Respiratory system2 Flashcards
What is oxygenation failure?
The respiratory system is unable to adequately provide oxygen to the body, leading to hypoxia
What is ventilatory failure?
Reduced ventilatory effort of the respiratory muscles and thorax impairs alveolar ventilation, and leads to accumulation of carbon dioxide.
What is the difference between type I and II respiratory failure?
Type I - hypoxemia
Type II - hypoxemia and hypercarbia
What are the components of a focused respiratory assessment?
Inspection
Palpation
Percussion
Auscultation
What about someone’s head and neck may indicate respiratory distress?
Colour of oral mucous membranes
Nasal flaring
Pursed lip breathing
Mouth vs nose breathing
Tracheal deviation
Tracheal tug
Evidence of trauma
What about someone’s thorax may indicate respiratory distress?
Asymmetrical chest wall movement
Accessory muscle use
Recession
Rate, rhythm and pattern of breathing
Trauma or deformities
What may cause asymmetrical chest wall movement?
Bronchial obstruction, which can be caused by:
mucous plugs
pneumothorax
fibrosis
atelectasis/ collapse of lobes
What muscles are involved in inspiration?
Diaphragm
External intercostal muscles
Scalene muscles
Sternocleidomastoids
What muscles are involved in expiration?
Internal intercostals
External and internal obliques
Rectus and transversus abdominus
What is a prolonged expiratory phase associated with?
Airway inflammation and increase airway resistance
Define V/Q ratio and what is the normal ratio.
The V/Q ratio evaluates with matching of ventilation, the amount of air in your lungs (V) to perfusion, the blood flow in the capillaries in your lungs (Q).
When the ratio is above or below 0.8, you may have V/Q mismatch.
What is happening when there is a V/Q mismatch?
Part of the lung receives oxygen without blood flow or blood flow without oxygen due to obstructed airway or blood vessel.
VQ mismatch can cause hypoxemia
Types of V/Q mismatches?
Dead space - area with ventilation but inadequate perfusion, e.g. a PE.
Shunt - adequate perfusion but not enough ventilation e.g. pneumonia or pulmonary oedema.
Issues with over-administering oxygen?
Continued exposure to high concentrations of oxygen result in heightened free radical production.
Free radicals can damage the pulmonary epithelium, inactivate surfactant, induce intra-alveolar oedema, interstitial thickening, fibrosis, and ultimately lead to pulmonary atelectasis.
It can also hide symptoms of deterioration and affect treatment
Best practice is the administration of the minimum concentration of oxygen required to achieve an SpO₂ > 94%
How does HFNO reduce hypercapnia?
Dead space is flushed by humidified oxygen in upper airway and pharynx by high flowing gas, creating a reservoir of fresh gas available for each breath, minimising CO2 re-breathing
