respiratory system

Question 1

nasopharynx

Answer 1

continuation of nasal cavity to the soft palate

Question 2

oropharynx

Answer 2

• soft palate to the upper border of epiglottis
• at 2nd cervical vertebrae
• passageway for food moving from mouth to esophagus and air from nasal cavity

Question 3

laryngopharynx

Answer 3

extends from upper border of epiglottis to lower portion of the third, bodies of 4-5, upper portion of 6th vertebra

extends to esophagus

Question 4

diaphragm origin

Answer 4

• xiphoid process
• costal margin
• laterally ribs 6-12
• posteriorly L1 and L2

Question 5

diaphragm insertion

Answer 5

• central tendon
• thin but strong aponeurosis
• located near center of diaphragm but more anterior than posterior
• R and L hemidiaphragms

Question 6

T/F: diaphragms separate different cavities w/different pressures

Answer 6

True

Question 7

displacement of the diaphragm

Answer 7

• quiet breathing: 2/3 inch

- max excursion: 2.5-4 in

Question 8

what might limit diaphragm displacement?

Answer 8

• obesity
• pregnancy
• size of various GI organs
• ascites

Question 9

supine effects on diaphragm

Answer 9

• no effects of gravity
• level of diaphragm rises; greater excursion
• lung volumes low because of elevated position of abdominal organs

Question 10

upright position effects on diaphragm

Answer 10

• diaphragm pulled down because effects of gravity

- reduced excursion but lung volumes increased

Question 11

SL effects on diaphragm

Answer 11

• hemidiaphragms unequal
• uppermost side drops to lower position and has less excursion than in sitting
• higher but has less excursion
• lowermost (dependent) side rises higher in thorax and has greater excursion

Question 12

T/F: You should position a patient with an injured lung with the injured side up so the “good lung” has greater excursion

Answer 12

True

Question 13

which intercostal is used for inspiration?

Answer 13

external

Question 14

which intercostal is used for expiration

Answer 14

internal

Question 15

T/F: inspiration is a passive process at rest and during exercise

Answer 15

False: Active

contraction of diaphragm and external intercostals

Question 16

relaxed breathing

Answer 16

• ribs drop

- diaphragm relaxes

Question 17

elastic recoil

Answer 17

rebound of lungs after stretched by inhalation

Question 18

why does elastic recoil occur?

Answer 18

• elastin in CT of lungs

- surface tension of the film of fluid lining alveoli

Question 19

what are the muscles for inspiration

Answer 19

• external intercostals
• SCM
• scalenes
• pec minor/major
• upper trap
• SA
• rhomboids
• serratus posterior superior
• thoracic erector spinae

Question 20

where is the apex of the lung located?

Answer 20

• in the root of the neck

- highest point approx 1 inch above middle 1/3 of each clavicle

Question 21

lobar bronchi

Answer 21

pass into a lobe of the lungs from R or L bronchus

Question 22

segmental bronchi

Answer 22

pass through a segment of each lobe

Question 23

bronchioles

Answer 23

smallest segments of bronchi

Question 24

respiratory zone

Answer 24

gas exchange airways made up of:

1. respiratory bronchioles
2. alveolar ducts
3. alveoli

Question 25

layers of the lungs?

Answer 25

1. pleural space 2. visceral pleura 3. cervical parietal pleura 4. costal parietal pleura 5. mediastinal parietal pleura 6. diaphragmatic parietal pleura 7. costo-diaphragmatic recess

Question 26

subatmospheric pressure is also called

Answer 26

negative intrapulmonary pressure

Question 27

what causes air to flow into the lungs

Answer 27

difference in pressure between the atmosphere and alveoli. (high to low)

Question 28

Intrapulmonary pressure change during 1. inspiration 2. expiration

Answer 28

1. -3 | 2. +3

Question 29

Intrapleural pressure change during 1. inspiration 2. expiration

Answer 29

1. -6 | 2. -3

Question 30

Transpulmonary pressure change during 1. inspiration 2. expiration

Answer 30

1. +3 | 2. +6

Question 31

how to measure static and dynamic lung volumes

Answer 31

spirometer

Question 32

resting TV

Answer 32

350-500 mLs

Question 33

minute ventilation

Answer 33

- assessment of effective ventilation - L/min - calculated by multiplying RR x TV - rest: 5 L/min - max ex: 70-125 L/min

Question 34

Lung Compliance

Answer 34

- lungs have capacity to expand and stretch - ease at which lungs can expand relative to pressure - speaks to distensability of lung tissue - stiffness of tissue

Question 35

Elasticity

Answer 35

ability of lungs to return to their initial size after being stretched

Question 36

T/F: emphysema has decreased compliance and are very difficult to inflate and have reduced capcity to recoil

Answer 36

False - easy to inflate - increased compliance - decreased capacity to recoil

Question 37

formula for lung compliance

Answer 37

ΔV/ΔP

Question 38

surface tension

Answer 38

1. created by fluid secreted onto lining of alveoli 2. resists lung expansion/distension 3. acts to collapse alveolus and raises pressure of alveolar air

Question 39

surfactant

Answer 39

compound that reduces surface tension

Question 40

what happens in the absence of surface tension

Answer 40

- recoil goes up - compliance goes down lungs of a pre term baby

Question 41

Why don't our lungs collapse when we aren't actively breathing?

Answer 41

1. because lungs are stuck to thoracic wall, always under elastic tension 2. at functional residual capacity, elastic recoil of lung is balanced by elastic recoil of chest wall

Question 42

V/Q ratio

Answer 42

0.8

Question 43

distribution of pulmonary ventilation

Answer 43

2.5 x greater at base than apex

Question 44

distribution of pulmonary perfusion

Answer 44

6x greater at base than apex

Question 45

when does shunting occur

Answer 45

if perfusion occurs but very limited ventilation. excess perfusion results in a R to L shunt

Question 46

dead space

Answer 46

- if ventilation occurs w/limited perfusion

Question 47

excess of ventilation results in

Answer 47

physiologic dead space

Question 48

does a pulmonary embolism cause a shunt or dead space

Answer 48

shunt?

Question 49

defects in ventilation perfusion matching can lead to

Answer 49

- hypoxia | - red oxygen delivery to peripheral tissue

Question 50

Ventilation / perfusion scar

Answer 50

- test that measures air and blood flow in lungs - most often dx or rule out PE - involves radioactive albumin injected into blood and radionuclide into air breathed in

Question 51

Dalton's Law

Answer 51

- total pressure of gas mix is equal to sum of pressures of each gas in it

Question 52

partial pressure

Answer 52

pressure of an individual gas multiply % of gas by total pressure

Question 53

CO2 transport in the blood

Answer 53

1. CO2 dissolved in blood 2. carried as bicarbonate ion 3. carried combined w/hemoglobin

Question 54

Increased CO2 in the blood

Answer 54

1. shift to the R increases CO3 and H 2. reduces blood pH 3. CO2 retention (hypercapnic) 4. hypoventillation 5. reduced exhalation volumes

Question 55

decreased CO2 in blood

Answer 55

1. shift to L: decreased CO3 and H 2. increases blood pH 3. greater amounts of CO2 exhaled (hypocapnic) 4. hyperventilation 5. reduced exhalation volumes

Question 56

How much O2 is delivered through a nasal canula in adults

Answer 56

1-6 L/min

Question 57

what are some concerns using a nasal cannula

Answer 57

irritated and dried nasal mucosa

Question 58

FIO2

Answer 58

fraction of inspired air that's oxygen = 21% for every L/min, increases by 4%