Exam 2 264 Flashcards by Jason Wardle

What is Eupnoea

Normal RR

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What is orthopnoea

Difficulty breathing when lying flat

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What does hypercapnia trigger?

Increase in RR to breathe off excess CO2

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How does hypopxia impact RR

Causes increase to improve alveolar ventilation.

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What causes an hypoxic drive?

Exposure to chronic CO2 levels and acidosis the chemoreceptor function becomes blunted and low levels of O2 become the trigger for increased RR.

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What are some factors that can cause a decrease in RR?

Increased ICP
Alcohol / narcotics
Sleep / rest
hypocapnia
hypothermia

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What are some factors that can cause an increase in RR?

Anxiety
Caffeine
Pain
Exertion
Hypercapnia
Fever
Haemorrhage
Acidosis
Lung disease
Cardiac disease
Young age

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What is Kussmaul breathing?

Hyperventilation. Associated with diabetic ketoacidosis and inc ICP.

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What is Biot’s breathing?

irregular period of rapid breathing followed by variable periods of apnoea with inconsistent depth.

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What is Biot’s breathing associated with?

neurological damage
inc icp
meningitis

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What is cluster breathing?

periods of tachypnoea separated by periods of apneoa. Associated with damage to medulla oblongata

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What is central neurogenic hyperventilation

RR 40-60. Neuro damage

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What should arterial PO2 be?

80-100mmHG

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What is the difference between hypoxaemia and hypoxia?

Hypoxaemia = arterial blood
Hypoxia = tissues

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What is hyperoxia?

O2 toxicity
Caused by supplemental O2 that is too high over too long a period.

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What damage can hyperoxia cause?

Lung injury
Retinal injury
CNS effects such as seizure

How is hypoxaemia manifested?

tachycardia
tachypnoea
cyanosis (severe cases)

How is o2 toxicity manifested?

Resp failure
Loss of visual acuity
seizure
altered loc

What is extrinsic asthma?

strong allergic component.

What is the tx for asthma?

Drug based
Allergen avoidance

What are asthma trigger factors?

Inhaled aeroallergens eg dust (esp minute dried faecal particles of dust mites), pollen, mould spores, cat fur and dander

cold dry air, fog, smoke

exercise

RTI

sleep

anxiety

What is the hygiene hypothesis?

The theory that asthma and other allergic disorders occur when the immune system during the first 12-24 months after birth is inadequately exposed to foreign antigens. It never fully learns to distinguish between dangerous and harmless antigens and mounts an inappropriate immune response.

What is asthma characterised by?

Chronic inlfammationi in the airway wall

What is bronchospasm?

contraction of airwary smooth muscle

what inflammatory airway changes contribute to bronchoconstriction?

excess viscous sticky mucous airway wall oedema infiltration of inflammatory cells (leukocytes) - occupy space

what causes asthma attack?

Chronic inflamm causes airway hyperresponsiveness/hyperactivity

What are S&S of asthma?

wheezing dyspnoea coughing

What happens if you can't hear wheezing in asthma attack?

The airways may be completely closed and pt requires ventilation

What happens in an asthma attack?

airway inflammation mucous production airway muscle tightening swollen bronchial membranes All resulting in narrow breathing passages and wheezing, cough, sob

What effects on respiratory muscles of asthma?

Tracheal tug Flattened diaphragm and associated hyperinflation Inspiratory contraction of diaphragm - a form of paradoxical breathing

What happens to FEV1 and PEFR during asthma excacerbation?

They fall

what happens to FVC during asthma exacerbation?

Will not decrease much

what is the spirometric grading of airway obstruction severity?

FEV1 % predicted. >70 mild obstruction to <35 very severe obstruction and various degrees in between.

What is pulmonary hyperinflation?

This is where astmatics breathe at higher than normal lung volumes as their airway obstruction worsens

What does a blood PC02 above 45mmHg indicate?

respiratory failure

What is pulsus paradoxus?

Increased inspiratory effort causes a drop in intrapleural pressure that is transmitted to the heart and arterial bp. BAD!