Test Bank For Cardiopulmonary Anatomy & Physiology: Essentials of Respiratory Care, Exams of Nursing

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Test Bank For Cardiopulmonary Anatomy &

Physiology: Essentials of Respiratory Care

primary function of the respiratory system is - ANSWER>>to promote gas exchange move oxygen (O²) into the lungs blood removal of carbon dioxide (CO²) from the lungs. Conducting airway divided into: - ANSWER>>Upper airway Lower airways The upper airway consists of - ANSWER>>nose oral cavity pharynx larynx what are the upper airway primary functions - ANSWER>>Conduction of air humidify and warm inspired air prevents foreign material from entering the tracheobronchial tree to facilitate speech and smell What are the three parts that the pharynx divided into - ANSWER>>Nasopharynx Oropharynx Laryngopharynx nasopharynx - ANSWER>>Is positioned between the posterior portion of the nasal cavity and superior portion of the soft palate. oropharynx - ANSWER>>Oropharynx lies between the soft palate superiorly and the base of the tongue inferiorly laryngopharynx (hypopharynx) - ANSWER>>Or (hypopharynx) lies between the base of the tongue and the entrance of the esophagus. The epiglottis is the upper part of the larynx and is positioned Epiglottis - ANSWER>>is the upper part of the larynx and is positioned Larynx (voice box) - ANSWER>>located between the base of the tongue and the upper end of the trachea Three functions of the larynx: - ANSWER>>passageway of air between the pharynx and the trachea protects against aspiration of solids and liquids; closure during exhalation (Valsalva's maneuver) generates speech

The larynx is lined by a mucous membrane that forms two pairs of folds. - ANSWER>>False vocal cords are the upper pair. True vocal cords are the lower pair. The space between the true vocal cords is referred to as the glottis. In the adult the glottis is the narrowest point of the larynx. The larynx consists of nine cartilages. - ANSWER>> Along the superior border is the V-shaped notch called the thyroid cartilage - ANSWER>>thyroid notch. thyroid cartilage - ANSWER>>is the largest cartilage of the larynx Epiglottis - ANSWER>>serves to prevent aspiration of food and liquid The epiglottis and the base of the tongue are connected by folds of mucous membranes, which form a small space between the epiglottis and base of tongue - ANSWER>>vallecula In the infant, up to 8 y/o - ANSWER>>the cricoid cartilage is the narrowest point. Acute Epiglottitis - ANSWER>>Inflammation of the epiglottis due to infection. Laryngotracheobronchitis (LTB) - ANSWER>>inflammation of the larynx, trachea, and bronchi (the acute form is called croup) What airway landmarks are important to the respiratory therapist? - ANSWER>>carina Mallampati Score - ANSWER>>Used to predict the ease of intubation. Score ranges from I-IV. Classes I and II are associated with relatively easy intubation while classes III and IV are associated with increased difficulty. lower airway - ANSWER>>trachea, bronchi, bronchioles, alveoli tracheobronchial tree - ANSWER>>branching structures of the respiratory system that resemble an upside-down tree trunk and its branches; includes trachea, bronchi, and bronchioles. The Lower Airways - ANSWER>>The tracheobronchial tree consists of a series of branching airways referred to as generations. Two major forms: - ANSWER>>cartilaginousairways, Noncartilaginous noncartilaginous airways - ANSWER>>airways; conducts the air and provides gas exchange.

cartilaginous airways; - ANSWER>>serve only to conduct air between the external environment and the sites of gas exchange. tracheal and bronchial - ANSWER>>reinforce respiratory passages cartilaginous layer - ANSWER>>outer-most layer of the tracheobronchial tree,diminishes in size, becomes absent at bronchioles The cartilaginous layer is the outer most layer of the tracheobronchial tree. - ANSWER>>consists of the trachea, main stem bronchi, lobar bronchi, segmental bronchi, and subsegmental bronchi. It divides into the right and left bronchi called - ANSWER>>Carnina main stem bronchi - ANSWER>>At the trachea, two major bronchi distribute air into the right and left lungs. The angle of the right bronchus from the trachea is less than the left bronchus. The right bronchus is wider, more vertical, and 5 cm shorter than the left bronchus. Lobar Bronchi (2nd generation) - ANSWER>>right bronchus divides into upper, middle and lower lobar bronchi left bronchus divides into upper and lower lobar bronchi Segmental Bronchi (3rd generation) - ANSWER>>Branch off from the lobar There are 10 segmental bronchi in the right lung There are 8 segmental bronchi in the left lung Sub-segmental Bronchi (4th thru 9th) - ANSWER>>Range in diameter 1 - 4 cm in diameter Peribronchial connective tissue containing nerves, lymphatics, and bronchial arteries surround the sub-segmental bronchi The tracheobronchial tree consists of three layers: - ANSWER>>Epithelial lining Lamina propria, Cartilaginous layer. The epithelial lining - ANSWER>>extend into the trachea to the respiratory bronchioles. The epithelium contain cilia, approximately 200 cilia/cell which help move mucous or foreign material out of the lungs. acute epiglottis - ANSWER>>is a supraglottic airway obstruction resulting from inflammation of the epiglottis, aryepiglottic fold and false vocal fold and is a life- threatening emergency

The lamina propria is the bronchial (submucosal) layer. - ANSWER>>It's made up of loose, fibrous tissue containing tiny blood vessels, lymphatic vessels, and branches of the vagal nerve. The sol and gel layers - ANSWER>>the mucosal blanket help facilitate foreign particles out to the larynx at a rate of 2cm/min. The mucus then enters the oropharynx by - ANSWER>>coughing called the mucocilliary transport mechanism. The bronchial glands are innervated - ANSWER>>the vagal parasympathetic nerve (10th cranial nerve) which produce 100 mL of bronchial secretions daily. The sol and The mucus is produced by - ANSWER>>goblet cells and bronchial (submucosal) glands. Pathology includes: - ANSWER>>Excessive production and accumulation of thick bronchial airway secretions Partial bronchial obstruction and air trapping Alveolar hyperventilation and complete airway obstruction and alveolar collapse Mast cells:assist the immunologic mechanism are found throughout. - ANSWER>>smooth-muscle bundles intra-alveolar septum submucosal cell Mast cells play two major immune responses - ANSWER>>Cellular immunity and humoral immunity cellular immunity response (delayed, hypersensitivity) - ANSWER>>involves the sensitized lymphocytes responsible for tissue rejection in transplants. The humoral immunity response - ANSWER>>involves the circulating allergic response. (i.e.. Asthma) These antibodies (immunoglobulins) are proteins that defend against environmental antigens. IgE antibody is basic to the allergic response. IgE antibody- antigen reaction Hazards Associated with Endotracheal Tubes - ANSWER>>Over-inflated and pressurized tracheal tube Close-up of dilated trachea around tracheal tube Close anatomic proximity of tracheostomy tube cuff and innominate artery and esophagus Optimal position - ANSWER>>the ETT is between T2-T

Correct Placement of ET tube - ANSWER>>4-6 Cm above the carina when a pt. head and neck are in neutral position Neck Flexion 2cm descent of the ETT (2 - 4cm from the carina) Neck extension 2 cm ascent of the ETT (7-9 cm from the carina Non-cartilaginous Airways composed of - ANSWER>>1. Bronchioles

2. Terminal bronchioles Bronchioles (10th - 15th) - ANSWER>>< 1 mm in diameter cartilage is absent Terminal bronchioles (16th - 19th) - ANSWER>>Conducting tubes Diameter 0.5 mm Cilia and mucous glands progressively disappear Canals of Lambert - small channels of terminal bronchioles Canals of lambert are found in the - ANSWER>>small channels of terminal bronchioles Non-cartilaginous Airways The Sites of Gas Exchange - ANSWER>>1. The respiratory bronchioles
3. alveolar ducts 3.alveolar sacs Respiratory bronchioles are characterized by - ANSWER>>alveoli budding from the walls. Each alveoli are separated by - ANSWER>>septal walls containing smooth muscle fibers Most gas exchange occurs - ANSWER>>at the alveolar-capillary membrane Alveolar Epithelium Two principle cell types: - ANSWER>>-type I cell major sites of alveolar gas exchange

• type II cell are the producers of pulmonary surfactant Pores of Kohn - ANSWER>>Small holes in the inter-alveolar septa Alveolar Macrophages - ANSWER>>Type III alveolar cells Important part of removing bacteria and other foreign particle interstitium - ANSWER>>Shape , support, and surround the alveolar-capillary cluster Pulmonary Vascular System - ANSWER>>arteries, arterioles, capillaries, venules, veins Arteries - ANSWER>>RV pumps blood into the pulmonary arteries

Arterioles - ANSWER>>Wall of vessel consist of endothelial layer, smooth-muscle fibers elastic layer, and layer of Supply nutrients to the respiratory bronchioles, alveolar ducts, and alveoli Capillaries - ANSWER>>Rise from the pulmonary arterioles Where gas exchange occurs Selective permeability to substances such as water, electrolytes, and sugars Venules and Veins - ANSWER>>Tiny veins continuous of the capillaries Empty into the veins which carry blood back to the heart Major Pulmonary Vessels - ANSWER>>Superior pulmonary vein

2. Pulmonary 3.Right lung hilum
3. left lung hilum
4. Aorta
5. Inferior pulmonary vein Bronchial Blood Supply - ANSWER>>Fed by bronchial arteries Arise from the aorta and descend to the terminal bronchioles Eventually merge with pulmonary arteries and capillaries 1 % of the cardiac output (CO) Lymphatic vessels of bronchial airways, pulmonary arteries, and veins lymph nodes produce - ANSWER>>lymphocytes and monocytes lymph node function - ANSWER>>Act as filters for particulate matter and bacteria from the bloodstream and the lungs Lymphatic vessels are found - ANSWER>>around the lungs, between the visceral pleura, connective tissue wrapping of the bronchioles, bronchi, pulmonary arteries, and pulmonary veins lymphatic system functions - ANSWER>>is to remove excess fluid and protein molecules that leak from the pulmonary capillaries Asthma - ANSWER>>-Reversible bronchial smooth muscle constriction

• Airway inflammation
• Excessive production of thick, whitish bronchial secretions
• Mucus plugging
• Air trapping and hyperinflation of alveoli Autonomic nervous system - ANSWER>>balance of bronchial and arteriolar smooth muscle control regulates involuntary vital functions of cardiac muscle, smooth muscle, and glands

Divides into two sections Asthma - ANSWER>>episodes of breathing difficulty due to narrowed or obstructed airways, inflammation which result in mucosal edema and airway swelling. Excessive production of thick, whitish secretion. When stimulated causes - ANSWER>>Bronchodilation Vomiting Coughing Hiccups Gaging Innervation of the lungs - ANSWER>>Alpha and beta (β) are present on airway smooth muscles without direct innervation of sympathetic system. The airway is innervated by a third pathway that is non-adrenergic - non-cholinergic nervous system via the vagal nerve (10th cranial nerve. When stimulated causes Bronchodilation Vomiting Coughing Hiccups Gaging The airway is innervated - ANSWER>>by a third pathway that is non-adrenergic - non- cholinergic nervous system via the vagal nerve (10th cranial nerve. Alpha and beta - ANSWER>>are present on airway smooth muscles without direct innervation of sympathetic system. The apex - ANSWER>>each lung is pointed, and the base is broad and concave Rise to the level of the 1st rib Extends anteriorly to about the 6th rib Posteriorly to the 11th rib Mediastinal border is concave to fit the heart and other mediastinal structures Hilum - ANSWER>>is the center of the mediastinal border where the main stem bronchi, blood vessels, lymph vessels, and various nerves enter and exit the lungs Right lung - ANSWER>>3 lobes larger and heavier than the left upper, middle, lower separated by the oblique and horizontal fissures left lung - ANSWER>>2 lobes upper and lower

separated by oblique fissure All lobes are further divided into Bronchopulmonary segments Mediastinum - ANSWER>>area between the lungs containing the heart, aorta, venae cavae, esophagus, and trachea Postural Drainage - ANSWER>>Position for anterior segment of right-lower lobe Canals of Lambert are found in the ____ _____ - ANSWER>>terminal bronchioles The tracheobronchial tree is nourished by the ___ ___. - ANSWER>>Bronchial arteries What does the soft palate consist of? - ANSWER>>Packed collagen fibers that project backward ending in the soft, fleshy structure called the uvula. What muscle elevates the soft palate? - ANSWER>>Levator veli palatinum Name the cartilages that make up the larynx: - ANSWER>>a. thyroid cartilage b. cricoid cartilage c. epiglottis d. arytenoid cartilage e. corniculate cartilage f. cuneiform cartilage