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swelling caused by fluid collection withinthe interstitial space.
the insertion of an endotracheal tubeinto the trachea.
a surgical opening in the trachea,generally located 1 to 3 cm below the cricoid cartilage.
narrowing of the bronchi caused bybronchial smooth muscle constriction.
laryngeal stimulation resulting inocclusion of the tracheal opening due to closure of the vocal cords.
blood that travels throughthe pulmonary vasculature without participating in gas exchange; it is the mostcommon cause of hypoxemia.
decreased oxygen content in the blood.
the difference between thewater content of a gas at room temperature and the water content of a gas atbody temperature.
Ventilation—the process ofmoving gas into and out of the lung
Respiration—the transfer ofoxygen and CO2 between air and blood
External respiration—the exchange of oxygen and CO2 betweenair and blood
Internal respiration—the exchange of oxygen and CO2 betweenblood and body fluids (cells)
Distinguish between ventilation and respiration,and between internal and external respiration.
Stridor is caused by the vibration of air flowing through anarrowed upper airway. Edema and swelling due to infection or trauma partiallyobstruct the upper airway, causing the high-pitched crowing sound.
What is the origin of the sound called “stridor”?
Besides speech, what are other importantfunctions of the vocal cords?
About 30–40%. So that most ofthe inhaled gas can come into contact with the gas-exchanging membrane. Anendotracheal tube would decrease dead space because it bypasses the upperairway.
What percent of a single breath volume remainsin the conducting airways at the end of an inspiration? Why is this important?Would endotracheal intubation change this percent? Explain.
Loss of normal pharyngeal muscle tone during sleep causes thetongue to fall back and partially occlude the upper airway, increasing airwayresistance. Abnormal enlargement of soft tissue can further narrow the airway,causing further obstruction, which leads to periods of apnea.
What is obstructive sleep apnea?
Because of the angle of the right bronchus, if theendotracheal tube is placed too deep into the trachea it will be more likely toenter the right bronchus, which will prevent gas flow into the left lung.
Why does inserting an endotracheal tube too deepinto the trachea tend to reduce or prevent ventilation of the left lung?
Tobacco smoke decreases motility of the cilia and causes the mucus glands to proliferate and spread into small bronchioles.
Describe how mucous glands and ciliary activityare affected by tobacco smoke.
IgE binds to specific receptor sites on the mast cell surface sensitizing the mast cell. The antigen combines with IgE molecules on the mastcell surface inactivating the antigen and causing the mast cell to rupture.Rupture of the mast cell releases histamine and other inflammatory mediators that lead to bronchoconstriction, inflammation, and increased mucus production.
Explain the sequence of events that precipitatethe symptoms of asthma, beginning with antigen attachment IgE antibodies.
The tethering retractileforces of elastic parenchymal tissue. They are called bronchioles.
The mixing ofoxygenated and unoxygenated blood.
Respiratorypatient’s complaint of shortness of breath or air hunger.
Insertion of a large-bore needle into the pleural space for the purpose of removing fluid orair.
Chemicalsubstance that transmits nerve impulses across ganglionic synapses and neuromuscular junctions.
Chemical substance that binds to a receptor site and elicits a response.
Chemical substance that binds to a receptor site and prevents other chemicals from binding to that receptor.
The presence of a pleural effusionmeans fluid has collected between the ___________ and the ___________. Whatwould this look like on a chest x-ray (CXR) image? What would the treatment befor the situation?
If the normal pleural space were made to communicate with atmospheric air (e.g., via a puncture wound through the chest wall), the result would be pneumothorax. Signs and symptoms a patient might exhibit in this situation include difficulty breathing, hypoxemia, abnormal/absent breath sounds, and deviation of the trachea. The treatment for this situation is insertion of a chest tube and application of suction to remove the air and re-expand the lung.
What events would occur if the normalpleural space were made to communicate with atmosphere air (e.g. a puncturewould through the chest wall)? What signs and symptoms might a patient exhibitin this situation? What would be the treatment for this situation?
Explain why a pneumothorax will causethe trachea to shift its position-which what might it shift, and why?
Consider deoxygenated blood flowsfrom the right ventricle through the lung capillaries where it is exposed toalveolar gas, then leaves the lungs to become arterial blood, what accounts forthe difference between the PO2 of alveolar gas and arterial blood?(i.e. alveolar gas PO2 is always 5 to 10 mmHg greater.)
What is likely the consequence of aC2 spinal cord transaction?
Vagal stimuli are also known as____________ stimuli, which cause what kind of response in bronchial smooth muscle?
During breathing, the “bucket-handlerib movements mainly change the _________ dimensions of the chest wall.
Pressure gradient across the entire respiratory system (lung and chest wall); difference between airway opening pressure and body surface pressure
The volume of air in the lung after a maximal-effort inspiration; the sum of allvolumes
The volume of air remaining in the lung after a maximal expiration
The volume of air that can be exhaled from a resting (tidal) end-expiratory level
Ameasure of the lung’s opposition to inflation; the change in lung volume produced by a unit of pressure change (ΔV/ΔP)
frictional resistance to gas flow, (P1 –P2)/V.
Lung and chest wall compliance measured while air is flowing
Lung and chest wall compliance measured under conditions of no airflow
Maximum pressure occurring during a breath delivered by a mechanical ventilator
The amount of time needed for the lungs to inflate or deflate to a certain proportion of their volume; the product CL × Raw determines the time constant of the lung
Contributes most to lung elasticity
Mouth pressure during spontaneous breathing
Pressure between chest wall and lung
Zero pressure gradient
Alveolar pressure minus pleural pressure
Subdivision of a capacity
Sum of all volumes
Cannot be exhaled
Maximum amount of air exhaled in a single breath after a maximal inspiration
Maximum inspiratory lung volume from end-tidal level
Exhalable volume beyond resting end-tidal level
Functional residual capacity
Volume remaining in the lung at end-tidal exhalation
What structures are responsible forsubstantially increasing the surface area of the nasal cavity?
What are the main functions of the nose?
Obese, snore,daytime sleepiness, fatigue
Individuals with obstructive sleep apneatypically have what characteristics?
What sound is associated with high-velocity airflowing through a narrowed glottis?
What is the term that describes a volume of gasthat is approximately 150 mL in the average adult and does not participate ingas exchange?
What cells engulf microorganisms and foreign material in the alveolus?
Liver pushes it up; heart pushes left side down
What are the explanations for the left hemidiaphragmatic surface being slightly lower than the right?
The diaphragm contracts, causing a deep inspiration.
A slight inspiratory pause occurs.
The muscles in the larynx close the glottis, sealing theupper airway.
The abdominal expiratory muscles contract forcefully.
The glottis suddenly opens, explosively releasingcompressed gas.
What is the correct sequence of events forgenerating a cough?
What is the primary muscle of respiration that is active during quiet breathing?
· What muscles considered accessory muscles of respiration?
What reflex(es) cause smooth muscle relaxation and bronchodilation after a deep inspiration?
Downward movement of diaphragm
What mechanisms by far are the most significant cause of thoracic cavity enlargement during inspiration?
Flattening of the diaphragm
· If the lungs fail to empty normally during exhalation, because of either weakened elastic recoil forces or high resistance to airflow, the retained volume causes what change in the chest radiograph?
Strong inspiratory efforts may create enough subatmospheric pressure in the thoracic cavity to suck the intercostal muscles inward. This physical finding is called?
What causes air to move in or out of the lungs?
· At the end of a spontaneous 500 mL inspiration,the PA is 0 mm Hg, and at the end of a positive pressure lung inflation to 500mL, PA is 10 mm Hg. Why does the lung contain the same volume at these two different alveolar pressures?
What term(s) defines the amount of gas the lung contains after a maximal inspiratory effort?
Severe compromise if MIP > -20 cm H2O
· What is the minimum MIP required to confirm adequacy of ventilatory muscle strength?
Normal = 0.2 L/cm H2O or 200 mL/cm H2O
What is the normal lung compliance (CL)?
What is the best word to define elastance?
What lung condition(s) is/are characterized by aloss of elastic lung tissue?
What lung condition(s) is/are characterized by high lung recoil forces?
According to Laplace’s law, if surface tension remains constant, what will happen to small alveoli?
What is the normal composition of the surfactant?
What is the function of the surfactant?
What is the normal airway resistance?
According to Poiseuille’s law, if an airway’s radius decreases to one-half of its original size, what pressure will be required to maintain the original flow through the airway?
A patient’s PIP has increased significantly since the last measurement 2 hours ago. It is noticed that the Pplat has not changed. What is the most probable explanation for the increased PIP?
People with emphysema have an increased work of breathing (WOB) as a result of their high expiratory Raw. In order to keep their airways open during exhalation, they perform which of the following maneuvers?
· A time constant determines how rapidly the source pressure and lung pressure equalize. Which of the following parameters determine the time constant?
With normal values for total compliance (0.1L/cm H2O) and Raw (1.0 cm H2O/L/sec), one TC should be approximately:
If the calculated time constant is 0.1 sec, what time will be required to achieve 99.3% equilibrium of pressure or volume?
· Patients with pulmonary fibrosis tend to have rapid and shallow respiration. Which of the following lung conditions explains their breathing pattern? High compliance or high Elastance?
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