respiratory Flashcards
shunt vs dead space
shunt is air passing through lungs without participating in gas exchange
dead space is is volume of gas not participating in gas exchange due to ventilation without perfusion
what is oxygen hemoglobin disassociation curve
shows percent saturation of hemoglobin at various partial pressures of oxygen.
which way does curve shift in alkalosis?
left
which way does the curve go in acidosis
right
in acidosis, does hemoglobin have higher or lower affinity for O2?
lower
in acidosis, does hemoglobin have higher or lower affinity for O2?
lower
In alkalosis, does hemoglobin have higher or lower affinity for O2
higher
Bohr effect
in acidosis state, hemoglobin has lower affinity for O2 resulting in dumping. causes curve to shift down and to the right.
in alkalosis, hemoglobin has higher affinity for O2 causing curve to shift up and to the left.
malignant hyperthermia
uncontrolled release of intracellular calcium in skeletal muscle
sustained muscle contractions
elevated ATP causes hypermetabolic state, Increased oxygen consumption and CO2 production
causes lactic acidosis, hyperthermia, hypertension, mottled cyanosis, arrhythmia
elevated potassium and magnesium
later AKI, DIC, liver failure, cerebral edema seizures
what is a normal tidal volume?
500cc
which parts of the brain controls breathing?
brain stem, medulla oblongata and pons
what is dead space ventilation?
volume in airways and lungs that does not participate in gas exchange
what is mechanical dead space
artificial airways and ventilator circuits
how much space does physiological dead space account for?
alveolar and anotomic dead space accounts for approx 30% of total ventilation
2 main atmospheric gases of volume of air
nitrogen 78%
oxygen 21% = 760mmHg at sea level
What is the ventilation/perfusion ratio
V= ventilation, air reaching alveoli
Q= perfusion, blood that reaches alveoli
together determine blood oxygen concentration
V/Q= alveolar ventilation/cardiac output
how does CPAP effect preload and afterload
CPAP increases intrathoracic pressure, which decreases systemic venous return to RV, which decreases preload.
Also, decreases afterload by altering pulmonary venous pressure.
,
what is most common cause of pleural effusion?
pneumonia
which imaging technique is commonly used diagnose pleural effusion?
ultrasound
transudative pleural effusion is often associated with:
heart failure
exudatvie pleural effusion can be caused by:
a) cirrhosis of the liver
b) vitamin deficiency
c)allergic reactions
d) hypothyroidism
cirrhosis of the liver
which of tye following is a potential complication of untreated pleural effusion
a) diabetes
b)htn
c) rheumatoid arthritis
d) PE
PE
which of the following is NOT a common mode of transmission of pneumonia
a) airborne droplets
b) direct contact
c) contaminated surfaces
d) coughing and sneezing
b) direct physical contact
what is the key difference between cardiogenic and non-cardiogenic pulmonary edema?
a) origin of fluid accumulation
b) response to antibiotics
c) onset duration
d) presence of fever
a) origin of accumulation
which of the following assessment findings indicates most improvement in a patient with pulmonary edema?
a) increased urine output
b) cyanosis worsening
c) deceased HR
D) decreased BP
a) increased urine output
what class of medications is commonly given to reduce preload and afterload in pulmonary edema?
a) ACE inhibitors
b) diuretics
c beta blockers
d) CCBs
b) diuretics
Define ARDS
stiffening of the lung parenchyma secondary to insult to the lungs. Leads to difficulty with lung inflation, ventilation and oxygenation
