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respiratory failure Flashcards

1
Q

how many units of energy do you get from a single carbohydrate molecule in presence of oxygen and without oxygen

A
  • with oxygen= 36 ATP molecules
  • without oxygen= 2 ATP molecules
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2
Q

how do we inspire (quiet inspiration)

A
  • diaphragm contracts and becomes flat
  • external intercostal muscles contract pulling the ribcage upwards and outwards
  • contraction of both of the muscles causes the volume of the thoracic cavity to increase which thus decreases pressure (creates this negative pressure- suction effect)
  • pressure gradient generated causes air to flow in down pressure gradient
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3
Q

what happens during quiet expiration (passive)

A
  • diaphragm relaxes becomes v shaped
  • external intercostal muscles relax- ribcage moves downwards and inwards
  • thoracic cavity volume decreases and pressure increases (alveolar and intrapulmonary)
  • pressure gradient results in air to flow out as well as the recoiling of the elastin fibres in alveoli
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4
Q

what happens during active expiration e.g during coughing, exercise

A
  • involves muscle contraction
  • diaphragm relaxes as well as external intercostal muscles
  • internal intercostal muscles contract further pulling the ribcage downwards and inwards
  • accessory muscles (abdominal muscles) contract (pushes diaphragm upwards)
  • this results in a decrease in thoracic cavity volume increasing the pressure more than in passive expiration
  • greater pressure gradient formed air moves out the lungs
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4
Q

what happens during active forced inspiration

A
  • contraction of diaphragm and external intercostal muscles
  • abdominal muscles (accessory muscles) also contract
  • lung volume increases and thoracic pressure decreases- pressure gradient drives air into the lung
  • happens during exercise, respiratory distress such as asthma
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4
Q

why do we get a sore throat when breathing through are mouth

A
  • nasal cavity adds moisture to air
  • oral cavity does not
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5
Q

what are the conducting zones

A
  • trachea
  • bronchus
  • bronchioles specifically terminating bronchioles
  • larynx
  • pharynx
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6
Q

what are the respiratory zones

A
  • respiratory bronchioles
  • alveoli
  • alveolar sac
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7
Q

what is the upper respiratory region

A
  • nasal cavity
  • oral cavity
  • pharynx
  • larynx
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8
Q

what is the lower respiratory region

A
  • trachea
  • bronchus
  • bronchioles (respiratory and terminal)
  • alveolar sac
  • alveoli
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9
Q

what is tidal volume and what is the anatomical deadspace volume and alveolar volume

A
  • tidal volume 500mls
  • anatomical deadspace is 150mls and alveolar volume is 350mls
  • anatomical deadspace is fixed and does not change wether you breath fast or slow but alveolar volume can change
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10
Q

what noise do you get with upper airway obstruction and when

A
  • during inspiration
  • striddle
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11
Q

what noise do you get in lower respiratory obstruction and when

A
  • during expiration
  • wheezing
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11
Q

where is resistance greatest in respiratory system

A
  • resistance is greatest in upper respiratory zone
  • flow is turbulent
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12
Q

how is breathing controlled

A
  • dual innervated consists of autonomic control (medulla) and somatic control (hyperventilation)
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13
Q

how does the body increase breathing rate

A
  • chemoreceptors in carotid body and aortic arch sense changes in carbon dioxide, oxygen levels and ph
  • this stimulates sympathetic nervous system (medulla)
  • causes to breath faster and harder
14
Q

what happens when sympathetic nervous system fails to work and increase breathing rate

A
  • increased carbon dioxide levels as not cleared
  • decrease in ph which can trigger release of nitric oxide
  • causes vasodilation
  • makes up sleepy
15
Q

what happens when oxygen cannot get in

A
  • hypoxemic hypoxia
  • central and peripheral cyanosis
  • organ failure of brain, heart, kidneys
16
Q

what is cytotoxic hypoxia

A
  • oxygen not utilised by tissues
  • cyanide poisoning
  • mitochondria do not work
17
Q

what is respiratory failure and the types

A
  • partial pressure of oxygen <8kPa
  • type 1 respiratory failure is when there’s low oxygen but carbon dioxide is also cleared
  • type 2 respiratory failure is when there’s both low oxygen and carbon dioxide is not cleared so raised carbon dioxide levels (hypercapnia)
18
Q

how do we measure oxygen levels

A
  • pulse oximeter to measure hb saturation
  • arterial blood gas to measure partial pressure of oxygen
19
Q

what is the oxygen cascade

A
  • stepwise decrease in partial pressure of oxygen between the atmospheric air and the mitochondria
  • essentially shows the decrease In partial pressure of oxygen as it moves from the atmosphere to the specific areas of our body
  • drop in oxygen is fixed
  • if this drop is altered suggests somethings wrong
  • if measuring oxygen in artery need to know much oxygen initially breathing to calculate drop in oxygen
20
Q

what is the oxygen dissociation curve

A
  • a curve to show hb saturation at different partial pressures of oxygen
  • sigmoid shape
  • increasing partial pressure increases hb saturation
  • positive cooperatively so binding of first oxygen makes it easier for subsequent oxygen to bind
  • won’t be able to tell how well lung working of a patient if inspired oxygen very high as there’s mimcl changes in hb saturation when partial pressure Is high
21
Q

what are some causes of respiratory failure

A
  • pneumonia
  • asthma
  • pulmonary oedema
  • COPD
  • pneumothorax
  • PE
  • opioid poisining
  • neuromuscular disease
22
Q

what is pneumonia, causes, symptoms, what type of lung disease, what can it cause

A
  • caused by pathogen e.g. streptococcal pneumonia, pneumocystis jiroveci
  • infection of the lungs specifically alveoli
  • shunt (poor ventilation but good perfusion) specifically intrapulmonary shunt where alveoli is obstructed with fluid
  • can cause hypoxemic hypoxia
  • symptoms include fever, breathlessness, cough
  • obstructive lung disease
23
Q

what is asthma, what type of lung disease, what it causes and treatment, symptoms

A
  • obstructive lung disease
  • narrowing of bronchioles (airways) secondary to inflammation
  • wheezing and mucus plugging
  • shunt
  • leads to hypoxemic hypoxia
  • leads to exhaustion and therefore ventilation
  • use salbutamol a bronchodilator to dilate airways
24
Q

what is COPD, type of lung disease, causes and mechanism, risk factor

A
  • obstructive
  • irreversible with bronchodilator
  • caused by high compliance of lungs and low elastic recoil
    -associated with emphysema, chronic bronchitis and mucus plugging
  • smoking is a risk factor
25
Q

what is pneumothorax

A
  • restrictive lung disease
  • hole in lungs and therefore air enters the intrapulmonary cavity but cannot get out and this causes an increase in pressure which causes lungs to collapse, alveolar compressed
  • can cause hypoxia
26
Q

what is pulmonary embolism

A
  • blood clot in pulmonary circulation
  • poor perfusion
  • dead space- physiological
27
Q

what opioid poisoning

A
  • reduced ventilatory drive so hypoventilation takes place
  • carbon dioxide increases
  • drop in oxygen
  • shunt
28
Q

what is neuromuscular disease in terms of respiratory diseases

A
  • smaller breaths
  • exhaustion
  • rising carbon dioxide
  • oxygen falls
29
Q

what is pulmonary oedema

A
  • swelling of tissues between blood vessels and air spaces due to back pressure from the left ventricle
  • more difficult for oxygen diffusion
  • build up of fluid
  • restrictive
  • intrapulmonary shunt

circulation and breathing (13 decks)

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