Chapter 35 - Oxygenation (Week 4 quiz) Flashcards
memory tips for heart and lungs:
Tri = right (three lobes/tricuspid valve) Bi = left (two lobes/bicuspid valve)
apex is opposite (Heart bottom, lung top)
:)
The pulmonary, cardiovascular , mucsoskeletal and neurological systems work together to achieve _______
oxygenation
Type II alveolar cells produce ________, a lipoprotein that lowers the surface tension within alveoli to allow them to inflate during breathing
surfactant
Two major processes occur in the pulmonary system. ______ which is the movement of air into/out of the lungs
__________ is the exchange of oxygen/carbon dioxide
Alveolar capillary/capillary cell membrane
Ventilation (physical)
Movement of air into/out of the lungs which is called inhalation/exhalation
Respiration (chemical)
Exchange of oxygen/carbon dioxide
takes place in Alveolar capillary/capillary cell membrane
During _______ the diaphragm contracts, causing expansion of chest cavity (intercostals pull up and out) and lungs (creates negative pressure-and air is drawn in).
______ occurs when the diaphragm and intercostals relax, chest returns to normal resting size.
inhalation
exhalation
In vital signs we covered repisratory rate, depth, hyperventillation, hypoxemia, hypoventilation. Describe each!
Respiratory rate (# of times a person breathe in a full minute; count for full minute is new pt and to ensure accuracy vs for 15-30)
depth (tidal volume is the amt of air taken in on inspiration) - can be deep, shallow, or normal
rhythm-regular or irregular (cheyne stokes in the dying, Biot’s, kussmauls)
effort-effortless, dyspnea (labored breathing), orthopnea (inability to breath lying down), bradypnea, tachypnea
hyperventillation is rapid and deep breathing resulting in excess loss of CO2 (hypocapnea). Too much carbon monoxide can cause this. Pt may complain of feeling light-headed and tingly HYPOXEMIA is a mild form og hyperventillation except it is when there is a low level of oxygen in the blood. EMIA!!!
hypoventillation is when the rate and depth of respirations are decreased (small amount) and CO2 is retained. Can result in hypoxia (O2 def to tissues)
_______ _____ refers to the ease of lung inflation. It can be reduced by conditions that cause elastin fibers to be replaced with scar tissues, edema or loss of surfactant.
lung compliance
__________ _________ refers to tendency of elastin fibers to return to their original position (like a rubber band stretched and then snapped). This causes it to lose recoil over time. Lung can inflate easily but not deflate, leaving air trapped in alveoli
Lung elasticity
Usually _____ ____ is minimal. HOwever, during bronchospasm, the slightest reduction in diameter can cause trouble.
airway resistance
Which diagnostic test/exam would best measure a client’s level of hypoxemia?
a. chest x-ray b. pulse oximeter reading c. ABG d. peak expiratory flow rate
Correct answer: C
The term “hypoxemia” means low levels of oxygen in the blood. Arterial blood gas sampling is the most direct way in which the level of oxygen in the blood can be measured.
What is the difference between internal and external respiration?
External takes place between alveoli and capillary (will touch the external world as some point going in and out)
Internal takes place between the capillary and tissue (cell membrane)
(takes place soley inside capillaries/cells)
http://www.youtube.com/watch?v=qM1A4O3urGE
AP2: RESPIRATORY SYSTEM: EXTERNAL & INTERNAL RESPIRATION
Breathing is controlled by _________ located int he medulla, brainstem, carotid arteries and the aorta which detect changes in pH, O2, CO2.
Normally, the blood CO2 level provides the primary stimulus to breathe.
In addition, lung ______ located in the lung and chest wall are sensitive to breathing patterns/lung expansion/compliance/airway resistance/and respiratory irritants. Resp ctr uses feedback from these to adjust ventillation.
chemoreceptors
What allows us to control breathing in order to talk?
voluntary control of breathing via motor cortex
What factors infuence pulmonary function?
Developmental stage:
Less than 35 wk gestational - do not have full developed alveolar surfactant system/at risk for RDS (atelectasis - alveoli collapse), hypoxemia/hypercarbia; apnea;
Infants - susceptible to nfection
TOddlers put toys in their mouths - ingesting germs; possibly choking; drowning
Adolescents - start using tobacco
Young/middle/older adults - lack of exercise, smoking; organ decline; reduced lung expansion; difficulty expelling mucus, declining immune response, GERD
Environment: stress allergies air quality altitude
lifestyle:
pregnancy - O2 demand increases; limited diaphragm movement
occupational hazards - chemicals, fine particles, etc
nutrition
obesity - causes sleep apnea AND fat preses upward on diaphragm, preventing chest expansion which leads to hypovent.dyspnea;increase risk of lung infection
exercise
smoking
substance abuse
Medications - that depress CNS (anesthesia/opioids/antianxiety med/diazepam (valium), neuromuscular bloicking agents.
pathophysiological conditions - prob with gas exchange, resp infections, pulmonary system/circulation , cns and neuromuscular abnormalties,
Difference between hypoxia and hypoxemia?
hypoxia - inadequate O2 in tissues/organs
hypoxemia - low arterial blood O2 levels
The location!
What is the difference between hypercarbia and hypercapnia?
Nothing. The mean the same thing - excess of dissolved CO2 in the blood.
T or F: Hypocarbia (aka hypocapnia) is a low level of dissolved CO2 in the blood. In most cases (except high altitude) blood O2 levels remain normal. Caused by hyperventilation.
True
What is the differences in symptoms of URI vs Flu
Flu has the symptoms of URI (colds) BUT are more severe AND cause headache, fatigue, weakness, exhaustion and HIGH FEVER.
What are some pulmonary system abnormalties?
structural - broken rib, pneumothorax, fluid
airway inflammation/obstruction - astham / swollen tonsils
alveolar-capillary membrane disorders - alveoli become stiff and diffcult to ventiliate/gas exchange impaired
Atelectasis - alveolar collaps
What is a pulmonary embolus?
obstruction of pulmonary artery circulation due to clot/air/fat
_________ ________ is elevated pressure in the pulmonary artery system. High pressure causes the heart to have to work harder and eventually leads to right-sided heart failure, w/reduced amt of blood pumped into circulation.
pulmonary hypertension
Any CONDITION that alters CNS Function can interfere with the regulation of breathing. What are some common conditions?
Trauma
Stroke
Medications
Know what these are: eupnea dyspnea orthopnea bradypnea/tachypnea kussmaul's breathing Biot's breathing Cheyne-Stokes
eupnea 9normal breathing)
dyspnea (labored breathing),
orthopnea (inability to breath lying down),
bradypnea/tachypnea (slow/fast)
kussmaul’s breathing (youtube this! http://www.youtube.com/watch?v=TG0vpKae3Js )
Biot’s breathing https://www.youtube.com/watch?v=FpKdq-_ZvsI
Cheyne-Stokes ( note: may be alarming! https://www.youtube.com/watch?v=6_kxzDyV6J8 )
What is the best way to assess a cough?
OLDCART +
Is the cough dry,productive or hacking?
_____ ____ is a noninvasivce est. or arterial blood O2 saturation (SaO2). SaO2 relfects % of hgb carrying oxygen. Normal is 95-100%
pulse oximetry
hgb = iron contraining pigment of red blood cells
SaO2 - saturation of Oxygen that is actually bound to hemoglobin
There are two methods for measuring O2 and CO2 levels in the body. What are they? Which is most reliable?
ABG (Most reliable) - measure PAO2/PC02/Bicarbonate
Pulse ox - measures )2 saturation with a light beam
Def:
P02 (pp of O2 in blood) - amt of O2 availble to combine wih hgb to make Oxyhemoglobin; normal 80-100mmHg n arterty/40mg in vein
PC02 (pp of CO2),
Bicarbonate - blood pH