Cardiopulmonary System Flashcards
Define Airway Clearance Techniques
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.
Define Active Cycle of Breathing.
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.
Define Directed Cough.
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.
Define Huffing,
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.
Define Postural Drainage.
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.
Define Percussion.
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
Define Vibration
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.
Postural Drainage Positioning: Apical Segments Right and Left Upper Lobes- Patient Position & technique.
Position: the pt is in a sitting position, leaning back 30-40 degrees
Technique: percussion and vibration are performed above the clavicles.
Postural Drainage Positioning: Posterior Segment Right Upper Lobe- Patient Position and Technique
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.
Postural Drainage Positioning: Posterior Segment Left Upper Lobe- Patient Position &Technique
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.
Postural Drainage Positioning: Lingula Left Upper Lobe- Patient Position and Technique
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.
postural Drainage Positioning: Anterior Segments Right and Left Upper Lobes- patient position & technique
Position: the patient is in supine with the bed horizontal
Technique: Percussion and vibration are performed below the clavicles
Postural Drainage Positioning: Right Middle Lobe- Patient Position and Technique
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
Postural Drainage Positioning: Superior Segments Left and Right Lower Lobes- Patient Position and Technique
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.
Postural Drainage Positioning: Anterior Basal Segments Left and Right Lower Lobes- Patient Position and Technique
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.
Postural Drainage Positioning: Posterior Basal Segments Left and Right Lower Lobed- Patient Position and Technique
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.
Postural Drainage positioning: Lateral Basal Segments Lower Lobes- Patient Position & Technique
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.
Apex of the Heart.
The lowest part of the heart formed by the inferolateral part of the left ventricle.
Base of the Heart.
The upper border of the heart involving the left atrium, part of the right atrium, and the proximal portion of the great vessels.
Endocardium
The endothelial tissue that lines the interior of the heart chambers and valves.
Epicardium.
The serous layer of the pericardium that contains the epicardial coronary arteries and veins, autonomic nerves, and lymphatics.
Myocardium.
The thick contractile middle layer of muscle cells that forms the bulk of the heart wall.
Pericardium.
A double- walled connective tissue sac that surrounds the outside of the heart and great vessels.
Aorta
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.
Inferior Vena Cava.
The vein that returns venous blood from the lower body and viscera to the right atrium.
Pulmonary Arteries.
The arteries that carry deoxygenated blood from the right ventricle to the left and right lungs
Pulmonary Veins.
The veins that carry oxygenated blood from the right and left lungs to the left atrium.
Superior Vena Cava.
The vein that returns venous blood from the head, neck, and arms to the right atrium
Atrial Septum
The wall between the right and left atria
Pulmonary Valve.
The valve that controls blood flow between the right ventricle and pulmonary artery.
Right Atrium
The superior chamber of the right side of the heart that collects blood from the body and passes it on to the right ventricle
Mitral Valve
The valve that controls blood flow between the left atrium and left ventricle
Left Ventricle
The inferior chamber of the left side of the heart that collects blood from the left atrium and pumps it to the body.
Aortic Valve
The valve that controls blood flow between the left ventricle and aorta
Left Atrium
The superior chamber of the left side of the heart that collects blood from the lungs and passes it on to the left ventricle
Right Ventricle
The inferior chamber of the right side of the heart that collects blood from the right atrium and pumps it to the lungs.
Ventricular Septum
The wall between the right and left ventricles
Tricuspid Valve
The valve that controls blood flow between the right atrium and right ventricle.
Coronary Arteries.
The blood vessels that carry oxygenated blood to the myocardium
Plasma
Is the liquid component of blood, in which the blood cells and platelets are suspended.
Consists of water, electrolytes, and proteins.
Red Blood Cells
Ie: erythrocytes
Contain hemoglobin, a protein that gives blood its red color and enables it to bind with oxygen.
Blood Platelets
Ie thrombocytes
Assist in blood clotting by clumping together at a bleeding site and forming a plug that helps to seal the blood vessel
White Blood Cells,
Ie leukocytes
Protect against infection
Neutrophils
Are a type of white blood cell that help protect the body against infections by ingesting bacteria and debris
Lymphocytes
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
Monocytes
Are a type of white blood cell that ingest dead or damaged cells and help defend against infectious organisms.
Eosinophils.
Are a type of white blood cell that kill parasites, destroy cancer cells, and are involved in allergic responses.
Basophils
Are a type of white blood cell that participate in allergic responses.
Identify Bronchopulmonary Segments: Right Lung, Upper Lobe
Apical, Anterior, and Posterior Segments
Identify Bronchopulmonary Segments: Right Lung, Middle Lobe
Medial and lateral segments
Identify Bronchopulmonary Segments: Right Lung, Lower Lobe
Superior, medial basal, anterior basal, lateral basal, and posterior basal segments.
Identify Bronchopulmonary Segments: Left Lung, Upper Lobe
Superior: anterior and apicoposterior segments
Inferior (lingual)- superior and inferior segments.
Identify Bronchopulmonary Segments: Left Lung, Lower Lobe
Superior, lateral basal, posterior basal, and anteromedial basal segments.
Ankle- Brachial Index Values: Describe Severity of Disease
> 1.40
Indicates rigid arteries and the need for an ultrasound test to check for peripheral artery disease.
Ankle- Brachial Index Values: Describe Severity of Disease 1.0- 1.40
Normal; no blockage
Ankle- Brachial Index Values: Describe Severity of Disease 0.8- 0.99
Mild blockage; beginnings of peripheral artery disease.
Ankle- Brachial Index Values: Describe Severity of Disease 0.4- 0.79
Moderate blockage, may be associated with intermittent claudication during exercise.
Ankle- Brachial Index Values: Describe Severity of Disease
< 0.4
Severe blockage suggesting severe peripheral artery disease; may have claudication pain at rest.
Ankle- Brachial Index Testing Procedire: Artery Utilized for Upper Extremity
Brachial Artery
Ankle- Brachial Index Testing Procedire: Artery Utilized for Lower Extremity
Tibialis Posterior artery (or dorsalis pedis artery)
Arterial Blood Gases
Arterial blood gases are collected to evaluate:
- Acid- base status (pH)
- Ventilation (PaCO2)
- oxygenation of arterial blood (PaO2)
Normal Values: pH
7.4
(7.35- 7.45)
Normal Values: PaCO2
40 mm Hg
(35- 45 mm Hg)
Normal Values: PaO2
97 mm Hg
(80- 100 mm Hg)
Normal Values: HCO3-
24 mEq/ L
(22- 26 mEq/L)
Normal Values: SaO2
95- 98%
Acidemia
Elevated acidity of blood
Alkalemia
Decrease acidity of blood
Eucapnia
Normal level of CO2 in arterial blood
Hypercapnia
Elevated level of CO2 in arterial blood
Hypocapnia
Low level of CO2 in arterial blood
Hypoxemia
Low level of O2 in arterial blood
Hypoxia
Low level of O2 in the tissue despite adequate perfusion of the tissue.
Systolic Blood Pressure
The force exerted against the arteries during the ejection cycle
Diastolic Blood Pressure
The force exerted against the arteries during rest
Pulse Pressure
The difference between systolic and diastolic pressure
Korotkoff Sounds: Phase I
The first appearance of clear tapping sounds correspongto the appearance of a palpable pulse;
Corresponds to systolic blood pressure.
Korotkoff Sounds: Phase II
The sounds become softer and longer than in Phase I
Korotkoff Sounds: Phase III
The sounds become crisper and older than in Phase II
Korotkoff Sounds: Phase IV
The sounds become muffled and softer than in Phase III
Korotkoff Sounds: Phase V
The sounds disappear completely; the diastolic pressure is the pressure at the last audible sound.
Normal Blood Pressure
120/ 80
Stage 1 Hypertension
130-139/ 80-89
Stage 2 Hypertension
140/ 90
Bronchial Sounds
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
Vesicular Sounds
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.
Crackle
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).
Pleural Friction Rub.
DRY, crackling sound heard during both inspiration and expiration.
It occurs when inflamed visceral and parietal pleurae rub together
Wheeze
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
Rhonchi
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
Stridor
A continuous high- pitched wheeze heard with inspiration or expiration that indicates an upper airway obstruction.
Breathing Exercises.
