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A+P II > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

Diaphragm

A

Primary muscle of respiration

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2
Q

Diaphragmatic Hernia

A

GI organs migrate into the thoracic cavity through esophageal hiatus

Dx: No heart sounds on one side of chest or may hear gut sounds

Tx: Sx- must use ventilator

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3
Q

Spinal Cord Injury

A

Cervical vertebrae

Can’t use phrenic nerve-innervates the diaphragm

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4
Q

Pleura

A

Serous membrane that lines the thoracic cavity
Lined with simple squamous epithelium- movement
Mucous/goblet cells reduce friction
Parietal: lines the thoracic wall
Visceral: lines the organs within the thoracic cavity

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5
Q

Mediastinum

A

Serous membrane that divides left and right side of lungs

Prevents both lungs from collapse and infection

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6
Q

Intrapleural Space

A

Necessary to inflate lungs
Negative pressure
Vacuum
No air (Shouldn’t contain anything in this space)

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7
Q

Trachea/Bronchial Tree

A

Airway

O2 inhaled, C02 exhaled

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8
Q

Aspiration Pneumonia

A

Inflammation of the lungs caused by inhalation of foreign substances

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9
Q

Bronchioles

A

Lined with smooth muscle-involuntary

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10
Q

Alveolar Sacs

A

Lined with simple squamous epithelium
Surrounded by yellow elastic connective tissue
Gas exchange occurs here

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11
Q

Emphysema

A

A condition in which the alveolar sacs are damaged resulting in a decrease in pulmonary compliance (measure of the lungs ability to stretch and expand)

Tx: Oxygen therapy –> only adds O2 to system but does not help flush out expired CO2

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12
Q

Respiration

A

Inhalation: active process, contraction of muscles, intercostal, diaphragm pulled caudal into abdomen

Exhalation: passive process, muscles relax, diaphragm pulled cranial (help force CO2 out)

Composition of Air:
>02=21%, N2=79%, CO2=<1% (300 ppm)

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13
Q

Acid/Base Balance

A

pH of blood: 7.35-7.45

Lungs: When CO2 is increased –> pH decreases –> K+ in blood

Kidneys: When NaHCO3 is increased –> K+ in blood –> HR decreases

*Hyperkalemia –> Bradycardia

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14
Q

Pneumotaxic Center

A

Nuclei in brain stem
Measures CO2 levels
CO2 is what drives respiration

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15
Q

Tidal Volume

A

10-15 ml/kg

Amount of air contained in one entire breathe

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16
Q

Minute Volume

A

Tidal vol. X RR

Amount of air contained one one minute worth of breathing

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17
Q

Gas Exchange in the Alveoli (Capillary)

A

Low in CO2:
-pO2- 40 mmHg

High in CO2
-pCO2- 46 mmHg

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18
Q

Gas Exchange in the Alveoli (Alveoli)

A

Low in CO2
-pCO2- 40 mmHg

High in CO2
-pO2- 100mmHg

*Termed ETCO2 (end tidal CO2)
Should be 25-45 mmHG

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19
Q

Respiratory Alkalosis

A

Respiratory alkalosis is a primary decrease in carbon dioxide partial pressure (Pco2) with or without compensatory decrease in bicarbonate (HCO3−); pH may be high or near normal.

*Eliminating too much CO2

High pH
Low pCO2
Low HCO3- kidneys excrete bicarbonate

Caused by: Hyperventilation, iatrogenically during anesthesia

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20
Q

Respiratory Acidosis

A

Respiratory acidosis is a condition that occurs when the lungs cannot remove all of the carbon dioxide the body produces. This causes body fluids, especially the blood, to become too acidic.

Not removing enough CO2

Low pH
High pCO2
High HCO3- tries to neutralize acid

Caused by: neurological, respiratory, paralysis

3 Types: Intrapleural, intraalveolar, misc.,

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21
Q

Intrapleural Causes

A 
AKA atelectasis (collapsing of alveolar sacs)
Something extra in plueral space
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22
Q

Intraalveolar Causes

A

Anything which causes no gas exchange

  • Drowning
  • Pneumonia
  • Pulmonary contusion
  • Pulmonary edema- fluid in lungs
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23
Q

Emphysema

A

Lungs loose elasticity
Hardening of yellow elastic connective tissue
Increase of CO2 in blood

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24
Q

Obstructed Airway Causes

A

Aspiration
Strangulation
Mucous plug in ET tube
Medications- OPIODS- extreme resp. depressants

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25
Q

Asphyxiation

A

Deprivation of oxygen

NEVER leave pop-off valve closed

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26
Q

2 Main Reasons for Ventilating a Pt. on Anesthesia

A
  1. Decrease excess CO2- prevent hypercapnia

2. Prevent atelectasis- collapsing of alveolar sacs

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27
Q

4 Elements of Blood Gas

A

ph= 7.35-7.45
pCO2= 35-45 mmHg
HCO3= 18-25 mmol/L
Anion Gap= 12-24 meq/L

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28
Q

Metabolic Acidosis

A 
Low pH (<7.35)
Low HCO3 (bicarbonate)
Caused by --> renal failure, ketoacidosis
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29
Q

Metabolic Alkalosis

A 
High pH (>7.45)
High HCO3 (bicarbonate)
Caused by --> vomiting (decrease in HCl)
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30
Q

3 Functions of the Cardiovascular System

A
  1. Transportation of O2, CO2, nutrients, hormones, vitamins, waste
  2. Regulation of pH, fluid balance body temp.
  3. Defense against foreign organisms
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31
Q

Plasma

A

Fluid portion of anti-coagulated blood

Contains clotting factors, has ability to clot

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32
Q

Serum

A

Fluid portion of coagulated blood

Does not contain clotting factors

33
Q

Dissolved Substances

A 
Proteins- albumin, clotting factors, antibodies
Nutrients- glucose, oxygen
Electrolytes- Na+, Cl-, K+
Waste Products- BUN, bilirubin
Hormones and Enzymes
Cells
34
Q

Electrical Conduction System of the Heart

A
  • Sinoatrial Node (SA node)- Right atrium
  • Atrial-Ventricular Node (AV node)- Septim between atria and ventricles
  • Bundle of His- Septum of ventricles (interventricular septum)
  • Purkinjie Fibers- Travel up right and left ventricular walls
  • Both atria contract simultaneously with SA node
  • Both ventricles contract simultaneously with AV node
35
Q

Diastole

A

Relaxation of ventricles

36
Q

Systole

A

Contraction of ventricles

37
Q

Blood Flow Through the Heart

A

Vena Cava –> Right atrium –> Tricuspid valve –> Right ventricle –> Pulmonary valve –> Pulmonary artery –> Lungs –> Pulmonary vein –> Left atrium –> Bicuspid valve –> Left ventricle –> Aortic valve –> Aorta

38
Q

Normal HR for Canines, Felines, and Equine

A

Canines: 60-160 bpm
Felines: 140-220 bpm
Equine: 30-40 bpm

39
Q

Cardiac Output Formula

A

C.O= stroke volume (mls) X HR (bpm)

*C.O has a direct impact on BP

40
Q

Normal Pressure Values

A

Systolic: 100-160 mmHg
Diastolic: 60-100 mmHg
Mean: 80-120 mmHg

41
Q

How to Control BP

A

Regulate vessel diameter with vasoconstrictors –> increase BP
Control C.O with inotropic drugs (increase force of ventricular contraction) –> increase S.V
Regulate blood volume with IV fluids –> increase BP

*Give fluid bolus to pts. with low BP

42
Q

Right Heart Failure (RHF)

A

Symptoms: ascites (fluid inside abd. cavity)

43
Q

Left Heart Failure (LHF)

Congestive Heart Failure

A

*More common
Symptoms: pulmonary edema, decreased BP due to tachycardia
Treatment: O2, diuretic (draws fluid out of lungs), cardiac regulator (inotropic drugs)

44
Q

Purpose of an ECG

A

Helps diagnose arrhythmias

Shows electrical activity of the heart

45
Q

5 Leads to Attach to ECG

A 
White: right axillary
Black: left axillary
Red: left inguinal
Green: right inguinal
Tan: sternum
46
Q

5 Parts to an ECG

A

P wave: atrial depolarization (contraction, systole)
QRS complex: ventricular depolarization (contraction, systole)
T wave: ventricular repolarization (relaxation, diastole)_

47
Q

6 Step Approach

A
  1. Rate (bradycardia, tachycardia, normal)
  2. R-R Interval (want to stay consistent)
  3. P-wave for every QRS complex
  4. QRS complex for every P-wave
  5. QRS complex normal size and shape? (tall and thin)
  6. T-waves normal? (no more than 25% of height of R wave)
48
Q

Respiratory Sinus Arrhythmia

A

Common in large, deep chested breeds
Can be normal variation in dogs
HR will increase on inhalation and decrease on exhalation

49
Q

Ventricular Premature Contraction (VPC)

A

Some ectopic force is causing the ventricle to beat prematurely
If occasional –> OK
Treatment: Lidocaine, Procainamide

50
Q

Ventricular Tachycardia

A

More than 3 VPCs in consecutive sessions
–> significant decrease in C.O
Treatment: Lidocaine (IV), Procainamide

51
Q

Ventricular Fibrillation (V-FIB)

A

Ventricle is not contracting in a normal fashion

Treatment: defibrillation

52
Q

2nd Degree AV Block

A

Block in conduction between SA node and AV node
–> bradycardia
Treatment: anticholinergics (atropine sulfate) (IV)

53
Q

3rd Degree AV Block

A

SA and AV node are not communicating
P-wave and QRS complex are not coordinated
Treatment: pace maker

54
Q

Patent Ductus Arteriosus (Congenital)

A

*Most common defect in mammals
Opening between the pulmonary artery and the aorta in fetal circulation (should normally close after birth)
Causes machinery murmur (whoosh whoosh)
Symptoms: lethargic upon exercise, cyanotic mm
Treatment: sx, suture ductus closed (not open heart sx, trocharize thorax)

55
Q

Patent Foramen Ovale (Congenital)

A

Opening between left and right atrium in fetal circulation (should normally close after birth)
Treatment: open heart sx, suture a patch over foramen (dacron patch)

Very expensive
Can produce hypothermic pt. (85 degrees will allow for 45 min. without damage to cardiac muscle)

56
Q

Aortic Stenosis

A

Due to scar tissue
Causes dilation of left ventricle –> LHF
Symptoms: pulmonary edema
Treatment: dissect scar tissue (can create more scar tissue)

57
Q

Pulmonic Stenosis

A

Causes dilation of right ventricle –> RHF
Symptoms: ascites
Treatment: dissect scar tissue

58
Q

Ventricular Septal Defect (VSD)

A

Should never be an opening between right and left ventricle

Treatment: open heart sx- patch the foramen

59
Q

A-V Insufficiency (Acquired)

A

Opposite of stenosis, valves hang open
Valves should be closed during systole (contraction)
Causes machine murmur
More commonly effects left side
Common Causes: dental dz, poorly performed prophylaxis
Treatment: vasodilators, sx to repair mitral valve

60
Q

Heartworm Dz (Acquired)

A

Microfilaria live in pulmonary artery (can cause obstruction)
Blood will back up to right ventricle
Most common in southern/eastern states
Treatment: heartworm prevention meds

61
Q

Vegetative Endocarditis (Acquired)

A

Bacterial colonies on heart valves
Caused by: dental dz
Symptoms: dyspnea, exercise intolerance, enlarged heart, coughing

62
Q

Cardiomyopathy (Acquired)

A
  1. Dilated
    Caused by weak muscle –> myocardial infarction (heart attack)
    Symptoms: wet cough
    Treatment: diuretics, cardiac regulators
2. Hypertropic 
Caused by overwork of the heart muscle
Common in maine coon cats (genetic test)
Decrease HR
Treatment: Anti-adrenergics- propranol

*Geriatric animals are predisposed to both

63
Q

Cardiac Tamponade (Acquired)

A

Due to pericardial effusion (fluid build up in pericardial sac)
Causes pressure build up in sac –> will collapse chambers of the heart, decrease C.O
Dx: auscultation, very quiet heart beat
Treatment: pericardial centesis

64
Q

Atherosclerosis (Acquired)

A

Narrowing of vessels
More common in humans due to diet
Treatment: removal bypass

65
Q

Hypovolemic Shock

A

AKA traumatic shock
Acute blood loss (hemorrhaging, H2O loss)
Treatment: IV fluids

66
Q

Septic/Distributive Shock

A

Septicemia
Bacterial endotoxins
Caused by: injury to GI tract, dental dz, gram positive bacteria (release exotoxins) –> blood will get trapped by the sphincters
Treatment: IV fluids, bacteriostatic antibiotics (tetracyclines)

67
Q

Anaphylactic Shock

A

Can be caused by injectable vaccines or antibiotics
Stimulates mast cells in resp. and GI tracts
Release histamines –> vasodilation –> sphincters close
Treatment: IV fluids, corticosteroids IV (reduce inflammation), +/- epinephrine

68
Q

Neurogenic Shock

A

Neocortex overrides brainstem
Mildest form: syncope (fainting)
Can result from life threatening situations
Humans are prone to this

69
Q

Cardiogenic Shock

A

Caused by myocardial infection –> heart attack
Humans are prone to this
Failure of heart to pump blood adequately
–> drastic decrease in C.O
Treatment: cardiac regulator, inotropic drugs to increase C.O

70
Q

Early Shock Signs

A 
Tachycardia (up tp 240 bpm)
Bounding pulses
Bright mm
Fast CRT
Proper mentation (alert)
71
Q

Compensatory Shock Signs

A

Tachycardia
Pale mm
Weak pulses
Depressed mentation

72
Q

Decompensatory Shock Signs

A 
Variable HR
Poor/absent pulses
Prolonged CRT
Pale mm
Dull mentation (almost comotose)
73
Q

Crystalloids

A

LRS, Normosol, 0.9% NaCL (PSS)

Cheaper

74
Q

Colloids

A

Hetastarch- replacement blood product

Best option

75
Q

Hypertonic Saline

A

7% NaCl

76
Q

Pulse Sites for Equine

A 
Transverse facial artery
Facial artery (submandibular)
Lateral/dorsal metatarsal artery (between hock and fetlock) *mostly anesthesia
77
Q

Digital Arteries

A

Used to evaluate the condition of the horse’s feet

Not used to palpate pulse

78
Q

Venipuncture Sites for Equine

A

Jugular vein
Transverse facial vein (should not be pulsating)
Medial sacral vein (“tail bleeding”, used in cattle)

A+P II (4 decks)

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