RESP Flashcards
Hyperventilation
Seen In (5), Subtype, Conseq?
SEEN IN:
- Hypoxemia
- PE
- Tumor
- Salicylates
- Hysteria
Kussmaul Respirations: Deep labored breathing.
Seen in DKA.
CONSEQ =↓PCO2 -> Resp Alkalosis
Ventilation
Mech of Defect, MC Defect, Pres of Defect?
MECH OF DEFECT:
↓vent to alveoli, however perfusion still present ->
Intrapulm SHUNT
MC DEFECT = RDS
PRES = Hypoxemic p/t given 100% O2 for 20 mins and NO↑in PO2
Hypoventilation
Seen In (8), Conseq?
SEEN IN:
- Lung collapse
- Airway obstruction
- Acute or Chronic Lung Disease
- ALS
- Guillain-Barre Sx
- Drugs that depress Resp Center: Sedatives, Narcotics, Opioids
- Broken ribs
- Weakening of diaphragm + other resp muscles
CONSEQ =↑PCO2 > 40 mmHg -> Resp Acidosis
Cheyne-Stokes Respirations
Def’n, Seen In (2)?
Oscillating slow/fast breathing.
SEEN IN:
- ↑ICP
- Central Apnea in CHF
Perfusion
Mech of Defect, MC Defect, Pres of Defect?
MECH OF DEFECT:
↓blood flow -> ↑Dead Space
MC DEFECT = Pulmonary Embolus
PRES = Hypoxemic p/t given 100% O2 for 20 mins and PO2 does ↑.
V / Q Ratio #1
Def’n?
- > 0 in? Result of 100% O2?
- > 1 in?
- > ∞ in? Result of 100% O2?
Alveolar Ventilation (V) / Pulm Blood Flow (Q).
Ideally, V and Q are matched for adequate gas exchange.
*** ↑V/Q = ↑Gas Exchange.
V/Q approaching 0 or ∞ = NO gas exch.***
V/Q -> 0 in AIRWAY (V) obstruction = R-to-L Shunt.
100% O2 does NOT ↑PO2.
V/Q -> 1 in ↑CO / exercise (dilation of apical capillaries)
V/Q -> ∞ in BLOOD FLOW (Q) obstruction = Dead Space
(eg embolism occluding Pulm art).
100% O2 ↑PO2
V / Q Ratio #2
Mismatch Causes (2)?
MISMATCH CAUSES:
- R-to-L Shunt (airway obstruction)
- Dead Space (blood flow / bl vessel leading to lung obstruction, eg embolism occluding Pulm art)
Diffusion
Mech of Defect, Eg of Defects (3)?
MECH OF DEFECT:
Something in interface that O2 can’t get through.
- Fibrosis (ie Sarcoidosis)
- Fluid in HF
- Pulmonary Edema
Cyanosis
Def’n, Causes (2)?
↓O2 Sat.
CAUSES:
- CO Poisoning
- Hb Modifications
Hypoxia #1
Def’n, Causes (5, incl 4 Hb problems)?
↓O2 Delivery to tis = inadequate oxygenation of tis.
CAUSES:
- Ischemia (1st MCC)
- Hypoxemia (2nd MCC)
- ↓CO
- Hb problems
- Anemia (↓Hb)
- CO Poisoning (CO has higher affinity for Hb than O2 does)
- Cyanide Poisoning
- Methemoglobinemia (O2 can't bind to heme groups b/c they're
Fe3+)
- Oxidative Pathway problem
- Uncoupling
* Hypoxia causes vasodilation in all organs of body EXCEPT lungs,
where it causes VASOCONSTRICTION.*
(Important physiologically as it directs blood away from hypoxic / poorly ventilated regions and towards well ventilated regions.)
Pulm vasoconstriction ->↑PVR ->
↑work of R heart against higher resistance -> RV Hypertrophy.
Hypoxia #2
Conseq (2 Categories: 2 in 1st)?
CONSEQ:
- ↓ATP -> Body forced into Anaerobic Glycolysis (-> lactic a)
- > Denaturing of cell proteins + enzymes =>
- > Cells can no longer autodigest =>
- > Coagulation Necrosis
- > ATP pumps screwed up
- Na/K Pump: Na + H20 into cells -> cell swelling
- Ca Pump: Ca into cells -> cell damage - ↑EPO release -> ↑Erythrocytosis
Hypoxemia #1
Def’n, Causes (2 Categories: 3 in each)?
↓arterial PO2.
CAUSES:
- Hypoxemia due to INTRApulmonary problem: ↑A-a gradient
- Diffusion defect
- Perfusion defect
- V/Q mismatch
- Hypoxemia due to EXTRApulmonary problem: Normal A-a gradient
- Ventilation defect
- High altitude
- Resp Acidosis
Hypoxemia #2
RX, Comp (2)?
RX:
- Acetazolamide
COMP:
- Risk of PDA
- Necrotizing Enterocolitis
Ischemia
Def’n, Causes (3)?
↓in arterial bl flow.
CAUSES:
- Impeded arterial flow, ie thrombus in muscular artery (1st MCC)
- ↓CO
- ↓venous drainage
O2 Content of blood
Formula,↑Seen In,↓Seen In (2)?
O2 Content: (Hb x O2 Sat) + PaO2
↑SEEN IN:
- Polycythemia
↓SEEN IN:
- CO Poisoning
- Anemia
