Cardio And Resp Disorders Flashcards
Inspiration
Diaphragm contracts and moves down, thoracic cavity expands.
Intrathoracic pressure decreases, allowing air to flow into lungs.
Resp alkalosis
Carbon dioxide deficit in blood. PaCO2 less than 35 mmhg. (Hypocapnia)
Causes asa toxicity, anxiety, hypoxia, fever, pain
If untreated, convulsions and arrythmia
Respiratory center depression
causes:
Symptoms:
Causes: overdose, neurological damage- trauma or infarct
Symptoms: resp rate becomes shallow and slow, restless, anxious, confused, lethargic, cyanotic
COPD
Air trapping in alveoli
Loss of elasticity in lung tissue
Lungs remain distended
Increased airway resistance examples
Laryngeal edema- allergic reaction
Croup-child, URI that leads to laryngeal or tracheal swelling
Asthma- narrowing of airway
Sinusitis- block nasal passages
Tracheobronchitis- inflammation of trachea and bronchi, pulm secretions can block airway
OSA- collapse of soft tissue during sleep, blocking airway
Thick secretions
Hypercapnia
Increased level of CO2 in blood
Resp acidosis
Excess carbonic acid
High CO2 in blood PaCO2 over 45 mmhg
Can lead to resp failure
Flail chest
Trauma with rib fractures in multiple places
Ribs can’t support chest wall.
Most commonly occurs from impact with steering wheel in MVA.
Pleural effusion
Accumulation of fluid in pleural space of lungs
Affects lung expansion due to pressure from fluid
Alveolar- capillary membrane
Diffusion
Location in lungs where diffusion of oxygen and CO2 takes place.
Diffusion is Movement of gases from high concentration to lower levels of concentration.
Atelectasis
Collapse of alveoli
Can occur as complication post surgically when patient does not breathe deeply enough to move secretions out of alveoli to keep them inflated
Ventilation/ perfusion ratio
V/Q ratio
When a specific amt of capillary blood flows past an alveolus and is equally matched by gas,
The V/Q ratio is considered to be normal.
Shunting
Low V/Q ratio
Blood flows by alveoli, but without gas exchange.
Cause is usually obstruction of distal airways
Dead space
High V/Q ratio
Not enough blood to support gas exchange.
Dead space lacking blood
Cause: pulm emboli
Atherosclerosis causes narrowed arterial lumen which can cause:
Hypertension CAD Inflammatory heart disease Angina pectoris MI AAA Peripheral vascular disease Gangrene
Pulmonary embolus
Thrombus lodges in pulm blood vessel, impeding blood flow/ gas exchange beyond clot.
Can be blood clot or fat embolus.
Can be fatal and can lead to pulm hypertension.
Pulmonary hypertension
Pulm vascular resistance is increased, resulting in decreased blood flow and oxygen.
Can be caused by pulmonary embolism or COPD
or pulmonary hypertension can be a primary condition.
Thrombocytopenia purpura
Platelets are destroyed, resulting in decreasing circulating platelets and causing risk of hemorrhage
Smaller blood vessels in women causes:
Cardiac caths and other invasive procedures more difficult.
Also, atherosclerotic plaques can more easily occlude smaller vessels
Effects of aging on cardiovascular system
Elastin decreases and collagen increases in heart, causing decrease in contractility.
Arterial vessels in body thicken and lose elasticity which contributes to increase systolic BP.
PVD can develop as result of arterial narrowing in extremities.
Heart valves thicken due to lipid accumulation which can cause murmur.
decrease in SA node pacemaker cells cause bradycardia.
Effects of aging on respiratory system
Loss of elasticity in lung recoil and chest excursion. diameter of thorax increases.
Cough strength is weakened and cilia function decreased.
Functioning alveoli decrease.
Normal respiratory rate for infants, children, adults and elderly:
Infants: 35 per min Child age 2 or younger: 25-30 Child 2-4: 23-25 Adults: 12-18 Elderly: may have slightly higher than adults
Inspiration takes about half as long as expiration.
Pulsus paradoxus
Weakening of pulse during inspiration do to drop and systolic blood pressure. May occur with asthma or COPD.
Dyspnea
Difficulty breathing
Bradypnea
Slow deep breaths- under 10 per minute
Caused by overdose or increased intracranial pressure
Tachypnea
Over 20-25 breaths per minute
URI, fever, anxiety
Kussmaul breathing
Deep regular rapid resps. Caused by metabolic acidosis.
Common cause is ketoacidosis (DM)
Body is trying to decrease CO2 and decrease acidosis.
Normal breath sounds:
Vesicular:
Bronchial:
Bronchovesicular:
Vesicular: all lung fields except major bronchi. Quiet, soft and low pitched.
Bronchial breath sounds: loud, high pitched. Located over trachea.
Bronchovesicular: medium pitched. Heard over 1st and 2nd intercostal spaces, close to sternal border, between scapula.
Crackles (rales)
Fine, high pitched sounds on inspiration.
Indicates fluid in small airways or the collapse of small airways.
Can indicate atelectasis, pneumonia, CHF
Rhonchi
Low pitched sounds on expiration.
Indicates larger airway obstructed with fluid.
COPD and pneumonia
Wheezes
High pitched musical
Narrowed airways
Asthma, copd, foreign body, bronchospasm from anaphylaxis
Pleural friction rub
Harsh, grating sound on inspiration or expiration
Inflamed pleura rubbing together caused by infection
