Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

SEE Exam Review > Respiratory > Flashcards

Respiratory Flashcards

1
Q

What does a larger larynx correlate with?

A

Deeper Voice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

The Larynx is at what level?

A

C4-6 in most people

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Most superior region of the larynx?

A

Epiglottis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

The epiglottis is attached to what?

A

Hyoid bone
Inferior portion of the pharynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are the functions of the larynx?

A

Phonation
Respiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Name the cartilages of the larynx?

A

Epiglottis (1)
Cricoid (1)
Thyroid membrane (1)

Arytenoids (2)
Cornicate (2)
Cuneiform (2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does the thyroid membrane attach to

A

Superior Horns – attach to the hyoid bone by the lateral thyroid ligamament

Inferior horns – attach to the cricoid ligament through the cricothyroid ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What do the arytenoids do?

A

Abduct and Adduct the vocal cords

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What muscle forms the bulk of the vocal folds?

A

Vocalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What do the lateral cricoarytenoids do?

A

Adduct the vocal cords (close)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What do the posterior cricoarytenoids do?

A

Abduct the vocal cords (open)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does the cricothyroid do?

A

Tenses the vocal cords (creates pitch)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does the thyroarytenoid do?

A

Relaxes the vocal cords

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the motor innervation of the larynx?

A

Vagus nerve

Cricothyroid = External superior laryngeal branch
Everything else = Recurrent laryngeal branch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the sensory innervation of the larynx above the vocal cords?

A

Internal Superior Laryngeal Nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the sensory innervation of the larynx below the vocal cords

A

Recurrent Laryngeal NerveW

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the s/sx of injury to one side of the superior laryngeal nerve?

A

Hoarseness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What happens I future is damage to one side of the superior laryngeal nerve?

A

Voice will be affected because the vocal cord cannot stretched/tensed

can also affect gag reflex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What happens if there is damage to bilateral sides of the recurrent laryngeal nerves/

A

Respiratory compromise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What nerve innervates the motor to the pharynx?

A

Spinal accessory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What nerve innervates the pharynx to the sensory

A

glossopharyngeal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the normal P50 on the oxyhemoglobin dissociation curve?

A

26-27 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

When the oxyhemoglobin dissociation curve shifts to the left, what happens?

A

Decreased PaCO2
Decreased H+ ions
increased pH
Decreased Temperature
Decreased 2,3, DPG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What happens when the oxyhemoglobin curve shifts to the left?

A

Left shift increases the affinity of oxygen – locked on
Left = lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What causes the oxyhemoglobin dissociation curve to shift to the right?

A

Increased PaCO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What happens when the oxyhemoglobin curve shifts to the right?

A

Readily releases to the tissues from the blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What affects the oxyhemoglobin curve?

A

Bohr effect
Haldane effect
Hamburger effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How do the Haldane and Bohr effects affect the oxyhemoglobin curve?

A

Bohr effect helps the metabolizing tissues release oxygen from oxyhemoglobin (O2 dissociation curve)

Haldane effect helps the lungs release carbon dioxide from carboxyhemoglobin (CO2 dissociation curve)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

If your SaO2 is 90, what is your PaO2

A

60 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

If your SaO2 is 70%, what is your PaO2?

A

40 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the dissolved O2 equation?

A

0.003 x PaO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

O2 bound to Hbg equation

A

(1.34 x Hbg) (SaO2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the average total oxygen consumption per minute?

A

3-4 ml/kg/min OR around 250 ml/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is the equation for dissolved CO2

A

0.067xPaCo2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

How much (on average) Co2 is produced and eliminated per minute?

A

200 ml/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Where are the primary respiratory centers located?

A

In the medulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What are the primary respiratory centers?

A

Dorsal respiratory centers
Ventral respiratory centers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What do the dorsal respiratory centers control?

A

Phrenic and External intercostals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What does the ventral respiratory center control?

A

Internal Intercostal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What do the central chemoreceptors in the medulla respond to?

A

Increase H+
Increased PaCO2 in CSF
Decreased O2 <60 mmHg
Increased PaCo2
Increased H+ ions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Where are the perpipheral chemoreceptors located?

A

Cartoid – Glossopharyngeal nerve

Aortic – Vagus nerve (afferent)

Stretch receptors – vagus nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Where are the primary respiratory centers located?

A

in the pons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What are the secondary respiratory centers?

A

Apneustic Center
Pneumotaxic center

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is the apenustic center in control of?

A

Deep and prolonged respiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is the Pneumotaxic center in charge of?

A

Shutting off respiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What Principe is the partial pressure of Co2 in CSF based on?

A

LeChatelier’s Principle

a change in one variable that describes a system at equilibrium, produces a shift in the position of the equilibrium that counteracts the effect of this change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is an example of Lechatiler’s principle in anesthesia?

A

An increase in temperature will result in an increase in vapor pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Do pediatric patients have increased or decreased Pulmonary lung compliance? Chest wall compliance?

A

Decreased pulmonary lung compliance due to number of alveoli

Increased chest wall compliance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Do geriatrics have increased or decreased pulmonary lung compliance? Chest wall compliance?

A

Increased pulmonary lung compliance

Decreased chest wall compliance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is the normal V/Q Matching?

A

4/5 = 80%

MV/CO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

If your V/Q is 10/0, what does this mean?

A

Infinity

indicates dead space
complete ventilation, but no perfusion
Well ventilated, no perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

If your V/Q is 0/10, what does this mean?

A

0

Shunt

No ventilation, complete perfusion
Well Perfused, no ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What is physiologic deadspace?

A

Anatomic headspace and alveolar headspace

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What is anatomic Dead space?

A

conducting air passages + ETT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What is alveolar deadspace?

A

ventilation without perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What increases deadspace?

A

Age
PP Vent
PE
Lugn disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What is the equation for minute ventilation?

A

TV x RR

58
Q

What is the equation for compliance?

A

Change in ventilation/ Change in perfusion

59
Q

In the un-anesthetized patient, how does the lateral position change the V/Q matching?

A

nondependent lung: Decreased ventilation and perfusion in the nondependent lung

dependent lung: increased ventilation and increased perfusion

60
Q

In the anesthetized patient, how does the V/Q matching change in the lateral decubitus position?

A

nondependent lung: increased ventilation, decreased perfusion

dependent lung: decreased ventilation and increased perfusion

61
Q

What is the minimum flow according to Jackson Reese circuit?

A

5L/min

62
Q

In the Bain circuit, what is the minimum flow?

A

70 ml/kg or 100-300 ml/kg for

63
Q

How do you determine the PaO2 off of an anesthesia machine?

A

FiO2 x 5

64
Q

How do you determine the PAO2 off of an anesthesia machine?

A

FiO2 x 6

65
Q

LABEL THE DIAGRAM

A

A: Inspiratory Reserve Volume
B. Tidal Volume
C. Forced Vital Capacity
D. Reserve Volume
E. Inspiratory Capacity
F. Expiratory Reserve Volume
G. Vital Capacity
H. Closing Volume
I. Total Lung Capacity

66
Q

What are some examples of Obstructive respiratory issues?

A

Asthma
COPD
Bronchitis
Emphysema

67
Q

What happens in Obstructive Lung diseases in their PFTs?

A

Decreased FEV1
Normal FVC

Decreased FEV1/FVC (<0.8)

HARD TO GET AIR OUT

68
Q

What are some normal PFT ratios?

A

FEV1 = 4L
FVC = 5L

FEV1/FVC = 0.8W

69
Q

What is the best test to assess early stages of COPD?

A

small airway diseases
FEV25-75
Normal: 4.7 L/second

70
Q

What happens in a restrictive lung disease pattern?

A

Hard to get air in
Decreased FEV1
Decreased FVC
Normal to high FEV1/FVC (because both are proportionately low)

71
Q

What are some examples of airway diseases that are restrictive in nature?

A

Pulmonary Fibrosis
Pneumothorax
Scoliosis

72
Q

What are some red flags on a PFT to that the patient may be moderate risk?

A

FEV1 <2L
FEV1/FRC <50%

MORE TESTS NEEDED, should postpone to determine best plan

73
Q

What are some red flags in PFTs that the patient is HIGH risk?

A

FEV1 <1
FVC <1.5L or 20 ml/kg
FEV1/FVC <35%

74
Q

What is hyperbaric O2 used to treat?

A

CO2 poisoning
Gas embolism
Anaerobic respirations (gas gangrene)
Decompression sickness (bends)

75
Q

What are the 4 ways that CO2 is carried in blood?

A

Physically dissolved
Bicarbonate ions
Carbonic Acid
Protein Bound

76
Q

CO2 is ________ more soluble than O2

A

20x

77
Q

How much Co2 is produced per minute?

A

200 ml/min or 2.4-3.2 ml/kg/min

78
Q

What is the Total Co2 content of arterial blood?

A

48 ml co2/100 ml blood

79
Q

what is the total co2 content of venous blood?

A

52 ml co2/100 ml blood

80
Q

What is the normal CO2 arterial-venous difference?

A

4 ml co2/100 ml

81
Q

What is responsible for converting CO2 to HCO2

A

Carbonic Anhydrase

82
Q

What receptors respond to H+ ions in the CSF?

A

Central chemoreceptors

83
Q

What receptors respond to increased H+, Increased CO2 and increased HCO3 in blood?

A

Peripheral receptors

84
Q

What is the primary stimulus for ventilatory response?

A

PaCO2

85
Q

What cause bronchoconstriction through histamine release?

A

mast cells

86
Q

What are the six anatomical characteristics of a difficult intubation?

A

Short muscular neck
Protruding maxillary incisors
Limited TMJ joint <40 mm
Limited cervical neck mobility
Receeding mandible
Unable to visualize uvula

87
Q

What are the five contraindications to fiberoptic intubation

A

Hypoxia
Heavy Airway secretions
Bleeding not relieved with suctioning
LA allergy
Inability to cooperate

88
Q

What is COPD?

A

Peranment dilation of the bronchus or group of small bronchi
airway resistance increases
compliance increases

89
Q

How does a person with COPD breathe?

A

large tidal volumes
slow inspiratory flow rate
slow respiratory rate

90
Q

What does bronchitis look like?

A

copious secretioons
increased Hct
larger individuals
“Blue bloaters”

91
Q

What does emphysema look like?

A

coughing with exertion
scant sputum
smaller people
“Pink puffers”

92
Q

What are the two most common reasons for pulmonary edema?

A

Increased in pulmonary hydrostatic pressure
Increase in permeability of alveolar-capillary membrane

93
Q

What is the normal colloid osmotic pressure?

A

28W

94
Q

hat is the normal hydrostatic pressure?

A

6-8 mmHg

95
Q

What does ARDS do to the oxyhemoglobin curve?

A

Right to left shunt

96
Q

What are the causes of ARDS?

A

Shock
Fat or air emboli
Aspiration
Burns
Sepsis
Trauma
Drug ingestion
Uremia
Pancreatitis
Massive blood transfusion
Head injury
CPB
Radiation of thorax
Drowning

97
Q

What is the number one manifestation of ARDS?

A

Hypoxia

98
Q

What are the five types of hypoxia?

A

Hypoxic Hypoxia (diffusional)
Anemic hypoxia (Decreased Hbg)
Secondary venous to arterial cardiac shunt
histotoxic hypoxia
hypoxia related to pulmonary disease

99
Q

What is the number one histotoxic poisoning?

A

Cyanide poisoning (#1)
Toxicity
Vitamin poisoning

100
Q

What are the s/sx of aspiration?

A

Wheezing
Coughing
Cyanosis
Pulmonary edema
Shock
Hypoxemia

101
Q

What is the earliest and most reliable sign of aspiration?

A

hypoxemia

102
Q

What increases your risk of aspiration (gastric symptoms)?

A

pH <2.5
Gastric volume >25 ml

103
Q

What are the four causes of pulmonary restrictive disease?

A

acute intrinsic restrictive lung disease
chronic intrinsic restrictive lung diseases
chronic extrinsic lung diseases
disorders of the pleura or mediastinum

104
Q

What are some examples of acute intrinsic restrictive lung diseases?

A

ARDS
Aspiration
CHF

105
Q

What are some examples of chronic intrinsic restrictive lung diseases

A

Sarcoidosis
Drug induced

106
Q

What are some examples of chronic extrinsic restrictive lung diseases

A

obesity
ascites
pregnant

107
Q

What is sarcoidosis?

A

intrinsic lung disease – restrictive
restrictive cardiomyopathy

108
Q

what does sarcoidosis result in?

A

increased calcium levels
Splenomegaly
Hepatic granulomas
Optic and facial nerve involvement

109
Q

What are some s/sx of tension pneumothorax?

A

hypotension
hypoxemia
tachycardia

increased CVP
increased PIP
Absence of unilateral breath sounds
tracheal shifts
asymmetric chest wall movement

110
Q

How do you perform transtracheal jet ventilation?

A

through the cricothyroid membrane

111
Q

what are the complications of transtracheal jet ventilation

A

barotrauma
pneumothorax
mediastinal air (emphysema)
arterial perforation
Damage to tracheal mucosa
SQ emphysema
Exhalation difficulty
Esophageal puncture
Thickened secretions

112
Q

What are the spontaneous ventilation modes?

A

IMV
SIMV
MMV
PSV
HFJV

113
Q

What ventilation modes do not support spontaneous ventilation?

A

CMV
AC
PCV

114
Q

What is aminophylline?

A

phosphodiesterase inhibitor (PDE III)

When phosphodiesterase is inhibited:
- cAMP accumulates and bronchodilation occurs
- Also improves diaphragmatic contractility
- Xanthines cause the release of NE from sympathetic postganglionic neurons

115
Q

What does phosphodiesterase do?

A

breaks down cAMP

116
Q

What do you want to avoid with phosphodiesterase inhibitors?

A

Halothane
Adenosine

117
Q

What are some examples of methylated xanthines?

A

Caffeine
Theophylline

118
Q

What does Beta 2 receptor stimulation do?

A

activates adenylyl cyclase –> converts ATP to cAMP

Causes bronchodilation

119
Q

What is cromolyn sodium?

A

mast cell stabilizer that prevents the release of histamine and bradykinin

prevents bronchospasm in asthmatics

120
Q

what is cromolyn sodium not effective in

A

treating a bronchospasm once it develops – it is a chronic drug

121
Q

What is ipratroprium?

A

quaternary ammonium compound
antimuscarininc used to augment bronchodilation produced by B2 agonists

122
Q

what does blockade of muscarinic receptors lead to?

A

decrease of IP
Less calcium is released from intracellular vesicles

Smooth muscle tone is reduced

123
Q

What is doxapram?

A

non-xanthine central respiratory stimulant
increases tidal volumes and (smaller extent) RR

124
Q

How does doxapram work?

A

through peripheral chemoreceptors to stimulate the central chemoreceptors

125
Q

Who is doxapram not good for?

A

newborns because it is dissolved in benzyl alcohol

126
Q

How do you decide the ETT size for a child?

A

Age/4 +4 (uncuffed)

-0.5 (cuffed)

127
Q

How do you determine the length of an ETT from a child?

A

12+ age/2

128
Q

For a child <6.5 kg, what sized LMA, cuff volume, ETT and FOB do they need?

A

LMA 1
Cuff volume 4cc
ETT 3.5
FOB 2.7

129
Q

For a child <20 kg, what sized LMA, cuff volume, ETT and FOB do they need?

A

LMA 2
Cuff Volume 10 cc

ETT 4.5
FOB 3.5

130
Q

For a child 20-30 kg, what sized LMA, cuff volume, ETT and FOB do they need?

A

LMA 2.5
Cuff volume 14cc

ETT 5.0
FOB 4.0

131
Q

For a child >30 kg, what sized LMA, cuff volume, ETT and FOB do they need?

A

LMA 3, cuff volume 20 cc

ETT 6.0
FOB 5.0

132
Q

For a normal adult (kg), what sized LMA, cuff volume, ETT and FOB do they need?

A

LMA 4, cuff volume 30 cc

ETT 6.0
FOB 5.0

133
Q

For a large adult (kg), what sized LMA, cuff volume, ETT and FOB do they need?

A

LMA 5, cuff volume 40 cc

ETT 7.0
FOB 5.0

134
Q

For a larger adult (kg), what sized LMA, cuff volume, ETT and FOB do they need?

A

LMA 6, cuff volume 50 cc

ETT 7.0
FOB 5.0

135
Q

What are normal sterilization temperatures?

A

275F
135C

136
Q

What do you need to do if your patient experiences aspiration or regurgitation?

A

Head Down (#1)
Disconnect circuit
Suction
Examine with bronchoscope
Xray
Abx (debatable)
physiotherapy

137
Q

What are the differences in neonatal respiratory systems?

A

decreased lung compliance (less alveoli)
increased chest wall compliance (floppy ribs)
Decreased FRC (around 30 ml/kg)
Increased O2 consumption

138
Q

What is the average O2 consumption in a neonate?

A

7 ml/kg/min

139
Q

What is the average O2 consumption for an adult?

A

3.5 ml/kg/min

140
Q

What is the average thyrometnal distance?

A

3 fingerbreadths
>6.5cm

SEE Exam Review (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions