21, 22, 23, 24

Front 1

The lungs, in conjunction with the circulatory system, deliver ______ to and expel _____ ______ from the cells of the body.
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Back 1

oxygen; carbon dioxide

Front 2

The upper respiratory system...
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Back 2

warms and filters air.

Front 3

The lungs accomplish _____ ______

Back 3

gas exchange

Front 4

What are the structures of the upper respiratory system? 487-488

Back 4

Nose
Sinuses and nasal passages
Pharynx
Tonsils and adenoids
Larynx: epiglottis, glottis, vocal cords, and cartilages
Trachea

Front 5

The purpose of the cilia is ?

Back 5

move the mucus back to the larynx.
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Front 6

Paranasal sinuses? and purpose?

Back 6

frontal, ethmoid, sphenoid, maxillary
Purpose a resonating chamber in speech.

Front 7

Lower respiratory structures?

Back 7

Lungs
Pleura
Mediastinum
Lobes of the lungs:
Left: upper and lower
Right: upper, middle, and lower
Bronchi and bronchioles
Alveoli

Front 8

When does inspiration occur? Expiration occurs?

Back 8

I= during the first two/thirds of the respiratory cycle.
E= during the last two thirds.

Front 9

Inspiratory phase requires ____ but expiratory requires very little

Back 9

energy.

Front 10

Exception: In COPD expiration requires _______

Back 10

energy.

Front 11

Alveoli

Back 11

where gas exchange takes place.

Front 12

How many alveoli are there?

Back 12

300 million in clusters of 15 to 20.

Front 13

What are the three types of alveoli?

Back 13

Type 1- epithelial cells that form the alveolar walls.
Type 2- excrete surfactant (a phospholipid that prevents collapse)
Type 3- large phagocytic cells that ingest foreign matter and act as a defense mechanism.

Front 14

Thoracic cavity is an ____ chamber. The base of this chamber is the ____.

Back 14

airtight; diaphragm

Front 15

Inspiration

Back 15

contraction of the diaphragm and external costal muscles increases the space in the chamber.

Front 16

Expiration

Back 16

with relaxation, the diaphragm moves up and intrathoracic pressure increases. This increased pressure pushes air out of the lungs. Expiration requires the elastic recoil of the lungs.
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Front 17

Function of the respiratory system.

Back 17

oxygen transport, respiration, ventilation and gas exchange.

Front 18

Respiration

Back 18

The process of gas exchange between atmospheric air and the blood at the alveoli, and between the blood cells and the cells of the body.

Front 19

Why does exchange of gas occur?

Back 19

Exchange of gases occurs because of differences in partial pressures.

Front 20

Oxygen diffuses from the ____ into the ____ at the alveoli to be removed form the body.

Back 20

air into blood

Front 21

Carbon dioxide diffuses from the ____ into the ____ at the alveoli to be removed form the body.
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Back 21

blood into air

Front 22

What is ventilation?

Back 22

Ventilation is the movement of air in and out of the lungs.
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Front 23

Air must reach the _____ to be available for gas exchange.
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Back 23

alveoli

Front 24

What is (pulmonary) perfusion?

Back 24

Perfusion is the filling of the pulmonary capillaries with blood.
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Front 25

Adequate gas exchange depends upon what?

Back 25

Adequate gas exchange depends upon an adequate V/Q ratio, a match of ventilation and perfusion.
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Front 26

When does shunting occur?

Back 26

Shunting occurs when there is an imbalance of ventilation and perfusion. This results in hypoxia (oxygen deprivation).

Front 27

What is gas exchange between the lungs and blood and between the blood and tissues?
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Back 27

Respiration.

Front 28

Normal breath sounds

Back 28

Vesicular
Bronchovesicular
Bronchial

Front 29

Abnormal breath sounds

Back 29

Crackles
Wheezes
Friction rubs

Front 30

tidal volume

Back 30

air volume of each breathe (in and ex) during normal breathing.

Front 31

inspiratory reserve volume

Back 31

maximum volume that can be inhaled after a normal inhalation.
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Front 32

expiratory reserve volume

Back 32

maximum volume that can be inhaled after a normal exhalation

Front 33

vital capacity

Back 33

the maximum volume of air exhaled from a maximal inspiration, VC = TV + IRV + ERV.
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Front 34

forced expiratory volume

Back 34

volume exhaled forcefully over time in seconds. Time is indicated as a subscript, usually 1 second.
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Front 35

a spirometer measures

Back 35

volumes of air exhaled and is used to assess lung capacities.
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Front 36

When assessing TV, measure ____ breaths. TV varies from breath to breath.

Back 36

several

Front 37

Peak flow rate reflects ___ ___ ____ and is frequently done by patients using a home spirometer.

Back 37

maximal expiratory flow

Front 38

Inspiratory force measures

Back 38

the effort of the patient in making an inspiration.
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Front 39

Monometer measures and occludes what?

Back 39

A monometer which measures inspiratory effort can be attached to a mask or endotracheal tube to occlude the airway and measure pressure.
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Front 40

Normal inspiratory pressure is approximately ______
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Back 40

100 cm H2O.

Front 41

Inspiratory Force of less than ____ usually requires mechanical ventilation.
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Back 41

25 cm

Front 42

ABG

Back 42

Measurement of arterial oxygenation and carbon dioxide levels.
Used to assess the adequacy of alveolar ventilation and the ability of the lungs to provide oxygen and remove carbon dioxide.
Also assesses acid base balance

Front 43

Pulse Ox

Back 43

oxygen saturation in the blood.

Front 44

Pulse Ox does not replace ______

Back 44

abg and may be unreliable

Front 45

bronchoscopy

Back 45

direct examination or larynx, trachea, and bronchi. Fiberoptic ("bendy" tube )and rigid (straight tube) bronchoscopy

Front 46

bronchophony

Back 46

abnormal increase in clarity of transmitted voice sounds.

Front 47

compliance also known as

Back 47

dispensability... is the elasticity and expandability of the lungs and thoracic structures

measure of force required to expand or inflate the lungs.

Front 48

Diffusion is the...

Back 48

process by which oxygen and carbon dioxide are exchanged at the air-blood interface. high to low

Front 49

Pulmonary perfusion

Back 49

actual blood flow through the pulmonary circulation.

Front 50

the pulmonary circulation is considered _____ pressure because...

It can vary its ______

Back 50

systolic is 20-30 and dia is 5 to 15.

circulation

Front 51

Adequate gas exchange depends on

Back 51

adequate V/Q

Front 52

V/Q ratio

Back 52

ventilation-perfusion ratio

Front 53

ventilation-perfusion ratio imbalances because of

Back 53

inadequate ventilation, perfusion or both

Front 54

The air we breathe is a mixture of

Back 54

nitrogen (78.6%) oxygen (20.8%) ...with traces of carbon dioxide (0.04) and water vapor (0.05), helium and argon

Front 55

Atmospheric air pressure at sea level is 760mm

Back 55

true

Front 56

Partial pressure is pressure...

Back 56

exerted by each type of gas in a mixture of gases.

Front 57

Partial pressure is ________ to the concentration of that gas.

Back 57

proportional

Front 58

the total pressure is equal to

Back 58

the sum of partial pressures. no matter if its atmospheric or in the lungs.

Front 59

When a gas is exposed to a liquid, the gas _______ until an _____ is reach

Back 59

dissolves; equilibrium

Front 60

oxygen and carbon dioxide are transported simultaneously either _____ in blood or combined with hemoglobin in red blood cells.

Back 60

dissolved

Front 61

The Oxhemoglobin Dissociation Curve shows the relationship between

Back 61

partial pressure of oxygen and the percentage of saturation of oxygen.

Front 62

At the same time oxygen diffuses from the ___ to the ______, carbon dioxide diffuses from _____ to the to blood and transported to the lungs for excretion.

Back 62

oxygen- blood into tissue
carbon dioxide- tissue into blood

Front 63

____ ______ is the result of cyclic excitation of the respiratory muscles by the phrenix nerve

Back 63

resting respiration

Front 64

lungs and respiratory peak is between

Back 64

20 and 25 and decreases afterwards.

Front 65

Clubbing of the fingers is a sign of...

Back 65

lung disease

Front 66

Cyanosis

Back 66

is a VERY LATE indication of hypoxia. It appears when there is at least 5g/dL of unoxygenated hemoglobin.

Front 67

4 reasons the chest may not have a 1:2 ratio

Back 67

barrel chest- over inflation of the lungs
funnel chest- p. excavatum
Pigeon chest- p. carinatum
kyphoscoliosis

Front 68

eupnea
apnea

cheyne-stokes

biot's respiration

Back 68

normal breathing 12-18
period of cessation of breathing

regular cycle where rate and depth of breathing increase then decrease until apnea occurs.

periods of normal breathing followed by varying apneas

Front 69

Bronchophony and egophony are indicative of

Back 69

consolidation ie pneumonia or pleural effusion

Front 70

vesicular
bv and tracheal
bronchial

Back 70

I>E, soft, low
I=E intermediate (Bv)
I<E loud,
tracheal, very loud

Front 71

crackles

Back 71

soft, high pitched popping sounds during inspiration
course crackles- early inspiration
fine crackles- late inspiration

Front 72

wheezes

Back 72

musical sounds can be heard on inspiration but usually expiration

Front 73

rhonchi
friction rub

Back 73

low pitched wheezing rumbling sounds
leather rubbing together, crackling

Front 74

How is vital capacity measured?

Back 74

by having the pt take in max breath and exhale fully through a spirometer.

Front 75

Throracoscopy (endoscopic)

Back 75

evaulation of pleural effusions, pleural disease and tumors.

Front 76

Thoracentesis

Back 76

aspiration of fluid or air from the pleural space.

Front 77

Examples of upper respiratory diseases

Back 77

Infections
Rhinitis
Sinusitis: acute, chronic
Pharyngitis: acute, chronic
Tonsillitis, adenoiditis
Peritonisillar abscess (aka quinsy)
Laryngitis

Front 78

rhinitis

Back 78

inflammation of the mucous membranes of the nose.

Front 79

rhinosinusitus

Back 79

inflammation of the nares and paranasal sinuses, including frontal, ethmoid, maxillary,a nd sphenoid sinuses. thick mucous occludes sinsus cavity; prevents drainage

Front 80

pharyngitis

Back 80

inflammation of the throat; usually viral or bacterial in origin.

Front 81

potential complications of upper respiratory

Back 81

sepsis- bacterial infection
meningitis- brain and spinal cord inflammation
peri tonsuilar abscess
otitis media- middle ear infection
sinusitis

Front 82

S/S of upper respiratory

Back 82

hoarness, chest pain etc

Front 83

palpate _______ ______ _____ when assessing for an upper respiratory tract infection.

Back 83

neck lymph nodes

Front 84

use ___ for sore throat.

Back 84

gargles

Front 85

epistaxis, most common site

Back 85

bleeding from the nose; anterior septum

Front 86

how to treat epistaxis

Back 86

direct pressure 5-10 min with head titled forward.
nasal decongestants
topical vasoconstrictors ie (cocaine etc.)

Front 87

packing to control bleeding from posterior nose

Back 87

catheter, packing, strip

can use a ballon catheter

Front 88

If bleeding doesn't stop in 15 min. seek medical attentino.

Back 88

true

Front 89

reasons nasal airways may be obstructed

Back 89

deviation of nasal septum, hypertrophy of turbinate bones, pressure of nasal polyps.

Front 90

larynx (voice box) obstruction is usually due to ______

Back 90

edema.

Front 91

______ is characterized by episodes of life threatening laryngeal edema

Back 91

Hereditary angioedema (HAE)

Front 92

Categories of cancer of larynx

Back 92

Supraglottic: false vocal cords above vocal cords
Glottic: true vocal cords
Subglottic: below vocal cords

Front 93

S/S of cancer of the larynx

Back 93

hoarse, cough, sore throat, lump in neck

Back 94

affected voice sounds

Front 95

Medical treatment of larynx cancer

Back 95

radiation, chemo, surgery (Partial laryngectomy
Supraglottic laryngectomy
Hemilaryngectomy
Total laryngectomy)

Front 96

laryngitis

Back 96

inflammation of the larynx as a result of dust, chemicals, smoke, and other pollutants or as part of a URI.

Front 97

aphonia

Back 97

complete loss of voice, a sign of laryngitis. also severe cough.

Front 98

how to manage laryngitis

Back 98

rest voice, avoid irritants, and inhale cool steam or aerosol.

Front 99

signs of peritonsilar abscess

Back 99

trismus (unable to open mouth), sore throat, drooling

Front 100

vocal cord stripping

Back 100

used to treat dysplasia, hyperkeratosis (thickening if the stratum corneum), and leukoplakia.

Front 101

cordectomy

Back 101

exicision of the vocal cord, performed via transoral laser

Front 102

when is an electric larynx used?

Back 102

When esophageal speech is not successful or until the patient maters the technique.

Front 103

how to maintain a patent airway.

Back 103

fowler's or semi fowlers position to decrease edema

Back 104

Keep HOB elevated during, after tube feedings
Check gastric residual when administering tube feedings
When patient begins oral feeding, maintain upright bed position during, after feedings
Swallowing maneuvers to prevent aspiration
Use of thickened liquids