respiratory and airway Flashcards
1
Q
perfusion
A
circulation of blood through lungs
2
Q
diffusion
A
gas exchange co2 and o2
3
Q
where is respiratory center housed
A
brainstem specifically medulla
4
Q
wheezing
A
lower airways (bronchioles0
5
Q
Stridor
A
upper airway obstruction ( subglottic)
6
Q
rhonchi
A
secretions in broncial airways
7
Q
eupnea
A
normal respirations
8
Q
cheyne stokes breahtign
A
periods of breahting with periods of apnea
9
Q
biots respirations
A
regular deep respirations followed by periods of apnea
10
Q
apneustic respirations
A
deep gasping inspirations
associated with stroke or trauma
11
Q
kussmals
A
rapid and deep
12
Q
nasal cannula LPM and concentration
A
1-6 24-44%
13
Q
nebulizer LPM
A
4-6 handheld and 6-8 mask
14
Q
NRB LPM and concentration
A
12-15 80-100%
15
Q
BVM LPM, tidal volume, BPM
A
at least 15
adult 1 sec, 500ml tidal volume
dead space 150 ml
12 adults
20 peds
16
Q
CPAP indications
A
F’N CPAP
flail chest
near drowning
copd
pulmonary edema/embolixm
asthma
pneumonia
17
Q
miller blade goes where
A
directly to epiglottis
18
Q
endotrol tube
A
used in nasotracheal intubation
19
Q
Ped tube formula
A
(16+age)/4
20
Q
PH
A
7.35-45
21
Q
Co2 ABG
A
35-45
22
Q
bicarb
A
22-26
23
Q
ABG in respiratory acidosis
A
PH down
paco2 up
hco3 normal
24
Q
abg in respiratory alkaloiss
A
ph up
paco2 down
hco3 normal
25
abg in metabolic acidosis
ph down
paco2 normal
hco3 down
26
abg in metabolic alkalosis
ph up
paco2 normal
hco3 up
27
ROME acronym
respiratory opposite metabolic equal
respiratory
ph decreases co2 increases
metabolic
ph down, hco3 down
28
respiratory acidsois cause
hypoventialtion (retaining to much co2)
29
respiratory alkalosis cause
hyperventilation ( blowing off to much co2)
30
metabolic acidosis cause
build up of lactic acid ex
lactic acidosis, dka, renal failure, sepsis, toxins
31
metabolic acidosis treatment
respiratory rate, fluid, bicarb
32
metabolic alkalosis cause
loss of hydrogen ions (rare)
vomiting, suctioning, large amounts of baking soda or antacids
33
phases of etco2
phase 1- respiratory baseline, late phase of inspiration
phase 2- respiratory upstroke, exhalation of dead space gasses and gasses from alveoli
phase 3- respiratory plateau
airflow through alveoli with nearly constant co2 level
phase 4 - inspiratory phase, sudden downstroke on waveform
34
CPR etco2
10-15 mmhg
change cpr if less than 10
35
sharkfin etco2
prolonged expiratory phase,
asthma, copd, anaphylaxix, fabo, treat this with bronchodilators
36
rising baseline etco2
pt is rebreathing co2. check equipment for o2 flow, allow more time for exhalation, ensure cuff has good seal
37
prolonged waveform higher than 45mmhg
hypoventilation
38
shortened waveform less than 35 mmhg
hyperventilation.
consider dka, sepsis, tca od, methanol ingestion
39
breathing around ett etco2
angled sloped downstroke means cuff is to small or wrong size
40
curare cleft
dip on the plataeu, neuromuscular blockade is wearing off. pt is able to take a small breath at the top
41
what is COPD
umbrella term that covers chronic bronchitis and emphysema
42
chronic bronchitis
"blue bloater"
overweight
productive cough
coarse rhonchi
chronic cyanosis
resistance on inspiration and expiration
43
emphysema
pink puffer
thin
barrel chested
nonproductive cough
wheezing and rhonchi
dyspnea on exertion
pursed lip breathing
clubbing on fingers
44
what is asthma
bronchoconstriction and inflammation.
45
asthma symptoms
dyspnea
intercostal retractions
decreasing loc
inability to speak sentances
tachycardia
tachypnea
etco2 above 45 mmhg
46
status asthmaticus
severe prolonged asthma attack that has not been stopped by bronchodilators
47
asthma treatment
02 and bronchodilators
consider nebulized mag sulfate
steroids
IV fluids
Epi
cpap
48
what is pneumonia
infection that causes acute inflammatory response
bacterial, viral, fungal
49
pneumonia symptoms
productive cough
pleuritic chest pain tachypnea
wheezing crackles and rhonchi
fever
50
what is ARDS
form of hypoxemic respiratory failure
51
what causes ARDS
significant pulmonary edema leads to severe hypoxemia,, intrapulmonary shunting, reduced lung compliance and irreversible lung damage
52
Pulmonary embolism risk factors
bedridden
long flights
hx of dvt
femal pt on bc
smoking
53
PE ss
rapid onset dyspnea
cough
pain
anxiety
hypertension
tachypnea
tachycardia
crackles, wheezes, rhonchi
54
EKG finding PE
S1q3t3
Right axis deviation
55
PE obstructive shock
pt can enter obstructive shock. give 20 ml/kg fluid repeated as necessary
56
simple pneumothorax
presence of air in pleural space
diminshed breath sounds
dyspnea and restlessness
tachypnea
57
tension pneumothorax
accumulation of air in pleural space that causes. tension(obstruction)
ss
jvd
hyperresonance
subcutaneous emphysema
late sign will be obstructive shock
58
HAPE:
causes, when it develops, height, symptoms, treatment
increased pulmonary artery pressure
symptoms begin 24-72 hours after exposure above 8000 ft
all lung sounds plus tachycardia and cyanosis
treat with o2 and decend altitude
59
AMS causes, symptoms
rapidly ascending above 5000 ft
headache, nausea, vomiting, weakness, dizziness, fatigue, tachy or bradycardia, postural hypertension
ataxia marks the change to hace
60
atelectasis
collapse of lung tissue (alveoli) makes respiration difficult due to inadequate ability of the alveoli to function
61
carina
bifurcation of trachea into right and left bronchus
62
compliance
ease of expansion of lungs
63
diaphragm
muscular portion that divides lungs and thoracic area
64
expiratory reserve volume
amount of gas that can be expelled after a breath. normal is 1,100 ml
65
fick principal
oxygen delivered to an organ is equal to the amount of oxygen that is consumed by and carried away from the organ
66
hering breur reflex
reflex that prevents overinflation of lungs
67
hypoxic drive
stimulus to breathe is from low o2 levels
68
intrapulmonic pressure
pressure of gas in alveoli
69
intrathoracic pressure
pressure in pleural space or throracic cavity
70
lower airway
structures below glottis
71
mediastinum
area of body whihc includes trachea, esophagus, heart, great vessles
72
minute volume
amount of gas exhaled in 1 min
(rr x tidal volume)
normal is around 5L
73
oxyhemoglobin
oxygenated hemoblobin
74
carboxyhemoglobin
hemoglobin saturated by co
75
residual volume
amount of air in lungs after max exhalation
average is 1200
76
tidal volume normal
5-7L
77
total lung capacity
5800 ml
78
upper airway
area above glottic opening
79
vallecula
decompression between epiglottis and base of tongue
80
Vital capacity
amount of gas that can move on the deepest inspiration and expiration
81
what lines trachea
cilia and goblet cells
82
how many rings on trachea
15-20
83
pleural layers
visceral- lines the lungs
pleural space
parietal pleura- seperates rib muscle from pleural space
84
phrenic nerve
location and function
C3-5
initiates contraction at diaphragm
85
intrapulmonic pressure
pressure of gas in alveoli ( a bit above 760 mmhg)
86
intrathoracic pressure
pressure in pleural space
(typically below atmospheric pressure around 750
87
Normal breathing uses how much energy? vs abnormal
5% 30%
88
Hypoxemia
decreased o2 in arterial blood
89
Hypoxia
decreased o2 in tissue
90
Chemoreceptors
detect changes i co2 and hydrogen levels
91
O2 D cylander PSI/L
4000
350L
92
O2 E cylinder PSI/L
6000
625L
93
O2 M cylinder PSI/L
3450 PSI
3000L
94
H or K O2 cylinder PSI/L
4500 PSI
6900 L
95
suction requirements machine
LPM
MMHG
timing
intake:30 LPM
300mmhg when clamped
80-100 for adults
adult:15 sec
child:10 Sec
Infant:5 sec
96
management of upper airway obstruction
if able to speak encourage to cough
unable to speak= abd thrusts
unconscious = open airway, 2 ventilations, chest compressions
only finger sweep when foreign body is able to be seen, use magills
97
Racemic epi indications
croup, asthma, bronchospasm
