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12 Cards in this Set
- Front
- Back
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How does PCO2 drive breathing? |
Through production of H+ ion, which acts on chemoreceptors |
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Draw the effect of increased arterial PCO2 on breathing. |
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Where is diaphragm breathing controlled from? |
Medulla |
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Difference between respiratory and ventilatory failure? |
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What are the mechanisms of respiratory failure? |
Hypoxemic failure V/Q mismatch Shunt (perfusion but no ventilation) Exacerbated by low mixed venous O2 (SvO2) Hypercapnic failure Decreased minute ventilation (MV) relative to demand Increased dead space ventilation (opposite of shunt) |
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Know the five causes of hypoxemia: |
1. Decreased PiO2 2. Hypoventilation 3. V/Q inequality 4. Shunt 5. Diffusion limition
1,2 = normal A-a (no intrinsic lung disease) |
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Causes of hypercapnic resp failure: |
1. Central hypoventilation 2. Neuropathies 3. Muscle (pump) failure: muscular dystrophy, myopathies, myasthenia gravis 4. Airway obstruction |
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How to evaluate for resp failure? |
1. H & P 2. Vital signs including pulse oximetry 3. CXR 4. EKG 5. ABG (air blood gas) 6. CBC 7. Electrolytes 8. Sputum and blood cultures, UA 9. Helical CT Vs. V/Q scan (inhale Xe133 and see where the air went for ventilation) 10. PFT (pulmonary function test on outpatient basis) |
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Hypoxic respiratory failure: How to treat? |
1. Supplemental O2 2. Most common mech = V/Q mismatch |
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How to treat bronchospasm? |
Bronchodilators Beta2 agonists Anticholinergic agents Albuterol Ipratropium Formoterol
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How long does it take BDs to work? Is this enough to relieve all bronchospams? |
Albuterol = 5-10 min Iprotropium = similar Formoterol = rapid onset of action
No, may not be able to devilry to all areas of lung |
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What conditions for acute bronchospasm? |
Bee sting Asthma Anaphylaxis |
