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36 Cards in this Set
- Front
- Back
The physiologic hierarchy includes _____, ______, and _____. (in order)
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respiration, swallowing, and speech.
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***three types of respiration
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ventilation- the movement of air back and forth between the outside atmosphere and the inner spaces od the lungs
external respiration - exchange of gases between walls of lung spaces and the transporting blood internal respiration- gases are exchanged between blood and cells ofthe body |
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large alveolus = ____ collapsing pressure
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low
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small alveolus = ____ collapsing pressure
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high
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The small size of alveoli present a problem in keeping them open. ________ generates a pressure that can collapse alveoli
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surface tension
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Law that explains that the collapsing pressue on alveolus is equal to 2 times the surface tension divided by the radius of the alveolus
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Law of LaPlace
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****what combats the fact that small alveolus have a tendency to collape? how?
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Surfactant-- Without surfactant, the Law of LaPlace says that small alveolus will collapse. With surfactant, the small alveolus remain open.
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*** What is it called when small alveolus will collapse?
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atelectasis
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What is the space between 2 pleura?
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pleural cavity or intrpleaural space
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The thorax houses which system? what does this include?
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Pulmonary system- includes the trachea, bronchi, and lung structures themselves
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What is a collapsed lung called?
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Pneumothorax
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what are the 3 pumping actions of respiration?
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1) quiet inhalation- few muscles are used
2) forced inhalation- muscles enlarge volume of thorax and decrease pressure within the thorax so air will flow in the lungs 3) exhalation- compressive pumping action decreases volume of thorax and increases pressure on air within |
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Main way to increase vertical space in the thorax
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by way of diaphragm muscle
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respiratory physiology at rest
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1) quiet inhalation- active muscles expand thoracic volume to decrease internal air pressure
2) quiet exhalation- relaxation of muscles of inhalation so ribs and or diaphragm can return to their rest position, decreasing thoracic volume and increasing pressure |
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Most common pattern of coordination of respiration and swallowing: ____% do what?
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60-80% inhale, start to exhale, stop exhale, swallow and airway closes, return to exhalation thought to be protective, prevents residual food in the airway. Other method - begin on inhalation and return on inhalation
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An acute lung injury caused by acidic and particulate gastric contents such as reflux
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pneumonitis
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What is COPD? 2 types
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Chronic Obstructive Pulmonaty Disease: emphysema and chronic bronchitis
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** how fatal is aspiration pneumonia?
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fatal in 20-50% of the cases. Acute inflamnation caused by infection; reaction to acgteria and bacterial byproducts
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6 valves involved in swallowing
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1) lips
2) velar-lingual 3) tongue oral and base 4) velopahryngeal 5) laryngeal 6) cp muscles.UES |
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apnea
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pause during the swallow, 1/3 to 2/3 of a second; longer apneic pause with larger thicker boluses also longer with straw/cup drinking
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upper airway versus lower airway
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upper airway includes the oral, nasal, pharyngeal, and laryngeal tract. The lower airway includes the trachea, bronchi, and lungs
the larynx is the boundary between the upper and lower airway |
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main valves in the upper airway:
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oral- secondary airpway- use tp inhale or exhale if the nasal cavity is blcoked
nasal- primary airway pharyngeal tube- in swallowing, its open except for closing at certain points laryngeal tube- protection of airway, clears secretionsd, valve for throcic fixation so abdominal pressure can be accomplished (for heavy lifting) |
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setting of valves in upper airway during respiration depends on activity. how would you set them for quiet breathing?
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lips together, velopharyngeal port open, glottis open
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exerted breathing?
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lips open, VP closed, glottis open
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speech breathing?
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lips open,vp closed, larynx rapid movement
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swallowing?
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depends on phase
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normal respiration rate young
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16 per minute
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normal respiration rate elderly
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20 per minute
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4 structural esophageal dysphagia etiologies
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1) schatzki's ring
2) peptic stricture 3) hiatal hernia 4) esophageal diverticula |
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categories of esophageal dysphagia
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1) structural (the biggie!!)
2) motility 3) infectious 4) neoplastic (cancer) 5) inflammatory 6) iatrogenic |
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prevelance of schiatzki's ring. population.
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2nd most common cause of structual esophageal dysphagia. found in 4-15% of radiographic studies. autopsy shows 9%. typical age is 50-70 yo. ring size important. dysphagia common in rings greater than 13 mm.
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where is schiatzki's ring localized?
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to esphageal squmocolumnar junction and almost invariably coexist with a hiatal hernia which is most present in the Western population and about 60% of elderly
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"Steakhouse Syndrome"
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Schiatzki's ring
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what is a peptic stricture
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alergenic; mucosal rings that line esophagous and resemble the tracha, now the most common cause of esphageal dysphagia. treatable with meds, dietary restrictions, steroids and dialation
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hierarchy of GERD to major problems:
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1) 38% of people in US have heartburn at least once a month. 11% on daily basis
2) 1/3 of people seeking medical attention for symptoms of GERD have esophagitis 3) approx. 10-20% of people with esophagitis develop serious complications |
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name some local complicationd of esophagitis reflux
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erosive esophagitis
bleeding esoph. ulcers esoph. stricture barret's esophagus esophageal adenocarcinoma |