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105 Cards in this Set
- Front
- Back
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Central Nervous system
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Brain and Spinal cord
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Peripheral Nervous System
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Sensory and Motor neurons (everything else)
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Somatic nervous system
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Voluntary input from organs and output from skeletal muscles
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Autonomic Nervous system
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Involuntary Input from internal receptors and output from smooth muscle and glands
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Sympathetic system
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fight or flight responses (adrenergic system)
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Parasympathetic system
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relaxing responses (cholinergic system)
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Ventral Respiratory group
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contains inspiratory and expiratory neurons
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Control of inspiratory ramp signal is from?
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Ventral resp. Group (VRG)
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Dorsal Resp. Group (DRG)
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contains mostly Insp. Neurons
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DRG sends impulses to?
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Motor nerves of the diaphragm and External intercostals
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Pneumotaxic Center
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controls "I" time (control switch for inspiration)
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Hering-Breuer reflex
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sends stop signal when large Vt is inhaled
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J-Receptors
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Increases the capillary pressure
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Peripheral Proprioceptors
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Movement of tactile stimulation activates hyperpnea
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Heads Paradoxical Reflex
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responsible for Sigh and may be responsible for babies first breath
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Irritant Receptors
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stimulated by irritants in AW (causes asthma symptoms)
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Central Chemoreceptors
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Located bilaterally in medulla
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What stimulates Central Chemoreceptors
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Mostly H ions but indirectly by CO2
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Peripheral Chemoreceptors
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located in the carotid bodies and the aortic arch
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what stimulates Peripheral Receptors
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a decrease in PaO2 of less than 60 mmHg
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Normal anatomical shunt from 3 sources?
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Pleural Veins, Thebesian Veins, Bronchial Veins
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Primary Ventilatory muscles
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Diaphragm, Intercostals, and Scalene muscles
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Secondary Ventilatory Muscles
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Sternocleidomastoid,Pectoralis muscles, abdominals, Trapezius muscles
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Canals of Lambert connect?
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Terminal Bronchioles
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Pores of Kohn connect?
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Alveoli
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Laplace Law P=2T/r
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for a given ST. Smaller Alv. will be harder to distend than larger Alv
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Restrictive lung diseases
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Pneumothorax,ARDS,Consolidation,Pulmonary Edema, Pulmonary Fibrosis
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Restrictive diseases are characterized by?
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stiff lungs and inability to get air in
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AW resistance is described by
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Change in pressure/ flow rate
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Laminar flow
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calm, slow flow
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Turbulent flow
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choppy, fast flow
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Reynolds number
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>2000 considered Turbulent, <2000 considered Laminar
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Paradoxical Respirations
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Chest moves in on inspiration and out on Exhalation.
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Orthopnea is?
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Dyspnea while laying flat
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Platypnea is?
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dyspnea while upright
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What are obstructive diseases?
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CF,Chronic Bronchitis,Asthma,Emphysema,Bronchiectasis
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Neutrophils represent?
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increased=Bacterial infection or Trauma,
Decreased=Bone marrow disease |
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Eosinophils represent?
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allergic RX and parasite infection
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Basophils represent?
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Allergic RX
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Monocytes represent?
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invasion of foreign material
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Lymphocytes represent?
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increased=viral infection, decreased means immuno-deficiency problems
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Most important extracellular cation
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Sodium (Na)
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Most prominent anion
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Chloride (Cl)
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Main intracellular cation?
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Potassium (K)
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Synergistic Effect
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work better if given with another drug (1+1=3)
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Potentiation effect
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one of the drugs improves the performance of the other (1+0=3)
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Additive Effect
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sum of both drugs is the same as if given separately (1+1=2)
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Normal Isothermic Saturation Boundary (ISB)
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inspired air is completely saturated with humidity at 5cm below carina
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Body temp. Pressure Standard is?
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Temp=37C, Pressure of 47 torr, H2O vapor content=44mg/l, and barometric pressure of 760 mmHg
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Relative humidity equation is?
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Content/saturated capacity X 100
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Hazards of humidity Therapy?
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condensation, cross contamination, electric shock
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Indications for humidity therapy?
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to humidify medical gases (bubble humidifier), to treat humidity deficit when upper airway is bypassed.
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Definition of an Aerosol?
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suspension of a liquid within a gas
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can an aerosol be seen?
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yes is visible to the naked eye
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indications for Aerosol Tx?
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loosen and immobilize secretions, to deliver medications to the respiratory tract, administration of aerosolized meds.
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Hazards of Aerosol therapy?
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Infection, AW reactivity,Over hydration, drug re-concentration, side effects of medication being given
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External respiration is?
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diffusion of Co2 from Capillaries into Alv. (takes place in Lungs)
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Internal Respiration is?
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diffusion of gases from the capillaries to the tissues. (Takes place internally)
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Normal value for QT?
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normal is 4-8 Lpm
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What is Elasticity of the lung?
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Ability of the lung to return to normal size
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Things that affect QT?
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MI, HTN, Hypovolemia, Drug O/D
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things that decrease compliance
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Atelectasis,Pneumonia,ARDS,Pleural effusion,Pulmonary Edema
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Normal range for Airway Resistance (Raw)
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0.6-2.4 cm/H2O/L/Sec
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Henrys Law
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The amount of gas dissolved in a liquid at a given temp. is directly proportionate to the partial pressure of the gas (if you incr. Part. Press. you incr. the amount of gas absorbed)
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Grahams Law
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The rate of diffusion of a gas through a liquid is directly proportionate to solubility coefficient of the gas and inversely proportionate to the gram molecular weight (heavier the molecule less it dissolves)
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can a pt with decreased O2 diffusion rate due to A/C thickening benefit from Increased FiO2?
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Yes, Increased FiO2 increases Pressure which facilitates faster diffusion across A/C membrane
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Surface Tension causes?
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Alveoli to decrease in size
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Surfactant serves what purpose?
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to minimize the effect of ST. It prevents the ST from collapsing the alveoli and reduces the pressure need to to expand the alveoli
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Hemoglobin that is unbound is called?
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Deoxyhemoglobin
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Normal range for Hb?
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14-16 g/100ml of blood
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CaO2 measures?
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the O2 delivered to the tissues (also best index for O2 transport)
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CaO2 equation
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(Hb x 1.34 x SaO2) + (PaO2 x .003)
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What is a Swan-Ganz Catheter
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It is a balloon tipped flow directed catheter that is used to take blood from the Pulmonary Artery
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What is CVO2?
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total amount of Co2 carried in mixed venous blood
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CVO2 formula
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(Hb x 1.34 x SaO2) + (PVO2 x .003)
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Normal value for CVO2?
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12-18 %vol (15 %vol is absolute normal)
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C(a-v)O2 measures
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The O2 consumption at the tissue leve
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Normal value for C(a-v)O2?
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15 %vol
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Venous blood gas evaluates?
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The Heart
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Arterial Blood gas evaluates?
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the Lungs
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Causes for Hb to have increased affinity for O2
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Hypocapnia,Hypothermia, decreased 2,3 DPG, Alkalosis, COHb (carboxic hemoglobin)
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Hypoxemia level < 80 is considered
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Mild hypoxemia
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Hypoxemia level <60 is considered
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Moderate Hypoxemia
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Hypoxemia level of <40 is considered
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Severe
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Cyanosis occures when?
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Hb desaturation has reached 5g/dl
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Oxygen indications are?
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Acute MI
Hypoxemia Severe Trauma Increased Work of Breathing Tachycardia |
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To put a pt on a high flow device what requirements need to be met?
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RR >25
Irregular Vt Increased work of breathing |
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What are some hazards of O2 Therapy?
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R.O.P
Nitrogen washout Depression of Ventilation Oxygen Toxicity |
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Oxygen is transported what 2 ways?
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Attached to Hb
Dissolved in Plasma |
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What 3 ways is CO2 transported
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Bicarb
Bound to Hb Dissolved in Hb |
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What are the five things that decrease compliance?
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Pneumonia
Atelectasis Pulmonary Edema ARDS Pleural Effusion Pulmonary Fibrosis |
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The Acid/Base Balance is maintained in what 3 ways?
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Blood buffer regulation(hydration rxn)
Respiratory regulation Metabolic regulation |
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What is the Henderson-Hasselback Normal?
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HCO3= 24 mEq/L
H2CO2=1.2 mEq/L Pk=6.1 |
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Primary causes of Respiratory failure
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Cardiopulmonary disease
CNS depression Neuro/Neuromuscular disease Fatigue (status asthmaticus) |
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Alveolar Hyperventilation primary causes
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Hypoxemia
Compensation of metabolic acidosis CNS stimulation (drugs,trauma..) emotional disorders (pain, fear, anxiety) |
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Primary causes of Metabolic Alkalosis
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Loss of gastric contents
diarrhea Hypokalemia Hypochloremia Massive dosage of steroids diuretics ingestion of acid depleting drugs (NaHCO3) |
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Anion gap formula
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[Na] - [Cl] - [HCO3]
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Normal range for Anion gap is?
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9-14 mEq/L
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decreased 2,3 DPG can be causes
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Acidosis
Septic shock |
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increased production of 2,3 DPG causes
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Anemia
vigorous exercise High altitude COPD Alkalemia |
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hydration rxn is what?
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CO2 + HOH> H2CO3> H + HCO3
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Ficks Law
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the diffusion of a gas is directly proportinal to the area, diffusivity and partial pressures of the gas and inversely proportional to the thickness of the tissue
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Ficks Law equation
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Vgas= A x D x (P1-P2) / T
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Henrys Law
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The solubility of a gas at a given temperature is directly proportional to the partial pressure of the gas
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Grahams Law
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the diffusion of a gas through a liquid is directly proportional to the solubility coefficient of the gas and inversely proportional to the GMV
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