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The upper airway system structures
nose, sinuses, turbinates, phyrynx and larynx
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The nasal cavities are warmed and humidified by this
vasular and ciliated mucous membranes
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Cilia move mucous to
the back of the throat
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Nasal mucosa contain _____ cells
olfactory sensory
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Paranasal sinuses (location)
surrounding facial bones (4)
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Frontal sinuses (location)
in front of the frontal bone and extend above the orbital cavities(2)
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Ethmoidal sinuses (location)
honeycomb of small spaces b/w the eyes
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Sphendiodal sinuses (location)
behind the nasal cavity
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maxillary sinuses (location)
on either side of the nose
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The ___ sinuses are the largest and most accessible
maxillary
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Turbinates (define)
bones that change the flow of inspired air to moisturize and warm it better
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Pharynx
(throat) carries air from nose to larynx
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Pharynx is divided into 3 areas: name in order
nasopharynx, oropharynx and laryngeal pharynx
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Eustachian tubes
connect the phaynx to the middle earand are the means by which upper resp. infections spread to the middle ear
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Tonsils and adenoids ___ contribute to the resp system but instead protect against ____
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Larynx
voice box, cartilaginous framework b/w pharynx and trachea
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epiglottis
closes over the larynx during swallowing
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glottis
opening b/w vocal cords
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The lower resp. system consists of :
trachea, bronchi, bronchioles, lungs and alveoli
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carnia
the end of the trachea
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hilus
entrance of the bronchi
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Site of CO2 exchange
alveoli and capillaries in the lung
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There are 3 types of cells in alveoli. Type I does____.
- Type II does____. Type III does___.
- Type I lines most alveolar surfaces.
- Type II produces surfactant.
- Type III destroy foreign material such as bacteria.
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Surfactant
phospholipid that alters the suface tension of alveoli, preventing their colapse and limiting their expansions during inspration.
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Changes to what resp. structures influence the fact that older adults are at increased risk of resp. disease?
- Cartilage in nasal septum increases and hardens. Thinning alveolar walls.
- Fewer capillaries at alveoli, Lungs loose elasticity. Muscle tone, cough reflex and cilia decrease.
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mediastinum
wall that divides the thoracic cavity into halves
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respiration
exchange of O2 and CO2 b/w atmospheric air and the blood and b/w blood and the cells
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ventilation
actual movement of air in and out
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diffusion
exchange of CO2 across alveolar-capillary membrane at the cellular level
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perfusion
flow of blood in the pulmonary circulation
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distribution
delivery of atmospheric air to the separate gas exchange untis in the lungs
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The resp. center is located in the ___
medulla oblongata
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the ___ control the rate and depth of respirations
Pons
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____ determines the amount of CO2 in the body
alveolar respiration
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In the critacally ill client, the body attempts to maintain normal pH by:
The lungs eliminate carbonic acid by releasing CO2 and reabsorbing HCO3. The kidneys excrete more bicarbonate.
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Disturbance in the pH that involve the lungs are considered ___.
respiratory
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Disturbance in the pH that involves other mechanisms (not lungs) are considered ___.
metabolic
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Oxygen transport happens 2 ways:
small amount is dissolved in water in the plasma and a greater portion combines with heme in RBC
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pulmonary artery
transports venous blood from the right ventricle to the lungs
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what 3 things effect pulmonary perfusion
gravity,alveolar pressure and pulmonary artery pressure
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Clients with ____ and ___ disease may have decreased pulmonary perfusion
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ventilation/perfusion ratio
indicates the effectiveness of airflow within ventilation and perfusion
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A narrowed airway results from ___, ____ or ____
thick mucous, bronchospasm or edema
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hypoxia
decrease oxygen in the inspired air (tissue level)
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hypoxemia
decreased oxygen in the blood
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hypercapnia
increased CO2 in the blood
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hypocapnia
decreased CO2 in the blood
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Crackles
static sound or the sound made by hair rubbing together near your ear. Results from the delayed opening of of deflated airways. May be present b/c of inflammation or congestion, may indicate pulmonary edema or fluid in alveoli.
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wheezes
hissing or whistling sound. Musical sounds that can be heard during inspiration and expiration. Heard in clients with increased secretion.
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rhonchi (sonorous wheezes)
low pitched sounds from trachea and bronchi
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friction rubs
are heard as crakling or grating sounds on ispiration or expiration. Occur when pleural surfaces are inflammed.
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ABG (arterial blood gases)
- determine the blood's pH, oxygen-carrying capacity,levels of O2 &CO2 and
- HCO3
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blood gas samples are obtained from ___,___ or____ artery
brachial, femoral or radial
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Normal value of PaCO2 for ABG
35-45 mm Hg
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Normal value of PaO2 for ABG
80-100 mm Hg
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Normal value of SaO2 for ABG
95-100%
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Normal value of HCO3 for ABG
22-26 mm Hg
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Pulmonary function study
measure the functional ability of the lungs. Done to diagnose pulmonary conditions and to assess preoperative respiratory status. May also be used to screen employees or determine effectivness of bronchiodialtors.
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Pulmonary function is obtained with the use of a ____
spirometer
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tidal volume
volume of air inhaled and exhaled with a normal breath
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inspiratory reserve
max volume of air that normally can be inspired
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expiratory reserve
max volume of air that normally can be exhaled by force
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residual volume
volume of air left in lungs after max expiration
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vital capacity
max amount of air that can be expired after max inspired
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forced vital capacity
amount of air exhaled forcefully and rapidly after max inspiration
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inspratory capacity
max amount of air that can be inhaled after normal expiration
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functional residual capacity
amount of air left in lungs after normal expiration
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total lung capacity
total volume of air in the lungs when max inflated
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Sputum studies
sputum specimens are studied for pathogens and cancer cells
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radiography
show shape, size and position of lungs and other structures in thorax
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CT may be used to view and detect ____
view the lungs to detect tumors and other lung disorders during early stages
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pulmonary angiography
radioisotope study that allows the dr to assess arterial circulation of the lungs, particularly to detect pulmonary emboli
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V-Q scan
uses radioisotopes to detect patterns of blood flow through the lungs and patterns of air distribution in the lungs. Used to diagnoes COPD, lung cancer and pulmonary emboli
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Gallium scan
used to determine is any inflammatory conditions exhist within the lungs of if abscesses, adgesions or tumors are present
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PET
allows examiner to differentiate normal and abnormal tissue and view metabolic changes in lung tissue
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bronchoscopy
allows for direct visualization, used to treat, diagnose or evaluate lung disease. Also used to obtain biopsy or perform pulmonary cleansing.
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thoracentesis
the aspiration of excess pleural fluid by inserting a needle into the chest wall
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Signs and symptoms of respiratory disease include
dyspnea, persistent cough, increased sputum production, wheezing or other abnormal respirations, cyanosis, and hemoptysis.
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After the client has a bronchoscopy, it is most important to assess the client’s
breathing, any difficulty breathing (dyspnea), if the client is coughing up blood (hemoptysis), presence of cough reflex, and ability to swallow.
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For a client who has undergone thoracentesis, a chest radiograph is done after the procedure to rule out a ____
pneumothorax
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____,____ and ___ are complications that may follow thoracentesis, but a chest radiograph is not done specifically to look for any of them.
Subcutaneous emphysema, pulmonary edema, and cardiac distress
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What nursing intervention is the most important during a lung scan?
During inhalation, the client may need to hold his or her breath for short periods because scanning images are obtained
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The client receives medication before bronchoscopy—a sedative or narcotic to _____.
depress the vagus nerve.
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