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122 Cards in this Set
- Front
- Back
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What is Humidity Deficit?
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Change that body has to make up.
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What is absolute mass?
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Weight (mass) of water vapor in a given volume of gas.
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Relative Humidity
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content x 100 = rh%
BTPS= 100% |
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What is the vapor pressure in a body that has 100% sat.
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47 toor
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Hygrometer
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measures Rh of a patient directly.
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What are three types of hygrometers?
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Wet-dry, Electric, and Membrane-dry.
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What is an aerosol?
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Suspension of particles in a liquid collagen or compressed gas
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What is an atomizer?
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Device used to reduce a liquid or solid to small droplets in the form of a spray.
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Nebulizer
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Designed to deliver max # of particles by baffling.
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Liters that we normally inspire?
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10,000 to12,000 in 24hrs.
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What can particles both be?
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Natural and man made.
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What are the four functions of the nose?
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Filters, Humidifies, Warms, and Smell.
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What causes a sneeze?
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Irritation of mucosal surface
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Sensation of Ventilation
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Inhalation of gases
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Turbinates?
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vascularized, provide surface area for heat and moisture exchange, convoluted, and ensure adequate contact for air.
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How much gas can the nose humidify?
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Two-thirds to three-fourths of total bady sat.
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what is the dividing point of the Carina called?
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Isothermic Saturation Boundry (ISB)
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What is the temp. that the air should be at when it reaches the carina?
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98.6 degrees f or 37degrees c
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Nasopharyngeal mucosa supplies what?
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650-1000 ml/H2O/day
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You lose how much ml/H2O from the resp. tract
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250 ml of water a day
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What is the size of the particles that get filtered out in the nose or u.r.t.?
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10 microns
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90% means what?
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persentage of particles that settle on the Tracheobronchial Epithelium.
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What are the size of particles that usually penetrate the primary repiratory lobule?
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0.5-2 or 3u's.
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What is the second line of defense?
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Mucocilliary Transport
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What is mucus made of?
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95%-H2O, 2%muco or glyco protein, 1%carbohydrates, 1%lipids, and <.5% DNA
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what is sputum?
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mucus plus saliva, cellular debris bacterial and food particles
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What are the 3 sources that mucus is derived form
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water, DNA, mucopolysaccharides
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What is a mucus cell made up of?
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glycoproteins
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What is a serous cell made up of
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water
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Where are submucosal glands found
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in larger airways which have cartilaginous support
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What is Cranial nerve 10?
What does it stimulate? |
Vagus
stimulates the mucous glands |
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what do goblet cells produce?
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mucus or mucus substance
**people who smoke have an increase in goblet cells** |
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Where is a clara cell
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they are a clear cell located in the smaller airways (terminal bronchioles)
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What is Alveolar fluid?
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is a lipid that flows into the T-B airways - surfactant fatty substances
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Why is mucus hydroscopic
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it absorbs water
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Where is the largest # of mucus glands and how much fluid can they supply per day
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Nose
1 liter |
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How many cilia are on each cell
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200-250
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how many power strokes do cilia have per min
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1000-1500
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Ciliary movement are sensitive to what?
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Hydration
Temperature pH changes |
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Ciliary movement is inhibited by what?
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Alcohol
Cigarette smoke Noxiuos gases high [ ] of O2 over time |
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Humidity requirements are related to?
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Volume of a gas passing over mucosal membranes
Relative humidity Condition of pt. (dehydration) Fluid loss due to fever, diarrhea, vomiting burns |
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When talking about normal humidity what does dehydration=
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loss of ciliary activity
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If RH < 70 % in T-B tree what does that mean
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Ciliary transport can become paralyzed
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What does ISB stand for?
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Isothermic Saturation Boundary
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What happens if ISB shifts down?
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It can cause cell destruction, inflammation and necrosis
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What are some side effects of excessive humidity?
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Heat gain in a patient
Edema Polyuria Hyponatremia |
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What type of patients normally have humidity problems?
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patients with tracheostomy and endotracheal tubes
patients with infections and fevers |
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What are some indications that Humidity is necessary?
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Mucosal drying
Inspissated secretions Dry inspired air/decrease RH Artificial airway Increased Mucus Reduced airway resistance |
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What are the goals of humidity therapy?
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Dilute or thin secretions
Moisten dry secretions Preventive |
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What type of flow device is a humidifier?
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low flow
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What type of flow device is an aerosol?
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high flow
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Do you need to use humidification of gases at 1-4 LPM normally?
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No unless there is evidence to support a need
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In treating ______ & _____ its recommend to humidify any liter flow.
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infants and children
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What is the ANSI standards on humidification?
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10 mg/L and 30 mg/L for pts' with upper airway bypass
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what are three factors of vaporization?
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temp, pressure, and area of water and gas contact
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what is humidifer standerd
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10mg/l
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what is the relative huminity for an artifical airway?
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less then 70%
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Vaporization?
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Energy of any suface molecules with heat and h2o.
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Heat vaporization?
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changes a unti of mass of a liquid substance to a gas at the same temp.
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what are three factors of vaporization?
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temp, pressure, and area of water and gas contact
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what is humidifer standerd
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10mg/l
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what is the relative huminity for an artifical airway?
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less then 70%
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Vaporization?
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Energy of any suface molecules with heat and h2o.
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Heat vaporization?
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changes a unti of mass of a liquid substance to a gas at the same temp.
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vapor is what
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Molecular form of a substance below its boiling point dispersed in a gas
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what does vapor pressure do?
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*** Achieve Equillibrium********
@ 100% saturation in the body vapor pressure is 47torr. |
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What are the four ways of physiologic control of heat moisture exchange?
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Primary role of the upper airway, the nose, the mouth, and artifical airway puts stress on lower airway to provide heat and moisture.
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What are the four ways for humidification and warming of inspired gases?
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dry med gas of 4l/min or more, intubation of patient, hypothermia, and bronchospasms caused by cold air.
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what adds molecular water to gas?
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A humidifer
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Temperature?
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higher the temp. of gas. The more water it can hold.
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Surface area?
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affects the rate of evaporation
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Contact time?
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Evap. increases as contact time increases.
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Passover Humidity?
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Direct gas over a water surface.
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three types of passover humidity
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Reservoir, Wick, and membrane
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what is the difference between a cpap and bipap?
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cpap continous positive airway pressure
bipap, bi-level positive airway pressure. |
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wick type heated passover is what?
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cylinder of aborbent material, h2o reservoir surronded by a heating element, capillary draws h20 from reservoir and keeps wick saturated.
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How does the membrane humidifier work
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membrane keeps water and germs from going into the gas exchange part of humidifer.
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What can heated humidifers ensure?
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100% saturation or btps
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The most common humidifers are what?
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Bubble humidifiers
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4 factors that effect RH
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Bubble size, Depth of h2o, Liter flow of gas, and Temp of h2o
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What is the Joule Thompson effect?
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temp change of a gas or lliquid when forced through a valve or porous plug while insulated
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Most stable RH's are?
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increased flow rate 38-44% RH @ 2l/pm
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Over humidity causes what?
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Water in lungs and congestive heart failure.
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Pt's that need humidification?
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Invasive ventilatory support or tracheostomy tubes
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Artifical nose is a nickname for what?
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passive humidifers
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Heating systems are used primarily for what?
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pt's with bypass upper airways and mechanical ventilation.
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Five common heating elements?
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Hot plate, Wrap around, Yok or collar,Immersion type heater, and heated wire.
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30mg/l of humidity is recommended for who?
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Intubated patients
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A.N.S.I.?
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American National Standard Institute.
recommond levels of humidity for intubated pt's 30mg/l |
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Aerosol?
Humidity? Atomizer? Nebulizer? |
Particular H2O.
Molecular H2O. droplets into a spray generates an aerosol |
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Penetration
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maximum depth that the pancurak can penatrate...lol
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Penetration?
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max depth suspended aersol particle can be carried into respt. tract by inhaled vol. of air.
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Deposition?
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result of an aerosols instability or FALLING OUT of the air stream or air flow.
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Factors of stability?
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part. size, nature of matter, concentraction of part., humidity, stability, distance, and tubing baffles
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Resistance
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As aerosol parts. get smaller resistance to gravity is less due to air flow being less.
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Evaperation
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RH of carrier gas affects evap. type of particle. Hygroscopic, Isophilic, or hypophilic. Hotter it gets-smaller the particle
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Brownian motion
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affects particles below 1u. diffusion deposition of particles,
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What is retention?
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deposition of particles within the confines of a structure such as the respiratory tract
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What is a factor the can effect the browanin movement?
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ventilator pattern, ventilator time and breath holding
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What is clearance?
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Removal of deposited particels
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With the Mucociliary system what collects particles?
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Macrophages
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With the lymphatic system what is collected?
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liquid
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atomizers works on what two principles?
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Bernoulli and Venturi
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Aerosols generates primarily a ______ with no _____ size?
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spray
uniform |
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What is the most common device used for bland aerosol therapy?
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Large volume jet nebulizer
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Nebulizers are a type of what? that has a baffle
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Nebulizer
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What is a baffle?
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any obstruction around which aerosol particles
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when the low pressure at the jet draws fluid from the reservoir up the siphon tube what type of neb is this?
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Large volume jet nebulizer
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What are the factors that affect accuracy of FiO2 and aerosol?
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H20 in the tubing
any resistance to flow will increase FiO2 b/c of back pressure |
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What is an ultrasonic nebulizer?
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an electrically powered device that uses a piezoelectric Crystal to generate aerosol
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What type of nebulizer is the particle size is inversely proportional to signal frequency.
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Ultrasonic Nebulizer
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What type of nebulizer needs a power unit (transducer made of ceramic quartz material)
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Ultrasonic Nebulizer
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What is amplitude
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how high the wave is (intensity) can be adjusted on ultrasonic
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What is frequency
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how many cycles per min. determines the particle size
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what does the blower do?
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pushes out medication
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What are the hazards of a ultrasonic nebulizer?
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electrical leakage
pt.'s with pacemakers are at risk, can cause pacemaker to malfunction |
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What are some side effects of heating aerosol eqiup.
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over hydration
put infant into pulmonary edema rapid swelling of inspissated secretions dyspnea aerosol particles can cause bronchospasm due to inhalation of aerosol particles |
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what type of sputum inductions is when sputum should be fresh and obtained in the early am
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diagnostic studies
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What is Cytology
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the study of cells that have been spit up check for TB cancer cells and fungi
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What is C & S
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culture and sensitivity
what organism is present and what is the best antibiotic |
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What type of techniques is use with sputum inductions
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use a hypertonic saline solution administered by an aerosol.
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Explain how a hypertonic solution works
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by osmotic transduction least invasive
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