Pulmonary A&P/ Reg. Breathing/PT assessment

Gas exchange & mucous

100

The system that is responsible for gas exchange & how 

What is:

- the respiratory system

- Absorption of O₂ & excretion of CO₂

200

The gas exchange between tissue cells & systemic capillary blood (tissue level)

What is:

-Internal respiration

300

the exchange of gases in the alveoli of the lungs(between gas of the atmosphere & body)

What is:

-external respiration

400

the term for gas exchange across the lungs, in which the alveoli & capillary (A/C) membrane are responsible for the exchange of O₂  for CO₂  

What is:

-simple diffusion

500

the mucus from the lower airways but is ejected through the mouth 

what is:

Sputum

600

the mucus from TB(Tracheobronchial) tree not contaminated by oral secretions

what is:

Phlegm

700

the Sputum that contains pus cells 

what is: 

Purulent sputum

800

the sputum that is smelly

what is:

-Fetid sputum(foul smelling)

900

the sputum that has the presence of blood after coughing it up

what is:

-Hemoptysis

1000

the nerves that send signals from lungs, airways, and peripheral chemoreceptors to DRG

what is: 

-the Glossopharyngeal 

-&  vagus nerves 

1100

the cardiac output formula 

what is: SVxHR

5-10 L/min

Reflex & receptors

100

the reflex that causes a decrease in heart rate when stimulated from bronchoscopy, ET intubation, or tracheal suctioning 

what is:

-Vasovagal reflex

 

200

the receptors that cause rapid shallow breathing patterns (stimulated by pulmonary disease/congestion and inflammatory processes such as narrowing of glottis ) 

what is:

J receptors

300

the receptors responsible for the initial increase in ventilation at the beginning of exercise 

what is 

-Proprioceptors 

400

The receptors in the special nerve cells detect changes in the chemical composition of the blood and send information to the brain to regulate cardiovascular and respiratory functions. There are two major types.

what is: Chemoreceptors

 Central - Responds to changes in CO2 (by H ions) 

Peripheral - Respond to decrease in PaO2, changes in PaCO2

 

500

the occurrence of oxygen causing worsening V/Q mismatch in patients with chronically high CO2? And what other complications can occur from excessive O2 in this type of patient? (COPD, asthma)

 

-improving blood flow to poorly ventilated alveoli (not a lot of new air moving into lungs because of lack of elasticity while there is increased blood flow, less 02 available, and CO2 would continue to rise) 

-02 induced hypoventilation 

-Decreased hypoxic drive (removes stimulus - low 02) 

600

the stretch receptors at high lung volumes during inhalation are sent to DRG through the vagus nerve (for adults active at V_t greater than 800ml)

what is:

-Hering-Breuer inflation reflex

 

700

the reflex that causes a strong inspiratory effort 

what is:

-Deflation reflex

800

the reflex that stimulates a deeper breath upon inspiration (sigh)

what is:

-Head's paradoxical

900

the receptors that cause coughing, sneezing, and tachypnea

what is:

- the irritant receptor

s

1000

the irritant receptors' response in the lungs and airway

what is:

-Bronchospasm, cough, sneeze, tachypnea, narrowing of glottis (laryngospasm), or vasovagal 

1100

The Type II pneumocytes and their role(4 parts)

what is:

-only covering 7%,

 -reduce surface tension w/surfacant &

- are like stem cells to help repopulate/repair damaged alveolar surfaces with type I,

- will increase compliance and decrease WOB

Parts & Function

100

the route of fluid transport to and from the lungs

What is:

-traveling through the bronchial & pulmonary circulation along with the lymphatic system

200

the three functions of the lung's pulmonary circulation(3 parts)

what is:

- Gas exchange at the AC membrane (pick up oxygen and drop off CO2) 

- AC membrane controls fluid exchange in the lung 

- Production, processing, and clearance of a variety of chemicals and blood clots 

300

the VRG sends signals to which structures during inspiration(3 parts)

what is: the Diaphragm, larynx, and pharynx 

400

the 3 parts that make up the pharynx

what is:

-Nasopharynx- (nasal cavity to uvula) adenoids lie right where many particles impact

-Oropharynx- (uvula to tip of the epiglottis) palatine tonsils (removed as kid tonsillectomy)

- And Laryngopharynx- (tip of epiglottis to the larynx) is an anatomic location where respiratory & digestive tracts divide, also called the hypopharynx

500

 What is the primary function of the larynx?

what is: Protect the airway during eating or drinking (epiglottis movement)

600

the cause of Hypoxemia-mediated/ Hyperventilation

what is:

-pons are damage, Functions only when vagus nerve is served

700

the possible causes of tachypnea and diaphoresis(sweating)

what is:

-Exertion, Fever, hypoxemia, Anxiety, Atelectasis, and Pain 

800

The type of cells secretes pulmonary surfactant? What is the purpose of surfactant? 

What is:

- Type II pneumocytes 

- Surfactant reduces friction and promotes lung stability 

900

the purpose of gag reflex

what is:

prevent aspiration of bacteria & food

-if the patient is not conscious then intubate or they might aspirate

1000

the pores of Kohn & the canals of Lambert purpose

what is:

-the Pores of Kohn are responsible for allowing communication between alveoli(also if there is a mucus obstruction it gives an alternate route for repair)

-the Canals of Lambert are responsible for allowing communication between alveoli & bronchioles

1100

term for airways that participate in gas exchange & the term for those that don't participate but help facilitate it 

What is:

-respiratory zone

-conducting zone

Cartilage & parts

100

 the unpaired cartilage of the upper airway that contains the Adam's apple

what is:

-the thyroid

200

the unpaired cartilage of the upper airway that is the only complete ring

what is: 

-the Cricoid

300

the leaf-shaped cartilage extends from the base of the tongue to the thyroid cartilage 

What is:

-the Epiglottis

400

the paired cartilages of the upper airways

what is

- Arytenoid, Corniculate, and Cuneiform (paired)

 

500

the unpaired cartilage of the upper airways

what is: 

-Thyroid, Cricoid, & Epiglottis

600

What is the key landmark for oral intubation

What is:

- the Vallecula

700

The internal point that separates the left and right bronchus?

what is:

-the Carina 

800

 the different zones of the lungs

what is:

a. Respiratory bronchioles- Gas Exchange takes place 

b. Transitional airways -Between respiratory and conducting zones, gas is moved and participates in gas exchange 

c. Conducting airways-Terminal bronchioles are the smallest of the conducting airways, (Nares to terminal bronchioles)

900

the medulla contains

what is: Dorsal & ventral respiratory groups

1000

the nasal cavity and its defenses

what is: sinuses

cilia, nose hairs, heats & humidifies

 

1100

the opening between vocal cords

what is the glottis

Ribs & angles

100

the pair of ribs that are posterior only and do not connect to anything in the front

What is:

-11,12 

-floating ribs, blue in pic

200

the chest and spine configurations with increased AP diameter of the chest, the cause is emphysema. 

what is:

-barrel chest

Side note: Emphysema is a chronic lung condition that damages the air sacs in the lungs, called alveoli, making it difficult to breathe. Over time, the walls of the alveoli weaken and break, creating larger air spaces instead of many small ones. This reduces the surface area of the lungs, which in turn reduces the amount of oxygen that reaches the bloodstream 

300

 the different chest and spine configuration where the chest protrudes OUTWARD causing the lungs to be less effective( believed to be caused by cartilage growth of costal cartilage that grows faster than the bones)

what is: 

-pectus carinatum

400

the chest and spine configuration in which the chest protrudes out is caused when the sternum(cartilage that connects ribs to the breastbone) grows INWARD, resulting in a depression in the chest that may appear deep. The chest may have a "sunken in" or "funnel chest" appearance.

What is:

- Pectus excavatum

500

the chest and spine configuration that increases AP(anteroposterior) curvature of the spine 

what is:

-Kyphosis

600

the chest and spine configuration that is a lateral curve of the spine "S shaped"

what is:

-scoliosis

700

the ribs that connect directly to the sternum

what is:

-1-7

-true ribs

800

the ribs that do not articulate directly with the sternum

what is:

-false ribs

-8-10(do not articulate directly with the sternum. The costal cartilages of ribs eight to ten connect with the costal cartilages of the ribs above) pic green ribs

 

900

the angle of the right & left bronchi

what is:

right- 20-30 degrees, easier to turn down, and is 60% capacity

left- 45-55 degrees, not easy to turn into, and due to the heart is 40% capacity(thinner)

1000

the amount of lobes on the right and left lung

what is: 

right- 3 

left -2

1100

the arteries, veins, and nerves are located where in each ribs 

What is:

-Costal groove on the bottom of each rib

The breathing sounds

100

the breathing sound that is soft, muffled sounds heard during inspiration over parenchyma (normal breath sounds) 

What is:

-vesicular

200

the breathing sound that is a harsh hollow(normal)

What is:

-Tracheal

300

the loud breathing sound, tubular breath sounds equal during inspiration and expiration (normal)

what is:

-Bronchial

400

the breathing sound that is a high-pitched noise by bronchoconstriction(adventitious)

what is:

-wheezing

500

the low breathing sound caused by mucus. A cough or suction can improve this

what is:

-Rhonchi (coarse crackle)

600

the breathing sound of popping caused by alveoli opening or fluid (overload), is discontinuous, and is an adventitious breath sound "bubbling" 

What is:

-Crackle(rales)

700

the breathing sound of upper airway obstruction, high-pitched and continuous heard over trachea during inspiration

what is:

-Stridor

800

the breathing sound that is creaking or grating gets louder with deep breathing, not affected by cough 

what is:

-pleural friction rub

900

the breathing sound of little or no air movement (decreased aeration) caused by pleural effusion, hyperinflation, mucus plugging (reabsorption atelectasis), and shallow breathing (passive compressive atelectasis) 

what is:

-diminished 

1000

the primary muscle of ventilation

what is:

-the diaphragm 

- & intercostals

1100

the breathing signal to the diaphragm from the brain 

What is the Phrenic nerve

Harmful breathing patterns & effects

100

the breathing pattern that depth and rate increase then decrease then a period of apnea (caused by Brain injuries and CHF)

what is: Cheyne stokes

200

the breathing pattern that is caused by damage to the pons

what is: Apneustic breathing/Biot-breathing

300

the breathing pattern of the deep gasping type of respiration caused by DKA(Diabetic ketoacidosis)

what is:

-Kussmaul

400

the breathing pattern that has prolonged expiration

what is: Asthmatic

500

the decrease in pulse during inspiration, caused by hyperinflation (asthma, COPD), pericarditis, cardiac tamponade 

what is: the Pulsus paradoxical 

600

the  alternating strong and weak pulse; Caused by heart failure

what is: the Pulsus alternan

700

the occurrence of abdomen and chest "see-saw" opposite of each other, Caused by diaphragm weakness 

what is: the Abdominal paradox

800

the flail chest of one side of the chest inflates the other, does not, Caused by trauma, rib fx, severe pneumothorax 

what is: the Chest paradox

900

the two centers that exist in the pons below the medulla? Describe both

 what is: Pneumotaxix center  & Apnesustoc center. 

The pneumotaxic center controls IT and shuts off inspiration (normal breathing center)

-Apneustic center- only works when damage to pons; gasping breathing - not life-sustaining 

1000

the term pleuritic vs non-pleuritic pain, & causes

what is:

Pleuritic-lateral stabbing pain increased on inspiration; caused by pleuritis, PNA, PE 

 Nonpleuritic pain - Angina (chest pain caused by coronary artery obstruction) radiating down the shoulder

1100

the purpose of a small amount of fluid in the pleural space 

what is:

-to reduce friction

Volumes & Capacities

100

the chart for volumes & capacities 

200

the Tidal Volume (TV) capacity(normal, quiet breathing involves inspiration and expiration of TV)

what is:

-TV ~ 500-700 ml

300

the Inspiratory Reserve Volume (the additional volume of gas that can be inspired above TV on maximal inspiration)

what is: 

-IRV ~  3,100 mL

400

what is Expiratory Reserve Volume (ERV)(additional volume of gas that can be expired below TV on maximal expiration)

what is:

-ERV ~ 1,200 mL

500

The residual Volume (RV) (volume of gas that remains in the lungs following maximal expiration), cannot be measured by spirometry

what is:

RV ~ 1,200 mL

600

the lung capacity(greater than 2 volumes) for Inspiratory Capacity (IC), TV + IRV, amount of air inhaled after normal exhalation

what is:

IC ~ 3,600 mL

700

the lung capacity Functional Residual Capacity (FRC), ERV + RV, the volume of gas that remains in the lungs following normal TV expiration (equilibrium volume of lungs)

what is:

-FRC ~ 2,400 mL

800

the lung capacity Vital Capacity (VC), measures the maximum amount of air that can be inhaled and exhaled during breath.

IC + ERV = TV + IRV + ERV

what is:

-VC ~ 4,800 ml

900

the Total Lung Capacity (TLC)

-VC + RV = TV + IRV + ERV + RV

what is:

-TLC ~ 6 mL

1000

the when PaO2 falls to 60mmHg, the receptors located in aortic arch & bifurcation of common carotid arteries & condition

what is: PCR and Hypoxic

1100

the V_E=

what is:

-5-10 L/min

Possible test questions

100

how to calculate smoking pack history in years

Packs smoked per day # X # of years smoked

200

the coughing up of blood-streaked sputum is called

Hemoptysis

300

what is pedal edema and what is it associated with 

Is swelling in the lower extremities, most often due to right ventricular heart failure

400

palpation vs percussion

palpation is touching and percussion is tapping

500

what is central cyanosis

bluish color around the oral mucosa(makes torso blue as well) indicates respiratory failure due to low O2 levels

600

the hypothalamus's responsibilities and regulation 

Feeding, Fighting, Fleeting, Fahrenheit, fornication 

700

Systolic pressure range and diastolic, hypertension/hypotension range

Systolic- contractions of the left ventricle 90-140MMHG

diastolic- relaxation of ventricles 60-90MMHG

with pulse pressure between 30-40

hyper- >140/90

hypo- <90/60

800

SPO2 level in normal adult

92-100%

900

decrease and increase in tactile fremitus(chest palpation) is caused by 

decrease- air & fluid in pleural space, bronchus obstruction, emphysema, pneumothorax, pleural effusion, obesity, asthma(w/hyperinflation)

increase- consolidation in the lungs & pneumonia or atelectasis

1000

obstructive diseases CBABE

c- cystic fibrous(genetic)

b- bronchitis 

a- asthma

b- bronchiectasis

e- emphysema  

 

1100

serve pulmonary hyperinflation will cause?

an increase in lung volume & flattens diaphragm domes