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36 Cards in this Set

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The physiologic hierarchy includes _____, ______, and _____. (in order)
respiration, swallowing, and speech.
***three types of respiration
ventilation- the movement of air back and forth between the outside atmosphere and the inner spaces od the lungs

external respiration - exchange of gases between walls of lung spaces and the transporting blood

internal respiration- gases are exchanged between blood and cells ofthe body
large alveolus = ____ collapsing pressure
low
small alveolus = ____ collapsing pressure
high
The small size of alveoli present a problem in keeping them open. ________ generates a pressure that can collapse alveoli
surface tension
Law that explains that the collapsing pressue on alveolus is equal to 2 times the surface tension divided by the radius of the alveolus
Law of LaPlace
****what combats the fact that small alveolus have a tendency to collape? how?
Surfactant-- Without surfactant, the Law of LaPlace says that small alveolus will collapse. With surfactant, the small alveolus remain open.
*** What is it called when small alveolus will collapse?
atelectasis
What is the space between 2 pleura?
pleural cavity or intrpleaural space
The thorax houses which system? what does this include?
Pulmonary system- includes the trachea, bronchi, and lung structures themselves
What is a collapsed lung called?
Pneumothorax
what are the 3 pumping actions of respiration?
1) quiet inhalation- few muscles are used

2) forced inhalation- muscles enlarge volume of thorax and decrease pressure within the thorax so air will flow in the lungs

3) exhalation- compressive pumping action decreases volume of thorax and increases pressure on air within
Main way to increase vertical space in the thorax
by way of diaphragm muscle
respiratory physiology at rest
1) quiet inhalation- active muscles expand thoracic volume to decrease internal air pressure

2) quiet exhalation- relaxation of muscles of inhalation so ribs and or diaphragm can return to their rest position, decreasing thoracic volume and increasing pressure
Most common pattern of coordination of respiration and swallowing: ____% do what?
60-80% inhale, start to exhale, stop exhale, swallow and airway closes, return to exhalation thought to be protective, prevents residual food in the airway. Other method - begin on inhalation and return on inhalation
An acute lung injury caused by acidic and particulate gastric contents such as reflux
pneumonitis
What is COPD? 2 types
Chronic Obstructive Pulmonaty Disease: emphysema and chronic bronchitis
** how fatal is aspiration pneumonia?
fatal in 20-50% of the cases. Acute inflamnation caused by infection; reaction to acgteria and bacterial byproducts
6 valves involved in swallowing
1) lips
2) velar-lingual
3) tongue oral and base
4) velopahryngeal
5) laryngeal
6) cp muscles.UES
apnea
pause during the swallow, 1/3 to 2/3 of a second; longer apneic pause with larger thicker boluses also longer with straw/cup drinking
upper airway versus lower airway
upper airway includes the oral, nasal, pharyngeal, and laryngeal tract. The lower airway includes the trachea, bronchi, and lungs
the larynx is the boundary between the upper and lower airway
main valves in the upper airway:
oral- secondary airpway- use tp inhale or exhale if the nasal cavity is blcoked
nasal- primary airway
pharyngeal tube- in swallowing, its open except for closing at certain points
laryngeal tube- protection of airway, clears secretionsd, valve for throcic fixation so abdominal pressure can be accomplished (for heavy lifting)
setting of valves in upper airway during respiration depends on activity. how would you set them for quiet breathing?
lips together, velopharyngeal port open, glottis open
exerted breathing?
lips open, VP closed, glottis open
speech breathing?
lips open,vp closed, larynx rapid movement
swallowing?
depends on phase
normal respiration rate young
16 per minute
normal respiration rate elderly
20 per minute
4 structural esophageal dysphagia etiologies
1) schatzki's ring
2) peptic stricture
3) hiatal hernia
4) esophageal diverticula
categories of esophageal dysphagia
1) structural (the biggie!!)
2) motility
3) infectious
4) neoplastic (cancer)
5) inflammatory
6) iatrogenic
prevelance of schiatzki's ring. population.
2nd most common cause of structual esophageal dysphagia. found in 4-15% of radiographic studies. autopsy shows 9%. typical age is 50-70 yo. ring size important. dysphagia common in rings greater than 13 mm.
where is schiatzki's ring localized?
to esphageal squmocolumnar junction and almost invariably coexist with a hiatal hernia which is most present in the Western population and about 60% of elderly
"Steakhouse Syndrome"
Schiatzki's ring
what is a peptic stricture
alergenic; mucosal rings that line esophagous and resemble the tracha, now the most common cause of esphageal dysphagia. treatable with meds, dietary restrictions, steroids and dialation
hierarchy of GERD to major problems:
1) 38% of people in US have heartburn at least once a month. 11% on daily basis
2) 1/3 of people seeking medical attention for symptoms of GERD have esophagitis
3) approx. 10-20% of people with esophagitis develop serious complications
name some local complicationd of esophagitis reflux
erosive esophagitis
bleeding
esoph. ulcers
esoph. stricture
barret's esophagus
esophageal adenocarcinoma