Breathe Flashcards
1
Q
Atmospheric Partial Pressures
A
PO2: 159mmHg
PCO2: 0.3mmHg
2
Q
Alveolar Partial Pressures
A
PO2: 105mmHg
PC02: 40mmHg
3
Q
Most Abundant Gas
A
Nitrogen
4
Q
Gas Mass
A
760
5
Q
Each inhalation/exhalation in Milliliters
A
500ml
6
Q
Tidal Volume
A
One breath
7
Q
% of volume involved in gas exchange
A
70%
8
Q
% of Anatomical Dead Space
A
30%
9
Q
Eupnea
A
Normal quiet breathing
10
Q
Costal Breathing is
A
shallow
11
Q
Diaphragmic Breathing is
A
Deep
12
Q
Costal breathing movement
A
upward and outward movement of chest
13
Q
Diaphragmic breathing movement
A
Outward movement of abdomen
14
Q
External Respiration is
A
pulmonic gas exchange
15
Q
External respiration involves
A
alveoli and pulmonary capillaries
16
Q
Internal Respiration movement
A
Outward movement
17
Q
Internal Respiration involves
A
02 and CO2 exchange in capillaries and tissue
18
Q
P02 in Systemic Capillaries
A
100mmHg
19
Q
PO2 in tissue
A
40mmHg
20
Q
Partial Pressure of Oxygenated Blood
A
PO2: 100mmHg
PC02: 40mHg
21
Q
Partial Pressure Deoxygenated Blood
A
PO2: 40mmHg
CO2: 45mmHg
22
Q
Muscles of quiet exhalation (passive)
A
Diaphragm and external intercostal
23
Q
Muscles of forced exhalation
A
Internal Intercostal
External Oblique
Internal Oblique
Transverse Abdomen
Rectal Abdomen
24
Q
O2 and CO2 transfer by
A
Passive diffusion
25
3 factors of oxygen transport
CAT
Carbon dioxide, acidity, temperature
26
Atmospheric Pressure is Higher than...
alveolar
27
Lung Volume decreases, alveolar pressure...
increases and passive diffusion occurs
28
Carbon Dioxide Transport 3 main forms
7% of CO2 dissolves into plasma
23% is bound to amino acids (hemoglobin)
greatest percentage of CO2 is bicarb at 70%
29
HCO3
Bicarbonate ions
30
Rest Pressure : alveolar and intrapleural
alveolar 760mmHg
intrapleural 756mmHg
31
Resting pressure is equal to
Atmospheric pressure
32
Inhalation Pressure vs Atmospheric Pressure
Below atmospheric
33
Exhalation Pressure vs Atmospheric Pressure
Above Atmosphere
34
Oblique Fissure
divides left lung into 2 lobes and right lung into 3
35
Microscopic Airway Path
Terminal bronchioles
Respiratory bronchioles
Alveolar Ducts
Alveolar Sacs
Alveoli
36
Branching of Bronchial Tree
Trachea
Main Bronchi
Lobar Bronchi
Segmental Bronchi
Bronchioles
Terminal Bronchioles
37
Muscles of Quiet Inhalation
Diaphragm (75% of air entering lungs)
External Intercostal
Thoracic Floor
38
Deep breath muscles
Sternocleidomastoid
Scalene
Pectoralis Minor
39
3 Bronchi aka Bronchial Tree
Primary: Main
Secondary: Lobar
Tertiary: Segmental
40
Inhaled particles are removed by
Macrophages
41
4 layers of lungs
Pleural Membrane
Parietal Pleura
Pleural Cavity
Visceral Pleura
42
Pleural Membrane
Prötec
43
Parietal Pleura
Attaches to diaphragm and thorax
44
Visceral Pleura
Attached to lungs
45
Pleural Cavity
lubricating fluid
46
L vs R Lung size difference
L is 10% smöller
47
Fissures
deep grooves that divide lungs into lobes
48
Conducting Zone
Connecting cavities outside and within the lungs that filter, warm and moisten air
49
Respiratory Zone
Consists of tissue within lungs where gas exchange occurs
50
Conducting Zone Anatomy
Nose
Nasal Cavity
Pharynx
Larynx
Trachea
Bronchi
Terminal Bronchioles
51
Respiratory Zone Anatomy
Respiratory Bronchioles
Alveolar Ducts
Alveolar Sac
Alveoli
52
exchanges small amounts of air with auditory tubes to equalize pressure between middle ear and atmosphere
Nasopharynx
53
Two tonsil pairs
palatine and lingual
54
Greater air pressure equals
greater sound
55
Pitch is controlled by
vocal folds
56
Trachea has how many rings
16-20 c-shaped rings
57
Respiratory Control Center
pons and medulla
58
Controls basic rhythm of respiration
Medulla Oblongata
59
Generates nerve impulses that establish basic rhythm of normal quiet breathing
Dorsal Respiratory Group
60
Phrenic Nerve
innervates the diaphragm
61
Ventral Respiratory Group
nerve impulses for forceful breathing
62
Cortical influence on Respiration
cerebral cortex allows for voluntary breath hold
63
Allows Emotional stimuli to alter respirations (2)
Hypothalamus and Limbic System
64
Central Chemoreceptors Location
medulla
65
Peripheral Chemoreceptors Location
aortic arch
66
Chemoreceptors are what type of feedback system?
Negative
67
Hypercapnia
Increase in arterial PCO2 above 40mmHg; peripheral chemoreceptors will respond
68
Hypoxia
O2 deficiency below 50mmHg; chemoreceptors are simulated
69
Hypocapnia
arterial PCO2 falls below 40mmHg; no chemoreceptors stimulated.
70
Second rib reference point
Angle of Louis
71
Angle of Louis aka
manubriosternal junction
72
Costal Angle
90 degrees with ribs inserted at 45 degrees
73
Vertebra Prominence
C7, seen and palpated with head bent forward.
If two are felt the lower is T1.
74
Landmarks of the center of the chest (descending)
Suprasternal notch
Manubrium
Angle of Louis
Sternum
Xiphoid Process
75
Pregnancy respiration rate and rhythm; is; influenced by what hormone
-pregnant women have deeper and increased respirations
-influenced by excess estrogen
76
Variation with Age
-alveoli are less elastic and more fibrous
-mucous membranes become more dry
-decreased vital capacity
77
Barrel Chest
results from loss of muscle strength in the thorax and diaphragm; chest wall may stiffen, and expansion is decreased.
78
Sweet Smell
DKA
79
Ammonia smell
uremia
80
Musty fish
hepatic failure
81
Foul Smell/feculent
intestinal obstruction
82
Foul Smell/putrid
respiratory infection
83
Halitosis
angina or gingivitis
84
Cinnamon smell
TB
85
Normal Respirations rate
12-20 for 60 seconds
86
Secondary Apnea
requires resuscitative measures to breath again
87
Orthopnea
SOB when lying down
88
Platypnea
increases with standing up/walking
89
Cheyne-Stokes
regular breathing with patterns of apnea
90
Biot respirations
irregular respirations varying in depth and with periods of apnea
91
Kussmal Breathing
deep and labored associated with DKA
92
Tactile Fremitus
Palpable vibration of the chest wall from speech
93
Vesicular Sounds
heard most over lung fields; low pitch
94
Broncho Vesicular Sounds
heard over main stem bronchi and upper right posterior lung; medium pitched
95
Bronchial-Tracheal sounds
heard over trachea and high pitched
96
Bronchophony positive
greater clarity and increased loudness of spoken words
97
Whispered pectoriloquy
whispered sounds not normally heard
98
Ronchi
Sonorous wheeze
99
Scoliosis
lateral curvature of spine
100
Lordosis
curvature off lumbar spine
101
Dullness indicates
lung consolidation
102
Costal angle for pregnancy
up to 103
103
Metabolic Acidosis
pH of body has decreased
104
Episodic or chronic symptoms of wheezing, dyspnea, or cough.
Asthma
105
Most Common Asthma
Allergenic
106
Catamenial Asthma
Menstrual Asthma
107
Cardiac Asthma
Cough or wheezing associated with L. Side Heart Failure;
not true asthma
108
Common Allergic Asthma Symptoms
Polyps
Nasal swelling
increased secretions
associated skin symptoms
109
Asthma Labs/Tests (2)
ABG
PFT (before and after inhaler)
110
Asthma Clinical pearl
chest pain triggered by cough
111
Young people with chest pain clinical pearl
cocaine use
112
Asthma Med class
Long and Short Term Beta Blockers
113
Asthma Vaccinations
Influenza and Pneumovax 23
114
Immediate Asthma Tx
SABA
115
Asthma Systemic Corticosteroid
Prednisone .5-1mg/kg per day
116
Severe Exacerbations tx
O2
SABA
Systemic Corticosteroids
117
RADs
Reactive Airway Disease
118
RAD characteristics
exposure to high concentration of gas/fumes
sx within 24h-3 months
119
4 types of RAD agents
household
chemical
industrial
other
120
RAD meds
O2 and oral corticosteroids
121
COPD
Chronic Obstructive Pulmonary Disease
122
COPD 3 subtypes "ECO"
Emphysema
Chronic Bronchitis
Obstructive Asthma
123
Chronic inflammation of COPD causes
structural changes, airway narrowing, and lung tissue destruction
124
COPD hallmark
acute exacerbation:
dyspnea
cough
increased sputum
125
Most Common cause of COPD in US
smoking
126
Emphysema findings "pink puffer"
dyspnea
50+
cough with clear sputum
thin
accessory muscle use
decreased breath/heart sounds
127
Chronic Bronchitis "blue bloater"
Productive cough x3 months
frequent chest infections
30-40s
mild dyspnea
Ronchi or wheezing
128
COPD tests
Peak flow
Spirometry
129
Is digital clubbing common in COPD
no
130
COPD Tx
O2
SABA
Short acting Muscarinic SAMA
131
COPD Tx for PTs with mild disease
LAMA
132
Do patients with Asthma get antibiotics?
Not without pneumonia
133
Consider what medication class with COPD meds?
Antibiotics
134
Pulmonary Edema Sx
tachy
diaphoresis
rales/rhonchi
135
Cardiogenic Pulmonary Edema causes
MI
CHF
LV regurgitation
Mitral Stenosis
136
Determining if Pulmonary Edema is Cardiogenic
EKG/Xray/ECG
137
Non Cardiac Pulmonary Edema causes
IV opioids
ICP
altitude
Sepsis
Shock
138
Pulmonary Edema Hallmark
pink frothy sputum
139
Pulmonary Edema Tx "N-DOM"
O2 NRB*
Morphine
Diuretics
Nitrates
140
Bronchospasm Tx
Beta Agonist
141
Virchow's Triad
venous stasis
injury to vessel wall
hypercoagulability
142
Pulmonary Embolism Tx
O2 Nasal Cannula or NRB
LOVENOX
MEDECAV
143
Hemoptysis Labs/Imaging
CBC
Xray**************************************************************************************
CT
144
2 Massive Hemoptysis Criteria
500ml or more x24 hours
or
100ml per hour
145
URI aka
Common Cold
146
URI Sx Duration
3-10 days
147
URI sx
erythemic nares without intranasal purulence
cough
congestion
malaise
headache
148
URI usual lung sounds
Clear bilaterally
149
URI Tx
Acetaminophen 325mg 1-2 tabs Q4-6
Sudafed
150
Bronchitis Hallmarks
Cough with midline burning chest px
fever
dyspnea
151
Clinical difference between bronchitis and pneumonia on X-ray
presence of infiltrate on chest x-ray for pneumonia
152
Chronic Bronchitis criteria
daily productive cough for 3 months or more in 2 years
153
Bronchitis lung sounds
rhonci that clears with cough
154
Bronchitis Tx
Tylenol/NSAIDS
Tessalon Perles
SABA
Guaifenesin
155
Tessalon Perles generic name
Benzonatate
156
Bronchitis primary cause
virus
157
Pneumonia lung sounds
bronchial breath sounds and rales
158
Community acquired pneumonia causes
bacterial and viral
159
Community Acquired Pneumonia aka
acute lung infection
160
Community Acquired Pneumonia Symptoms
fever/sweats
cough (productive and non productive)
dyspnea
rigors
161
3 Pulmonary Defense Mechanisms
Cough Reflex
Mucocilary clearance system
Immune Response
162
Common viral causes of Community Acquired Pneumonia
Flu
RSV
Adenovirus
Parainfluenza
163
Cough with expectoration of foul- smelling purulent sputum suggests:
anaerobic pulmonary infection
164
Aspirated Pneumonia cause
aspiration of infected oropharyngeal contents
165
Aspirated Pneumonia Meds
Macrolides "-mycin"
or
DOXY
166
S pneumonia meds
fluoroquinolones
167
Chest Tube size
36or 40 French
168
Secondary Pneumothorax
occurs as a complication of an underlying pulmonary disease
169
Primary Pneumothorax
young males who smoke; spontaneous
170
STOP BANG
Snore
Tired
Obstruction
Pressure
BMI
Age
Neck
Gender
171
OSA BMI considerations
28
172
OSA neck circumference
17" or more
173
OSA treatment
treat underlying causes
174
Sudden onset of intermittent fleeting pain in chest wall
Pleuritis
175
Pleuritis worsened by
cough, sneeze, deep breath, or movement
176
Pleuritis causes
viral, bacterial or trauma
177
Pleuritis Tx (Meds)
Analgesics/NSAIDs
Codeine
178
Pleuritis Disposition
Medevac
179
Most common injury sustained in blunt thoracic trauma
Rib fracture
180
Which rib fracture indicates severe trauma
first rib
181
Flail Chest first line of tx
low 02
182
Central Chemoreceptor function
respond to changes in Hydrogen and PCO2 in CSF
183
Peripheral Chemoreceptor function
sensitive to levels of PCO2, PO2 and H in the blood
184
Pregnancy inhibits expansion of what breathing organ?
diaphragm
185
Where does the trachea divide into bronchi?
T5
186
Male/female inspiratory reserve
3100ml/1900ml
187
Male/female expiratory reserve
1200ml/700ml
188
vital capacity decreased by what % at the age 70?
35%
189
Oxygen is what percent of normal air
20.9%
190
Listening posts
Posterior 10
Frontal 8
Left 4C
Right 4S
191
Pulmonary Opacities indicate what on Chest X-ray
TB
192
Bacteria causing Pneumonia
Strep Pneumonie
193
# of acid bacilli tests to confirm TB
3 morning specimens
