Anatomy, Physiology, Pathophysiology

Question 1

The upper airway is responsible for _______ and ________ incoming air.

Answer 1

Warming and Humidifying

Question 2

How many liters of air are filtered, warmed, humidified, and exchanged each day

Answer 2

Approximately 10,000 liters

Question 3

What is Kiesselbach’s plexus, where is is located, and what is it’s function.

Answer 3

It’s a rich supply of blood vessels in the lower nasal septum that warms inspired air.

Question 4

The larynx is composed of three pairs of cartilage. Name them

Answer 4

thyroid (arytenoid)
cricoid (corniculate)
epiglottis (cuneiform)

Question 5

The vocal cords and the space in between them are referred to as the ___________.

Answer 5

glottic opening

Question 6

Approx how long is the treachea

Answer 6

10 cm

Question 7

The right and left mainstem bronchi divide at this point.

Answer 7

Carina

Question 8

The mainstem bronchi divide into the __________ (lobar) bronchi.

Answer 8

Secondary

Question 9

The secondary bronchi divide into the __________ (segmental) bronchi.

Answer 9

Tertiary

Question 10

The tertiary bronchi divide into the __________.

Answer 10

Bronchioles (small airways)

Approx 1 mm thick

Question 11

After approx 22 divisions, the bronchioles become ___________.

Answer 11

Terminal bronchioles

Question 12

The terminary bronchioles divide into the ________.

Answer 12

Respiratory bronchioles

Question 13

Gas exchange in the lungs first begins at the level of the ______________

Answer 13

Respiratory bronchioles

Question 14

The respiratory bronchioles divide into the _______.

Answer 14

Alveolar sacs.

This is where most of the gas exchange in the lungs take place

Question 15

What is the purpose of surfactant?

Answer 15

Decrease surface tension of the alveoli, thus keeping them open for gas exchange.

Question 16

How many lobes are in each lung?

Answer 16

3 lobes in the right

2 lobes in the left

Question 17

Three important processes allow gas exchange to occur

Answer 17

Ventilation
Diffusion
Perfusion

Question 18

As inspiration begins, the diaphragm (contracts/expands), the intercostal muscles (contract/expand). These 2 actions result in an expansion in chest volume, which produces an (increase/decrease) in the air pressure in the chest cavity.

Answer 18

contracts
contracts
decrease

Question 19

Inspiration is dependent on 2 things.

Answer 19

Intact chest wall

Intact pleural cavity

Question 20

During respiration, approx ______ mL of air move in and out of the lungs. This is referred to as the _____ volume.

Answer 20

500 mL

Tidal volume

Question 21

Total lung capacity _____mL

Answer 21

6000 mL

Question 22

Anatomical dead space is approx ______ ml

Answer 22

150 mL

Question 23

Which part of the brainstem controls ventilation

Answer 23

Medulla

Question 24

Describe the hypoxic drive

Answer 24

In COPD pt, the body becomes less responsive to changes in arterial PCO2. Instead, the major stimulus to breathe comes from the level of O2 detected in arterial blood by blood receptors in the aortic arch.
Measured PCO2 levels between 50-60 mmHg are not uncommon

Question 25

Describe diffusion

Answer 25

Process by which gasses move between the alveoli and the pulmonary capillaries

Question 26

Lung perfusion is dependent on three conditions

Answer 26

Adequate blood volume Intact pulmonary capillaries Efficient pumping of blood by the heart

Question 27

What does hemoglobin do

Answer 27

It is the transport protein that carries oxygen in the blood

Question 28

Hemoglobin with O2 bound is ________ | Hemoglobin without O2 bound is _______

Answer 28

Oxyhemoglobin | Deoxyhemoglobin

Question 29

What are some properties of hemoglobin

Answer 29

Made up of 4 iron containing heme molecules and a protein containing globin O2 molecules bind to heme portion, which changes its striation allowing additional O2 molecules to bind more readily

Question 30

Carbon dioxide is transported from the cells to the lungs in one of three ways. Name the three.

Answer 30

As bicarbonate ion (70%) Bound to the globin portion of hemoglobin (23%) Dissolved in plasma (7%)

Question 31

Cheyne-Stokes respirations

Answer 31

Vent pattern with progressively increasing tidal volume, followed by a declining volume, separated by periods of apnea

Question 32

Kussmaul's respirations

Answer 32

Deep, rapid breaths that result as a corrective measure against conditions such as diabetic ketoacidosis (which produces metabolic acidosis)

Question 33

Thick green or brown sputum is characteristic in which disease

Answer 33

bronchitis

Question 34

Thin, yellow or pale, grey sputum is characteristic in which disease

Answer 34

Inflammation or an allergic reaction

Question 35

What is tactile fremitus?

Answer 35

Vibrations felt in the chest during speaking

Question 36

What is ARDS? What is affected by it?

Answer 36

Acute Resp Distress Syndrome Affects gas exchange in the lungs. It is a form of pulmonary edema that is caused by fluid accumulation in the interstitial space within the lungs

Question 37

Which disease ultimately causes pulmonary hypertension, which in turn leads to right sided heart failure (also knows as ______)

Answer 37

Emphysema (pink puffers) | Cor pulmonale

Question 38

It is best to keep PEEP pressure at ___________

Answer 38

<10 cm/H20

Question 39

What is pulsus paradoxes?

Answer 39

A drop in blood pressure of 10 mmHg or more with inspiration

Question 40

Which disease will commonly present with chest pain, fever, tachypnea, tachycardia, and a cough. Auscultation will commonly demonstrate crackles (rales) in the involved lung segment

Answer 40

Pneumonia

Question 41

What disease presents with sore throat, rhinorrhea, chills, rigors, myalgias, headache, and diarrhea.

Answer 41

SARS

Question 42

Hemoglobin with carbon monoxide bound to is is referred to as __________

Answer 42

Carboxyhemoglobin

Question 43

Carbon monoxide has an affinity for hemoglobin ______ to _______ times that of oxygen.

Answer 43

200 to 250 times

Question 44

A pulmonary embolism is a _________ or some other particle that gets lodged in a __________.

Answer 44

Thrombus | Pulmonary artery

Question 45

A ___________ ____________ is defined as a pneumothorax that occurs in the absence of blunt or penetrating trauma

Answer 45

Spontaneous Pneumo

Question 46

Guillain-Barre

Answer 46

Caused by disfunction of nervous system. Myelin covering of nerve is damaged, causing loss of nerve impulse. Most pt will require ventilatory assistance.

Question 47

Absence of breath sounds in trauma versus medical patient

Answer 47

Pneumothorax in medical | Hemothorax in trauma

Question 48

Where do you auscultate

Answer 48

Right and Left Apex (right below clavicle) Right and left midaxillary line (4th and 5th intercostal) Right and left base (8th or 9th intercostal midclavicular line) Also 6 locations on the posterior