Chapter 9 Airway, Respiration And Artificial Ventilation Flashcards
Basic idea of ventilation
The moving of air in and out of the lungs.
- required for effective oxygen and respiration
Inhalation process
Inhalation- active part of ventilation. Diaphragm and intercostal muscle contract, intrathoracic pressure decreases, vacuum is created, thorax enlarges, air passes through the upper to the lower airway then to the alveoli
Exhalation process
Passive; diaphragm and intercostal muscles relax, thorax decreases in size, air is compressed put of lungs, intrathoracic pressure exceeds atmospheric pressure
What is Tidal Volume
The amount of air inhaled/exhaled in one breath
What is hypoxia
Inadequate delivery of O2 to the cells
Early indications of hypoxia
Restlessness, anxiety, irritability, dyspnea, tachycardia
Late signs of hypoxia
Altered or decreased LOC, severe dyspnea, Cyanosis, bradycardia
CO2 drive and Hypoxic drive
CO2- the body’s primary system for monitoring breathing status; CO2 levels are monitored in the blood and cerebral fluid
Hypoxic- backup to the CO2 drive; monitors O2 levels in plasma
What is oxygenation
The delivery of O2 to the blood
- ventilation is required but does not insure oxygenation
What percent of O2 is in the air ?
What percent is in expired air?
Surrounding air: 21%
Expired air- 16%
What is Respiration
The gas exchange of O2 and CO2
Time frame for brain damage due to lack of O2
Begins- 4min
Permanent- 6min
Irrecoverable- 10min
Signs of inadequate breathing
-abnormal RR
- Nasal Flaring
- paradoxical motion ( flail chest)
- unequal chest rise and fall
- dyspnea
- cyanosis
- agonal respiration ( dying gasps or apnea [no breathing] )
What is Auscultation
Using a stethoscope to listen to lung sounds
What are the points you listen to lungs
point to/ look up picture of unsure
List 4 different lung sounds and what they indicate
Absent/ diminished- indicates little /no air exchange
Wheezing- High pitched sounds usually heard on exhalation (asthma COPD)
Rales- wet/ crackling sounds
Stridor- high pitch sound in the upper airway indicating a partial blockage in the upper airway (neck)
Atelectasis occurs when
A deficiency of surfactant causes alveolar collapsed.
In contrast to negative pressure ventilation positive pressure ventilation
May impair blood return to a heart.
When does negative pressure ventilation occur?
When air is drawn into the lungs then intrathorasic pressure decreases.
What does the fraction of inspired oxygen increase with?
Supplemental oxygen.
The exchange of oxygen and carbon dioxide between the alveoli and the blood in the pulmonary capillaries is called.
External respiration
The lowest portion of the pharynx anteriorly and the esophagus posteriorly is the ?
Laryngopharynx
How does the Central nervous system regulate breathing?
The rate and depth are regulated by the brainstorm specifically than the medulla omblongata and the pons. These centers respond to changes in blood levels of carbon dioxide oxygen and ph to adjust breathing patterns. Chemoreceptors monterwood gas levels and sen signals to the respiratory centers to modify breathing as needed.
Describe. Biot(ataxic) respirations
Irregular pattern rate and depth of respiration with intermittent periods of apnea. Results from increased ICP
What are bronchovesicular sounds
Combination of tracheal and vehicular sounds. Heard at the upper part of sternum and between the scapula
Cheyne- stoles respirations
Gradually increasing rate and depth of respirations followed by a gradual decrease of with intermittent periods of apnea
Delayed sequence innovation.
The sedating medication is given before the paralytic
Depolarizing neuromuscular blocker characteristics
A drug that competitively binds with acetylcholine receptor sites but it’s not affected as quickly by acetylcholinesterase. Ex. Sux
Dysphonia
Difficulties speaking
Fasciculations
Brief on coordinated twitching of small muscle groups in the face neck trunk and extremities maybe seen after the administration of depolarizing drugs
Hypercapnia
Increase carbon dioxide content in arterial blood
Hypoexemia
A decrease in arterial oxygen level
Negative pressure ventilation
Airflow from a region of higher pressure ( outisde) to a region of lower pressure. (Inside) the case in regular respirations.
Orthopnea
Positional dyspnea
Vesicular breath sounds
Soft muffled bread sounds in which the expiratory phase is barely audible
Apneustic respirations
Prolonged gasping inhalation followed by extremely short ineffective exhalation associated with brainstein insult.
Phase 1(A-B) of capnographic waveform
The initial stage of exhalation. Gas sample consists of dead space gas which is free of carbon dioxide.
Phase 2(B-C) of capnographic waveform
Expiratory upslope. At point B alveolar gas mixes with dead space gas.
Phase 3 (C-D) of capnographic waveform
Alveolar plateau. Point D is max ETCO2 levels
Phase 4 (D-E) of capnographic waveform
Inspiratpry downstroke. Fresh gas is introduced. This downstairs displaces carbon dioxide.
What does shark fin capnography indicate
Bronchospasm
When should you replace an oxygen cylinder
200psi
