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Upper respiratory system consists of
mouth, nose, paranasal sinuses and pharynx
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Lower respiratory system consists of
larynx, trachea, principal bronchi, bronchial tree, pleura, mediastinum, lungs, and diaphragm
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Conducting airway is from the _____ to the ______
nose to the terminal bronchioles
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Larynx starts and ends where
starts at base of tongue (hyoid bone) and extends to beginning of trachea.
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3 paired cartilages of larynx
- arytenoid
- corinculate
- cuneiform
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3 unpaired cartilages of larynx
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extrinsic muscles of larynx (4)
- -inferior constrictor
- -sternothyroid
- -thyrohyoid
- -stylopharyngeus and palatopharyngeus (few fibers)
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Extrinsic muscles of Larynx
(Indirect elevators 3)
- Geniohyoid
- stylohyoid
- mylohyoid
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Extrinsic muscles of Larynx
(Indirect depressors 2)
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List intrinsic muscles of Larynx (7)
- 1. cricothyroid
- 2. cricoarytenoid (posterior and lateral)
- 3. transverse arytenoid
- 4. oblique arytenoid
- 5. aryepiglotticus
- 6. thryoarytenoid
- 7. thyroepiglotticus
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Fx of cricothyroid (intrinsic) muscle of larynx
lengthen and stretches vocal cords tensor muscle
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Fx of posterior and lateral cricoarytenoid (intrinsic) muscle of larynx
posterior- only one that abducts, all others adduct
lateral- adducts cords and closes glottis
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Fx of transverse arytenoid (intrinsic) muscle of larynx
only unpaired muscle, adducts, pulls arytenoids toward eachother
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Fx of oblique arytenoid (intrinsic) muscle of larynx
narrow inlet, constricts
(something about disease in notes ????)
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Fx of aryepiglotticus (intrinsic) laryngeal muscle
close opening when swallowing occurs
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fx of thyroarytenoid (intrinsic) muscles of larynx
tensor, wide inlet, lower voice pitch
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Fx of thyroepiglotticus (intrinsic) muscles of larynx
widens inlet, involved with closure of epiglottis during swallowing
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sphincter of the vestibule in larynx
aryepiglotticus
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opener of laryngeal inlet
thyroepiglotticus
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abductors of the vocal cords
posterior cricoarytenoid
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tensors of the cord
cricothryoid
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adductors of the cord
- transverse arytenoid
- lateral cricarytenoid
- cricothyroid
- thyroarytenoid
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relaxers of the cord
thryoaryenoid vocalis
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Internal laryngeal nerve is located _____ the vocal cords and the recurrent laryngeal nerve is located ____ the vocal cords
above
below
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Damage to internal laryngeal nerve abolishes?
This increases risk for what?
cough reflex
This increases risk for foreign body or aspiration pnemonia
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Vocal cords open for _____ and close for ______?
inspiration and swallowing
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Superior laryngeal nerve has what two nerves and what do they do
- internal laryngeal nerve- sensory info above vocal cords
- external laryngeal nerve- motor fx to cricothyroid cartilage.
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Recurrent laryngeal nerve does what
- (does both sensory and motor)
- sensory info below vocal cords
- motor fx to all muscles of larynx except cricothyroid
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Unilateral damage to superior nerve (internal and external) causes.....
-bilateral damage......
unilateral- subtle finding
bilateral- hoarseness
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Unilateral recurrent laryngeal nerve injury
Bilateral injury acute and chronic.....
unilateral injury- deterioration of voice quality (hoarseness)
- bilateral-
- *acute-stridor and distress
- *chronic- less severe body will adapt
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Causes of recurrent laryngeal nerve injury
- thyroid malignancies
- lung and esophageal tumors
- aortic arch aneurysms
- mitral stenosis- left pulmonary artery pushed upwards, nerve gets compressed, between the Left pulmonary artery and the arch of aorta.
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Vagal nerve damage causes what
bilateral flaccid midline cords
phonation impaired- airway control is rarely a problem.
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Parasympathetic innervation (muscarinic) of resp system
contraction and constriction of airways
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Sympathetic innervation of resp system
Example of a drug:
beta 2 receptors on bronchi activated by epinephrine (adrenal medulla) and beta 2 agonists.
Albuterol
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Right main bronchus
- 2.5 cm long (from the carina)
- shorter, wider, and more vertical than left stem
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Left main bronchus
- -narrower than right
- -5 cm long
- -5 cm uninterrupted lumen by branching makes it suitable for intubation and blocking in thoracic surgery
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Left main bronchus degree
In children
takes off at 45 degrees
55 degrees
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Right main bronchus degree
takes off at 25 degrees
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How many alveoli in each lung
300 million
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Alveoli are lined with surfactant that helps....
decrease surface tension
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type I cells that form alveoli are called and do what
pneumocytes , and they are structural cells
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type II cells that form alveoli are called_____ and do what?
pnemocytes and they produce surfactant to reduce alveolar collapse from surface tension
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Tidal Volume
normal TV
- normal quiet breathing
- 500 ml
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IRV
total volume
additional volume that can be inspired above tidal volume
3000ml
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ERV
total volume
- the additional volume that can be expired below TV
- 1200
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RV
total volume
the volume of gas remaining in the lungs after a maximal forced expiration
1200ml
***cannot me measured by spirometry
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TLC=
TOTAL VOLUME
RV+ERV+VT+IRV
5900 ml
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VC=
TOTAL VOLUME
ERV+VT+IRV
4700ml
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FRC=
total volume
RV+ERV
2400ml
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Inspiratory capacity=
total volume
VT+IRV
3500ml
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FRC is
the balance point between the tendency of the chest wall to spring outwards and the tendency of the lung to recoil
--what is remaining in the lungs after normal tv is expired
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