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ACCP > Resporstory > Flashcards

Resporstory Flashcards

1
Q

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

A

Hyoid

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2
Q

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

A

Top of thyroid cartilage

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3
Q

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

A

Cricoid cartilage and thyroid

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4
Q

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

A

Suprasternal notch

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5
Q

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

A

Carina

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6
Q

Where would you typically create a surgical tracheostomy

A

2nd and 3rd tracheal rings

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7
Q

How many lobes in left lung

A

2

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8
Q

How many lobes in right lung

A

3

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9
Q

What cranial nerves supply the larynx via the pharyngeal plexus

A

IX Glossopharyngeal
X Vagus
XI accessory

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10
Q

Name the two nerves that supply the larynx

A

Superior laryngeal nerve (SLN)

Recurrent laryngeal nerve (RLN)

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11
Q

Name the blood supply to the larynx

A

Superior and inferior laryngeal artery

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12
Q

Where does the trachea start

A

Below the cords / C6

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13
Q

What vessels follow airways

A

Pulmonary arteries follow airways, veins don’t

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14
Q

Inspiration muscles:

A

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

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15
Q

Active expiration muscles

A

Mostly passive
Active:
Internal intercostal
Abdominal
External and internal oblique

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16
Q

Describe tidal volume

A

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

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17
Q

Describe inspiratory reserve volume

A

Excluding TV, volume that can be inhaled with maximum effort

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18
Q

Describe expiratory reserve volume

A

Excluding TV, volume that can be exhaled upon maximum effort

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19
Q

Describe residual volume

A

Volume left in lungs following maximum exhalation

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20
Q

Describe vital capacity

A

Total volume that can be inhaled and exhaled

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21
Q

Total lung capacity

A

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

22
Q

Inspiratory capacity:

A

Volume including normal tidal volume and inspiratory reserve volume

23
Q

Functional residual capacity

A

Volume left in lungs after normal exhalation (TV)

24
Q

Describe dead space

A

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

25
Q

Describe shunt

A

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

26
Q

Describe Ventilation-Perfusion (V/Q) mismatch

A

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

27
Q

Describe shunt fraction

A

Percentage of cardiac output from the left ventricle not oxygenated

28
Q

Name the 3 gas laws

A

Boyles
Charles
Gay Lussacs

29
Q

Describe boyles law

A

Constant = temperature

Pressure & volume inversely proportional

30
Q

Describes Charles law

A

Constant - pressure

Temp & volume directly proportional

31
Q

Describe Gay Lussacs law

A

Constant - mass/volume

Pressure & temperature are directly proportional to

32
Q

Describe atmospheric pressure

A

1 ATM = 101KPa = 760 mmHg

33
Q

Describe a gas

A

Substance in gaseous form above critical temperature

34
Q

Describe critical temperature

A

Temperature below which gas cannot be liquified with pressure alone

35
Q

Describe Dalton’s law

A

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

36
Q

Describe Henry law

A

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

37
Q

Describe oxygen cascade

A

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

38
Q

Name 2 methods of oxygen transportation in the blood

A

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

39
Q

How many oxygen molecules can bind to a haemoglobin molecule

A

4

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

40
Q

Fully saturated haemoglobin:
describe huffners constant

A

1.34ml of oxygen per Gram of HB

41
Q

Deoxyhaemoglobin is what type of structure and affinity

A

Tight structure with low affinity for oxygen

As oxygen binds it relaxes and increases affinity / desire for more oxygen to bind

42
Q

Which part of haemoglobin does oxygen bind to

A

Iron atom on the haemoglobin

43
Q

Describe oxygen dissociation curve

A

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

44
Q

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

A

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

45
Q

Describe bohr effect

A

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

46
Q

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

A

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

47
Q

How is carbon dioxide carried in the blood?

A
  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)
48
Q

Symptoms of superior laryngeal nerve injury:

A

Cricothyroid paralysis causing hoarseness

49
Q

Symptoms of recurrent laryngeal nerve injury:

A

Cord paralysis
Unilateral hoarseness
Bilateral stridor

50
Q

What are the central controllers of breathing in the brain stem

A

Medulla and Pons

51
Q

What chemoreceptors respond to paC02

A

Central chemoreceptors (medulla)

52
Q

What chemoreceptors respond to pa02 and blood ph

A

Peripheral chemoreceptors (carotid/aortic arch)

ACCP (16 decks)

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