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142 Cards in this Set
- Front
- Back
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What are the four different types of cells found in the upper and lower airways?
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1. stratified squamous epithelium
2. pseudostratified columnar ciliated epithelium 3. simple cuboidal epithelium 4. simple squamous epithelium |
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What does stratified mean?
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layers
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Where are cells generated?
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basement membrane
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Where are stratified squamous epithelium cells found?
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1. nasal and oral cavity
2. oropharynx 3. laryngopharynx |
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Where are pseudostratified columnar ciliated epithelium cells found?
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1. the posterior 2/3 of the nasal cavity
2. the tracheobronchial tree |
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Where do pseudostratified columnar ciliated cells start?
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glottis
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Where are simple cuboidal cells found?
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bronchioles
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Where are simple squamous epithelium cells found?
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1. wall of the alveoli
2. pulmonary capillaries that surround alveoli |
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Typically, how many alveoli are found in the body?
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300-600 million
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How many lobes are found left lung and what are they called?
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-2 lobes
1. superior 2. inferior |
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What are the lobes in the left lung divided by?
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the oblique fissure
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What is the lingula?
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eqivalent to the right middle lobe
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How many bronchopulmonary segments are there?
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eight
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How many lobes are in the right lung and what are they called?
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- 3 lobes
1. superior 2. middle 3. inferior |
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The right upper lobe and the right middle lobe are separated by what fissure?
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transverse fissure
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What fissure separates the right middle lobe from the right lower lobe?
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oblique fissure
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What are the lungs bordered by?
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1. ribs
2. mediastinum |
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What is considered the costal surface?
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ribs
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What is the hilum where vessels, nerves and bronchi enter and exit the lungs?
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mediastinum
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What is the mediastinum mostly made of?
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connective tissue
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What is the general term used to describe the serous membrane surrounding the lungs?
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pleurae
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Where is the visceral pleura located?
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next to the lungs and extends into fissures
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Where is the parietal pleura located?
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lines the thoracic wall and the diaphragm
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What is the space called between the two pleuras?
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potential space
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If the pleuras fell apart/seperate what is it called and how can it be fixed/corrected/treated?
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1. pneumothorax
2. chest tube |
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What are the three main purposes of the pleural cavity?
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1. fluid acts as a lubricant
2. negative pressure in intrapleural space is required for ventilation 3. separates thoracic organs |
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What are the three most important things about the rib cage?
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1. protects and supports organs
2. plays a major role in breathing 3. some bones produce blood cells |
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What structure articulates with the clavicles and costal cartilage of the 1st and 2nd ribs?
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the sternum
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Where does the body of the sternum attach?
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the costal cartilage of 2nd to 10th ribs
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What is the structure that is the attachment for the abdominal muslces?
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xyphoid process
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What are the three parts of the sternum and which part are CPR compressions supposed to occur at?
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1. menubrium
2. sternal body *cpr occurs here 3. xyphoid process |
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How many pairs of ribs do we have?
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12 pairs
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How many pairs of true ribs do we have and how are they attached to the sternum?
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1. seven pairs
2. costal cartilage |
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Which pairs of ribs are considered the false ribs and where are the attached?
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1. 8th, 9th and 10th pairs
2. attached to costal cartilage of the 7th rib |
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What ribs are considered the floating ribs and what are the attached to?
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1. 11th and 12th
2. attached to muscles |
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Explain the bucket handle effect?
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when the volume in the thoracic cavity increases, the pressure in the lungs decrease which cause the ribs to move out and up like a bucket handle. this allows us to ventilate.
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How is it possible that we ventilate?
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surface tension
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The ribs are attached to vertebrae via what?
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1. head
2. tubercle |
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What is the costal groove in place for?
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protection vessels and nerves
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What are the spaces between the ribs called?
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intercostal spaces
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Airflow into and out of the lungs is possible due to what?
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pressure difference
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If there is no difference in pressure between the atmosphere and the inside of the lungs, what happens?
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no air flow
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What are the three main muscles of ventilation?
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1. diaphragm
2. external intercostals 3. internal intercostals |
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What muscle is responsible for inspiration?
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external intercostals
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What muscle is reponsible for expiration?
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internal intercostals
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What is the diaphragm composed of and how are they connected?
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two hemidiaphragms attached in the middle by a tendon
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What kind of muscle is the diaphragm made of?
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striated muscle
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What shape is the diaphragm when relaxed and what is the shape when it contracts?
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- dome when relaxed
- flattens when contracts |
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What is the main purpose of PEEP?
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lung recruitment
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What direction do the muscle fibers in the external intercostals move?
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down and forward
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What muscles increase the lateral dimension of the thorax?
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external intercostals
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From the main muscles of ventilation, which muscles are the outermost between the ribs and which are the innermost?
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- outer: external intercostals
- inner: internal intercostals |
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In what direction do the internal intercostal muscle fibers move?
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downward and backwards
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Which muscles draw the ribs together and depresses the thorax?
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internal intercostals
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What is deadspace ventilation?
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when breaths don't get near/reach gas exchange areas
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What are the four accessory muscles and why would they be used?
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1. sternocleidomastoid
2. pectoralis major 3. scalenus 4. trapezius - used with laboured or stressed breathing |
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Where does the sternocleidomastoid connect?
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the menubrium of the sternum
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What is the purpose of the sternocleidomastoid?
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increases A-P diameter of chest by elevating sternum
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What is the purpose of the pectoralis major and what patients are the evident in?
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- increase A-P diameter
- COPD patients |
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What are the muscles of the abdomen used for and what are they made of?
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- expiration
- 4 pairs of flat, sheet like muscles |
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What is the purpose of using abdominal muscles during expiration?
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increases pressure in abdominal cavity and forces diaphragm upward
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What are the four muscles used in expiration and which of these is the strongest, most superficial?
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1. external obliques (strongest)
2. internal obliques 3. transverse abdominus 4. rectus abdominus |
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What are the two functional areas of the respiratory system?
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1. conducting portion
2. respiratory portion |
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What are the five components of the conducting portion of the respiratory system?
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1. nasal cavity
2. paranasal sinuses 3. pharynx 4. larynx 5. trachea and further |
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What are the boundaries of the upper airway and what are it's components?
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- from anterior nares to the true vocal folds
1. oral cavity 2. pharynx 3. larynx |
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If a patient is on an SVN, how should you consult them to breathe?
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with their mouths
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Where are the paranasal sinuses located? (4)
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1. frontal
2. maxillary 3. ethmoid 4. sphenoid |
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What are the three parts of the pharynx?
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1. naso
2. oro 3. hypo/laryngo |
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What kind of cells and tissue are found in the nasopharynx and what tube is found there?
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- cells: pseudostratified ciliated columnar epithelium
- tissue: lymphoid tissue - eustachian tube |
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What cells and tissue are found in the oropharynx?
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- cells: nonciliated stratified squamous epithelium
- tissue: lymphoid tissue |
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Where is the laryngo-/hypopharynx located?
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between the base of the tongue and the entrance to the esophagus
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What reflex is found at the laryngopharynx?
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pharyngeal reflex (gag or swallowing reflex)
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What kind of cells are found in the larygnopharynx?
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nonciliated stratified squamous
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What we need to know for intubating!!
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1. vallecula
2. epiglottis 3. aryepiglottic folds 4. arytenoid, cuneiform, and corniculate 5. esophagus 6. vocal folds 7. trachea |
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What are the three single cartilages in the larynx?
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1. thyroid
2. cricoid 3. epiglottis |
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What are the three paired cartilages in the larynx?
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1. arytenoid
2. coniculate 3. cuneiform |
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What is the largest cartilage of the larynx?
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thyroid
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What is the superior border of the thyroid cartilage?
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thyroid notch
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What is the hyoid bone suspended by?
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thyroid membrane
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What is the only complete cartilage in the airway?
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cricoid
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What is the base of the epiglottis attached to?
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medial surface of thyroid
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What is the main function of the epiglottis?
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prevent aspiration by occluding glottis during swallowing
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What is the opening between the vocal cords called?
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glottis
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What cells are present above the vocal folds?
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stratified squamous
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What cells are present below the vocal folds?
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pseudostratified ciliated columnar
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What is the boundary between the upper and lower airway?
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vocal folds
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What cranial nerve provides motor innervation to laryngeal muscles?
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10
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How could the valsalva maneuver affect a patient?
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breathe against a closed glottis and could pass out
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When should you perform the sellick maneuver?
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with an unconcious patient
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What is the sellick maneuver?
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pressure to the cricoid cartilage
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What are the hazards of the sellick maneuver?
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very low chance of hazards, unless patient's esophagus is damaged or injured
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If the "last gas in" is the "first gas out", then why dont you smell on expiration?
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air is directed out instead of up to the olfactory
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Which nerves, when stimulated, produce the pharyngeal gag reflex?
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9 and 10
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What percentage of the population does not have the gag reflex?
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10-15%
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Name the structures of the tracheobronchial tree in order starting from the nose and nasal cavity.
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1. nose and nasal cavity
2. nasopharynx 3. oropharynx 4. laryngopharynx 5. larynx 6. trachea 7. carina 8. right and left mainstem 9. lobar bronchi 10. segmental bronchi 11. subsegmental bronchi 12. bronchioles 13. respiratory bronchioles 14. alveolar ducts 15. alveoli |
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How many bifurcations in the cartilaginous parts of the tracheobronchial tree:
1. trachea 2. mainstem bronchi 3. lobar bronchi 4. segmental bronchi 5. subsegmental bronchi |
1. 0
2. 1 3. 2 4. 3 5. 4-9 |
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How many bifurcations in the non-cartilaginous areas of the tracheobronchial tree:
1. bronchioles 2. terminal bronchioles |
1. 10-15
2. 16 |
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How many bifurcations in the respiratory zone:
1. respiratory bronchioles 2. alveolar ducts 3. alveolar sacs |
1. 17-19
2. 20-14 3. 25 |
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What are the other names for alveoli?
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1. primary lobule
2. lung parynchema 3. terminal respiratory unit 4. functional unit 5. acinus |
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What does the peribronchial connective tissue effect?
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lung compliance
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What parts of the tracheobronchial tree are cartilaginous?
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1. trachea
2. mainstem bronchi 3. lobar bronchi 4. segmental bronchi 5. subsegmental bronchi |
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How long is an adult trachea and what is the diameter?
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1. 10-13cm
2. 1.5-2.5 cm |
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How long and what is the diameter of the right mainstem and what angle does it branch off at?
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1. ~2-5 cm
2. ~1.4 com 3. 25 degree angle |
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How long and what is the diameter of the left mainstem and what angle does it branch off at?
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1. ~1cm
2. ~1cm 3. 40-60 degree angle |
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The lobar bronchi on the right divides into what segments? What segments does the left divide into?
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1. upper, middle and lower lobar bronchi
2. upper and lower lobar |
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What shape are the cartilaginous rings in the lobar bronchi?
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c shaped rings become continuous rings
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How many segmental bronchi are there in the right lung?
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10
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Why don't the lungs collapse?
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the negative pressure in the lungs produce radial traction which holds the lungs open
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What is a lockula and what can it not be treated by?
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a hole in the chest that does not become a pnemothorax. cannot be treated by a chest tube
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What is the range in diameter of the subsegmental bronchi?
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~ 1-4 mm
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What disappears beyond the level of the subsegmental bronchi?
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peribronchial sheath
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What does the peribronchial connective tissue contain?
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nerves, lymphatics (juxtalveolar lymphatics), bronchial arteries
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What structures are the non-cartilaginous airways composed of?
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bronchioles and terminal bronchioles
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What is the diameter of the bronchioles?
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< 1mm
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What is the diameter of the terminal bronchioles?
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< 0.5mm
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What disappear at the terminal bronchioles?
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cilia and mucous glands
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What are the three major layers the airway is composed of?
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1. epithelial lining
2. lamina propria 3. cartilaginous layer |
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What does ventolin target?
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smooth muscles
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What kind of cells is the epithelial lining compsed of?
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pseudostratified ciliated colunmar
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What structure seperates the epithelial lining from the lamina propria?
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basement membrane
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What kind of cells lin the basement membrane?
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basal cells
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How many cilia are there per cell?
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~ 200
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What is mucous produced by?
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goblet cells
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What are some factors that affect cilia production?
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1. cigarette smoke
2. dehydration 3. PPV, indwelling ETT 4. ETT sxn 5. highly inspired FiO2's 6. hypoxia 7. atmospheric pollutants 8. general anesthetics 9. parasympatholytics |
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What are the 3 hallmarks to asthma?
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1. increased secretions
2. bronchospasm 3. cough |
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What controls airflow in the respiratory tree?
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smooth muscle
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What impact do RTs have on the lamina propria?
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1. target area for drugs
2. high pressures in the cuff of an ETT can cause injury |
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Define ventilation
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bulk movement of gas moving in and out of the lungs
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Define Internal and external respiration
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internal: blood to cell
external: gas exchange from alveoli to blood |
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Where does the flow of gas essentially stop?
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terminal bronchioles
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What percentage of type 1 cells form the alveolar surface, and what percentage of type 2 cells form it?
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- type 1: 95%
- type 2: 5% |
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Define:
1. barrotrauma 2. volutrauma 3. biotrauma 4. histotrauma |
1. pressure
2. volume 3. pressue + volume 4. cellular disruption |
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What type of pneumocytes can reproduce within the lung?
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type 3
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What are the two compartments of the interstitium?
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1. tight space
2. loose space |
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Where are tight space junctions found?
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between alveolar epithelium and endothelium of pulmonary capillaries
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Where are loose space junctions found?
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surrounds acini
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What is collagen believed to limit?
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alveolar distensability
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What are canals of lambert?
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small channels between alveoli and terminal bronchioles
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What are pores of kohn?
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small holes or channels between interalveolar septa
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What is the function of the pores of kohn?
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permit gas to move between adjacent alveoli
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Why do pores of kohn form?
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1. disease
2. age 3. macrophages |
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What is pulmonary congestion and what is pulmonary edema?
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- congestion: fluid sits in A/C membrane
- edema: fluid sits in alveoli |
