Tiêu đề NCM 112 MIDTERMS ✅

NCM 112 MIDTERMS by TONS and MADS 1. 4 pairs of bony cavities that lined with nasal mucosa and ciliated pseudostratified columnar epithelium connected by series of ducts that drain pinto nasal cavity. 2. Serve as resonating chamber in speech. 3. Common site of infection. D. Pharynx (throat) 1. Tubelike structure that connects nasal and oral cavities to larynx. 2. Passageway for respiratory & digestive tracts 3. 3 regions: nasal, oral, and laryngeal. a) Nasopharynx: posterior to nose and above soft palate. b) Oropharynx: faucial or palatine tonsils. c) Llaryngopharynx extends from hyoid bone to cricoid cartilage. 4. Adenoids or pharyngeal tonsils a) Roof of nasopharynx b) Important links in chain of lymph nodes guarding from invasion by organisms entering nose and throat 5. Trachea (Part of Upper in Book) - windpipe a) composed of smooth muscle with C-shaped rings of cartilage at regular intervals. b) cartilaginous rings incomplete on posterior surface give firmness to the wall of trachea, preventing it from collapsing. c) Passage between larynx and bronchi. II. LOWER RESPIRATORY TRACT A. Trachea B. Mainstream Bronchi C. Alveolar Ducts & Alveoli - basic unit of gas exchange D. Lungs 1. Divided into 5 lobes a) 3 in Right: RU, right middle (RML), RL lobe b) 2 in Left 2. Paired elastic structures enclosed in thoracic cage, which is an airtight chamber with distensible walls. 3. Lobes - subdivided into 2-5 segments separated by fissures, which are extensions of pleura E. Pleura 1. Serous membrane that lines the lungs and wall of the thorax a) Visceral pleura covers lungs b) Parietal pleura lines thorax. 2. Pleura and small amount of pleural fluid between two membranes lubricate thorax and lungs and permit smooth motion of lungs within thoracic cavity w/ each breath. F. Mediastinum - in middle of thorax, between pleural sacs that contain two lungs. 1. Contains all thoracic tissue outside lungs (heart, thymus, certain large blood vessels [aorta, vena cava], and esophagus). G. Bronchi and Bronchioles 1. Lobar bronchi (3 in right and 2 in left lung). a) Divide into segmental bronchi (10 on right and 8 on left) 2. Segmental bronchi - structures identified when choosing most effective postural drainage position for a given patient a) Divide into subsegmental 3. Subsegmental bronchi a) Surrounded by connective tissue that contains arteries, lymphatics, and nerves. b) Branch into bronchioles 4. Bronchioles a) have no cartilage in walls; Patency depends on elastic recoil of surrounding smooth muscle and alveolar pressure. b) Contain submucosal glands, which produce mucus that covers inside lining of airways. c) Bronchi and bronchioles are lined with cells that have surfaces covered w/ cilia which create constant whipping motion that propels mucus and foreign substances away from lungs toward the larynx. d) Bronchioles branch to terminal bronchioles, which do not have mucus glands or cilia. 5. Terminal (respiratory) bronchioles a) transitional passageways between conducting and gas exchange airways. b) Conducting airways contain about 150mL air in tracheobronchial tree that does not participate in gas exchange “physiologic dead space” 6. Respiratory bronchioles → alveolar ducts and sacs → alveoli (O2 and CO2 exchange). H. Alveoli 1. 300 million arranged in clusters of 15-20; would cover 70sqm (tennis court) 2. 3 types koooo k2

NCM 112 MIDTERMS by TONS and MADS inactivity, depressed function of medullary centers (anesthesia, brain disorders). c) Irritation of mucous membranes anywhere in respiratory tract → COUGH d) Stimulus that produces cough: infectious process or airborne irritant (smoke, smog, dust, gas) e) Persistent frequent cough → exhausting, pain. f) May indicate serious pulmonary disease, cardiac disease, medication reactions (amiodarone, ACE inhibitors, smoking, GERD) g) To determine cause, describe the cough: (1) Dry, irritative cough: URTI viral or side effect of ACE inhibitor. (2) Irritative high-pitched cough: laryngotracheitis (3) Brassy cough: tracheal lesion (4) Severe or changing cough: bronchogenic carcinoma. (5) Pleuritic chest pain w/ coughing: pleural/chest wall (musculoskeletal) involvement. h)Inquire about onset & time of coughing. (1) Coughing at night: onset of left-sided HF or bronchial asthma. (2) Cough in morning with sputum production: bronchitis. (3) Cough worsens when supine: postnasal drip (rhinosinusitis). (4) Coughing after food intake: aspiration in tracheobronchial tree. (5) Cough of recent onset: acute infection. i) Persistent cough → embarrassment, exhaustion, inability to sleep, and pain. j) Violent coughing → bronchial spasm, obstruction, further irritation of bronchi → syncope (fainting). k) Severe repeated nonproductive uncontrolled cough → exhausting harmful. 3. Sputum Production a) coughs long enough → produces sputum. b)reaction of lungs to constantly recurring irritants. c) may be associated w/ nasal discharge. d) Nature of sputum is indicative of its cause. (1) Profuse purulent (thick, yellow, green, or rust-colored) or change in color: bacterial infection. (2) Thin mucoid: viral bronchitis (3) Gradual increase of sputum: chronic bronchitis or bronchiectasis (4) Pink Tinged mucoid: lung tumor. (5) Profuse, frothy, pink material, often welling up into throat: pulmonary edema. (6) Foul-smelling sputum & bad breath: lung abscess, bronchiectasis, or infection caused by fusospirochetal or other anaerobic organisms. 4. Chest Pain or Discomfort a) If associated with pulmonary conditions: (1) Sharp, stabbing, intermittent; or (2) Dull, aching, and persistent. b) Pain usually on the side where pathologic process is located, but may be referred elsewhere (neck, back, or abdomen) c) May occur with pneumonia, pulmonary embolism with lung infarction, pleurisy, or late symptom of bronchogenic carcinoma. d) Carcinoma: pain dull & persistent because cancer invaded chest wall, mediastinum, or spine. e) Lung disease does not always cause thoracic pain because lungs and visceral pleura lack sensory nerves and insensitive to pain stimuli. (1) Parietal pleura has rich supply of sensory nerves stimulated by inflammation & stretching of membrane → Pleuritic pain (sharp and seems to “catch” on inspiration) “like the stabbing of a knife.” (2) Lay on affected side because this splints chest wall, limits expansion and contraction of lung, reduces friction between injured or diseased pleurae (Pain associated with cough reduced manually by splinting rib cage.) f) Assess quality, intensity, radiation of pain & identify & explore precipitating factors & relationship to patient’s position, inspiratory and expiratory phases 5. Wheezing a) high-pitched musical sound on expiration (asthma) or inspiration (bronchitis). b) often major finding in bronchoconstriction koooo k4