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ACP > 100b > Flashcards

100b Flashcards

1
Q

upper air way

A
  1. Pharynx
    - Nasopharynx – nose to uvula
    - Oropharynx – Nasopharynx to epiglottis
  2. Larynx – epiglottis to glottis
  3. Thyroid cartilage
  4. Glottic opening
  5. Arytenoid cartilage – false vocal cords
  6. Pyriform fossae
  7. Cricoid ring
  8. Vallecula – base of tongue meeting epiglottis, hyoid epiglottic ligament
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2
Q

lower air way

A

Functions to exchange O2 and CO2

Trachea – glottis to bronchi bifurcation, 16-20 cartilaginous incomplete rings, carina

Bronchi

Bronchioles – smallest airway without alveoli

Alveoli

Lungs – L 2 lobes, R 3 Lobes

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3
Q

pharynx

A

nasopharynx
oropharynx
(epiglottis sits between oro and hypo)
hypopharynx

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4
Q

larynx

A

vocal cords
thyroid cartilage
cricoid cartilage

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5
Q

esophagus

A

attaches to the stomach, runs postieor to the larynx

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6
Q

minute volume

A

tidal volume x ventolations per min

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7
Q

tidal volume

A

amount of air inhaled in one breath

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8
Q

dead space

A

the air that fills the upper and lower airways but doesnt actually get used by the body simply fills the cavities
approx 150ml

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9
Q

perfusion

A

delivery of oxygenated blood to tissues

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10
Q

shock

A

lack of end organ perfusion leading to anaerobic metabolism

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11
Q

effects of anaerobic metabolism

A

cause build up of waste products acids eg. latic acid and pyruvic acid. and cell death

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12
Q

anaerobic metabolism

A
  • which can be defined as ATP production without oxygen
  • much less effective
  • occurs in 3 stages glycolysis , the Krebs cycle , and electron transport
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13
Q

fick principle

A
  • adequate supply of O2
  • on loading of O2 to RBCs
  • delivery of oxygenated RBCs to tissue
  • off loading of O2 from RBC to tissue
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14
Q

cellular respiration

A

chemical reactions breaking down food to use as energy

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15
Q

increased H+ in the body

A

causes decreased PH causing metabolic acidosis

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16
Q

brain damage
heart damage
organ damage

A

4-6 min
starts 30-60 seconds
minutes to hours depending on the organ

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17
Q

norepinephrine

A

released causing peripheral vasoconstriction

increased chrontropic, inotropic effects increasing organ perfusion

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18
Q

stroke volume

A

amount of blood pumped by the heart in one contraction

approx 70ml

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19
Q

perload

A
  • passive stretching on the walls of the heart

- more blood in, increased stretching, increased contraction, increased output

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20
Q

blood pressure

A

force that blood exerts on artery walls

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21
Q

cardiac out put

A

stroke volume x heart rate (BPM)

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22
Q

blood buffer system

A
  • almost instant
  • protects form changes in H+
  • chemical sponge absorbing H+ when there is excess and releasing H+ when levels are low
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23
Q

ratio of Bicarb to H+

A

20:1

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24
Q

respiratory buffer

A

-aids in correcting acid base imbalance by controlling CO2 levels
-CO2 in the body increase, resp rate increases to blow off CO2
-increased resp = decreased CO2 and H2CO3 = increased PH
decreased resp = increased CO2 and H2CO3 = decreased PH

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25
Q

decreased CO2

A

increased blood PH

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26
Q

increased CO2

A

decreased blood PH

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27
Q

renal buffer

A
  • slowest to act but most effective

- kidneys excrete H+ and form HCO3

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28
Q

CO2 + H2O = H2CO3 = H + HCO3

A

uses buffer systems to shift back and forth to maintain PH (homeostasis)

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29
Q

4 types of imblances

A

respiratory acidosis
respiratory alkalosis
metabolic acidosis
metabolic alkalosis

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30
Q

respiratory acidosis

A
  • decreased resp rate causing the body to retain CO2
  • increased CO2 in blood causing decreased PH and a surplus of H2CO3
  • easily correctable by increasing resp rate and blowing off CO2
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31
Q

respiratory alkalosis

A
  • increased resp rate causing excess CO2 to be exhaled

- decreased CO2 leads to increased PH and decreased H2CO3

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32
Q

metabolic acidosis

A
  • renal impairment
  • decreased HCO3 increased H2CO3
  • increased PH
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33
Q

metabolic alkalosis

A
  • ingestion of alkaline products (baking soda, tums)
  • prolonged vomiting (decreasing acid in body)
  • increased HCO3 and decreased H2CO3
  • decreased PH
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34
Q

3 stages of shock

A

compensated - < 15% blood loss
decompensated - 15%-25% blood loss
irreversible - > 25% blood loss

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35
Q

compensated shock (stage 1)

A
  • body recognizes a problem and attempts to correct it by initiating a sympathetic response
  • norepi and epi released, increased HR, peripheral vasoconstriction, increased BP
  • shunting blood from limbs
  • decreased urine out put
  • increased resp rate (combat metabolic acidosis)
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36
Q

decompensated shock (stage 2)

A

body cant compensate forever, condition worsens and compensatory mechanisms begin to fail

  • BP decreased with increased HR and RR
  • epi is still being released in an attempt to oxygenate vital organs
  • peripheral cells are now hypoxic and anaerobic metabolism is the only option, this produces greater amounts of acid and increases the acidity (decreased PH) in the body.
  • metabolic acidosis increases and vital organs began to get affected
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37
Q

irreversible shock (stage 3)

A
  • body can no longer compensate even with medical interventions
  • BP, HR, RR and perfusion decline and begin to fail
  • blood shunted from liver, kidneys and lungs in an attempt to oxygenate heart and brain
  • organs start to die
  • decreased LOC, feeling of impending doom
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38
Q

hypovolemic shock

A
  • caused by fluid loss
  • can be blood, or fluid volume
  • internal or external loss
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39
Q

cardiogenic shock

A

-caused by heart failure, most common the left ventricle. If L ventricle is 40% damaged the heart is unable to properly pump blood

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40
Q

neurogenic shock

A
  • disconnect between nervous system and body
  • unable to control blood vessels, they relax and dilate creating to large a space for the volume of blood to full
  • no compensated phase
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41
Q

septic shock

A
  • caused by infection

- toxins released cause vasodilation

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42
Q

anaphylactic shock

A
  • caused by exposure to allergen triggering a histamine release
  • bronchoconstriction
  • vasodilation
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43
Q

stage 1 vasoconstriction

A

15%

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44
Q

stage 2 capillary and venule opening

A

15%-25%

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45
Q

stage 3 disseminated coagulation

A

25%-35%

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46
Q

stage 4 multiple organ failure

A

greater than 35%

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47
Q

beta 1

A

increased chronotropic, inotopic and dromotropic

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48
Q

beta 2

A

bronchodilation

smooth muscle dilation

49
Q

norepinephrine

A
  • primary alpha 1 and 2
  • vasoconstriction
  • increased PVR and afterload
50
Q

AVP arginine vasopressin

A

also known as ADH
released from pituitatry glad
increased water absorption and decreased urine out put

51
Q

renin-angiotensin

A
  • renin released from kidneys
  • renin and angiotensin combine and produce angiotensin I
  • angiotensin I converted to agiotensin II by enzymes
  • potent vasoconstrition
  • sodium reabsorption
  • inotropic and chrontropic
52
Q

aldosterone

A

defends fluid volume
sodium reabsorption
water retention
decreased urine output

53
Q

Drug Sources

A

Five major sources of drugs

  • Plants
  • Animals/humans
  • Minerals
  • Microorganisms
  • Chemical substances
54
Q

Drug Names

A
  1. Chemical
    - chemical make up or structure
  2. Generic or Non-proprietary
    - Not capitalized
    - abbreviated chemical name
  3. Trade, Brand or proprietary name
    - copyright name designed by selling drug company
  4. Official
    - usually the same as generic name followed by USP or NF
55
Q

Drug Control in Canada

A
  • Department of health Canada – bureau of drug surveillance
  • Canada food and drugs act & regulation
  • Narcotics Control act & regulations
56
Q

General Properties of Drugs

A

1-Action – what the drug does and how it goes about this
2-Indications - what the drug is used for
3-Contraindications – conditions for which the drug should not be given
4-Therapeutic effects – desirable drug actions
5-Major Side Effects – undesirable or harmful drug actions
6-Precautions – conditions or potential problems of which you should be aware
7-Preparations – how the drug comes packaged
8-Dosage – how much is given to achieve desired effects

57
Q

Potential Reactions to Drug Therapy

A
  • Antagonists
  • Contraindication
  • Cumulative action
  • Depressant
  • Allergy
  • Dependence
  • Interaction
  • Idiosyncrasy
  • Potentiation
  • Stimulant
  • Summation
  • Synergism
  • Therapeutic action
  • Tolerance
  • Untoward effect
58
Q

Antagonist

A

agents designed to inhibit or counteract effects of other drugs or undesired effects caused by normal or hyperactive physiological mechanisms

59
Q

contraindication

A

medical or physiological factors that make it harmful to admin a drug

60
Q

cumulative action

A

tendency for repeated doses to accumulate in blood and organs causing increased and sometimes toxic effects

61
Q

depressant

A

substance which decreases a function or activity

62
Q

allergy

A

systemic reaction to a drug resulting from a previous sensitizing exposure and development of immunological mechanism. Can be initiated by drug itself or a metabolite of

63
Q

dependance

A

state of which withdrawal of a drug causes intense physical or emotional disturbance

64
Q

interacton

A

beneficial or detrimental modification of the effects of one drug by the prior or concurrent admin of another drug

65
Q

idosyscrasy

A

abnormal or peculiar response to a drug

66
Q

potentiation

A

enhancement of effects caused by concurrent admin of two drugs in which one drug increases effects of the other

67
Q

stimulant

A

drug that enhances or increases body function or activity

68
Q

Summation

A

combined effect of two drugs such that the total effects equals sum of individual effects (1+1=2)

69
Q

Synergism

A

the combined action of two drugs such that the total effect exceeds the sum of the individual effects (1+1=3)

70
Q

Therapeutic action

A

desired intended actions of drug

71
Q

Tolerance

A

decreased physiological response to repeated admin of a drug

72
Q

Untoward effect

A

side effect proving harmful

73
Q

Types of Drug Reactions

A

Type I – Anaphylaxis, IgE antibody and antigen complexes stimulating release of histamines

Type II – Cytotoxic, IgG antibody and antigen stimulating hemolysis and platelet destruction

Type III – Serum Sickness, IgG antibody and antigen complexes producing inflammatory reaction

Type IV – Contact dermatitis reaction – topical application stimulates T lymphocyte production causing dermatitis

74
Q

biotransomation

A
  • process by which the drug is chemically converted to a metabolite
  • liver is the primary site and aim is to “detoxify” the drug
75
Q

agonists

A

drug that binds to a receptor and causes a response

76
Q

antagonists

A

drug that binds to a receptor to inhibit a response or block something else from binding to that site

77
Q

Sympathetic (adrenergic)

A

Parasympathetic (cholinergic)

78
Q

Sympathetic exits from thoracic and lumbar regions of spinal cord

A

Parasympathetic exits from cranial and sacral portion of spinal cord

79
Q

Sympathetic ganglia are found near spinal column

A

Parasympathetic ganglia are found near the effector organ

80
Q

Types of Nerve Fibers

A

Visceral Afferent – Sensory – convey impulses from organs to CNS

Visceral Efferent – Motor – convey impulses from CNS to organs

Somatic Afferent – Sensory – Convey impulses from head, body wall and extremities to CNS

Somatic Efferent – Motor -Convey impulses from CNS to striated muscle

81
Q

preganglionic neuron

A

located in CNS passes between CNS and ganglia

fibers are autonomic

82
Q

postganglionic neuron

A

located in the periphery, passes between ganglia and effector organ
fibers are sympathetic

83
Q

synapse

A

junction between 2 neurons

84
Q

acetylcholine (ACH)

A

neurotransmitter

fibers that release ACH are cholinergic

85
Q

nicotinic

A

excitatory response

86
Q

muscarinic

A

can excite or inhibit

87
Q

sympathetic

A

alpha and beta recptors

88
Q

parapympathetic

A

nicotinic and muscarinic receptors

89
Q

cholinergic is parasympathomimetic (mimic parasysmpathic)

A

cholinergic blocking is parasympatholytic

90
Q

adrenergic is sympathomimetic

A

adrenergic blocking is sympatholytic

91
Q

Respiration

A

exchange of oxygen and carbon dioxide between an organism and the environment

92
Q

External Respiration

A

transfer of oxygen and carbon dioxide between inspired air and capillaries

93
Q

Internal Respiration

A

Transfer of oxygen and carbon dioxide between peripheral blood capillaries and tissue cells

94
Q

Pressure gradient (required for gas flow into lungs) produced by differences in

A

Atmospheric pressure

Intrapulmonic pressure

Intrapleural (intrathoracic pressure)

95
Q

Inspiration and Expiration Based on

A

Muscles of respiration

Compliance

Work of breathing

Pulmonary surfactant – lipoproteins reduce surface tension allowing alveoli to stay open

Airway resistance

Structural Changes in lungs or thorax

96
Q

gass pressures

A

PaO2 - partial pressure of arterial O2, normal 80-100mmHg

PO2 - partial pressure of venous O2

PaCO2 - partial pressure arterial CO2, normal 35-45mmHg

PCO2 - partial pressure of venous CO2

97
Q

Oxy-Hemoglobin Dissociation Curve

A

Offloading of O2 based on need, in exercising tissues percentage of saturation of hemoglobin can decrease to 25%, results in release of 75% of transported O2

Partial pressure can maintain for a while but will then drop off quick

98
Q

`BOHR Effect

A

High CO2 equals drop in pH and decrease of O2 affinity for Hgb

Low CO2 equal rise in pH and increase in O2 affinity for Hgb

99
Q

6 P’s of RSI

A
  • Preparation
  • Preoxygenation
  • Pretreatment
  • Paralysis with induction
  • Placement of tube
  • Postintubation management
100
Q

Phernic nerve

A

responsible for moving the diaphragm

101
Q

right upper quadrant

A 
liver
gallbladder
pylorus
duodenum
pancreas head
R adrenal glad
top of R kidney
colon- ascending and transverse
102
Q

left upper quadrant

A 
left lobe of liver
spleen
stomach
body of pancreas
left adrenal glad
portion of left kidney
transverse and descending colon
103
Q

right lower

A 
lower pole of kidney
appendix
ascending colon
bladder
ovary
uterus
104
Q

left lower

A 
lower pole of kidney
sigmoid colon
descending colon
bladder
ovary
uterus
105
Q

cranial nerves

A 
1-Olfactory        7-Facial
2-Optic             8-Acoustic
3-Oculomotor  9-Glossopharyngeal
4-Trachlear      10-Vagus
5-Trigeminal    11-Spinal accessory
6-Abducens    12-Hypoglossal
106
Q

cranial nerve 1

A

olfactory- sensor nerve

107
Q

cranial nerve 2

A

optic- sensory nerve

108
Q

cranial nerve 3

A

oculomotor- motor nerve

109
Q

cranial nerve 4

A

trachlear- motor nerve

110
Q

cranial nerve 5

A

trigeminal- both

111
Q

cranial nerve 6

A

abducens- motor

112
Q

cranial nerve 7

A

facial- both

113
Q

cranial nerve 8

A

acoustic- sensory

114
Q

cranial nerve 9

A

glossopharyngeal- both

115
Q

cranial nerve 10

A

vagus- both

116
Q

cranial nerve 11

A

spinal- motor

117
Q

cranial nerve 12

A

hypoglossal- motor

118
Q

percussion sounds

A 
loudest to quietest
tympany
hyperresonance
resonance
dullnes
flatness

ACP (15 decks)

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