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TEX Respiratory Rev
| Question | Answer |
|---|---|
| External Respiration | also called breathing; is the exchange of oxygen and CO2 between the lung and the environment |
| Inhaled Air | is warmed, moistened, and filtered to prepare it for work by the body |
| Respiratory and Cardiovascular System work together to | deliver oxygen to the cells, where energy is provided needed to carry out metabolism |
| Internal Respiration | exchange of oxygen and CO2 at the cellular level; O2 enters the cells while CO2 leaves |
| Blood Stream plays role of | transporter of the oxygen to necessary places |
| Failure of Resp or Cardio System results in | rapid cell death from oxygen starvation |
| Air enters respiratory tract through | the nose where the air is filtered, moistened, and warmed |
| Nares | two nasal openings that air enters first |
| From the nose and nares air enters into | the nasal cavity |
| Nasal Septum | Separates the nares; lined with vascular mucous membrane providing warmth and moisture needed |
| Nasal Septum secretes about | a liter of moisture every day |
| Turbinates OR Conchae | three scroll-like bones lateral to the nasal cavity; cause air to move over a larger surface area; allows more time for warming and moisturizing |
| Tiny hairs lining the nasal cavities | trap dust and other foreign particles and prevent them from entering the lower respiratory tract |
| 4 Paranasal Sinuses | frontal, maxillary, sphenoid, and ethmoid cavities |
| Frontal Cavity | first of 4 paranasal sinuses |
| Maxillary Cavity | Second of 4 paranasal sinuses |
| Sphenoid Cavity | Third of 4 paranasal sinuses |
| Ethmoid Cavity | Fourth of 4 paranasal sinuses |
| 4 Paranasal Sinuses do what | communicate with the nasal structures and are hollow places that make the skull lighter |
| 4 Paranasal Sinuses are lined | with mucous membranes like the nasal cavity |
| Nasal Infections can cause | sinusitis which is uncomfortable and hard to treat |
| Mucosa | of the nasal cavities; where the receptors for the sense of smell are located |
| Mucosa of the nasal cavities are | the nerve endings of the olfactory nerve, the first cranial nerve |
| Olfactory Nerve | The first cranial nerve |
| Nasolacrimal Ducts | tear ducts; communicate with the upper nasal chamber |
| When you cry what happens? | copious nasal secretions occur |
| pharynx (or throat) | tubular structure about 5 in (13 cm) long extending from the base of the skull to the esophogus and situated just in front of the vertebrae |
| Pharynx is the passageway for | food and air |
| pharynx is divided into | three subdivisions: nasopharynx, oropharanyx, and laryngopharynx |
| nasopharynx | 1st of three subdivisons of the pharynx; the mst superior portion |
| oropharynx | 2nd of three divisions of pharynx; posterior to mouth |
| laryngopharynx | 3rd of three subdivisions of pharynx; directly superior to larynx |
| Eustachian tubes enter on | either side of the nasopharynx, connecting it to the middle ear |
| Because inner lining of pharynx and eustatian tube are continuous | an infection in the pharynx can spread easily to the ear; common in children |
| adenoids | pharyngeal tonsils in the nasopharynx |
| palatine tonsils | located in the oropharynx |
| larynx | organ of voice is supported by nine areas of cartilage and connects the pharynx with the trachea |
| thyroid cartilage | or Adam's Apple; largest area of cartilage supporting the larynx composed of two fused plates |
| Thyroid cartilage | or Adam's apple is same size in F and M until puberty and then enlarges in males |
| epiglottis | large leaf shaped area of cartilage that protects the larynx when swallowing; covers the larynx tightly to prevent food from entering the trachea and directs food to the esophogus |
| Vocal Cords | contained in the pharynx; air rushes over vocal cords causing vibration, enables speech to occur |
| Glottis | opening between the vocal cords |
| trachea | OR windpipe; tubelike structure that extends about 5 in (11 cm) to the midchest where it divides into R and L bronchi; anterior to the esophogus, connects larynx with bronchi |
| Ventral (anterior) part of trachea | surface of this tube is covered in the neck by the isthmus (narrow connection) of the thyroid gland |
| Ventral (anterior) part of the trachea contains | C-shaped cartilaginous rings that keep it from collapsing |
| Open C-Rings in the trachea | lie posterior to the column anterior to the esophagus which allows esophagus to expand during swallowing while still maintaining the patency of the trachea; necessary for uninterrupted breathing |
| Cilia | small hairlike processes on the outer surface of small cells, aiding metabolism by producing motion or current in a fluid |
| Trachea is lined with | mucuos membranes and cilia that sweep dust or debris upward toward the nasal cavity; large particles cause cough reflex |
| tracheostomy | surgical opening into the trachea through which an indwelling tube may be inserted; patient then breathes through the opening, rather than the nose; below the larynx so patient can't speak |
| alveoli | sac-like structures resembling grapes, where gas exchange takes place |
| Each alveoli has | blood capillary where diffusion of blood and o2 takes place |
| surfacant | lubricant like covering of alveoli that prevents collapsing |
| R lung | weighs 625g |
| L lung | weighs 570g |
| Lungs receive blood from where? | recieve their blood supply directly from heart |
| Diffusion of CO2 occurs | between blood and lung capillaries and alveolar air |
| visceral pluera | thin moist serous membrane covering each lung |
| parietal pluera | thin , war, moist covening of the thoraic cavitity |
| plueral cavity | is air-tight and contain negative air pressure |
| plueral effusion | an accumulation of too much serous secretion in plueral space |
| when plueral effusion occurs | the plueral space isdistended and breathing is difficult |
| thoracentesis | ned-like instrument inserted into plueral cavity to excess fluid caused by plueral effusion |
| Inspiration lasts how long? | lasts 2 seconds |
| expiration lasts how long? | lasst 3 seconds |
| Room air contains what percent O2 | 21% o2 |
| exhaled air contains what percent O2/CO2 | 16.5% O2 and 3.5 co2 |
| Normal range of respiration | 14 to 20 per minute |
| respiration rate is affected by | sex, age, activity, disease,body temp |
| newborn respiration | 40 to 60 |
| medulla oblongata | responsible for basic rhthm |
| pons of the brain | control depth of respiration |
| Chemoreceptors | located in aorta and carotid |
| Chemoreceptors are sensistive to | blood CO2, decreasing blood level of o2,blood acid levels |
| CO2 is also know as | carbonic acid |
| The more co2 in blood the more | acidic the blood is |
| Ph for blood is | 7.35 to 7.45 |
| If deviation of PH occurs | patient develops acidosis or alkalosis |
| What organs does the Upper Respiratory Tract contain and where are they located? | The nose and nasal cavities, pharynx, larynx, and upper trachea and they are located outside the chest cavity. |
| What organs does the Lower Respiratory Tract contain and where are they located? | The lower trachea, bronchi, bronchioles, alveoli, and lungs and are located in the chest cavity. |
| Which parts of the Lower Respiratory Tract are located in the lungs? | The lower parts of the bronchi, bronchioles and alveoli |
| What are the tiny air sacs located at the end of the respiratory passages? | The alveoli |
| What is the partitian called that separates the nasal cavities into right and left halves? | nasal septum |
| The other name for throat? | Pharynx |
| What are the three parts of the Pharynx? | An upper section called the nasopharynx, a middle section called the oropharynx, and a lower section called the laryngopharynx. |
| Which parts of the Pharynx are part of both the digestive and respiratory systems and function as a passageway for both food and air? | The oropharynx and the laryngopharynx |
| The other name for Voice Box? | Larynx |
| What are the 3 functions of the Larynx? | It acts as a passageway for air during breathing; it produces sound, your voice (hence the name voicebox); and it prevents food and other foreign objects from entering the breathing structures (trachea). |
| What is Rhinorrhea? | A runny nose |
| What structure is made up of primarily of cartilage, muscles, and ligaments? | Larynx |
| Which structure, located at the top of the larynx, acts as a flap to cover the opening of the trachea during eating so food does not enter the lungs? | The epiglottis |
| What are the names for the two types of vocal cords? | True and False vocal cords. |
| Why are the false vocal cords called false? | Because they do not produce sounds. Instead, the muscle fibers in this structure help to close the airway during swallowing. |
| Air flowing from the lungs through the glottis during exhalation causes what to vibrate, thereby producing sound? | the true vocal cords |
| Who developed a procedure designed to dislodge the obstructing object in a choking person? | Dr. Heimlich |
| During the Heimlich maneuver where should your hands be placed? | Between the person's navel and the bottom of the rib cage. |
| What extends from the lower edge of the larynx downward into the thoracic cavity, where it splits into the right and left bronchi? | The trachea |
| What is the condition called when an infant is born with an opening between the trachea and the esophagus? | This condition is a tracheoesophageal fistula (TE fistula) |
| What are the 3 parts of the Bronchial Tree? | The bronchi, the bronchioles, and the alveoli. |
| Where are the lungs located? | In the pleural cavities |
| Which lung has three lobes, the right lung or the left lung? | The right lung has three lobes: the superior, middle, and inferior lobes. |
| What is the upper, rounded part of the lung is called? | The Apex |
| What is the lower part of the lung called and where does it rest? | The Base and it rests on the diaphragm |
| Primary purpose of the respiratory system | gas exchange; the transfer of O2 and CO2 between the atmosphere and blood |
| Normal tidal volume | 500ml - volume of air exchanged with each breath |
| Alveoli | small sacs that form the functional unit of the lungs |
| Surfactant | a lipoprotein that lowers the surface tension in the alveoli, reduces the amount of pressure needed to inflate the alveoli and decreases the tendency of alveoli to collapse |
| What two types of circulation do the lungs have | pulmonary and bronchial |
| Pulmonary circulation does what? | provides the lungs with blood for gas exchange |
| Bronchial circulation does what? | provides oxygen to the bronchi and other pulmonary tissue |
| How many ribs are in a human body | total of 24 - 12 on each side |
| Thoracic cages refers to | the ribs and sternum |
| Parietal pleura | a membrane that lines the chest cavity |
| Visceral pluera | the membrane that lines the lungs |
| Which pleura does not have nerve endings or afferent pain fibers? | visceral pleura |
| Which pleura has afferent pain fibers? | parietal pleura |
| Intrapleural space | the space between the pleural layers |
| What is the purpose of the intrapleural space | provides lubrication, allowing the layers of the pleura to slide over each other during breathing; it increases cohesion between the pleural layers |
| How much fluid is normally in the pleural space | 20-25ml |
| Empyema | purulent pleural fluid with bacterial infection |
| The major muscle of respiration | diaphragm |
| What is the flow of gas? | from an area of higher pressure (atmospheric) to one of lower pressure (intrathoracic) |
| Elastic recoil | the tendency for the lungs to recoil after being stretched of expanded |
| Compliance (distensibility) | a measure of the elasticity of the lungs and thorax |
| What happens when compliance is decreased | the lungs are more difficulty to inflate |
| Diffusion | How O2 and CO2 are moved back and forth across the alveolar capillary membrane |
| PaO2 represents what? | arterial oxygen tension |
| PaO2 represents what? | The amount of oxygen disolved in the plasma |
| SaO2 represents what? | arterial oxygen saturation |
| SaO2 represents what? | The amount of oxygen bound to hemoglobin in comparison with the amount of oxygen the hemoglobin can carry |
| PaO2 is expressed in? | millimeters of mercury (mm Hg) |
| SaO2 is expressed in? | % |
| ABG analysis includes the measurement of | PaO2, PaCO2, acidity (pH), and bicarbonate (HCO3-) in arterial blood |
| Blood for ABG's can be obtained by | arterial puncture or from an aterial catheter in the radial or femoral artery |
| pH of blood is? | 7.35-7.45 |
| PaO2 range? | 80-100 mm Hg |
| SaO2 should be? | >95% |
| HCO3- should be? | 22-26 mEq/L |
| S/S of inadequate oxygenation on the CNS | unexplained apprehension, restlessness/irritability, confusion/lethargy (early or late), Combativeness (late), Coma (late) |
| S/S of inadequate oxygenation on the respiratory system | Tachypnea, Dyspnea on exertion, Dyspnes at rest (late), Use of accessory muscles (late), Retraction of interspaces on inspiration (late), Pause for breath between sentences/words (late) |
| S/S of inadequate oxygenation on the Cardiovascular system | Tachycardia, Mild HTN, Arrhythmias (ex:PVC'S)(early or late), Hypotension (late), Cyanosis (late), Cool / clammy skin (late) |
| Other S/S of inadequate oxygenation | Diaphoresis (early or late), Decreased urinary output (early or late), Unexplained fatigue (early or late) |
| Normal SpO2? | >95% |
| SpO2 is what? | the oxygen saturation value obtained by pulse oximetry |
| Sites of pulse oximetry | finger, toe, ear, forehead , or bridge of nose |
| Hypoxemia | an abnormal deficiency in the concentration of oxygen in arterial blood |
| Hypoxia | abnormally low oxygen availability to the body or an individual tissue or organ |
| What is the first evidence of hypoxemia | apprehension, restlessness or irritability |
| The mechanism that stimulates the release of surfactant is | alveolar stretch from deep breathing |
| During inspiration, air enters the thoracic cavity as a result of | decreased intrathoracic pressure relative to pressure at the airway |
| The ability of the lungs to adequately oxygenate the arterial blood is determined by examination of the | aretiral oxygen tension |
| The most important respiratory defense mechanism distal to the respiratory bronchioles is the | alveolar macroophage |
| A rightward shift of the oxygen-hemoglobin dissociation curve | facilitates release of oxygen at the tissue level |
| During the respiratory assessment of the older adult, the nurse would expect to find | increased anteroposterior chest diameter |
| When assessing activity-exercise patterns related to respiratory health, the nurse inquires about | dyspnea during rest or exercise |
| The vibration of tactile fremitus is best assessed using the nurse's | palms |
| Which of the following finding is an abnormal assessment finding of the respiratory system? | presence of rhonchail fremitus |
| A diagnostic procedure done to remove pleural fluid for analysis is | thoracentesis |
| Hypercapnia | excess CO2 in the blood |
| Structural changes r/t aging | dec. Elastic recoil, dec. Chest wall compliance, Inc. Anteroposterior diameter, dec. Functioning aveoli |
| Defense mechanism changes r/t aging | dec cell-mediated immunity, dec specific antibodies, dec. cilia function, dec. cough force, dec. alveolar macrophage function |
| Respiratory control r/t aging | dec. response to hypoxemia, dec. response to hypercapnia |
| If a patient is a smoker, sputum is usually | clear to gray with occasional specks of brown |
| If patient has COPD, sputum may be | clear, whitish, or slightly yellow, especially in the morning on rising |
| Normal sputum is | clear to slightly whitish; odorless |
| These respiratory conditions can cause chest pain | pleurisy, fractured ribs, and costochondritis |
| Description of pleuritic pain | sharp, stabbing pain associated with movement or deep breathing |
| Description of fractured rib pain | localised sharp pain asssociated with breathing |
| Description of costochondritis pain | along the the borders of the sternum and is associated with breathing |
| Assessment of the nose | mucous mem should be pink and moist, with no evidence of edema (bogginess), exudate or bleeding |
| Assessment of the pharynx | should be smooth and moist with no evidence of exudate, ulcerations, swelling or postnasal drip |
| Gagging response indicates that | cranial nerves IX (glossopharyngeal) and X (vagus) are intact |
| Assessment of the neck | symmetry and presence of any tender or swollen areas; palpate the lymph nodes |
| Normal respiratory rates in the elderly | 16-25 breaths per minute |
| Kussmaul | rapid, deep breathing |
| Cheyne-Stokes | abnormal patterns of respiration characterized by alternating periods of apnea and deep, rapid breathing |
| Biot's | irregular breathing with apnea every 4-5 cycles |
| Cyanosis is best observed where in dark-skinned people | conjuctiva, lips, palms, and soles of feet |
| Causes of cyanosis | hypoxemia or decreased cardiac output |
| Clubbing | an increase in the angle between the base of the nail and the fingernail - usually accompanied by sponginess of the end of the finger |
| What is normal tracheal position | midline |
| Resonance | low-pitched sound heard over normal lungs |
| Hyperresonance | loud, lower-pitched sound than normal resonance heard ofver hyperinflated lungs, such as in chronic obstructive lung disease and acute asthma |
| Tympany | Drumlike, loud, empty quality heard over gas-filled stomach or intestines, or pneumothorax |
| Dull | Medium-intensity pitch and duration heard over areas of "mixed" solid and lung tissue, such as over the top area of the liver, partially consolidated lung tissue (pneumonia) or fluid-filled pleural space |
| Flat | Soft, high-pitch sound of short duration heard over very dense tissue where air is not present |
Created by:
elizabethlaughlinlee
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