Week 1

Question 1

Which are the main functions of the nose?

Answer 1

An air conditioning and filtering structure
Breathing route of choice for adults

Question 2

What size particles do NOT gain entry to the lower airways due to the filtering capacity of the nose?

Answer 2

5 micrometers in diameter

Question 3

When an endotracheal tube is introduced to a patient requiring mechanical ventilation, which of the following functions of the nose is lost?

Question 4

State complications caused by a lack of humidification with artificial airways

Question 5

What are considered the goals of humidification in mechanical ventilation regarding temperature and relative humidity?

Question 6

Which pair of reflexes is responsible for preventing aspiration of foreign material into the lungs? (2)

Answer 6

pharyngeal and laryngeal

Question 7

After a tracheal tube is in place, which action will form a seal a between the tracheal wall and tube to minimize aspirating of pharyngeal contents?

Answer 7

artificial airway with an inflatable cuff

Question 8

What ventilator associated pneumonia (VAP)?

Question 9

In a deeply unconscious patient, what is the most common threat to upper airway patency?

Answer 9

soft tissue obstruction
meaning loss in muscle tone allowing the base of the tongue to rest against the posterior wall of the pharynx

Question 10

Which maneuver best describes the sniffing position?

Answer 10

airway patency
extending the neck and pulling chin anteriorly

Question 11

Which of the following structures is an important landmark during the insertion of a tube into the trachea?

Answer 11

Vallecula
the space between epiglottis and tongue

Question 12

What is the treatment for patients with obstructive sleep apnea? Include AHI and CPAP pressures.

Question 13

What is the epiglottis, name when swelling is present and what is the recommended treatment?

Answer 13

A thin, flat leaf shaped cartilage that rises above the glottis
“Epiglottitis”
Immediate placement of an artificial airway

Question 14

What is the narrowest portion of the airway in the INFANT?

Answer 14

cricoid cartilage

Question 15

In cases when an emergency airway (tracheostomy) opening is required, where should the incision be made?

Answer 15

midline
between the thyroid and cricoid cartilages

Question 16

What is the narrowest space of the airway that an endotracheal tube will go through in the adult larynx?

Answer 16

Vocal cords/Glottis

Question 17

What sound is associated with high-velocity air flowing through a narrowed glottis?

Answer 17

Croup/Stridor
high pitched crowing sound

Question 18

A lateral soft tissue x-ray of the neck of a 5-year-old with respiratory distress reveals the classic “thumb sign.” What is the most probable diagnosis?

Answer 18

a swollen epiglottis needing immediate placement of an artificial airway

Question 19

An x-ray of the neck of a 5-year-old with respiratory distress reveals the classic “Steeple sign”. What is the most probable diagnosis?

Answer 19

a viral infection aka croup

Question 20

Which mechanism explains why drowning victims often have little water in their lungs?

Question 21

What is the length of an adult trachea?

Answer 21

11 cm

Question 21

What is the carina?

Answer 21

The point of trachea division → bifurcates into the R and L bronchi

Question 22

Define the purpose of the rigid, horse-shoe shaped cartilages or C shaped rings in the trachea and how it’s different within bronchial areas

Answer 22

Preventing collapse from external pressure, especially during vigorous coughing

Question 23

Know the angles (degrees) of the right and left main stem bronchi and clinical importance.

Answer 23

R bronchi - 20 to 30 degrees from midline
L bronchus - 45 to 55 degrees from midline

Question 24

If an endotracheal tube is inserted too far in the process of intubation, listening to the lungs will reveal: Diminished breath sounds on which side?

Answer 24

right side

Question 25

Which of the following is the term that describes a volume of gas that is approximately 150 mL in the average adult and does not participate in gas exchange?

Answer 25

Dead Space/ wasted ventilation

Question 26

Which conditions are associated with neutrophilic infiltration of the airways?

Question 27

describe Columnar

Question 28

describe ciliated pseudostratified epithelial cells

Question 29

describe gobelt cells

Question 30

describe submucosal glands

Answer 30

greater amount of mucus production than goblet cells

Question 31

describe clara cells

Question 32

describe gel and sol layer

Answer 32

cilia reach into gel layer, exert rapid forward stroke directing gel toward pharynx, recovery is a backward movement through the less viscous sol

Question 33

Describe how eosinophils, fight against foreign organisms in the airway?

Answer 33

associated with asthma caused by allergens

Question 34

Describe how neutrophils fight against foreign organisms in the airway?

Answer 34

associated with bacterial infections neutrophils release neutrophil elastase ; elastase degrades elastin and collage of lung tissue

Question 35

Describe how mast cells fight against foreign organisms in the airway?

Answer 35

on epithelial surface of airways mast cell rupture release mediators of inflammation from granules

Question 36

Describe proteolytic enzymes and clinical significance.

Question 37

Describe Type I cells and their role.

Answer 37

compromise most of alveolar surface area extremely flat 93% of alveolar lining

Question 38

Describe Type II cells and their role.

Answer 38

compact, polygonal-shaped protrude into alveolar airspace contain lamellar bodies : store and secrete surfactant

Question 39

Describe alveolar macrophages and their role

Question 40

Mediastinum

Answer 40

the space between the lung containing the heart, aorta, esophagus, great veins such as sup/inf vena cava, trachea and mainstem bronchi

Question 41

cardiac notch

Answer 41

Anterior border of the left lung forms cardiac notch Makes room for the hearts protrusion into the left half of the thoracic cavity

Question 42

diaphragm

Answer 42

diaphragm separates the thoracic and abdominal cavities curving upward

Question 43

hilium

Answer 43

arteries, veins and main bronchi penetrate the lung mediastinal surfaces through the hilium

Question 44

lingula

Answer 44

a thin anterior portion of the upper lobe of the left lung overlaps the heart and continues downward to a narrow point A tongue shaped anatomical counterpart of the middle lobe of the right lung

Question 45

costophrenic recess (costophrenic angles)

Answer 45

the area where the lowest margin of the diaphragm meets the chest wall. lungs borders do not extend into this recess, but the parietal pleural membrane does

Question 46

Know the pleural membranes and what they line

Answer 46

Visceral pleura - attaches to lung's surface Parietal - attaches to inner chest wall surface Pleural space - potential space between visceral and parietal pleura

Question 47

what is the function of pleural fluid?

Answer 47

extremely thin layer of serous pleural fluid which lubricates membranes

Question 48

define pleural effusion

Answer 48

when a pleural membrane becomes inflamed by disease, making fluid form in the pleural space

Question 49

Define pneumothorax and treatment

Answer 49

Air in the thorax treatment is the placement of a chest tube (thoracostomy) into the pleural space and application of suction to remove air and expand the lung

Question 50

Describe bronchial circulation

Answer 50

lungs systemic blood supply arises from the aorta as bronchial arteries, which supply the airway from the major bronchi down to the respiratory bronchioles

Question 51

Describe pulmonary circulation

Answer 51

originates from the right ventricle of the heart as pulmonary artery and carries O2 poor blood to the lungs to be re-oxygenated