Mod II Flashcards
Dyspnea
An abnormality of breathing rate, pattern, or effort. May cause or be caused by hypoxia. Prolonged without intervention may cause anoxia.
Anoxia
Absence or near absence of oxygen. Premorbid. Brain can only survive 4-6 Minutes in this state.
Upper Respiratory Issues
Foreign Body Airway Obstruction, Swelling from anaphylaxis or burns, Epiglottitis, Croup
Coughing
Forceful exhalation of large volume of air from lungs. Performs protective function in expelling foreign material from lungs.
Sneezing
Sudden, Forceful exhalation from the nose. Usually caused by nasal irritation.
Hiccoughing
Hiccup Sudden Inspiration caused by spasmodic contraction of the diaphragm with spastic closure of glottis. It serves no known physiologic purpose.
Occasionally associated with acute MI on inferior surface of heart.
Sighing
Slow, deep involuntary inspiration followed by prolonged expiration, hyper inflates lungs and re expands atelactic alveoli.
Grunting
Forceful expiration occurs against partially closed epiglottis. Usually sign of respiratory distress.
Pulsus Paradoxus
Drop in blood pressure greater than 10 torr, due to increased pressure in thoracic cavity impairing ability of ventricles to fill. Indicative of severe obstructive lung disease.
Biot’s Respiration’s
Irregular pattern of rate & depth with sudden, periodic episodes of apnea. Indicates increased cranial pressure.
Cheyene-Stokes Respirations
Progressively deeper, faster breathing alternating gradually with shallow, slower breathing. Indicative of brain stem injury.
Kussmauls Respirations
Deep, slow or rapid gasping breathing. Commonly found in diabetic ketoacidosis.
Central Neurogenic Hyperventilation
Deep, Rapid respiration’s indicating increased intracranial pressure.
Agonal Respirations
Shallow, slow, infrequent breathing indicating brain anoxia.
Esophageal Intubation
Absence of a wave form or presence of a small disorganized wave form, indicates esophageal intubation.
Curare Cleft
Appears when neuromuscular blockers begin to subside. The depth of the cleft is inversely proportional to the degree of drug activity.
Rebreathing
Can result in failure of the capnogram to meet the baseline. This can be due to hyperventilation or to problems in the breathing circuit.
Obstructive Disease
Obstructive pulmonary diseases such as Asthma, COPD, obstruct air entry, and alter the shape of the capnogram. These diseases give the typical “shark fin” shape to the capnogram.
Hypoventilation
Results in CO2 retention and a progressive elevation in exhaled CO2 Levels.
Hyperventilation
Leads to elimination of CO2 and a progressively lowered exhaled CO2 Level.
Gradual Increase in ETCO2
Caused by Rising body temp Hypoventilation CO2 Absorption Partial airway obstruction Reactive airway disease
Gradual Lowering of ETCO2
Hypovolemia
Decreasing Cardiac Output
Decreasing body temp
Drop in metabolism
Sudden increase in ETCO2
Accessing an area of the lung previously obstructed
Release of tourniquet
Sudden increase in blood pressure
Change in CO2 Baseline
Calibration Error
Water Droplet in analyzer
Mechanical failure of vent
Exponential Decrease of CO2
Pulmonary Embolism
Cardiac Arrest
Hypotension
Severe Hyperventilation
Sudden Decrease of ETCO2 (not to zero)
Leak in ventilator system, obstruction
Partial disconnect of vent circuit
Partial airway obstruction
Sudden drop of ETCO2 to 0
Esophageal intubation
Ventilator disconnect
Defect in CO2 Analyzer
CaO2
Arterial Oxygen concentration
Hypoxia Drive
Default drive activated when body becomes accustomed to hypoxemia. Increases respiratory stimulation when Pa02 falls and inhibits respiratory stimulation when PaO2 climbs.
Causes of upper airway obstruction
Tongue, foreign bodies, trauma, laryngeal spasm & edema, aspiration
Diffusion
Movement of gas from an area of higher cocentration (partial pressure) to an area of lower concentration. Attempting to reach equilibrium.
Atelectasis
Alveolar collapse when surfactant is insufficient or alveoli are not inflated.
Alveoli
Microscopic air sacs where most oxygen and carbon dioxide exchanges take place.
Bronchi
Branches of main tubes within lungs, tubes from trachea into lungs.
Sinuses
Air filled cavities lined with mucus membranes.
Nasal Septum
Highly vascular cartridge separating left and right nasal cavities.
Upper Airway
Extends from mouth and nose to larynx
Carbon Dioxide
Waste product of the bodies metabolism.
Oxygen
Gas necessary for energy production.
Total Lung Capacity TLC
Max lung capacity, total amount of air contained in lung at end of maximal inspiration. Average adult male TLC is 6 liters.
Forced Expiratory Volume FEV
Amount of air that can be maximally expired after max inspiration.
Functional Residual Capacity FRC
Volume of gas that remains in the lungs at the end of normal expiration. FRC = ERV+RV
Residual Volume RV
Amount of air remaining in the lungs after maximum expiration.
Inspiratory Reserve Volume IRV
The amount of air that can be maximally inhaled after normal inspiration.
Expiratory Reserve Volume ERV
Amount of air that can be maximally exhaled after normal expiration.
Alveolar Minute Volume
Amount of gas that reaches alveoli for gas exchange in 1 minute.
VA-Min (VT-VD) x Respiratory rate
Or
VA - Min = Va x Respiratory rate.
