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NSCC 7120 > Module 2: Resp Ax (Ventilation) > Flashcards

Module 2: Resp Ax (Ventilation) Flashcards

1
Q

what does ventilation play a critical role in?

A

CO2 clearance, determining arterial O2 saturation, and O2 supply

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2
Q

what is the main respiratory muscle?

A

diaphragm and then intercostal muscles

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3
Q

what is the tissue in the lungs?

A

elastic tissue. parietal pleura line thoracic wall and upper portion of diaphragm; visceral pleura line outside of each lung

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4
Q

type 1 alveolar cells

A
  • comprise 90% of alveolar wall, susceptible to injury, and are main structural cells
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5
Q

type 2 alveolar cells

A

double the number of type 1 cells; produce surfactant; and can divide into type 1 and 2 cells when lung tissue is damaged

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6
Q

what is the most sensitive region of the respiratory tract?

A

carina; triggers cough reflex

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7
Q

what is the role of surfactant?

A

increases lung compliance, prevents alveolar collapse, and decreases alveolar surface tension

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8
Q

ventilation assessment

A
  • main determinants = RR and tidal volume which define minute ventilation
  • RR and Vt are influenced by WOB
  • WOB is influenced by lung compliance, a/w resistance and respiratory muscle function
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9
Q

ventilation

A

movement of air in and out of the lungs

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10
Q

what is one way to determine effectiveness of ventilation?

A

measuring PaCO2

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11
Q

what are ax cues that can indicate an increase in PaCO2 levels (hypercapnia/hypercarbia)?

A
  • increased RR
  • shallow breaths
  • SOB/dyspnea
  • headaches, dizziness, confusion, decreased LOC
  • respiratory acidosis
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12
Q

ax cues for respiratory muscle function

A
  • medical hx, course of illness
  • nutrition status
  • prolonged ventilator dependence
  • neuro conditions
  • increased WOB leading to fatigue
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13
Q

compliance

A

measure of distensibility of a tissue

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14
Q

what is internal compliance?

A

how easily the alveoli/lung tissue can be stretched

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15
Q

what happens if internal compliance is decreased?

A

that means lungs are stiff, and trying to inflate poorly compliant lungs require more pressure and physical effort increasing WOB

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16
Q

what happens if internal compliance is increased?

A

lungs are easily stretched and require less pressure, so WOB is decreased

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17
Q

what is the effect of resp infections on internal compliance?

A

they reduce internal compliance b/c accumulation of fluid and thick mucus in alveoli makes it harder for lungs to expand and fill with air

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18
Q

ax cues for internal compliance

A
  • medical hx (COPD, pulmonary fibrosis, interstitial lung disease)
  • chest xray (consolidation, atelectasis)
  • secretions
  • crackles on auscultation
19
Q

what is external compliance?

A

the ability of the lungs to fully inflate and the diaphragm and chest wall to expand and contract

20
Q

ax cues for external compliance

A
  • medical hx (trauma, rib #s, chest burns)
  • anything inhibiting diaphragm expansion (obesity, ascites, pregnancy, bowel obstruction, rib or spinal deformities)
  • pneumo/hemothorax
  • pleural effusion
  • pain with breathing/coughing
21
Q

normal WOB is _____ of total body expenditure

A

<2%

22
Q

what can airway resistance be influenced by?

A

diameter of airway/artificial airway (the narrower the diameter, the greater the resistance therefore causing increased WOB)

23
Q

ax cues for airway resistance

A
  • wheezes/stridor
  • presence of bronchospasm
  • medical hx
  • a/w obstruction (anaphylaxis, tumors)
  • artificial airways
  • thick, copious secretions
24
Q

work of breathing

A

amount of effort required to breathe

25
Q

what three factors impact WOB?

A

1) force required to expand lungs
2) pressure required to overcome elastic recoil of lungs
3) resistance generated by airways

26
Q

when does WOB increase?

A

with any condition that impairs resp muscles, decreases lung compliance, or increases a/w resistance

27
Q

ax cues for increased WOB

A
  • nasal flaring
  • accessory muscle use
  • chest retractions
28
Q

tidal volume

A

volume of air that is inhaled and exhaled in a single breath during normal quiet breathing (mL)

29
Q

why is tidal volume important?

A

its a factor in determining overall efficiency of ventilation

30
Q

what is the equation for minute ventilation

A

minute ventilation (L/min) = tidal volume (mL) x RR (breaths/min)

31
Q

what is the primary compensatory mechanism in tidal volume?

A

a change in RR to maintain volume of air moving in and out per minute

32
Q

minute ventilation

A

amount of air inhaled and exhaled from the lungs in one minute determined by RR and tV

33
Q

what might directly impact tidal volume?

A
  • age, body size
  • resp muscle strength
  • resp disease, condition
  • meds
  • LOC
  • mechanical ventilation
34
Q

ax cues for tidal volume

A
  • observed depth of respirations
  • directly measured volumes through mechanical ventilation
35
Q

vital capacity

A

max volume (amount) of air that can be expired after a max inhalation (deep breath); reflects max lung capacity

36
Q

why is vital capacity important?

A

part of criteria used for determining if a pt can be weaned from ventilatory support

37
Q

what is a normal VC measurement? how can you obtain a measurement?

A

~3-5L. using settings on a ventilator (usually done by RT), or by coughing

38
Q

what is the most accurate way to determine vital capacity?

A

spirometry

39
Q

what factors directly impact vital capacity

A
  • resp muscle fx
  • internal/external compliance concerns
  • age related anatomic changes
40
Q

ax cues for vital capacity

A
  • ability to cough
  • pulm fx tests/spirometry
  • measurement via mechanical ventilator
41
Q

functional residual capacity

A

volume of air left in lungs at the end of normal exhalation; used in determining compliance

42
Q

what does FRC do?

A

allows air to flow easily into lungs during inhalation; helps prevent collapse of small airways and alveoli at the end of expiration

43
Q

how do conditions like atelectasis and ARDS affect FRC?

A

lead to alveolar collapse and loss of FRC = decreased compliance, increased WOB and impaired ventilation

44
Q

what factors directly impact FRC?

A
  • age
  • disease (COPD, asthma)
  • body position (decreased FRC in supine)
  • abdominal pressure
  • alveolar collapse (consolidation, ARDS, atelectasis decrease FRC and vol of air in lungs)

NSCC 7120 (8 decks)

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