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Acute > Pulmonary > Flashcards

Pulmonary Flashcards

1
Q

What is V/Q ratio? What should it be?

A

comparison of air that is passing through alveoli compared to blood flow

V - ventilation
Q - perfusion

normal is 0.8

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2
Q

What is V/Q mismatch?

A

insufficient air in alveoli or insufficient blood in blood flow

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3
Q

What is it called when there is excess air in the lungs? What might cause this to happen?

A

dead space

- occurs when there is a disruption of blood flow like a PE

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4
Q

What is used when there is an excess in perfusion compared to ventilation? What can cause this?

A

shunt

- lack of air flow (COPD, atelectasis)

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5
Q

What are primary inspiratory muscles?

A
  • diaphragm
  • external intercostals
    Accessory muscles - SCM, scalenes, pecs, traps
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6
Q

What are primary expiratory muscles?

A
  • rectus abdominus
  • external/internal obliques
  • internal intercostals
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7
Q

Apnea

- What causes it?

A

lack of airflow to the lungs for >15 seconds

- airway obstruction, cardiopulmonary arrest, narcotic overdose

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8
Q

Orthopnea

- What causes it?

A

Dyspnea that occurs in a flat supine position. Relief occurs with more upright sitting or standing
- Chronic lung disease, CHF

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9
Q

Bradypnea

- What causes it?

A

Ventilation rate <12 breaths per minute

- sedatives, narcotics, alcohol; neuro/metabolic disorders; fatigue

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10
Q

Tachypnea

- What causes it?

A

Ventilation rate >20 breaths per minute

- acute respiratory distress, fever, pain, emotions, anemia

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11
Q

Hyperpnea

- What causes it?

A

increased depth of ventilation

- activity, pulmonary infections, CHF

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12
Q

Hyperventilation

- What causes it?

A

Increased rate and depth of ventilation resulting in decreased PCO2
- anxiety, nervousness, metabolic acidosis

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13
Q

Hypoventilation

- What causes it?

A

Decreased rate and depth of ventilation resulting in increased PCO2
- sedation, neuro depression of respiratory centers, overmedication, metabolic alkalosis

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14
Q

Biot’s respiration

- What causes it?

A

Constant increased rate and depth of respiration followed by periods of apnea of varying lengths
- elevated intracranial pressure, meningitis

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15
Q

Cheyne-Stokes respirations

- What causes it?

A

Increasing depth of ventilation followed by a period of apnea
- elevated intracranial pressure, CHF, narcotic overdose

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16
Q

Kussmaul respirations

- What causes it?

A

Increased regular rate and depth of ventilation

- diabetic ketoacidosis, renal failure

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17
Q

Paradoxic ventilation

- What causes it?

A

Inward abdominal or chest wall movement w/ inspiration and outward movement w/ expiration
- diaphragm paralysis, ventilation muscle fatigue, chest wall trauma

18
Q

Sighing respirations

- What causes it?

A

the presence of a sigh > 2-3 times per minute

- angina, anxiety, dyspnea

19
Q

Hoover’s sign

- What causes it?

A

the inward motion of the lower rib cage during inhalation

- flattened diaphragm often related to decompensated or irreversible hyperinflation of the lungs

20
Q

Normal PaO2

A

> 80 mm Hg

21
Q

Normal PaCO2

A

35-45 mmHg

22
Q

Normal pH

A

7.35 - 7.45

23
Q

Normal HCO3

A

22-26 mEq/liter

24
Q

air trapping

A

retention of gas in lung as a result of partial or complete airway obstruction

25
Q

Bronchospasm

A

smooth muscle contraction of the bronchi and bronchiole walls resulting in a narrowing of the airway lumen

26
Q

Consolidation

A

transudate, exudate, or tissue replacing alveolar air

27
Q

Hyperinflation

A

over inflation of the lungs at resting volume as a result of air trapping

28
Q

Hypoxemia

A

a low level of O2 in the blood, usually PaO2 < 60-80 mmHg

29
Q

Hypoxia

A

low level of O2 in the tissue available for cell metabolism

30
Q

Respiratory distress

A

acute onset of dyspnea, respiratory muscle fatigue, abnormal respiratory pattern and rate, anxiety, and cyanosis related to inadequate gas exchange, the clinical presentation that usually precedes respiratory failure

31
Q

flail chest

A

blunt force trauma w/ rib fracture (2 or more), destabilizes the chest

32
Q

wheeze sound during breath means what?

A

airway obstruction, more common on expiration

33
Q

stridor sound during breath means what?

A

high-pitched wheeze, inspiration and expiration

34
Q

Rhonchi sound during breath means what?

A

low-pitched from airway obstruction

- sounds like someone snoring

35
Q

crackle sounds during breath means what?

A

bubbling, popping sounds from fluid/secretions or sudden opening of closed airway
- aka rails

36
Q

what is mediate percussion?

A

evaluates tissue densities within thoracic cage

- tapping of distal fingers on back

37
Q

goals for pulmonary rehab

A
  • Promoting independent functional mobility
  • Maximizing gas exchange
  • Increasing aerobic capacity
  • Increasing respiratory muscle endurance
  • Patient education about condition
38
Q

What position facilitates improved aeration to dorsal lung segments, improved V/Q matching, secretion drainage?

A

prone positioning

39
Q

What could be wrong if bronchial sounds are heard in areas where vesicular sounds should be heard?

A

fluid or secretion consolidation

- pneumonia

40
Q

What could be wrong if there is decreased or diminished vesicular sounds?

A

hypoventilation, severe congestion, or emphysema

41
Q

What could be wrong if there are no lung sounds?

A

pneumothorax or lung collapse

42
Q

hemoptysis vs hematemesis

A

hemoptysis - blood coughing from lungs

hematemesis - blood coughing from stomach

Acute (14 decks)

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