Breathing

Question 1

What is the largest airway?

Answer 1

Trachea

Question 2

How many lobes does the right lung have?

Answer 2

3

Question 3

What are the narrowest airways?

Answer 3

Bronchioles

Question 4

What are the small air filled sacs at the end of bronchioles called?

Answer 4

Alveoli

Question 5

What is the name of the slippery membrane that covers the lungs and the inside of the chest wall?

Answer 5

The pleura

Question 6

Where are intercostal muscles found?

Answer 6

Between the ribs

Question 7

Why does breathing not require conscious thought?

Answer 7

As it is controlled by the autonomic nervous system.

Question 8

What is the primary role of the vegas nerve?

Answer 8

Transports nerve signals to the brain to regulate involuntary functions like respiration, heart rate and blood pressure.

Question 9

What is gas exchange?

Answer 9

The physical process by which gassess move passively by diffusion across a surface.

Question 10

What two sites in the body does gas exchange occur?

Answer 10

The lungs and tissue

Question 11

What is the journey of the air through the body?

Answer 11

Trachea -> Bronchi -> Bronchioles -> respiratory bronchioles -> alveolar ducts -> alveoli

Question 12

What makes up the structure of the bronchioles?

Answer 12

Smooth muscle and the epithelium

Question 13

What is the role of the smooth muscle in the bronchi?

Answer 13

Help regulate the flow of air into the lungs by dialating when more air is needed and constricting when less air is needed.

Question 14

How is carbon dioxide cleared from the body?

Answer 14

It is transferred to the blood stream into the alveoli in the lungs and then exhaled from the lungs.

Question 15

Where does the internal respiration gas exchange occur?

Answer 15

Across the respiratory membrane in the metabolizing tissue.

Question 16

Where doe the external gas exchane occur?

Answer 16

Across the respiratory membrane in the lungs.

Question 17

What determines the direction and rate of diffusion across the respiratory membrane?

Answer 17

The partial pressure gradient of the gas.

Question 18

What is the mediastinum?

Answer 18

The space between the lungs.

Question 19

What is the upper part of the lung called?

Answer 19

Apex

Question 20

What is the lower part of the lung called?

Answer 20

The base

Question 21

What changes the pressure in the thoracic cavity?

Answer 21

The diaphragm

Question 22

How many pairs of intercostal muscles are there?

Answer 22

11

Question 23

What is asthma?

Answer 23

A chronic inflammatory disorder of the airways. Airflow is
limited due to bronchoconstriction, airway oedema, airway
hyperresponsiveness and airway remodelling

Question 24

What 3 factors casue small airway obstruction and narrowing?

Answer 24

• Bronchial mucosal swelling
• Bronchial muscle spasm and constriction
• Increased bronchial mucus and secretions

Question 25

What can trigger airway obstruction and narrowing?

Answer 25

respiratory infections, cold weather, exercise, hypersensitivity to antigens etc

Question 26

What are some examples of preventer medications asthmatics take?

Answer 26

anti- inflammatory/ steroid drugs e.g: beclometasone, budesonide and fluticasone

Question 27

Examples of reliever medications asthmatics?

Answer 27

Salbutamol, terbutaline and ipratropium bromide

Question 28

What are the main symptoms of moderate and severe asthma?

Answer 28

increased respiratory rate, decreased SpO2, wheeze, cough, chest tightness, shortness of breath; use of accessory muscles

Question 29

A patient over 50 with a history of breahtlessness and no other known causes should be treated as having what?

Answer 29

COPD

Question 30

What does salbutamol do?

Answer 30

Relaxes smooth muscle and dialates the airways

Question 31

What is an agonist drug?

Answer 31

A drug that binds to a receptor and acts the same as the substance that normally binds to it

Question 32

What does Ipratropium Bromide do?

Answer 32

Bronchodialator that also reduces secretions

Question 33

What is COPD?

Answer 33

An umbrella term used for a group of respiratory disorders characterised by by chronic and recurrent obstruction of airflow in the pulmonary airways.

Question 34

What is the target SpO2 for someone with COPD?

Answer 34

88-92%

Question 35

What condition causes long-term inflammation of the airways causing airway obstruction in the major and small airways.

Answer 35

Chronic Bronchitis

Question 36

When would chronic bronchitis be diagnosed?

Answer 36

If patient has a cough and sputum production for at least 3 months in each of 2 consecutive years.

Question 37

What does the loss of lung elasticity and abnormal enlargement of the air spaces below the terminal bronchioles in the “tree”, where the alveolar walls and capillary beds are destroyed by enzymes called proteases, describe?

Answer 37

Emphysema

Question 38

What are time critical features in COPD?

Answer 38

- Major ABCDE problems - Extreme breathing difficulty (by reference to patient's usual condition) - Cyanosis (although peripheral cyanosis may be ‘normal’ in some patients) - Exhaustion - Hypoxia (oxygen saturation <88%) unresponsive to oxygen (O2)

Question 39

When does wheezing occur?

Answer 39

when the bronchial tubes become inflamed and narrowed.

Question 40

What is the common cause of stridor in children?

Answer 40

laryngomalacia

Question 41

What does the V/Q ratio measure?

Answer 41

is a ratio used to assess the efficiency and adequacy of the ventilation- perfusion coupling

Question 42

What defines a pulmonary embolism?

Answer 42

A condition in which one of the pulmonary arteries in the lungs gets blocked by a blood clot.

Question 43

What are the four main types of pulmonary embolisms?

Answer 43

Multiple small PE, Segmental emboli with pulmonary infarction, Major pulmonary emboli obstruction of the larger branches of the pulmonary tree and Massive pulmonary emboli

Question 44

What are the primary symptoms of pulmonary embolisms?

Answer 44

Dyspnoea, pleuritic chest pain, substernal chest pain, apprehension, cough, haemoptysis and syncope

Question 45

What are the signs of deep vein thrombosis?

Answer 45

pain, swelling and tenderness in one leg, with the affected area warm and red.