Respi (Part 1) Flashcards
respiratory tract id divided into two airways:
Upper airways
Lower airways
Acts as a viscous fluid that decreases the friction of the lungs towards the other organs of the mediastinum whenever it is expanding
Pleura
The nose humidifies and warms the inhaled air by the presence of
cilia
The nose is prone to bleeding or
Epistaxis
Projections that divide each nasal cavity
Turbinates
Three turbinates
Superior
Middle
Inferior
Bones that increase the mucus membrane surfaces of
the nasal passages and slightly obstruct the air flowing
through them
Turbinates
4 pairs of bony cavities that are lined with nasal
mucosa and ciliated pseudostratified columnar
epithelium that drain into the nasal cavity
Paranasal sinuses
4 sinuses
frontal
ethmoid
sphenoid
maxillary
Prominent function of sinuses
resonating chamber in speech
Common problem in sinuses
infection (sinusitis)
Passageway; a tube-like structure that connects the nasal and oral cavity towards the larynx.
Pharynx
It is a passageway for both respiratory and digestive tract.
Pharynx
3 parts of pharynx
nasopharynx
oropharynx
laryngopharynx
Link the chain of lymph nodes guarding the body from
invasion by organisms entering the mouth and throat
Tonsils and adenoids
Function: vocalization and facilitates coughing
Larynx (voicebox)
Protects the lower airway from foreign substances
Larynx
Watchdog of the lungs” - if there are any foreign
bodies that attempts to enter the airway, the _____ will act on it by facilitating coughing
larynx
Serves as a flap of cartilage that covers the
opening of the larynx during swallowing.
Epiglottis
Opening of vocal cords in the larynx
Glottis
Largest cartilage structure. Part of it will form
Adam’s apple.
Thyroid cartillage
Only complete cartilaginous ring in the larynx.
Located just below thyroid cartilage
Cricoid cartilage
Only complete cartilaginous ring in the larynx.
Located just below thyroid cartilage
Vocal cords
Smooth muscle, C-shaped rings of cartilage at regular intervals
Trachea (Windpipe)
Passage between the larynx and the right and left main stem bronchi. It enters the lungs through the hilus
Trachea (Windpipe)
Sponge-like elastic, cone-shaped organs. Airtight chamber
Lungs
How many lobes are there in the right lungs?
3
How many lobes are there in the left lung?
2: narrower and smaller
- Cavity that surrounds the lungs
Pleura
Lubricates the thorax and the lungs to permit smooth motion of the lungs within the thoracic cavity during expansion or during inspiration and expiration
Pleura
it lines the thoracic cavity, the lateral wall
of the mediastinum, the diaphragm, and the inner aspects of the ribs
Parietal
In the middle of the thorax, between the pleural sacs that contain the two lungs.
Mediastinum
can be used to evaluate for the cardiac and pulmonary functioning
X-Ray
surrounded by connective tissue that contains arteries, lymphatics, and nerves.
Subsegmental bronchi
Numbers of segmental bronchi on the left and right
L: 8
R: 10
Facilitates effective postural drainage in patients
Segmental bronchi
Order of lung segments
lobar bronchi - segmental bronchi -subsegmental bronchi - bronchioles- terminal bronchioles
Peripheral aspect of the bronchioles. Considered to be the transitional passageways between the conducting airways and the gas exchange airways
Terminal bronchioles
There is an alveolus but no gas exchange would
take place.
Physiologic Dead Space
Amount of air in the trachea-bronchial tree
that does not participate in the gas exchange.
About 150 mL
Contains air which does not participate in the gas exchange. They remain on the branches of the trees of the bronchioles
Anatomic Dead Space
The basic unit of the lungs
Alveoli
Type of cells that make up the alveolar epithelium
Type I and II
Account for 95% of the alveolar surface area and acts as a barrier between the air and alveolar surface
Type 1
Composed of about five percent of the cells is
responsible for producing the type 1 cells and the surfactant
Type 2
AKA alveolar macrophages, they try to
engulf foreign bodies that would go towards our alveoli
Type 3
Chemicals that reduce the surface tension of the alveoli
Surfactant
O2 Transport and CO2 removal is done through the thin wall of _____ and _____
Capillaries and alveoli
Gas exchange between the atmospheric air and the blood & between the blood and cells of the body
Respiration
Involves the process of inspiration and expiration
Ventilation
involves the process of inspiration and
expiration brought about by the size and increasing capacity of the thoracic cavity and the diaphragm
ventilation
Movement of the air: area of_____ pressure →
area of _____ pressure
higher to lower
Determined by the radius or size of the airway, lung volumes, and airflow velocity
Airway resistance
As resistance increases = gas flow _____.
decreases
Causes of increased airway resistance:
Asthma
Chronic bronchitis
Mucus, Tumor, foreign body
Emphysema
Characterized by a connective tissue
encircling the airways, thereby keeping them
open during inspiration and expiration
Emphysema
Elasticity and expandability of the lungs and thoracic structures
Lung compliance
determined by examining the volume –
pressure relationship in the lungs and the thorax.
Compliance
rebound of the lungs; decrease of the size
of the lungs in response to inhalation
Recoil/Exhalation
Loss ability of lungs to recoil will result in
_______
overdistention: e.g. emphysema- air is
trapped because lungs is not able to recoil
Decreased lung compliance is present in conditions of:
Morbid obesity
Pneumothorax
Hemothorax
Pleural effusion
Pulmonary edema
Atelectasis
Pulmonary fibrosis
Acute respiratory distress syndrome (ARDS)
For ventilation to take place successfully, there needs to be a balance between___,___, and ____
air pressure
airway resistance
lung compliance.
Whenever there is acidosis, for the body to
compensate, the lungs will excrete____
CO2
If there is no adequate ventilation, CO2 stays in the body, eventually leading to ______
respiratory acidosis
During hyperventilation, the tendency of the body is to excrete CO2, eventually leading to _______
respiratory alkalosis
Generally, as the patient ages, the volume and the capacity of the lungs ______.
decreases
Amount of air (approximately 500 mL) moved in and out of the lungs with each normal quiet breath
Tidal volume
Amount of air (approximately 2100 to 3100 mL) that can be inhaled by forcibly over tidal volume
Inspiratory Reserve Volume (IRV)
Amount of air (approximately 1000 mL) that can be forced out over the tidal volume
Expiratory Reserve Volume (ERV)
Volume that remains after a forced expiration of approximately 1100 mL
Residual Volume
Total amount of air that can be inhaled and exhaled by the lungs
Vital capacity
Vital capacity formula
TV + IRV + ERV
inhalation of dust (ex. Coal dust, stone dust, silicone dust)
Pneumoconiosis
protects the lungs from the
protease mediated tissue destruction
Antiprotease
Pack years formula
no. of packs/day x no. of years smoking
Main sign of lung disease
Cough
Color of sputum when there is bacterial infection
yellow or green
Smokers with chronic bronchitis have ___sputum
mucoid sputum
Excessive pink, frothy sputum common in ____
pulmonary edema
Chronic Bronchitis
Characterized by excess sputum
It is characterized by a rust-colored sputum
Pneumococcal Pneumonia
Foul-smelling sputum. there is a deposit of pus in the lung cavity
Lung abscess
is the presence of blood in the sputum
Hemoptysis
is the abnormal growth in the lungs
Adenoma
Grossly bloody sputum
Tuberculosis, pulmonary infarction, bronchial adenoma, or lung abscess
Continuous or made worse by coughing, deep
breathing or swallowing
Chest pain
Intermittent during sleep. Difficulty of breathing that makes the patient wake up
at night
Paroxysmal nocturnal dyspnea (PND)
Shortness of breathing that occurs when lying down. Relieved when sitting up
Orthopnea
High-pitched musical sound
Wheezing
Wheezing in inspiration indicates
Asthma
Wheezing in expiration indicates
Bronchitis
___is the narrowing of airways
Bronchoconstriction
Type of Wheezing. Low-pitched continuous sounds are heard over the lungs. May also indicate partial airway obstruction
Rhonchi (Sonorous)
Refers to the thickening of the fingertips. Common indication for cyanotic/hypoxic conditions, chronic lung infections, or malignancies
Clubbing
Refers to the bluish discoloration of the skin.
Cyanosis
indicates increased respiratory effort
Nasal flaring
could be a sign of epistaxis which
could be caused by a ruptured artery or blood
vessel inside the nasal cavity.
Bleeding
If the patient has experienced an injury and manifests glucose-containing drainage, you would suspect _____
CSF leakage
Tonsil grade of “kissing” tonsils
Grade 4+
If there is tender and movable nodes, it suggests ___
Inflammation
an equipment used to visualize the
larynx; optimal for pandemic as it doesn’t require close
proximity with the patient.
Laryngoscope
abnormal voice (hoarseness). This can be an
initial sign for ___
Laryngeal cancer
It is a technique that can help people with asthma or COPD especially if they are having episodes of SOB (hypoventilation).
Pursed-lip Breathing
Anteroposterior diameter and lateral diameter
ratio of 1:1. Common among patients with COPD.
Barrel Chest
AKA “Pectus Excavatum”. This is a condition in which the sternum is sunken into the chest.
Funnel Chest
AKA “Pectus Carinatum”. A rare deformity that causes the sternum to be pushed outward instead of being flush against the chest wall.
Pigeon Chest/Keel Chest
A musculoskeletal disorder that is a combination of kyphosis and scoliosis
Kyphoscoliosis
Abnormal posterior and sideways curvature of the spine in both the coronal and sagittal planes.
Kyphoscoliosis
Regular cycle where the rate and depth of
breathing increase, then decrease until apnea
(usually about 20 seconds) occurs
Cheyne-Stokes Respiration
Periods of normal breathing (3-4 breaths),
followed by varying period of apnea (usually 10-60 seconds). AKA “ataxic breathing”
Biot’s Respiration
Asymmetric bulging of intercostal spaces on either side of the thorax
Hemithorax
Happens because of air trapped in and under the skin, aka subcutaneous emphysema
Crepitus (crackling sensation)
These may occur in cases of tracheostomy if there is tight closure of tissue around the tracheostomy tube
Crepitus (crackling sensation)
is an abnormal presence of air in the thoracic cavity
Pneumothorax
Vibration of chest wall produced when the patient speaks
Fremitus
Fremitus is decreased in
pneumothorax
pleural effusion
bronchial obstruction
Fremitus is increased in
pneumonia
Abscess
normal sound of a healthy lung
Resonance
Sound: Lung tissue contains fluid or solid. This
might signal that there is a presence of mass or a lot of fluid is being stored in the lungs
Dullness
is an indication of air traffic.
Hyperresonance
The measurement of how the diaphragm can go during inhalation.
Respiratory Excursion
Diminished or absent breath sounds indicates ___
atelectasis or pleural effusion
Soft-high pitched, discontinuous popping sounds (inspiration)
Crackles
Continuous musical sound detected at . Commonly found in chronic bronchitis or
bronchiectasis
Wheeze
Deep low-pitched detected at expiration. Indication of narrowed tracheobronchial passages associated with secretions of tumors
Sonorous wheeze (Rhonchi)
Continuous, musical, high-pitched whistle-like. detected at inspiration and expiration. Indicates bronchospasm, asthma, and buildup
secretions.
Sibilant wheeze
Harsh crackling sound (two pieces of leather being rubbed together). Brought about by inflammation of pleural cavity (pleuritis) and pleural effusion (excess fluid in the pleura.
Friction rubs
Measures how much carbon monoxide in the body.
Smoke Analyzer Test (Exhaled Carbon Monoxide Test)
Standard instrument for assessing the intensity of physical addiction to nicotine – the active substance in the cigarette
Fagerstrom Test
to identify the antibiotic that can be used
to treat the organism
Sensitivity
to identify sinusitis
Waters’ View X-Ray
Used for patients with respiratory tract disorders to evaluate the status of the chest and provide baseline comparison with future changes.
Chest X-Ray
useful when an x-ray reveals a suspicious lesion,
because pulmonary soft tissue densities, pulmonary nodules, tumors, and blood clots can be seen.
CT Scan
reflects the efficiency of gas exchange
PaO2
adequacy of ventilation of the lungs
Alveolar ventilation (PaCO2)
reflects the activity of the kidney in retaining or excreting Bicarbonate
Acid-base balance (HCO3)
More detailed than x-ray and CT scan (microvasculature)
MRI
Could rule out stage bronchogenic carcinoma,
evaluate inflammatory activity in interstitial lung
disease, acute PE, and chronic thrombolytic
pulmonary hypertension.
Magnetic Resonance Imaging
Prior to MRI assess for ______
claustrophobia
Refers to the flow of air into and out the alveoli
V = ventilation
Refers to the flow of blood to the alveolar
capillaries
Q = perfusion
This test would use a radioisotope substance to assess for normal lung function, pulmonary vascular supply, and gas exchange
Ventilation and Perfusion Scanning (V/Q scan)
Involves the use of gallium which is a radioactive substance
Gallium Scan
A disease that involves the abnormal collection of inflammatory cells known as granulomas
Sarcoidosis
There are deposits of inflammatory cells called as panda sign
Sarcoidosis
Detect and display metabolic changes in tissues. Evaluate nodules and malignancy
Positron Emission Tomography (PET Scan)
Insertion of a tube in the airways. Purpose: direct inspection and examination of airway structures and obtaining tissue sample for biopsy
Bronchoscopy
Insertion of a tube in the airways. Purpose: direct inspection and examination of airway structures and obtaining tissue sample for biopsy
Bronchoscopy
is intended to decrease the secretions and inhibit vagal stimulations
Atropine
If there is gag reflexpost-bronchoscopy, give ___
ice chips and fluids
Pleural cavity is examined with an endoscope and fluid and tissues can be obtained for analysis
Thoracoscopy
If the patient is complaining of SOB postthoracoscopy assume for the presence of
pneumothorax
Aspiration of pleural fluid & air from the pleural space
Thoracentesis
Insertion of a flexible tube (mediastinoscope) through the chest wall above the sternum into the area of the upper chest between the lungs.
Mediastinoscopy
Excision of a small amount of tissue on a specific part of concern to obtain sample for histologic analysis, culture, or cytologic examination.
Biopsy
The diagnostic standard for cancer
Biopsy
A fiber optic bronchoscope that ends in a brush
and this brush is moved back and forth to collect the specimen.
Transbronchial brushing
A tube is inserted in the bronchus with a needle at the end that extracts the specimen needed.
Transbronchial needle aspiration
A bronchoscope is inserted through the bronchus and the specimen will be collected using forceps at the end of the tube.
Transbronchial lung biopsy
The needle is inserted through the skin wherein
there is excision of a tissue done through a spinal needle or cutting needle for histologic study under fluoroscopy or CT guided.
Percutaneous needle biopsy
Could be used to detect spread of pulmonary
disease towards the lymph nodes
Lymph node biopsy
