Chapter 8 Pathophysiology Flashcards
The breakdown of molecules such as glucose through a series of reactions that produce energy within cells in the presence of oxygen is known as what?
Aerobic metabolism
what process occurs in the fluid portion of a cell (cytosol) & doesn’t require oxygen?
glycolysis
What are some other by-products of aerobic metabolism?
water, carbon dioxide, & heat
what is the by product “heat” used for in the body?
core temperature
What is anaerobic metabolism?
is the breakdown of molecules with air
What are the by product of anaerobic metabolism?
Lactic acid and a small amount of ATP
What is ATP?
ATP is produced by almost all living things in their cell’s organelles called mitochondria. It stands for adenosine triphosphate and it is the major ‘currency’ of energy in the body.
What happens when to a cell when its sodium potassium pump fails.?
When the pump fails sodium (NA) collects inside the cell because their is a lack of (ATP) energy to create the pump cycle and the potassium hangs around. Since water follows sodium water fills the cell and it eventually ruptures.
what causes cellular pump failure
The lack of oxygen
because oxygen is need in respiration and ventilation for the gas exchange to make ATP energy.
The delivery of oxygen, glucose, and other substances to the cells and the elimination of waste products is referred to as what?
Perfusion
What is needed to maintain adequate perfusion?
the components of the delivery and waste system must work properly.
What are the components of the delivery and waste system?
composition of ambient air patent airway mechanics of ventilation regulation of ventilation ventilation an perfusion ratio transport of oxygen & carbon dioxide blood volume pump function of the myocardium systemic vascular resistance microcirculation blood pressure
What happens to a cell if it has inadequate perfusion?
It shift from an aerobic to an anaerobic metabolism
What is ambient air?
is air that humans & other organism live in and breathe.
It is colorless, odorless, tasteless gaseous mixture
and at sea level its 78% nitrogen, 21% oxygen, 0.9 % argon & 0.03% carbon dioxide
How can you raise the cellular oxygenation in a patient who suffer from hypoxia?
increasing the concentration of oxygen that the patient is breathing and ensuring its at 21%
What is FiO2 and how is it expressed?
FiO2 is the fraction of inspired oxygen and it is expressed in decimal.
Example:
ambient air that contains 21% oxygen = 0.21
What does FDO2 mean?
fraction of delivered oxygen
What is the difference betweenFiO2 and FDO2?
FiO2 is oxygen given to a patient when they can breathe on their own and FDO2 is oxygen given to a patient who is ventilated unable to breathe on their own.
Some toxic gases displace the amount of oxygen in the air suffocating the patient while others (carbon monoxide) disrupts the ability of the blood to carry adequate amounts of blood to the cells.
when either takes place how do the cells end up?
Hypoxic
Another type of toxic gas interferes with the cells use of oxygen by the cell. What is the name of the gas?
cyanide poisoning
What is one of the most important aspects of any emergency care provided?
establish and maintain patent airway
What is patent airway?
an airway that is one open and not obstructed by blood, secretions, vomitus, tissue, bone, teeth, or any other substance.
An airway obstruction can happen in both the upper and lower airway including what?
nasopharynx, oropharynx, posterior pharynx, epiglottis, larynx, trachea, and bronchi
Why is it important to keep the nasopharynx clear?
The nasopharynx leads to the larynx, trachea, and the lungs.
Why is it important to keep the nasopharynx clear in infants?
they are obligate nose breathers
What can obstruct the nasopharynx?
blood, vomit, tissue swelling, bone fragment, & other substances.
What can obstruct the oropharynx and the pharynx?
tongue, foreign bodies, tissue swelling, hematomas, blood, vomit, & other substances
what does aspirated mean?
breathed into the lungs
what condition can occur if aspiration occurs?
hypoxia
What is the flap that is known as the glottis opening and it covers the opening of the larynx?
Epiglottis
If the epiglottis becomes inflamed from injury or infection what can occur?
an occlusion
What maneuver can clear the epiglottis for patent airway?
jaw-thrust or chin-lift
The larynx contains what?
vocal cords
What is the thyroid cartilage and where is it located?
Adams apple
anterior to portion of the larynx
What is the cricoid cartilage and where is it located?
its a cartilage ring
inferior portion of the larynx
who has a cylinder airway that is narrow at the top?
an adult
who has a cone shaped airway that is narrow at the cricoid cartilage?
a child under eight years of age
what is a laryngeal spasm?
it is were the vocal cords spasm and close together and it can cause an obstruction to larynx.
The larynx opens into what?
Trachea which extends downward and bifurcates at the carnia
Where is the Carnia located?
at the second intercostal space (angle of Louis)
What is the trachea composed of?
C-shaped cartilage rings with a soft, flexible muscle on the posterior aspect.
The integrity of ________plays an integral role of in maintaining normal ventilation.
thoracic cavity
The structures of the thoracic cavity are necessary for _______________to occur?
normal ventilation?
Define Boyle’s law?
An increase in pressure
will decrease the volume of gas
A decrease in pressure
will increase the volume of gas
Example: a syringe for taking blood. An empty syringe has a fixed amount of gas (air) in it; if the plunger is drawn back without the needle end being inserted into anything, the volume of the tube will increase and the pressure will drop, causing more air to move into the tube to equalize the pressure. If the syringe is inserted into a vein and the plunger drawn back, blood will flow into the tube since the pressure in the vein is higher than the pressure in the syringe.
because the energy must be expanded to contract the chest, inhalation is consider an_________process.
active
during exhalation the muscle relax and no energy is expanded, exhalation is consider_________process.
Passive
What are two condition that may require the use accessory muscle to generate a greater force to fill and empty lungs are____________.
higher airway resistance
and poor compliance
a measurable of the ability of the chest wall and lung to stretch, distend, and expand is known as
Compliance
Would a decrease or an increase in compliance make it harder for a patient to move air in and out of the lungs?
decrease
The movement of air during ventilation relies on what is called the__________________________.
bellows action of the chest
the ease of air flow down the conduit of airway structures leading to the aveoli is known as _______,
airway resistance
define Minute ventilation or minute volume
the amount of air moved in and out of the lungs ina minute.
the air moved in and out of the alveoli in one minute is known as______________>
Alveolar ventilation
Define dead air space.
dead space is the volume of air which is inhaled that does not take part in the gas exchange, either because it (1) remains in the conducting airways, or (2) reaches alveoli that are not perfused or poorly perfused. In other words, not all the air in each breath is available for the exchange of oxygen and carbon dioxide.
What is tidal volume?
lung volume representing the normal volume of air displaced between normal inspiration and expiration when extra effort is not applied. In a healthy, young adult, tidal volume is approximately 500 ml per inspiration or 7 ml/kg of body weight
Inadequate ventilation and cellular hypoxia can occur from?
low tidal volume
ventilatory rate that is to low
ventilatory rate that is to high
the primary involuntary control is trough the respiratory center of the brainstem. what does it send out to the respiratory muscles
stimulas impulses
specialized receptors that monitor the pH, carbon dioxide, and oxygen levels in the arterial blood is known as_______.
Chemoreceptors
How many groups of the chemoreceptors are there________.
2 central and peripheral
Where are the Chemoreceptors located and what are they sensitive to?
located near the respiratory center of the medulla, and are sensitive to the pH of their environment.
Where are the peripheral chemoreceptors and what are they sensitive to?
act principally to detect variation of the oxygen concentration in the arterial blood, & also monitoring arterial carbon dioxide and pH.
They are located in the aortic body and carotid body, on the transverse aortic arch.
What is Hypoxic Drive
In patients with COPD patients tend to retain carbon causing the central chemoreceptors become insensitive and no longer stimulate ventilation. peripheral receptors become primary thus a decrease in oxygen (Hypoxia) becomes the stimulus for ventilation in place of hybercarbia.
What are the 3 types of receptors in the lungs?
irritant, stretch, & J-receptors
define Irritant receptors
found in airway and are sensitive to irritants. they stimulate cough, bronchoconstriction, and increased ventilator rate.
Define stretch receptors
found in smooth muscle of the airway
protects the lung from overinflating by decreasing the rate and volume of ventilation due to high tidal wave.
Define J-receptors
found in capillary surrounding the alveoli
sensitive to increase pressure
stimulate rapid shallow ventilation
what are the 3 respiratory control centers in the brain stem
- the dorsal respiratory group
- the ventral respiratory group
- the pontine respiratory group
where are the the dorsal respiratory group
and the ventral respiratory group located?
medulla oblongata
where is the pontine respiratory group located?
the pons of the brain stem
The 3 respitory centers receive sensory input and transmit impulses to__________________.
skeletal muscle controlling ventilation
which respiratory group id responsible for causing the diaphragm to contract, which results in inhalation.
ventral respiratory group
Which respiratory group is responsible for both inhalation and exhalation?
dorsal respiratory group
which respiratory group sends an inhibitory message to the VRG to turn off inhalation?
the pontine respiratory group
what is ventilation/perfusion (V/Q)?
the relationship between the amount of ventilation that the alveoli receives and the amount of perfusion through the capillaries
