Week 6

Question 1

Lower respiratory tract

Answer 1

-trachea, bronchus, bronchioles

Question 2

Which bronchus do objects normally get aspirated into?

Answer 2

-Right primary bronchus is more vertical than left

Question 3

muscles used for inspiration and expiration

Answer 3

Inspiration:

• Diaphragm, external intercostals
• Accessory

Expiration:

• Quiet breathing:
  
  • Passive elastic recoil of lungs, rib cage, & diaphragm
• Active breathing:
  
  • Internal intercostals
  • Abdominal muscles

Question 4

Describe the clinical presentation of airway obstruction

Answer 4

Coughing, Wheezing, Stridor, Hemoptysis (bloody cough), Dysphagia (trouble swallowing), Cyanosis, Chest pain

Question 5

Identify normal values of HR, RR, BP, and SpO2 in a child

Answer 5

Preschool aged child (3-6yr)

HR = 80-140

RR = 20-25

BP: Systolic = 80-100 and Diastolic = 45-65

SpO2 = 97-98%

Question 6

Define SpO2

Answer 6

% of oxygenated hemoglobin in blood

Question 7

Define the significance of each term of Fick’s law of diffusion in relation to the structure and function of the lungs

Answer 7

Fick’s Law: Vx = (DAΔP)/ΔX

• D = gas diffusion constant—unique to each gas
• A = alveolar surface area
• ΔP = Pressure gradient
• ΔX = thickness of membrane being diffused through

Driving force is ΔP: Airway obstruction causes ↓ in ΔP → ↓ rate of diffusion

Question 8

Describe the relationship between SpO2 and gas exchange

Answer 8

SpO2 & gas exchange are directly related in that if gas exchange at the level of the lungs is decreased, the SpO2 also decreased.

↓ gas exchange → ↓ available O2 → ↓ amount of hemoglobin bound

Question 9

Explain how obtaining consent to treat may differ between adults and children

Answer 9

Consent of minor requires consent from parent or legal guardian unless emergency situation where parents can’t be reached, minor is emancipated, or consent is given by in loco parentis

Question 10

Describe the appropriate use of chest imaging in the evaluation of airway obstruction

Answer 10

Chest x-ray—PA & lateral view to determine location of foreign body in airway

Question 11

Discuss implied vs. implicit consent

Answer 11

Implied consent: consent is not given verbally or otherwise due to being incapacitated physically but it is assumed they would want treatment

Implicit: consent is directly given