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Respiratory > Seminars Respiratory > Flashcards

Seminars Respiratory Flashcards

1
Q

What is the single largest contributor to an increased resistance in airflow?

A

Reduction in airway diameter

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2
Q

What is the hallmark of an upper respiratory tract obstruction?

A

Respiratory noise (stridor) usually an inspiratory noise and prolonged inspiration

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3
Q

What is dyspnoea?

A

Difficulty breathing- can happen with upper or lower respiratory tract issues

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4
Q

What occurs with regards to sound in a lower respiratory obstruction or severe lung disease?

A

Silent dyspnoea, with exaggerated expiratory effort and prolonged expiration

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5
Q

What is the narrowest part of the URT?

A

Larynx

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6
Q

What is Poiseuille’s Law?

A

Airflow is proportional to r^4 (.5 obstruction- 1/16 the flow). A small obstruction can have a big impact on airflow.

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7
Q

Recurrent Laryngeal Neuropathy (Laryngeal hemiplegia)

A

An arytenoid cartilage that does not maximally open or does not open with sustained strength during exercise

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8
Q

Dorsal displacement of the soft palate

A

Large negative pressures during exercise dislodge the soft palate from its normal position

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9
Q

Collapse of the pharyngeal roof

A

causes obstruction URT

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10
Q

Axial collapse of the ariepiglottic folds

A

causes obstruction URT

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11
Q

Which species cannot mouth breathe?

A

Horses, rabbits, and rodents. They have a long soft palate which sits underneath the epiglottis forming an airtight seal around the larynx. Severe bilateral nasal obstruction is life threatening in these species.

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12
Q

Which species only mouth breathe when they are having difficulty breathing?

A

Cats, cattle, and sheep

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13
Q

Why might it be difficult to see nasal discharge in cattle?

A

They lick their noses

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14
Q

What is strangles?

A

high contagious bacterial infection (horses) caused by Streptococcus equi. Causes large abscesses in the URT lymph nodes. If the retropharyngeal lymph nodes are involved and they continue to enlarge without rupture, they push the roof of the pharynx down obstructing the airway.

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15
Q

Bovine nasal granuloma (allergic rhinitis)

A

Hypersensitivity reactions in the nasal mucosa cause extreme irritation and itching which leads to FBs lodged deep in the nasal passages

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16
Q

Calf diphtheria (laryngeal and oral necrobacillosis)

A

Anaerobic bacterium Fusobacterium necrophorum invade superficial ulcers in the larynx (or mouth) causing large proliferative necrotic lesions that obstruct the larynx. Ulcers can develop as a result of continual coughing, or mild URT infections, constant vocalization or inhaled irritants.

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17
Q

Brachycephalic Syndrome- dogs

A

Flattened faces (shortened noses)- stenotic nares, long soft palate, everted laryngeal saccules. Abnormal narrowing of the nostrils creates a need for greater inspiratory effort at rest and a larger negative pressure inside the airways. This helps to displace the elongated soft palate which flaps in front of the larynx, obstructing (getting sucked into) the airway, causing dyspnoea and a bigger inspiratory effort. Negative pressure also evert the laryngeal saccules, which cause greater laryngeal obstruction and dyspnoea.

18
Q

What does pulse oximetry measure?

A

Determines the degree of saturation of haemoglobin with oxygen

19
Q

Where do we clip pulse oximeters on animals?

A

Tongue, paw, lip, or oesophagus or cloaca

20
Q

What is a normal percentage saturation of Hb with oxygen?

A

95%

21
Q

What does a capnogram measure?

A

Expired CO2 in gases continuously sampled near the patients respiratory tract. End tidal CO2 tension reflects systemic arterial CO2 tension (more accurately measured by arterial blood gas analysis).

22
Q

What does the level of end tidal CO2 depend on?

A

Rate of production of CO2, the alveolar ventilation, and the CO and pulmonary perfusion. Thus monitoring end tidal CO2 tells us about metabolism, ventilation, and circulation

23
Q

What is a normal tidal CO2 value?

A

30-45 mm Hg

24
Q

What is blood gas analysis?

A

pH, partial pressure of oxygen (pO2), and pCO2. Also, bicarbonate, base excess, and percentage saturation of Hb with oxygen. (can also measure lactate, glucose and electrolytes) Arterial blood gas analysis is the gold standard for monitoring the respiratory system. Venous blood gas can also give information.

25
Q

What are the three ways CO2 is carried in the blood?

A

In solution (plasma 7-10%), bound to proteins (15-25%), and as bicarbonate (70-74%)

26
Q

How is oxygen carried in the blood?

A

pO2- bound to Hb (97-98%); dissolved in plasma (2-3%)

27
Q

What does arterial blood gas analysis tell us?

A

How well the blood is oxygenated in the lungs.

28
Q

What does venous blood gas analysis tell us?

A

How much oxygen remains in the blood after tissues have been perfused, depends on original uptake of oxygen in the lungs, tissue perfusion, and peripheral extraction of oxygen– reflects the pulmonary and cardiovascular statuses. Also tells us the acid/base status of the patient and helps us determine the cause (respiratory and/or metabolic)

29
Q

What is Hypoxaemia?

A

Poor oxygenation of the blood, whereas hypoxia is defined as poor oxygenation of the tissues.

30
Q

A low SpO2 on pulse oximetry or a low PaO2 on blood gas analysis, tells us what?

A

Patient is hypoxaemic

31
Q

What are the 5 main causes of hypoxaemia?

A

Low fraction of inspired oxygen, inadequate ventilation, impaired diffusion across the alveoli, ventilation perfusion mismatching or shunt.

32
Q

What can the A-a gradient tell us (alveolar to arterial)?

A

V/Q matching

33
Q

What does spirometry measure?

A

Tidal volume, minute ventilation, simple turbine propelled

34
Q

How do you measure oxygen in the blood?

A

Pulse oximetry and arterial blood gases

35
Q

How do you measure CO2 in the blood?

A

capnography and arterial blood gases

36
Q

What are some limitations of pulse oximetry?

A

Hypoxaemia (doesn’t measure pO2), movement, ambient lighting, vasoconstriction (hypothermia, drugs, compression of tissue), low output states, pigment

37
Q

What are the causes of hypoxaemia?

A

Low inspired oxygen concentration (FiO2)- high altitude for example, hypoventilation, venous admixture (v/q mismatch, shunt, diffusion impairment)

38
Q

What does it mean if CO2 < 35 mm Hg?

A

Hyperventilation- pain, hyperthermia, awakened during anesthesia

39
Q

What does it mean if PaCO2 > 45 mm Hg?

A

Hypoventilation, decreased elimination, rebreathing, increased production, restricted airflow, CNS depression due to opiates or anaesthetic agent, increased abdominal pressure, movement of lungs restricted (pneumothorax, tumor, etc.), lung disease (V/Q mismatch)

40
Q

When do you use IPPV?

A

Mechanical ventilation. PaCO2 > 60 mm Hg, Low volume minute, paralyzed patient, prolonged surgical/diagnositc procedure, PaO2 < 80 mm Hg, surgical procedure involving opening of thoracic area

Respiratory (11 decks)

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