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59 Cards in this Set
- Front
- Back
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What are the two types of respiratory classification
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Anatomy or Physiology
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What are the different zones with the physiology system?
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Conducting, Respirtory Zone, and Respiratory Pump
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What is the conducting zone?
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Nose/Mouth, Pharynx, Larynx, Trachea, Bronchi,and the bronchioles
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What is the function of the conducting zone?
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Air conduction, humidification, and filtration
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What is the Respiratory Zone?
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Terminal bronchioles, Respiratory bronchioles, Alveoli, and Alveolar Capillaries
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What is the job of the respiratory zone?
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Gas exchange, and transport
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What is the Respiratory Pump
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thorax, respiratory muscles, neuronal control centers and receptors
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What is the job of the respiratory pump?
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to change the structure of the lungs/to change the pressure gradaiant
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What is in the larynx?
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vocal cords, epiglottis, and glottis
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what does the glottis do?
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Protect the lower airway
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What is above and below the larynx?
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above - pharnnx
below - trachea |
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What is the position of the trachea from the esophagus?
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the trachea is anterior to the espohagus
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Why are the c-shaped cartilage rings a good thing in the trachea?
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the allow the trachea (the airway) to keep its shape even when something is pressing against it - like something stuck in the esophagus
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What stimulates the cough reflex?
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Hitting the carina
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Which brnochi do things go down?
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Right - mor vertical and shorter/wider than left main bronchus. Has three lobes an upper, middle, and lower
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T or F
The bronchioles have cartilage The Bronchi does not have cartilage |
Faluse
The bronchioles have no cartilage, and depend on transpulmonary puressures to remain open |
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What are the mechanics of inspiration?
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Diaphragm contracts as intercostal muscles expand the thoracic cavity, and the alveloar puressure is less than the atmospheric pressure - air enters into the lungs
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What are the mechanics of exhalation?
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The diaphragm relaxes and intercostal muscles contract the thoracic cavity. Alveolar pressure is greater than atmospheric pressure and air is expelled.
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What are the two neurological regulations
Voluntary / involuntary |
voluntary - cerebral cortex (control of conscious breathing via corticospinal tracts
Involuntary-brainstem respiratory centers in the medulla oblongata and pons. |
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What are the problems that arise a pt has a brain tumor/or a Charini Malformation
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The medulla/brainstem becomes compressed
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What do chemoreceptors respond to
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They are in the heart and brain and respond to pCO2 levels changing in the blood
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Chemoreceptors activate what part of the brain?
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The medulla and the pons
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What does the medulla oblongata do?
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Controls the rhythmacity and the pherenic nerve that innervates the diaphragm orginates here
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What do the pons do?
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they are the inspiration - the apneustic/pneumotaxic center
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What does the pO2 have to be to stimulate breathing directly
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less than 60
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What is the pneumotaxic center do
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The PRG limits the burst of action potentials in the phrenic nerve, effectively decreasing the tidal volume and regulating the respiratory rate. Absence of the PRG results in an increase in depth of respiration and a decrease in respiratory rate.
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What does the apneustic center
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The apneustic center of the lower pons appears to promote inspiration by stimulation of the I neurons in the medulla oblongata providing a constant stimulus.
The apneustic centre of pons sends signals to the dorsal respiratory centre in the medulla to delay the 'switch off' signal of the inspiratory ramp provided by the pneumotaxic centre of pons. It controls the the intensity of breathing. The pons apneustic center stimulates/prolongs inspiration |
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Where are all the places we have chemoreceptors that affect the breathing
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medulla obongata - central
aortic bodies - peripheral carotid bodies - peripheral |
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Which cranial nerves are important for resp.
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number 9 and number 10
glossopharyngeal and the vagus |
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What does the glossopharyngeal nerve do
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carotid chemoreceptor, the gag reflex - the protective reflex
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What does the vagus nerve do
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reads the aortic chemoreceptor
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Which part of the respiratory system controls ventilation
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the conducting
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What is ventilation
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flow of air in and out of the lungs
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What part of the resp. system controls gas exchange?
What is gas exchange |
Respiratory zone
Diffusion of O2 and CO2 between alvelop of the lungs and the blood |
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What part of the resp. system control transport?
what is the control transport? |
movement of o2 and co2 bia the blood and circulatory system
resp. pump |
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What do the babies do in utero and why is it important?
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they move their chest - the resp pump - irregular movement 30-70 per min sitmilate lung development
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How does alveolar growth change from babies to adult?
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95% alveolar growth occur after birth
term babies have 50 million alvoli eight years have 300 million alveoli present this is important because grown children have incredased serface area for gas exchange |
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What is ment that children have limited reserve?
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Children are working at maximum capicity all the time - they have limited abilty to "override" this capacity, and when they do they have fatigue faster than adults would
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T or F
Children have a smaller airway diameter and length than adults |
True
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Why are children obligate nose breathers?
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The eppilogotis covers the airway so they need to produce more pressure to open it up - this pressure is easier to "gain" breathing through the nose
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T or F
Children have large masses of adenoidal tissue |
True
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T or F
The chest characteristics of a child make it so breath shound are harder to hear, and are quiter |
False
Breath shounds are louder, harsher and retractions are more common |
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When does the chest wall diamer change in children
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1:1 ratio
at 6 years of age the chest becomes flatter with decreasing AP diamerer the AP becomes less than transverse |
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If you see a child who has a round chest after age 6 what shuould you suspect?
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some diease were there is chronic hyperinflation
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T or F
Immunizations have made pertussis more common and astham less common |
False
Immunizations desease the rate of pertussis and measles but astham is on the rise |
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Why is it important to review the GI system when assessing the resp
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reflex can cause symptoms that look like resp or can cause resp problems - microasprits also a large liver make it harder to fully inhale
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What is grunting?
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When a baby tries to breath through a partially closed glottis and is attempting to generate a phyciologic peep
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What kind of airway distress is stridor, sniffing, congestion, suprasternal, clavicular retractions?
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Upper airway signs of distress
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What does tactile fremitus tell you
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What is in the rib cage - air does not transmit vibration - but tissue and soilids do - if there is no vibration think bpd or any kind of hyperinflation
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What does a (percussion) flat sound tell you
dull tympanic hyper resonant |
bone
organ over air over inflated - bpd lungs |
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What is diapharagmatic excursion?
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the decent distance of the diaphragm - you percuss down the midscapular line bilaterally -
normally it is 3-6 cm - where the diaphragm is higer in the right |
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bronchioviscular sounds will be louder in the back -
true or faluse |
true
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What are fine crackels
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High pitched - they are crackling, and popping
They occur ding the end of inspiration and are not cleared by cough. They usually indicate pulmonary edema |
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What are coarse crackels
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Low pitched - a bubbling or gurgling
They occur during inspiration and are not cleare with cough - common in chrochiolitis |
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What are rhonci
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Sonorous wheezes that are low pitched. Coarse, and loud - snoring or moaning
Expiration (most common) or Inspiration Caused by bronchus or tracheal obstruction with mucus that may clear with cough |
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What is a wheeze
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a high pitched musical or squeaky that can occur on expiration (most common) or inspiration due tue a narrowing of the smaller airway - inflammation, and bronchoconstriction
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What is a pleural friction rub
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Coaruse rubbing sound of leather on leather - occurs on the end of inspiration and beginning of inspiration. Pleura inflammation of the visceral and parietal pleura rub
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What is the limation of a pulse ox
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wont tell you about ventilation
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What is the pulmonary function test - spirometry
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tell you about the vital capiacity (vc)
and the forced expiratory volume (fev1, fev2, fev3) and lung compliance |
