RCP 110 Anatomy and Physiology Exam I Study Guide

Upper Airways

• Primary components include the nose, oral cavity, larynx, and pharynx, essential for speech, smell, humidification, and protection against foreign objects.
• Nasal flaring indicates respiratory distress, common in conditions like asthma and pneumonia, where increased airway resistance occurs.
• Malpositioned Endotracheal (ET) tubes may enter the esophagus instead of the trachea during intubation.
• The epiglottis prevents aspiration by covering the trachea during swallowing.
• The larynx connects the pharynx to the trachea, prevents solid/liquid aspiration, and assists in sound generation.
• Post-extubation laryngeal edema results from trauma at the vocal cords, treated with aerosolized racemic epinephrine and high humidification.
• Croup is caused by viral infection leading to tracheal and laryngeal inflammation; epiglottitis is a bacterial infection causing severe swelling and airway obstruction.

Lower Airways

• Cough reflex suppression should be avoided to maintain mucociliary transport if compromised.
• Respiratory therapies for bronchial secretion mobilization include chest physiotherapy, cough exercises, flutter devices, and suctioning.
• The tracheobronchial tree comprises three layers: epithelial, lamina propria, and cartilaginous.
• Mast cells in the lamina propria release mediators, influencing bronchial airway diameter.
• The mucous blanket consists of 95% water and 5% glycoproteins, carbohydrates, lipids, and cellular debris, with gel and sol layers aiding in movement.
• Cilia are absent in terminal bronchioles, located between the 16th and 19th generations.
• Factors affecting mucociliary function include cigarette smoke, dehydration, positive pressure ventilation, endotracheal suctioning, and high FiO2.

Lung Anatomy and Blood Supply

• The right lung has 10 segmental bronchi; the left lung has 8.
• Non-cartilaginous airways are bronchioles and terminal bronchioles.
• Bronchial arteries supply oxygen to lungs, tracheobronchial tree, lymph nodes, nerves, and parts of the esophagus and pleura.
• Types of alveolar cells:
  • Type 1 pneumocytes (95% of surface, non-replicable)
  • Type 2 pneumocytes (5% of surface, produce surfactant, replicate)
  • Type 3 alveolar macrophages (remove pathogens).
• ET tube tip should sit 2-5 cm above the carina, the tracheal cartilage part where bronchi bifurcate.

Lung Mechanics and Circulation

• Beta-2 receptor stimulation leads to bronchodilation, relaxing airway musculature.
• Mediastinal structures include the apex, base, and hilum of the lung.
• Abnormal pleural conditions:
  • Pleurisy: inflammation causing pain
  • Pleural effusion: fluid accumulation
  • Empyema: infected fluid accumulation
  • Pleural friction rub: sound from pleural surface friction.
• Accessory muscles:
  • Inspiration: Scalene, Sternocleidomastoid, External Intercostals, Trapezius
  • Expiration: Abdominal muscles, Internal intercostals.

Circulatory Functions and Mechanics

• Pulmonary circulation moves blood from the heart to lungs for oxygenation; returns with reduced CO2.
• Systemic circulation distributes oxygenated blood to the body and collects CO2, returning deoxygenated blood.
• Elastance describes lung ability to return to original shape; compliance reflects ease of expansion.
• High elastance correlates with low compliance (stiff lungs), and low elastance correlates with high compliance (easy to expand).
• Static compliance measures non-moving lung volume; dynamic compliance measures moving lung volume.
• Ventilation is the gas exchange process between the environment and alveoli.
• Barometric pressure at sea level is 760 mm Hg; inspiration decreases pressure while expiration increases it.
• Tension pneumothorax leads to increased heart rate, respiratory rate, low blood pressure, hypoxia, tracheal deviation, and jugular vein distension.
• Surface tension is influenced by surfactant, produced by type 2 alveolar cells; deficiency conditions include RDS, ARDS, and lung inflammation.
• LaPlace's law relates surface tension, distending pressure, and radius, impacting alveolar stability.

This study guide covers key topics from the RCP 110 course, focusing on the anatomy and physiology of the upper airways. It includes components such as the nose, oral cavity, larynx, and pharynx, as well as their functions in respiration and speech. Additionally, it addresses conditions leading to nasal flaring during respiratory distress.