Respiratory System Exam Review and Key Concepts

Upper Airways

Warm, filter, and humidify air.

Nasopharynx

Lined with ciliated mucus that keeps contaminants out of the respiratory tract.

Nasal Air Passage

Air passing through the nose.

Pharynx

Located between naso and oro.

Oropharynx

Back of the throat, helps the epiglottis.

Mouth

Oral cavity, hard palate, soft palate, uvula, tongue.

Epiglottis

Separates the digestive and respiratory systems, blocks the trachea when food or liquids pass through to prevent aspiration.

Larynx

Where the upper and lower airway separate.

Lower Airways

Deliver oxygen to the alveoli.

Trachea

Tubular structure with cartilaginous rings, runs down the midline of the neck to the thoracic cavity.

Carina

Where the trachea divides into two main right and left bronchi.

Main Bronchus

Tubes directly off the trachea.

Bronchioles

Thin hollow tubes made of smooth muscle.

Diaphragm

Contracts during inhalation and relaxes during exhalation.

Alveoli

Millions of balloon-like sacs at the end of the airway, where exchange of carbon dioxide and oxygen occurs.

Lungs

Right and left, with visceral being outer and parietal being inside the thoracic cavity.

Phrenic Nerve

Controls the diaphragm.

Intercostal Nerves

Control the muscles between the ribs during ventilation.

Breathing Mechanics

Inhalation occurs when air goes in and lungs move up and out; exhalation occurs when air goes out and lungs go down.

Pons

Regulate the rate and depth of breathing.

Medulla Oblongata

Helps control the rhythm of breathing.

Path of O2

Nose/mouth, nasopharynx, oropharynx, pharynx, larynx, trachea, main bronchi, small bronchi, bronchioles, alveoli.

Gas Exchange

Involves the exchange of oxygen and carbon dioxide between the alveoli and blood.

Diffusion

The concentration of oxygen in the alveoli is higher than in the blood, causing oxygen to diffuse from alveoli into the blood.

Exhalation

When carbon dioxide-rich air in the alveoli is expelled from the body.

Oxygen (O2)

A gas essential for respiration, inhaled into the lungs.

Carbon Dioxide (CO2)

A gas produced by the body during metabolism, expelled during exhalation.

Inhalation

The process of taking air into the lungs, filling the alveoli with oxygen.

Role of Hemoglobin

A protein in red blood cells that binds to oxygen and transports it throughout the body.

Pulmonary Circulatory System

The system responsible for blood flow from the heart to the lungs and back, involving oxygenated and deoxygenated blood.

Deoxygenated Blood

Blood that has delivered oxygen to the body and is rich in carbon dioxide.

Right Atrium

The chamber of the heart that receives deoxygenated blood from the body via the superior and inferior vena cava.

Tricuspid Valve

The valve that allows blood to flow from the right atrium to the right ventricle.

Right Ventricle

The chamber of the heart that pumps deoxygenated blood into the pulmonary artery.

Pulmonary Artery

The only artery that carries deoxygenated blood from the heart to the lungs.

Pulmonary Vein

Veins that carry oxygenated blood from the lungs back to the heart.

Left Atrium

The chamber of the heart that receives oxygenated blood from the pulmonary veins.

Mitral Valve

The valve that allows blood to flow from the left atrium to the left ventricle.

Left Ventricle

The strongest chamber of the heart that pumps oxygenated blood into the aorta.

Aorta

The largest artery in the body, distributing oxygenated blood to the entire body.

Obstructed Airway

A blockage in the airway that prevents normal breathing.

Causes of Obstructed Airway

Foreign body or tongue obstruction.

Signs and Symptoms of Obstructed Airway

Inability to speak or cough, difficulty breathing, cyanosis, choking.

Treatment for Obstructed Airway

Ask if the person is choking, perform abdominal thrusts, or provide CPR for an unconscious person.

Assessing Respiratory Patients

Evaluate airflow, breathing rate, rhythm, quality, and chest rise and fall.

Upper Airway Obstructions

Caused by foreign bodies or swelling/inflammation from conditions like anaphylaxis or trauma.

Suction Duration

Should last 10 to 15 seconds to prevent hypoxia.

Soft vs Rigid Suction

Soft suction is for routine tracheal or oral cavity suctioning; rigid suction is for clearing the oropharynx of thick secretions or vomit.

CHF

Congestive heart failure is a chronic progressive condition in which the heart is unable to pump enough blood to meet the body's needs for oxygen.

Signs and symptoms of CHF

SOB, fatigue, weakness, swelling in legs, ankles or feet, tachycardia, cough or wheezing, weight gain.

Pneumonia

Infection of the lungs, secondary infection meaning can occur after a sore throat or cold.

Signs and symptoms of Pneumonia

Fever, abdominal pain, vomiting or dyspnea, cough, chills, chest pain.

Treatment for Pneumonia

NRB Mask!!!!! antibiotics, antiviral, antifungal, rest, fluid, pain relievers.

Inhalers

Bronchodilators relax muscles, and corticosteroids reduce inflammation.

Signs and symptoms to give Inhalers

Wheezing, SOB, chest tightness, coughing.

Pneumothorax

Air leaks into the space between your lungs, the pleural space, and disrupts the lining of the pleural cavity of the visceral and parietal.

Signs and symptoms of Pneumothorax

Chest pain and SOB, lung collapse.

Chronic bronchitis

Long-term inflammation of the airways.

Signs and symptoms of Chronic bronchitis

Coughing and mucus buildup.

Cystic fibrosis

A genetic disorder that affects the lungs and digestive system.

Signs and symptoms of Cystic fibrosis

Coughing with thick mucus, wheezing, SOB, lung infections, poor growth or weight gain, greasy, bulky stool.

COPD

Chronic obstructive pulmonary disease is a lung disease that makes it hard to breathe.

Emphysema

Lung condition where the air sacs or alveoli are damaged, making it hard to breathe.

Signs and symptoms of Emphysema

SOB, wheezing, chronic cough.

Pulmonary edema

Fluid buildup in the lungs.

Causes of Pulmonary edema

CHF or lung injury.

CHF or lung injury

Signs and symptoms include shortness of breath (SOB), wheezing, coughing up frothy sputum.

Hyperventilation

Recognizing the signs and symptoms: dizziness, anxiety, painful spasms, tingling, SOB.

Cause of hyperventilation

Illness or buildup of acids.

Anxiety in hyperventilation

Often psychological rather than caused by a condition.

Asthma

Acute spasm of the bronchioles associated with excessive mucus production and swelling of the lining of the respiratory passages.

Body response in asthma

Partial obstruction of the airway.

Signs and symptoms of asthma

Wheezing, bronchospasm, cyanosis, SOB.

What to do for asthma

Assist with inhaler medication, provide oxygen (O2).

Signs and symptoms of respiratory distress

Tachypnea, tachycardia, use of accessory muscles, nasal flaring, grunting in infants, anxiety, pale, diaphoresis, tripoding.

Signs and symptoms of respiratory failure

Marked tachypnea and bradypnea, altered mental status, cyanosis, absent or diminished breath sounds, loss of consciousness (LOC).

Signs and symptoms of normal breathing

10-20 breaths per minute (bpm), adequate tidal volume, breathing is quiet and effortless, skin is pink, warm, and dry.

Signs and symptoms of inadequate breathing

Signs include bradypnea and tachypnea, irregular rhythm, shallow or absent depth, effortful breathing, wheezing or stridor, altered mental status, cyanosis.

What to do for inadequate breathing

Clear the airway, assist ventilation, consider the cause, and transport.

Recognizing apnea

Absence of breathing for a short time, followed by continuous breathing, then back to apnea.

What to do for apneic patients

Use CPAP for severe cases or provide oxygen.

Tracheostomy

Surgery that creates a stoma in the throat to allow for ventilation.

What to do if something is wrong with a tracheostomy

Suction and ventilate.

Providing ventilation

Manually giving breaths through non-rebreather mask (NRB) or bag-valve-mask (BVM).

Normal breathing rates

10-20 bpm.

Indications for NRB

High concentration of oxygen to significant hypoxic patients, 15 mL/min, 90% oxygen.

Respiratory patterns

Normal: 10-20 bpm regular moderate healthy; Tachypnea: >20 bpm regular shallow; Bradypnea: <12 bpm regular; Apnea: absence; Cheyne-Stokes: varying periods of increased depth followed by apnea; Kussmaul: rate increase, regular rhythm, deep labored depth; Biots: irregular rate, irregular rhythm.

Lung sounds - Wheezing

Constriction and inflammation in the bronchus.

Lung sounds - Crackles

Sounds of fluid trying to pass by in the alveoli, inspiration, associated with CHF, pulmonary edema.

Lung sounds - Rhonchi

Secretion of mucus in the larger airways, associated with pneumonia, bronchitis.

Lung sounds - Stridor

Air trying to pass through an obstruction in the airway, a particle obstruction in the trachea.

Cyanosis

Bluish coloring of the skin, which happens when oxygen does not diffuse properly.

Ventilation

The physical act of air moving in and out.

Respiration

The actual exchange of oxygen and carbon dioxide in the alveoli as well as tissues.

Malaise

Feeling unwell.

Diaphoretic

Profusely sweating, very excessive sweating, happens during respiratory distress.

Acute

Short-term, not chronic.

Febrile

Having a fever.

Dyspnea

Difficulty breathing, associated with SOB, asthma, heart failure, or pneumonia.

Apnea

Temporary lack of breathing.