Respiratory Flashcards
the thorax has a natural tendency to _________ volume - opposed by forces of the lungs with a tenency to _________ volume
increase, decrease
volume at the end of exhalation
FRC (functional residual capacity)
with an increased compliance, lungs are (more/less) easily stretched
more
with a decreased compliance, lungs are (more/less) easily stretched
less
exhalation flow depends on _______
lung volume
varying resistance on inhalation compared to exhalation gives us the ______________ (flow/volume curve)
hysteresis loop
airway resistance progressively (increases/decreases) with reducing lung volumes
increases
as exhalation is forced, resistance __________ due to the external compression of the airways
increases
at lung volumes less than ___% of vital capacity, maximum expiratory flow is constant and independent of effort (more effort –> more resistance –> same flow)
80
most common site for drawing arterial blood:
radial artery
normal partial pressure of arterial oxygen: PaO2 = ___mmHg
80-100
normal oxygen saturation of arterial hemoglobin: SaO2 = ___%
> 90
normal blood hemoglobin content: Hgb = ___g/dL
12/16/2012
normal partial pressure of arterial carbon dioxide: PaCO2 = ___mmHg
35-45
neutral measure of acidity/alkalinity: pH = __
7
a pH of >7 = _______
alkaline
a pH of <7 = _______
acidic
normal bicarbonate ion concentration: HCO3- = ___mmol/L
22-26
indicator of total blood alkali content/deficit: BE = ___
+/- 2
PaO2% can be affected by:
pH, PaCO2, temperature
ABG’s that tell us oxygen carrying function:
PaO2, SaO2, Hgb
ABG’s that tell us ventilation:
PaCO2
ABG’s that tell us the acid-base balance:
pH, HCO3-, Base Excess
Low PaO2 is known as ___________ (<___mmHg)
hypoxemia, 80
hypoxemia is usually related to a ___________ impairment or __________
diffusion, hypoventilation
PaO2 can be chronically low in patients with ______
COPD
True/False: PaO2 and SaO2 are directly related
FALSE
measure of O2-carrying capacity of the blood
Hgb
Ventilation is determined by ______ (“ventilation limited”)
PaCO2
Hypoventilation –> PaCO2 > ____mmHg (_____________)
45, hypercapnia
Hyperventilation –> PaCO2 < ____mmHg (_____________)
35, hypocapnia
if you have low O2 and normal CO2, you can assume that the low O2 is caused by a _____________ impairment and not alveolar _____________
diffusion, hypoventilation
low O2 with high CO2 = ______________
hypoventilation
pH < 7.35 leads to _________; depression of the CNS, disorientation, coma
acidosis
pH >7.45 leads to ___________; hyperexcitability of the nervous system, tetany, convulsions, seizures
alkalosis
acids when readily release H+ ions and completely/quickly ionize can be said to be _________ acids
strong
acids which do not dissociate completely can be said to be __________ acids
weak
a compound capable of accepting H+ ions
base
a compound that will absorb/take up H+ ions
buffer
CO2 in blood = _________ acid
carbonic
Hypoventilation leads to ____________, _____________, ______________ in the respiratory mechanism of acid/base regulation
increased PaCO2, increased acidity, decreased pH
Hyperventilation leads to _____________, _____________, ______________ in the respiratory mechanism of acid/base regulation
decreased PaCO2, decreased acid, increased pH
Changes in the respiratory mechanism of acid/base regulaton occur (rapidly/slowly)
rapidly
the metabolic mechanism of acid/base regulation is primarily controlled by which organ?
Kidneys
the kidneys excrete ______ to control acid/base balance
bicarbonate
Changes in the metabolic mechanism of acid/base regulation occur (rapidly/slowly)
slowly
renal failure, causing metabolic alkalosis will cause ___________
hypoventilation
a person with COPD/hypercapnia will have chronically elevated ______ levels; this is compensated with renal retention of _______ to show a normal pH
PaCO2, bicarbonate
Chronic lung disorder characterized by dilation of the terminal airways
Emphysema
Emphysema type A:
Panacinar/panlobular
Emphysema type B:
Centrilobular/centriacinar
type of emphysema which affects the alveoli, is distributed throughout the lungs, and causes breakdown of the alveolar walls leading to loss of surface area for air exchange:
A
type of emphysema which affects the respiratory bronchioles, is distributed in the upper lobes, and is usually a progression of chronic bronchitis:
B
Hyperlucency of the lungs appear on x-rays from type __ emphysema patients
A
Barrel chest deformity is consistent with type __ ephysema patients
A
Dry cough, increased compliance, “Pink Puffers”: Type __ Emphysema
A
Cough with a chronic sputum, sometimes purulent is associated with type __ emphysema patients
B
Polycythemia, edema, pulmonary HTN, “Blue Bloaters”: Type __ Emphysema
B
Pulmonary HTN can lead to _____________, known as _____________
right ventricular failure, cor pulmonale
In emphysema, ventilation is _________ relative to perfusion
reduced
Method which slows the flow rate and raises intrapulmonary pressure to keep the airways open to get stale air out of the lungs
pursed-lip breathing
Obstructive, reactive airway disease
asthma
juvenile-onset asthma is usually caused by:
allergies
Asthma causes a reduced lumen of bronchi due to:
bronchospasm, increased bronchial wall thickness, increased secretions
Extrinsic triggers for asthma are usually associated with _______-onset
juvenile
Intrinsic triggers for asthma are usually associated with ________-onset
adult
Dilation of the bronchial walls in saccular or fusiform mechanisms, usually the result of a recurrent infection
Bronchiectasis
Treatment of bronchiectasis to prevent the accumulation of secretions
bronchial hygiene
Partial collapse of lung parenchyma (alveoli)
atelectasis
alveolar collapse, perhaps related to surface tension changes, can be diffused or localized
microatelectasis
atelectasis where the bronchus becomes occluded and air distal to the obstruction is absorbed and the lung region collapses
obstructive atelectasis
signs involved with microatelectasis
reduced excursion, crackles, bronchial sounds, tracheal shift (ipsilateral)
_________is the most common pathology of atelectasis
microatelectasis
occurs when a bronchus is completely occluded by: carcinoma, mucous plug, foreign object, endotracheal tube inserted too far
obstructive atelectasis
pneumonia usually associated with staphylococcal or streptococcal organisms
bronchial
pneumonia associated with patchy infiltrates on x-rays (little white spots)
bronchial
pneumonia associated with inflammation of airways with secretions; cough with large amounts of purulent sputum
bronchial
pneumonia associated with pneumococcus organisms
lobar
pneumonia associated with inflammation of the distal airways (alveoli) with red hepatization and pain
lobar
pneumonia associated with an initially dry cough, later productive of small amounts of golden, viscous, blood-flecked sputum
lobar
acute, often life-threatening lung disorder with 40-60% mortality
ARDS (adult respiratory distress syndrome)
fracture of a long bone can result in a _________
fat embolus
a loss in surfactant production can lead to __________
atelectasis