Resporstory

Question 1

Within the larynx, what anatomical feature would you typically expect to find at C3 vertebral level?

Answer 1

Hyoid

Question 2

Within the larynx, what anatomical feature would you typically expect to find at C4 vertebral level?

Answer 2

Top of thyroid cartilage

Question 3

Within the larynx, what anatomical feature would you typically expect to find at C6 vertebral level?

Answer 3

Cricoid cartilage and thyroid

Question 4

What anatomical feature would you typically expect to find at T2 vertebral level?

Answer 4

Suprasternal notch

Question 5

What anatomical feature would you typically expect to find at t4/5 vertebral level?

Answer 5

Carina

Question 6

Where would you typically create a surgical tracheostomy

Answer 6

2nd and 3rd tracheal rings

Question 7

How many lobes in left lung

Answer 7

2

Question 8

How many lobes in right lung

Answer 8

3

Question 9

What cranial nerves supply the larynx via the pharyngeal plexus

Answer 9

IX Glossopharyngeal
X Vagus
XI accessory

Question 10

Name the two nerves that supply the larynx

Answer 10

Superior laryngeal nerve (SLN)

Recurrent laryngeal nerve (RLN)

Question 11

Name the blood supply to the larynx

Answer 11

Superior and inferior laryngeal artery

Question 12

Where does the trachea start

Answer 12

Below the cords / C6

Question 13

What vessels follow airways

Answer 13

Pulmonary arteries follow airways, veins don’t

Question 14

Inspiration muscles:

Answer 14

Sternocleidomastoid (elevates sternum)
Scalenes (elevate upper ribs)
External intercostal muscles
Interchondral muscles (inner half of chest wall)
Diaphragm

Question 15

Active expiration muscles

Answer 15

Mostly passive
Active:
Internal intercostal
Abdominal
External and internal oblique

Question 16

Describe tidal volume

Answer 16

Volume of breath during normal breathing (6-8ml/kg)

Question 17

Describe inspiratory reserve volume

Answer 17

Excluding TV, volume that can be inhaled with maximum effort

Question 18

Describe expiratory reserve volume

Answer 18

Excluding TV, volume that can be exhaled upon maximum effort

Question 19

Describe residual volume

Answer 19

Volume left in lungs following maximum exhalation

Question 20

Describe vital capacity

Answer 20

Total volume that can be inhaled and exhaled

Question 21

Total lung capacity

Answer 21

Total volume that the lungs can bare, including vital capacity and residual volume

Question 22

Inspiratory capacity:

Answer 22

Volume including normal tidal volume and inspiratory reserve volume

Question 23

Functional residual capacity

Answer 23

Volume left in lungs after normal exhalation (TV)

Question 24

Describe dead space

Answer 24

An area that is ventilated but does not partake in gaseous exchange
Anatomical dead space: mouth and trachea (& equipment)
EXAMPLE:
PE, ETT, ventilator

Question 25

Describe shunt

Answer 25

Blood passed through the lung/tissue without gaseous exchange Perfused but not ventilated EXAMPLES: Pneumonia, pulmonary oedema

Question 26

Describe Ventilation-Perfusion (V/Q) mismatch

Answer 26

Presence of shunt / dead space causing pathological discrepancy between ventilation and perfusion

Question 27

Describe shunt fraction

Answer 27

Percentage of cardiac output from the left ventricle not oxygenated

Question 28

Name the 3 gas laws

Answer 28

Boyles Charles Gay Lussacs

Question 29

Describe boyles law

Answer 29

Constant = temperature Pressure & volume inversely proportional

Question 30

Describes Charles law

Answer 30

Constant - pressure Temp & volume directly proportional

Question 31

Describe Gay Lussacs law

Answer 31

Constant - mass/volume Pressure & temperature are directly proportional to

Question 32

Describe atmospheric pressure

Answer 32

1 ATM = 101KPa = 760 mmHg

Question 33

Describe a gas

Answer 33

Substance in gaseous form above critical temperature

Question 34

Describe critical temperature

Answer 34

Temperature below which gas cannot be liquified with pressure alone

Question 35

Describe Dalton’s law

Answer 35

In a mixture of non-reactive gasses, total pressure is equal to the sum of all individual gasses (Gas1+gas2=total pressure)

Question 36

Describe Henry law

Answer 36

Quantity of gas dissolved in liquid is proportional to: -partial pressure -solubility

Question 37

Describe oxygen cascade

Answer 37

Progressive reduction in partial pressure of oxygen in the blood as it travels through the body.. starting at 21% air..

Question 38

Name 2 methods of oxygen transportation in the blood

Answer 38

Bound to haemoglobin (97%) Dissolved in the blood (3%)

Question 39

How many oxygen molecules can bind to a haemoglobin molecule

Answer 39

4 Oxygen binding is cooperative - easier to bind as more are attached

Question 40

Fully saturated haemoglobin: describe huffners constant

Answer 40

1.34ml of oxygen per Gram of HB

Question 41

Deoxyhaemoglobin is what type of structure and affinity

Answer 41

Tight structure with low affinity for oxygen As oxygen binds it relaxes and increases affinity / desire for more oxygen to bind

Question 42

Which part of haemoglobin does oxygen bind to

Answer 42

Iron atom on the haemoglobin

Question 43

Describe oxygen dissociation curve

Answer 43

Represents the association between partial pressure of oxygen pa02 and saturated haemoglobin sa02 with respect to changes in physiology. Shift to the right / left..

Question 44

Causes of a RIGHT shift of the oxygen dissociation curve (Reduced affinity)

Answer 44

LOW ph HIGH c02 - bohr effect High Temperature High 2, 3 DPG

Question 45

Describe bohr effect

Answer 45

Excess c02 that dissolves in the blood combines with 02 to create hydrogen ions and reduce PH Reduces haemoglobin affinity to oxygen

Question 46

Causes of shifting oxygen dissociation curve to the LEFT (Increase affinity)

Answer 46

HIGH PH LOW C02 LOW Temperature LOW 2,3 DPG THINK: Hypothermia lowers metabolic drive and thus requirement for oxygen, HB still saturated so higher affinity

Question 47

How is carbon dioxide carried in the blood?

Answer 47

1. As bicarbonate (H20 + C02 = H2C03) 2. Carbamino compounds (C02 binds with proteins including Hb) 3. Dissolved (C02 is 20x more soluble than 02 in plasma)

Question 48

Symptoms of superior laryngeal nerve injury:

Answer 48

Cricothyroid paralysis causing hoarseness

Question 49

Symptoms of recurrent laryngeal nerve injury:

Answer 49

Cord paralysis Unilateral hoarseness Bilateral stridor

Question 50

What are the central controllers of breathing in the brain stem

Answer 50

Medulla and Pons

Question 51

What chemoreceptors respond to paC02

Answer 51

Central chemoreceptors (medulla)

Question 52

What chemoreceptors respond to pa02 and blood ph

Answer 52

Peripheral chemoreceptors (carotid/aortic arch)