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respiratory test Flashcards

1
Q

Tidal volume

A

The volume of air inhaled and exhaled with each normal breath

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2
Q

Residual volume

A

Air remaining in the lungs after maximum expiration

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3
Q

Expiratory reserve volumes

A

Maximum volume that can be moved out of the respiratory tract after normal expiration

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4
Q

Inspiratory reserve volume

A

Maximal amount of additional air that can be drawn into the lungs by determined effort after normal inspiration

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5
Q

Functional residual capacity

A

The volume of air left in the lungs after a normal passive exhalation

Sum of ERV+RV

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6
Q

Inspiratory capacity

A

The maximum volume of air that can be inspired after reaching the end of a normal quiet expiration

Sum of TV+IRV

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6
Q

Vital capacity

A

The largest of air an individual can move in and out of the lungs

TV+IRV+ERV

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7
Q

Total lung capacity

A

The total volume of air a lung can hold

TV+IRV+ERV+RV

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8
Q

CADET pneumonic

A

C- CO2

A- Acid

D- DPG (factor that controls how easily/difficult O2 is bound)

E- Exercise

T- Temperature

Any increase in these factors leads to a right shift and any decreases leads to a left shift

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9
Q

Shunt

A

Alveoli are perfused with blood normally but ventilation (supply of air) fails to supply the perfused region

Low VQ (0.5)

Very rarely a true shunt because then they are not breathing

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10
Q

Dead space

A

Alveoli are ventilated but not perfused

High VQ (2.0)

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11
Q

Atelectasis

A

Non aeration/ collapsed lung or part of a lung leading to decreased gas exchange or hypoxia interfering with blood flow through the lungs and alters ventilation and perfusion. If lungs are not re-inflated quickly the lung tissue can become necrotic

Signs and symptoms: small areas are asymptomatic but large areas cause dyspnea, tachycardia, tachypnea, and abnormal/asymptomatic chest expansion

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12
Q

SPO2

A

Works to measure the amount of oxygenated hemoglobin to deoxygenated hemoglobin in the blood stream and can be affected by factors like light, shivering, pulse volume, vasoconstriction, carbon monoxide poisoning, and nail polish

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13
Q

Bronchodilators

A

Beta 2 agonist that works on the cells in the lungs and stimulates beta cells to relax smooth muscles in the air ways to treat bronchoconstriction for asthma, COPD, and emphysema

Most common is Ventolin

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14
Q

Long-acting bronchodilators

A

Has long-acting beta 2 agonist and some steroids either in them or used in conjunction to provide control not relief

Most common puffers are Advair and Symbicort

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15
Q

Anticholinergics

A

Blocks parasympathetic response as sympathetic increases HR and causes bronchodilation, parasympathetic decreases HR and causes bronchoconstriction

Most common is ipratropium (Atrovent)

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16
Q

Corticosteroids

A

Reduce bronchial swelling through IV or inhalation with long term negative effects like high BS, decreased immune system, and generalized edema

Most common are dexamethasone, prednisone, hydrocortisone, betamethasone

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17
Q

Diuretics

A

Maintain BP and remove fluid from the body and beneficial to patients with pulmonary edema but a negative side effect is the lost potassium

Most common is Lasix (Furosemide)

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18
Q

Sympathomimetics

A

Stimulate beta 2 receptors and assist with bronchodilation given IM

Most common is Epinephrine

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19
Q

URT

A

Nose, pharynx, larynx

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20
Q

What does the pharynx do

A

Nasopharynx- nares to soft palate

Oropharynx- soft palate to hyoid bone

Laryngopharynx- hyoid bone to esophagus

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20
Q

LRT

A

Trachea, bronchial tree, lungs

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21
Q

What does the nose do

A

Passageway for air going to/ from the lungs

Traps microorganisms

Examines for substances that might irritate the respiratory tract

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22
Q

What does the larynx do

A

Triangle shaped cartilage attached by muscles that’s lined by mucous membranes to protect the airway against solids/liquids during swallowing, remove dust particles and humidify air

Contains voice box

Passageway for air from pharynx to the trachea

23
Q

Thyroid cartilage

A

Characteristic triangle shape to anterior wall (adams apple)

24
Q

Epiglottis

A

Cartilage that projects upward behind the tongue and hyoid bone and moves up and down during swallowing

24
Q

Arytenoid cartilage

A

Borders circoid cartilage and serves as points of attachment for vocal cords

Narrowest part of an adult airway but bigger in children

Circoid cartilage is the narrowest part of a pediatric airway

25
Q

What does the trachea do

A

Cartilaginous ring to support the airway that opens posteriorly to allow the esophagus to expand to allow air to get from the outside to the lungs

26
Q

What does the bronchial tree do

A

Prinamry brochi has two routes- left with a 45-degree angle and right with a 25-degree angle

Secondary bronchi stems into 3 on the right and two on the left

Tertiary bronchi are the alveolar ducts and alveoli and the cartilage decreases with size and absent in tertiary bronchioles and smooth muscle increases

27
Q

Dyspnea

A

Subjective feeling of discomfort when a person can’t inhale enough air

Severe is accompanied by nasal flaring and accessory muscle use

Orthopnea is SOB when supine due to pooling blood in the lungs

Cyanosis is due to large amounts of deoxygenated hemoglobin in the blood

28
Q

URTI

A

Common cold is caused by a viral infection of the URT thats spread through resp droplets either inhaled or touch

Signs and symptoms: red mucous membrane of nose/pharynx, copious water discharge, mouth discharge, change in tone, cough from irritation of discharge

29
Q

Sinusitis

A

Bacterial infection to a cold or allergy that’s obstructed drainage of one or more of the paranasal sinuses causing a buildup leading to severe pain

30
Q

Croup (Layngotracheobronchitis)

A

Viral infection common between children ages 1-2 that begins as an upper resp condition with nasal congestion and cough. The larynx and subglottic area become inflamed with swelling and exudate causing a braking cough, hoarse voice, and stridor

Treat with cool, moist air

31
Q

Epiglottitis

A

Acute bacterial infection in children between 3-7 that causes swelling of the larynx, supragottic area, and epiglottis with a rapid onset and fever and sore throat develop as the child wont swallow so excessive drooling is present

32
Q

Pneumonia

A

Developed as an acute infection in the lungs or secondary to another resp/systemic condition from organisms entering the lungs via inhalation or aspiration

A risk of aspiration or inflammation in the lung when the fluid pools or cilia are reduced

Classified as viral, bacterial, or fungal

33
Q

Lobar pneumonia

A

Infection localized to one or more lobes

34
Q

Bronchopneumonia

A

Diffuse pattern of infection in both lungs more so in the lower lobes

35
Q

Viral pneumonia

A

Caused by influenza and respiratory viruses that begins with inflammation of the musoca of URT then moves into the lungs

36
Q

Tuberculosis

A

Infection affecting the lungs primarily but can also affect other organs that is transmitted by oral droplets released from a person with active infection inhaled into the lungs

Primary infection- when microorganisms enter the lungs that creates small area of necrotic tissue on the lungs that stays dormant as long as the immune system stays strong

Secondary infection- arises when immune system is down creating large areas of necrosis in lung tissues forming open areas and erosion into the bronchi and blood vessels

36
Q

Legionaires disease

A

gram negative bacteria that thrives in warm, moist environments

37
Q

Primary atypical pneumonia (PAP)

A

Viral and involves interstitial inflammation around the alveoli

38
Q

Cystic fibrosis

A

Genetic disorder that results in thick mucus secretion in the lungs that obstructs airflow in the bronchioles causing air trapping and damage to alveoli as well as infections from the stagnant mucus

39
Q

Aspiration

A

Passage of foreign material into the trachea or lungs where the right lower lobes is the most commonly affected

Solids can cause a complete airway obstruction and a collapse of the area distal to the obstacle

Fluids cause severe inflammation leading to narrowing of airways and increased secretions making the lungs difficult to expand, impairing gas exchange if alveoli are affected

40
Q

COPD

A

Progressive tissue degeneration and obstruction of the airways causing irreversible damage to the lungs, and debilitating conditions like asthma, emphysema, and bronchitis

41
Q

Asthma

A

Periodic episodes of severe bronchial obstruction that can be acute or chronic and triggered by an inhaled antigen (extrinsic) or respiratory infections, exposure to cold, exercise, drugs, and stress (intrinsic)

42
Q

Emphysema

A

Destruction of alveolar walls leading to large permanently inflated alveolar spaces that is contributed by factors like genetic deficiency or smoking

43
Q

Chronic bronchitis

A

Significant changes to bronchi from constant irritation, smoking, or exposure to pollutants with irreversible effects resulting in inflammation and obstruction to bronchi, repeated infections, and chronic coughing

44
Q

Pulmonary embolus

A

Blood clot/mass of materials obstructing pulmonary artery/ branch blocking blood flow through lung tissue and effects largely depend on the size and location of the clot

45
Q

Pleural effusion

A

Excess fluid in the pleural cavity more often involving one lung but can involve both inflammation/ swelling of pleural membranes (pleurisy) may follow

The fluid creates higher pressures preventing normal lung expansion leading to atelectasis

46
Q

Adult respiratory distress syndrome (ARDS)

A

A restrictive disorder secondary to injury like sepsis, shock, burns, aspiration, and smoke inhalation that occurs 1-2 days after the injury and associated with multiple organ dysfunction

47
Q

Acute respiratory failure

A

Result of many pulmonary disorders and occurs when there are inadequate O2/CO2 levels for the body’s needs at rest affecting the CNS and respiratory control factors ending in respiratory arrest

48
Q

How PCO2 changes affect resp system

A

Medulla has sensors in the nervous system to detect changes in PO2, PCO2, and pH

PCO2 acts on chemoreceptors that are sensitive to CO2 changes in arterial blood and when stimulated from increased PCO2 results in faster breathing and greater volumes of air moving in and out of the lungs. When stimulated for decreased PCO2 it results in inhibition of medulla rhythmicity and slows respirations

49
Q

Cerebral cortex

A

Impulses from motor area of the brain to respiratory center can increase/decrease respirations voluntarily but eventually the automaticity of the system will take over when CO2 levels rise in the blood and involuntary breathing is resumed

50
Q

Pons

A

Coordinates actions of medulla for a smooth breathing center that has stimulating neurons and inhibitory neurons to start/ block actions to increase/decrease the rate and depth of inspiration based on chemical/pressure levels

Homeostatic balance of rate and depth of respirations

51
Q

Medulla

A

Controls rhythmic nature of breathing

Inspiratory center is the pacemaker of the respiratory control center that depolarizes and send impulses via phrenic nerve in diaphragm and intercostal nerves to the intercostal muscles

Expiratory center is when deeper expiration is needed that is not involved during normal breathing and impulses are sent to intercostals and abdominal muscles to aid in the expiration

52
Q

CO2 transported by bicarbonate

A

More than 2/3 of blood is transported this way (65-70%) in the form of bicarbonate ions (HCO3)

CO2 dissolves in plasma and some molecules bind with H2O to form carbonic acid while others dissociate to form H+ and bicarbonate ions.
More CO2 means higher levels pof carbonic acid pulling the system towards bicarbonate formation so more CO2 can dissolve in plasma increasing CO2 carrying capacity of the blood

53
Q

CO2 dissolved in plasma

A

Small amounts of CO2 dissolved in plasma and is transported as a solute (10% is transported this way) and the dissolved CO2 produces the PCO2 of blood plasma

54
Q

Carbamino compounds

A

25-35% of CO2 in blood unites with hemoglobin

CO2 combines with HB and creates carbaminohemoglobin and the higher the PCO2 levels accelerate the binding process and the lower PCO2 levels slows this process

55
Q

CPAP

A

Lungs have a decreased ability to keep alveoli open due to fluid in the lungs so CPAP works to hold the alveoli open with positive pressure through the respiratory cycle so O2 and CO2 can diffuse normally

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