Progidy- Respiratory fundamentals Flashcards
What structure is most commonly injured during a nasal intubation?
The inferior concha
Where is the point in the airway where cartilage tissue is no longer present
the respiratory bronchiole
What are the most powerful inspiratory muscles?
The external intercostals
What innervates the nasopharnyx?
The opthalmic and maxillary divisions of the trigeminal nerve
What innervates the tongue?
Anterior 2/3 -Taste - CN 7 - Sensation- CN 5 - V2 maxillary Posterior 1/3 -Taste- CN 9 - GP Motor CN 12- Hypoglossal
What is pleural pressure at rest?
~ negative 3-5cm H20
T/F- static compliance is decreased in emphysema
true
-the lungs expand more easily but the elastic recoil is lost
Formula for dynamic compliance
Tidal volume
/
PIP-PEEP
Dynamic vs static compliance
Static compliance is measured during periods of no air flow; dynamic compliance measures changes in volume as pressure changes where air is moving in and out
T/f- closing capacity usually increases with age
True
What law is reynold’s number based on?
Poiseuille’s law
A reynolds number > _______ is indicative of turbulent flow
4,000
Which princple explains the relationship between the diameter of a tube and the resistance to flow through the tube?
Poiseuille’s law
According to Poiseuille’s law, woud a longer or shorter legnth needle result in slower flow
longer length
Shifting CO2 curve to the right vs
Decreasing the slope
What do opioids vs inhalationals do to the curve?
shifting right = higher co2 level is required to get the same ventilatory response
decreasing slope = you get less of a ventilatory response at a particular CO2 level
opioid - shift right
inhalational- shift right + decreased slope
1g of fully saturated hemoglobin can carry how many mls of o2?
1.34ml
T/F- the oxygen saturation tells you the actual oxygen content of the blood
FALSE
-it tells you how much o2 is bound to hgb ? maybe? lol I should know this
What PFT measures air flow through the medium-sized airways?
FEF25%-75%
What is trachealmalacia?
weaking within the tracheal wall
Which conidition will exhibit a decreased peak expiratory flow rate ina flow-volume loop?
A> COPD
B> Sarcoidosis
C> Unilateral VC paralysis
D> Pulmonary fibrosis
A> COPD
A patient is undergoing a pulmonary function test in which they are asked to inhale and exhale as deeply as possible for 15 seconds. The value is then extrapolated out to the volume produced in one minute. This test is known as the A. forced spirometric minute B. forced vital capacity C. forced expiratory volume D. maximum voluntary ventilation
D.
The termination of a large tidal volume breath by signals from stretch receptors within the lung tissue is a result of the A. Bainbridge reflex B. Vasovagal reflex C. Hering-Breuer reflex D. Moro reflex
C
The anatomic deadspace of an 80 kg patient would be approximately A. 80 mL B. 160 mL C. 320 mL D. 640 mL
B (2ml/kg)
Which lung function test involves the inhalation of a gas mixture containing carbon monoxide? A. Body plethysmography B. FEF 25-75 C. Inhalation challenge test D. Diffusion capacity
D
The carotid bodies are capable of sending messages to the central respiratory centers to increase ventilation via the A. glossopharyngeal nerve B. trochlear nerve C. hypoglossal nerve D. vagus nerve
A
Cover Girl, AV node
(Carotid, Glosso)
(Aortic, Vagus)
When oxygen binds with hemoglobin in the lungs, it promotes the release of carbon dioxide from the bloodstream. This is called the A. Oxyhemoglobin saturation effect B. Hering-Breuer effect C. Haldane effect D. Bohr effect
C
T/F- if jet ventilation is performed, the pt must have NMB on board
true
The interincisior distance should be atleast ___cm or ___fbs
4cm or 3FB
A neck circumfrance > ___cm should raise awareness for potential difficult DL
43cm
T/F: The most common reason for suboptimal ventilation & oxygenation is a poor mask-fit.
True
What is the single most significant risk factor for difficult mask ventilation
Presence of a beard
What is the first step in any airway algorithm?
The phsyical assesment of a patient and their airway
What is croup?
airway edema and inflammation BELOW the level of the cords
laryngotracheobronchitis
What does an oral RAE stand for?
Ring-Adair-Elwyn
How many huge breaths should a patient take prior to going off to sleep?
4 @ 100% o2 in 30 second period
What is the most common cause of suboptimal preoxygenation?
inadequate mask seal
What is the best way to preoxygenate a patient who complians of claustophobia during the preoxygenation phase?
have the patient hold the mask in place
Objective extubation criterea:
- VC of at least ___ml/kg
- neg insp. pressure of at least _______
- __sec sustained head lift
- Sustained tetany
- TOFR > ______
- TV > _____ml/kg
- VC at least 10ml/kg
- neg insp pressure of at least -20cm H20
- 5 second sustained headlift
- sustained tetany
- TOF ratio > 0.7
- TV >6ml/kg
An LMAM will leak when the airway pressure exceeds what?
20cm H20
Normal HcO3
22-28
The kidneys are responsible for controlling how much bicarbonate is screted through the _________.
proximal tubule
What equation expresses the relationship between pH, CO2 and HCO3?
Henderson=Hasselbalch
in the Henderson hasselbalch equation, what does 6.1 express?
what about 0.03
the pKa of carbonic acid
0.03 is the solubility coefficient of CO2
*what disorder has the highest risk of precipitating ARDS?
Sepsis
> bacterial pna
trauma
aspiration pneumonitis
What is status asthmaticus
life-threatening bronchospasm that is unresponsive to treatment
How does aminophylline treat bronchospasm
-it’s a PDE inhibitor
>inhibits breakdown of cAMP
>increases diaphragmatic contractility
>causes bronchodilation
T/F- H2 blockers such as cimetidine and ranitidine are helpful in asthmatic patients
False- reports of bronchospasm
639: What pathogen is responsible for the development of epiglottitis?
Haemophilus influenzae type B
The most common presenting signs include sudden onset of fever, dysphagia, drooling, voice changes, and a preference for a seated position with the chest leaned forward and the head extended.
Epiglottitis
What age group is most affected by epiglotttis
6-12yo
DVT’s most commonly originate from veins in which regions of the body?
90% of them originate in the iliofemoral vessels
What are the three components of Virchow’s triad?
Virchow’s triad is a set of three factors that predict a high risk for pulmonary embolism. It includes: hypercoagulability, venous stasis, and vessel wall abnormalities.
What are the three components of Virchow’s triad?
Tachycardia 2. Decrease in ETCO2
Which is the normal FEV1 value in a pulmonary function test?
The FEV1 is typically equal to or greater than 75 percent of the FVC. (FEV1/FVC > 0.75)
