100% Correct
From the atmosphere, what structures does air pass through during ventilation? - Starts 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? - To warm/humidify air as it
passes through
What is the difference between respiration and ventilation? - Respiration 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? - nose, mouth, tongue, jaw, pharynx and
larynx
What structure is considered a landmark that divides the upper airway from lower? - The
larynx, anything above is upper. The larynx and below are lower.
What are the structures of the lower airways? - larynx (includes adam's apple/thyroid
cartilage, cricothyroid membrane, cricoid cartilage), trachea, bronchi, bronchioles, alveoli
Describe the anatomy of the larynx. - From 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. - False, 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? - bronchioles, and alveoli
True or false: the lungs use muscles found in the lateral lobes to expand and contract? -
False: 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. - True, 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. - False: 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? - The diaphragm, cervical muscles (neck),
intercostals, abdominal muscles, and pectoral muscles.
What muscles are involved in expiration? - none, 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?) - The
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? - Backup 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? - medulla-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 - True 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? - amount of air moved in/out of lungs in single breath. Usually
500 ml in adult
What is inspiratory reserve volume? - Deepest breath you can take after normal respiration
What is expiratory reserve volume/Vital Capacity? - maximum amount you can breathe out
after normal breath.
What is residual volume? - Remaining gas in lungs after exhalation. This is to keep lungs
inflated
,What is dead space? What structures are considered part of dead space? - Part 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? - Minute 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 - Volume of air moved through lungs in 1 minute minus the dead
space. Alveolar Minute Volume = (tidal volume - dead space) x RR
Alveolar Ventilation - Volume of air that reaches alveoli.
Alveolar ventilation = tidal volume - dead space
Name the characteristics of normal breathing - 1. 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)? - Chapter 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? - Pt 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? - location-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? - location-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? - location - lungs (beta-2 is
beta-tube)
effect - bronchodilation (more air enters lungs)
Where are the muscarinic receptors located? What is their effect? - location - 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? - Epineprhine 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? - Study of how normal physiologic processes are affected by
disease
What is respiratory compromise? - Inability of body to move gas effectively. Can result in
decreased O2 (hypoxia) and increased CO2 (hypercarbia)
What factors can impair ventilation? - 1. Obstruction
a. foreign objects - toys, food, teeth tongue etc
b. physiological - induced by asthma, allergic rxns, infection
2. Impairment
a. brain injury - to medulla/pons
b. breathing muscles - diaphragm,
c. nerves - neuromuscular disease like cerebral palsy can affect phrenic nerve
3. Other factors
a. drugs - opioids can reduce RR
b. loss of consciousness - can cause impaired ventilation