CI Terminology Flashcards
Tidal volume (Vt)
Air inhaled or exhaled during a single normal breath
Inspiratory reserve volume (IRV)
Maximum amount of air that can be inspired on top of a normal tidal inspiration
Expiratory reserve volume (ERV)
Maximum amount of air that can be exhaled following a normal tidal expiration
Residual volume (TLC)
Volume of air remaining in the lungs after a maximal expiration
Total lung capacity (TLC)
Total volume of lungs at the end of maximal inspiration
Vital capacity (VC)
Maximum amount of air that can be inspired and expired in a single breath
Functional residual capacity (FRC)
Volume of air remaining in the lungs at the end of normal tidal expiration
Costophrenic angle
Where the diaphragm meets the ribs
Abnormal breath sounds (bronchial breathing)
Occurs when air is replaced by solid tissue, which transmits sound more clearly. e.g, consolidation, areas of collapse, pleural effusion
Diminished breath sounds
If air entry is compromised by an obstruction or decreased airflow. e.g. pneumothorax, pleural effusion, emphysema, collapse, obesity, difficulty breathing
Crackles
Occur when airways that have been narrowed or closed (usually by secretions) are suddenly forced open on inspiration.
Fine crackles
Crackles originating from small, distal airways
Coarse crackles
Crackles originating from large, proximal airways
Wheeze
Caused by air being forced through narrowed or compressed airways. e.g. bronchospasm, muscosal oedema, sputum retention.
Pleural rub
Sound heard when pleural surfaces are inflamed or infected, or become rough and rub together. Creates creaking or grating sound heard equally in inspiration and expiration.
Respiratory acidosis (uncompensated)
Decreased pH, increased PaCO2
Metabolic acidosis (uncompensated)
Decreased pH, decreased HCO3
Respiratory alkalosis (uncompensated)
Increased pH, decreased PaCO2
Metabolic alkalosis (uncompensated)
Increased pH, increased HCO3
Controlled mechanical ventilation (CMV)
Ventilator performs all work of breathing with breathing parameters preset
Central venous pressure (CVP)
Measured near right atrium within the superior vena cava. Information about circulating blood volume, effectiveness of heart pump, vascular tone and venous return.
Cerebral perfusion pressure (CPP)
Pressure required to ensure adequate blood supply to the brain. MAP - ICP
Ejection fraction
Stroke volume as a % of total volume of the ventricle before systolic contraction
Intracranial pressure (ICP)
Pressure from the brain tissue, CSF and blood volume within the skull and meninges. Rises in ICP cause decreased blood supply to the brain.
Mean arterial pressure (MAP)
Average pressure of blood being pushed through the circulatory system. Relates to cardiac output, systemic vascular resistance and tissue perfusion pressure.
Benefits of lung positioning
Maximize lung volumes, increase lung compliance, improve ventilation/perfusion ratio, reduce work of breathing, aid secretion removal and cough. Bad lung up!
Entry options for airway suction
1) nose - nasopharyngeal
2) mouth - oropharyngeal
3) tracheostomy
Steroids
Reduce inflammatory response
e.g. hydrocortisone
Mucolytics
Break down proteins within sputum, thereby reducing viscosity and enhancing clearance
e.g. pulmozyme
Diuretics
Cause increased urine production to reduce total body fluid load
e.g. fruzemide
Anti-hypertensives
Reduce blood pressure through vasodilation
e.g, captopril
Sedatives
Reduce the alertness of the patient, often used in conjunction with analgesia
e.g. midazolam, diazepam
Antibiotics
Directly fight bacterial infections
e.g. penicillin
Inotropes
Increase blood pressure through enhanced contractility of the heart or widespread vasoconstriction
e.g. adrenaline, noradrenaline, dobutamine
Anti-coagulants
Reduce the clotting levels of the blood
e.g. warfarin, heparin
Bronchodilators
Relax the smooth muscle of the airways
e.g. salbutamol, ventolin
Anti-arrhythmics
Stabilize the cardiac muscle to control abnormal rhythms (e.g. atrial flutter)
e.g. amiodarone, metoprolol (a beta blocker)
Anti-emetics
Reduce nausea, specifically vomiting
e.g. maxolon
Analgesics
Interfere with the reception of pain signals
e.g. oxycodone, endone, aspirin, morphine
Reason for diminished breath sounds
Hyper inflation, small pleural effusion, shallow breathing, small pneumothorax, obesity
Reasons for absent breath sounds
No air entry - large pnemothorax, obesity, obstruction, severe bronchospasm
Reason for bronchial breath sounds
Loss of normal air/alveolar interface, i.e. lung becomes solid = Darth Vader sound - pneumonia, lung contusion, segmental collapse, consolidation, collapse of peripheral bronchi.
Reasons for coarse crackles
Sputum, secretions
Reasons for coarse or fine crackles
Collapse, pulmonary oedema, surgical emphysema, interstitial fibrosis
Reasons for wheezes
Bronchospasms, secretions or sputum plug, tumour obstructing airway, diffuse airway obstruction
SIMV
Synchronised intermittent mandatory ventilation - boosts spontaneous breaths of patient whilst maintaining minimums for breathing
4 criteria of extubation
1) Can the patient breathe on command
2) Does the patient have a strong cough (including in response to suction)
3) Does the patient have excess secretions
4) Is the patient alert and able to cooperate with PT
2/4 = borderline.
