Podcast
Questions and Answers
Which of the following is NOT a primary function of the upper airways?
Which of the following is NOT a primary function of the upper airways?
What causes nasal flaring in patients?
What causes nasal flaring in patients?
If an endotracheal tube is improperly positioned, where can it end up?
If an endotracheal tube is improperly positioned, where can it end up?
Which structure primarily prevents aspiration during swallowing?
Which structure primarily prevents aspiration during swallowing?
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What should patients avoid suppressing if the mucociliary transport mechanism is compromised?
What should patients avoid suppressing if the mucociliary transport mechanism is compromised?
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What are the three layers of the tracheobronchial tree?
What are the three layers of the tracheobronchial tree?
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Which therapist modality is NOT typically used to mobilize and expectorate bronchial secretions?
Which therapist modality is NOT typically used to mobilize and expectorate bronchial secretions?
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What treatment is indicated for post-extubation laryngeal edema?
What treatment is indicated for post-extubation laryngeal edema?
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Croup is characterized by which of the following?
Croup is characterized by which of the following?
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What distinguishes epiglottitis from croup?
What distinguishes epiglottitis from croup?
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What is the primary physiological role of mast cells in the lamina propria?
What is the primary physiological role of mast cells in the lamina propria?
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Which of the following statements about the mucous blanket layers is correct?
Which of the following statements about the mucous blanket layers is correct?
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At what point in the tracheobronchial tree is cilia absent?
At what point in the tracheobronchial tree is cilia absent?
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What factor can cause paralysis of cilia, thereby impacting the mucociliary transport mechanism?
What factor can cause paralysis of cilia, thereby impacting the mucociliary transport mechanism?
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How many segmental bronchi does the left lung have?
How many segmental bronchi does the left lung have?
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Which airways are classified as non-cartilaginous?
Which airways are classified as non-cartilaginous?
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What is the role of type 2 pneumocytes in the alveoli?
What is the role of type 2 pneumocytes in the alveoli?
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What is the recommended position for the tip of an endotracheal tube in relation to the carina?
What is the recommended position for the tip of an endotracheal tube in relation to the carina?
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Which type of alveolar cells are responsible for removing bacteria?
Which type of alveolar cells are responsible for removing bacteria?
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Positive pressure ventilation can cause damage to which structure?
Positive pressure ventilation can cause damage to which structure?
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What is the carina of the trachea?
What is the carina of the trachea?
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What occurs when beta 2 receptors in the lungs are stimulated?
What occurs when beta 2 receptors in the lungs are stimulated?
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Which condition is characterized by inflammation of the pleura?
Which condition is characterized by inflammation of the pleura?
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Which accessory muscle is primarily involved in inspiration?
Which accessory muscle is primarily involved in inspiration?
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What is the primary function of pulmonary circulation?
What is the primary function of pulmonary circulation?
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How does elastance relate to lung compliance?
How does elastance relate to lung compliance?
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Which of the following abnormalities involves fluid accumulation in the pleural cavity?
Which of the following abnormalities involves fluid accumulation in the pleural cavity?
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Which accessory muscle is NOT involved in expiration?
Which accessory muscle is NOT involved in expiration?
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Which statement correctly describes systemic circulation?
Which statement correctly describes systemic circulation?
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What is static compliance?
What is static compliance?
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What occurs during inspiration in terms of diaphragm movement and intra-plural pressure?
What occurs during inspiration in terms of diaphragm movement and intra-plural pressure?
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Which vital sign changes are associated with a tension pneumothorax?
Which vital sign changes are associated with a tension pneumothorax?
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What is the role of surfactant in the lungs?
What is the role of surfactant in the lungs?
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What produces surfactant in the lungs?
What produces surfactant in the lungs?
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Which condition is NOT associated with surfactant deficiency?
Which condition is NOT associated with surfactant deficiency?
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According to LaPlace's law, how is the distending pressure related to surface tension and alveolar radius?
According to LaPlace's law, how is the distending pressure related to surface tension and alveolar radius?
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What psychological response is likely to occur during a tension pneumothorax?
What psychological response is likely to occur during a tension pneumothorax?
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What happens to the diaphragm at the end of expiration?
What happens to the diaphragm at the end of expiration?
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What is the measurement of barometric pressure at sea level?
What is the measurement of barometric pressure at sea level?
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How does expiration differ from inspiration regarding pressure changes?
How does expiration differ from inspiration regarding pressure changes?
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Study Notes
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.
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Description
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.