EXAM 2 - Week 6 (Respiratory) Flashcards
Typical ventilation-perfusion ratio
9:1
Good ventilation, poor perfusion = HIGH ratio
Low ventilation, good perfusion = LOW ratio
Example of ventilation but poor perfusion
Respiration is occurring but the oxygen/blood isn’t getting to the lungs; no gas exchange
Pulmonary emboli
Example of poor ventilation but perfusion
Blood is getting to the lungs but problems with inspiration, expiration, or diffusion at ACJ
COPD, Asthma
Sneezing
Reflex response to irritation in upper respiratory tract that helps remove irritant
Associated with inflammation or foreign material
Coughing
Irritation due to nasal discharge, inflammation or foreign material in lower respiratory tract due to inhaled irritants
Tidal Volume
Amount of air exchanged with normal inspiration and expiration (500 mL of air)
Residual Volume
The amount of air left in lungs after max expiration
Inspiratory reserve volume (IRV)
Max volume of air inspired in excess of normal
IRV = ERV - TV
Expiratory reserve volume (ERV)
Max volume of air expelled after normal/passive expiration (RV - TV)
Vital Capacity
Forced vital capacity = max amount of air expired following max inspiration
TV + ERV + IRV
Total lung capacity
Total amount of air in lungs after max inspiration
Forced expiratory volume in 1 second (FEV1)
Blow out air for as long as you can after max inhalation and measure for 1 second
Carbonic Anhydrase
catalyzes decomposition of carbonic acid into carbon dioxide and H2O – facilitates transfer of CO2 from tissues to blood and from blood to alveolar air
-helps CO2 diffuse into red blood cells
Retractions
Superclavicular region will suck in and retract when someone is trying to change the thoracic pressure so much that it is pulling and retracting in some areas without bone
Abnormal breathing pattern - Eupnea
Rhythm is smooth and even with expiration longer than inspiration (~20 breaths/min)
Tachypnea
Rapid superficial breathing, regular or irregular rhythm
Bradypnea
Slow respiratory rate, deeper than usual depth, regular rhythm (less than 20/min)
Apnea
Cessation of breathing
Hyperpnea
Increased depth of respiration with a normal to increased rate and regular rhythm
Cheyne-Stokes Respiration
Periodic breathing associated with periods of arena, alternating regularly with a series of respiratory cycles; the respiratory cycle gradually increases then decreases in rate and depth.
Ataxic Breathing
Periods of apnea alternating irregularly with a series of shallow breaths of equal depth
Kussmaul’s Respiration
Deep regular sighing respirations with an increase in respiratory rate
Apneusis
Long, gasping respiratory phase followed by a short, inadequate expiratory phase
Obstructed breathing
Long, ineffective expiratory phase with shallow increased respirations
Long expiratory phase b/c trying to get air out, and shallow b/c too much air is trapped
Crackles
Constricted, narrow airways from fluid accumulation
-High pitched near alveoli
Ex: pneumonia, CHF, adylectasis
Wheezing
Obstruction in small airways/high pitched whistling sound
Ex: Asthma
Rhonchi
Low pitch snoring sound, usually caused by mucous (clear by cough)
Stridor
High pitched squeaking sound r/t obstruction in larynx and pharynx
Alpha-1 Anti-Trypsin
Gets rid of proteolytic enzymes near alveoli - when the proteolytic enzymes are not removed, they can degrade the alveoli themselves
Difference between emphysema and chronic bronchitis
Emphysema: destruction of alveolar wall leads to hyperinflation, thus reduced airway patency; mainly difficulty with expiration
Chronic Bronchitis: no damage of wall, rather, inflammation of bronchial tree of airway + hypertrophy/hyperplasia of mucous glands leads to difficulty getting air in AND out
A single small embolus may be…
“silent”
Multiple small emboli equivalent to…
large embolus blocks circulation
Moderate size embolus…
likely to cause respiratory distress and pulmonary infarction
Very large embolus….
blocks all pulmonary circulation leading to shock and cardiac arrest
Large embolus causes…
decreased blood returning in pulmonary vein and decreased cardiac output
Components of Virchow’s Triad
Circulatory stasis, endothelial injury, and hyper coagulability
TB is caused by what bacteria?
M. tuberculosis
How is TB spread?
Oral droplets
