The Respiratory System

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The Respiratory System
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REVIEW OF RESPIRATORY SYSTEM

• External nares
• nasal cavity
• nasopharynx
• oropharynx
• larynx
• glottis
• trachea
• rt/lt bronchi

• Hilum
• secondary bronchi/tertiary bronchi bronchial
  tree
• bronchioles
• terminal branchs aka respiratory bronchioles
• alveolar ducts

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BRONCHOGRAPHY

• chest physiotherapy
• TOSS EVERYTHING ELSE OUT ON THIS TOPIC.
• CT IS PREFERRED TOOL

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THORACIC CT (pg 717)

• Chest x-ray still preferred as screening tool
• Pathologic indications
• Review the procedure for complete CT of chest and
  answer the following questions

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• Where slices are to be obtained is determined
  how?
• Scanning to ascertain pulmonary metastasis
  continues to the adrenals. Why?
• High resolution chest CT 2-3 mm vs. 7- 10 mm
  slices for routine CT studies
• Radiopaque esophageal creams are used for what
  reason?
• Two sets of window settings in Chest CT lung
  windows and mediastinal windows page 739

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Alternative imaging modalities

• Sonography
• Nuc Med
• MRI

• Pleural effusion
• Guidance for needle insertion
• Pulmonary emboli
• Pneumonia
• Metastasis
• See pg 91
• Adjunct to CT

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LUNG BIOPSY

• Indications
• bronchogenic carcinoma
• solitary pulmonary nodule
• multiple nodules

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LUNG BIOPSY CONT.

• Equipment
• r/f or C-arm
• CT if lesion cannot be visualized by fluoro
• US if lesion is fluid filled or well defined
• CHIBA
• Crash cart

• Patient prep
• Clotting time test
• Pulmonary function test
• mild sedation
• Post
• 15 of casespneumothorax
• 5 temp.hemoptysis
• Empyema

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LUNG BIOPSY PROCEDURE

• PT prone for post. Lesion
• supine for ant. Lesion
• localized by biplane fluoro
• skin above marked, local given - into pleura
• needle inserted during rested suspended
  respiration
• needle inserted to periphery of lesion
• suction applied to obtain sample
• 3 passes with 22 gauge

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Cardiac Pacemaker(Page 458) Comprehensive
Pathology)
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Facts about cardiac pacemakers

• Maintains cardiac rhythm
• Tip of pacemakerapex of right ventricle
• Pa and Lat. To confirm position
• Chest x-rays to r/o electrode fractures
• near pulse generator, bends of wires, where
  inserted in epicardium
• Perforation of myocardium
• at insertion or a few days later
• no sense or elicits a ventricular response

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ECG (EKG)

• Patient care book, pg 345
• P wave
• QRS complex
• T wave
• U wave
• Sinus bradycardia
• Sinus tachycardia
• PVC