Respiratory Flashcards
Which muscles tense the vocal cords
Cricothyroid
(CricoThyroid = cords tense)
Which muscles relax the cords?
Thyroarytenoid
ThyroaRytenoid = They Relax
Which muscles ABDUCT the vocal cords?
Posterior Cricoarytenoid
“PCA”
“Please Come Apart”
Which muscles ADDUCT the cords
Lateral cricoarytenoid
“Let’s close the airway”
Which branch of the trigeminal nerve innervates the nares and anterior ⅓ of the septum?
V1 (ophthalmic)
Which branch of the trigeminal nerve innervates the turbinates and septum
V2
Which branch of the trigeminal nerve innervates the anterior ⅔ of the tongue
V3
(Think anterior ⅔, V2-V3 like climbing grades)
The posterior ⅓ of the tongue is innervated by what nerve?
Glossopharyngeal
The soft palate is innervated by what nerve?
Glossopharyngeal
The oropharynx is innervated by which nerve?
Glossopharyngeal
The vallecula is innervated by which nerve?
The glossopharyngeal
The anterior side of the epiglottis is innervated by which nerve?
Glossopharyngeal?
The glossopharyngeal innervates these 5 structures
Posterior ⅓ of the tongue
Soft palate
Oropharynx
Valeculla
Anterior side of the epiglottis
What are the 2 branches of the Superior Laryngeal Nerve?
Internal branch
External branch
Which nerve/branch innervates the posterior side of the epiglottis —> to the level of the vocal cords
Internal branch
Which nerve provides motor interaction to the cricothyroid muscle (but no sensory innervation)
External branch of SLN
This nerve innervates everything below the cords to the trachea
Recurrent Laryngeal Nerve
Acute bilateral RLN injury affects the airway:
RESPIRATORY DISTRESS
Does chronic bilateral RLN injury affect the airway?
No respiratory distress
Bilateral SLN injury results in
Hoarseness
Unilateral SLN injury results in:
No respiratory distress
The palatoglossal arch at the anterior tonsilar pillar is the landmark for which airway block?
Glossopharyngeal nerve block
What are the 3 airway blocks?
- Glossopharyngeal nerve block
- Superior laryngeal nerve block
- Transtracheal nerve block
The greater cornu of the hyoid is the landmark for which airway block?
Superior laryngeal nerve block
The cricothyroid membrane is the landmark for which airway block?
Transtracheal nerve block
Is the epiglottis an unpaired or paired cartilage?
Unpaired
Is the thyroid an unpaired or paired cartilage?
Unpaired
Is the cricoid cartilage an unpaired or paired cartilage?
Unpaired
Is the corniculate cartilage an unpaired or paired cartilage?
Paired
Is the Arytenoid an unpaired or paired cartilage?
Paired
Is the cuneiform cartilage paired or unpaired?
Paired
The Larynx extends from:
C3-C6
Which type of administration will provide the fastest onset of Succinylcholine if IV access is not available?
Submental administration
What is the only NMB that can be given IM?
Rocuronium
Which gas law applicable to respiration?
Boyle’s law
Which muscle increases the anterior-posterior diameter of the chest?
External intercostals
Is expiration active or passive?
Passive (usually)
What muscles are involved in active expiration? (4)
Abdominis muscles (rectus admoninis and transversus abdominis)
Oblique muscles (external and internal)
*total of 4
How many muscles are used in active expiration?
4
Accessory muscles that aid in inspiration
Sternocleidomastoid
Scalene muscles
2 main muscles for inspiration:
- Diaphragm
- External intercostals
Contraction of inspiratory muscles (reduces/increases) thoracic pressures and (reduces/increases) thoracic volume
REDUCES thoracic pressure
INCREASES thoracic volume
What is the amount of air in a single breath X the number of breaths per minute?
TV X RR
Minute ventilation
What measures the fraction of minute ventilation that is available for gas exchange?
Alveolar ventilation
= (TV - anatomic dead space)XRR
What is this equation for?
Alveolar ventilation
Is Alveolar ventilation (VA) directly or indirectly proportional to CO2 production?
DIRECTLY
Is Alveolar Ventilation directly or indirectly proportional to PaCO2?
INDIRECTLY
What are the 4 types of dead space?
- Anatomic
- Alveolar
- Physiologic
- Apparatus
This dead space is defined as air confined to the conducting airway
Anatomic
This dead space is defined as alveoli that are ventilated but not perfused
Alveolar dead space
This dead space is defined as anatomic dead space + alveolar dead space
Physiologic dead space
This dead space is defined as dead space added by equipment
Apparatus dead space
How many mL/kg Vital Capacity is required for an effective cough?
15 mL/kg
What are the 3 zones of the lung (not West’s)
Conducting
Transitional
Respiratory
If TPP is positive, does the airway stay open or closed?
Open
Pressure outside of the airway is called
Pleural pressure
Pressure inside the airway is called
Alveolar pressure
How much is the normal dead space in a 70 kg adult?
2 mL/kg or 150 mL
Does atropine increase or decrease anatomic dead space?
Increase
*bronchodilator = increases the volume of the conducting zone
3 factors that increase Vd/Vt ratio
Face mask
Atropine
Neck extension
Factors that decrease the ratio of Vd to Vt
ETT
LMA
neck flexion
Which equation can be used to calculate physiologic dead space?
Bohr equation
Vd/Vt = (PaCO2 - PeCO2)/PaCO2
The best ventilated alveoli are the most
Compliant
V/Q ratio represents
Ventilation to perfusion
Normal minute ventilation
4 L/min
Normal cardiac output
5 L/min
Normal VQ ratio
0.8
V/Q mismatch:
When the number is greater that 0.8, this moves toward
dead space
V/Q mismatch:
When the number is smaller than 0.8, this moves toward
Shunt