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BSNC 1000 > Module 5 > Flashcards

Module 5 Flashcards

1
Q

Ventilation

A

physiological process of breathing

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2
Q

Gas exchange

A

process of oxygen transport from lungs to tissue cells and carbon dioxide from tissue cells to lungs

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3
Q

How does gas exchange occur?

A

Diffusion across pressure gradients

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4
Q

Respiratory membrane

A

capillary membrane, basement membrane, alveolar wall

typically it is very thin

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5
Q

Anoxia

A

total depletion of oxygen in the tissues. will lead to cellular death

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6
Q

Hypoxia

A

depletion of oxygen levels in the tissues.

can be caused by impaired perfusion or low oxygen in arterial blood

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7
Q

Hypoxemia

A

reduced oxygen levels in arterial blood

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8
Q

Types of chemoreceptors

A

Central

Peripheral

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9
Q

Central Chemoreceptors

A

Located in the medulla oblongata of the brainstem

Monitor CO2 levels in cerebrospinal fluid

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10
Q

Peripheral Chemoreceptors

A

Located in the arch of the aorta + carotid bodies

Monitor O2 levels in cerebrospinal fluid

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11
Q

What stimulates breathing?

A

Indirectly: Carbon dioxide oxygen
Directly: Hydrogen ions

reduction in pH triggers breathing due to the carbonic anhydrase equation

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12
Q

Normal Inspiratory Muscles

A

Diaphragm

External Intercostal Muscles

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13
Q

Forced Expiratory Muscles

A 
Abdominal Muscles (transverse, oblique)
Internal Intercostal Muscles
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14
Q

Forced Inspiratory Muscles

A

Sternocleidomastoid

Scalene

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15
Q

Types of alveolar cells

A

Type 1 - provide surface area
Type 2 - produce surfactant
Macrophages - phagocytocize cellular debris

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16
Q

Anatomy of bronchial tree

A

Trachea + bronchi/larger bronchioles are smooth tissue with cartilagenous rings –> plates

Smaller bronchioles + alveoli = smooth muscle

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17
Q

Alveoli anatomy

A

Alveoli = singular sac
Alveolar septum = tissue that separates alveoli (contributes to surface area)
Alveolar sac = cluster of alveoli
Alveolar duct = continuous with respiratory bronchiole

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18
Q

Bronchial Tree

A 
Major Bronchi (right/left)
Lobar Bronchi
Segmental Bronchi
Bronchioles
Terminal Bronchioles
Respiratory Bronchioles
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19
Q

Two Respiratory Zones

A

Conducting -> move air

Respiratory -> participate in gas exchange

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20
Q

Conducting Zone

A 
nose
pharynx
larynx
trachea
bronchi
terminal bronchioles
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21
Q

Respiratory Zone

A

respiratory bronchioles
alveolar duct
alveoli

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22
Q

Methods of Oxygen transport

A

dissolved in plasma - 3%

bonded with heme in hemoglobin - 97%

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23
Q

Methods of Carbon Dioxide transport

A

dissolved in plasma - 7%
bonded with heme in hemoglobin - 20%
bicarbonate ions - %

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24
Q

Carbonic Anhydrase Equation

A

carbon dioxide diffuses across plasma membrane of red blood cells and enters cytosol

in cytosol CO2 + H2O –> H2CO3 (carbonic acid) –> H+ & HCO3 (bicarbonate)

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25
Q

Enzyme that catalyzes water and carbon dioxide

A

Carbonic anhydrase

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26
Q

Factors increasing oxygen affinity

A

low temperature
high pH
high partial pressure of oxygen
low partial pressure of carbon dioxide

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27
Q

Factors decreasing oxygen affinity

A

high temperature
low pH
low partial pressure of oxygen
high partial pressure of carbon dioxide

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28
Q

Atmospheric air

A

a combination of gases

70% Nitrogen
21% Oxygen
Water Vapor
Other gases

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29
Q

Pneumothorax

A

Collapsed lung

Occurs when there is a change in the intrapleural pressure

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30
Q

Anemia

A

a collection of disorders characterized by low red blood cells

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31
Q

Polycythemia

A

creation of new blood cells

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32
Q

What is Sp02

A

oxygen saturation
95-100%

measures the saturation of available hemoglobin

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33
Q

What is PaO2

A

partial pressure of oxygen in arterial blood
normally 80 mm Hg

measures amount of oxygen dissolved in blood plasma

34
Q

4 Processes of Respiration

A

Alveolar Ventilation
Alveolar Perfusion
Alveolar-capillary diffusion
Gas transport in circulation

35
Q

Factors impairing ventilation

A

Damage to CNS –> respiratory muscles require continuous innervation
Disorder to nasopharynx/lungs
Reduction in pulmonary/alveolar elasticity
Changes in atmospheric O2 (less O2 at higher altitudes)
Narrowed airways - inflammation, occlusion
Pulmonary edema

36
Q

Right-sided Heart Failure

A

occurs due to increased pulmonary blood pressure
right ventricle has to work harder to pump blood which leads to ventricular hypertrophy
inefficient pumping of blood causes blood to backflow into vena cava causing peripheral edema

37
Q

Pulmonary edema

A

caused by left-sided heart failure
trauma to chest
pneumonia

38
Q

Pulmonary embolism

A

blockage in the pulmonary artery

usually caused by deep vein thrombosis in the legs

39
Q

Clinical Manifestations of COPD

A 
fatigue
confusion 
high blood pressure 
high respiratory rate
increased work of breathing 
hypoxia/hypoxemia
hypercapnia --> acidosis 
cyanosis 
clubbing of nails due to prolonged hypoxia 
barrel chest (emphysema)
productive cough
asymmetric thorax
40
Q

Normal Respiratory Rate

A

10-20 breaths/minute

41
Q

Problem-Based History

A 
cough
dyspnea (shortness of breath) especially on exertion
chest pain while breathing
productive cough
fatigue 
anxiety
42
Q

Cues of Impaired Ventilation/Gas exchange

A

tripod position
anxiety
changes in mentation

43
Q

Innervation of diaphragm

A

Phrenic Nerve - Cervical spine

44
Q

Innervation of external intercostal muscles

A

Nerves originating from Thoracic spine

45
Q

Lung Sounds

A

Stridor - bronchoconstriction
Rhonchi - blockages in airway
Crackles - fluid in lungs
Wheezes

46
Q

Diagnostic Tests

A

Lab tests (arterial blood gases, complete blood count, sputum exam, skin test, pathologic)
Radiologic
Pulmonary Function Tests

47
Q

Treatment

A 
Oxygen Therapy
Pulmonary respiratory community groups
Rest therapy
Respiratory muscle training
Medication
Nutrition therapy 
Diaphragmatic breathing 
Works simplification
48
Q

Respiratory center

A

located in the medulla oblongata/pons

49
Q

Dorsal Respiratory Center

A

controls rhythm of breathing

50
Q

Ventral Respiratory Center

A

controls inhalation

51
Q

Respiratory lobule

A

terminal bronchiole, alveolar duct, alveoli, pulmonary blood vessels + lymphatic vessels

52
Q

Factors contributing to alveolar-capillary diffusion

A

surface area of alveoli
thinness of respiratory membrane
diffusion distance
pressure gradients

53
Q

Parasympathetic Effects on Respiratory System

A

airway constriction

vasodilation

54
Q

Sympathetic Effects on Respiratory System

A

airway dilation

vasoconstriction

55
Q

Factors Affecting Lung Ventilation

A

Chest Wall Compliance

Lung Compliance

56
Q

Lung Volumes and Capacities

A

Tidal Volume
Vital Capacity
Forced Expiratory volume

57
Q

Factors Affecting Lung Compliance

A

elastin and collagen fibers
water content
surface tension (surfactant)

58
Q

Forced Expiratory Capacity

A

75-85% of vital capacity in one second

maximum amount of air you can exhale in one second

59
Q

Types of emphysema

A

Panacinar

Centriacinar

60
Q

Causes of COPD

A

Smoking
Environmental pollutants (physical, chemical)
Genetic (lack of production of alpha-1 anti-trypsin)
Frequent childhood respiratory infections
Age

61
Q

Hypercapnia

A

Elevated levels of CO2 in the blood

62
Q

COPD Treatment

A 
Rest therapy
Oxygen therapy
Diet (reduced carbohydrates)
Respiratory muscle retraining 
Medication
63
Q

Pack years

A

used to measure how much a person has smoked over time

64
Q

Pack year equation

A

packs/day x years

OR

of cigarettes smoked per day/20 x years

(1 pack = 20 cigarettes)

65
Q

What is PaCO2

A

35-45 mm HG normally

66
Q

Ventilation Perfusion Ratio

A

Ventilation/Perfusion

can be affected by reduced ventilation or reduced perfusion

Ideally this number should be 1 for optimal function

67
Q

Causes of hypoxemia

A

hypoventilation
mismatch between ventilation/perfusion
impaired perfusion
impaired ventilation

68
Q

SpO2 of COPD patients

A

88-92%

69
Q

COPD

A

chronic disease that causes obstruction to expiration
leads to hypoxemia and hypercapnia

includes two diseases: chronic bronchitis and emphysema

70
Q

Chronic Bronchiits

A 
inflammation of the airways 
hypertrophy of the mucus glands/goblet cells lead to an overproduction of mucus
fibrosis of bronchiolar wall 
clogs the airway impeding ventilation
V/Q mismatch --> hypoxemia, cyanosis
chronic productive cough (sputum)
repeated respiratory infections
71
Q

Emphysema

A

destruction of elastic tissue distal to the terminal bronchioles
caused by elastase digesting elastin fibers –> weakens alveolar wall, alveolar duct, alveolar septum
reduces surface area/compliance of alveoli inhibiting ventilation
no V/Q mismatch
pursed light breathing
increased anteroposterior thorax (barrel chest)
increased work of breathing

72
Q

Tidal Volume

A

amount of hear inhaled/exhaled in one breath

~500 mL

73
Q

Forced Vital Capacity

A

maximal amount of air you can exhale after maximal inhalation

74
Q

Residual volume

A

amount of air remaining in lungs following exhalation

75
Q

Forced expiratory volume

A

amount of air you can exhale in 1 sec

should be 75-85% of expiratory reserve volume

76
Q

What is lung compliance

A

lung compliance is the ability of the lungs to expand during inspiration

77
Q

Three factors decreasing lung compliance

A

water content in alveoli (infection)
increased surface tension in lungs (reduced surfactant)
loss of elastin, collagen fibers

78
Q

Factors affecting alveolar-capillary diffusion

A

surface area
concentration gradient of gases
diffusion distance (thinness of respiratory membrane, edema)

79
Q

Consequences of impaired gas exchange

A

increased work of breathing
hypoxemia/hypercapnia
hypoxic cell injury

80
Q

Compensatory Mechanisms

A

increased respiratory rate
polycythemia
increased heart rate –> increased blood pressure
redistribution of blood from peripheral extremities to core systems

81
Q

Normal PaCO2

A

35-45 mm HG

82
Q

Recommended nutrition for COPD patients

A

high calorie
high protein
smaller meals if dyspneic

BSNC 1000 (10 decks)

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