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SEE review Horvath > SEE best study guide ever - RESP > Flashcards

SEE best study guide ever - RESP Flashcards

1
Q

what does RLN innervate sensory?

A

below vc to trachea

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2
Q

what does external SLN innervate motor?

A

cricothyroid

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3
Q

stimulation of ____ = laryngospasm

A

SLN motor

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4
Q

internal SLN sensory area?

A

above vocal cords and cords

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5
Q

what is the function of the posterior cricoarytenoid?

A

abduction - please come apart

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6
Q

what is the function of the lateral cricoarytenoid?

A

adduction - lets close airway

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7
Q

what is the function of the cricothyroid?

A

tenses vocal cords

CT = cords tense

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8
Q

what is the function of the thyroarytenoid?

A

relaxes cords

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9
Q

what is the only intrinsic muscle that receives motor innervation from the SLN?

A

cricothyroid

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10
Q

what nerve provides the sensory innervation for pharynx?

A

glossopharyngeal

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11
Q

what nerve provides the motor innervation for the pharynx?

A

spinal accessory

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12
Q

which laryngeal cartilages are paired?

A

cuneiform, corniculate, arytenoids

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13
Q

which laryngeal cartilages are unpaired?

A

epiglottis, thyroid, cricoid

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14
Q

which laryngeal cartilage is the only one that has a complete cartilaginous ring?

A

cricoid

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15
Q

where does the transtracheal block puncture?

A

cricothyroid membrane

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16
Q

Oxyhemoglobin dissociation curve - what does it mean when the curve is shifted to the right?

A

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

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17
Q

Oxyhemoglobin dissociation curve - what causes a right shift

A 
inc PCO2, H+, acidosis (so dec pH), 
inc temp (think inc metabolism), inc 2,3 DIPG, sickle cell
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18
Q

Oxyhemoglobin dissociation curve - what does it mean when the curve is shifted left?

A

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.

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19
Q

what is a normal P50?

A

26-27

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20
Q

Oxyhemoglobin dissociation curve - what causes a left shift?

A

dec PCO2, dec H+, inc ph(alkalosis), dec temp, inc CO poisoning (carboxyhemoglobin), fetal hemoglobin, methemoglobin, smoking

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21
Q

what is the bohr effect

A

an increase in H+ decreases Hb’s affinity for O2 (right shift).

so this increases the delivery of O2 to tissues

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22
Q

what is the hb p50 point?

A

Sao2% = 50, PaO2 = 27

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23
Q

haldane effect

A

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

24
Q

hamburger shift

A

when the RBC releases HCO3 into the plasma, CL- is transported into the RBC to maintain electroneutrality

25
Q

what is the formula for O2 content in blood?

hint: it involves O2 carried on Hb and dissolved in plasma

A

CaO2 = (SO2 x Hb x 1.31) + (PO2 x 0.003)

26
Q

what is the formula for O2 content in blood?

hint: it involves O2 carried on Hb and dissolved in plasma

A

CaO2 = (SO2 x Hb x 1.31) + (PO2 x 0.003)

27
Q

what has a stronger affinity for CO2 - carbon monoxide or nitric oxide?

A

nitric oxide - it binds 200k times more readily than o2

carbon monoxide binds 250x more than o2

28
Q

PRBC used for transfusions are stored ___, have ____ 23DPG, so Hb in stored blood initially shows a ___ shift

A

cold, diminished, left

29
Q

what are the 4 ways CO2 is carried in the blood

A

physically dissolved (5%), carbonic acid(<1%), bicarb ion (90%), protein bound (5%)

30
Q

T/F Venous blood transports more CO2 than arterial blood

A

TRUE

31
Q

what is the pacemaker of respiration

A

dorsal resp group.

it controls inspiration and resp rhythm.

32
Q

DRG receives signals from what 3 sources?

A

peripheral chemoreceptors, baroreceptors, lung receptors

33
Q

do geriatric lungs have increased or decreased compliance

what about peds?

A

increased geri

decreased peds d/t dec # alveoli

34
Q

Dead space = 0 or infinity?

dead space = good perfusion or good ventilation?

A

infinity
well vent, poor perfusion

think: “dead space = infinite amt of breathing”

35
Q 
shunt = 0 or infinity? 
shunt = good perfusion or good ventilation?
A

0

well perfuse, poor vent

think: shunt = 0 breathing

36
Q

how does the lateral position affect v/q mismatch?

A

when a patient is anesthetized, ventilation is better in the nondependent lung and perfusion is better in the dependent lung

37
Q

For tx of hypoxemia during OLV, add __ of ___ to the nondependent lung, and ___ of ___ to the dependent lung

A

10 CPAP nondependent

5 PEEP dependent

38
Q

what 2 spirometry components make up FRC

A

ERV + RV (35ml/kg)

39
Q

what tests can measure FRC?

A

nitrogen washout, helium wash in, or body plethysmography

40
Q

what is the best test to assess early stages of COPD?

A

FEV25-75

41
Q

what are the 2 high risk PFT results

A

FEV <2L (normal is 5, should be able to get 80% of that which is 4)

and

FEV/FVC <0.5 (normal is 80%)

42
Q

what is a normal FEV1

A

4L

43
Q

what is a normal FVC

A

5L male, 3.7F

44
Q

how do you expect PFT’s to change on someone with restrictive disease?

A

dec FEV1, dec FVC, normal to high FEV1/FVC

45
Q

how do you expect PFT’s to change on someone with obstructive disease?

A

dec FEV1, normal FVC, dec FEV1/FVC

46
Q

T/F Hyperbaric O2 is used to treat CO2 poisoning, gas embolism, anaerobic infections (gas gangrene) , and decompression sickness (bends)

A

TRUE

47
Q

carbonic anhydrase is responsible for converting ___ to ___

A

CO2 to HCO3

48
Q

what do central chemoreceptors respond to?

A

H+ in the CSF

49
Q

what do peripheral chemoreceptors respond to?

A

inc H+. inc CO2, and dec PaO2

50
Q

what is the 3-3-2 rule?

A

3 finger mouth opening(inter incisor distance), 3 thyromental, 2 floor mouth to top of thyroid

51
Q

how does thyromental distance predict intubation

A

want at least 3 fingers which is 6cm. >7 is an easy tube, <6 or >9 is diff

52
Q

Mendelsons syndrome: Ph = ___, volume = ___

A

ph <2.5, gastric volume >25

53
Q

what are the risk factors for laygospasm

A

age >1, GERD, URI <2weeks, hypervent, hypocap.

54
Q

what is the succs dose to break spasm in an adult?

how about in a child/neonate?

A

adult/child 1mg/kg

neonate/infant 2mg/kg IV

55
Q

a child <5y should receive atropine @ ___mg/kg with succs to prevent bradycardia

A

.02

56
Q

lung zones:

A

zone 1 = PA > Pa > PV
zone 2 = Pa > PA > PV
zone 3 = Pa > PV > PA

SEE review Horvath (10 decks)

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