Cardiopulmonary System Flashcards

1
Q

Define Airway Clearance Techniques

A

Are intended to manage or prevent the consequences of impaired mucociliary transport or the inability to protect the airway (e.g., impaired cough).

The techniques may include breathing strategies, manual and mechanical techniques, and postural drainage.

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2
Q

Define Active Cycle of Breathing.

A

ACB technique was developed under the name “forced expiratory technique” to assist secretion clearance in patients with asthma.

The name of the technique was changed to “active cycle of breathing” to emphasize that ACB always couples breathing exercise with the huff cough.

It includes three phases: breathing control, thoracic expansion exercises, and forced expiratory technique.

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3
Q

Define Directed Cough.

A

Tries to compensate for the patient’s physical limitations to elicit a maximum forced exhalation.

Examples of directed coughing include forced expiratory technique and manually assisted cough.

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4
Q

Define Huffing,

A

A forced expiratory maneuver performed with the glottis open.
- similar to fogging a pair of glasses with your breath.
- although a huff does not produce the same airflow velocity as a cough, the potential for airway collapse is less.

Huffing may be reinforced by a quick adduction of the arms to self- compress the chest wall.

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5
Q

Define Postural Drainage.

A

Consists of positioning the patient so that gravity will help drain bronchial secretions from specific lung segments toward the central airways where they can be removed by cough or mechanical aspiration.

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6
Q

Define Percussion.

A

AKA cupping and clapping, is the rhythmic clapping or striking of the thorax with a cupped hand or mechanical percussor directly over the lung segment being drained.

This rhythmic sequence should last for several minutes and should not be painful

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7
Q

Define Vibration

A

The application of a fine, tremulous action on the chest wall over the lung segment being drained in the direction the ribs move during exhalation.

It may be performed manually or with a mechanical vibrator

Vibration should be performed during exhalation.

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8
Q

Postural Drainage Positioning: Apical Segments Right and Left Upper Lobes- Patient Position & technique.

A

Position: the pt is in a sitting position, leaning back 30-40 degrees

Technique: percussion and vibration are performed above the clavicles.

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9
Q

Postural Drainage Positioning: Posterior Segment Right Upper Lobe- Patient Position and Technique

A

Position: The pt is turned 1/4 from prone on the left side with the bed horizontal and the head and shoulder raised on a pillow

Technique: Percussion and vibration are performed around the medial border of the right scapula.

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10
Q

Postural Drainage Positioning: Posterior Segment Left Upper Lobe- Patient Position &Technique

A

Position: pt is turned 1/4 from prone on the right side with the bed horizontal and the head and shoulders raised on a pillow

Technique: percussion and vibration are performed around the medial border of the left scapula.

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11
Q

Postural Drainage Positioning: Lingula Left Upper Lobe- Patient Position and Technique

A

Position: the pt is turned 1/4 from supine on the right side with the foot of the bed elevated 12 inches

Technique: percussion and vibration are performed over the left chest between the axillary and the left nipple.

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12
Q

postural Drainage Positioning: Anterior Segments Right and Left Upper Lobes- patient position & technique

A

Position: the patient is in supine with the bed horizontal

Technique: Percussion and vibration are performed below the clavicles

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13
Q

Postural Drainage Positioning: Right Middle Lobe- Patient Position and Technique

A

Position: the pt is turned 1/4 from supine on the left side with the foot of the bed elevated 12 inches.

Technique: percussion and vibration are performed over the right chest between the axillary and the right nipple

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14
Q

Postural Drainage Positioning: Superior Segments Left and Right Lower Lobes- Patient Position and Technique

A

Position: the pt is prone with the bed horizontal.

Technique: percussion and vibration are performed below the inferior border of the left and right scapulae.

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15
Q

Postural Drainage Positioning: Anterior Basal Segments Left and Right Lower Lobes- Patient Position and Technique

A

Position: the patient is in supine with the foot of the bed elevated 18 inches.

Technique: percussion and vibration are performed over the lower ribs on the left and right side.

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16
Q

Postural Drainage Positioning: Posterior Basal Segments Left and Right Lower Lobed- Patient Position and Technique

A

Position: the patient is in prone with the foot of the bed and elevated 18 inched

Technique: percussion and vibration are performed over the lower ribs on the left and right side of the chest.

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17
Q

Postural Drainage positioning: Lateral Basal Segments Lower Lobes- Patient Position & Technique

A

Position: the patient is in sidelying with the foot of the bed elevated 18 inches

technique: percussion and vibration are performed over the lower ribs.

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18
Q

Apex of the Heart.

A

The lowest part of the heart formed by the inferolateral part of the left ventricle.

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19
Q

Base of the Heart.

A

The upper border of the heart involving the left atrium, part of the right atrium, and the proximal portion of the great vessels.

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20
Q

Endocardium

A

The endothelial tissue that lines the interior of the heart chambers and valves.

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21
Q

Epicardium.

A

The serous layer of the pericardium that contains the epicardial coronary arteries and veins, autonomic nerves, and lymphatics.

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22
Q

Myocardium.

A

The thick contractile middle layer of muscle cells that forms the bulk of the heart wall.

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23
Q

Pericardium.

A

A double- walled connective tissue sac that surrounds the outside of the heart and great vessels.

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24
Q

Aorta

A

The body’s largest artery and the central conduit of blood from the heart to the body that begins at the upper part of the left ventricle.

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25
Q

Inferior Vena Cava.

A

The vein that returns venous blood from the lower body and viscera to the right atrium.

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26
Q

Pulmonary Arteries.

A

The arteries that carry deoxygenated blood from the right ventricle to the left and right lungs

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27
Q

Pulmonary Veins.

A

The veins that carry oxygenated blood from the right and left lungs to the left atrium.

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28
Q

Superior Vena Cava.

A

The vein that returns venous blood from the head, neck, and arms to the right atrium

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29
Q

Atrial Septum

A

The wall between the right and left atria

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30
Q

Pulmonary Valve.

A

The valve that controls blood flow between the right ventricle and pulmonary artery.

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31
Q

Right Atrium

A

The superior chamber of the right side of the heart that collects blood from the body and passes it on to the right ventricle

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32
Q

Mitral Valve

A

The valve that controls blood flow between the left atrium and left ventricle

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33
Q

Left Ventricle

A

The inferior chamber of the left side of the heart that collects blood from the left atrium and pumps it to the body.

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34
Q

Aortic Valve

A

The valve that controls blood flow between the left ventricle and aorta

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35
Q

Left Atrium

A

The superior chamber of the left side of the heart that collects blood from the lungs and passes it on to the left ventricle

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36
Q

Right Ventricle

A

The inferior chamber of the right side of the heart that collects blood from the right atrium and pumps it to the lungs.

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37
Q

Ventricular Septum

A

The wall between the right and left ventricles

38
Q

Tricuspid Valve

A

The valve that controls blood flow between the right atrium and right ventricle.

39
Q

Coronary Arteries.

A

The blood vessels that carry oxygenated blood to the myocardium

40
Q

Plasma

A

Is the liquid component of blood, in which the blood cells and platelets are suspended.

Consists of water, electrolytes, and proteins.

41
Q

Red Blood Cells

A

Ie: erythrocytes

Contain hemoglobin, a protein that gives blood its red color and enables it to bind with oxygen.

42
Q

Blood Platelets

A

Ie thrombocytes

Assist in blood clotting by clumping together at a bleeding site and forming a plug that helps to seal the blood vessel

43
Q

White Blood Cells,

A

Ie leukocytes

Protect against infection

44
Q

Neutrophils

A

Are a type of white blood cell that help protect the body against infections by ingesting bacteria and debris

45
Q

Lymphocytes

A

Are a type of white blood cell that help protect against viral infections and can detect and destroy some cancer cells and also can develop into cells that produce antibodies.

Cancer cells= T lymphocytes, natural killer cells
Antibodies= B lymphocytes

46
Q

Monocytes

A

Are a type of white blood cell that ingest dead or damaged cells and help defend against infectious organisms.

47
Q

Eosinophils.

A

Are a type of white blood cell that kill parasites, destroy cancer cells, and are involved in allergic responses.

48
Q

Basophils

A

Are a type of white blood cell that participate in allergic responses.

49
Q

Identify Bronchopulmonary Segments: Right Lung, Upper Lobe

A

Apical, Anterior, and Posterior Segments

50
Q

Identify Bronchopulmonary Segments: Right Lung, Middle Lobe

A

Medial and lateral segments

51
Q

Identify Bronchopulmonary Segments: Right Lung, Lower Lobe

A

Superior, medial basal, anterior basal, lateral basal, and posterior basal segments.

52
Q

Identify Bronchopulmonary Segments: Left Lung, Upper Lobe

A

Superior: anterior and apicoposterior segments

Inferior (lingual)- superior and inferior segments.

53
Q

Identify Bronchopulmonary Segments: Left Lung, Lower Lobe

A

Superior, lateral basal, posterior basal, and anteromedial basal segments.

54
Q

Ankle- Brachial Index Values: Describe Severity of Disease
> 1.40

A

Indicates rigid arteries and the need for an ultrasound test to check for peripheral artery disease.

55
Q

Ankle- Brachial Index Values: Describe Severity of Disease 1.0- 1.40

A

Normal; no blockage

56
Q

Ankle- Brachial Index Values: Describe Severity of Disease 0.8- 0.99

A

Mild blockage; beginnings of peripheral artery disease.

57
Q

Ankle- Brachial Index Values: Describe Severity of Disease 0.4- 0.79

A

Moderate blockage, may be associated with intermittent claudication during exercise.

58
Q

Ankle- Brachial Index Values: Describe Severity of Disease
< 0.4

A

Severe blockage suggesting severe peripheral artery disease; may have claudication pain at rest.

59
Q

Ankle- Brachial Index Testing Procedire: Artery Utilized for Upper Extremity

A

Brachial Artery

60
Q

Ankle- Brachial Index Testing Procedire: Artery Utilized for Lower Extremity

A

Tibialis Posterior artery (or dorsalis pedis artery)

61
Q

Arterial Blood Gases

A

Arterial blood gases are collected to evaluate:
- Acid- base status (pH)
- Ventilation (PaCO2)
- oxygenation of arterial blood (PaO2)

62
Q

Normal Values: pH

A

7.4
(7.35- 7.45)

63
Q

Normal Values: PaCO2

A

40 mm Hg
(35- 45 mm Hg)

64
Q

Normal Values: PaO2

A

97 mm Hg
(80- 100 mm Hg)

65
Q

Normal Values: HCO3-

A

24 mEq/ L
(22- 26 mEq/L)

66
Q

Normal Values: SaO2

A

95- 98%

67
Q

Acidemia

A

Elevated acidity of blood

68
Q

Alkalemia

A

Decrease acidity of blood

69
Q

Eucapnia

A

Normal level of CO2 in arterial blood

70
Q

Hypercapnia

A

Elevated level of CO2 in arterial blood

71
Q

Hypocapnia

A

Low level of CO2 in arterial blood

72
Q

Hypoxemia

A

Low level of O2 in arterial blood

73
Q

Hypoxia

A

Low level of O2 in the tissue despite adequate perfusion of the tissue.

74
Q

Systolic Blood Pressure

A

The force exerted against the arteries during the ejection cycle

75
Q

Diastolic Blood Pressure

A

The force exerted against the arteries during rest

76
Q

Pulse Pressure

A

The difference between systolic and diastolic pressure

77
Q

Korotkoff Sounds: Phase I

A

The first appearance of clear tapping sounds correspongto the appearance of a palpable pulse;
Corresponds to systolic blood pressure.

78
Q

Korotkoff Sounds: Phase II

A

The sounds become softer and longer than in Phase I

79
Q

Korotkoff Sounds: Phase III

A

The sounds become crisper and older than in Phase II

80
Q

Korotkoff Sounds: Phase IV

A

The sounds become muffled and softer than in Phase III

81
Q

Korotkoff Sounds: Phase V

A

The sounds disappear completely; the diastolic pressure is the pressure at the last audible sound.

82
Q

Normal Blood Pressure

A

120/ 80

83
Q

Stage 1 Hypertension

A

130-139/ 80-89

84
Q

Stage 2 Hypertension

A

140/ 90

85
Q

Bronchial Sounds

A

Are loud, tubular sounds normally heard over the trachea.

The inspiratory phase is shorter than the expiratory phase and there is a slight pause between them

86
Q

Vesicular Sounds

A

Are low- pitched, breezy sounds normally heard over the distal airways in healthy lung tissue.
The inspiratory phase is longer than the expiratory phase and there is no pause between them.

87
Q

Crackle

A

Abnormal, discontinuous, high- pitched pooping sound heard more often during inspiration.
It typically represents the movement of fluid or secretions during inspiration (wet crackles) or occurs from the sudden opening of closed airways (dry crackles).

88
Q

Pleural Friction Rub.

A

DRY, crackling sound heard during both inspiration and expiration.
It occurs when inflamed visceral and parietal pleurae rub together

89
Q

Wheeze

A

Continuous, “musical” or whistling sound composed of a variety of pitches.
It’s heard during both inspiration and/ or expiration, but variable from minute to minute and area to area

90
Q

Rhonchi

A

Continuous low- pitched sounds described as having a “snoring” or “gurgling” quality that may be heard during both inspiration and expiration.
They can be caused by air passing through an airway which is obstructed by inflammatory secretions or liquid, bronchial spasm or neoplasms in the smaller or larger airways.
Smaller airways= Sibilant Rhonchi
Larger airways= Sonorous Rhonchi

91
Q

Stridor

A

A continuous high- pitched wheeze heard with inspiration or expiration that indicates an upper airway obstruction.

92
Q

Breathing Exercises.

A