Brainscape's Knowledge GenomeTM

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


See full index

Emily's IPE Revision > Respiratory > Flashcards

Respiratory Flashcards

1
Q

What is Boyel’s Law?

A

pressure of a gas is inversely proportional to volume: p∝1/V

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

What is Charles’ Law

A

Increase in temperature results in an increase in pressure due to the increased kinetic energy of molecules

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

What is the ideal gas law?

A

pressurevolume= amount in molesideal gas constant* temperature

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

What is partial pressure?

A

the pressure that would be exerted by one of the gases in a mixture if it occupied the same volume on its own.

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

What is vapour pressure?

A

pressure exerted by gaseous water in a mixture

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

What is the saturated vapour pressure at 37 degrees C?

A

6.28kPa

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

What is gas tension?

A

the partial pressure of a gas dissolved in a liquid

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

What is gas content?

A

total amount of gas in a liquid - reacted+dissolved gas

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

Which cells secrete surfactant?

A

Clara cells in the bronchioles and type 2 alveolar cells

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

Which intercostal muscles allow for exhalation and what is their orientation?

A

innermost and internal intercostal muscles, posterior/inferior

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

Which intercostal muscles allow for inhalation and what is their orientation?

A

external intercostal muscle anterior/inferior

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

At what level does the oesphagus pass through the diaphragm?

A

T10

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

At what level does the Aorta pass through the diaphragm?

A

T12

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

which nerve and roots innervate the diaphragm?

A

The phrenic nerve, C3,4,5

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

What is the difference between the right and left bronchi?

A

The Left bronchi is longer and more horizontal than the right

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

Describe the lobes and the fissures of each lung

A

The right lung has 3 lobes - the upper, middle and lower. These are separated by the horizontal and oblique fissure respectively. The Left lung is smaller due to the heart sitting on the left side of the chest, and has just an upper and lower lobe separated by an oblique fissure

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

Which muscles are involved in inspiration?

A

Diaphragm and external intercostal muscles

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

Which muscles are involved in forced expiration?

A

Abdominal muscles and innermost and internal intercostal muscles

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

What are the accessory inspiratory muscles?

A

sternocleidomastoid, scalenes and pec. minor

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

How does surfactant work?

A

Surfactant reduced the interaction between molecules, reducing surface tension. This reduced surface tension prevents alveoli from collapsing, and increases lung compliance.

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

What is frick’s first law of diffusion?

A

diffusion rate = (pressure difference x area of fluid x gas solubility)/(distance x √molecular weight)

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

What are the partial pressures of CO2 and O2 in alveolar air?

A

O2 - 13%

CO2 - 5.3

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

What are the partial pressures of CO2 and O2 in arterial blood?

A

O2 - 13.2%

CO - 5%

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

What are the partial pressures of CO2 and O2 in venous blood?

A

O2 - 5.2%

CO2 - 6%

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

What is serial, alveolar and physiological dead space?

A

serial - volume of the airways
alveolar - volume of lung that is not airway and does not support gas exchange
physiological dead space is the sum of serial and alveolar dead space

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

What is the pulmonary ventilation rate?

A

tidal volume x resp rate

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

What is the dead space ventilation rate?

A

dead space volume x resp rate

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

What is the alveolar ventilation rate?

A

pulmonary ventilation rate - dead space ventilation rate

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

what is the inspiratory capacity?

A

the biggest breath that can be taken in from resting expiratory volume

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

what is the functional residual capacity?

A

volume of air which remains in the lungs at the resting expiratory volume

31
Q

what is the vital capacity?

A

largest possible volume of air inhaled from forced expiratory volume

32
Q

what is total lung capacity?

A

the volume of air in the lungs at the end of maximal inspiration

33
Q

What is Graham’s Law?

A

smaller molecules tend to diffuse faster than larger ones

34
Q

What factors affect the diffusion rate of gases across the air-blood inter-phase (5)

A
  • pressure differences
  • solubility of the gas
  • surface area of the of fluid
  • diffusion distance (0.6 nano metres)
  • molecular weight of the gas
35
Q

What is tidal volume?

A

volume of air breathed in and out at rest

36
Q

what is the inspiratory reserve volume?

A

the extra volume which can be inhaled above that at rest

37
Q

what is the expiratory reserve volume

A

the extra volume which can be exhaled above that at rest

38
Q

what is the residual volume

A

the volume remaining in the lung following maximal expiration

39
Q

How would a restrictive pattern differ from a normal on on spirometry?

A

decreased compliance would allow for normal rate of flow initially, however the overall lung volume is reduced. therefore fev1 may be normal but FVC will be lower

40
Q

How would a obstructive pattern differ from a normal on on spirometry?

A

there is increased compliance, so although they may be able to expire the same volume the rate will be lower. therefore FEV1 is reduced but FVC may be normal

41
Q

What is measured with helium dilution and how?

A

residual volume. mixture of gases with known helium concentration is given. level of dilution of helium in expired gases allows residual volume to be calculated

42
Q

what is measured with a nitrogen wash out and how?

A

serial dead space.
patient is given 1 breath of pure O2,patient expires into a metre which detects nitrogen. volume expired before nitrogen is detected is the serial dead space.

43
Q

How are acute changes in PO2 detected?

A

By peripheral chemoreceptors in the carotid and aortic bodies. This is a crude measure which only responds to large drops in PO2. If there is a decrease it causes increase in RR and HR and sends more blood to vital organs.

44
Q

How are changes in PCO2 detected?

A

Indirectly by central chemoreceptors which detect changes in pH of the CSF. This is the main mechanism by which ventilation is controlled, as it is fast and sensitive.

45
Q

How are chronic decreases in respiration detected and monitored?

A

In patients who chronically hypoventilate, the kidney increases HCO3- levels to compensate for the respiratory acidosis. Choroid plexus cells in the CNS can respond to this persistent increase in HCO3, by allowing an increase in the CSF concentration of HCO3. This decreases the CSF acidity despite persistent high CO2 levels allowing a chronic compensated respiratory alkalosis not to increase resp rate. These patients tend to run on a lower PO2 because of this, so controlled oxygen targets should be lower for them (88-92%).

46
Q

What is type 1 respiratory failure? What can cause it?

A

Adequate CO2 exchange but inadequate O2 exchange

type 1 -VQ mismatch e.g. PE, Impaired diffusion e.g. ILD

47
Q

What is type 2 respiratory failure?

A

Inadequate O2 and CO2 exchange

respiratory pump failure e.g. head injury, neurological muscle weakness, chest wall problems like trauma

48
Q

What three things characterise asthma?

A

1- reversible airway obstruction due to smooth muscle contraction
2- airway wall inflammation and remodelling
3- increase in airway responsiveness to some stimuli e.g. temperature, smoke, pollen

49
Q

What can precipitate an asthma exacerbation? (4 things)

A

lack of treatment adherence
exposure to allergen or triggering drug
respiratory virus
cold air

50
Q

What sort of wheeze is typically present in asthma

A

a high pitched, polyphonic, expiratory wheeze

51
Q

What test is diagnostic of asthma?

A

low peak expiratory flow rate
low FEV1/FEV
a 12% increase in FEV1 following salbutamol

52
Q

What is the MRC Dyspnoea scale?

A

1- not troubled by breathlessness except on strenuous exercise
2- short of breath when hurrying or walking uphill
3- walks slower than contemporaries on flat ground, or has to stop to catch breath when walking at own pace
4- stops for breath after walking about 100m or after a few minutes on level ground
5a- too breathless to leave the house but independent of ADLs
5b - housebound and dependent on others for ADLs

53
Q

What is lobar pneumonia?

A

Pneumonia with consolidation confined to one or more lung lobes

54
Q

What is broncho pneumonia?

A

Diffuse and patchy pneumonia which originates from the airways and spreads into lung tissue. On CXR there tend to be multiple small nodular or reticulonodular opacities which tend to be patchy and/or confluent

55
Q

What is aspiration pneumonia?

A

pneumonia secondary to aspiration of food, drink, saliva or vomit. On CXR there may be airspace opacification in a lobar or segmental distribution

56
Q

What is the CURB-65 score?

A

scoring system for hospital acquired pneumonias
C- new mental confusion
U- Urea >7mmol/L
R- Resp rate over 30/min
B - blood pressure <90/60
65 - age over 65yrs
a score of 2 or more is an indication to be admitted to hospital

57
Q

What is a transudate? What causes transudative effusions in the pleura?

A

Serous fluid with a low protein content - <30g/L

Causes include cardiac failure, hypoalbuminaemia, nephrotic syndrome, sepsis

58
Q

What is exudate? What causes exudative accumulations in the pleura?

A

Serous fluid with a high protein content, >30g/L

Neoplasm, TB or Pneumonia, connective tissue disease, rheumatoid athritis,

59
Q

4 causes of low PaO2

A

Hypoventilation
Diffusion Impairment
Shunt
V/Q Mismatch

60
Q

What is massive haemoptysis?

A

> 240mls in 24 hours

>100mls over consecutive days

61
Q

What is a mild asthma attack?

A

PEFR > 75%

No features of severe asthma

62
Q

What is a moderate asthma attack?

A

PEFR 50-75% predicted

No features of severe asthma

63
Q

What is a severe asthma attack?

A 
PERF 33 -50%
Or any of the following:
Cannot complete sentences in one breath
Resp rate over 25/min
Heart rate over 110/min
64
Q

What is a life threatening asthma exacerbation?

10 thing

A 
PEFR < 33%
Or any of the following:
Sats < 92% or ABG pO2 < 8kPa
Cyanosis
Poor respiratory effort 
Near or fully silent chest 
Exhaustion 
Confusion
Hypotension 
Arrhythmia
Normal PCO2
65
Q

What is a near fatal asthma attack?

A

Raised PCO2

66
Q

WHO performance scale

A

0- normal, fully active
1- restricted in physically strenuous activity
2- ambulatory and capable of all self care but not able to work up and about more than 50% of waking hours
3 - capable only of limited self care, confined to bed or chair more that 50% of waking hours
4- completely disabled, no self care, confined to bed or chair
5- dead

67
Q

What are the absolute contraindications for thrombolysis? (6)

A 
Haemorrhaging or ischaemic stroke in last 6 months 
CNS neoplasm 
Recent trauma or surgery
GI bleed in last month 
Bleeding disorder
Aortic dissection
68
Q

What are the relative contraindications to thrombolysis?

A

Warfarin
Pregnancy
Advanced liver disease
Infective endocarditis

69
Q

What are the criteria for discharge following an asthma exacerbation? (8)

A
  • PEFR >75%
    • Stop regular nebulisers for 24 hours prior to discharge
    • Inpatient asthma nurse review to reassess inhaler technique and adherence
    • Provide PEFR meter and written asthma action plan
    • At least 5 days oral prednisolone
    • GP follow up within 2 working days
    • Respiratory Clinic follow up within 4 weeks
    • For severe or worse, consider psychosocial factors
70
Q

Causes of eosinophilia (7)

A 
Asthma
COPD
Hay fever
Allergic bronchopulmonary aspergillosis 
Drugs e.g. recurrent antibiotics 
Vasculitis 
Eosinophillic pneumonia
71
Q

What is the aim of long term oxygen therapy?

A

Prevent renal and cardiac damage due to hypoxia

72
Q

What are the requirements for long term oxygen therapy?

A

pO2 consistently below 7.3 kPa
pO2 consistently below 8kPa with cor pulmonale
Must be a non-smoker who doesn’t retain high levels of CO2

73
Q

What is Kartagener syndrome?

A

Triad of bronchiectasis, sinusitis and situs inversus

74
Q

What are the causes of bronchiectasis?

A

Post infective - whooping cough, TB
Immune deficiency - hypogammaglobulinaemia
Genetic - CF, kartagener

Emily's IPE Revision (5 decks)

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