respiratory Flashcards
what is diffusion
O2 and CO2 movement between alveoli and blood
what is perfusion
circulation of blood through an area of the body
what Is the chemical make up of blood
pH, CO2, O2
what controls ventilation
autonomic
what is an example of voluntary ventilation
breathing exercises
holding your breath is an example of
voluntary and involuntary; holds breath is involuntary, begin breathing again is voluntary
factors affecting ventilation
age, gender, metabolic, stress, medication, environment
respiratory structures
upper airway, lower airway, thoracic cavity
the upper airway is composed of
nose, pharynx, larynx, traches
the lower airway is composed of
right lung and left lung; right has 3 lobes, left has 2 (heart of left)
thoracic cavity composed of
rib cage, muscles, diaphragm
questions to ask about respiratory assessment
allergies, family history (lung cancer, tuberculosis, COPD, asthma, emphysema), persistent cough, sputum, fatigue, chest pain, OSB, activity intolerance, smoking
what to inspect on respiratory assessment
shape/symmetry of chest (barrel chest), breathing rate, depth of respirations, effort of breathing, oxygen supply(room air)
what do you palpate on respiratory assessment
chest excursion, vocal/tactile fremitus, lumps, massess, tenderness
how to assess chest excursion
posterior, hands spread thumbs touching, have take deep breath and thumbs should separate
how to assess tactile fremitus
posterior, hands on right and left lobes, have pt say 99, feel. for vibrations on upper, middle and lower lobes
what do you auscultate for respiratory assessment
assess air movement thru tracheobronical tree, breath sounds
what are the four general types of breath sounds
bronchial, bronchovesicular, vesicular, adventitious
how do you listen to breath sounds, where
compare lungs from side to side; anterior 5, posterior 9
what are adventitious sounds
crackles, rhonchi, wheezes, plural friction rub, stridor
abnormal lung sound causes
fluid, mucus, narrowed or obstructed airways, alveolar collapse, inflammation of pleural lining
what are the different crackle sounds and the cause
fine and course due to fluid in lungs, commonly in lower lobes
what do fine crackles sound like
high pitched, heard at end of inspiration
what do coarse crackles sound like
louder, bubbly sounds during inspiration
what are rhonchi sounds and the cause
low, low pitched, rumbling sounds; secondary to mucus/fluid in larger airways; may be cleared with coughing
what are wheezing sounds and the cause
high pitched, continuous musical sounds, squeaking; caused by high velocity airflow thru narrowed airways
what are stridor sounds and cause
harsh honking wheeze with severe bronchospasm, air passing thru very constricted airway; secondary to croup o r a swallowed object caught in airway
what are pleural friction rub sounds and cause
dry, grating sound, heard on inspiration, heard over lateral anterior lung; secondary to inflamed pleura(parietal rubbing visceral)
examples of abnormal respiration conditions
pneumothorax, atelectasis, subcutaneous emphysema
what is pneumothorax
air or gas in pleural cavity, result of puncture thru chest wall; causes collapse of lung requiring reinflation via chest tube
what is atelectasis
collapse or incomplete ling expansion; result of mucus, hypoventilation of alveoli or compression by tumors/ enlarged lymph nodes
what is subcutaneous emphysema
leak of air from lung tissue into subcutaneous tissue
what patients are at risk for subcutaneous emphysema
post-op thoracic surgeries and blunt trauma patients
examples of abnormal breathing patterns
kussmaul’s respirations, cheyne-stokes respirations, biots respiration
what are kussmuals respirations
type of hyperventilation; exaggerated deep, regular, rapid breathing; normal with exercise; may be present with aspirin overdose (pain, fever, cardiac disease)
what are cheyne-stokes respirations
alternating periods of deep, rapid breathing followed with periods of apnea; associated with end of life
what are biots respirations
irregular pattern of shallow respirations followed by periods of apnea; associated with intracranial pressure and respiratory compromise
