Final final

Question 1

Define Departitioning

Answer 1

Loss of alveolar walls and attached capillaries, often due to obstructive diseases like COPD.

Alveoli destroyed → capillaries lost → reduced gas exchange.

Question 2

Decrease blood vessels in diseases such as COPD makes it harder for the ____ hard to pump.

Answer 2

Right

Question 3

_________ is a _______ enzyme in the lung that destroys protein and is similar to trypsin. What inhibits this

Answer 3

Neutrophil Elastase

Protease

Alpha 1 Antitrypsin

Question 4

Describe the lung volume changes in restrictive lung diseases

Answer 4

Everything decreases

ERV decreases the most
IRV decreases the least

Question 5

Describe the lung volume changes in obstructive lung diseases

Answer 5

RV expands the most

ERV decreases the most
IRV decreases

Inspiratory capacity & Vt can be equal when you’re maxed out to TLC

Question 6

Vt increases in obstructive disease diseases dt _______

Answer 6

Increase alveolar dead space

Question 7

Irritant receptor send messages back to the ________ via ______. What is an example?

Answer 7

Brain stem

V2 of trigeminal nerve

Ex) Sneeze

Question 8

_________ (2) are two ways to prevent a sneeze via _________ mechanisms

Answer 8

1. Drinking water
2. Pinching upper lip

Lateral inhibition

Question 9

Describe the anatomy and the naming of the L and R vagus nerve

Answer 9

From brainstem –> neck –> heart –> lungs

Hairpin turn = “ recurrent” laryngeal nerve

After turn = “inferior” laryngeal nerve

-R recurrent happens under R subclavian artery & more superior
-L recurrent goes under the aortic arch & more inferior

Question 10

Risk of thyroid removal poses risk of what?

Answer 10

Damage to one of the recurrent or inferior laryngeal nerves

Question 12

The _______ innervates the larynx and gives you the ability to _____

Answer 12

vagus nerve (which turns into the Inferior laryngeal nerves)

Speak

Question 13

What does the inferior laryngeal nerve innervate?

Answer 13

5/6 sets of laryngeal muscles:
-Posterior cricoarytenoid
-Lateral cricoarytenoid
-Thyroarytenoid
-Transverse arytenoid
-Oblique arytenoid

Early part of trachea

Question 14

What innervates the cricothyroid muscle?

Answer 14

External branch of the Superior laryngeal nerve

(Contracted = harder to intubate)

Question 15

The Superior laryngeal nerve has ____ branches and the ______ branch covers sensory of the larynx

Answer 15

2

internal

Question 16

__________ is the place where the internal & external superior laryngeal branches meet.

Answer 16

Galen’s Anastomosis

SN: everyone doesn’t have this anomaly

Question 17

________ is the hole for the internal branch of the superior laryngeal nerve. Where is this hole?

Answer 17

“Foraman for superior laryngeal ARTERY and nerve” (both the vessel & nerve)

This is in the thyrohyoid membrane attached superiorly to the thyroid cartilage and inferiorly to hyoid bone

Question 18

Describe the pharyngeal constrictors

Answer 18

Location: surround pharynx; at & above larynx

type: skeletal muscle

3 sets: superior, middle, inferior

Causes laryngospasms
Prefer to be relaxed = easier to get airway

Question 19

What are the Suprahyoid muscles? (5)

Answer 19

1. Digastric muscle-anterior belly
   -Part 1/2
   -3 tendons total – 1 on each end & 1 in the middle
   -attached to 2 bellies
   -Bellie fasten hyoid to mandible
2. Digastric muscle – posterior belly
   -fasten hyoid to mastoid process
3. Stylohyoid
   -direct connection
   -attaches Hyoid bone to styloid process (Next to mastoid process)
4. Mylohyoid
   -attaches inside mandible to top of hyoid bone
5. Geniohyoid
   -attaches middle/top part of hyoid bone to mandible

Question 19

T/F: styloid process is a thin bone that is mostly broken on a skull used for learning

Answer 19

T

Question 20

The _______ connect the anterior and posterior bellies

Answer 20

Intermediate tendon

Question 21

What are the Infrahyoid muscles? (5)

Answer 21

1. Thyrohyoid: Connect bottom of thyroid & hyoid
2. Sternohyoid: connect sternum and hyoid
3. Sternothyroid: sternum and thyroid
4. Omohyoid superior belly
5. Omohyoid inferior belly
   -has 3 tendons & 2 bellies
   -connected by intermediate tendon
   -intermediate tendon tied down to attachment point at top of thorax

Question 22

When you contract the suprahyoid muscles it pulls the hyoid _____ & when the infrahyoid muscles contracts it pulls it ______

Answer 22

up

down

Question 23

The hyoid bone has ___ horns that are on the _____. Describe whats important

Answer 23

4 (2 on each side)
Body

Front view:
2 Lesser horns are in the front
2 Greater horns are at the rear

Question 24

Stretch receptors are also called ____

Answer 24

J-Receptors

Question 25

Describe the Hering–Breuer reflex

Answer 25

"Inflation reflex" -triggered by stretch receptors during inspiration -inhibits of further inspiration when at planned lung volume via J-receptors/stretch receptors

Question 26

_______ is most similar to apneustic breathing. Please describe

Answer 26

Cheyne-Stokes Seen in brain or blunt force trauma Varying periods of increasing rate/depth of respirations followed by a period of apnea

Question 27

Describe Kussmaul breathing

Answer 27

Rapid, deep, labored hyperventilation Caused by DKA - trying to blow off CO2 % buffer acids -less risk of passing out from low CO2

Question 28

Describe Biot breathing

Answer 28

irregular breathing at lower rate & depth caused by opioid overdose

Question 29

What is the 1st sign of MH?

Answer 29

Increase PCO2

Question 30

Capnograph waveform: Tall waveforms. What are the reasons that can cause this? (8)

Answer 30

**high CO2 levels** Reason: Hypoventilation -fever -bicarb infusion -release of tourniquet -increased CO -increased BP -MH (steady increase) -pregnancy

Question 31

Capnograph waveform: Low waves What are the reasons that can cause this? (10)

Answer 31

Low CO2 levels Reason: Hyperventilation -hypothermia -decreased CO -decreased BP -PE -extubation (flat line) -airway obstruction -circuit disconnection (flatline) -alveolar deadspace development -esophageal intubation (flatline)

Question 32

Capnograph waveform: Decline in waveforms

Answer 32

Decrease in CO Reason: MI

Question 33

Capnograph waveform: Increase in waveforms

Answer 33

Increase in metabolism Reason: MH Successful CPR

Question 34

Capnograph waveform: Upsloping "shark fin"

Answer 34

Uneven emptying of lung Reason: Bronchospasm

Question 35

Capnograph waveform: Flat line

Answer 35

Disconnection/self extubation Esophageal intubation

Question 36

T/F: You can get a capnograph waveform with esphageal intubation

Answer 36

T May have air in the stomach but gets smaller and disappears quickly

Question 37

Describe the capnography of a single lung transplant

Answer 37

Good Long will empty first & sick Long will empty second There will be a dip in the middle of the plateau

Question 38

Describe what happened to the capnpgraphy when you burp

Answer 38

There will be an increase in the middle of the plateau dt a random spike in CO2

Question 39

Describe the capnograph during pregnancy

Answer 39

There will be a spike at the end of the waveform This is dt operating at lower lung volume

Question 40

Equation: Boyle's Law

Answer 40

P1V1 = P2V2

Question 41

What are lung pressures when sedated, paralyzed and supine?

Answer 41

anterior: P_Pl = -13 cmH2O posterior: P_Pl = +4 cmH2O

Question 42

How do you fix the V/Q ratio when sedated, paralyzed and supine?

Answer 42

1) Increase fio2 to 30% 2) Increase Vt 3) Increase PEEP

Question 43

When sedated, paralyzed and supine the fresh air goes to the ______ lung first

Answer 43

anterior

Question 44

Where does the air go first when awake & supine or sedated & supine?

Answer 44

Fresh air goes to posterior lung first (Lung more compliant in zone 3 at a higher lung volume)

Question 45

Describe Henry's law

Answer 45

The amount of gas dissolved in a liquid is proportional to its partial pressure and solubility. It explains how O₂ and CO₂ dissolve in blood based on their partial pressures in the alveoli

Question 46

Describe Graham's law

Answer 46

The rate of gas diffusion is inversely proportional to the square root of its molecular wt. Lighter gases like O₂ diffuse faster than heavier ones like CO₂.

Question 47

Describe Dalton's law

Answer 47

The total pressure of a gas mixture equals the sum of the partial pressures of each individual gas. This law helps calculate how much O₂ or CO₂ is available in inspired air.

Question 48

Describe Ohm's law

Answer 48

Flow = Delta P / Resistance (V = IR). In the lungs, airflow depends on the pressure gradient between the atmosphere and alveoli and is reduced by airway resistance

Question 49

Describe Fick's law

Answer 49

The rate of gas diffusion across a membrane is proportional to surface area and partial pressure difference, and inversely proportional to membrane thickness. It explains how gases like O₂ and CO₂ move across the alveolar-capillary barrier.