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Take My Breath Away > Review > Flashcards

Review Flashcards

1
Q

Upper respiratory system consists of?

A
  • Nose
  • Pharynx
  • Associated structures
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2
Q

Lower respiratory system includes?

A
  • Larynx
  • Trachea
  • Bronchi
  • Lungs
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3
Q

What zone consists of a series of interconnecting cavities and tubes?

A

Conducting Zone
- nose, pharynx, larynx, trachea, bronchi, bronchioles, and terminal bronchioles that conduct air into the lungs

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4
Q

What zone consists of tissue within the lungs where gas exchange occurs?

A

Respiratory zone
- respiratory bronchioles, alveolar ducts, alveolar sacs, alveoli

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5
Q

What is the double layered serous membrane that encloses and protects each lung?

A

Pleural membrane

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6
Q

What is the outer layer that is attached to the wall of the thoracic cavity and diaphragm?

A

Parietal pleura

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7
Q

What is the inner layer that is attached to the lungs?

A

Visceral pleura

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8
Q

What is the narrow space located between the visceral and parietal pleura which contains a lubricating fluid secreted by the membrane?

A

Pleural cavity

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9
Q

How does the pleural cavity keep the pleural membrane adhered to one another during inhalation?

A

by generating surface tension

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10
Q

What secretes alveolar fluid which keeps the surface between the cell and the air moist?

A

Surfactant cell

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11
Q

What is a mixture of phospholipids and lipoproteins that reduces the tendency of alveoli to collapse?

A

Surfactant cells

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12
Q

What are wondering phagocytes that removes fine dust particles and other debris in the alveolar spaces?

A

Alveolar Macrophages

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13
Q

Contracting of the diaphragm is responsible for what percentage of the air that enters the lungs during quiet breathing?

A

75%

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14
Q

What muscles are used during deep labored inhalation?

A
  • Sternocleidomastoid
  • Scalene
  • Pectoralis
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15
Q

When is exhalation active?

A

only during forceful breathing

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16
Q

During forced exhalation what muscles are used?

A
  • Internal and External obliques
  • Transverse and Rectus abdominis
  • Internal intercostal
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17
Q

At rest just before inhalation, the air pressure inside the lungs is the same as the pressure of the atmosphere. What is the pressure of the atmosphere?

A

760 mmHg at sea level

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18
Q

Air flows from an area of high pressure within the alveoli to the area of lower pressure in the atmosphere

A

Air flows from an area of high pressure within the alveoli to the area of lower pressure in the atmosphere

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19
Q

Each inhale and exhale moves what amount of air in and out of the lungs?

A

500ml

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20
Q

What is the term for volume of 1 breath?

A

Tidal volume

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21
Q

What percentage of tidal volume actually reaches the respiratory bronchioles and alveolar sacs and participates in gas exchange?

A

70%

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22
Q

What percentage does not participate in gas exchange and where does it go?

A

30% goes to the anatomical dead space
- conducting zone

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23
Q

What is the volume of air that remains even after expiratory reserve volume is expelled?

A

Residual Volume (RV)
- 1200 in male, 700 in females

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24
Q

What is the sum of inspiratory reserve volume, tidal volume, and expiratory reserve volume?

A

Vital Capacity (VC)
- 4800 in males, 3100 in females

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25
Q

Normal pattern of quiet breathing?

A

Eupnea

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26
Q

Shallow breathing, upward and outward movement of the chest?

A

Costal breathing

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27
Q

Deep breathing, outward movement of the abdomen?

A

Diaphragmatic breathing

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28
Q

Partial pressure of oxygen?

A

158.8 mmHg

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29
Q

What is the most abundant gas in the atmosphere?

A

Nitrogen

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30
Q

What is the diffusion of O2 from air in the alveoli of the lungs to the blood in the pulmonary capillaries and the diffusion of CO2 in the opposite direction. Occurs in the lungs?

A

External respiration

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31
Q

What is the exchange of O2 and CO2 between systemic capillaries and tissue throughout the body?

A

Internal Respiration

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32
Q

What percentage of O2 is contained in the blood plasma?

A

1.5%

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33
Q

What percentage of O2 is bound to hemoglobin?

A

98.5%

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34
Q

What factors influence O2 release from hemoglobin?

A
  • CO2
  • Acidity
  • Temp
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35
Q

What percentage of CO2 dissolves in the blood plasma?

A

7%

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36
Q

What percentage of CO2 is bound to amino acid?

A

23%

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37
Q

What is the area from which nerve impulses are sent to the respiratory muscles to control respiratory rates?
Where is it located?

A

Respiratory Center
- located in both the pons and medulla oblongata

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38
Q

What is located in the medulla and controls the basic rhythm of respiration?

A

Medullary respiratory center

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39
Q

What generates nerve impulses establishing basic rhythm of quiet normal breathing, causes contraction of the diaphragm via the phrenic nerve and external intercostal muscles via the intercostal nerves, and impulses last about 2 seconds?

A

Dorsal respiratory group (DRG)

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40
Q

The neurons of what area supply nerve impulse for forceful breathing and remain inactive during quiet breathing?

A

Ventral Respiratory Group

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41
Q

What area is active during inhale and exhale, transmit nerve impulses to the DRG in the medulla, plays a role in both inhalation and exhalation by MODIFYING/MODERATE the rhythm of breathing generated by the VRG?

A

Pontine respiratory group

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42
Q

What receptors in the medulla, responds to changes in the H+ and CO2 levels in the cerebrospinal fluid?

A

Central Chemoreceptors

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43
Q

What is located within the arc of the aorta and common carotids are sensitive to levels of O2, H+, and CO2 in the blood?

A

Peripheral Chemoreceptor

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44
Q

What is the increase of arterial PCO2, even slightly above the normal 40mmHg?

A

Hypercapnia

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45
Q

What responds vigorously due to the resulting increase in H+ caused by elevated CO2?

A

Central chemoreceptors

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46
Q

Term for when arterial PCO2 falls below 40 mmHg?
central and peripheral chemoreceptors are not stimulated and no impulses are sent?

A

Hypocapnia

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47
Q

What is a deficiency of O2?
What receptors are stimulated?

A

Hypoxia
Peripheral Chemoreceptors

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48
Q

What increases rate and depth of respiration due to anticipation of activity or emotional anxiety?

A

Limbic system

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49
Q

What increases the rate and depth of respirations due to input from proprioceptors as result of joint and muscle movement. These proprioceptors stimulate the inspiratory area of the medulla. Respiration increases even before changes in PO2, PCO2, or H+ occur?

A

Proprioceptor Stimulation

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50
Q

The subcostal angle of a pregnant service member progressively increase to?

A

103.5%

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51
Q

What is heard over most of the lung fields , they are soft and low pitched?

A

Vesicular sounds

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52
Q

What sound is hear over the main stem bronchi and over the upper right posterior lung field, they are medium pitched?

A

Broncho vesicular sounds

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53
Q

What sounds are heard only over the trachea and are high pitched?

A

Bronchial/tracheal

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54
Q

What is the most common type of asthma?

A

Allergic asthma

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55
Q

What is a chronic disorder of the airway characterized by variable airway obstruction, airway hyperresponsiveness, and airway inflammation?

A

Asthma

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56
Q

What is used for the evaluation of asthma?

A

Spirometry

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57
Q

Pink Puffer?

A

Emphysema

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58
Q

Blue Bloater?

A

Chronic bronchitis

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59
Q

What presents with a productive cough for 3 months in each of 2 successive years?

A

Chronic bronchitis

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60
Q

What is the essential test to confirm the diagnosis and establish the staging of COPD to establish and FEV score?

A

Spirometry

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61
Q

In most patients with cardiogenic pulmonary edema, and underlying cardiac abnormality can usually be detected clinically by what test?

A

ECG

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62
Q

Production of pink frothy sputum is a sx of what disease?

A

Pulmonary edema

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63
Q

What can occur in response to pulmonary edema and may itself cause hypoxemia and dyspnea?

A

Bronchospasm
TX: Beta-adrenergic

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64
Q

Clots that form pulmonary emboli are most commonly from where?

A

Femoral or Pelvic venous beds

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65
Q

PE will develop in what percentage of patients with proximal DVT?

A

50-60%

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66
Q

What percentage of patients with symptomatic PE will have lower extremity DVT?

A

50-70%

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67
Q

Streptokinase, urokinase, and recombinant tissue plasminogen activator aka?

A

Clot Busters

68
Q

The most important initial study for all patients presenting with hemoptysis is?

A

Chest X-ray

69
Q

What is the most common cause of severe upper airway obstruction in adults?

A

Laryngeal edema from thermal injury or Angioedema

70
Q

What is the injury of the lung parenchyma with hemorrhage and edema without associated laceration?

A

Pulmonary contusion

71
Q

What is the most common complication of pulmonary contusions?

A

Pneumonia

72
Q

What diagnosis presents with fleeting pain in the chest wall, usually follows an injury or illness, px worsened by cough/sneezing/deep breathing/movement?

A

Pleuritis

73
Q

What is the most common bacterial pathogen identified in most studies of community acquired pneumonia?

A

Streptococcus

74
Q

What is the most common viral cause of community acquired pneumonia?

A

Influenza

75
Q

Parenchymal infiltrate on a chest radiograph is indicative of?

A

Pneumonia

76
Q

Cough associated with midline burning chest px, fever, and dyspnea is indicative of?

A

Bronchitis

77
Q

What is the primary clinical difference between bronchitis and pneumonia?

A

Presence of an infiltration on the chest x-ray in the cause of pneumonia

78
Q

What is the most frequent acute illness in the united states and throughout the industrialized world?

A

URI

79
Q

What is the initial step in the management of hemoptysis?

A

O2

80
Q

Malaise, HA, and cough are associated sx of?

A

URI

81
Q

What is clinically defined as massive hemoptysis?

A
  • > 500mL of expectorated blood over 24hrs
  • > 100mL/hour
82
Q

Although unspecific for PE and ECG may show?

A

ST and T wave abnormalities

83
Q

What presents with an onset of sx within 24hrs after exposure with persistence for at least 3 months?

A

Reactive airway disease

84
Q

What is the leaf-shaped piece of elastic cartilage that is covered with epithelium?

A

Epiglottis

85
Q

What is the initial treatment for hemoptysis?

A

O2

86
Q

How long does a URI last?

A

3-10 days

87
Q

What diagnosis presents with subcutaneous emphysema after a MVA or trauma?

A

Broncho-tracheal injury

88
Q

What percentage of Brach-tracheal injuries are identified?

A

25%

89
Q

What is the mortality rate of bronchial -tracheal injuries?

A

80%

90
Q

Patient with COPD present with what spine deformity?

A

Kyphosis

91
Q

What is a long term sign of hemoptysis?

A

Clubbed fingers

92
Q

Massive hemoptysis heart sounds?

A

Bruit

93
Q

What is the number of days with sputum for TB?

A

3 days

94
Q

Right sided bronchial injuries occur more commonly and are typically more severe, while almost 80% occur with 2cm of the?

A

Carina

95
Q

All patients in respiratory distress with suspected trachea-bronchial injury should be?

A

Endotracheal intubated

96
Q

What is the sum of vital capacity and residual volume?

A

Total lung capacity

97
Q

Larynx aka?

A

Voice box

98
Q

Trachea aka?

A

Wind pipe

99
Q

The larynx lies midline of the neck and anterior to what vertebrae?

A

C4-C6

100
Q

The mucus membrane of the larynx form what 2 pairs of folds?

A
  • Vestibular folds (Upper Pair)
  • Vocal folds (Lower Pair)
101
Q

What fold can hold your breath against pressure in the thoracic cavity when you strain to lift a heavy object?

A

Vestibular fold

102
Q

What fold is known as the false vocal cords?

A

Vestibular fold

103
Q

What fold contains elastic ligaments stretched between pieces of rigid cartilage?

A

Vocal fold

104
Q

What are the muscles of quiet unforced inhalation?

A
  • Diaphragm
  • External intercostal
105
Q

What are the muscles of quiet unforced exhalation?

A
  • Diaphragm
  • External intercostal
106
Q

Is quiet inhalation active or passive?

A

Active

107
Q

Is quiet exhalation active or passive?

A

Passive

108
Q

What is the volume of air that remains even after expiratory reserve volume is expelled?

A

Residual Volume

109
Q

Is Residual volume part of Vital capacity?

A

NO!

110
Q

What percentage of tidal volume actually reaches the respiratory bronchioles and alveolar sacs to participate in gas exchange?

A

70%

111
Q

What nerve controls the diaphragm?

A

Phrenic

112
Q

Hemothorax lung sounds?

A

Dull

113
Q

Percussion finding for pneumothorax?

A

Hyper resonance

114
Q

Partial Pressure
Atmosphere?

A

PO2 = 159
PCO2= 0.3

115
Q

Partial Pressure
Alveolar?

A

PO2 = 105
CO2 = 40

116
Q

Partial Pressure
Tissue?

A

PO2 = 100 mmHg

117
Q

Partial Pressure
Oxygenated blood?

A

PO2 = 100
PCO2 = 40

118
Q

Partial Pressure
Deoxygenated / systemic capillaries?

A

PO2 = 40
PCO2 = 45

119
Q

What is the microscopic air pathway?

A
  • Terminal Bronchioles
  • Respiratory Bronchioles
  • Alveolar ducts
  • Alveolar sacs
  • Alveoli
120
Q

What is 2 or more alveoli that share a common opening to the alveolar duct?

A

Alveolar Sac

121
Q

What is a cup-shaped outer pouching of the alveolar sac?

A

Alveoli

122
Q

The L lung is how much smaller than the R lung?

A

10% smaller

123
Q

What are deep groove that divide the lungs into lobes?

A

Fissures

124
Q

What are the fissure of the R lung?

A
  • Oblique
  • Horizontal
125
Q

What are the fissure of the L lung?

A

Oblique

126
Q

What exchanges small amounts of air with the auditory tubes to equalize air pressure in the between the pharynx and middle ear?

A

Nasopharynx

127
Q

What are the 2 tonsil pairs?

A
  • Palantine
  • Lingual
128
Q

What are the 3 parts of the pharynx?

A
  • Naso
  • Oro
  • Laryngo
129
Q

How many rings does the trachea have?

A

16-20

130
Q

What allows us to hold our breath voluntarily?

A

Cerebral Cortex

131
Q

Where are Central chemoreceptors located?

A

Medulla
- responds to changes in the CSF

132
Q

Where are Peripheral Chemoreceptors located?

A

Aortic arch

133
Q

Term for dyspnea increase in upright position?

A

Platypnea

134
Q

Term for SOB that begins or increases when the lies down?

A

Orthopnea

135
Q

Term for curvature/deviation of the spine?

A

Scoliosis

136
Q

Term for curvature of the lumbar spine?

A

Lordosis

137
Q

Term for asthma during menstrual cycle?

A

Catamenial

138
Q

What are the 3 subtypes of COPD?

A
  • Emphysema
  • Chronic Bronchitis
  • Chronic Obstructive Asthma
139
Q

The acute exacerbation of sx beyond day to day variations including increased dyspnea, increased frequency of cough, and increase sputum volume or character is a hallmark of what disease?

A

COPD

140
Q

What is the essential test to confirm the diagnosis and establish the staging of COPD?

A

Spirometry

141
Q

Pulmonary opacity on a chest x-ray indicates what?

A

TB

142
Q

Acid fast bacilli light microscopy testing for TB requires how many specimens?

A

3 consecutive morning

143
Q

What is the first line of tx for flail chest?

A

O2

144
Q
  • Dyspnea
  • Cough with or w/o sputum
  • WHEEZING DURING INHALATION
  • Acute chest illness
A

Asthma

145
Q
  • Dry cough x 3 months
  • Hemoptysis
  • Fever
  • MIDLINE BURNING CHEST PX
  • RHONCI THAT CLEARS WITH COUGH
  • Crackles
  • Wheezing
A

Bronchitis

146
Q
  • Fever
  • Cough
  • Smoking Hx
  • Nasopharyngeal or GI bleed
  • BLOOD STREAKING OF SPUTEM
  • Gross blood from between the vocal cords or lungs
A

Hemoptysis

147
Q
  • Fever or Hypothermia
  • Cough
  • Dyspnea
  • Chest disconfort
  • Sweats or rigors
  • RHONCI AND RALES ON AUSCULTATION
  • Tachypnea
  • Tachycardia
A

Pneumonia

148
Q
  • Decreased breath sounds
  • Dullness to percussion
  • Respiratory distress and hypotension
  • Tachypnea
  • HYPOTENSION AND FLATTENED NECK VEIN
A

Hemothorax

149
Q
  • ABSENT OR DECREASED BREATHE SOUNDS
  • HYPER RESONANCE TO PERCUSSION
  • PLEURITIC CHEST PX
  • Dyspnea
  • Decreased tactile fremitus
  • Decreased chest movement
  • Hyper resonance of the affected side
  • TYPICALLY YOUNG, TALL, MEN WHO SMOKE 20-40 Y/O
A

Pneumothorax

150
Q
  • Tracheal deviation away from the pneumothorax with respiratory distress and hypotension
A

Tension Pneumothorax

151
Q
  • ACUTE ONSET OR WORSENING OF OF DYSPNEA AT REST
  • Tachycardia
  • Diaphoresis
  • Cyanosis
  • PULMONARY RALES IN ALL LUNG FIELDS, RHONCHI, EXPIRATORY WHEEZING
  • PINKY FROTHY SPUTEM
A

Pulmonary Edema

152
Q
  • DAYTIME FATIGUE
  • HISTORY OF LOUD SNORING WITH WITNESSED APNIC EVENTS
  • Advancing age
  • Male
  • Obesity
  • CRANOFACIAL MORPHOLOGY OR UPPER AIRWAY SOFT TISSUE ABNORMALITIES
A

Obstructive Sleep Apnea

153
Q
  • HX OF BLUNT FORCE TRAUMA OR MVA
  • Localized px
  • CREPTIUS
  • Pain with inspiration
  • Dyspnea
A

Rib fracture

154
Q
  • SUDDEN ONSET OF INTERMITTENT (FLEETING) PX IN CHEST WALL
  • Usually follows an injury or ilness
  • Px worsened by coughing, sneezing, deep breathing, or movement
  • IN YOUNG OTHERWISE HEALTHY PT, PREVIOUS VIRAL RESPIRATORY ILLNESS OR PNEUMONIA
  • Previous trauma to the chest wall such as rib fractures may be the cause
A

Pleuritis

155
Q
  • Px and respiratory distress
  • Usually from significant blunt force trauma
A

Flail Chest

156
Q
  • Virchows Triad
  • Dyspnea, cough, anxiety, and chest px
  • Hemoptysis, tachycardia, tachypnea
  • Low grade fever, Hypotension, cyanosis, DVT, pleural friction rub
A

PE

157
Q
  • FATIGUE, WEIGHT LOSS, FEVER, NIGHT SWEATS, PRODUCTIVE COUGH
  • HX OF TRAVEL TO ENDEMIC AREA
  • Crackles present upon inspiration
A

TB

158
Q
  • Clear rhinorrhea, nasal congestion
  • Malaise, HA, cough
  • Sx last 3-10 days
A

URI

159
Q
  • Most frequent injury of non penetration trauma
  • Pneumonia is common
  • Hypoxia
  • Dyspnea
  • Hemoptysis
  • Tachycardia
A

Pulmonary contusion

160
Q
  • Usually results from MVA and crush injury
  • Dyspnea
  • SUBCUTANEOUS EMPHYSEMA OF THE NECK OR UPPER THORACIC REGION
  • HOARSNESS
  • Hemoptysis
  • Hypoxia
  • PERSISTENT PNEUMOTHORAX
A

Tracheobronchial injury

161
Q
  • STRIDOR
  • UNABLE TO SPEAK
  • VISIBLE SWELLING OR MAS ON NECK
  • Tongue or other structures of the mouth may be swollen
A

Acute respiratory distress

162
Q

Tx for Pneumonia

A

Macrolides

163
Q

Tx for Pulmonary edema?

A

Diuretics
Nitrates

164
Q

Tx for Flail chest?

A

O2
Opioids

165
Q

Tx for acute respiratory distress caused by angioedema?

A

Epi

Take My Breath Away (2 decks)

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