RCP 110 Anatomy and Physiology Exam I Study Guide

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.