FP-C #6 Flashcards
Mean airway pressure (MAP)
amount of positive pressure in the airway averaged over the inspiratory and expiratory cycles
Vital capacity (Vc)
the maximum amount of air that can be exhaled after a maximum inhalation
I:E Ratio
ratio of the inspiratory phase time to the expiratory phase time
Ataxic respiration
varying depth and rate of breathing followed by periods of apnea, irregular
Vesicular breath sounds
soft , low-pitched sounds heard over peripheral lung tissue
Perfusion
blood must flow to the pulmonary vasculature to transport blood to the system
Obstructive diesases
diseases that result in difficulty moving air out of the lungs and involve an increased airway resistance
Hyperpnea
energetic (deep and rapid) respiration that occurs normally after exercise or abnormally with fever or various disorders
LEMON mnemonic purpose
a tool to use to assess for a difficult airway
Peak inspiratory pressure (PIP)
the highest circuit pressure generated during an inspiratory cycle
Time-cycled ventilator
type of positive pressure ventilator in which the ventilator ends inspiration after a selected inspiratory time has been achieved
Functional residual capacity (FRC)
volume of air remaining in the lungs following exhalation of the tidal volume (ERV + RV)
Cheyne-Stokes respirations
abnormal pattern of breathing characterized by progressively deeper and sometimes faster breathing followed by a gradual decrease that results in a temporary apnea
Apneustic breathing
deep, gasping inspiration, then pause, then an insufficient expiration - usually seen with brain stem lesions
Central neurogenic hyperventilation
sustained regular, rapid and deep breathing from brainstem lesion between lower midbrain and upper pons
Shunt
perfusion without ventilation
Mechanical ventilation
the application of a device that provides varying degrees of ventilatory support
Respiratory insufficiency
inability of the respiratory system to meet its oxygen needs and remove excess amounts of CO2
Pleural friction rub
low pitched, dry, grating sound heard during inspiration and expiration indicating pleuritis
Invasive ventilation
application of mechanical ventilation via an endotracheal tube or tracheostomy tube
Crackles
fluid in the bronchioles and alveoli heard as snapping or bubbling on inspiration
Respiratory depression
general condition caused by either a decrease in the rate or depth of respiration or both
Stridor
high-pitched, crowing sound that occurs with an obstruction in the upper airway
Ventilation
The airflow in and out of the lungs
PO2 in the alveolus
100 mmHg
Anatomic dead space (Vd)
volume of air in the conducting passages - doesn’t participate in gas exchange)
Restrictive diseases
result in difficulty moving air into the lungs and occurs due to loss of chest or lung compliance
Obstructive diseases
diseases in which the flow resistance of the airway is increased
Rhonchi
lower-pitched sounds caused by secretions in larger airways
Indications: mechanical ventilation
apnea - improving distribution of inhaled gases - ventilatory or respiratory failure
Auto- peep
unintentional air trapping which occurs when inspiration begins before the previous breath’s expiration has ended
Barotrauma
injury to the chest or lungs as a result of increased intrathoracic pressure
Tachypnea
an abnormally rapid rate of respiration
Residual volume (RV)
the amount of air that remains in the lungs after a person exhales as forcefully as he or she can
PO2 in the capillary
40 mmHg
PCO2 in the capillary
45 mmHg
Bradypnea
slow respiratory rate, usually below 10 respirations per minute
Inspiratory capacity (IC)
maximum amount of air that can be inspired after a normal expiration (IRV + TV)
Noninvasive ventilation
technique uses positive pressure to keep alveoli open and improve gas exchange without airway intubation
Wheezes
continuous high-pitched whistling sounds produced during breathing
Distribution
The delivery of air to the areas of the lung that can participate in gas exchange
Fraction of inspired oxygen (FiO2)
concentration of oxygen - the portion of oxygen in relation to total inspired gas
Eupnea
normal relaxed breathing
Cluster breathing
a short series of irregular respirations followed by periods of apnea at irregular intervals
Positive end expiratory pressure (PEEP)
the amount of pressure above atmospheric pressure present in the airway at the end of the expiratory cycle
Seldinger technique
a method for introducing a catheter into a hollow lumen structure or body cavity through the use of a guide wire
Arterial blood gas
measures the partial pressures of oxygen and carbon dioxide in the arterial blood
V/Q ratio
relationship between alveolar ventilation and alveolar capillary perfusion (normal value is 0.8)
Alveolar ventilation (Va)
amount of air reaching the alveolar-capillary membrane each minute [respiratory rate x (tidal volume - anatomic dead space)]
Sensitivity (concerning ventilators)
ventilator control that regulates the amount of negative pressure required by the patient to ‘trigger’ a delivered breath
Total lung capacity (TLC)
the maximal volume of air that the lungs can contain (VC + RV)
Bronchovesicular sounds
loud , high pitched hollow sounds normally heard over the trachea and the large bronchi
Restrictive diseases
pathologies characterized by decreased compliance of lung tissue
Adventitious breath sounds
abnormal breath sounds (such as wheezes, rhonchi, and rales)
Hypopnea
shallow breathing
Capnography
a recording or display of the measurement of exhaled carbon dioxide concentrations
Transillumination
use of light across a tube to view the thin tissue that covers the trachea
Flow cycled ventilator
positive pressure ventilator that ends inspiration when a predetermined flow rate is achieved
PCO2 in the alveolus
40 mmHg
BiPAP
mechanical delivery of set positive inspiratory pressure each time the patient begins to inspire (as the patient begins to exhale, the machine delivers a lower set end-expiratory pressure)
Mode (concerning ventilators)
the particular way in which a mechanical ventilation is delivered
Flow rate
the speed at which tidal volume is delivered
Respiratory failure
The reduction of breathing to the point where oxygen intake is not sufficient to support life
SpO2
the non-invasive method of pulse oximetry
Ventilation-perfusion mismatch
occurs in conditions during which either the flow of oxygen is limited in the alveoli or the circulation through the pulmonary capillary is compromised
Minute volume
The volume of air moved through the lungs in 1 minute (calculated by multiplying tidal volume and respiratory rate)
Kussmaul’s respiration
respirations are abnormally deep, regular, and increased in rate WITHOUT periods of apnea
Complications: mechanical ventilation
barotrauma, low cardiac output, ventilator assisted pneumonia, oxygen toxicity
Retrograde intubation
method of intubating using a guide wire through the cricothyroid membrane and placing an ETT over the guide wire
Expiratory reserve volume (ERV)
amount of air that can be forcefully exhaled after a normal tidal volume exhalation
Inspiratory reserve volume (IRV)
amount of air that can be forcefully inhaled after a normal tidal volume inhalation
Biot’s respirations
varying depth and rate of breathing followed by periods of apnea, irregular
Apnea
absence of spontaneous respiration
Mallampati classification
correlates the degree of visibility of the oral structures with the degree of difficulty of rigid laryngoscopy (4 classes)
Pressure cycled ventilator
delivers a flow of air to the lungs during inspiration until a preset pressure is reached
Negative-pressure ventilator
an approach to ventilation in which negative pressure is intermittently applied to the chest surface in an effort to cause inflation of the lungs
3-3-2 rule
evaluates airway for intubation: Less than 3 fingers between teeth, 3 fingers between mentum and hyoid, or 2 fingers between thyroid notch and hyoid indicates a difficult airway
LEMON stands for what?
(L) look externally
Agonal respirations
slow, shallow, irregular respirations or occasional gasping breaths - sometimes seen in dying patients.
Esophageal detection device
a bulb or syringe that is attached to the proximal end of an ETT used to confirm proper placement
Tracheal breath sounds
loud and high-pitched breath sounds with equal length of inspiration and expiration located near the suprasternal notch
Capnometry
the use of a capnometer, a device that measures the amount of expired carbon dixoide
Continuous positive airway pressure (CPAP)
improves oxygenation to splint open alveoli which increases FRC where the patient is allowed to breathe spontaneously while constantly maintaining a base pressure above atmospheric pressure
Tidal volume (TV)
amount of air that moves in and out of the lungs with each respiratory cycle
Face-to-face intubation
performing an intubation on a patient where you are eye-to-eye and nose-to-nose
Respiratory diffusion
the actual process of gas exchange
I time
the time interval for delivery of a tidal volume
Positive-pressure ventilator
uses pressures above atmospheric pressure to push air into lungs (requires use of an artificial airway
