Upper & Lower Respiratory Flashcards

1
Q

primary functions of respiratory system

A

gas transport
gas exchange
acid-base balance

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2
Q

secondary functions of respiratory system

A

air conditioning

defense against pathogens

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3
Q

what does the upper respiratory do to air

A

filters
warms
humidifies
purifies

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4
Q

what kind of breathers were we designed to be?

A

nose breathers

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5
Q

difference between infant/child anatomy & adults

A

large tongue
small mouth
elevated pharynx
swollen epiglottis is a huge problem

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6
Q

who has a more horizontal eustachian tube?

A

infants –> more ear infxns

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7
Q

who are obligate nose breathers?

A

infants

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8
Q

when do infants become better mouth breathers?

A

6 months

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9
Q

how can parents help their children with stuffiness?

A

bulb syringe & saline nasal drops

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10
Q

air pathway through nose

A

nose > conchae > nasopharynx > oropharynx > laryngopharyx

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11
Q

air pathway through mouth

A

mouth > teeth > oral cavity > hard & soft palates > epiglottis > larynx > vocal folds > thyroid cartilage > cricoid cartilage > trachea > bronchus > bronchioles > alveoli

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12
Q

one of the most common birth defects in US

A

cleft palate

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13
Q

difficulties with cleft palate

A

feeding, talking, ear infections, hearing loss

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14
Q

what folds on top to protect trachea?

A

epiglottis

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15
Q

what consists of the vocal folds, thyroid cartilage, cricoid cartilage & trachea

A

larynx

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16
Q

emergency airway

A

cricoidthyrotomy

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17
Q

what kind of cells surround trachea?

A

ciliated pseudostratified columnar epithelial cells

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18
Q

what do the ciliated pseudostratified columnar cells of the trachea contain?

A

secretory glands & cilia

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19
Q

which way does cilia beat?

A

toward pharynx

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20
Q

what is the mechanism of cilia?

A

continuous transport of contaminant out of lungs

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21
Q

what happens with damaged or paralyzed cilia?

A

increased risk of infections
pneumonia
bronchiectasis

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22
Q

most common cause of damaged or paralyzed cilia

A

smoking

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23
Q

can cilia regrow?

A

yes, with quitting of smoking

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24
Q

what coats the alveolar epithelial surface?

A

surfactant

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25
Q

how does surfactant work?

A

decreases surface tension allowing expansion of alveoli with inspiration

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26
Q

what would happen without surfactant?

A

alveoli would collapse during expiration

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27
Q

atelectasis overview

A

diminished volume affecting part or all of the lung caused by a collapsed or airless state of the alveoli

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28
Q

is atelectasis acute or chronic?

A

either

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29
Q

two types of atelectasis

A

obstructive

non-obstructive

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30
Q

most common type of atelectasis

A

obstructive

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31
Q

what is obstructive atelectasis caused by?

A

mucous
tumor
foreign body

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32
Q

what can obstructive atelectasis cause

A

infection

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33
Q

what happens if obstruction causing atelectasis is removed?

A

infection can subside, returns to normal

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34
Q

what happens if obstruction causing atelectasis is persistent?

A

fibrosis or bronchiectasis

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35
Q

loss of contact between visceral and parietal pleura

A

non-obstructive pleural effusion or pneumothorax

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36
Q

when does IRDS occur in kids?

A

when infants are born <37 weeks

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37
Q

lack of surfactant (adhesive) disorders

A

ARDS
radiation pneumonitis
IRDS

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38
Q

when else can atelectasis occur?

A

post-op (after thoracic or upper abdominal surgery and diaphragm is irritated by anaesthesia)

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39
Q

signs and symptoms of atelectasis

A

dyspnea
chest pain
cough
low-grade fever

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40
Q

what are the lungs innervated by?

A

ANS

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41
Q

sympathetic affect on lungs

A

pulmonary vasoconstriction
inhibition of secretion
bronchial smooth muscle relaxation

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42
Q

parasympathetic effect on lungs

A

pulmonary vasodilation
mucous gland secretion
bronchial smooth muscle constriction

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43
Q

things that cause bronchoconstriction

A

allergens
cold air
viral infection

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44
Q

things that cause bronchodilation

A

exercise
epinephrine
norepinephrine

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45
Q

what monitors O2 and CO2 concentration in blood?

A

specialized nerve cells in aorta and carotid bodies

46
Q

what happens when O2 decreases?

A

increased respiratory rate & depth

47
Q

what happens when CO2 increases?

A

increased respiratory rate & depth

48
Q

what exclusively monitors CO2 in CSF

A

chemoreceptors in the medulla

49
Q

what happens when CSF is acidotic?

A

increase respiratory rate & depth

50
Q

what happens when pH is high?

A

decease respiratory rate & depth

51
Q

where are stretch receptors located?

A

lungs & chest wall

52
Q

what happens when lungs are over-inflated?

A

signal to respiratory centers to exhale and inhibit inspiration

53
Q

what happens with respirations with pain and strong emotions?

A

increased respirations

54
Q

what tells the respiratory center to speed up, slow down, or stop?

A

nerve centers in the cortex

55
Q

result of chemical irritants

A

contraction of respiratory muscles causing you to sneeze or cough

56
Q

whats the main function of the respiratory system

A

gas transport

57
Q

how is over 98% of the oxygen carried in the blood?

A

by attachment to hemoglobin

58
Q

what does oxygen + hemoglobin form

A

oxyhemoglobin

59
Q

how many oxygen molecules can each hemoglobin molecule bind?

A

4

60
Q

what is oxygen saturation a measure of?

A

a percentage of the hemoglobin saturated with oxygen

61
Q

what has a higher affinity to Hgb than O2

A

CO

62
Q

what helps report Hgb saturation with O2 and CO

A

pulse oximetry (but not accurate)

63
Q

what is CO poisoning caused by

A

inhaling combustion fumes

64
Q

what can produce CO

A

appliances fueled by wood, gas, or coal

65
Q

signs & symptoms of CO poisoning

A
headache
dizziness
weakness
nausea
vomiting
chest pain
confusion
66
Q

HbCO (carboxyhemoglobin) levels for

A

non-smoker 15%

67
Q

treatment for CO poisoning

A

oxygen

hyperbaric chamber

68
Q

what serves as a means for the body to exchange gases with the atmosphere via the blood?

A

respiration

69
Q

what is greater, pO2 in air of alveolar spaces or pO2 in blood?

A

alveolar spaces

70
Q

where is pCO2 higher?

A

blood

71
Q

normal paO2

A

75-105mmHg

72
Q

low paO2 means…

A

hypoxemia!

73
Q

what value of paO2 is critical

A

<45mmHg

74
Q

normal paCO2

A

33-45mmHg

75
Q

abnormal paCO2

A

60mmHg

76
Q

what are ABGs?

A

arterial blood gases

used to determine gas exchange levels in blood related to respiratory, metabolic, and renal function

77
Q

what are ABGs indications

A

Check for severe breathing problems and lung dz, such as asthma, cystic fibrosis orchronic obstructive pulmonary disease (COPD).
Evaluate how well treatment for lung dzis working.
Find out if pt. needs extra oxygen or help with breathing (mechanical ventilation).
Find out if pt. is receiving the right amount of O2 while on O2 in the hospital.

78
Q

patients you’d consider measuring the acid-base level

A
heart failure
kidney failure
uncontrolled diabetes
sleep disorders
severe infections
drug overdose
79
Q

divide the ABG process into 4 parts

A
  1. determine nature of pH of blood
  2. determine PaCO2 direction
  3. determine pH direction
  4. determine presense of compensation and which organ is compensating
80
Q

ideal pH for the body

A

7.4 (7.35-7.45)

81
Q

2 systems that regulate pH

A

lungs and kidneys

82
Q

how do lungs regulate pCO2

A

respiratory rate
tidal volume
goal pCO2 (40mmHg)

83
Q

goal HCO3 for the kidneys

A

24 mEq/L

84
Q

low pH high CO2

A

respiratory acidosis

85
Q

high pH low CO2

A

respiratory alkalosis

86
Q

low pH low CO2

A

metabolic acidosis

87
Q

high pH high CO2

A

metabolic alkalosis

88
Q

acidosis and alkalosis limits

A

acidosis 7.46

89
Q

what happens to pH when CO2 is dissolved in the blood

A

CO2 dissolved –> carbonic acid
normal 35-45mmHg
increase CO2 increase acid

90
Q

respiratory acidosis and alkalosis limits

A

acidosis >46

alkalosis <34

91
Q

what happens to pH when bicarbonate is dissloved into the blood

A

increased HCO3 makes it more basic

92
Q

where is HCO3 made by?

A

metabolically by the kidneys

93
Q

normal value for HCO3

A

22-26meq/L

94
Q

metabolic acidosis and alkalosis limits for HCO3

A

acidosis< 21meq/L

alkalosis >27meq/L

95
Q

tidal volume

A

relaxed, normal inspiration/ expiration

about 500ml

96
Q

vital capacity

A

largest amount of air breathed out
TV + IRV + ERV
about 5700-6200 ml

97
Q

expiratory reserve volume (ERV)

A

amount of air that can be forcibly exhaled after tidal volume
1000-1200ml

98
Q

inspiratory reserve volume (IRV)

A

amount of air that can be forcibly inhaled over and above normal respiration
3000-3300ml

99
Q

residual volume (RV)

A

leftover air after a forceful expiration

1200ml

100
Q

measurement of lung size and represents volume of air in the lungs that can be exhaled following a deep inhalation

A

forced vital capacity (FVC)

101
Q

a measure of how much air can be exhaled in one second following a deep inhalation

A

FEV1 (forced expiratory volume)

102
Q

represents the percent of the lung size that can be exhaled in one second

A

FEV1/FVC

103
Q

fastest flow rate reached at any time during the FVC

A

peak expiratory flow PEF

aka peak flow PF

104
Q

when does PEF normally occur

A

in the begining of forcing breath out

105
Q

what does self-monitorying of spirometry include

A

assessing the frequency and severity of symptoms

106
Q

what is so important in monitoring spirometry

A

a baseline

107
Q

what to look at when monitoring pts with obstructions

A

FEV1 and FEV1/FVC ratio

108
Q

what is super important in interpreting spirometry numbers?

A

considering height, age, and sex

109
Q

flow rate in the middle of a breath out

A

maximum mid-expiratory flow (MMEF) (FEF25-75)

110
Q

what is a very sensitive measure of airflow obstruction in those with a mild disease?

A

MMEF

111
Q

two types of lung function tests

A

spirometry

peak flow