Module 13: Capnography (Part 01)

Question 1

The pulmonary system is made up with what?

Answer 1

(1) Two (2) Lungs
(2) Airways
(3) Blood Vessels that serve the lungs and the chest wall or thoracic cage

Question 2

This is the noninvasive measurement of peak CO2 at the end of the tidal expiration measured by capnography.

Answer 2

End tidal CO2

Question 3

The upper airway is consisted of what?

Answer 3

(1) Nose
(2) Oral Cavity
(3) Pharynx
(4) Larynx

Question 4

This lines the upper airway that warms and humidifies inspired air and removes foreign substances.

Answer 4

Ciliated mucosa

Question 5

This is the area of the upper airway structures that does not participate in gas exchange.

Answer 5

Anatomic Dead Space

Question 6

What does the anatomic dead space include?

Answer 6

(1) Nasal Passages
(2) Oral Cavity
(3) Pharynx
(4) Trachea
(5) Largest Airways

Question 7

This connects the upper airways.

Answer 7

Larynx

Question 8

These muscles control the length and tension of the vocal cord.

Answer 8

Internal Laryngeal Muscles

Question 9

These muscles move the larynx as a whole.

Answer 9

External Laryngeal Muscles

Question 10

In what processes are the Internal Laryngeal Muscles and External Laryngeal Muscles involved in?

Answer 10

(1) Swallowing
(2) Ventilation
(3) Vocalization

Question 11

This contains branching airways.

Answer 11

Tracheobronchial tree

Question 12

This connects the larynx to the bronchi, the conducting airways of the lungs.

Answer 12

trachea

Question 13

How does the bronchi branches?

Answer 13

The trachea bifurcates into the right and left main stem bronchi. The main stem bronchi branch into lobar, segmental and sub segmental bronchi. The sub segmental bronchi branch into terminal and respiratory bronchioles, and into alveolar ducts and alveoli.

Question 14

This zone is where alveolar ventilation and gas exchange takes place

Answer 14

Respiratory Zone

Question 15

What does the respiratory zone include?

Answer 15

(1) respiratory bronchioles,
(2) alveolar ducts and sacs
(3) and alveoli.

Question 16

These are responsible for changes in oxygen (O.) and carbon dioxide (CO.).

Answer 16

Alveolar volume and alveolar minute ventilation

Question 17

This is the alveolar volume times the respiratory rate.

Answer 17

Alveolar minute ventilation

Question 18

This is approximately two-thirds of the respiratory tidal volume.

Answer 18

Alveolar volume

Question 19

This measures the partial pressure of CO.

Answer 19

Capnography

Question 20

In the exhaled breath at the end of expiration of normal tidal volume is termed what?

Answer 20

end-tidal or etCO

Question 21

This pertains to the process of inhalation and exhalation

Answer 21

Respiratory cycle

Question 22

This pertains to the number of respiratory cycles/minute

Answer 22

Respiratory Rate

Question 23

This is the measure of the adequacy or inadequacy of respiration or breathing, and is monitored by capnography noninvasively or PaCO. invasively.

Answer 23

Ventilation

Question 24

This is the process that describes the exchange of oxygen between alveoli and blood. Commonly assessed by either arterial oxygen tension PaO, in the blood or noninvasively by pulse oximetry.

Answer 24

Oxygenation

Question 25

This pertains to the noninvasive measurement of CO, at the end of expiration, measured by capnography.

Answer 25

End-tidal CO. (etCO.

Question 26

This is the process by which concentration of oxygen in the tissues increase. Oxygen being inhaled into the lungs, dispersed by the alveoli to the blood, distributed to and metabolized by the cells of our muscles and organs.

Answer 26

Oxygenation

Question 27

This provides a non-invasive means to monitor oxygenation

Answer 27

Pulse oximetry

Question 28

This is the inspiratory and expiratory phases as both are needed for exchange of oxygen and carbon dioxide, the latter being a waste product of metabolism.

Answer 28

Ventilation

Question 29

This is the cyclical breathing movements that alternately move gas into and out of the lungs. Inspiration fills the lungs with oxygenated air and expiration removes carbon dioxide from the body.

Answer 29

Ventilation

Question 30

The efficiency of gas exchange is dependent on what?

Answer 30

Ventilation

Question 31

These are both needed, in proper proportion, to sustain an adequate and safe quality of life.

Answer 31

Oxygenation and ventilation

Question 32

All cells require this for aerobic metabolism

Answer 32

Oxygen

Question 33

This is produced as a metabolic byproduct of the breakdown of metabolic fuels.

Answer 33

Carbon Dioxide

Question 34

What happens when there is a high metabolic rate?

Answer 34

The higher the metabolic rate (during exercise, exertion or increased body temperature), the higher the CO. production.

Question 35

How is carbon dioxide produced and conveyed?

Answer 35

CO. is produced by both aerobic and anaerobic metabolism within cells. CO. dissolves rapidly in cell water and easily diffuses out of cells into the vascular system. Then it is transported in both the dissolved and combined state with hemoglobin. CO. is carried by the vascular system through the heart and into the pulmonary arteries to reach the capillaries surrounding pulmonary alveoli.

Question 36

What happens under normal conditions?

Answer 36

Under normal healthy conditions, one pass of blood through the alveolar capillary allows the partial pressure of CO. in the alveolar air (PaCO. - alveolar PCO, in mm Hg or Torro nearly match (usually within 5 mmHg) the partial pressure of CO, in the arterial blood (PaCO. - arterial PC02 in mm Hg or torr where P means partial pressure) as measured by arterial blood gasses.

Question 37

This is an indicator of V/Q status, is the difference between the arterial carbon dioxide partial pressure (PaCO.) and end-tidal carbon dioxide partial pressure (etCO.) values.

Answer 37

Gradient

Question 38

This is referred to as the relationship between ventilation (V), or airflow to the alveoli, and perfusion (Q), or blood flow to the pulmonary capillaries.

Answer 38

ventilation-perfusion matching or V/Q ratio.

Question 39

How do you calculate a gradient?

Answer 39

Calculating the gradient requires obtaining a simultaneous arterial blood gas sample and an etCO. measurement. In normal, healthy lungs, there is a good match of alveolar ventilation and perfusion to the pulmonary capillaries resulting in an etCO. that closely correlates with or matches the PaCO.

Question 40

What is the normal gradient in patients?

Answer 40

2 mmHg to 5 mmHg

Question 41

These are conceptually defined as areas of ventilation without perfusion

Answer 41

Dead Space

Question 42

This can be defined as the portion of inspired volume that passes through the anatomical dead space to mix with gas at the alveolar level, but does not take part in gas exchange.

Answer 42

Alveolar dead space (may happen due to pulmonary embolism or decreased cardiac output)

Question 43

This is defined as perfusion without ventilation.

Answer 43

Shunt

Question 44

This occurs when areas of the lungs are perfused but not ventilated.

Answer 44

Shunt Perfusion (This can occur in conditions that cause the alveoli to collapse or fill with fluid, such as increased bronchial and alveolar secretions that cause mucus plugging or atelectasis)

Question 45

This is the phase where inhalation will begin. Oxygen fills the airway and CO. levels drop back to zero. Identified as the rapid descent at the end of the respiratory cycle. When inspiration does begin again, the amount of measure CO. quickly drops to zero.

Answer 45

Phase 0 or D.E

Question 46

The return to baseline is called what?

Answer 46

phase 0.1