Questions and Answers
What type of cells in the lamina propria release substances that alter bronchial airway diameter?
Which layer of the mucous blanket lies closer to the lumenal surface?
At which level of the tracheobronchial tree are cilia absent?
What effect does cigarette smoke have on cilia in the respiratory system?
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How many segmental bronchi are found in the right lung?
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Which of the following structures is nourished by bronchial arteries?
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What percentage of the alveolar surface is made up of Type 1 pneumocytes?
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How far above the carina should the tip of an endotracheal tube be placed?
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What are the primary functions of the upper airways?
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Nasal flaring during respiratory distress is primarily caused by which of the following conditions?
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When an endotracheal tube is malpositioned, where can it incorrectly end up?
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Which laryngeal cartilage prevents aspiration of food and liquids?
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What is the primary function of the larynx?
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How is post-extubation laryngeal edema typically treated?
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Which condition is characterized by a viral infection causing inflammation of the trachea and larynx?
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What should patients avoid suppressing if the mucociliary transport mechanism is compromised?
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What is the carina of the trachea?
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What effect does stimulation of beta 2 receptors in the lungs have?
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What is pleurisy?
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Which of the following is an accessory muscle of expiration?
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What characterizes pulmonary circulation?
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What does high elastance in lung tissue indicate?
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What is ventilation?
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What is the barometric pressure at sea level?
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What happens to the diaphragm during inspiration?
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What physiological change occurs at the end of expiration?
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What effect does a tension pneumothorax have on heart rate?
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Which cells are responsible for producing surfactant?
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What is the relationship described by LaPlace's Law?
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What is a condition that can lead to surfactant deficiency?
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How does the pressure change during expiration?
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Which characteristic is NOT associated with tension pneumothorax?
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Study Notes
Upper Airways
- Primary components: nose, oral cavity, larynx, pharynx; essential for speech, smell, humidifying, and temperature control of inhaled air.
- Nasal flaring indicates respiratory distress, linked to conditions like asthma and pneumonia, which increase airway resistance.
- Improper endotracheal tube positioning can result in esophageal placement instead of the trachea.
- The epiglottis prevents aspiration of food and liquids by covering the trachea during swallowing.
- The larynx functions as an airway passage, prevents aspiration, and generates speech sounds.
- Post-extubation laryngeal edema treatment: aerosolized racemic epinephrine, high humidity, voice rest, and cough medications.
- Croup is a viral infection causing inflammation of the trachea and larynx; epiglottitis is a bacterial infection causing epiglottis swelling and airway obstruction.
Lower Airways
- Patients should not suppress the cough reflex, crucial for clearing secretions if the mucociliary mechanism is compromised.
- Respiratory therapies include chest physiotherapy, flutter valves, breathing exercises, and suctioning to aid secretion mobilization.
- Three layers of the tracheobronchial tree: epithelial, lamina propria, cartilaginous layer.
- Lamina propria contains mast cells that release mediators affecting bronchial airway diameter.
- Mucous blanket layers:
- Gel layer: viscous, near lumen surface.
- Sol layer: thinner, adjacent to epithelial lining.
- Cilia are absent in terminal bronchioles (16th to 19th generations).
- Factors impairing mucociliary transport: cigarette smoke, dehydration, positive pressure ventilation, endotracheal suctioning, high FiO2 levels.
- The cartilaginous airways are referred to as the conducting zone.
- Right lung has 10 segmental bronchi; left lung has 8 segments.
- Non-cartilaginous airways include bronchioles and terminal bronchioles.
- Bronchial arteries nourish lung structures, including the tracheobronchial tree and parts of the pleura and esophagus.
- Types of alveolar cells:
- Type 1 pneumocytes: 95% surface area, non-reproducible.
- Type 2 pneumocytes: produce surfactant and can replicate.
- Type 3 alveolar macrophages: eliminate pathogens.
Key Structures and Measurements
- Endotracheal tube should sit 2-5 cm above the carina of the trachea.
- Carina: cartilage junction at the lowest trachea, separating the bronchi.
Lymphatic, Vascular, Pleura
- Stimulation of beta-2 receptors leads to bronchodilation via airway muscle relaxation.
- Accessory muscles of inspiration: scalene, sternocleidomastoid, external intercostals, trapezius; expiration: abdominal muscles, internal intercostals.
- Differences between pulmonary and systemic circulation:
- Pulmonary: heart to lungs (oxygen uptake, CO2 release); returns oxygenated blood to the heart.
- Systemic: heart to body (oxygen delivery, CO2 collection); returns deoxygenated blood to the heart.
- Elastance reflects lung stiffness; high elastance denotes low compliance (difficult to inflate), while low elastance indicates high compliance (easier to expand).
Ventilation and Pressures
- Ventilation: gas exchange between the external environment and alveoli.
- Barometric pressure at sea level: 760 mm Hg or 1033 cm H2O.
- Pressure changes during respiratory phases:
- Inspiration: pressure decreases; diaphragm descends.
- End-inspiration: pressures stabilize; diaphragm movement halts.
- Expiration: pressure increases; diaphragm ascends.
- End-expiration: pressure stabilizes; diaphragm movement stops.
Tension Pneumothorax
- Physiologic response: increased heart rate, decreased breath sounds, tracheal deviation, diminished cardiac output, decreased blood pressure, and confusion.
Surface Tension and Surfactant
- Surface tension defined as the resistance of a liquid surface, modified by surfactant produced by type II pneumocytes.
- Surfactant deficiency conditions include infant respiratory distress syndrome and atelectasis.
- LaPlace's Law: describes the relationship between surface tension and radius in maintaining distending pressure within liquid spheres in the lungs.
Labeling
- Able to identify the visceral pleura, parietal pleura, and pleural cavity/space as part of lung anatomy.
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Description
Prepare for your RCP 110 anatomy and physiology exam with this comprehensive study guide. Focus on the components and functions of the upper airways, including the nose, oral cavity, larynx, and pharynx. Understand key concepts such as the role of these structures in airflow and their importance in speech and smell.
