Chapter 40 Flashcards
Active process, stimulated by chemical receptors in the aorta
Inspiration
Process of moving gases into and out of the lungs
Ventilation
A passive process that depends on the elastic recoil properties of the lungs, requiring little or no muscle work
Expiration
A chemical produced in the lungs to maintain the surface tension of the alveoli and keep them from collapsing
Surfactant
A collapse of the alveoli that prevents normal exchange of oxygen and carbon dioxide
Atelectasis
The amount of blood ejected from the left ventricle each minute
Cardiac output
The volume of blood ejected from the left ventricle during systole
Stroke volume
The resistance to left ventricular ejection
Afterload
Amount of blood in the left ventricle at the end of diastole
Preload
The electrical activity of the conduction system
Electrocardiogram (ECG)
Extra cellular fluid loss and reduced circulating blood volume
Hypovolemia
Alveolar ventilation is inadequate to meet the oxygen demand of the body or eliminate sufficient carbon dioxide
Hypoventilation
State of ventilation in which the lungs remove carbon dioxide faster than it is produced by cellular metabolism
Hyperventilation
In adequate tissue oxygenation at the cellular level
Hypoxia
Rhythm disturbances
Dysrhythmias
Life threatening dysthymia a because of the decreased cardiac output and potential to deteriorate into ventricular fibrillation
Ventricular tachycardia
Sudden cardiac death
Ventricular fibrillation
Supply of blood to the myocardium from the coronary arteries is insufficient to meet myocardial oxygen needs
Myocardial ischemia
Transient imbalance between myocardial oxygen supply and demand
Angina pectoris
Sudden decreases in coronary blood flow or an increase in myocardial oxygen demand without adequate coronary profusion
Myocardial infraction (MI) or acute coronary syndrome
Subjective sensation of difficult or uncomfortable breathing
Dyspnea
Abnormal condition in which a patient uses multiple pillows when reclining to breathe easier
Orthopnea
Bloody sputum
Hemoptysis
Bloody sputum from gastrointestinal tract
Hematemesis
High-pitched musical sound caused by high-velocity movement of air through a narrowed airway
Wheezing
Increased rate and depth of respirations
Kussmaul respiration
The absence of respirations for a period of time
Apnea
Decreased blood flow or injury to the brainstem
Cheyne-Stokes respirations
The process of adding water to gas
Humidification
Adding moisture or medications to inspired air by mixing particles of varying sizes with air
Nebulization
A group of therapies for mobilizing pulmonary secretions
Chest physiotherapy (CPT)
Component of pulmonary hygiene; consists of drainage, positioning, and turning and is sometimes accompanied by chest percussion and vibrations
Postural drainage
Short-term artificial airway to administer mechanical ventilation, relieve upper airway obstruction, protect against aspiration, or clear secretions
Endnoteachial (ET) tube
A surgical tube is made into the trachea and a short artificial airway (tracheostomy tube) is inserted
Tracheostomy
Encourages voluntary deep breathing by providing visual feedback to patients about inspiratory volume
Incentive spirometry
Used to prevent using invasive artificial airways (ET) in patients with acute respiratory failure, cardiogenic pulmonary edema, or exacerbation of COPD
Noninvasive positive-pressure ventilation (NPPV)
Ventilatory support used to treat patients with obstructive sleep apnea, patients with congestive heart failure, and preterm infants with under developed lungs
Continuous positive airway pressure (CPAP)
Ventilatory support used to treat patients with obstructive sleep, patients with congestive heart failure, and preterm infants with under developed lungs
Bi-level positive airway pressure (BiPAP)
A catheter inserted through the thorax to remove air and fluids from the pleural space, to prevent air or fluid from reentering the pleural space, or to reestablish normal intrapleural and intrapulmonic pressures
Chest tube
Collection of air in the pleural space
Pneumothorax
An accumulation of blood and fluid in the pleural cavity between the parietal and visceral pleura, usually as a result of trauma
Hemothorax
Simple, comfortable device used for precise oxygen delivery. 2 nasal prongs inserted into nostrils
Nasal cannula
Deep inspiration and prolonged expiration through pursed lips to prevent alveolar collapse
Pursed-lip breathing
Determines ability of the lungs to efficiently exchange oxygen and carbon dioxide
Pulmonary Function Test
Patient walks on a treadmill at a specified speed and duration of time. Evaluates the cardiac response to physical stress
ECG Exercise Stress Test
Noninvasive measure of heart structure and heart wall motion. It graphically demonstrates overall cardiac performance.
Echocardiography
Portable ECG worn by a patient. Produces a continuous ECG tracing over a period of time.
Holter Monitor
Used to visualize cardiac chambers, valves, the great vessels, and coronary arteries. Pressures and volumes within the four chambers of the heart are also monitored.
Cardiac Catheterization and Angioplasty
Visual examination of the tracheobronchial tree through a narrow, flexible fiberoptic scope.
Bronchoscopy
Surgical perforation of chest wall and pleural space with a needle to aspirate fluid for diagnostic or therapeutic purposes or to remove a specimen for biopsy
Thoracentesis
Obtained to identify a specific microorganism or organism growing in sputum
Sputum Specimen
Provide important information for assessment of patient’s respiratory and metabolic acid/base balance and adequacy of oxygenation
Arterial blood gasses
ECG stress test with the addition of thallium-201 injected intravenously. It determines coronary blood flow changes with increased activity.
Thallium Stress Test
An abnormally rapid heart rate, greater than 100 bpm in adults
Tachycardia
Absence of oxygen
Anoxia
Abnormally slow breathing
Brandypnea
Abnormally rapid respiration
Tachypnea
A slow heartbeat marked by a pulse rate below 60 bpm in an adult
Bradycardia
What are some diseases or medical problems that affect oxygenation?
COPD, Asthma, Pregnancy, Upper Respiratory Infection, Anemia, MI, Obesity
The exchange of oxygen and carbon dioxide during cellular metabolism
Respiration
Where does the exchange of respiratory gases occur?
Between the environment and the blood.
What controls the rate and depth of respiration in response to changing tissue oxygen demands?
Neural and chemical regulators
Which two systems supply the oxygen demands of the body?
Cardiac and respiratory
What is the primary function of the lungs?
To transfer oxygen from the atmosphere into the alveoli and carbon dioxide out of the body.
Gases move into and out of the lungs through
Pressure changes
Interpleural pressure is __________. It is ____mm Hg at sea level.
negative; 760
For air to flow into the lungs, intrapleural pressure becomes ________ __________
more negative
The ability of the cardiovascular system to pump oxygenated blood to the tissues and return deoxygenated blood to the lungs
Perfusion
Exchange of respiratory gases in the alveoli and capillaries
Diffusion
The major inspiratory muscle
diaphram
The effort required to expand and contract the lungs
WOB (work of breathing)
The amount of energy expended on breathing depends on the ________ and ___________ of breathing, ________ and _________
rate; depth; compliance; airway resistance
The ease with which the lungs can be expanded
Compliance
Decreases in diseases such as pulmonary edema, interstitial and pleural fibrosis, and congenital or traumatic structural abnormalities such as kyphosis or fractured ribs
Compliance
The increase in pressure that occurs as the diameter of the airways decreases from mouth/nose to alveoli
Airway resistance
What increases airway resistance?
Diseases such as asthma & tracheal edema.
What is the result of airway resistance?
Decreased O2 delivered to the alveoli
The amount of air exhaled after normal inspiration
Tidal volume
The amount of air left in the alveoli after a full expiration
Residual volume
The maximum amount of air that can be removed from the lungs during forced expiration
Forced vital capacity
Measures the volume of air entering or leaving the lungs
spirometry
Primary function is to move blood to and from the alveolar capillary membranes for gas exchange
Pulmonary circulation
What are 4 things that effect oxygen transport
Ventilation, Perfusion, Rate of diffusion, 02 carrying capacity
What is one disease that effects oxygen-carrying capacity
anemia
A carrier for O2 and Carbon dioxide, transports most O2 (97%)
Hemoglobin
Diffuses into red blood cells and is hydrated into carbonic acid (H2CO3)
Carbon dioxide
What does carbonic acid dissociate into?
hydrogen (H) and bicarbonate (HCO3-)
Neural and chemical regulators control the process of _____
respiration
__________ controls the respiratory rate, depth, and rhythm.
CNS
Regulates the voluntary control of respiration
Cerebral cortex
Maintains the rate and depth of respirations based on changes in the blood concentrations of CO2 and O2, and in hydrogen ion concentration (pH)
Chemical regulation
________ sense changes in the chemical content and stimulate neural regulators to adjust.
Chemoreceptors
Which side of the heart recieves deoxygenated blood?
Right
Where does oxygenated blood travel to?
The left side of the heart
The right ventricle pumps blood through the….
pulmonary circulation
The left ventricle pumps blood through the….
systemic circulation
As the myocardium stretches, the strength of the subsequent contraction increases.
Starling’s law
How do you determine cardiac output
Cardiac Output (CO) = Stroke volume (SV) x Heart rate (HR)
Myocardial blood flow S1
mitral and tricuspid close
Myocardial blood flow S2
aortic and pulmonic close
Branch of systemic circulation that supplies the myocardium with oxygen and nutrients and removes wastes
Coronary artery circulation
Arteries and veins deliver nutrients and oxygen to tissues and remove waste products
Systemic circulation
Influences the rate of impulse generation and the speed of conduction pathways
Autonomic nervous system
Increase the rate of impulse generation and impulse transmission and innervates all parts of the atria and ventricle
Sympathetic nervous system
Decreases the rate and innervates atria, ventricles, and sinoatrial and atrioventricular nodes
Parasympathetic system
Originates with the sinoatrial (SA) node or pacemaker and is transmitted to the atrioventricular (AV) node, bundle of His, and Purkinje fibers
Conduction system
