Podcast
Questions and Answers
What is the main function of the epiglottis?
What is the main function of the epiglottis?
- Prevent aspiration of food and liquids (correct)
- Regulate airflow into the trachea
- Facilitate speech production
- Assist in the humidification of inhaled air
What is a common consequence of nasal flaring during respiration?
What is a common consequence of nasal flaring during respiration?
- Widening of nostrils due to air resistance (correct)
- Complete obstruction of airflow
- Increased oxygenation of blood
- Hyperventilation leading to CO2 buildup
Which of the following is NOT a primary component of the upper airways?
Which of the following is NOT a primary component of the upper airways?
- Oral cavity
- Larynx
- Bronchi (correct)
- Nose
What condition can result from improper placement of an endotracheal tube?
What condition can result from improper placement of an endotracheal tube?
What should patients with compromised mucociliary transport avoid suppressing?
What should patients with compromised mucociliary transport avoid suppressing?
What is the main treatment for post-extubation laryngeal edema?
What is the main treatment for post-extubation laryngeal edema?
Which layer is NOT part of the tracheobronchial tree?
Which layer is NOT part of the tracheobronchial tree?
Which of the following distinguishes croup from epiglottitis?
Which of the following distinguishes croup from epiglottitis?
What happens to intra-plural pressure at the end of inspiration?
What happens to intra-plural pressure at the end of inspiration?
Which physiological response is NOT associated with a tension pneumothorax?
Which physiological response is NOT associated with a tension pneumothorax?
Which cells are primarily responsible for the production of surfactant in the lungs?
Which cells are primarily responsible for the production of surfactant in the lungs?
What factor is NOT affected by surface tension in the lungs according to LaPlace's law?
What factor is NOT affected by surface tension in the lungs according to LaPlace's law?
What is the barometric pressure at sea level?
What is the barometric pressure at sea level?
In which of the following conditions would surfactant deficiency be most likely observed?
In which of the following conditions would surfactant deficiency be most likely observed?
What occurs during expiration with regard to diaphragm movement?
What occurs during expiration with regard to diaphragm movement?
Which of the following is a common psychological response to tension pneumothorax?
Which of the following is a common psychological response to tension pneumothorax?
What is the primary role of mast cells in the lamina propria when activated?
What is the primary role of mast cells in the lamina propria when activated?
Which layer of the mucous blanket is characterized as a viscous layer that lies closer to the lumenal surface?
Which layer of the mucous blanket is characterized as a viscous layer that lies closer to the lumenal surface?
At which level of the tracheobronchial tree is cilia absent?
At which level of the tracheobronchial tree is cilia absent?
What effect does cigarette smoke have on ciliary function?
What effect does cigarette smoke have on ciliary function?
How many segmental bronchi are present in the right lung?
How many segmental bronchi are present in the right lung?
What type of alveolar cell is primarily responsible for removing bacteria and foreign pathogens?
What type of alveolar cell is primarily responsible for removing bacteria and foreign pathogens?
What is the consequence of high levels of FiO2 on cilia?
What is the consequence of high levels of FiO2 on cilia?
How far above the carina should the tip of an endotracheal tube ideally be positioned?
How far above the carina should the tip of an endotracheal tube ideally be positioned?
What anatomical structure is referred to as the carina?
What anatomical structure is referred to as the carina?
What is pleurisy primarily characterized by?
What is pleurisy primarily characterized by?
In pulmonary circulation, blood is transported from the heart to where?
In pulmonary circulation, blood is transported from the heart to where?
What is the relationship between elastance and lung compliance?
What is the relationship between elastance and lung compliance?
Which accessory muscle is involved in expiration?
Which accessory muscle is involved in expiration?
What is the primary characteristic of pleural effusion?
What is the primary characteristic of pleural effusion?
During which phase is static lung compliance measured?
During which phase is static lung compliance measured?
Which statement about inspiratory accessory muscles is correct?
Which statement about inspiratory accessory muscles is correct?
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Study Notes
Upper Airways
- Key components include the nose, oral cavity, larynx, and pharynx.
- Functions: important for speech and smell, humidify and warm/cool inhaled air, act as air conductors, and prevent foreign particles from entering the tracheobronchial tree.
- Nasal flaring indicates respiratory distress; can occur due to conditions like asthma or pneumonia.
- Misplaced endotracheal tube can enter the esophagus instead of the trachea during intubation.
- The epiglottis is the laryngeal cartilage that prevents aspiration of food and liquid.
- The larynx connects the pharynx and trachea, prevents aspiration, and generates sound for speech.
- Post-extubation laryngeal edema is treated with aerosolized racemic epinephrine and high humidification, along with voice rest and cough medications.
- Croup is a viral infection causing tracheal and laryngeal inflammation, while epiglottitis is a bacterial infection leading to epiglottis swelling and airway obstruction.
Lower Airways
- Cough reflex should not be suppressed when mucociliary transport is compromised as it's crucial for secretion mobilization.
- Respiratory therapy modalities for bronchial secretions include chest physiotherapy, flutter devices, cough breathing exercises, and suctioning.
- Tracheobronchial tree comprises three layers: epithelial, lamina propria, and cartilaginous layer.
- The lamina propria contains mast cells that trigger bronchial airway changes when activated.
- The mucous blanket consists of 95% water; primary components include glycoproteins, carbohydrates, and cellular debris arranged in a gel layer and a sol layer.
- Cilia are absent in terminal bronchioles (between 16th to 19th generations).
- Factors affecting mucociliary transport: cigarette smoke, dehydration, positive pressure ventilation, endotracheal suctioning, and high FiO2 levels.
- Conducting zone is another name for cartilaginous airways.
- Right lung contains 10 segmental bronchi, and the left lung has 8.
- Non-cartilaginous airways include bronchioles and terminal bronchioles.
- Bronchial arteries supply oxygenated blood to the lungs, tracheobronchial tree, lymph nodes, nerves, portions of the esophagus, and pleura.
- Alveolar cells: Type 1 pneumocytes (95% of surface, non-reproducible), Type 2 pneumocytes (5% of surface, produce surfactant, able to reproduce), Type 3 macrophages (clean up bacteria and pathogens).
- Endotracheal tube should be positioned 2-5 cm above the carina.
- The carina is the area between the two bronchi at the lower trachea.
Lymphatic, Vascular, and Pleural Considerations
- Beta-2 receptor stimulation in lungs causes bronchodilation by relaxing airway muscles.
- Abnormal pleural conditions: Pleurisy (inflammation), pleural effusion (fluid accumulation), empyema (infected fluid), and pleural friction rub (sounds from pleural layers rubbing).
- Accessory muscles of inspiration: scalene, sternocleidomastoid, external intercostals, trapezius.
- Accessory muscles of expiration: abdominal muscles, internal intercostals.
- Pulmonary circulation: blood picks up oxygen in lungs and returns to heart; systemic circulation delivers oxygen to body while collecting CO2.
- Elastance refers to the lungs' ability to return to original shape; high elastance equals low compliance (stiff lungs), while low elastance equals high compliance (easily stretchable lungs).
- Static compliance measures unstretched lungs, while dynamic compliance measures stretched lungs.
- Ventilation moves gases between the environment and alveoli; barometric pressure at sea level is 760 mm Hg.
- Tension pneumothorax leads to vital sign changes such as increased heart rate, tachypnea, hypotension, hypoxia, tracheal deviation, and jugular vein distension.
- Surface tension causes liquid molecules to attract each other; surfactant produced by type 2 cells reduces this surface tension in alveoli.
- Surfactant deficiency conditions include RDS, ARDS, pneumonia, pulmonary lavage, and pulmonary embolism.
- LaPlace's law relates surface tension to alveoli radius and distending pressure, influencing lung mechanics.
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