FISDAP Airway With Complete Solution

FISDAP Airway With Complete Solution From the atmosphere, what structures does air pass through during ventilation? - correct answerStarts in atmosphere, then nose, nasopharyngeal space/orophargyneal space (if mouth breather), then pharynx, larynx, trachea, bronchi, bronchioles, alveoli What is the purpose of the nasal passages and nasopharynx? - correct answerTo warm/humidify air as it passes through What is the difference between respiration and ventilation? - correct answerRespiration refers to the exchange of gases in the alveoli, ventilation refers to the movement of air into the lungs. Respiration is needed to provide O2 to cells and remove waste products. Also regulates pH of blood. What are the structures of the upper airway? - correct answernose, mouth, tongue, jaw, pharynx and larynx What structure is considered a landmark that divides the upper airway from lower? - correct answerThe larynx, anything above is upper. The larynx and below are lower. What are the structures of the lower airways? - correct answerlarynx (includes adam's apple/thyroid cartilage, cricothyroid membrane, cricoid cartilage), trachea, bronchi, bronchioles, alveoli Describe the anatomy of the larynx. - correct answerFrom superior to inferior. Thyroid cartilage, cricothyroid membrane, and cricoid membrane. The thyroid cartilage and cricoid cartilage are anterior to the larynx, and the cricothyroid membrane is posterior to both structures. True or false: the lungs are completely equal in the midsaggital plane. - correct answerFalse, right lungs has 3 lobes, left lung only has 2 lobes. Together they have 5 total. Also, the right bronchi is inferior to the left bronchi. What are the structures of the lungs in order of ventilation? - correct answerbronchioles, and alveoli True or false: the lungs use muscles found in the lateral lobes to expand and contract? - correct answerFalse: the lungs are hollow organs and contain no muscles. When the diaphragm contracts it expands the thoracic cavity. The pleural space has a negative pressure and the lungs expand. This results in a slightly negative pressure (compared to the atmosphere) and air rushes in. True or false: Air rushes into the lungs because of negative pressure. - correct answerTrue, when the lungs expand, they are creating a vacuum because they are expanding the volume of the container. This increase in volume causes influx of air into the container until the pressure is equalized with the atmosphere. True or false: The parietal pleura lines the lungs and the visceral pleura lines the lungs. The space between is called the anterior pleura. - correct answerFalse: the visceral pleura lines the lungs, the parietal pleura lines the body cavity and the pleural space is the space in between both where body fluid allows for both to smoothly glide. What muscles are involved in inhalation? - correct answerThe diaphragm, cervical muscles (neck), intercostals, abdominal muscles, and pectoral muscles. What muscles are involved in expiration? - correct answernone, expiration (if done passively) is achieved by the relaxation of the diaphragm. What is the primary driver of respiration? (Why would we increase/decrease RR?) - correct answerThe CSF in the brain has chemoreceptors sensitive to CO2. When there is too much CO2. The pH changes. These sensors feed back to the medulla oblongata, which stimulates the phrenic nerve which innervates the diaphragm. They cause an increase in activity of the diaphragm. This increases the RR which causes us to increase tidal volume. This means more CO2 is exhaled. And brings our pH back to normal. We also have the less sensitive hypoxic drive What is hypoxic drive? - correct answerBackup system to control respiration. Chemoreceptors in brain, aorta, and carotid arteries. But they are "satisfied" by a small amount of O2, which means it is not as sensitive as pH control of CO2 What two areas of the brain are involved in respiration? - correct answermedulla-controls rhythm, initiates inspiration, sets base pattern for respirations, and stimulates diaphragm to contract. pons-changes depth of inspiration, expiration or both. True or false: arteries bring oxygenated blood to organs/capillaries - correct answerTrue in most cases with one exception. Arteries (away) bring blood away from the heart. Usually this is oxygenated blood. But the pulmonary arteries bring oxygen poor blood away from the heart, to the lungs to be oxygenated. What is the tidal volume? - correct answeramount of air moved in/out of lungs in single breath. Usually 500 ml in adult What is inspiratory reserve volume? - correct answerDeepest breath you can take after normal respiration What is expiratory reserve volume/Vital Capacity? - correct answermaximum amount you can breathe out after normal breath. What is residual volume? - correct answerRemaining gas in lungs after exhalation. This is to keep lungs inflated What is dead space? What structures are considered part of dead space? - correct answerPart of respiratory system not involved in active respiration. Air moves through here but little to no respiration occurs. Mouth, trachea, bronchi and bronchioles considered dead space What is minute volume? What does it measure? - correct answerMinute volume = RR x tidal volume. Volume of air moving through lungs in 1 minute. Can be estimated quickly. Count RR rate. If normal check to see chest rise and fall (tidal volume). If chest rise and fall is weak and/or little air coming out of nose, then the person has small minute volume. Alveolar Minute Volume - correct answerVolume of air moved through lungs in 1 minute minus the dead space. Alveolar Minute Volume = (tidal volume - dead space) x RR Alveolar Ventilation - correct answerVolume of air that reaches alveoli. Alveolar ventilation = tidal volume - dead space Name the characteristics of normal breathing - correct answer1. Normal rate (12-20) 2. regular pattern of inhalation/exhalation 3. clear bilateral lung sounds 4. regular and equal chest rise/fall 5. adequate depth (tidal volume) What are the characteristics of inadequate breathing (adults)? - correct answerChapter 6 1. labored breathing (activating accessory muscles of respiration) 2. 12 or 20 breaths/minute 3. muscle retractions above clavicles or between ribs and below rib cage 4. pale/cyanotic skin 5. cool, damp, clammy skin 6. tripod position Chapter 10 1. 12 or 20 2. irregular rhythm 3. diminished, absent or noisy auscultated breath sounds 4. reduced flow of expired air at nose/mouth 5. unequal or inadequate chest expansion 6. labored breathing 7. shallow depth 8. pale, cyanotic, cool or moist skin 9. retractions around ribs or above clavicles What are agonal gasps? What should you do if a pt has agonal gasps? - correct answerPt in cardiac arrest has occasional gasping breaths because respiratory center in brain continues to send signals to breathing muscles. Artificial ventilations and chest compressions. Where are the alpha-1 receptors located? What is their effect? - correct answerlocation-blood vessels constricted blood vessels, skin is pale, cool, clammy They essentially increase BP Where are the Beta-1 receptors located? What is their effect? - correct answerlocation-heart effect- increased HR, increased force of contraction They essentially increase CO since CO = HR x SV Where are the Beta-2 receptors located? What is their effect? - correct answerlocation - lungs (beta-2 is beta-tube) effect - bronchodilation (more air enters lungs) Where are the muscarinic receptors located? What is their effect? - correct answerlocation - heart effect - decreased HR, decreased force of contraction Muscarinic is parasympathetic system and do complete opposite of Beta-1 which is sympathetic What hormones activate the sympathetic nervous system? - correct answerEpineprhine and norepineprhine, which are released from he adrenal gland after stimulation by the sympathetic nervous system. These hormones stimulate heart and blood vessels. What is pathophysiology? - correct answerStudy of how normal physiologic processes are affected by disease What is respiratory compromise? - correct answerInability of body to move gas effectively. Can result in decreased O2 (hypoxia) and increased CO2 (hypercarbia)