RCP 110 Anatomy and Physiology Exam I Study Guide

Questions and Answers

Which of the following is NOT a primary function of the upper airways?

Prevent foreign objects from entering the tracheobronchial tree

Contribute to speech and smell

Facilitate the exchange of oxygen and carbon dioxide (correct)

Humidify and cool inhaled air

What causes nasal flaring in patients?

Decreased lung compliance

Enhanced airflow through the nasal passages

Widening of the nostrils during respiratory distress (correct)

Increased nasal congestion

If an endotracheal tube is improperly positioned, where can it end up?

In the trachea

In the pharynx

In the esophagus (correct)

In the right main bronchus

Which structure primarily prevents aspiration during swallowing?

Epiglottis Signup and view all the answers

What should patients avoid suppressing if the mucociliary transport mechanism is compromised?

Cough reflex Signup and view all the answers

What are the three layers of the tracheobronchial tree?

Epithelial, lamina propria, and cartilaginous layers Signup and view all the answers

Which therapist modality is NOT typically used to mobilize and expectorate bronchial secretions?

Application of cold compresses Signup and view all the answers

What treatment is indicated for post-extubation laryngeal edema?

Aerosolized racemic epinephrine Signup and view all the answers

Croup is characterized by which of the following?

Viral infection with trachea and larynx inflammation Signup and view all the answers

What distinguishes epiglottitis from croup?

Epiglottitis causes swelling of the epiglottis and can lead to airway obstruction Signup and view all the answers

What is the primary physiological role of mast cells in the lamina propria?

To release substances that alter bronchial airway diameter Signup and view all the answers

Which of the following statements about the mucous blanket layers is correct?

The sol layer lies next to the epithelial lining. Signup and view all the answers

At what point in the tracheobronchial tree is cilia absent?

Between the 16th and 19th generations Signup and view all the answers

What factor can cause paralysis of cilia, thereby impacting the mucociliary transport mechanism?

Cigarette smoke Signup and view all the answers

How many segmental bronchi does the left lung have?

8 Signup and view all the answers

Which airways are classified as non-cartilaginous?

Bronchioles and terminal bronchioles Signup and view all the answers

What is the role of type 2 pneumocytes in the alveoli?

They produce pulmonary surfactant Signup and view all the answers

What is the recommended position for the tip of an endotracheal tube in relation to the carina?

2-5 cm above carina Signup and view all the answers

Which type of alveolar cells are responsible for removing bacteria?

Type 3 alveolar macrophages Signup and view all the answers

Positive pressure ventilation can cause damage to which structure?

Cilia Signup and view all the answers

What is the carina of the trachea?

The ridge at the lowest part of the trachea between the bronchi Signup and view all the answers

What occurs when beta 2 receptors in the lungs are stimulated?

Relaxation of airway musculature and bronchodilation Signup and view all the answers

Which condition is characterized by inflammation of the pleura?

Pleurisy Signup and view all the answers

Which accessory muscle is primarily involved in inspiration?

Scalene muscles Signup and view all the answers

What is the primary function of pulmonary circulation?

Transport deoxygenated blood to the lungs Signup and view all the answers

How does elastance relate to lung compliance?

High elastance equals low lung compliance Signup and view all the answers

Which of the following abnormalities involves fluid accumulation in the pleural cavity?

Pleural effusion Signup and view all the answers

Which accessory muscle is NOT involved in expiration?

Sternocleidomastoid Signup and view all the answers

Which statement correctly describes systemic circulation?

Delivers oxygen to body cells and collects CO2 Signup and view all the answers

What is static compliance?

Compliance assessed when lungs are not moving Signup and view all the answers

What occurs during inspiration in terms of diaphragm movement and intra-plural pressure?

Pressure decreases and diaphragm moves downward. Signup and view all the answers

Which vital sign changes are associated with a tension pneumothorax?

Tachycardia and hypotension. Signup and view all the answers

What is the role of surfactant in the lungs?

To reduce surface tension, preventing alveolar collapse. Signup and view all the answers

What produces surfactant in the lungs?

Type 2 alveolar cells. Signup and view all the answers

Which condition is NOT associated with surfactant deficiency?

Chronic bronchitis. Signup and view all the answers

According to LaPlace's law, how is the distending pressure related to surface tension and alveolar radius?

Distending pressure is inversely proportional to radius and directly proportional to surface tension. Signup and view all the answers

What psychological response is likely to occur during a tension pneumothorax?

Anxiety and panic due to difficulty breathing. Signup and view all the answers

What happens to the diaphragm at the end of expiration?

Diaphragm movement stops and pressure increases. Signup and view all the answers

What is the measurement of barometric pressure at sea level?

760 mm HG. Signup and view all the answers

How does expiration differ from inspiration regarding pressure changes?

Pressure increases and diaphragm moves upward. Signup and view all the answers

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.