chest recoil?
Adding paralytics will cause what to happen?

A

Intercostal Muscles

Adding paralytics decreases their tone = decreases lung volume

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8
Q

Where does the majority of the control in rate and depth of breathing take place?

A

Brain Stem/Medulla

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9
Q

What is the physiology behind SIDS per lecture?

A

-Parts of the brainstem haven’t fully developed yet = run into Blood gas problems
 If brainstem takes longer to develop and they don’t have as good of a sleeping respiratory control system they may not be able to adjust and counteract the problem

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10
Q

The Brain stem is looking at these 3 compounds in the CSF:
Which ones does the brain stem primarily look at?
What is the name of these receptors?

A

High Protons > High CO2 > Low O2

Central chemoreceptors

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11
Q

Where exactly are the central chemoreceptors located?

When stimulated, what do they do?

A

Anterolateral medulla

Increase Respiratory drive

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12
Q

What is the main thing that is able to cross the BBB?

A

CO2

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13
Q

Normal pH, PCO2, Protein levels in the CSF

A

pH = 7.32 (or 7.31)
PCO2 = 50 mmHg
Low levels of protein buffers

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14
Q

As far as the chemoreceptors go, how much of the blood gas sensing and feedback do the central chemoreceptors take care of?
What about the peripheral chemoreceptors?

A

Central: 85%
Peripheral: 15%

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15
Q

Why is the PCO2 higher in the CSF compared to the blood?

A

It is being produced in the CSF

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16
Q

What is one thing that is unique/interesting about the control of these respiratory centers per lecture?

A

This is one system where we can alternate between having voluntary or automated control. Awake vs. asleep

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17
Q

Central Chemosensitivity

Where is the true location in which the vast majority of blood gas management is taken care of?
Why?

A

Front of the frontal lobe

The body doesn’t rely on the chemoreceptors much for blood gas management because the brain is anticipating the changes already

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18
Q

Where are the peripheral chemoreceptors located?

A

2 pairs of carotid bodies located superior of bifurcation of the internal and external carotid arteries.
3-5 Aortic Bodies

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19
Q

How do the peripheral chemoreceptors (“bodies”) relay their information back to the brainstem?

A

Carotid bodies = CN IX (Glossopharyngeal Nerve)

Aortic Bodies = CN X (Vagus Nerve)

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20
Q

What do the peripheral chemoreceptors look at?
Which one primarily?

A

Also protons, CO2 and PRIMARILY O2

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21
Q

At what measure are the peripheral chemoreceptors able to vary their output/impulses?
What happens at higher or lower levels?
When do we really see a sharp increase in impulses?

A

They are able to measure their output at 80 mmHg of PaO2 +.

> 80mmHg = impulses slow down
< 80mmHg = impulses speed up

See a sharp upstroke at 60 mmHg

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22
Q

Do we utilize the peripheral chemoreceptors often?

A

NO! Only unless there is a major problem.

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23
Q

How does the body manage changes in ventilation?
Why?

A

By first changing Tidal volume, if that isn’t enough then the RR changes second

VT = Easier to manage than RR changes

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24
Q

When there is a large increase in CO2 and protons, the Oxygen levels drop: what is the next response by the body?

A

Increase C.O.
Recruits the heart to help out to increase gas exchange

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25
Q

Can we lower BP by only changing settings on the ventilator?
How?

A

YES!

Increase ventilation (blow off CO2)

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26
Q

Why do we have to be cautious when changing the ventilation to lower BP?

A

We could severely deplete our ionized Calcium levels.

27
Q

Why does increasing ventilatory rate decrease ionized Ca levels?
What does this do to our C.O.?

A

When we blow off more CO2/Protons, the negatively charged areas inside proteins (albumin) are left vacant = therefore Calcium will move into the proteins and hang around the negatively charged areas which decreases their ionized levels

Decreases C.O.

28
Q

What are the 2 layers of connective tissue surrounding the lungs?

A

Visceral = connected to the lung itself
Parietal = connected to the inside of the ribcage

29
Q

Where are the intercostal muscles located?
How are they described in terms of their relationship to one another?

A

In between each of the first 10 Ribs

They are a paired set (Internal = Deep) (External = more superficial)

30
Q

What happens when the internal intercostals contract?
Are they primarily involved in inspiration or expiration?

A

Tightens the chest
Decreases Lung volumes
More positive Ppl

Primarily involved with expiration

31
Q

What happens when the external intercostals contract?
Are they primarily involved in inspiration or expiration?

A

Ribcage is pulled out
Increase in lung volume
More negative Ppl

Primarily involved with inspiration

32
Q

If we were to be asked a second muscle that helps out with resting breathing (besides the diaphragm), which one would you pick?

A

External Intercostal muscles

33
Q

Where does the sternocleidomastoid muscle connect?
What is its primary role?

A

Top of the sternum to the mastoid process (behind the ear)
Helps with stabilization of the ribcage when diaphragm contracts

34
Q

Contraction of the sternocleidomastoid muscle during inspiration will…

A

oppose the ribcage from getting pulled down

35
Q

Contraction of the Serratus Anterior muscle on inspiration will cause what to happen?

A

Ribcage will be pulled outward & the lung volume will increase

36
Q

The pec minor is connected to the ___ & ___.
Is it an inspiratory/expiratory accessory muscle?

A

Scapula & front of the ribcage

Inspiratory

37
Q

When might we visibly see contraction of the pec minor?

A

When someone is VERY worn out.

38
Q

What is the significance of utilizing a stable base (resting on something) when worn out and contracting the pec minor?

A

If we are resting our arms on a stable base, when the pec minor is contracted = the shoulders won’t move down. The stable base prevents the pec minors from pulling the ribcage down and allows more air into the chest better than if we weren’t leaning/using a stable surface.

39
Q

4 Abdominal muscles discussed in lecture?

A

Rectus Abdominus
Internal Oblique
External Oblique
Transverse Abdominus

40
Q

Complete list of the accessory muscles to remember for this class:

A

Serratus Anterior
Pec Minor
Sternocleidomastoid
Scalene Muscles
Internal/external Intercostal muscles
4 Abd. muscles

41
Q

What 3 components per lecture make up the “upper airway”?

A

Nasopharynx
Oropharynx
Laryngo-pharynx

42
Q

2 names for the opening that allows for drainage of the middle ear on each side of the skull and helps middle ear pressure equilibrate to atmospheric pressure

A

Pharyngeal Tympanic Tube or Eustacian Canal

43
Q

Roles of the nose for the upper airway:

A

Filtration
Mucous production
Humidification
Warming of the air

44
Q

Vascularity of the nose is primarily sourced by the ___.
Why do we bleed so much from injury here?

A

External carotid artery.

This is a protected circulation = body will always ensure blood keeps pumping to the carotids no matter what.

45
Q

Which is a more protected circulation?
Internal or External carotid branches:

A

Internal

46
Q

How would we describe the bones in the nose?
Pros and Cons of this?

A

Porous
Pros: Allows for vessels to snake through, more surface area, more warming/humidification can occur
Cons: bones are way weaker and are easier to break off

47
Q

The function of the bones in the nose are similar to a ___.

A

Turbine

48
Q

3 sets of ___ in the nose that are used for spinning the air/water that enter the nose.

A

Concha/turbinates (inferior, middle and superior)

49
Q

What are the names of the bones that house the concha?

A

Inferior = maxillary bone
Middle & Superior = Ethmoid bone

50
Q

Describe the location and relevance of the crista galli?

A

Superior projection of the ethmoid bone where the falx cerebri anchors into it.

51
Q

If we are doing a nasal airway, which concha would we try to stay close to?

A

Inferior Concha: stay midline and on the lower part of the nose

52
Q

The trigeminal nerve (CN V) provides afferent innervation to which locations?

A

Majority of the mouth
Superficial areas of the nose

53
Q

The Vagus nerve (CN X) provides afferent innervation to which locations?

A

Back of the throat (behind tongue)
Larynx and further down into the trachea.

54
Q

What nerve takes care of the afferent innervation in the lower part of the nasopharynx?

A

Glossopharyngeal Nerve (CN IX)

55
Q

Would a difficult intubation be described as more or less hard palate?
More or less compliant soft palate?

A

Less Hard Palate
More Compliant soft palate

56
Q

Which tonsils are usually the culprits if we need a tonsillectomy?

A

Palatine tonsils

57
Q

Which tonsil, when enlarged, will push on soft palate and make the uvula hang down a lot further?

A

Pharyngeal Tonsils

58
Q

If you were involved in a slapping competition and got smacked along the side of the face, which gland would be affected?

A

Parotid Gland

59
Q

What is the source of the fluid that we use to make saliva?

A

Blood, thats why there are a lot of blood vessels in the glands like the parotid.

60
Q

Describe the 3 divisions of the Trigeminal Nerve:

A
  • V1: Topmost split point, ophthalmic branch = eyes and forehead sensory
  • V2: Maxillary division = top of the mouth, nose sensory
  • V3: Mandibular division = majority of mandible sensory
61
Q

Which CN primarily takes care of somatic sensation of the tongue?
What about the secondary nerve?

A

CN V (V3 branch)
- Front 2/3rds of the tongue

CN IX (Glossopharyngeal)
- Back 1/3rd of the tongue

62
Q

What nerve primarily takes care of the sensory innervation to the epiglottis?

A

Vagus Nerve

63
Q

Nerves taking care of taste sensation?

A

Front 2/3rds = Facial Nerve (CN VII)
Back 1/3rd = Glossopharyngeal (CN IX)

Schmidtty Final (3 decks)

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