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Pathophysiology Exam 2 > Chapter 23- Ventilation & Gas Exchange > Flashcards

Chapter 23- Ventilation & Gas Exchange Flashcards

1
Q

Ventilation?

A

Movement of air between the atmosphere and respiratory portion of the lungs

MOVEMENT

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2
Q

Perfusion?

A

Flow of blood through the lungs

BLOOD FLOW

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3
Q

Diffusion?

A

Transfer of gases between the air filled spaces in the lungs and the blood

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4
Q

Examples of perfusion?

A
  • thrombus in vessels

- severe anemia

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5
Q

When inserting an endotracheal tube, a medical professional will typically advance the tube where?

A

To the right, due to the nature of the trachea.

  • Right side of trachea into the lungs is a wider angle
  • left side of trachea into the lungs is a more narrow turn
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6
Q

Dissolved oxygen = _______ or _________?

A

PaO2 or PO2

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7
Q

What is the normal value of dissolved oxygen?

A

Normal value > 80mm Hg

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8
Q

Oxygen bound to hemoglobin = ?

A

Oxyhemoglobin

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9
Q

Normal Oxygen saturation value is ______ to _______?

A

94% to 100%

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10
Q

Dissolved carbon dioxide = _______ or _________?

A

PaCO2 or PCO2

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11
Q

Normal Carbon Dioxide value = ?

A

35-45 mm Hg

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12
Q

Carbon dioxide bound to hemoglobin =?

A

Carbaminohemoglobin

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13
Q

When you exhale you remove _______ from your blood?

A

CO2

  • you also decrease the amount of carbonic acid, raising your blood PH
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14
Q

Hypoxemia?

A

Reduced oxygenation of the arterial blood

  • PO2 <60mm Hg or Pox around 90%
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15
Q

What is Cyanosis?

A

Bluish discoloration

Of the skin & mucous membranes

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16
Q

Central Cyanosis is evident where?

A

In the tongue and lips

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17
Q

Peripheral Cyanosis is evident where?

A

On the extremities & tip of the nose and ears

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18
Q

Which is more serious, Peripheral cyanosis OR central cyanosis?

A

Central cyanosis

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19
Q

If a patient has hypoventilation, there building up _______ and not getting enough ________.

A

Building up: CO2

Not getting enough: O2

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20
Q

Signs and symptoms of Hypoxemia?

A
  • Tachypneic (fast breathing)

- SOB

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21
Q

Ways to diagnose Hypoxemia?

A
  • Pox
  • Arterial blood gas (ABG)
  • 92% —> nasal canula (2-3L/min)
  • 74% —> oxymask ALL THE WAY UP (15L/min)
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22
Q

Treatment for Hypoxemia?

A
  • Treat the underline cause
  • Oxygen via nasal cannula, mask, or nonrebreather

If No Improvement

  • continuous positive airway pressure (CPAP) (night)
  • Bilevel positive airway pressure (BIPAP) (on 1st)
  • Intubation
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23
Q

Atelectasis?

A

Incomplete expansion of the lung or portion of a lung

can be small segment or entire lung

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24
Q

Atelectasis is most commonly seen in who?

A

Postoperative patients

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25
Q

What are the two early signs & symptoms of Atelectasis?

A
  • Tachypnea (fast breathing)

- Tachycardia (fast HR)

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26
Q

Atelectasis signs and symptoms?

A
  • Tacypnea
  • Tachycardia
  • Dyspnea
  • Cyanosis
  • Absence of breath sounds
  • Fever
  • Signs of infection
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27
Q

Treatment for Atelectasis?

A
  • incentive spirometry
  • coughing
  • deep breathing
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28
Q

What is Hypercapnia?

A

Increased carbon dioxide in the arterial blood

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29
Q

Hypercapnia is PCO2 of ___________?

A

> 50mm Hg

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30
Q

Signs & Symptoms of Hypercapnia?

A
  • Hypoventilation
  • decreased RR
  • Altered mental status
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31
Q

________________ covers the lungs?

A

Visceral pleura

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32
Q

____________ lines the thoracic wall and superior aspect of the diaphragm?

A

Parietal pleura

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33
Q

Pleural cavity is what?

A

Space between the two layers

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34
Q

_________ contains a thin layer of serous fluid?

A

Pleural cavity

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35
Q

Pleuritic Chest Pain originates from where?

A

Originates from parietal pleura involvement

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36
Q

Signs & Symptoms of Pleuritic Chest Pain?

A
  • Sharp
  • Abrupt onset
  • Unilateral
  • Lower
  • Can be referred to shoulder
  • Worse with chest movement
    (Cough, deep breathing, movement)
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37
Q

Pleuritic chest pain results in what?

A

Rapid, shallow breaths, reflex splinting

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38
Q

What is Pleural Effusion?

A

Fluid in the Pleural Cavity

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39
Q

Hydrothorax: ?

A

Serous fluid

40
Q

What is the most common cause of Hydrothorax?

A

Congestive Heart Failure (CHF)

41
Q

Empyema: ?

A

Pus; s/s of infection

42
Q

Causes of Empyema?

A
  • Direct infection of pleural space
  • rupture of lung abscess
  • invasion from subdiaphragmatic infection
  • trauma
43
Q

Hemothorax: ?

A

Blood

44
Q

Causes of Hemothorax?

A
  • Injury to chest
  • surgery
  • malignancy
  • rupture of great vessel
45
Q

Signs and symptoms of Pleural Effusion?

A
  • Dyspnea
  • Decreased breath sounds
  • Pleuritic chest pain
  • Mild Hypoxemia
  • Shift in mediastinal structures
  • Decreased lung expansion
46
Q

Treatment of Pleural Effusion?

A
  • directed towards cause
  • Drainage of fluid
    ( chest tube or multiple chest tubes)
  • possibly surgery
47
Q

What is Pneumothorax?

A

Air enters the pleural cavity

  • Air takes up space, restricting lung expansion
  • can be partial or complete collapse of the affected lung
48
Q

What are 2 types of pneumothorax?

A
  1. Spontaneous pneumothorax

2. Traumatic pneumothorax

49
Q

What is spontaneous pneumothorax?

A

An air-filled blister on the lung ruptured

50
Q

What is traumatic pneumothorax?

A

Air enters through chest injuries

51
Q

What are 2 types of traumatic pneumothorax?

A
  1. Tension pneumothorax

2. Open pneumothorax

52
Q

What is Tension pneumothorax?

A

Air enters pleural cavity through the wound on inhalation, but cannot leave on exhalation

Life Threatening

53
Q

What is Open pneumothorax?

A

Air enters pleural cavity through the wound on inhalation and leaves on exhalation

54
Q

Air ________ in the lung?

A

Rises

55
Q

Fun Fact:

In patients with Tension Pneumothorax

  • place needle by 2nd rib. Pull out needle and the tubing serves as a way for air escape!
A

💉💉

56
Q

Signs and symptoms of pneumothorax?

( and also Hemothorax)

A
  • Depends on size and lung response
  • Chest pain
  • Tachypnea
  • Tachycardia
  • Asymmetry of chest movement
  • Hypoxemia
  • Tracheal deviation with tension pneumothorax
57
Q

Asymmetry of chest movement is seen more with what?

A

Car accidents & Trauma

58
Q

Treatment of pneumothorax?

A
  • Depends in cause
  • Removal of air with needle or chest tube
  • surgery if necessary
59
Q

Tension Pneumothorax = ?

A

Needle Decompression

60
Q

What is Hemothorax?

A

Blood within the pleural space

61
Q

Causes of Hemothorax?

A
  • Trauma
    - MVC
    - Gun shot
    - Stabbing
    - Assault
    - Fall
62
Q

Where should a chest tube be placed in a patient with Hemothorax?

A

Lower in lung

  • since blood is heavier than air!
63
Q

Tension pneumothorax is associated with what?

A

Tracheal deviation

64
Q

What are chronic obstructive airway diseases?

A
  • Chronic bronchitis
  • Emphysema
  • Bronchiectasis
  • Cystic Finrosis
65
Q

What are Obstructive Airway Disorders?

A
  • Bronchial asthma
  • Chronic obstructive airway diseases
    - Chronic bronchitis
    - Emphysema
    - Bronchiectasis
    - Cystic fibrosis
66
Q

Asthma is due to what?

A

Airway inflammation

67
Q

___________ makes Asthma worse in 10% of individuals?

A
  • Over the counter meds
    (Anti-inflammatories)

AVOID—> ibuprofen, aleve, aspirin

68
Q

Signs and symptoms of MILD asthma?

A
  • Chest tightness

- Expiratory wheezing

69
Q

Signs and symptoms of SEVERE asthma?

A
  • Dyspnea
  • Fatigue
  • Loud inspiratory & expiratory wheezing
  • accessory muscle use
  • Tripod position
70
Q

What symptoms would there be in a patients with asthma whose airflow has significantly decreased?

A
  • Breath sounds inaudible
    (Due to full occlusion)
  • Diminished wheezing
  • will lead to respiratory failure/arrest
71
Q

High CO2 levels will cause what in COPD patients?

A

Unresponsiveness

- All other assessments will be normal!
Vitals, etc.

72
Q

What should you monitor with COPD patients?

A

CO2 Levels

73
Q

In COPD patients they can’t get _____ in and cant blow off _______.

A

Can’t get O2 in

Can’t blow off CO2

74
Q

In COPD patients there ABG will look _________ and there CO2 will be ________.

A

Good

Elevated

75
Q

In COPD patients what does the saying Low & Slow mean?

A

Increase O2 1L at a time

  • usually don’t go above 3L *
76
Q

What is Emphysema?

A

Enlargement of air spaces and destruction of lung tissue

77
Q

What is the problem with Emphysema?

A

Major mechanism of airflow is limited due to the loss of elastic recoil

( allows air in the lungs during inspiration and prevents collapsing on exhalation)

78
Q

Causes of Emphysema?

A
  • smoking 🚬

- genetics 🧬

79
Q

What respiratory disease cause Mucus Hypersecretion ?

A

Chronic bronchitis

80
Q

What is Chronic bronchitis?

A
  • Chronic irritation, inflammation, and obstruction of airways
81
Q

COPD & Chronic Bronchitis occur more in what sex?

A

More MEN

It can still occur in women, but it’s less likely

82
Q

Chronic bronchitis occurs more in ______, __________, ___________________.

A
  • Middle ages men
  • Smokers
  • Recurrent infection
83
Q

What is a symptom of Chronic Bronchitis?

A
  • Chronic, Persistent, productive cough
84
Q

In somebody with COPD & Chronic Bronchitis, where do we want there Pox?

A

Where there Pox is normal, is where we want it to be!

85
Q

Signs & Symptoms of Chronic Bronchitis ?

A
  • Dyspnea
  • Decreasing exercise tolerance
  • Labored breathing (eventually even @ rest)
  • Prolonged expiatory phase
  • Hypoxemia
  • Hypercapnia
  • Cyanosis
86
Q

Pursed Lips helps to do what?

A

Helps to blow off CO2 longer

87
Q

Emphysema Signs & Symptoms

A
  • Dyspnea
  • Increased ventilatory effort
  • use of accessory muscles
  • Barrel chest
  • Pursed lip breathing
88
Q

What Labs to look for in COPD patients & why ?

A
  • ABG
  • CBC
  • Low WBC’s = COPD exacerbation (breathing treat.)
    High WBC’s = Pneumonia (Antibiotics)
89
Q

What is a Pulmonary Embolism?

A

Something blocking a branch of a pulmonary artery and obstructs flow

(Thrombus, air, fat)

90
Q

Pulmonary Embolisms almost always arise from ______________________________.

A

Deep Vein Thrombosis (DVT) OR Venous Thromboembolism (VTE)

91
Q

What are complications of Pulmonary Embolisms?

A
  • Pulmonary Hypertension
    ( increases pressure to try and push everything pass the blockage)
  • Right-sides heart failure develops
92
Q

Fat emboli are common with what?

A

Common with large bone breaks

(Ex: Femur)

93
Q

Pulmonary Embolism Signs & Symptoms ?

A
  • Chest pain
  • Dyspnea
  • Tachycardia
  • Tachypnea
  • Low Pox
  • Hypoxemia without CO2 retention
  • Large emboli May be fatal
94
Q

D-dimer testing can be used to diagnose what ?

A

Pulmonary Embolism

95
Q

In patients with Pulmonary Embolisms, anticoagulants are used to prevent what ?

A

Prevents further growing of the thrombus

Pathophysiology Exam 2 (6 decks)

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