Fundamentals Study Guide - Exam 1

Week 1-3

Identify the major structures of the upper respiratory tract.

Nasal cavity, Sinuses, Nose, Mouth, Pharynx, Larynx, Nasopharynx, Osopharynx, Glottic Opening.

How do airways move mucus?

cilia move the mucus through a wave like motion called mucociliary escalator.

Describe the blood-gas barriers (alveolar-capillary membrane) and how it functions normally.

the thin wall between alveoli and capillaries. It has three layers (alveolar epithelium, basement membrane, capillary endothelium). Its job is simple: oxygen in, carbon dioxide out.

(Think: “ABC → Air–Blood Connection”)

• A = Alveolar epithelium

• B = Basement membrane

• C = Capillary endothelium

What is the primary function of the respiratory system?

Absorption of O2 and excretion of CO2

Differentiate between internal and external respiration.

Internal: Gas exchange between tissue cells and systemic capillary blood

External: Gas exchange between the gas of the atmosphere and blood

What is the primary function of the lymphatic system?

clear fluid from the interstitial and pleural spaces to help maintain the fluid balance in the lungs

What are the plains (imaginary lines) of the anterior and posterior thorax?

Anterior: Right / left midclavicular line, midsternal line

Posterior: left/right scapular line, midspinal line

How many pairs of ribs are there in an adult?

12

What is the primary muscle of inspiration?

Diaphragm and intercostals

What are the accessory muscles of inspiration? When are they active?

scalene and sternocleidomastoids, Active only during increased demand

What nerve innervates the diaphragm?

The phrenic nerve

Differentiate between ventilation and respiration.

Ventilation is the act of breathing air in and out of the lungs, while respiration is the actual exchange of gases.

Ventilation = Vent (airflow), Respiration = Resp (swap gases).

What is the only point of attachment for the lungs?

hilum

Differentiate between visceral and parietal pleurae.

visceral pleura: Serous membrane that covers the lungs

parietal pleura: Inner layer lined with serous membrane. (diaphragm)

Visceral = on the lung, Parietal = on the wall.

What is the primary function of each of the following: AARC

American Association for Respiratory

Care - advocates for profession

What is the primary function of each of the following: NBRC

National Board for Respiratory Care: offers certification and registry examination

What is the primary function of each of the following: CoARC

Committee on Accreditation for Respiratory Care: accreditation body for respiratory care education programs

What is the primary function of each of the following: OSRC

Ohio Society for Respiratory Care: promotes the education, licensing, and safety of respiratory care services and issues in Ohio

What is the primary function of each of the following?: KBRC

Kentucky Board of Respiratory Care: regulates respiratory care practitioners within Kentucky

What two factors affect normal volume of ventilation?

Tidal volume (vt) and respiratory rate

Describe the importance of surfactant.

Reduces surface tension and alveolar tendency to collapse

Differentiate between compliance and airway resistance.

Compliance = how easily the lungs and chest expand when filled with air. (High compliance = easy to expand, low compliance = stiff lungs).

Airway resistance = how much the airways resist airflow. (High resistance = harder for air to move, like in asthma or obstruction).

Compliance = stretch

Resistance = push air

Is normal exhalation active or passive? Explain.

Passive as the lungs/chest wall naturaly recoil. Muscles are only needed for forced exhalation.

What is work of breathing?

WOB: how hard and much energy your body has to work just to breathe.

Describe how oxygen and CO2 move between the atmosphere and tissues.

Simple Diffusion: Oxygen moves from high partial pressure to low partial pressure in the tissues.

Carbon Dioxide moves in the opposite direct from high Partial Pressure in tissues to low Partial Pressure in atmosphere.

Define diffusion.

movement of gases.

Describe each of the following: Hyperventilation

breathing faster/deeper then normal

Describe each of the following: Hypoventilation

too slow/too shallow (low o2)

Describe each of the following: Tachypnea

fast breathing rate (faster than 20 bpm)

Describe each of the following: Bradypnea

abnormally slow breathing rate (slowler than 12 bpm)

Describe each of the following: Tachycardia

fast heart rate of more than 100 beats per minute when at rest

Describe each of the following: Bradycardia

slow heart rate, defined as fewer than 60 beats per minute (BPM) at rest

How do you estimate anatomical deadspace in an adult (nonintubated)?

Vdanat = 1 ml/ lb IBW

What is the costophrenic angle?

the sharp corner where the diaphragm meets the ribs (chest wall) on each side of the lungs.

How do you calculate IBW for a male or female?

Male: 106 + 6(height in inches – 60)/2.2

Female: 105 + 5(height in inches – 60)/2.2

Name the cartilaginous structures in the adult larynx.

Unpaired:

Thyroid cartilage

Cricoid cartilage

Epiglottis

Paired (two of each):

Arytenoid cartilages

Corniculate cartilages

Cuneiform cartilages

Differentiate between the right and left main stem bronchi.

Right: Wider, Shorter, branches at 20- 30-degree angle

Left: Narrower, Longer, branches at 45- 55-degree angle

Describe the structure and function of the mucociliary escalator.

Structure: Mucociliary escalator is formed by the lining of the airway, the two main parts are cilia and mucus layer.

Function: Lungs self cleaning system

Trace the normal flow of blood through the adult heart.

Body → RA → RV → Lungs → LA → LV

What causes gas to flow from the mouth to the alveoli?

pressure gradient created by breathing muscles

How do you calculate PAO2? (Alveolar Gas Equation)

PAO2 = (Pb – 47) x FIO2) – (PaCO2/0.8)

How do you calculate A-a gradient?

PAO2 – PaO2

How do you calculate minute ventilation?

VE = Vt x f

How do you calculate minute alveolar ventilation?

VA = (Vt – Vd) x

What is the function of the epiglottis?

Closes laryngeal opening during swallowing, to prevent liquids and food from entering respiratory tract

What is the largest cartilage in the larynx?

thyroid cartilage

What is the Valsalva maneuver?

takes a deep breath and forcefully exhales against a closed airway (like closing the mouth and pinching the nose while trying to blow out).

• can be used to decrease heart rate

Name the parts of the sternum.

manubrium, body, and xiphoid process

What are the general functions of the Upper Airways?

 Passageway for gas flow

 Filter

 Humidification