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Questions and Answers
What primary function do the upper airways NOT perform?
What primary function do the upper airways NOT perform?
Which condition could lead to nasal flaring?
Which condition could lead to nasal flaring?
Where might an endotracheal tube end up if improperly positioned?
Where might an endotracheal tube end up if improperly positioned?
What is the role of the epiglottis?
What is the role of the epiglottis?
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Which treatment option is NOT recommended for post-extubation laryngeal edema?
Which treatment option is NOT recommended for post-extubation laryngeal edema?
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Croup can be differentiated from epiglottitis based on which factor?
Croup can be differentiated from epiglottitis based on which factor?
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Which layer is NOT part of the tracheobronchial tree?
Which layer is NOT part of the tracheobronchial tree?
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In cases where the mucociliary transport mechanism is compromised, what reflex should patients avoid suppressing?
In cases where the mucociliary transport mechanism is compromised, what reflex should patients avoid suppressing?
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Which method is least likely to help mobilize and expectorate bronchial secretions?
Which method is least likely to help mobilize and expectorate bronchial secretions?
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What is the primary role of the carina in the respiratory system?
What is the primary role of the carina in the respiratory system?
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What effect does stimulation of beta 2 receptors in the lungs induce?
What effect does stimulation of beta 2 receptors in the lungs induce?
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Which condition is characterized by an accumulation of fluid in the pleural cavity?
Which condition is characterized by an accumulation of fluid in the pleural cavity?
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What is defined as the process that moves gases between the external environment and the alveoli?
What is defined as the process that moves gases between the external environment and the alveoli?
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Which muscles are primarily engaged during expiration?
Which muscles are primarily engaged during expiration?
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What is the barometric pressure at sea level, measured in mm HG?
What is the barometric pressure at sea level, measured in mm HG?
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What physiological change occurs during inspiration?
What physiological change occurs during inspiration?
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What is the primary difference between pulmonary and systemic circulation concerning gas exchange?
What is the primary difference between pulmonary and systemic circulation concerning gas exchange?
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What defines elastance in the context of lung function?
What defines elastance in the context of lung function?
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Which of the following vital sign changes is NOT associated with tension pneumothorax?
Which of the following vital sign changes is NOT associated with tension pneumothorax?
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Which cell type in the alveoli cannot reproduce?
Which cell type in the alveoli cannot reproduce?
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What is the primary function of surfactant produced by type 2 alveolar cells?
What is the primary function of surfactant produced by type 2 alveolar cells?
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How do high elastance and low compliance compare in the functionality of the lungs?
How do high elastance and low compliance compare in the functionality of the lungs?
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What consequence does dehydration have on cilia function?
What consequence does dehydration have on cilia function?
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At what level of the tracheobronchial tree are cilia absent?
At what level of the tracheobronchial tree are cilia absent?
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What condition is characterized by a deficiency of surfactant?
What condition is characterized by a deficiency of surfactant?
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What distinguishes static compliance from dynamic compliance in lung measurement?
What distinguishes static compliance from dynamic compliance in lung measurement?
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Which airway structure is not considered cartilaginous?
Which airway structure is not considered cartilaginous?
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What does LaPlace's law describe concerning the relationship between surface tension and alveolar size?
What does LaPlace's law describe concerning the relationship between surface tension and alveolar size?
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Which of the following conditions would create a pleural friction rub?
Which of the following conditions would create a pleural friction rub?
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Which of the following can result in jugular vein distension?
Which of the following can result in jugular vein distension?
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What is the main function of Type 2 pneumocytes within the alveoli?
What is the main function of Type 2 pneumocytes within the alveoli?
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What occurs at the end of expiration regarding diaphragm movement?
What occurs at the end of expiration regarding diaphragm movement?
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What effect does positive pressure ventilation have on cilia?
What effect does positive pressure ventilation have on cilia?
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Which layer of the mucous blanket is closer to the lumenal surface?
Which layer of the mucous blanket is closer to the lumenal surface?
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Anxiety and confusion in a patient are likely results of which condition related to breathing?
Anxiety and confusion in a patient are likely results of which condition related to breathing?
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How many segmental bronchi are found in the left lung?
How many segmental bronchi are found in the left lung?
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What happens when mast cells in the lamina propria are activated?
What happens when mast cells in the lamina propria are activated?
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Where should the tip of an endotracheal tube be positioned relative to the carina?
Where should the tip of an endotracheal tube be positioned relative to the carina?
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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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Description
This study guide focuses on the anatomy and functions of the upper airways, including the components such as the nose, oral cavity, larynx, and pharynx. It also covers clinical conditions like nasal flaring associated with respiratory distress. Prepare effectively for your RCP 110 exam with this comprehensive overview.
