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IDC School > Resp > Flashcards

Resp Flashcards

1
Q

What makes up the upper respiratory system?

A

Nose, nasal cavity, pharynx, and associated structures

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2
Q

what does the lower respiratory system consist of?

A

larynx(voice box), Trachea (windpipe), bronchi and lungs

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3
Q

what is the conducting zone

A

consists of a series of interconnecting cavities and tubes both outside and within the lungs-nose, nasal cavity, pharynx, larynx, trachea, bronchi, bronchioles and terminal bronchioles that filter warm and moisten air and conduct air into the lungs

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4
Q

What is the respiratory zone

A

tissues within the lungs where gas exchange occurs between air and blood- the respiratory bronchioles, alveolar ducts, alveolar sacs, and alveoli

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5
Q

What is the entrance of the respiratory system

A

nose

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6
Q

what are the four paranasal sinuses

A

frontal, sphenoidal, maxillary and ethmoidal

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7
Q

The interior structure of the nose has 3 basic functions, what are they

A

1) filtering, warming and moistening incoming air
2) detecting olfactory stimuli
3) modifying the vibrations of speech sounds

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8
Q

What is a funnel-shaped tube that starts at the internal nares and extends partway down the neck

A

pharynx(throat)

functions as the passageway for air and food, provides a resonating chamber for speech sounds, and houses the tonsils, which participate in immunological response

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9
Q

what is a short tube of cartilage lined by mucous membrane that connects the pharynx with the trachea

A

larynx

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10
Q

What is the thyroid cartilage common name?

A

Adams apple

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11
Q

what is a ring of hyaline cartilage that forms the inferior wall of the larynx and is attached to the first tracheal cartilage

A

cricoid cartilage

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12
Q

What is the vestibular folds also known as

A

false vocal cords

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13
Q

what is the lower pair of larynx folds called

A

true vocal cords

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14
Q

what is the tubular passageway for air that is located anterior to the esophagus and extends from the larynx to the upper part of the fifth thoracic vertebra (T5) where it divides into right and left main bronchi?

A

Trachea

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15
Q

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

A

pleural membrane

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16
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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17
Q

what is the narrow space between the visceral and parietal pleurae and contains a lubricating fluid secreted by the membranes

A

pleural cavity

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18
Q

what is the broad bottom portion of the each lung called?

A

base

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19
Q

what is the narrow top portion of the lungs called

A

apex

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20
Q

the left lung has an indentation called what

A

cardiac notch, in which the heart lies

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21
Q

Which lung is smaller, the right or the left

A

the left lung is about 10 percent smaller than the right lung

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22
Q

Exchange of O2 and CO2 between air spaces in the lungs and the blood takes place by diffusion across alveolar and capillary walls which together form what?

A

Respiratory membrane

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23
Q

What are the layers of the respiratory membrane

A
  1. type I alveolar cells that form the wall of an alveolus
  2. epithelial basement membrane underlying the alveolar cells
  3. Capillary basement membrane that is often fused to the epithelial basement membrane
  4. endothelial cells of a capillary walls
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24
Q

What is the muscle that is used in quiet (unforced) inhalation?

A

diaphragm

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25
Q

Contraction of the diaphragm is responsible for about what percentage of air that enters the lungs during quiet breathing

A

75 percent

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26
Q

during deep, labored inhalations what muscles elevate the sternum

A

sternocleidomastoid

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27
Q

Because no muscular contractions are involved, quiet exhalation, unlike quiet inhalation is a what process

A

passive

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28
Q

Exhalation becomes active only during _____

A

Forceful breathing, such as playing a wind instrument or during exercise

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29
Q

as the lungs expand, the air molecules inside occupy a larger volume which causes the air pressure inside to

A

decrease

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30
Q

At rest just before an inhalation the air pressure inside the lungs is the same as the pressure of the atmosphere, which is about

A

760 mm HG at sea level

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31
Q

as the diaphragm and external intercostals contract and the overall size of the thoracic cavity increases the volme of the lungs increases and the alveolar pressure decreases from 760 to what

A

758 mm HG

Now there is a pressure difference between the atmosphere and the alveoli and air flows from the atmosphere (higher pressure) yo the lungs (lower pressure)

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32
Q

when the diaphragm and external intercostals relax, lung elastic recoil causes the lung volume to decrease and alveolar pressure rises from 758 to what

A

762 mm HG

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33
Q

the volume of one breath is called

A

tidal volume

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34
Q

how much air is moved in and out of the lungs on inhalation and exhalation

A

500 mL of air

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35
Q

what is minute volume

A

the total volume of air inhaled and exhaled each minute- is equal to breathing rate multiplied by tidal volume

MV = 12breaths/min x 500 mL
= 6000mL/min or 6 L a min

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36
Q

What percentage of tidal volume actually reaches the respiratory bronchioles and alveolar sacs, thus participating in gas exchange

A

70 percent (350ml)

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37
Q

The other 30 percent that does not participate in gas exchange because it remains in a space called

A

anatomical dead space

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38
Q

What is the apparatus commonly used to measure respiratory rate and the amount of air inhaled and exhaled during breathing

A

spirometer
(the record of this is called a spirogram)

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39
Q

when you take a deep breath the additional inhaled air is called what

A

inspiratory reserve volume

3100 ml in average adult male
1900 ml in average adult female

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40
Q

if you inhale normally and then exhale as forcible as possible the extra 1200 ml in males and 700 ml in females is called what

A

expiratory reserve volume

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41
Q

what is the sum of inspiratory reserve volume, tidal volume, amd expiratory reserve volume?

A

Vital capacity

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42
Q

what is the sum of vital capacity and residual volume called?

A

total lung capacity

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43
Q

what is the term for a normal pattern of quiet breathing

A

eupnea

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44
Q

what is a pattern of shallow (chest) breathing called

A

costal breathing (upward and outward movement of the chest)

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45
Q

what is a pattern of deep (Abdominal) breathing called

A

diaphragmatic breathing

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46
Q

breathing also provides humans with methods for expressing emotions such as laughing, sighing, and sobbing. Exhaled air can be used to expel foreign matter through actions such as sneezing or coughing. What is a term that describes these actions

A

modified breathing

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47
Q

what is the diffusion of oxygen from air in the alveoli in the lungs to blood in the pulmonary capillaries and diffusion of CO2 in the opposite direction called?

A

External respiration, also termed pulmonary gas exchange

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48
Q

What are the partial pressures of o2 and co2 in atmospheric air?

A

Po2= 159 mm HG
Pco2= 0.3 mm hg

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49
Q

what is the partial pressures of o2 and co2 in alveolar air?

A

Po2= 105 mm hg
Pco2= 40 mm HG

(o2 inhaled —> pulmonary capillaries)

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50
Q

What is the partial pressure of o2 and co2 in oxygenated blood?

A

Po2= 100 mm hg
Pco2= 40 mm hg

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51
Q

What is the partial pressure of o2 and co2 in the systemic tissue cells?

A

Po2 = 40 mm HG
Pco2= 45 mmhg

(Where internal respiration happens, gas exchange between systemic capillaries and tissue cells. This happens after blood is oxygenated)

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52
Q

What is the partial pressure of o2 and co2 in deoxygenated blood?

A

Po2 = 40mm hg
Pco2 = 45 mm hg

(same as systemic tissue cells)

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53
Q

How much o2 in blood is dissolved into blood plasma?

A

1.5 %

oxygen doesnt dissolve easily in water

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54
Q

What percent of blood o2 is bound to hemoglobin in red blood cells

A

98.5%

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55
Q

What other factors influence the amount of 02 released by hemoglobin

A

Carbon dioxide
Acidity
Temperature

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56
Q

What percent of co2 is dissolved into blood plasma

A

7 %

upon reaching the lungs it diffuses into alveolar air and is exhaled

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57
Q

what percent of co is bound to amino acids

A

23 %

Hemoglobin that has bound to co2 is termed carbaminohemoglobin (Hb-CO2)

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58
Q

The greatest percentage of CO2 is transported in blood plasma as bicarbonate ions what percent is this

A

70%

HCO3-

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59
Q

Clusters of neurons located in the brain stem are collectively called the respiratory center can be divided into what two principal areas on the basis of location and function

A

medullary respiratory center in the medulla oblongata
The pontine respiratory group located in the pons

60
Q

what are the two collections in the medullary resp center called

A

Dorsal respiratory group (DRG)
Ventral Respiratory group (VRG)

61
Q

The VRG becomes activated when what occurs

A

Forceful breathing is required such as during exercise or at high altitudes

62
Q

What plays a role in both inhalation and exhalation by modifiying basic rhythm of breathing generated by the VRG, as when exercising, speaking or sleeping?

A

PRG
Pontine respiratory group

63
Q

what sets the basic rhythm of breathing

A

DRG
Dorsal respiratory group

64
Q

Voluntary control of holding your breath is limited due to what respiratory group being strongly stimulated and forcing you to resume breathing

A

DRG neurons

65
Q

Nerve impulses from where stimulate the respiratory center and allow for modified breathing

A

hypothalamus and limbic system

66
Q

what is rapid and deep breathing called

A

Hyperventilation

67
Q

How does temperature effect breathing

A

fever = increases the rate of breathing
plunging into cold water causes temporary apnea

68
Q

How does pain influence breathing

A

sudden, severe pain may cause brief apnea but prolonged somatic pain increases breathing rate

69
Q

how does irritation of airways influence breathing

A

physical or chemical irritation of the pharynx or larynx brings about coughing or sneezing

70
Q

What part does the inflation reflex play in breathing

A

pressure-sensitive stretch receptors and when stretched during overinflation the DRG is inhibited and as a result exhalation begins

71
Q

what nerves stimulate the diaphragm to contract

A

phrenic nerves

72
Q

the main muscles that power quiet breathing are the

A

diaphragm and external intercostals

73
Q

how does aging play a role in decrease in lung capacity

A

aging results in decreased vital capacity, decreased blood level of O2 and diminished alveolar macrophage activity

74
Q

What muscles are used in forced inhalation?

A

pectoralis minor, sternocleidomastoid, and scalene

75
Q

what volumes make up vital capacity

A

tidal, inspiratory reserve, and expiratory reserve

76
Q

what is the most abundant nutrient to the body

A

nitrogen

77
Q

where are the central chemoreceptors located

A

CSF in medulla

78
Q

What is hypercapnia and what is stimulated?

A

increase in CO2 and the central chemoreceptors are stimulated

79
Q

What is hypoxia and what responds?

A

Deficiency in O2 and Peripheral chemoreceptors responds

80
Q

If there is a decrease in CO2 what chemo receptors will respond

A

none will respond

81
Q

When exercising and increasing RR what is first stimulated

A

Proprioceptors, they account for the increase in rate and decrease in oxygen. (theyre in the muscles and joints)

82
Q

What type of exercise causes a change in proprioceptors

A

Moderate exercise

83
Q

what is the most common type of asthma

A

Allergic

84
Q

What is used to diagnose asthma

A

spirometry

85
Q

what is the treatment for asthma

A

inhaled corticosteroid- Flovent (this is for maintenance of asthma)
SABA - Albuterol is used for abortive therapy

86
Q

what are the three types of COPD

A

Chronic obstructive asthma
chronic bronchitis
emphysema

87
Q

What is the number one sign/symptom of pulmonary edema

A

Pink frothy sputum

88
Q

what is the initial treatment of pulmonary edema

A

diuretic (furosemide)

89
Q

what tool is used to differentiate between cardiogenic pulmonary edema and noncardiogenic?

A

EKG

90
Q

what will you see on a chest xray of someone with pulmonary edema

A

increased interstitial markings

91
Q

what is the most common cause of pulmonary edema in developed countries

A

decompensated CHF

92
Q

What is the treatment for pulmonary embolism

A

streptokinase = clot buster

Lovenox = preventative (blood thinner)
Both of these will require MO to approve

93
Q

what is defined as massive hemoptysis

A

> 500 mL in less than 24 hours
100 mL in an hour

94
Q

what position will you place a patient with hemoptysis

A

on the affected side

ex: R lung bleeding, you will lay the patient on their right side

95
Q

How will you position a patient with pulmonary edema

A

Sitting up, with their feet dangling

dont lay them down

96
Q

in a pulmonary contusion what is the most common complication

A

pneumonia

97
Q

what is the most common cause, in healthy adults, of upper airway obstruction

A

angioedema (allergic reaction)

98
Q

what is the treatment for angioedema upper airway obstruction?

A

Epinephrine

99
Q

what is the first line treatment for almost every respiratory disease

A

oxygen

100
Q

What is the initial treatment for hemoptysis

A

Oxygen

101
Q

What imaging is used to confirm the diagnosis of hemoptysis

A

X ray

102
Q

What is a complication of hemopthysis

A

Death

103
Q

What is another term used to define URI

A

Common cold

104
Q

What is the timeline for URI, soonest you will feel better to the latest you will feel better

A

3-10 days beyond that were thinking it may be bronchitis

105
Q

How does bronchitis become chronic

A

A cough lasting longer than 3 months in 2 consecutive years

106
Q

What lung sounds are associated with bronchitis

A

Rhonchi

107
Q

What labs/imaging would you order for a person diagnosed with bronchitis

A

None are indicated

108
Q

What sound will you hear upon percussion of the lungs with someone who has a hemothorax.

A

Dullness

109
Q

30 y/o Caucasian male, 7 feet tall, 170 pounds and smoker comes in complaining of chest pain, what are you thinking the diagnosis could be

A

Spontaneous pneumothorax

110
Q

32 year old male who had pneumonia 2 weeks ago, has no fever, coming in for 9/10 chest pain what are you thinking

A

Tension pneumothorax

111
Q

What percussion sound will be heard on someone who has a pneumothorax

A

Hyper resonance

112
Q

If you see flattening of the blood vessels, what are are you thinking is the cause

A

Hemothorax

113
Q

If you see enlarged blood vessels in the neck, what are you thinking is the cause

A

Pneumothorax

114
Q

The costal angle of the average person is 90 degrees, what does it go to when someone is pregnant

A

103 degrees

115
Q

What type of back shape would you see in someone who is pregnant

A

Lordosis, because its compensating for the lung expansion

116
Q

What type of test do you perform to determine if someone has long term respiratory problems

A

Shamrock test (clubbing of the finger nails)

117
Q

What doe it mean if someone has increased tactile fremitus

A

Consolidation or fluid

118
Q

What is the only sound you can hear on the anterior chest wall

A

Brachialtracheal

119
Q

If you hear wheezing what diagnosis might the person have

A

Asthma, pulmonary edema

120
Q

If you hear crackles, what diagnosis might the person have

A

Pneumonia, pulmonary edema

121
Q

If you hear strider lung sounds, what might the diagnosis be

A

Obstruction, brachialtracheal injury or ARD

122
Q

If someone has a barrel chest (1:1 ratio instead of 2:1) what diagnosis causes that to happen

A

COPD
Chronic asthma
Chronic bronchitis
Emphysema
Cystic fibrosis

123
Q

What is associated with aspirated pneumonia

A

Bad teeth, foul smelling breath

124
Q

If someone has a cinnamon smell to them, what diagnosis is associated with that

A

TB

125
Q

What is normal breathing called

A

Eupnea

126
Q

What is it called when you’re standing and having shortness of breath

A

Platypnea

127
Q

What is it called when you’re laying down and having trouble breathing?

A

Orthopnea

128
Q

What is rapid, labored breathing?

A

Kussmaul

129
Q

What virus is associated with pneumonia

A

Influenza

130
Q

If you hear a chest bruit or a murmur that increases with inspiration, what is this associated with

A

Large pulmonary arteriovenous malformation (AVM)

131
Q

If someone comes in to be seen again after being treated for bronchitis and states they still don’t feel better, however the vital signs show no change (stable) what treatment are you going to do

A

Treat symptomatically

132
Q

How long does it take for someone to recover from community acquired pneumonia

A

6 weeks or longer, especially if they are a smoker

133
Q

If you palpate and feel subcutaneous emphysema and note some absent breath sounds what is likely happening

A

Tracheobronchial injury

O2, needle d, chest tube will all fail as well. So the MOI will assist in diagnosis (which is only caught 25% of the time anyway)

134
Q

What antibiotics will you give for community acquired pneumonia

A

Azithromycin (macrolide)
Doxycycline (tetracycline)
Or moxifloxacin

135
Q

What is the confirmatory test for pneumonia

A

Chest x ray

136
Q

What connects both the esophagus and the larynx

A

Laryngopharnx

137
Q

What is attached to the anterior rim of the thyroid cartilage and hyoid bone. It is also defined as a large, leaf-shaped piece of elastic cartilage that is covered with epithelium.

A

Epiglottis

138
Q

What is a ring of hyaline cartilage that forms the inferior wall of the larynx and is attached to the first tracheal cartilage

A

Cricoid cartilage

139
Q

What is the tubular passage way for air that is located anterior to the esophagus

A

Trachea (windpipe)

140
Q

The primary bronchi contain what

A

Incomplete rings of cartilage and are line by pseudostratrified ciliated columnar epithelium

141
Q

What are the fissures that divide the right and left lung

A

Oblique and horizontal in the right
ONLY OBLIQUE in the left

142
Q

What is the main site of gas exchange

A

Alveoli

143
Q

What is the purpose of surfactant

A

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

144
Q

What are alveolar macrophages (dust cells)

A

Wandering phagocytes that remove fine dust particles and other debris in the alveolar spaces

145
Q

During forced exhalation what muscles are involved

A

Internal intercostal
External oblique
Internal oblique
Transverse abdominis
Recuts abdominis

These group of muscles contract to move the lower ribs downward and compress the abdominal visor a thus forcing the diaphragm upwards

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