1 - Intro Flashcards
O2 content in arterial blood is dependent on?
PO2
Hg level
Tissue oxygenation depends on what?
Arterial blood O2
-PO2
-Hg level
Cardiac output
Factors that affect ventilation?
Airway resistance (narrow/wide)
Alveolar surface tension (water increases surfactant decreases)
Lung compliance
What can cause a shirt in hemoglobin carrying capacity of O2?
pH
PCO2
Temp
H pH L PCO2, Temp -> bind O2
L pH H PCO2, Temp -> release O2
What forms is CO2 carried in blood?
Bicarbonate (85%)
Carbaminophemoglobin
Dissolved CO2
What triggers breathing?
CO2 buildup, not low O2
Inspiratory capacity
Tidal volume + inspiratory reserve volume
Largest volume of air that can be inspired after normal resting exhalation
Vital capacity
Tidal volume + inspiratory reserve + expiratory reserve
Volume change between max inspiration and max expiration (80% TLC)
Total lung capacity
Tidal volume + inspiratory reserve + expiratory reserve + residual volume
Max inhalation (5-8L)
Functional residual capacity
Expiratory reserve volume + residual volume
Volume of air present in lungs at end of resting exhalation
Tidal volume
Typical volume of respiration
500ml
70/30 broncholes/deadspace
Definition of tachypenia
Rapid respiratory rate
>20
Hyperventilation
Greater than amount required to maintain normal CO2 elimination
- decreased arterial PCO2
Orthopenia definition
Shortness of breath while recumbent
- cardiac disease MC cause
Occurs immediately upon lying down
Paroxysmal nocturnal dypsnea definition
waking from sleep w dypsnea
Doesnt occur immediately upon lying down
Platypnea definiton
Opposite of orthopnea
SOB while upright
Trepopnea definition
SOB while lying on side
DDX for dypsnea?
Respiratory disease Cardiovascular disase Increased respiratory drive -Hyperthyroid -pregnancy Anxiety/psych
Hemoptysis
Coughing/spitting up blood from airway or lung
DDX for hemoptysis
Airway disease (MC)
Parenchymal disease
Pulmonary vascular lesions
What causes lung pain?
Lungs do not have sensory pain fibers so…
Pathology to parietal pleura, diaphragm or mediastinum
Diaphragmatic pain refers to shoulder
Pleural pain stays in chest wall
What is the usual cause of diaphragmatic pain?
Usually results from inflammation or malignancy
Rate, rhythm, depth/tidal volume and time spend?
Pattern of breathing
Rate 12-14 breaths/min
Rhythm: regular
Tidal volume: 5mL/kg
Inspiratory: expiratory time 2:3
Sigh?
Prevents alveolar collapse and occurs approx every 90 breaths
Kussmaul breathing
Rapid, large-volume
Metabolic acidosis
Cheyne-stokes
Rhythmic waxing/waning of tidal volume w regular apnec episodes
Left ventricula failure; high altitude; neurologic dz
Rapid shallow breathing
Restrictive lung disease, respiratory failure
Accessory muscle use at rest
Significant impairment
Expansion of chest w collapse of abdomen
Diaphragm weakness
Asymmetric chest expansion
Atelectasis; effusion; fibrosis; splinting; unilateral airway obst
Adventitious breath sounds?
Abnormal breath sounds
Continuous sounds
Wheezes - High pitched, muscle whistling
Rhonchi - Lower pitched, sonorous, gurgling quality
Discontinuous sounds
Crackles: brief, discrete, nonmusical, popping
- fine: explosive opening of airways
- coarse: gas bubbling through fluid
Digital clubbing means
Chronic lung infections
Lung/pleura malignancies
Chronic interstitial lung disease
AV malformations & non-pulm conditions
Is cyanosis a reliable indicator of hypoxemia?
No
Extrapulmonary signs of pulmonary disease
Digital clubbing
Cyanosis
Peripheral edema
Grades for peripheral edema?
Grade 0+ : no pitting Grade 1+ : mild pitting 2mm Grade 2+ : moderate pitting 4mm Grade 3+ : moderate/severe 6mm Grade 4+ : severe pitting 8mm
