Oxygenation

Question 1

Blood returns to the heart from the lower extremities and abdomen via the ______.

Answer 1

Inferior Vena Cava

Question 2

Blood from the thorax and upper extremities returns to the heart via the ______.

Answer 2

Superior Vena Cava

Question 3

Deoxygenated blood travels from the heart to the lungs in what order?

Answer 3

Vena cava > right atrium > right ventricle > pulmonary artery> alveoli capillaries

Question 4

In what order does oxygenate blood travel from the lungs’ alveoli to the heart?

Answer 4

Alveoli capillaries > pulmonary vein > left atrium > left ventricle… to be ejected into the systemic blood flow through the aorta.

Question 5

How many lobes make up the right lung?

Answer 5

3 - The superior/upper lobe, the middle lobe, and the inferior lobe.

Question 6

How many lobes make up the left lung?

Answer 6

2 - The superior/upper lobe and the inferior/ lower lobe

Question 7

What is the name of the inward curve of the left lung?

Answer 7

Cardiac notch - This is where the lower/apex of the heart sits.

Question 8

What are the bronchi of the lungs?

Answer 8

The airways into the lungs from the trachea.

Question 9

In what order does oxygen arrive at the alveolar capillaries from the trachea?

Answer 9

Carina > primary bronchus > secondary bronchus> segmental (tertiary bronchus) > subsegmental bronchus > bronchioles > alveoli >alveolar sac > diffuses across the wall and into the bloodstream.

Question 10

Ventilation

Answer 10

The flow of air into and out of the alveoli

Question 11

Perfusion (alveoli)

Answer 11

The blood flow by the cardiopulmonary system into the alveolar capillaries.

Question 12

Surfactant

Answer 12

A chemical compound used to decrease surface tension. Surfactant is used in the alveoli to prevent them from collapsing.

Question 13

What is the primary muscle used in breathing?

Answer 13

Diaphragm

Question 14

What are the secondary muscles used in breathing?

Answer 14

intercostal muscles (external and internal)

Question 15

What are the accessory muscles used in breathing?

Answer 15

Sternocleidomastoid muscles, scalene muscles, pectoralis minor, the abdominal muscles, latissimus dorsi, serratus anterior

Question 16

What happens when the diaphragm contracts?

Answer 16

When the diaphragm contracts, it flattens and moves downward. This increases the volume of the chest cavity, which decreases the pressure in the lungs. The higher pressure of the air outside and the lower pressure in the lungs allow air to move into the lungs. (Vaccum/ Sucction/Inhalation) (See: Boyle’s law)

Question 17

How do the intercostal muscles aid in breathing?

Answer 17

External: Aid in inhalation by lifting the ribs during contraction. (internals are relaxed)

Internal: Aid in exhalation by pulling the ribs down during contraction. (externals are relaxed)

Question 18

How do the accessory muscles aid in breathing?

Answer 18

The sternocleidomastoid, pectoralis minor, and scalene muscles raise the upper ribs during contraction to aid in forceful inhalation.

During forceful exhalation, the abdominal and serratus anterior muscles push down or inwards on the chest cavity.

Question 19

How does gas exchange occur at the alveolar capillaries?

Answer 19

Diffusion: Moving from a place of high concentration of solute/substance to a lower concentration.
EX: CO2 has a higher concentration in deoxygenated blood than the alveoli after inhalation, which causes it to travel to a lower concentration in the alveoli. Oxygen travels from its high concentration in the alveoli to a lower/ absent concentration in the blood. (Concentration gradient causes diffusion from higher to lower areas until there is no gradient.)

Question 20

Haldane Effect

Answer 20

Describes how O2 affects hemoglobin’s affinity for CO2

A high concentration of O2 in the tissue leads to a decreased affinity hemoglobin affinity for CO2. This causes the hemoglobin to release/ deliver CO2 to the lungs and pick up oxygen.

Question 21

Bohr’s Effect

Answer 21

Describes how CO2 affects hemoglobin’s affinity for oxygen

A High concentration of CO2 in the tissue leads to a decrease in hemoglobin O2 affinity. This causes hemoglobin to release/deliver O2 to tissue and carry CO2 to the lungs.

Question 22

What factors affect oxygenation?

Answer 22

1. Age/Development
2. Breathing patterns
3. Infections of the lungs
4. Chronic Obstructive Lung Disorders/Diseases
5. Medications
6. Addictions: Smoking, Vaping
7. Blood disorders: sickle cell anemia, anemia, and low hemoglobin

Question 23

What is the common factor affecting oxygenation in infants?

Answer 23

Apnea due to immature lower airways.

Question 24

What is the common factor affecting oxygenation in toddlers?

Answer 24

Upper respiratory infections

Question 25

What is the common factor affecting oxygenation in school-age kids to adolescents?

Answer 25

Asthma and Influenza

Question 26

What is the common factor affecting oxygenation in young adults?

Answer 26

Smoking and vaping lead to lung cancer, tar buildup, secretion immobility, and fibrosis (scarring).

Question 27

What is the common factor affecting oxygenation in older adults (seniors)?

Answer 27

1. Increased risk of respiratory infections (pneumonia)(decreased immune response)
2. Weakened ability to cough
3. Decreased mucomotility clearance ( cilia in bronchi cannot effectively remove mucous and foreign objects.

Question 28

How do you assess for hypoxia/hypoxemia

Answer 28

1. Check vital signs ( increased pulse rate, respiration rate, and blood pressure)(decreased SpO2 or SpO2< 95%)
2. Check for edema in extremities
3. Check peripheral pulses (Rate and quality)
4. Observe skin color for pallor or cyanosis (Mucous Membranes)
5. Capillary refill time in fingers and toes
6. Check fingernails and toenails for signs of clubbing (chronic low O2) and spooning (anemia).
7. Ausciltate for adventitious (bad/abnormal) lung sounds. (Wheezing, rhonchi, crackles/ rales, stridor)
8. Check for barrel chest
9. Assess for productive cough (sputum color, amount, odor, consistency, hemoptysis, and duration of the cough)

Question 29

Hypoxemia

Answer 29

Low O2 levels in blood circulation
Note: Hypoxemia leads to hypoxia

Question 30

Hypoxia

Answer 30

Low levels of O2 perfusion at tissue/cell

Question 31

What are life-threatening conditions caused by hypoxia if left untreated?

Answer 31

1. Respiratory failure
2. Fatal Cardiac Dysrhythmias
3. Cardiac Arrest
   **All leading to death **

Question 32

What are the signs and symptoms of hypoxia and hypoxemia?

Answer 32

Signs (Objective data):
Shortness of breath (SOB)
Nasal Flaring
Behavior: agitation, irritation, restlessness
Decreased level of consciousness

Early Stage: Increased pulse rate, respiration rate, and blood pressure.

Late Stage: Decreased respiration rate, pulse rate, blood pressure, and temperature. Clubbing of fingernails, cyanosis mucosal, and peripheral.

Symptoms (Subjective): Dizziness, fatigue, inability to concentrate, feelings of apprehension.

Question 33

Causes of Hypoxia