Fund 51 - ch 17 Flashcards
crackles (inhale crac, but not all at once)
nonmusical, discontinuous popping during inspiration
hemoptysis
hemoptysis - blood from respiratory
larnyx
watchdog of lungs. protects from foreign substances.
parietal pleura
parietal pleura - lines thoracic cavity, lateral wall of mediastinum, diaphragm, and inner aspects of ribs.
mediastinum
mediastinum - all thoracic tissue outside of lungs, ie heart, thymus, aorta and vena cava, esophagus.
3 types of alveoli
alveoli - 3 types. type 1 and 2 are the epithelium. type 1 is 95% of surves and is a barrier btw air and alveolar surface. type 2 is 5% and produces type 1 cells and surfactant. 3rd type is alveolar macrophages.
respiration
after capillary exchange, blood enters venous circulation and goes to pulmonary circulation. O2 in blood in capillaries is lower than in the alveoli. O2 then diffuses from alveoli to blood. Co2 the other direction.
respiration definition
gas exchange btw atmospheric air and blood and blood and cells.
inspiration during first
third of respiration cycle, expiration during latter 2/3.
tidal volume
500 mL - may not vary even with severe disease.
inspiratory reserve volume USE your reserve - (inspired but reserved by the movie 3000)
- 3000 mL. max volume of air that can be inhaled.
expiratory reserve volume (she expired at 11 and went to heaven)
- 1100 mL - max that can be forceably exhaled.
residual volume (cindella was just residual)
1200 mL - air remain gin in lungs after max exhalation
vital capacity (it is vital to take it all 46)
4600 mL - max exhaled from point of max inspiration.
inspiratory capacity (my inspiration maxed out at 35)
- Inspiratory capacity is the sum of tidal volume plus inspiratory reserve volume.
functional residual capacity (not functioning at 23)
2300 mL - air remaining in lungs after normal expiration
total lung capacity (totally inspiring at 58)
5800 mL - air in lungs after max inspiration.
pulmonary is considered low or high pressure?
low pressure
perfusion is influenced by
alveolar pressure.
severe hypoxia occurs when shunting exceeds
20%
PAO2 is
this pressure ensure diffusion of O2 access the alveolar.
he higher the PaO2, the greater the amount of
O2 dissolved. therefore the amount of dissolved O2 is directly proportional to the parietal pressure
patterns of perfusion are determined (the pattern of art, gravity and alveoli)
artery pressure, gravity and alveolar pressure.
oxygen saturation - 150 mm Hg
hemoglobin is 100% saturated.
VQ (and what are the states)
V/Q - ventilation perfusion ratio. different in different parts of the lungs.
V/Q states are: normal, low, high and silent.
oxyhemoglobin dissociation curve (is the curve oxygenated)
shows relationship btw partial pressure of oxygen and % of saturation of oxygen. % of sat. can be affected by CO2, hydrogen ions, temp.
oxyhemoglobin dissociation curve - shift to the right (right is less)
increase shifts curve to the right, thus less oxygen is picked up by lungs, but more is related to the tissues, if PaO2 is unchanged.
oxyhemoglobin dissociation curve - shift to the left (heme takes oxys then exits left)
a decrease causes a shift to the left, making bond btw oxygen and hemoglobin stronger.
advantage is if PaO2 decrease from 100 to 80, hemoglobin of arterial blood is still saturated at 94%.
breathing in and out controlled by
medulla oblongata and pons controls rate and depth of ventilation
central chemoreceptors in medulla respond to (chemo cerebro)
chemical changes in cerebrospinal fluid, which results from chemical changes in blood. the receptors respond to change in pH and then tell lungs to change depth and and then rate
peripheral chemoreceptors located in
aortic arch and carotid respond first to PaO2, then partial pressure of carbon dioxide and ph.
mechanoreceptors in lungs respond to changes in (the lungs are resistant to change)
resistance by altering breathing patterns.
at 50, alveoli lose elasticity. dead space increases.
acute lung disease causes
more sever grade of dyspnea than chronic diseases.
COPD = wheezing on expiratory or inspiratory? (COPD weezy out the door)
COPD = wheezing on expiratory. (out the door with COPD)
tumor - type of breathing (tumors are loud)
noisy breathing
laryngotracheitis - high or low cough (larry has a high pitched cough)
high pitched cough
sever or changing cough -
bronchogenic carcinoma
bad breath and foul smelling is (bad arms)
lung abscess
pleuritic pain is
sharp and seems to catch. tabbing. pt more comfortable with ethey all on affected side bc it splints the chest wall.
wheezing - heard on inspiration or expiration? You knew this one…
high pitched continous, heard on inspiration and expiration.
asthma - inspiration or expiration? (she expired from asthma)
expiration
bronchitis - inspiration or expiration? (inspired by bronchitis)
inspiration
hemoptyosis symptoms
initial symptoms include tickling in throat, salty taste, burnin or bulling in chest, and maybe chest pain. it has a pH higher than 7.
blood from stomach is
vomited and usually much darker, looks like coffee grounds. the pH is less than 7.
patients with anemia
early develop cyanosis, and pts with polycythemia (high RBCs) may appear to cyanotic but they have enough O2.
funnel chest
funnel chest - depression in lower sternum. may compress heart causing murmurs. occurs with rickets
kyphoscoliosis
kyphoscoliosis - elevation of scapula and corresponding S-shaped spine. occurs with osteoporosis.
cheyne-stokes (cheyenne - many mountains, and then nothing)
cheyne-stokes - rate and depth increase, then apnea. heart failure, drugs, tumor, trauma.
biot’s (don was normal, and then he stopped)
biot’s - normal breathing, 3-4 breaths, and periods of apnea. also called ataxic breathing. respiration depression from drug overdose and brain injury.
obstructive - (obstruct CABs)
obstructive - long expiratory - airway narrowing - asthma, COPD, and bronchitis.
tactile fremitis with emphysemia and also pneumonia (emphsyma is fizzled out)
pts with emphasema have no fremitus . pneumonia has fremitus over the whole lobe.
percussion - normal and also with fluid (fluid is dull)
percussion - normal lung sound should be resonance. dullness with fluid or solid tissue. usually start at posterior