Respiratory System Flashcards by Faith L

Process of acquiring, transporting, utilizing O2 to support cellular metabolism, thereby maintaining body function

OXYGENATION

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Process in which oxygen is transported from atmosphere to the cells and carbon dioxide came from the cells to the atmosphere.

RESPIRATION

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What are the 3 process of respiration?

VENTILATION
DIFFUSION
PERFUSSION

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Movement of air to and from the alveoli which has 2 aspects: inhalation and exhalation which controlled by medulla and pons

VENTILATION

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Exchange of oxygen and carbon dioxide between alveoli and blood from an area of high concentration to low concentration with out ATP expenditure.

DIFFUSION

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Availability and movements of blood for transport of gases; nutrients and metabolic waste products.

PERFUSION

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Opening of the nose
1. Nostrils
2. Chonae

NARES

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Funnel shape tube that extends from nose to larynx.

PHARYNX

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3 components of Pharynx?

NASOPHARYNX
OROPHARYNX
LARYNGOPHARYNX

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Voice box
Located above the trachea
Contains 2 pairs of vocal cord, true and false cords
The opening between the true vocal cords is the glottis, which plays an important role coughing, the most fundamental defense mechanism of the lungs.

LARYNX

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Air filled space lined with mucous membrane, located within some of the bones of the skull.
It provides resonance during speech.

PARANASAL SINUSES

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Paranasal sinuses according to their location

FRONTAL
ETHMOIDAL
SPHENOIDAL
MAXILLARY

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Left shape elastic flap structure at the top of the larynx.
Prevents food from entering the tracheobronchial tree by closing over the glottis during swallowing.

EPIGLOTTIS

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Wind pipe
Located in front of esophagus
Conducts air toward the lungs
It’s mucosa is lined up with mucus and cilia to trap particles and carry them towards the upper airway
Contains cilia which are microscopic hair like projections that is needed to remove foreign particles through rapid, coordinated, unidirectional motion

TRACHEA

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The right and left primary bronchi begin at the carina
The function is for air passage
Divide into secondary or lobar bronchi that enter each of the lobes of the lung
Are lined with cilia, which propel mucus up and away from the lower airway to the trachea where it can be expectorated or swallowed

BRONCHI

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The primary bronchus further divides into secondary, tertiary then into bronchioles.
The terminal bronchioles is the last part of the conducting airway
The terminal bronchiole contains no cilia and do not participate in gas exchange
Contain no cartilage and depend on the elastic recoil of the lung for patency

BRONCHIOLES

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The chief respiratory organ
Acinus, is a term used to indicate all structures distal to the terminal bronchiole
Functions for gas exchange through the respiratory membrane

RESPIRATORY ACINUS

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Respiratory acinus consist of;

RESPIRATORY BRONCHIOLE
ALVEOLI DUCT
ALVEOLI SAC

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Located in the pleural cavity in the thorax
Extend from just above the clavicles to the diaphragm, the major muscle of inspiration
The respiratory structures are innervated by the phrenic nerve, the vagus nerve and thoracic nerve.

LUNGS

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What are the 2 types of pleura?

PARIETAL PLEURA
VISCERAL PLEURAL

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Lines the inside of the thoracic cavity, including the upper surface of the diaphragm

PARIETAL PLEURA

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Covers the pulmonary surfaces
A thin fluid layer, which is produced by the cells lining the pleura, lubricates the visceral pleura and the parietal pleura, allowing them to glide smoothly and painlessly during aspiration.
Blood flows throughout the lungs via the pulmonary circulation system.

VISCERAL PLEURA

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The chest wall composed of the sternum and the rib cage
The cavity is separated by the diaphragm, the most important respiratory muscle.

THORACIC CAVITY

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The respiratory membrane is composed of two epithelial cells

RESPIRATORY MEMBRANE

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Most abundant, thin and flat. This is where gas exchange occurs. Lines the alveoli

TYPE 1 PNEUMOCYTE

Secretes the lung surfactant Surfactant is a phospholipid protein that reduces the surface tension in the alveoli; without surfactant, the alveoli would collapse.

TYPE 2 PNEUMOCYTE

The macrophage that ingest foreign material and act as an important defense mechanism

TYPE 3 PNEUMOCYTE

Accessory muscles of respiration

1. SCALENE MUSCLES 2. STERNOCLEIDOMASTOID MUSCLES 3. TRAPEZIUS AND PECTORALIS MUSCLES

Elevates the first ribs

SCALENE MUSCLES

Raise the sternum

STERNOCLEIDOMASTOID MUSCLES

Fixed the shoulders

TRAPEZIUS AND PECTORALIS MUSCLES

Function of lower airways

CLEARANCE MECHANISM COUGH MUCOCILIARY SYSTEM MACROPHAGE LYMPHATICS

General functions of the respiration system

FOR GAS EXCHANGE ACID BALANCE BASE- imbalance can cause alterations in arterial pH ELIMINATION OF CO2 FLUID BALANCE TEMPERATURE REGULATION

Obtained by expectoration or tracheal suction in order to assist in identifying organisms or abnormal cells

SPUTUM SPECIMEN

Direct visual examination of the larynx, trachea and bronchi with a fiber optic bronchoscope.

LARYNGOSCOPY AND BRONCHOSCOPY

Tissue samples are obtained from central lung masses and lymph nodes, using a bronchoscope with the help of ultrasound guidance Monitor for signs of bleeding and respiratory distress

ENDOBRONCHIAL ULTRASOUND

An invasive fluoroscopic procedure A catheter is inserted through the antecubital or femoral vein into the pulmonary artery or one of its branches Involves an injection of iodine or radiopaque contrast material

PULMONARY ANGIOGRAPHY

Removal of fluid or air from the pleural Space via trans thoracic aspiration

THORACENTESIS

A transbronchial biopsy and a transbronchial needle aspiration may be performed to obtain tissue for analysis by culture or cytological examination

LUNG BIOPSY

Frequently used to diagnose pulmonary embolism IV injection of contrast medium is used. If not, a ventilation-perfusion V/Q scan will be done.

SPIRAL (helical) COMPUTED TOMOGRAPHY (CT) SCAN

Perfusion scan, evaluates blood flow to the lungs Ventilatory scan: determines the patency of the pulmonary airways Radionuclide may be injected for the procedure

VENTILATION- PERFUSION LUNG SCAN

An intradermal injection to help diagnose various infectious disease

SKIN TESTS

Measurement of the dissolved oxygen and carbon dioxide in the arterial blood to indicate acid base state how well oxygen is being carried to the body. Avoid suctioning the client before drawing an ABG sample because the suctioning procedure will deplete the client’s oxygen, resulting in inaccurate ABG result.

ARTERIAL BLOOD GASES

A noninvasive test that registera oxygen saturation of the client’s hemoglobin The normal value is 96% to 100%

PULSE OXIMETRY

Measure clot formation and lysis Helps to diagnose the presence of thrombus

D-DIMER

Breathing retraining (pursed lip breathing and diaphragmatic breathing) o inhale through the nose and exhale through the mouth.

RESPIRATORY TREATMENT

What are the 8 supplemental oxygen delivery systems?

NASAL CANNULA FOR LOW FLOW NASAL HIGH FLOW RESPIRATORY THERAPY SIMPLE FACE MASK VENTURI MASK PARTIAL REBREATHER MASK NON REBREATHER MASK TRACHEOSTOMY COLLAR AND T BAR OR T PIECE FACE TENT

For client with chronic airflow limitation and for long term oxygen use 1 to 6 Lpm 24-44%

NASAL CANNULA FOR LOW FLOW

For hypoxemic clients in mild to moderate respiratory distress

NASAL HIGH FLOW RESPIRATORY THERAPY

For short term oxygen therapy or to deliver oxygen in an emergency Use to deliver 40-60% if concentration Minimum of 5lpm

SIMPLE MASK

For at risk for or experiencing accurate respiratory failure High flow oxygen deliver system An adapter is located between the bottom of the mask and the oxygen.

VENTURI MASK

A partial rebreather mask consists of mask with a reservoir bag that provided an oxygen concentration of 70-90% with flow rates of 6 to 15 L/m . When the oxygen concentration needs to be raised; not usual prescribed for a client with COPD

PARTIAL REBREATHER MASK

For Client as deteriorating respiratory status who might require intubation Can deliver an FiO2 higher than 90% depending on the clients ventilators pattern

NON REBREATHER MASK

To deliver high humidity and the desired oxygen to the client with a tracheostomy; the T bar or T piece is used to deliver the desired FiO2.

TRACHEOTOMY COLLAR AND T BAR OR T PIECE

Used instead of a tight fitting mask from the client who has facial trauma or burns

FACE TENT

What are the types of Mechanical ventilation

PRESSURE CYCLED VENTILATOR TIME CYCLED VENTILATOR VOLUME CYCLED VENTILATOR

The ventilator pushes air into the lungs until a specific airway pressure is reached It is used for short periods.

PRESSURE CYCLED VENTILATOR

The ventilator pushes air into the lungs until a preset time has elapsed

TIME CYCLED VENTILATOR

The ventilator pushes air into the lungs until present volume is delivered A constant tidal volume is delivered regardless of the changing compliance of the lungs and chest wall or the airway resistance in the client or ventilator

VOLUME CYCLED VENTILATOR

Maintains a set positive airway pressure during inspiration and expiration; beneficial in clients who have acute exacerbations of COPD or obstructive sleep apnea

CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP)

Provide positive airway pressure during inspiration and ceases airway support during expiration; there is only enough pressure provided during expiration to keep the airways open; usually used if CPAP is ineffective.

BILEVEL POSITIVE AIRWAY PRESSURE (BiPAP)

Bleeding from the nose caused by rupture of tiny, distended vessels in the mucus membrane

EPISTAXIS

Most common site anterior septum cause in Epistaxis

TRAUMA INFECTION HYPERTENSION BLOOD DYSCRASIA CANCER RHEUMATIC HEART DISEASE

Infection and inflammation of the tonsils Can be viral bacterial ( most complicated infection)

TONSILITIS

Sudden and life threatening deterioration of the gas exchange function of the lungs Occurs when the lungs no longer meet the body’s metabolic needs Occurs when the insufficient oxygen is transported to the blood or inadequate carbon dioxide is removed from the lungs and the clients compensatory mechanisms fail.

ACUTE RESPIRATORY FAILURE

Acute respiratory failure defined clinically as;

PaO2 OF LESS THAN 50 mmHg PaCO2 OF GREATER THAN 50 mmHg ARTERIAL pH OF LESS THAN 7. 35

The acute Episode of airway obstruction is characterized by airway hyperactivity to various stimuli that results in recurrent wheezing brought about by edema and bronchospasm

ASTHMA

Permanent abnormal dilation of the bronchi with destruction of muscular and elastic structures of bronchial wall Caused by bacterial infection; recurrent lower respiratory tract infection; congenital defects (altered bronchial structures), lung tumors

BRONCHIECTASIS

Most common chest injury resulting from blunt trauma which can cause potential intrathoracic injury such as pneumothorax or pulmonary contusion Ribs 4-8 are most commonly fractured because chest muscles least protect them. Splintered or displaced fractured ribs may penetrate the pleura and lungs.

FRACTURED RIBS