Breathe Flashcards

1
Q

Atmospheric Partial Pressures

A

PO2: 159mmHg
PCO2: 0.3mmHg

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2
Q

Alveolar Partial Pressures

A

PO2: 105mmHg
PC02: 40mmHg

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3
Q

Most Abundant Gas

A

Nitrogen

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4
Q

Gas Mass

A

760

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5
Q

Each inhalation/exhalation in Milliliters

A

500ml

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6
Q

Tidal Volume

A

One breath

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7
Q

% of volume involved in gas exchange

A

70%

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8
Q

% of Anatomical Dead Space

A

30%

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9
Q

Eupnea

A

Normal quiet breathing

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10
Q

Costal Breathing is

A

shallow

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11
Q

Diaphragmic Breathing is

A

Deep

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12
Q

Costal breathing movement

A

upward and outward movement of chest

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13
Q

Diaphragmic breathing movement

A

Outward movement of abdomen

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14
Q

External Respiration is

A

pulmonic gas exchange

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15
Q

External respiration involves

A

alveoli and pulmonary capillaries

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16
Q

Internal Respiration movement

A

Outward movement

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17
Q

Internal Respiration involves

A

02 and CO2 exchange in capillaries and tissue

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18
Q

P02 in Systemic Capillaries

A

100mmHg

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19
Q

PO2 in tissue

A

40mmHg

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20
Q

Partial Pressure of Oxygenated Blood

A

PO2: 100mmHg
PC02: 40mHg

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21
Q

Partial Pressure Deoxygenated Blood

A

PO2: 40mmHg
CO2: 45mmHg

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22
Q

Muscles of quiet exhalation (passive)

A

Diaphragm and external intercostal

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23
Q

Muscles of forced exhalation

A

Internal Intercostal
External Oblique
Internal Oblique
Transverse Abdomen
Rectal Abdomen

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24
Q

O2 and CO2 transfer by

A

Passive diffusion

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25
Q

3 factors of oxygen transport
CAT

A

Carbon dioxide, acidity, temperature

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26
Q

Atmospheric Pressure is Higher than…

A

alveolar

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27
Q

Lung Volume decreases, alveolar pressure…

A

increases and passive diffusion occurs

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28
Q

Carbon Dioxide Transport 3 main forms

A

7% of CO2 dissolves into plasma
23% is bound to amino acids (hemoglobin)
greatest percentage of CO2 is bicarb at 70%

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29
Q

HCO3

A

Bicarbonate ions

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30
Q

Rest Pressure : alveolar and intrapleural

A

alveolar 760mmHg
intrapleural 756mmHg

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31
Q

Resting pressure is equal to

A

Atmospheric pressure

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32
Q

Inhalation Pressure vs Atmospheric Pressure

A

Below atmospheric

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33
Q

Exhalation Pressure vs Atmospheric Pressure

A

Above Atmosphere

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34
Q

Oblique Fissure

A

divides left lung into 2 lobes and right lung into 3

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35
Q

Microscopic Airway Path

A

Terminal bronchioles
Respiratory bronchioles
Alveolar Ducts
Alveolar Sacs
Alveoli

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36
Q

Branching of Bronchial Tree

A

Trachea
Main Bronchi
Lobar Bronchi
Segmental Bronchi
Bronchioles
Terminal Bronchioles

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37
Q

Muscles of Quiet Inhalation

A

Diaphragm (75% of air entering lungs)
External Intercostal
Thoracic Floor

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38
Q

Deep breath muscles

A

Sternocleidomastoid
Scalene
Pectoralis Minor

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39
Q

3 Bronchi aka Bronchial Tree

A

Primary: Main
Secondary: Lobar
Tertiary: Segmental

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40
Q

Inhaled particles are removed by

A

Macrophages

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41
Q

4 layers of lungs

A

Pleural Membrane
Parietal Pleura
Pleural Cavity
Visceral Pleura

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42
Q

Pleural Membrane

A

Prötec

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43
Q

Parietal Pleura

A

Attaches to diaphragm and thorax

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44
Q

Visceral Pleura

A

Attached to lungs

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45
Q

Pleural Cavity

A

lubricating fluid

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46
Q

L vs R Lung size difference

A

L is 10% smöller

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47
Q

Fissures

A

deep grooves that divide lungs into lobes

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48
Q

Conducting Zone

A

Connecting cavities outside and within the lungs that filter, warm and moisten air

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49
Q

Respiratory Zone

A

Consists of tissue within lungs where gas exchange occurs

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50
Q

Conducting Zone Anatomy

A

Nose
Nasal Cavity
Pharynx
Larynx
Trachea
Bronchi
Terminal Bronchioles

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51
Q

Respiratory Zone Anatomy

A

Respiratory Bronchioles
Alveolar Ducts
Alveolar Sac
Alveoli

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52
Q

exchanges small amounts of air with auditory tubes to equalize pressure between middle ear and atmosphere

A

Nasopharynx

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53
Q

Two tonsil pairs

A

palatine and lingual

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54
Q

Greater air pressure equals

A

greater sound

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55
Q

Pitch is controlled by

A

vocal folds

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56
Q

Trachea has how many rings

A

16-20 c-shaped rings

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57
Q

Respiratory Control Center

A

pons and medulla

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58
Q

Controls basic rhythm of respiration

A

Medulla Oblongata

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59
Q

Generates nerve impulses that establish basic rhythm of normal quiet breathing

A

Dorsal Respiratory Group

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60
Q

Phrenic Nerve

A

innervates the diaphragm

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61
Q

Ventral Respiratory Group

A

nerve impulses for forceful breathing

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62
Q

Cortical influence on Respiration

A

cerebral cortex allows for voluntary breath hold

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63
Q

Allows Emotional stimuli to alter respirations (2)

A

Hypothalamus and Limbic System

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64
Q

Central Chemoreceptors Location

A

medulla

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65
Q

Peripheral Chemoreceptors Location

A

aortic arch

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66
Q

Chemoreceptors are what type of feedback system?

A

Negative

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67
Q

Hypercapnia

A

Increase in arterial PCO2 above 40mmHg; peripheral chemoreceptors will respond

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68
Q

Hypoxia

A

O2 deficiency below 50mmHg; chemoreceptors are simulated

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69
Q

Hypocapnia

A

arterial PCO2 falls below 40mmHg; no chemoreceptors stimulated.

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70
Q

Second rib reference point

A

Angle of Louis

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71
Q

Angle of Louis aka

A

manubriosternal junction

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72
Q

Costal Angle

A

90 degrees with ribs inserted at 45 degrees

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73
Q

Vertebra Prominence

A

C7, seen and palpated with head bent forward.
If two are felt the lower is T1.

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74
Q

Landmarks of the center of the chest (descending)

A

Suprasternal notch
Manubrium
Angle of Louis
Sternum
Xiphoid Process

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75
Q

Pregnancy respiration rate and rhythm; is; influenced by what hormone

A

-pregnant women have deeper and increased respirations
-influenced by excess estrogen

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76
Q

Variation with Age

A

-alveoli are less elastic and more fibrous
-mucous membranes become more dry
-decreased vital capacity

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77
Q

Barrel Chest

A

results from loss of muscle strength in the thorax and diaphragm; chest wall may stiffen, and expansion is decreased.

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78
Q

Sweet Smell

A

DKA

79
Q

Ammonia smell

A

uremia

80
Q

Musty fish

A

hepatic failure

81
Q

Foul Smell/feculent

A

intestinal obstruction

82
Q

Foul Smell/putrid

A

respiratory infection

83
Q

Halitosis

A

angina or gingivitis

84
Q

Cinnamon smell

A

TB

85
Q

Normal Respirations rate

A

12-20 for 60 seconds

86
Q

Secondary Apnea

A

requires resuscitative measures to breath again

87
Q

Orthopnea

A

SOB when lying down

88
Q

Platypnea

A

increases with standing up/walking

89
Q

Cheyne-Stokes

A

regular breathing with patterns of apnea

90
Q

Biot respirations

A

irregular respirations varying in depth and with periods of apnea

91
Q

Kussmal Breathing

A

deep and labored associated with DKA

92
Q

Tactile Fremitus

A

Palpable vibration of the chest wall from speech

93
Q

Vesicular Sounds

A

heard most over lung fields; low pitch

94
Q

Broncho Vesicular Sounds

A

heard over main stem bronchi and upper right posterior lung; medium pitched

95
Q

Bronchial-Tracheal sounds

A

heard over trachea and high pitched

96
Q

Bronchophony positive

A

greater clarity and increased loudness of spoken words

97
Q

Whispered pectoriloquy

A

whispered sounds not normally heard

98
Q

Ronchi

A

Sonorous wheeze

99
Q

Scoliosis

A

lateral curvature of spine

100
Q

Lordosis

A

curvature off lumbar spine

101
Q

Dullness indicates

A

lung consolidation

102
Q

Costal angle for pregnancy

A

up to 103

103
Q

Metabolic Acidosis

A

pH of body has decreased

104
Q

Episodic or chronic symptoms of wheezing, dyspnea, or cough.

A

Asthma

105
Q

Most Common Asthma

A

Allergenic

106
Q

Catamenial Asthma

A

Menstrual Asthma

107
Q

Cardiac Asthma

A

Cough or wheezing associated with L. Side Heart Failure;
not true asthma

108
Q

Common Allergic Asthma Symptoms

A

Polyps
Nasal swelling
increased secretions
associated skin symptoms

109
Q

Asthma Labs/Tests (2)

A

ABG
PFT (before and after inhaler)

110
Q

Asthma Clinical pearl

A

chest pain triggered by cough

111
Q

Young people with chest pain clinical pearl

A

cocaine use

112
Q

Asthma Med class

A

Long and Short Term Beta Blockers

113
Q

Asthma Vaccinations

A

Influenza and Pneumovax 23

114
Q

Immediate Asthma Tx

A

SABA

115
Q

Asthma Systemic Corticosteroid

A

Prednisone .5-1mg/kg per day

116
Q

Severe Exacerbations tx

A

O2
SABA
Systemic Corticosteroids

117
Q

RADs

A

Reactive Airway Disease

118
Q

RAD characteristics

A

exposure to high concentration of gas/fumes
sx within 24h-3 months

119
Q

4 types of RAD agents

A

household
chemical
industrial
other

120
Q

RAD meds

A

O2 and oral corticosteroids

121
Q

COPD

A

Chronic Obstructive Pulmonary Disease

122
Q

COPD 3 subtypes “ECO”

A

Emphysema
Chronic Bronchitis
Obstructive Asthma

123
Q

Chronic inflammation of COPD causes

A

structural changes, airway narrowing, and lung tissue destruction

124
Q

COPD hallmark

A

acute exacerbation:
dyspnea
cough
increased sputum

125
Q

Most Common cause of COPD in US

A

smoking

126
Q

Emphysema findings “pink puffer”

A

dyspnea
50+
cough with clear sputum
thin
accessory muscle use
decreased breath/heart sounds

127
Q

Chronic Bronchitis “blue bloater”

A

Productive cough x3 months
frequent chest infections
30-40s
mild dyspnea
Ronchi or wheezing

128
Q

COPD tests

A

Peak flow
Spirometry

129
Q

Is digital clubbing common in COPD

A

no

130
Q

COPD Tx

A

O2
SABA
Short acting Muscarinic SAMA

131
Q

COPD Tx for PTs with mild disease

A

LAMA

132
Q

Do patients with Asthma get antibiotics?

A

Not without pneumonia

133
Q

Consider what medication class with COPD meds?

A

Antibiotics

134
Q

Pulmonary Edema Sx

A

tachy
diaphoresis
rales/rhonchi

135
Q

Cardiogenic Pulmonary Edema causes

A

MI
CHF
LV regurgitation
Mitral Stenosis

136
Q

Determining if Pulmonary Edema is Cardiogenic

A

EKG/Xray/ECG

137
Q

Non Cardiac Pulmonary Edema causes

A

IV opioids
ICP
altitude
Sepsis
Shock

138
Q

Pulmonary Edema Hallmark

A

pink frothy sputum

139
Q

Pulmonary Edema Tx “N-DOM”

A

O2 NRB*
Morphine
Diuretics
Nitrates

140
Q

Bronchospasm Tx

A

Beta Agonist

141
Q

Virchow’s Triad

A

venous stasis
injury to vessel wall
hypercoagulability

142
Q

Pulmonary Embolism Tx

A

O2 Nasal Cannula or NRB
LOVENOX
MEDECAV

143
Q

Hemoptysis Labs/Imaging

A

CBC
Xray********************
CT

144
Q

2 Massive Hemoptysis Criteria

A

500ml or more x24 hours
or
100ml per hour

145
Q

URI aka

A

Common Cold

146
Q

URI Sx Duration

A

3-10 days

147
Q

URI sx

A

erythemic nares without intranasal purulence
cough
congestion
malaise
headache

148
Q

URI usual lung sounds

A

Clear bilaterally

149
Q

URI Tx

A

Acetaminophen 325mg 1-2 tabs Q4-6
Sudafed

150
Q

Bronchitis Hallmarks

A

Cough with midline burning chest px
fever
dyspnea

151
Q

Clinical difference between bronchitis and pneumonia on X-ray

A

presence of infiltrate on chest x-ray for pneumonia

152
Q

Chronic Bronchitis criteria

A

daily productive cough for 3 months or more in 2 years

153
Q

Bronchitis lung sounds

A

rhonci that clears with cough

154
Q

Bronchitis Tx

A

Tylenol/NSAIDS
Tessalon Perles
SABA
Guaifenesin

155
Q

Tessalon Perles generic name

A

Benzonatate

156
Q

Bronchitis primary cause

A

virus

157
Q

Pneumonia lung sounds

A

bronchial breath sounds and rales

158
Q

Community acquired pneumonia causes

A

bacterial and viral

159
Q

Community Acquired Pneumonia aka

A

acute lung infection

160
Q

Community Acquired Pneumonia Symptoms

A

fever/sweats
cough (productive and non productive)
dyspnea
rigors

161
Q

3 Pulmonary Defense Mechanisms

A

Cough Reflex
Mucocilary clearance system
Immune Response

162
Q

Common viral causes of Community Acquired Pneumonia

A

Flu
RSV
Adenovirus
Parainfluenza

163
Q

Cough with expectoration of foul- smelling purulent sputum suggests:

A

anaerobic pulmonary infection

164
Q

Aspirated Pneumonia cause

A

aspiration of infected oropharyngeal contents

165
Q

Aspirated Pneumonia Meds

A

Macrolides “-mycin”
or
DOXY

166
Q

S pneumonia meds

A

fluoroquinolones

167
Q

Chest Tube size

A

36or 40 French

168
Q

Secondary Pneumothorax

A

occurs as a complication of an underlying pulmonary disease

169
Q

Primary Pneumothorax

A

young males who smoke; spontaneous

170
Q

STOP BANG

A

Snore
Tired
Obstruction
Pressure
BMI
Age
Neck
Gender

171
Q

OSA BMI considerations

A

28

172
Q

OSA neck circumference

A

17” or more

173
Q

OSA treatment

A

treat underlying causes

174
Q

Sudden onset of intermittent fleeting pain in chest wall

A

Pleuritis

175
Q

Pleuritis worsened by

A

cough, sneeze, deep breath, or movement

176
Q

Pleuritis causes

A

viral, bacterial or trauma

177
Q

Pleuritis Tx (Meds)

A

Analgesics/NSAIDs
Codeine

178
Q

Pleuritis Disposition

A

Medevac

179
Q

Most common injury sustained in blunt thoracic trauma

A

Rib fracture

180
Q

Which rib fracture indicates severe trauma

A

first rib

181
Q

Flail Chest first line of tx

A

low 02

182
Q

Central Chemoreceptor function

A

respond to changes in Hydrogen and PCO2 in CSF

183
Q

Peripheral Chemoreceptor function

A

sensitive to levels of PCO2, PO2 and H in the blood

184
Q

Pregnancy inhibits expansion of what breathing organ?

A

diaphragm

185
Q

Where does the trachea divide into bronchi?

A

T5

186
Q

Male/female inspiratory reserve

A

3100ml/1900ml

187
Q

Male/female expiratory reserve

A

1200ml/700ml

188
Q

vital capacity decreased by what % at the age 70?

A

35%

189
Q

Oxygen is what percent of normal air

A

20.9%

190
Q

Listening posts

A

Posterior 10
Frontal 8
Left 4C
Right 4S

191
Q

Pulmonary Opacities indicate what on Chest X-ray

A

TB

192
Q

Bacteria causing Pneumonia

A

Strep Pneumonie

193
Q

of acid bacilli tests to confirm TB

A

3 morning specimens