SEE best study guide ever - RESP Flashcards
what does RLN innervate sensory?
below vc to trachea
what does external SLN innervate motor?
cricothyroid
stimulation of ____ = laryngospasm
SLN motor
internal SLN sensory area?
above vocal cords and cords
what is the function of the posterior cricoarytenoid?
abduction - please come apart
what is the function of the lateral cricoarytenoid?
adduction - lets close airway
what is the function of the cricothyroid?
tenses vocal cords
CT = cords tense
what is the function of the thyroarytenoid?
relaxes cords
what is the only intrinsic muscle that receives motor innervation from the SLN?
cricothyroid
what nerve provides the sensory innervation for pharynx?
glossopharyngeal
what nerve provides the motor innervation for the pharynx?
spinal accessory
which laryngeal cartilages are paired?
cuneiform, corniculate, arytenoids
which laryngeal cartilages are unpaired?
epiglottis, thyroid, cricoid
which laryngeal cartilage is the only one that has a complete cartilaginous ring?
cricoid
where does the transtracheal block puncture?
cricothyroid membrane
Oxyhemoglobin dissociation curve - what does it mean when the curve is shifted to the right?
right = released
O2 is unloaded from blood
hemoglobin has less affinity for O2 and releases it, so saturation will be less for a given PO2
Oxyhemoglobin dissociation curve - what causes a right shift
inc PCO2, H+, acidosis (so dec pH), inc temp (think inc metabolism), inc 2,3 DIPG, sickle cell
Oxyhemoglobin dissociation curve - what does it mean when the curve is shifted left?
left shift increases O2 affinity.
left = love = locked
hemoglobin has a higher affinity for O2, binds O2, so saturation will be higher for a given PO2.
what is a normal P50?
26-27
Oxyhemoglobin dissociation curve - what causes a left shift?
dec PCO2, dec H+, inc ph(alkalosis), dec temp, inc CO poisoning (carboxyhemoglobin), fetal hemoglobin, methemoglobin, smoking
what is the bohr effect
an increase in H+ decreases Hb’s affinity for O2 (right shift).
so this increases the delivery of O2 to tissues
what is the hb p50 point?
Sao2% = 50, PaO2 = 27
haldane effect
Hb carries more CO2.
love-locked-left
this allows hemoglobin to load more carbon dioxide at the tissue level and release more CO2 in the lungs
this affects the CO2 dissociation curve not the oxy
hamburger shift
when the RBC releases HCO3 into the plasma, CL- is transported into the RBC to maintain electroneutrality
what is the formula for O2 content in blood?
hint: it involves O2 carried on Hb and dissolved in plasma
CaO2 = (SO2 x Hb x 1.31) + (PO2 x 0.003)
what is the formula for O2 content in blood?
hint: it involves O2 carried on Hb and dissolved in plasma
CaO2 = (SO2 x Hb x 1.31) + (PO2 x 0.003)
what has a stronger affinity for CO2 - carbon monoxide or nitric oxide?
nitric oxide - it binds 200k times more readily than o2
carbon monoxide binds 250x more than o2
PRBC used for transfusions are stored ___, have ____ 23DPG, so Hb in stored blood initially shows a ___ shift
cold, diminished, left
what are the 4 ways CO2 is carried in the blood
physically dissolved (5%), carbonic acid(<1%), bicarb ion (90%), protein bound (5%)
T/F Venous blood transports more CO2 than arterial blood
TRUE
what is the pacemaker of respiration
dorsal resp group.
it controls inspiration and resp rhythm.
DRG receives signals from what 3 sources?
peripheral chemoreceptors, baroreceptors, lung receptors
do geriatric lungs have increased or decreased compliance
what about peds?
increased geri
decreased peds d/t dec # alveoli
Dead space = 0 or infinity?
dead space = good perfusion or good ventilation?
infinity
well vent, poor perfusion
think: “dead space = infinite amt of breathing”
shunt = 0 or infinity? shunt = good perfusion or good ventilation?
0
well perfuse, poor vent
think: shunt = 0 breathing
how does the lateral position affect v/q mismatch?
when a patient is anesthetized, ventilation is better in the nondependent lung and perfusion is better in the dependent lung
For tx of hypoxemia during OLV, add __ of ___ to the nondependent lung, and ___ of ___ to the dependent lung
10 CPAP nondependent
5 PEEP dependent
what 2 spirometry components make up FRC
ERV + RV (35ml/kg)
what tests can measure FRC?
nitrogen washout, helium wash in, or body plethysmography
what is the best test to assess early stages of COPD?
FEV25-75
what are the 2 high risk PFT results
FEV <2L (normal is 5, should be able to get 80% of that which is 4)
and
FEV/FVC <0.5 (normal is 80%)
what is a normal FEV1
4L
what is a normal FVC
5L male, 3.7F
how do you expect PFT’s to change on someone with restrictive disease?
dec FEV1, dec FVC, normal to high FEV1/FVC
how do you expect PFT’s to change on someone with obstructive disease?
dec FEV1, normal FVC, dec FEV1/FVC
T/F Hyperbaric O2 is used to treat CO2 poisoning, gas embolism, anaerobic infections (gas gangrene) , and decompression sickness (bends)
TRUE
carbonic anhydrase is responsible for converting ___ to ___
CO2 to HCO3
what do central chemoreceptors respond to?
H+ in the CSF
what do peripheral chemoreceptors respond to?
inc H+. inc CO2, and dec PaO2
what is the 3-3-2 rule?
3 finger mouth opening(inter incisor distance), 3 thyromental, 2 floor mouth to top of thyroid
how does thyromental distance predict intubation
want at least 3 fingers which is 6cm. >7 is an easy tube, <6 or >9 is diff
Mendelsons syndrome: Ph = ___, volume = ___
ph <2.5, gastric volume >25
what are the risk factors for laygospasm
age >1, GERD, URI <2weeks, hypervent, hypocap.
what is the succs dose to break spasm in an adult?
how about in a child/neonate?
adult/child 1mg/kg
neonate/infant 2mg/kg IV
a child <5y should receive atropine @ ___mg/kg with succs to prevent bradycardia
.02
lung zones:
zone 1 = PA > Pa > PV
zone 2 = Pa > PA > PV
zone 3 = Pa > PV > PA
