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Iggy Book > Ch 29: Resp System > Flashcards

Ch 29: Resp System Flashcards

0
Q

The pharynx is divided into three spaces. what are they

A

Nasopharynx, oropharynx, laryngopharynx

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1
Q

The upper airways consist of what structures

A

Nose, sinuses, pharynx, larynx

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2
Q

The cricoid cartilage is located where

A

The larynx. And contains the vocal chords

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3
Q

The lower airways are made up of what structures

A

The trachea; 2 mainstem bronchi;lobar, segmental, and subsegmental bronchi; bronchioles; alveolar ducts; and alveoli

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4
Q

Where discuss exchange take place in the lung tissue

A

Between the alveoli and the lung capillaries, not in the airways

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5
Q

What is unique about the right bronchus

A

Is slightly wider, shorter, and more vertical than the left. Can be accidentally intubated when an ET tube is passed. Also when a foreign object is aspirated from the throat, it usually enters the right bronchus.

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6
Q

Why is gas exchange reduced in atelectasis

A

Because Alveolar surface area is reduced

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7
Q

Surfactant

A

Fatty protein that reduces surface tension in the alveoli. Without it atelectasis occurs. Secreted by the Alveolar walls that have cells called type II pneumocytes

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8
Q

Describe the position of the lungs in the thorax

A

The apex extends above the clavicle, the base lies just above the diaphragm

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9
Q

Right versus left lung

A

Rt lung is larger, divided into 3 lobes.

Lt lung is narrower and smaller, divided into 2 lobes

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10
Q

60 to 65% of lung function occurs in which lung

A

Right lung. Problems here interfere with oxygenation to a greater degree than problems in the left.

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11
Q

What is the order of pulmonary circulation

A

Oxygen poor blood travels from the right ventricle into the pulmonary artery which eventually branches into arterioles that form capillary networks. Freshly oxygenated blood travels from the capillaries to the pulmonary veins then to the lt atrium. then into the lt ventricle where it is pumped throughout the systemic circulation

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12
Q

What are the accessory muscles of respiration

A

Scalene, sternocleidomastoid, trapezius and pectoralis. Back and abdominal muscles are used when the work of breathing is increased

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13
Q

What does oxygen bind to in the RBC

A

Hemoglobin. Each molecule can bind 4 oxygen molecules

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14
Q

How do you calculate pack-years?

A

Number of packs smoked per day multiplied by number of years the patient has smoked

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15
Q

Mucoid sputum

A

Smokers with chronic bronchitis

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16
Q

Excessive pink frothy sputum

A

Common with pulmonary edema

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17
Q

Rust colored sputum

A

Bacterial pneumonia

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18
Q

Foul smelling sputum

A

Often occurs with a lung abscess

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19
Q

Hemoptysis

A

Most often seen in patients with chronic bronchitis or lung cancer

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20
Q

Grossly bloody sputum

A

Patients with tuberculosis, pulmonary infarction, bronchial adenoma, or lung abscess

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21
Q

Normal cardiac pain is usually

A

Intense and crushing. May also radiate to the arm shoulder or neck.

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22
Q

Pulmonary pain

A

Varies depending on the cause. Being described as rubbing inside is more common. Pulmonary pain is not made worse by touching or pressing over the area

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23
Q

Is dyspnea subjective or objective

A

Subjective

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24
Q

What is PND

A

Paroxysmal nocturnal dyspnea; intermittent dyspnea during sleep

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25
Q

PND and orthopnea often occur with what two conditions

A

Chronic lung disease and left-sided heart failure

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26
Q

Tender nodes that are movable suggest

A

Inflammation

27
Q

Nodes that are hard and do not move with palpation suggest

A

Malignancy

28
Q

What common conditions push the trachea away from the affected area

A

Tension pneumothorax, large plural effusion, mediastinal mass, and tumors

29
Q

Common conditions that pull the trachea toward the affected area

A

Pneumonectomy, fibrosis, and atelectasis

30
Q

Decreased tracheal mobility may occur with

A

Cancer or fibrosis of the mediastinum

31
Q

Crepitus

A

Air trapped in and under the skin, aka subcutaneous emphysema. felt as a crackling sensation beneath the fingertips. Document when occurs around a wound site or tracheostomy site or if a pneumothorax is suspected

32
Q

Name the five notes of percussion

A

Resonance ,hyperresonance, flatness, dullness, Tympany

33
Q

Normal breath sounds are known as

A

Bronchial or tubular, broncovesicular, and vesicular

34
Q

Words used to describe breath sounds

A

Normal, increased, diminished, or absent

35
Q

Where is it abnormal to hear bronchial breath sounds

A

at the lung edges

36
Q

When Bronchovesicular breath sounds are heard in an abnormal location it may indicate

A

Normal aging or an abnormality such as pulmonary consolidation and chronic airway disease

37
Q

Find crackles fine rales and high-pitched rales are associated with what conditions

A

Asbestosis, atelectasis, interstitial fibrosis, bronchitis, pneumonia, chronic pulmonary diseases

38
Q

Coarse crackles and low pitched crackles are associated with what conditions

A

Bronchitis, pneumonia, tumors, pulmonary edema

39
Q

Wheezing is associated with what conditions

A

Inflammation, bronchospasm, edema, secretions, pulmonary vessel engorgement

40
Q

Ronchi are associated with what conditions

A

Thick, tenacious secretions, sputum production, obstruction by foreign body, tumors

41
Q

Pleural friction rub is associated with what conditions

A

Pleurisy, TB, pulmonary infarction, pneumonia, lung cancer

42
Q

What size is a normal intercostal space and what causes an increase in this space?

A

One finger breadth, or 2 cm. the distance increases in disorders that cause air trapping such as emphysema

43
Q

When might retractions occur

A

When the patient is working hard to inhale around an obstruction

44
Q

Normal PaO2

A

80-100 mm Hg

45
Q

Normal PaCO2

A

35-45 mm Hg

46
Q

Normal pH up to 60 yrs? 60-90 yrs? >90 yrs?

A
  1. 35-7.45
  2. 31-7.42
  3. 26-7.43
47
Q

Normal HCO3

A

21-28 mEq/L

48
Q

Normal SpO2

A

95-100%

Older adults: values may be slightly lower

49
Q

Important question to ask before CT with contrast

A

Known allergies to iodine or shellfish

50
Q

When patients have any degree of impaired peripheral blood flow the most accurate place to test oxygen saturation is

A

On the forehead

51
Q

SpO2 Results lower than ____ are an emergency and require immediate assessment and treatment

A

91% (and certainly below 86%)

52
Q

Two methods that measure the amount of carbon dioxide present in exhaled air

A

Capnometry and capnography

53
Q

Capnometry and capnography measure

A

End-tidal carbon dioxide levels ETCO2

54
Q

The normal pressure of end-tidal carbon dioxide (PETCO2) ranges? and changes mean??

A

20-40 mm Hg; changes reflect changes in breathing effectiveness and may occur before hypoxia can be detected using pulse oximetry

55
Q

Increased PETCO2 levels?

A

Reflect inadequate oxygenation such as fever, hypoventilation, partial airway obstruction and rebreathing exhaled air

56
Q

Decreased PETCO2 levels?

A

Reflect poor ventilation such as hypothermia,poor cardiac output, hypertension, hypovolemia, pulmonary embolism, apnea, total airway obstruction, and tracheal extubation

57
Q

What is the most common reason PFTs are performed

A

To determine the cause of dyspnea

58
Q

Common things to prepare a patient for PFTs

A

No smoking for 6-8 hours before testing, bronchodilator drugs may be withheld for 4-6 hours before the test. Help reduce anxiety by describing what will happen

59
Q

What to monitor the patient after PFTs for

A

Observe for increased dyspnea or bronchospasm

60
Q

Use of benzocaine spray to numb the oropharynx may induce

A

Methemoglobinemia

61
Q

Major characteristic and treatment of methemoglobinemia

A

Blood is a characteristic chocolate brown in color. Can be reversed with oxygen and IV injection of 1% methylene blue

62
Q

Care following bronchoscopy

A

Assess breath sounds every 15 minutes for the first two hours

63
Q

To prevent reexpansion pulmonary edema, usually no more than ____ of fluid is removed at one time during a thoracentesis

A

1000mL

64
Q

Important things for care after a thoracentesis

A

Chest x-ray is performed to rule out pneumothorax and mediastinal shift. Urge pt to breathe deeply to promote expansion of the lung. Teach about manifestations of a pneumothorax which can occur within the first 24 hours.

65
Q

Serious complications of needle biopsy and open lung biopsy

A

Pneumothorax. Report reduced or absent breast sounds immediately. Monitor for hemoptysis. Monitor breath sounds at least every 4 hours for 24 hours

Iggy Book (1 decks)

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