Med Surg Ch 29

  1. What are the two functions of the respiratory system?
    • Gas exchange between the air and blood at the alveoli 
    • movement of air into and out of the lungs
  2. what is nasal mucosa made out of and what's it's function?
    • Ciliated epithelium - highly vascular
    • warms and moistens inhaled air
  3. What produces mucus that traps dust and microorganisms and sweeps them backward down the pharynx?
    Goblet cells
  4. What are the paranasal sinuses lined with?
    ciliated epithelium
  5. What are the three parts of the pharynx?
    Nasopharynx, oropharynx, laryngopharynx
  6. The nasopharynx is a passage way for ____ and is located _____
    Air, above the soft palate
  7. The _____ tubes from the middle ear cavities open into the nasopharynx
  8. The oropharynx is a passage way for ___ and is located ___
    Air and food, posterior to the oral cavity
  9. the laryngopharynx is a passage way for _____ and is located ___
    Air and food, opens anteriorly into the larynx and posteriorly into the esophagus
  10. what is the voice box?
  11. The larynx is the air between ____ and ____
    pharynx and trachea
  12. the larynx is lined with ____ to trap pathogens
    Ciliated epithelium
  13. What is the function of the epiglottis and where is it located
    covers the larynx like a flap when the larynx is elevated during swallowing
  14. How is speech produced?
    the vocal cords are vibrated by exhales air
  15. How long is the trachea and where does it extend to?
    • 4-5 inches in length
    • extends from the larynx to the primary bronchi
  16. What keeps the trachea open?
    C shaped pieces of cartilage in the wall
  17. where does dust and microorganisms found in the larynx go?
    Swept upward by cilia toward the pharynx and are usually swallowed
  18. T or F: Bronchioles have cartilage in the walls to maintain patency
    false: bronchioles have no cartilage
  19. T or F: Bronchioles may be closed completely by contraction of their smooth muscle
  20. the ___ membranes are the serous membranes of the thoracic cavity
  21. the ___ is the membrane that covers the lungs
    visceral pleura
  22. the ___ lines the chest cavity
    parietal pleura
  23. ___ prevents friction and adheres the membranes together during breathing
    serous fluid
  24. what is the functional unit of the lungs
  25. what are alveoli
    air sacs that are the site of gas exchange (respiration)
  26. alveoli & alveolar capillaries are made of ___
    • simple squamous tissue
    • only one cell thick
    • diffusion of gases
  27. define surfactant
    lipoprotein that mixes with the tissue fluid and decreases the surface tension to permit inflation
  28. alveoli are alveolar macrophages. define alveolar macrophage
    phagocytize pathogens or fine dust particles and debris that have not been trapped and swept out by the cilia
  29. define ventilation
    movement of air into and out of the alveoli
  30. what are the two respiratory centers?
    medulla, pons
  31. what are the main respiratory muscles?
    • diaphragm inferior to the lungs
    • external and internal intercostal muscles between the ribs
  32. define intrapleural pressure
    potential pleural space between the pleural membranes
  33. the pressure in the potential pleural space is always ___ atmospheric pressure
    • below
    • called negative pressure
  34. define intrapulmonic pressure
    • pressure inside the alveoli and bronchial tree
    • fluctuaes below and above atmospheric pressure during each cycle of breathing
  35. define inhalation / inspiration
    occurs when motor impulses from the medulla cause contraction of the respiratory muscles
  36. what happens during inhalation?
    intercostal nerves -> external intercostal muscles -> rib ^ and out -> expanded chest cavity
  37. as the lungs expand, ___ pressure falls below ___ pressure and air enters the nose and respiratory passages
    alveolar, atmospheric
  38. define normal exhalation
    passive process that begins when motor impulses from the medulla decrease and the diaphragm and external intercostal muscles relax
  39. describe the normal exhalation process
    alveolar pressure rises above atmostpheric pressure and air is forced out of the lungs until the two pressures are again equal
  40. t or f: engery is required for exhalation
    false, the elasticity of the lungs causes recoil and forces air out
  41. where is oxygen carried?
    in the blood by iron in the hemoglobin of the red blood cells
  42. how is carbon dioxide carried?
    in the blood in the form of bicarbonate ions in the plasma
  43. How is respiration regulated?
    by nervous and chemical mechanisms
  44. What type of center does the medulla oblongata contain?
    inspiratory centers and expiratory center
  45. t or f: normal breathing is essentially a reflex
    true. but becuase the respiratory muscles are skeletal muscles, it is possible to force changes
  46. What is the major regulator of respiration
    carbon dioxide because even small changes in its blood level change the pH
  47. What does the chemical regulation of respiration involve?
    blood levels of the oxygen and carbon dioxide
  48. what detects a decreased blood oxygen level?
    chemoreceptors in the carotid body and aortic body
  49. What is the response by the medulla when decreased blood oxygen level is detected?
    increase respiration to take more air into the lungs
  50. what detects and increased blood carbon dioxide level or a decrease in pH?
    central chemoreceptors in the medulla and peripheral chemoreceptors
  51. what is the bodys response to an increased blood carbon dioxide level?
    increased respiration to exhale more carbon dioxide which raises pH back to normal
  52. Any decrease in the rate or efficiency of respiration permits what?
    excess carbon dioxide to accumulate in the blood
  53. Respiratory Acidosis
    when the decreased rate of respiration cuases excess hydrogen ions and lowers pH
  54. Respiratory Alkalosis
    occurs when the rate of respiration increases, eliminating the exhlaed co2 very rapidly.

    decreased co2 -> decreased hydrogen ions -> increased pH
  55. What is in an important question to ask pts who screen them for TB?
    have you recently experienced night sweats, chills, or fevers
  56. Retraction
    • use of accessory muscles for breathing
    • indicates respiratory distress
    • occurs when airways are obstructed
  57. Barrel Chest
    • when a chest is more rounded
    • associated with trapped air in the lungs
  58. Ausculatation can be done in what position if a pt can not sit straight?
    side lying position
  59. adventitious
    abnormal breath sounds
  60. what is the job of the LPN when an ABG is performed?
    hold the site for five minutes
  61. what is a cbc
    measurement of rbc and hemoglobin
  62. Describe what causes course crackles and list associated disorders
    • fluid in the airways
    • pulmonary edema, bronchitis, and pneumonia
  63. why would a doctor order a sputum for afb?
    when tb is suspected
  64. why is a throat culture performed?
    to determine the presence of viral or bacterial pathogens in the pharynx
  65. Oxygen saturation test
    simple noninvasive way to measure aterial oxygenation
  66. what does and o2 sat test measure?
    the percentage of hemoglovin that is saturated with oxygen
  67. sputum culture
    identifies pathogens present in the sputum. the sensitivty test determines which antibiotics will be effective against those pathogens
  68. what should you instruct the pt to do when collecting a sputum culture?
    take several deep breaths and cough sputum into the container
  69. capnography
    the process of meauring a person's exhaled carbon dioxide level
  70. what is the normal pH level of blood?
    • 7.35-7.45
    • increased in res. alkalosis
    • decreased in res. acidosis
  71. ventilation perfusion scan
    a radioactive substance is injected IV and a sacan is done to view blood flow to the lungs

    radioactive substance is then inhaled and scanning shows how well o2 is distributed into the lungs
  72. what does a ventilation perfusion scan detect>
    pulmonary embolism
  73. tidal volume
    air inspired and expired in one normal breath
  74. What should you check on a pt who just had a bronchoscopy before offering fluids or food?
    gag reflex by checking the pharynx with a cotton swab
  75. bronchoscopy
    involves the use of a flexible endoscope to examine the larynx, trachea, and bronchial tree
  76. why is a bronchoscopy performed?
    for visualization or to obtain a biopsy specimen for examination
  77. After anigography, what position is the pt placed in and for how long?
    flat in bed for 3 to 8 hrs to prevent bleeding
  78. pulmonary angiography
    xray examination of the pulmonary vessels after iv admin of radiopaque dye through a PICC line
  79. why is a pulmonary angiography performed?
    help diagnose pulmonary embolism or other pulmonary vessel disorders
  80. purpose of pursed lip breathing
    • promotes co2 excretion
    • forces max air to be expelled
  81. when is a pt usually placed on supplemental o2?
    when o2 sat falls below 90% on room air
  82. when is a nasal cannula most effective?
    when pt is breathing through his or her nose
  83. nonrebreather mask
    one or both side vents closed to limit the mixing of room air and o2
  84. how much o2 should a COPDer be placed on?
    no more than 1 to 2 L of o2 per minute
  85. venturi mask
    used for pt who requires percentages of oxygen
  86. how often is a nebulized mist treatment ordered?
    q 4 to 6 hr or prn
  87. metered dose inhalers
    administer topical medications directly into the lungs, minimizing systemic side effects
  88. why is it important to not overuse bronchodilator inhalers?
    has a rebound effect and could even cuase death
  89. how often should a pt use incentive spirometry?
    10 times q 1 hr
  90. thoracentesis
    involves the insertion of needle into the pleural space, most commonly to sapirate fluid in the pts with pleural effusion
  91. what position should a pt be placed in for thoracentesis?
    sittioin position, bending over a bedside table
  92. how much fluid is usually removed when thoracentesis is performed?
    as much as 2L, immediate reduction of dyspnea
  93. what does a doctor usually order after a thoracentesis procedure?
    chest xr to make sure the lung was not punctured
Card Set
Med Surg Ch 29
Respiratory system