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61 Cards in this Set

  • Front
  • Back

Lower Respiratory Tract (conducting airways and gas exchange airways) consists of:

1. bronchi


2. alveoli


3. lungs


4. pleura


5. pleural cavity

Accessory structures of the respiratory tract consist of:

1. rib cage (12 pair of ribs and sternum)



2. intercostal muscles (located between ribs)



3. diaphragm (separates thoracic cavity from abdominal cavity; flattens [contracts] during inspiration via phrenic nerve to allow greater chest expansion)

The responsibilities of the nose are:

1. to filter, humidify, and heat inspired air.


2. for nasal hairs to trap airborne particles in mucus.


3. for olfactory nerve receptors to allow for sense of smell.

The paranasal sinuses are:

1. air-filled cavities in frontal, maxillary, ethmoid, and sphenoid bones


2. that contribute to mucus production and voice resonance.

The pharynx:

1. is made up of the nasopharynx, laryngopharynx, and the oropharynx.


2. contains lymphatic tissue in adenoids (nasopharynx) and tonsils (oropharynx) that contributes to immune function.

The larynx:

1. contains vocal cords that vibrate to produce voice.


2. contains the epiglottis which closes during swallowing to prevent passage of food into the trachea.

The trachea:

1. connects the upper and lower respiratory tracts.


2. divides into the right and left mainstem bronchi.

The bronchi:

1. consists of the right and left mainstem bronchi (conducting airways)


2. which lead into smaller bronchioles


3. that eventually terminate in alveoli.


The right mainstem bronchus:

curves less sharply than the left,


making it a more common passage for aspirated gastric contents and dislocated endotracheal tubes.

The alveoli:

1. are air-filled sacs in the lungs.


2. oxygen diffuses from alveoli (gas exchange airways) into the blood across alveolar-capillary membrane (primary site of gas exchange).


3. carbon dioxide (CO2) diffuses back into the alveoli.


4. surfactant decreases surface tension.

The lungs consist of:

1. right lobe (3 lobes: upper, middle, lower).


2. left lobe (2 lobes: upper, lower).



3. The upper area is called the apex.


4. The lower area is called the base.

The pleura:

1. is a two-layer membrane covering the lungs (visceral pleura) and thoracic cavity (parietal pleura).



2. Pleural fluid lubricates the pleural layers and holds them together during inspiration and expiration.

The pleural cavity is:

air-filled space of the thoracic cavity which houses structures of the lower respiratory tract.

Accessory structures of the respiratory tract:

1. contribute to mechanics of breathing and/or provide support and protection.



2. Rib Cage: 12 pairs of ribs and the sternum.


3. Intercostal muscles located between the ribs.


4. Diaphragm, which separates the thoracic cavity from the abdominal cavity.

Diaphragm:

1. separates the thoracic cavity from the abdominal cavity.


2. flattens (contracts) during inspiration via the phrenic nerve to allow greater chest expansion.

The respiratory system's primary function is:

gas exchange (process of O2 and CO2 exchange).

Respiration involves:

1. ventilation,


2. perfusion,


3. diffusion,


4. nervous system control.

Ventilation is:

the passage of gases (O2 and CO2) between the atmosphere and the lungs during inspiration and expiration.

The adequacy of ventilation is influenced by:

1. tissue properties,


2. airway resistance,


3. lung volumes and capacities,


4. body position,


5. disease processes.

Pulmonary ventilation is:

total volume of gas exchange between the atmosphere and the lungs.

Alveolar ventilation is:

the volume of air that undergoes gas exchange.

Describe inspiration:

1. the stimulation of the phrenic nerve causes the diaphragm to contract and increase the diameter of the thoracic cavity,


2. the intrapleural pressure becomes more negative,


3. air moves from the atmosphere to alveoli and pulmonary capillaries where gas exchange occurs.

Describe expiration:

1. the diaphragm relaxes and pushes upward,


2. intrapulmonic pressure becomes higher than atmospheric pressure, allowing passive air flow from the lungs into the atmosphere,


3. smaller airways may collapse during expiration, particularly in supine position.

Intrapulmonic pressure:

equals atmospheric pressure (760 mm Hg) when the glottis is open and there is no air movement.

Intrapleural pressure is:

1. negative pressure produced by oppossite forces of elastic recoil between lungs and chest wall.



2. normally negative intrapleural pressure prevents lung collapse.

Intrathoracic pressure generally:

has negative pressure that equals intrapleural pressure.



With forced expiration against a closed glottis (Valsalva maneuver), it becomes positive.

Describe compliance.

1. The elastic property of lungs because of elastic and collagen fibers.


2. Higher compliance allows for easier lung distention.


3. Lower compliance (lung stiffness) makes distention more difficult.

Elastic recoil is:

the ability of lungs to return to original shape after air is expelled.

Airway resistance is:

the obstruction to airflow caused by:


1. conditions of respiratory system tissues (elastic recoil, compliance),


2. changes in airway diameter (bronchoconstriction, mucus obstruction),


3. pressure differences between atmospheric air and intrapulmonary air.

Describe lung volumes and capacities:

Volumes: normal individual quantities of air exchanged during a specific period of breathing cycle.



Capacities: combined quantities of lung volumes during specific periods of the breathing cycle.

Body position: gravity accounts for greater ventilation in dependent areas of the lungs.

With upright body (sitting, standing) during inspiration, airflow has less resistance in reaching lung bases.

Define perfusion:

Blood flow through pulmonary capillary bed in pulmonary and bronchial circulation to respiratory system structures.

Describe pulmonary circulation.

1. The pulmonary artery carries deoxygenated (venous) blood from the right ventricle,


2. branches into pulmonary capillaries,


3. and connects to alveoli.



4. CO2 is exchanged for O2 at pulmonary capillary membranes.


5. Capillary membranes merge into pulmonary venules and pulmonary veins that carry oxygenated blood back to the left atrium of the heart.

Describe bronchial circulation.

1. The bronchial arteries branch from the thoracic aorta to circulate blood to conducting airways and other respiratory tract tissues.



2. Bronchial blood does not circulate to alveoli and is not included in the gas exchange.

Characteristics of respiratory system circulation include:

blood pressure and resistance to blood flow are lower in pulmonary blood vessels than systemic blood vessels.

Describe diffusion.

1. The movement of air and O2 from the atmosphere into alveoli.



2. O2 crosses into pulmonary capillaries.


3. CO2 diffuses out of pulmonary capillaries into alveoli.

Variables that influence gas exchange include:

1. tidal volume (VT),


2. inspiratory reserve volume (IRV),


3. expiratory reserve volume (ERV),


4. residual volume (RV),


5. total lung capacity (TLC),


6. inspiratory capacity (IC),


7. vital capacity (VC),


8. functional residual capacity (FRC).

Define tidal volume (TV).

Total air volume inspired and expired during one breathing cycle.

Define inspiratory reserve volume (IRV).

Maximum air volume inspired with forced inspiration (i.e. movement of air from atmosphere into respiratory system) following normal inspiration.

Define expiratory reserve volume (ERV).

Air volume that can be expired with force following normal expiration.

Define residual volume (RV).

Air volume remaining in lungs following forced expiration.

Define total lung capacity (TLC).

Maximum capacity of air volume in lungs.



TLC = IRV + VT + ERV + RV

Define vital capacity (VC).

Maximum air volume that can be exhaled after a maximum inhalation.



VC = IRV + VT + ERV

Define functional residual capacity (FRC).

Residual air volume in lungs after a normal exhalation.



FRC = ERV + RV

Define inspiratory capacity (VC).

Maximum air volume that can be inhaled following a normal exhalation.



IC = VT + IRV

Describe the ventilation-perfusion relationship.

Adequate gas exchange requires alveolar ventilation of about 4 lpm balanced with alveolar capillary perfusion of about 5 lpm.




Normal ventilation-perfusion (V/Q) ratio is 4:5.

Describe the nervous system control of breathing.

1. Initiated within the medulla oblongata (inspiration, expiration, breathing pattern) and pons (rate, depth) of brainstem.



2. Sensory inputs to brainstem that influence respiration include:


a. chemoreceptors (increased PCO2 and/or decreased blood pH),


b. stretch receptors (alveolar septa, bronchi, bronchioles),


c. proprioceptors (muscles and tendons of moveable joints),


d. baroreceptors (aortic arch, carotid sinus),


e. external environment factors (cold, physical stress, air pollution, smoking, pain, infection, fever).

Motor nerve impulses travel from brain stem via phrenic nerve to diaphragm and:

stimulate muscle contraction for breathing.

Variables that influence gas exchange include:

1. partial pressure of gas,


2. surface area,


3. molecular weight and gas solubility,


4. thickness of membrane.

Supplemental oxygen increases:

partial pressure of inspired air.

Loss of lung tissue by surgery or disease decreases:

surface area available for gas exchange.

CO2 is more soluble in membranes and diffuses more quickly than oxygen.



This is an example of what variable that influences gas exchange?

molecular weight and gas solubility

Membrane is thickened by some disease processes, such as:

1. pneumonia,


2. pulmonary edema.



A thicker membrane impedes effective air exchange.

Types of radiological studies used for clients with respiratory disorders include:

1. chest x-ray (CXR),


2. computed tomography (CT),


3. magnetic resonance imaging (MRI),


4. pulmonary angiogram,


5. ventilation-perfusion scan.

Upper respiratory tract (conducting airways) consists of:

1. nose,


2. paranasal sinuses,


3. pharynx,


4. larynx,


5. trachea.

Name the radiological study that:



visualizes structures, fluid, and air in the thoracic cavity.

CXR (chest x-ray)



1. Anterior-posterior and lateral views are most common.


2. Appropriate use of lead shielding reduces overall exposure to x-rays.

Name the radiological study that:



1. Provides a cross-sectional view of tissue,


2. Detects lesions not identified by x-ray,


3. Is performed with or without contrast media.

CT (computed tomography:



Check allergies to iodine or seafood if contrast is used.

Name the radiological study that:



Has computerized images similar to CT that identify subtle changes in tissue structure.

MRI (magnetic resonance imaging)



1. Assess client to ensure metal sources are removed.


2. Clients with metal implants may be ineligible for MRI.

Name the radiological study that:



1. Outlines pulmonary vasculature;


2. Radioactive contrast medium is injected through a central venous catheter into the right side of the heart and pulmonary artery;


3. Identifies tumors and circulation abnormalities (congenital, thromboembolism).


Pulmonary angiogram.



Assess client for iodine and/or seafood allergies.

Name the radiological study that:



Is performed with a radioactive isotope injected to identify areas of ventilation and perfusion within the lungs.

Ventilation-perfusion scan.



Also called VQ (ventilation quotient) scan.

Describe pulse oximetry.

1. Monitors arterial oxygen saturation (SpO2 or percentage of O2 bound to hemoglobin (Hgb) compared to volume that Hgb is capable of binding),


2. Normal SpO2 is usually 95% or greater if client has no lung disease,


3. Target SpO2 is 90% or greater in clients with lung disease,


4. May be measured intermittently (such as with vital signs or ambulation) or continuously.