Pulmonary

Question 1

Def Ventilation

Answer 1

Process of moving air into and out of the lungs. e.g mucus plug

Question 2

Def Diffusion

Answer 2

Process of gas molecules passing from an area of high concentration to one of lower concentration. e.g flash pulmonary edema makes diffusion difficult.

Question 3

Def Perfusion

Answer 3

Proccess of transporting gases to the body (capillary) via the circulatory system. e.g PE

Question 4

ABG normal values. PaO2, pH, PaCO2, HCO3, SaO2, Base Excess

Answer 4

PaO2: 80-100mmHg
pH 7.35-7.45
PaCO2 35-45 mmHg
HCO3 22-26
SaO2 >95%
Base +/- 2

Question 5

What is a normal SVO2 gas?

Answer 5

60-80%

Question 6

How can you tell how much O2 was extracted?

Answer 6

SaO2- SvO2 = extracted/used O2.
Normal extraction is 25%. Low SVO2 means higher demand.

Question 7

Acute RF def

Answer 7

Failure of pulmonary system to provide adequate oxygenation or ventilation. Sudden drop in PaO2 or elevation in PaCO2

Question 8

Def of Restrictive Lung Disorders

Answer 8

Pulmonary disorders that restrict the lungs from expanding. Lung compliance and volumes are decreased. eg pna, TB, lung abscess

Question 9

Def ARDS

Answer 9

ARDS is a syndrome, not disease. Group of physical manifestations that are primarily pulmonary, and result from lung injury that is then followed by inflammation.

Question 10

PaO2/Fio2 Equation

Answer 10

PaO2 86
FiO2 21%
86/.21=409

Question 11

mild, mod and severe are levels of ARDs severity. What are the numbers?

Answer 11

Severe <100
Mods <200
Mild <300

Question 12

What are treatment options for ARDS?

Answer 12

Keep pt oxygenated and alive until lung heals. Some patients never get off the vent.

Question 13

How to increased V/Q matching with positioning?

Answer 13

Good lung down.
Ventilation/ Perfusion

Question 14

Def of Obstructive Lung Disorders?

Answer 14

Airway obstruction and gas trappings are the main problem. e.g COPD, ephysema, asthma

Question 15

Def cor pulmonale

Answer 15

R heart failure

Question 16

Why is O2 treatment questionable in COPD patients?

Answer 16

Increased O2 means increased CO2

Question 17

What does COPD look like on chest xray?

Answer 17

flatten diaphragm, decreased vascular markings.

COPDers require more kcal, and typically can’t even eat that much

Question 18

Pulmonary emboli def

Answer 18

Occlusion in the pulmonary arterial circulation, blocking flow to a region of the lung and creates dead space ventilation.

Question 19

What’s Virchow’s Triad?

Answer 19

1. Venous stasis
2. Hypercoagulability
   3.Vascular wall Damage

Question 20

What does an ABG look like one someone with a PE?

Answer 20

Hypoxemia with respiratory alkalosis. CO2 is blown off, lack of V/Q makes uptake of O2 difficult

Question 21

Normal PaO2 levels?

Answer 21

80-100mmhg

Question 22

Gold test to find PE?

Answer 22

Pulmonary angiogram.

Question 23

Pg 201 on chest contusion skipped

Answer 23

…

Question 24

Where in the brain ins expressive aphasia (brocca’s) located?

Answer 24

Dominant frontal lobe

Question 25

Where in the brain is the lobe responsible for receptive aphasia (wernicke’s)

Answer 25

temporal lobe

Question 26

Cranial nerve 6 does what?

Answer 26

Abducens, moves eyes laterally outwards

Question 27

Cranial nerve does what?

Answer 27

Oculomotor, eye moves up and in, down and in

Question 28

** How does positive pressure ventilation affect BP/Stroke Volume and CO?

Answer 28

Positive pressure ventilation increases intrathoracic pressure. This increased pressure decreases venous return to the R side of the heart -> decreases BP.

Decreasing PEEP means lower intrathoracic pressure, and higher venous return and increased BP, stroke volume and CO.

Question 29

**What is RSBI and how is it calculated? It’s used to determine extubation success

Answer 29

Rapid Shallow Breathing Index = RR/ VT (L)

if RSBI<105, then pt has a higher chance of extubation success