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PAR2012 - Respiratory > Week 12 - revision > Flashcards

Week 12 - revision Flashcards

1
Q

define ventilation?

A

the movement of the air in and out of the lungs

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2
Q

define internal respiration?

A

transfer of o2 and co2 between the capillary red blood cells and the tissue

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3
Q

define external respiration?

A

transfer of o2 and co2 between the inspired air and the pulmonary capillaries

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4
Q

how are the mechanisms of breathing and boyels law related?

A

as volume increases, pressure decreases in the lungs = drawing air into lung

as volume decreases, pressure increases in the lungs = moving air out of lung

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5
Q

what is daltons law?

A

in a mixture of non-reacting gases, the total pressure exerted is equal to the sum of partial pressures of individual gases.

basically

total pressure = pressure 1 + pressure 2

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6
Q

how much of the atmospheres pressure is accounted for by O2?

A

21%

as it makes up 21% of the atmosphere

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7
Q

what happens at higher altitude with daltons law?

A

o2’s partial pressure decreases.

making it harder to enter blood stream as the partial pressures don’t facilitate diffusion

hypoxia occurs

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8
Q

what are the characteristics of acidosis?

A

condition of having a lower pH than normal

  • Academia is caused by acidosis
  • ph of blood is below 7.35- main types are metabolic and respiratory acidosis
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9
Q

what are the characteristics of alkalosis?

A

condition of having a higher pH than normal

  • Alkalemia is caused by alkalosis
  • ph of blood is above 7.45- main types are metabolic and respiratory alkalosis
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10
Q

what is the normal pH range?

A

7.35-7.45

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11
Q

what are s&s of respiratory acidosis?

IMPORTANT

A
  • hypoventilation = hypoxia
  • rapid shallow resps
  • decreased BP with vasodilation
  • Dyspnea
  • headache
  • hyperkalemia
  • Dysrhthmias (increased k+)
  • drowsiness, dizziness, disorientation
  • muscle weakness, hyperreflexia
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12
Q

WHat are the causes of respiratory acidosis?

A

Airway obstuction:

  • COPD exacerbation
  • Bronchial asthma

Respiratory muscle weakness

CNS Depression:

  • head trauma
  • post ictal
  • drug toxicity
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13
Q

what are s&s of respiratory alkalosis?

IMPORTANT

A
  • seizures
  • deep, rapid breathing
  • hyperventilation
  • tachycardia
  • decreased or normal BP
  • Hypokalemia
  • numbness & tingling in extremities
  • Lethargy & confusion
  • Light headedness
  • nausea, vomiting
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14
Q

WHat are the causes of respiratory alkalosis?

A 
Pain, anxiety, panic attacks
- pregnancy
- high altitude
- drug toxicity
hyperventilation
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15
Q

What are the causes of metabolic acidosis?

A

DKA
Sever diarrhea
renal failure
shock

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16
Q

what are the causes of metabolic alkalosis?

A

severe vomiting
excessive GI suctioning
diuretics
excessive NaHCO3

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17
Q

WHat is the pathological mechanism behind resp acidosis?

A

alveolar hypoventilation

= co2 retention

18
Q

WHat is the pathological mechanism behind resp alkalosis?

A

increases RR and or tidal volume= alveolar hyperventilation

= co2 washout

19
Q

factors that increase co2 in respiration also increase what?

A

carbonic acid

20
Q

what is the process of creating carbonic acid?

A

co2 levels increase and excess co2 reacts with water (via an enzyme Carbon Anhydrase) = forming carbonic acid

Carbonic acid then dissociates to form H+ ions and bicarbonate ions.

Increase in H+ causes pH to decrease

21
Q

What occurs in regards to carbonic acid in resp alkalosis?

A

as co2 levels decrease, H+ ions react with bicarbonate to form carbonic acid.

The carbonic acid dissociates to form water + Co2, resulting in a decrease in H+ in the body, causing increase in pH

22
Q

what can you do with a CPOD patient that deteriorates?

A

assisted ventilations

consult CPAP (MICA skill)

23
Q

what are droplet precautions for infection control?

A

put mask on you and your patient

24
Q

why does overoxygenation cause issues in COPD patients?

A

it impacts V/Q mismatch and also the Haldane effect

25
Q

Explain what happens with V/Q ratio in a COPD patient given too much oxygen?

A

in COPD patients, they optimise gas exchange by hypoxic vasoconstriction leading to altered alveolar ventilation-perfusion rations (VQ)

Excessive o2 administration overcomes this, leading to increased blood flow to poorly ventilated alveoli

leading to: increased VQ mismatch and increased deadspace

26
Q

Explain what happens with haldane effect in a COPD patient given too much oxygen?

A

deoxygenated haemoglobin binds to co2 with greater affinity than oxygenated haemoglobin.

27
Q

what is cor pulmonale?

A

abnormal enlargement of the right side of the heart as a result of disease of the lungs or the pulmonary vessels

28
Q

what is the process cuasing cor pulmonale?

A

lung disease -> causes inflammation/hypoxia/fibrosis/parenchymal loss

  • > leads to arterial stiffness, vascular remodelling, endothelial dysfunction
  • > leads to pulmonary hypertension
  • > causes RV hypertrophy -> RV Failure

= cor pulmonale

29
Q

What are some s&S of right sided heart failure?

A
  • fatigue
  • increased peripheral venous pressure
  • ascites
  • enlarged liver/spleen
  • JVD
  • anorexia & complaints of gastric distress
  • weight gain
  • dependent oedema
30
Q

what happens during aaspiration?

A

Pulmonary:
aspirating water washes out surfactamt, often produicing non cardiogenic PO and ARDS

neuro:
hypoxemia and ischaemia cause nuronal damage which can produce cerebral oedema and increase ICP

Cardiovascular:
arrythmias due to hypothermia and hypoxia are seen in non fatal drowning

acid base and electrolytes:
acidosis often observed, often only when submerged in weird shit. like the dead sea

31
Q

what are the 4h’s and 4 t’s of reversible causes in cardiac arrest

A

hypothermia
hypoxia
hypovolaemia
Hypo/hyperkalaemia

tension pnuemo
toxins
thrombosis
tamponade

32
Q

what are the critical outcomes/factors in submersion injuries?

A
  • duration of submersion is key - >5mins
  • time to effective BLS >10mins
  • resuscitation duration >25mins
  • Age >14
  • GCS <5
  • persistent apnea and requirement of CPR
  • arterial blood pH <7.1 upon presentation
33
Q

what are adrenoreceptor agonist drugs?

A

acts on alpha and beta receptors

  • used to treat asthma, croup, anaphylaxis, cardiac arrest and inadequate perfusion
  • salbutamol and adrenaline
34
Q

What do adrenoreceptor agonists do?

A

ALPHA:
vasoconstriction of smooth muscle

BETA 1:
- bronchodilation

BETA 2:
- cardiac contractility

35
Q

why do we give adrenalise nebulised for croup?

A

bronchodilation and airway mucosal vasoconstriction leading to reduction in airway wall oedema

36
Q

why do we give adrenaline for asthma?

A

reduce mucosal oedema
enhance bronchodilation
stabalise mast cells

37
Q

what is salbutamol?

A

a selected B2 adrenergic agonist

  • skeleteal muscle is also activated by B2 stimulation
38
Q

what is ipratropium bromide?

A

a muscarinic antagonist acting on M3 receptor

  • competitive antagonise
  • blocks bronchocontriction
39
Q

What is dexamethasone?

A

an exogenous glucocorticoid

anti-inflammatory agent

40
Q

what are the unwanted side effects of excessive glucocorticoid steroid administration?

A

(Cushings syndrome)

  • euphoria
  • buffalo hump
  • hypertension
  • thinning of skin
  • thin arms and legs
  • benign intracranial hypertension
  • cataracts
    moon face with red cheeks
  • increased abdo fat
  • easy bruising
  • poor wound healing

PAR2012 - Respiratory (13 decks)

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