Respiratory Panopto Part 1 Flashcards
Abnormal breathing sounds =
Adventitious Breathing
Involuntary cessation of breathing =
Apnea
Incomplete expansion or collapse of a part of the lungs =
Atelectasis
Slow rate of breathing =
Bradypnea
Gradual increase and then gradual decrease in depth of respiration followed a period of apnea =
Cheyne-Strokes Respirations
Crackling sounds made as air moves through wet secretions in the lungs =
Crackles
A grating sound or sensation under the skin around the lungs, or in the joints =
Crepitus
Bluish coloring of the skin =
Cyanosis
Difficult or labored breathing =
Dyspnea
Sputum containing blood =
Hemoptysis
Condition in which there is more than the normal amount of air entering and leaving lungs =
Hyperventilation
Decreased rate or depth of air movement into the lungs =
Hypoventilation
Inadequate amount of oxygen available to the cells =
Hypoxia
Nostrils widen while breathing, indicates difficulty in breathing =
Nasal Flaring
Shortness of breath when lying flat and relieved by sitting or standing =
Orthopnea
Air in the pleural space =
Pneumothorax
Harsh, high-pitched sound usually heard on inspiration when upper airway become narrowed =
Stridor
Rapid rate of breathing =
Tachypnea
High-pitched, musical noise that sounds like a squeak =
Wheezes
What does the upper respiratory tract include?
The Nose
Mouth
Pharynx
Epiglottis
Larynx
Trachea
What connects the Nose to the Pharynx?
The Nasal Cavity
What does the nose do to air to protect the lower airway?
Warms, Filters, & Humidifies
How many parts does the Pharynx have?
What are they?
3
The Nasopharynx, The Oropharynx, & The Laryngopharynx
Is located at the roof of the nose. Gives you your sense of smell =
Olfactory Nerve Endings
Air moves through the larynx, then the epiglottis, then the trachea.
True or false?
False, it first travels through the Epiglottis, then the Larynx, then the Trachea
A small flap behind the tongue that closes over the Larynx during swallowing (to prevent food + liquids from going down into the lungs) =
Epiglottis
When you get particles into the lung, causing an inflammatory response that can trigger a pulmonary infection =
Aspiration Pneumonia
If food or drink goes into the larynx and the epiglottis doesn’t function appropriately, what can happen?
Aspiration Pneumonia
As you go down the trachea, what does it do?
It Bifurcates, meaning it splits into two.
Whenever it splits into two, it goes to the left and right Main Stem Bronchi.
What is the point of the trachea called that Bifurcates?
The Carina
The Carina is highly-
Sensitive
Touching the Carina during suctioning causes-
Vigorous Coughing
What is the Lower Respiratory Tract made of?
Bronchi (Right & Left Main Stem Bronchus)
Bronchioles
Alveolar Ducts
Alveoli
Lungs
How many loves does the right lung have?
3 (Upper, Middle, Lower)
How many loves does the left lung have?
2 (Upper, Lower)
The top, rounded part of the lung is called-
The Apex of the lung
The lower part of the lung is called-
The Base of the lung
The Base of the lung rests upon the-
Diaphragm
What contains the Bronchiole Tree?
The Base of the lung
Why is the left lung smaller than the right?
To make room for the heart
Repeated division of the Bronchi which ends with Terminal Bronchioles =
Bronchial Tree
Terminal Bronchioles eventually lead to the -
Alveoli
This is where Gas Exchange occurs, after the air passes through the Terminal Bronchioles =
Alveoli
Formed from Alveolar & Capillary Walls =
Alveolar Capillary Membrane
The Alveolar Walls are covered by a mesh of-
Pulmonary Capillaries
Gas Exchange occurs when the CO2 and O2 diffuse across a semipermeable membrane, thus it happens by-
Diffusion
The movement of molecules from an area of higher concentration to an area of lower concentration =
Diffusion
The greatest concentration for oxygen molecules is on -
The Alveoli Side
The greatest concentration for Carbon Dioxide is on -
The Capillary Side (From deoxygenated blood from the Right Ventricle)
The Main Stems of the bronchi sub-divide into the-
Bronchioles
Beyond your Bronchioles are your-
Alveolar Ducts + Alveolar Sacs
The Bronchioles have muscles that can-
Constrict & Dilate
What is it called when the Bronchioles are Constricted?
Bronchoconstriction
What is it called when the Bronchioles are Dilated?
Bronchodilation
The Airflow that comes through the Trachea and the Bronchi =
The Pathway to conduct gases to the alveoli
Are the Alveoli in contact with the Pulmonary Capillaries?
Yes
Excess fluid that fills the interstitial space, and the alveoli =
Pulmonary Edema
Pulmonary Edema does what to gas exchange?
It Greatly Decreases Gas Exchange
Occurs when alveolar ventilation is inadequate to meet the oxygen demand of the body or eliminate sufficient carbon dioxide =
Hypoventilation
A state of ventilation in which the lungs remove carbon dioxide faster than it is produced by cellular metabolism =
Hyperventilation
Inadequate tissue oxygenation at the cellular level =
Hypoxia
Infant + Toddler Developmental Factors that Influence Oxygenation =
Infants + Toddlers are at risk for Upper Respiratory Infections.
Especially due to 2nd hand smoke and being around other children.
They’re also at risk for airway obstruction due to foreign objects.
School-Age + Adolescent Developmental Factors that Influence Oxygenation =
Cigarette Smoke
Experimenting with Cigarettes or Electronic Cigarettes (Vapes)
Lifestyle Factors that Influence Oxygenation =
Nutrition
Hydration
Exercise
Smoking
Substance Abuse
Stress
Obesity
Inactive (Sedentary) Lifestyle
Unhealthy Diets
Excess Intake of Caffeinated Drinks/ Energy Drinks
Young and Middle-Aged Adult Developmental Factors that Influence Oxygenation =
Unhealthy Diets
Lack of Exercise
Stress
Smoking
Meds (Prescribed + Over The Counter)
Older Adult Developmental Factors that Influence Oxygenation =
Physiological Changes
Lifestyle Factors
Secreted by Alveoli, which makes the Alveoli less likely to collapse =
Surfactant
Collapsed, Airless Alveoli =
Atelectasis
Volume of air exchanged with each breath =
Tidal Volume (V T)
Air in this space is NOT used in gas exchange =
Anatomic Dead Space (V D)
If air is in either of these two structures, then the air is in the Anatomic Dead Space =
Trachea OR Bronchi
The normal Tidal Volume =
500 mL
Of each 500 mL inhaled, approximately how many mL goes into the Anatomic Dead Space?
~150 mL
Membranes that line the chest cavity =
Pleura
A continuous thin membrane that makes up the Pleural Cavity =
Pleura
What are the 2 pleural membranes?
Parietal Pleura
Visceral Pleura
Pleura that lines the chest wall (Thorax) & Diaphragm =
Parietal Pleura
Pleura the lines the lung surface =
Visceral Pleura
The pleura are joined, and they from a-
Double Wall Closed Sac
The Intra-Pleural Space is also called-
The Pleural Cavity
The space between the visceral and the parietal pleura =
The Pleural Cavity
The Pleural Cavity holds how much pleural fluid?
What does this fluid do?
~25 mL.
It lubricates membranes.
It also allows pleura to slide easily without friction, during respirations.
What are the types of pressure?
Intra-Pleural Pressure
Atmospheric Pressure
Intra-Thoracic (Intra-Pulmonic) Pressure
What is Intra-Pleural Pressure?
Normal Expansion.
Pressure in the Pleural Cavity, around the lungs.
What is Atmospheric Pressure?
The pressure outside the chest in the atmosphere
Intra-Thoracic (Intra-Pulmonic) Pressure
Pressure inside the lungs
You should have a negative or low pressure in the pleural space, so your Intra-Pleural pressure should be less pressure than-
Why?
The Atmospheric Pressure + Intra-Thoracic Pressure.
To allow room for the lungs to expand
What does positive or increased intra-pleural pressure do to the lungs?
Air goes into the intra-pleural space which causes a collapse of the lung (Which is called a Pneumothorax)
What is positive or increased intra-pleural pressure caused by?
This is caused by an open chest cavity like a stab wound or surgery
A Pneumothorax will have what effect on the lung?
Diminished / Absent Lung Sounds.
The respirations will be asymmetrical, there will be sharp pain, tachypnea, restlessness, and anxiety
How does a pneumothorax get treated?
A chest tube or a thoracentesis is done to remove the air, blood, and pus from the intra-pleural space
When you take a needle and go into the lung to remove air, blood, or pus, this is called a-
Thoracentesis
The lungs expand due to -
If this is changed then what happens?
The negative intra-pleural pressure.
The lung collapses (Pneumothorax).
What’s the difference between intra-pleural and intra-pulmonic?
Intra-pleural = In between the Pleura
Intra-Pulmonic = Inside the lung
What are the 2 different types of pneumothorax?
Open Pneumothorax
Closed Pneumothorax
A Pneumothorax caused by an external wound =
Open Pneumothorax
In an Open Pneumothorax, air will enter through the-
Opening in the chest wall and Parietal Pluera (The outer lining of the pleura)
A pneumothorax with no external open wound =
Closed Pneumothorax
When does a Closed Pneumothorax occur?
When the Visceral Pleura is disrupted, this allows air to enter the pleural space through the lung
Exchange of respiratory gases (O2 & CO2) between the atmosphere and blood =
Oxygenation
What are the 3 steps of the oxygenation process?
Ventilation (Also called Pulmonary Ventilation or breathing)
Gas Exchange
Transport
Breathing, move gases in & out of lungs via inhalation and exhalation =
Ventilation
Diffusion of O2 & CO2 between alveoli & pulmonary capillaries =
Gas Exchange
O2 transported to organs and tissues + returns CO2 back to lungs for exhalation (returns deoxygenated blood to the lungs to the alveoli) =
Transport
The Diaphragm plays a big role in-
Ventilation, because it helps the lungs to expand
Deoxygenated blood gets to the alveoli via-
The Pulmonary Artery
Oxygenated blood gets to leave the alveoli via-
The Pulmonary Vein
Inspiration/Inhalation is a-
Active Process
Diaphragm contracts & moves downward = lungs expand =
More Lung Volume = Decreased Intra-Thoracic Pressure = Negative Intra-Pleural Pressure = air drawn in = O2 moves into lungs
Exhalation/Expiration is a-
Passive Process
The diaphragm relaxes (and moves back up) and the lungs recoil (return to their normal size) =
Less Lung Volume = Increased Intra-Thoracic Pressure = Positive Intra-Thoracic Pressure = air
flows out = CO2 moves out of lungs
Abnormal Ventilation = Lung Disease =
Extra Effort to Ventilate = Takes more energy to breath in/out
What form of breathing should you expect from a pt who requires extra effort to ventilate?
Pursed Lip Breathing
What does Optimum Ventilation Require?
Clear Airways
Intact CNS (Central Nervous System) & Respiratory Center
Thoracic Cavity that can Expand + Contract
Pulmonary Compliance & Recoil
The lung’s ability to expand, stretch, and inflate. Needed for normal Inspiration =
Lung’s Compliance
Lung’s ability to “reduce” after stretching. Needed for normal Exhalation =
Elastic Recoil
What conditions cause a decreased Lung Compliance?
Age
Pulmonary Edema
Pleural Vibrosis
Cystic Vibrosis
Congenital Abnormalities (like Muscular Dystrophy)
Structural Problems (like Kyphosis which is also called a hunch back)
Trauma (like Fractured Ribs)
Thickened lung tissue or pleura =
Pleural Vibrosis
This is a genetic disorder. A patient with this will have mucus that is too thick and sticky =
Cystic Vibrosis
What conditions cause a decreased Elastic Recoil?
Chronic Obstructive Pulmonary Disease (COPD)
Age
What are all of the accessory muscles of respirations for pt’s with decreased lung compliance or elastic recoil?
Anterior Neck Muscles
Intercostal + Abdominal Muscles (Work harder to increase lung volume, so fatigue occurs easily)
What are some subjective things that you may hear from a pt who is using a lot of their accessory muscles for ventilation?
You may hear from them that they are:
Tired
Worn Out
Smothering
What are some objective things that you may see from a pt who is using a lot of their accessory muscles for ventilation?
You may see:
An elevation of the clavicles with inspiration.
May have a barrel chest (Bigger chest diameter).
Pursed Lip Breathing.
The exchange of respiratory gases is also called-
Where does this occur at?
Diffusion.
Occurs at the:
Alveolar Capillary Network
Organ & Tissue/Cellular Level (Oxygen goes from the blood to the tissues, CO2 goes from the tissues to the blood)
What factors create an Ineffective Diffusion?
Thickness of alveolar capillary membrane (Pulmonary Edema, Pulmonary Effusion)
Altered Alveoli Surface (From Chronic Lung Diseases, Pneumothorax, or Lung Surgery)
Ineffective Tissue Perfusion, this means problems at the tissue level (Phlebitis, Peripheral Edema, Poor Circulation)
Lung Surgery =
Lobectomy
O2 Transport depends on-
Ventilation, Gas Exchange, Oxygen-Carrying Capacity
Oxygen-carrying red pigment in RBC’s, composed of iron, carrier for O2 & CO2 =
Hemoglobin (HgB)
What effects O2 + CO2 transport?
Decreased Cardiac Output
Number of RBC’s (Erythrocytes)
Exercise (Due to increased cardiac output + respirations)
