N212 Lecture 9 Flashcards
(137 cards)
1
Q
What are the 3 steps in the process of oxygenation
A
ventilation, perfusion and diffusion
2
Q
The exchange of respiratory gases occur between which 2 things?
A
environment and blood
3
Q
Respiration is the exchange between oxygen and co2 during cellular metabolism, true or false
A
true
4
Q
The process of moving gases into and out of the lungs is called
A
Ventilation
5
Q
the ability of the cardiovascular system to pump oxygenated blood to the tissues and return deoxygenated blood to the lungs is called
A
perfusion
6
Q
exchange of respiratory gases in the alveoli and capillaries is called
A
Diffusion
7
Q
for ventilation, it requires coordination of the muscular and elastic properties of the lung and thorax, true or false
A
true
8
Q
diffusion is responsible for moving the respiratory gases from one are to another by concentration gradients, true or false
A
true
9
Q
for exchange of respiratory gases to occur what needs to be intact
A
the organs, nerves and muscle of respiration along with the CNS being able to regulate the cycle
10
Q
the active process stimulated by chemical receptors in the aorta is called
A
inspiration
11
Q
the passive process that depends on the elastic recoil properties of the lungs requiring little or no muscle work is called
A
expiration
12
Q
the chemical produced in the lungs to maintain the surface tension of the alveoli and keep them from collapsing is called
A
surfactant
13
Q
patients with advanced COPD lose elastic recoil of the lungs and thorax, results in increase of breathing, true or false
A
true
14
Q
the collapse of the alveoli that prevents normal exchange of oxygen and co2 is called
A
atelectasis
15
Q
ability for the lungs to expand is called
A
compliance
16
Q
the increase in pressure that occurs as the diameter of the airways decreases from mouth/nose to alveoli is called
A
airway resistance
17
Q
decreased lung compliance, increased airway resistance, and the increased use of accessory muscles increase the work of breathing, true or false
A
True
18
Q
The process for the exchange of respiratory gases in the alveoli and the lungs and the capillaries of the body tissues is called
A
diffusion
19
Q
the thickness of the membrane affects the rate of diffusion, true or false
A
true
20
Q
what type of patients have slow diffusion, slow exchange of respiratory gases and decreased delivery of oxygen to tissues ?
A
patients with pulmonary edema, pulmonary infiltrates or pulmonary effusion due to thickened membrane
21
Q
what alters the amount of alveolar capillary membrane surface area
A
chronic diseases (emphysema), acute diseases (pneumothorax) and surgical processes (lobectomy)
22
Q
the oxygen transport system consist of what 2 things
A
lungs and cardiovascular system
23
Q
what 3 things influence the capacity of the blood to carry oxygen
A
the amount of dissolved oxygen in the plasma, the amount of hemoglobin, and the ability of hemoglobin to bind with oxygen
24
Q
the regulation of respiration is necessary to ensure sufficient oxygen intake and co2 elimination to meet the demands of the body, true or false
A
true
25
neural and chemical regulators control what?
the process of respiration
26
the neural regulation includes the CNS control of respiratory rate, depth, and rhythm, true or false
true
27
chemical regulation maintains the appropriate rate and depth of respirations based on changes of co2, o2, and hydrogen ion concentrations pH in the blood, true or false
true
28
the amount of blood ejected from the left ventricle each minute is called
cardiac output
29
amount of blood ejected from the left ventricle with each contraction is called
stroke volume
30
stroke volume (SV) x heart rate (HR) =
cardiac output (CO)
31
resistance to left ventricular ejection is called
afterload
32
the normal cardiac output in a healthy adult at rest is from
4-8L/min
33
the circulating volume of blood changes according to the oxygen and metabolic needs of the body, true or false
true
34
stroke volume is affected by preload, afterload, and myocardial contractility, true or false
true
35
the amount of blood in the left ventricle at the end of diastole, often referred to as end diastolic volume is called
preload
36
the more stretch on the ventricular muscle, the greater the contraction and the greater the volume( starlings law), true or false
true
37
the resistance to left ventricular ejection is called
afterload
38
the diastolic aortic pressure is a good clinical measure of afterload, true or false
true
39
in hypertension the afterload increases, making cardiac workload also increase, true or false
true
40
what affects stroke volume and cardiac output
myocardial contractility
41
the myocardium of the older adult is stiffer with a slower ventricular filling rate and prolonged contraction time, true or false
true
42
what influences the rate of impulse generation and the speed of transmission through the conductive pathway and the strength of atrial and ventricular contractions
autonomic nervous system
43
what generates the rhythmic relaxation and contraction of the atria and ventricles
cardiac conduction system
44
what innervates all parts of the atria, ventricles and the sinoatrial(AV) and atrioventricular (AV) nodes
sympathetic and parasympathetic nerve fibers
45
sympathetic fibers increase the rate of impulse generation and speed of transmission, true or false
true
46
the parasympathetic fibers originate from the vagus nerve decrease the rate, true or false
true
47
the conduction system originates with the SA node " pacemaker" of the heart, true or false
true
48
in an adult at rest the impulses at the SA node are initiated at an intrinsic rate of 60 to 100 cardiac action potentials per minute, true or false
true
49
the AV node mediates impulses between the atria and the ventricles, true or false
true
50
what reflects the electrical activity of the conduction system
electrocardiogram ( ECG)
51
ECG monitors the regularity and path of the electrical impulse through the conduction system, true or false
true
52
ECG does not reflect the muscular work of the heart, true or false
true
53
what is called the normal sequence on the ECG
normal sinus rhythm (NSR)
54
NSR implies that the impulse originates at the SA node and follows the normal sequence through the conduction system, true or false
true
55
what represents the electrical conduction through both atria
the P wave, atrial contraction follows the P wave
56
what represents the impulse travel time from the SA node through the AV node, through the bundle of His and to the Purkinje fibers
The PR interval
57
the normal length of the PR interval is
0.12 to 0.2 seconds
58
an increase in the time greater than 0.2 sec indicates a block in the impulse transmission through the AV node, true or false
true
59
a decrease of less than 0.12 sec indicates the initiation of the electrical impulse from ta source other than the SA node, true or false
true
60
what indicates the electrical impulse traveled through the ventricles
the QRS complex
61
normal QRS duration is between
0.06 to0.1 seconds
62
an increase in QRS duration indicates a delay in conduction time through the ventricles, true or false
true
63
what contraction usually follows the QRS complex
ventricular contraction
64
what represents the time needed for ventricular depolarization and repolarization
The QT interval
65
the normal QT interval is from
0.12 to 0.42 sec
66
this interval varies inversely with changes in heart rate, true or false
true
67
what causes conduction disturbances
electrical impulses that do not originate from the SA node
68
what is called when theres a deviation from the normal sinus heart rhythm, are classified by cardiac response and site of impulse origin
dysrhythmias
69
tachycardia is more than 100 bpm and bradycardia less than 60 bpm, true or false
true
70
the electrical impulse in atria is chaotic comes from multiple sites is called
atrial fibrillation
71
a sudden, rapid onset of tachycardia originating above the AV node is called
paroxysmal supraventricular tachycardia
72
a ectopic site of impulse formation within the ventricles which are life threatening rhythms that require immediate intervention is called
ventricular dysrhythmias (causes decreased cardiac output and sudden death)
73
rhythm disturbances are called dysrhythmias which means a deviation from the normal sinus heart rhythm, true or false
true
74
dysrhythmias occur as a primary conduction disturbance such as in response to ischemia; valvular abnormality; anxiety; drug toxicity; caffeine; alcohol or tobacco use or a complication of acid base or electrolyte imbalance, true or false
true
75
what is classified by cardiac response and site of impulse origin
dysrhythmias
76
what causes lower cardiac output and blood pressure
tachydysrhythmias and bradydysrhythmias
77
what reduces cardiac output by decreasing diastolic filling time
tachydysrhythmias
78
what lowers cardiac output because of the decreased heart rate
bradydysrhthmias
79
whats a common dysrhythmia in older adults
atrial fibrillation (afib)
80
abnormal impulses originating above the ventricles are called
supraventricular dysrhythmias
81
a sudden, rapid onset of tachycardia originating above the AV node is called
paroxysmal supraventricular tachycardia
82
paroxysmal supraventricular tachycardia often begins and ends spontaneously which is caused by excitement, fatigue, caffeine, smoking, or alcohol, true or false
true
83
an ectopic site( originates in the ventricle) of impulse formation within the ventricles is called
ventricular dysrhythmias
84
these life threatening rhythms require immediate intervention are called
ventricular tachycardia and ventricular fibrillation
85
if the ventricular failure is significant, the amount of blood rejected from left ventricle drops which decreases cardiac output, true or false
true
86
when the left ventricle continues to fail, blood begins to pool in the pulmonary circulation causing ?
pulmonary congestion
87
left sided heart failure symptoms are crackles in the bases of the lungs on auscultation, hypoxia, sob on exertion, cough and paroxysmal nocturnal dyspnea, true or false
true
88
the impaired functioning of the right ventricle and more commonly from pulmonary disease or as a result of long term left sided failure is from?
right sided heat failure
89
the primary pathological factor in right sided failure is elevated ?
pulmonary vascular resistance (PVR)
90
for PVR the oxygen demand of the heart increases and the amount of blood ejected from the right ventricle declines causing blood to " back up" in the systemic circulation, true or false
true
91
with PVR the patient has weight gain, distended neck veins, hepatomegaly, splenomegaly and dependent peripheral edema, true or false
true
92
an acquired or congenital disorder of a cardiac valve that causes either hardening (stenosis) or impaired closure (regurgitation) of the valves is called
Valvular heart disease
93
when ventricles contract the blood escapes back into the atria causing a murmur or " whooshing" sound, true or false
true
94
a transient imbalance between myocardial oxygen supply and demand is called
angina pectoris
95
angina pectoris results in chest pain that is aching, sharp, tingling, burning or like pressure, true or false
true
96
chest pain is typically left sided or substernal and radiates to the left or both arms, the jaw, neck and back and usually relieved with rest and coronary vasodilators, the most common being nitroglycerin preparation, true or false
true
97
sudden decrease in coronary blood flow or an increase in myocardial oxygen demand without adequate coronary perfusion is called ?
Myocardial Infarction (MI) or acute coronary syndrome (ACS)
98
infarction occurs because ischemia is not reversed, true or false
true
99
cellular death occurs after 20 minutes of myocardial ischemia, true or false
true
100
chest pain associated with MI in men are described as crushing, squeezing or stabbing, true or false
true
101
mens MI pain is often in the left chest and sternal are, may be felt in the back and radiates down the left arm to the neck, jaws, teeth, epigastric area, back, and occurs at rest or exertion and lasts more then 20 minutes, true or false
true
102
rest, position change or sublingual nitroglycerin administration might not relive MI pain, true or false
true
103
women's symptoms for MI are angina but also atypical symptoms such as fatigue, indigestion, sob, back or jaw pain, and have 2x the risk of dying within the first year after a heart attack than men, true or false
true
104
hypertension is often asymptomatic, true or false
true
105
prehypertension is diagnosed in adults when an average of 2 or more readings of past two visits of 120 and 129 systolic and greater than 80 diastolic, true or false
true
106
diastolic readings greater than 90 and systolic greater than 140 define hypertension, true or false
true
107
what is associated with thickening and loss of elasticity in the arterial walls
hypertension
108
peripheral vascular resistance increases within thick and inelastic vessels, true or false
true
109
the dilation of the arteries in the vascular bed, the loss of a substantial amount of blood volume or the failure of the heart muscle to pump adequately is ?
hypotension
110
what is associated with pallor, skin mottling, clamminess, confusion, increased HR, or decreased urine output
hypotension
111
a normotensive person develops symptoms and a drop in systolic pressure by at least 20mm hg or a drop in diastolic pressure by at least 10 mm hg within 3 minutes of arising to an upright position is
orthostatic hypotension/postural hypotension
112
patients who are dehydrated, anemic or have been on bed rest or recent blood loss are at risk for orthostatic hypotension particularly in the morning, true or false
true
113
orthostatic readings taken within 3 minutes of patient changing positions, true or false
true
114
low levels of arterial oxygen is called
hypoxemia
115
anemia causes decreased oxygen carrying capacity and inhalation of toxic substances, true or false
true
116
carbon monoxide is the most common toxic inhalant decreasing the oxygen carrying capacity of blood, true or false
true
117
conditions such as shock and severe dehydration causes extracellular fluid loss and reduce circulating blood volume is called
hypovolemia
118
decreasing circular blood volume results in hypoxia to body tissue, true or false
true
119
when fever persists the metabolic rate remains high and the body begins to break down protein stores, true or false
true
120
oxygenation decreases as a direct consequence of chronic lung disease, true or false
ture
121
the normal arterial co2 tension is between 35 to 45 mm hg, true or false
true
122
the normal arterial o2 tension is between 80 to 100 mm hg, true or false
true
123
hypoventilation and hyperventilation are often determined by arterial blood gas analysis, true or false
true
124
when alveolar ventilation is inadequate to meet the oxygen demand of the body or eliminate sufficient co2 is called
hypoventilation
125
the resulting hypoventilation causes excessive retention of co2 which can lead to respiratory acidosis and respiratory arrest, true or false
true
126
signs and symptoms of hypoventilation include mental status change, dysrhythmias, and potential cardiac arrest, true or false
true
127
signs and symptoms of hyperventilation are rapid respirations, sighing breaths, numbness and tingling of hands/feet, lightheadedness and loss of consciousness, true or false
true
128
refers to a decrease in the amount of arterial oxygen is called
hypoxia
129
normal spo2 is greater than or equal to 95%, true or false
true
130
causes of hypoxia include 1) decreased hemoglobin level and lowered oxygen carrying capacity of the blood 2) a diminished concentration of inspired oxygen 3) the inability of the tissues to extract oxygen from the blood, as with cyanide poisoning 4) decreased diffusion of o2from the alveoli to the blood as in pneumonia 5) poor tissue perfusion with o2 blood as with shock 6) impaired ventilation as with multiple rib fractures, true or false
true
131
symptoms of apprehension, restlessness, inability to concentrate, decreased level of consciousness, dizziness and behavioral changes are causes of
hypoxia
132
blue discoloration of the skin and mucous membrane caused by the presence of desaturated hemoglobin in capillaries is called
cyanosis
133
central cyanosis observed in the tongue, soft palate and conjunctiva of the eye indicates hypoxemia, true or false
true
134
peripheral cyanosis seen in extremities, nail beds, earlobes is a result of vasoconstriction and stagnant blood flow, true or false
true
135
pulse oximetry provides instant feedback about the patients level of oxygenation, true or false
true
136
Xray, blood work such as arterial blood gases and TB test help with reviewing patients oxygenation levels, true or false
true
137
