Test 2 Ch.1 Flashcards by Kiesha Alexis

The movement of air into an out of the lungs

ventilation

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involves the exchange of oxygen and carbon dioxide between an organism and its environment

Respirations

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Contraction of the muscles of inspiration, which causes expansion of the thorax. what kind of breath is this?

Spontaneous breath

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Accessory muscles of inspiration (4)

Scalene
Sternoclediomastoids
Pectoralis
Trapezius

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Accessory muscles of expiration (6)

rectus abdominus
external oblique
internal oblique
transverse abdominal
Serratus ( anterior and posterior)
Latissimus dorsi

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_______ ________ is pressure is when your breathing in

Negative pressure

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________ ____________ is on the vent and pushing positive pressure into the lungs

postive pressure

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From air to flow through a tube or airway what must exist?

pressure gradient

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pressure at one end of the tube must be higher than pressure at the other end of the tube

pressure gradient

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What changes as a result of gas flow into and out of the airways

Lung volumes

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This is caused by changes in the pressure gradient between the airway opening and the alveoli

Lung volume change

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Concentration of the inspiratory muscle

Inspiration

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Alveolar pressure becomes less than the pressure at the airway opening and gas flow into the lungs

Inspiration

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Relaxation of the inspiratory muscles causes in a decrease in the thoracic volume

Expiration

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Intrapulmonary pressure or lung pressure

Alveolar pressure (PA or Palv)

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Highest pressure at the end of inspiration

peak pressure

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If peak pressure is high then what needs to be done?

Suctioning b/c of secretions

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is also called PIP or peak airway pressure

peak pressure

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PIP can increase if

a pt is fighting the vent while awake

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An airway pressure measurement is called the

plateau pressure

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measured after a breath has been delivered to the pt and before exhalation begins

plateau pressure

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__________ is prevented by the vent for a brief moment _____ to ______ seconds

Exhalation; 0.5 to 1.5 s

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To obtain the measurement the ventilator operator normally selects a control marked

“inspiratory hold” or “inspiratory pause”

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The relative ease w/ which the structure distends

Compliance (c)

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Normal compliance in spontaneous breathing pts

0.05 to 0.17 L mL/cmH2O

Normal compliance in intubated pts

Males :40 to 50 up to 100 Females: 35 to 45 up to 100

The tendency of a structure to return to its original form after being stretched or acted on by an outside force

Elastance (e)

Elastance is the

opposite of compliance

In the clinical setting compliance measurements are used to describe

the elastane forces that oppose lung inflation

-30 for plateau pressure is

normal

The compliance by the respiratory system is determined by

measuring the change (🔺) of volume (v) that occurs when pressure (P) is applied to the system

🔺V/🔺P

For pts receiving MV, compliance measurements are made during

static conditions

The tidal volume used in this calculation is to determine by measuring the pt's exhaled volume near the pt connected

static compliance (cs)

What are the 2 cs equation

- cs=(exhaled tidal volume /plateau pressure -EEP) - cs =Vt/ (Pplat- EEP)

EEP is the en expiratory pressure, which some clinicians call the

baseline pressure ; it is the baseline from which pt breathes

Normal resistance values for unintubaned pts

0.6 to 2.4 cm H2O (L/s) at 0.5 L/s flow

Normal resistance values for intubated pt

Approximately 6 cm H20 or higher (airway resistance increase as ETT size decreases)

Attempts to mimic the function of the respiratory muscles to allow breathing through the normal physiological mechanism

Negative pressure ventilation (NPV)

With this device, the pt's head and neck are exposed to ambient pressure while the thorax and the rest of the body are enclosed in an airtight container that is subjected to negative pressure

Iron Lung

Mechanical ventilator is used to deliver air into the pt's lungs by way of an ETT or positive pressure mask

Positive pressure ventilation (ppv)

Uses above normal ventilating rates with below- normal ventilating volumes

high frequency ventilation

3 types of high frequency ventilation strategies

- high frequency positive pressure ventilation (HFPPV) - high- frequency jet ventilation (HFJV) - high- frequency oscillatory ventilation (HFOV)

Uses respiratory rates of about 60 to 100 breaths/ min

high frequency positive pressure ventilation (HFPPV)

Uses rates between 100 and 400 to 600 breaths/ min

high- frequency jet ventilation (HFJV)

uses rates into the thousands up to 4000 breaths/ min

high- frequency oscillatory ventilation (HFOV)

____ can be trapped in the lungs during MV if not enough time is allowed for exhalation

air

The most effective way to prevent air trapping complication is to monitor the

pressure in the ventilator circuit and the end of exhalation

If no extrinsic PEEP is added and the baseline is greater than zero

air trapping or auto-PEEP is present

Airway pressure are measured relative to a

baseline value

If baseline is zero it indicates that

no additional pressure is applied at the airway opening during expiration and before inspiration

If the baseline is higher than zero the ventilator operator selects a..... AND IS CALLED

higher pressure to be present at the end of end of exhalation; positive end- expiratory pressure (PEEP)

When PEEP is set the ventilator prevents the pt from

exhaling to zero (atmospheric pressure)

PEEP increases the volume of gas remaining in the lungs at the

end of a normal exhalation

PEEP applied by the operator is called

extrinsic PEEP

The air that is accentually trapped in the lungs

Auto-PEEP (intrinsic PEEP)

Usually occurs when a pt does not have enough time to exhale completely before the ventilator delivers another breath

Intrinsic PEEP

Physiologically everyone has a PEEP of

1mm HG =

136 cm H20

The pressure difference between the alveolus (Palv) and the body surface is called

Transthoracic pressure

Define elastance

Ability of a structure to return to its natural shape after stretching

What is the formula used for compliance?

C=🔺V/🔺P

Another term for airway pressure

Airway opening pressure

Intraalveolar pressure (in relation to atmospheric pressure) at the end of inspiration during a normal quiet breath is

0 cm h20

Which of the following Associated with Increase in airway resistance

Decreasing the flow rate of gas into the airway

Which of the following statements is true regarding negative pressure ventilation (npv)

Thes ventilators mimc normal breathing mechanics

PEEP is best defined

Positive pressure at the end of exhalation on a mechanical ventilator

Which of the following statements is true regarding plateau pressure

Plateau pressure is used as a measure of alveolar pressure

One time constant should allow approximately what percentage of a lung unit to fill

63%