Respiratory, cardiovascular and diagnosis blood test Flashcards
Events during inspiration
Diaphragm and external intercostals muscles contract–> volume of thoracic cavity increases–> interpleural pressure becomes more negative–> lungs expand–> intrapulmonary pressures becomes more negative–> air flows into lungs.
Boyles law
The pressure of a gas is inversely proportional to the volume of its container.
Define quiet expiration
Passive process in which the diaphragm and the external intercostal muscles relax and the elastic lungs and thoracic wall recoil inward. This decreases the volume and therefore increases pressure within the thoracic am cavity and lungs.
Define quiet inspiration
During quiet inspiration the diaphragm and the external intercostal muscles contract. Increase the volume decreases pressure within the thoracic cavity and the lungs
How are functional heart murmurs detected? Can these abnormalities be seen on an EKG?
Abnormal sound produced by a regular blood flow
Abnormalities cannot be seen on EKG because the EKG only picks up the electrical activity of the heart.
What is a lead?
Electrode
What is an EKG?
Recording of the electrical activity of the heart.
How is mean arterial pressure calculated?
Mean arterial pressure = ( pulse pressure\ 3) + diastolic pressure
How is pulse pressure calculated?
Pulse pressure = systolic pressure - diastolic pressure
How will you find the brachial artery?
Palpate for it
What is BP?
What are the units of measurement for pressure?
Pressure of blood exerted against arterial walls
MmHg
What is a sphygmomanometer and what is it used for ?
It is used as a pressure cuff to measure blood pressure
Where is the brachial artery and what are its two major branches?
Brachial region
- radial
- ulnar
What is Pulse ?
Pressure wave produced when the aorta stretches
What does Each wave of a cardiac cycle represent?
P wave- atrial depolarization.
QRS complex- ventricular depolarization
T wave- ventricular re-polarization
Events during expiration
Diaphragm and external intercostal muscles relax–> volume of thoracic cavity increases–> inter pleural pressure becomes less negative –> lungs recoil–> intrapulmonary pressure rises above atmospheric pressure –> air flows out of the lungs .
Why is untreated hypertension dangerous?
b/c having constant high bp thickens the walls inwardly and the lumen gets smaller, increasing TPR ultimately increasing BP, which can lead to a stroke or heart attack
How does mild exercise affect bp and pulse?
The sympathetic division of the ANS turns on. the baroreceptors send no stretch the parasympathetic division therefore the sympathetic division increases HR, SV, AND TPR–> INCREASES BP
How does placing one hand in ice affect bp?
Bp will increases b/c the cold causes vasoconstriction and increases TPR. all the blood is being shunted towards the core.
How did pulse rate change when going from sitting to standing?
The venous return is decreased therefore SV decreases, and BP decreases. The baroreceptors instantaneously turn on the sympathetic division of the ANS and pulse/ heart rate increase.
What is systolic pressure?
What is diastolic pressure?
Systolic pressure- pressure when the ventricles contract
diastolic pressure- pressure when the ventricles relax.
What causes heart sounds?
Closing of the valves
- The first sound (lub): closing of the AV valves
- Second sound (dub): closing of the semilunar valves
What are the functions of blood?
Which component of blood carries out each of these functions?
- Transporting of nutrients and waste
- regulation
- protection
What are the distinguishing features of ventricular tachycardia?
Anything above 100bpm
Surface tension does what with and without surfactant ?
With surfactant - decrease ST
without surfactant- increases ST
Define lung compliance
ease at which the lungs expand
amount of elastic tissue has to do with what/
stretchability of lungs
How is resistance affected by changes in airway diameter?
When diameter decreases, resistance increases
when diameter increases, resistance decreases
How does increased resistance affect airflow?
It provides less air flow b/c more constriction
Factors affecting airway resistance
Diameter of airway
-do this by contracting or relaxing smooth muscles in airway walls especially the bronchioles
What are intrapulmonary pressure changes?
pressure within the alveoli of the lungs also called intrapulmonary alveoli pressure
where are the visceral and parietal pleurae
The visceral covers surface of lungs and the parietal sits on top on the visceral
Define tidal volume
The volume of gas inspired or expired in an unforced respiratory cycle
define inspiratory reserve volume
The maximum volume of gas that can be inspired during forced breathing in addition to tidal volume
define expiratory reserve volume
the maximum amount of gas that can be expired during forced breathing in addition to tidal volume
How does air get into the lungs?
Air gets into the lungs by volume changes,which cause pressure changes and the air moves down the pressure gradient.
What are the 3 most significant factors that determine vital capacity?
age, sex, and height
Why are resistance and compliance important in breathing?
Because if resistance goes up it is harder to breathe because there is less air flow.
if compliance goes up it is easier to breathe
Which values cause total minute volume to increase during exercise?
- Tidal volume
- # of breaths per minute
Does all of the total minute volume reach the alveoli?
No, b/c it gets trapped in the conducting zone. This is where no gas exchange occurs.
How is hyperventilation different from hyperpnea?
Hyperventilation is uncontrolled rapid breathing
Hyperpnea is increased deep breathing.
- Hyperpnea happens when exercising b/c ventilation and CO2 production increase, therefore more CO2 = increase pH=more vasodilation.
Venous blood contains some oxygen, explain
venous blood contains 02 due to hemoglobins high affinity for oxygen, so it will not let all of it go in one pass
Why is it important to monitor percent hemoglobin saturation in a patient under general anesthesia (with paralyzed muscles)
b/c when temperature is decreased the pH is increased, leading to a decrease in 02 delivery to the tissues b/c hemoglobins affinity for 02 has increase therefore there is a decrease of unloading.
Anatomy of the bronchiole tree
air enters the lungs thru primary bronchi–>secondary bronchi–>tertiary bronchi–>bronchioles–>terminal bronchioles–>respiratory zone
Define vital capacity
the maximum amount of gas that can be expired after a maximum inspiration
Vital Capacity contains what?
Tidal volume+expiratory reserve volume+inspiratory reserve volume
total lung capacity=
vital capacity+residual volume
Define total lung capacity
the total amount of gas in the lungs after a maximum inspiration
Define residual volume
the volume of gas remaining in the lungs after a maximum expiration
Define agglutination
- clumping
- special kind of run
Causes of polycythemia?
High altitudes
Write out the flow diagram of the negative feedback system that maintains a normal # of RBC’s
02 decreases–>kidneys release erythroproetin–>bones–>stimulates hematapoasis
Total white blood cell count
total # of wbc’s in a mm3 of blood
normal ranges: 4500-1100 abc/mm3
Hematocrit (packed cell volume)
The percentage of blood volume compromised of cells
normal ranges:
F: 4-5L blood, 36%-46%
M: 5-6L blood, 41%-53%
total RBC count
the total # of RBC’s in mm3 of blood
-too high=anemia
-too low= polycythemia
normal ranges: 4.5-5.9 mill RBC/mm3
Hemoglobin concentration
the concentration of hemoglobin in g/dL.
normal ranges:
F- 12-16 g/dL
M-13.5-17.5 g/dL
What are possible cause of anemia?
- Iron deficiency (most common)
- Lack of vitamin B12
- Sickle cell anemia
- Destruction of bone marrow
what is leukocytosis
increased # of WBC
-causes: infection, some types of poisoning
What is leukopenia?
decreased # of WBC
-causes: infections that damage WBC’s (ex; measles, cirrhosis of the liver, radiation exposure)
Differential white blood cell count
the percentage of each of the 5 types of WBC’s
- this test can help determine the type of infection or immune response
Platelets
NOT CELLS!!!
- huge role in clotting and causes vasoconstriction
ranges: 130,000-400,000 mm3
Type O blood
- No antigens
- A and B antibodies
Type AB blood
- A and B antigens
- no antibodies
Type A blood
- A antigen
- B antibody
Type B blood
- B antigen
- A antibody
What is an antigen?
an antigen sits on the surface of RBC’s
-turns o an immune system
What is an antibody?
antibody is a protein made by WBC to fight against something foreign
during inspiration is Intrapulmonary pressure high or low
low
during expiration is IPP high or low
high
