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43 Cards in this Set

  • Front
  • Back
List accessory muscles used in respiration
• Trapezius
• Platysma
• Scalenes
List the order of air flow, from trachea to alveolar sacs
Trachea » Bronchi » Bronchioles » Terminal bronchioles » Respiratory bronchioles » Alveolar ducts » Alveolar Sacs
Which airways are conducting airways?
• trachea
• bronchi
• bronchioles
• terminal bronchioles
Which airways are respiratory airways?
• respiratory bronchioles
• alveolar ducts
• alveolar sacs
How many lobes and segments are in the right and left lung?
• Right lung has 3 lobes and 10 segments
• Left lung has 2 lobes and 8 segments
Name and describe the 4 volumes of the lungs
• Tidal volume (TV): volume of air inspired or expired with each normal breath (~ 500 ml)

• Inspiratory reserve volume (IRV): the extra volume of air that can be inspired over & above the normal tidal volume (~3000 ml)

• Expiratory reserve volume (ERV): the extra amount of air that can be expired by forceful expiration after the end of a normal tidal expiration (~1100 ml)

• Residual volume: the volume of air remaining in the lungs after the most forceful expiration (~1200 ml)
Name and describe the 4 lung capacities
• Inspiratory Capacity (IC): tidal volume + inspiratory reserve volume

• Functional residual capacity (FRC): expiratory reserve volume + residual volume (the amount of air that remains in the lungs at the end of a normal expiration

• Vital capacity (VC): inspiratory reserve volume + tidal volume + expiratory reserve volume; the maximum amount of air you could move in a single breath (~3700-4600 ml)

• Total lung capacity (TLC): the maximum volume that the lungs can be expanded; vital capacity + residual volume (~5800 ml)
Which lung volume increases with age?
residual volume
What is FEV1?
• forced expiratory volume in one second
• deep breath & expire as hard and as fast as you can
• ~ 75-80% of the volume capacity
• most sensitive indicator of diseased state
What is compliance?
• the ease with which volume can be changed; distensibility
• C = change in volume/change in pressure
What is hyaline membrane disease?
• respiratory distress syndrome in premature infants
• caused by a lack of surfactant
What are the 3 forms of CO2 in the blood?
• dissolved CO2 (10%)
• bound to hemoglobin (30%)
• bicarbonate (60%)
What do carotid and aortic bodies monitor?
oxygen and H+ levels
What is a normal PaO2 level?
75-100 mm Hg
What is the main respiratory regulator?
carbon dioxide
What is a normal PCO2?
What is the most common cause of acute V/Q mismatch? of chronic V/Q mismatch?
• acute mismatch: pulmonary embolism
• chronic mismatch: COPD
What is a right shift on the oxygen-hemoglobin dissociation curve and what are some causes?
• right shift represent decreased affinity of hemoglobin for oxygen
• caused by an increase in PCO2, fever, increased 2,3-DPG, & acidosis
What is a shift to the left in the oxygen dissociation curve and what are some causes?
• shift to the left represents an increased affinity of hemoglobin for oxygen
• occurs in alkalosis, decreased body temperature, decreased PCO2, increased CO2
What is the name of the bright red compound, when hemoglobin binds with carbon monoxide (CO)?
What are causes of hypoventilation?
• chest wall abnormalities
• drugs
• neuromuscular disease
• respiratory center structural damage
What are causes of abnormal diffusion?
• decreased number of open capillaries
• decrease in equilibration
• increased distance to alveolar capillary membrane
• increased rate of blood flow
• reduced driving pressure from alveolus to blood (high altitudes)
What is hypercapnia?
increase in PCO2
What is the definition of respiratory failure?
defined as hypoxia with or without hypercapnia
Pulse oximetry of 90% is approximately equal to a PO2 = ____
What are things that effect PO2?
• altitude

• Ventilation/Perfusion (V/Q) mismatch (can cause atelectasis, COPD, pneumonia, pulmonary edema, pulmonary fibrosis, asbestosis)

• Diffusion impairments (either not getting enough circulation to alveoli OR increased O2 consumption)

• Alveolar hyperventilation w/o O2 supplementation (COPD, asthma, pneumonia)
Hyperventilation will cause hypercapnia/hypocapnia?
Hypoventilation will cause (hypercapnia or hypocapnia)?
What pulmonary disease states can cause hypocapnia?
• sepsis
• pulmonary embolus
• pulmonary insufficiency
What are causes of hypoventilation (decreased PO2, increased PCO2)?
• Depression of respiratory center (ex. CNS disorders, drugs, head trauma)

• Interruption of ventilatory motor nerves & muscles (ex. Myastenia gravis, drigs, severe kyphosis or scoliosis, severe arthritis)

• Abnormal lung mechanism (pleural effusion, pneumonia, pulmonary fibrosis, pneumothorax, cancer, foreign body obstruction)
Severe acidemia is a pH below what level?
• less than 7.2
• can cause decreased myocardial contractions, arrhythmias, CNS depression, high K+
What can induce metabolic acidosis (at the ion level)?
• an inability of the kidneys to excrete the dietary hydrogen (H+) load
• an increase in the generation ogf H+
• loss of bicarbonate (HCO3-) due to inappropriate wasting by the kidney or the GI tract
List causes of metabolic acidosis
• aspirin overdose
• profuse diarrhea (unretractable)
• renal failure (produces inadequate H+ excretion)
• uncontrolled DM (ketoacidosis)
Metabolic acidosis causes K+ shift from the intracellular fluid, causing hyperkalemia. True/False: It is important to immediately correct the hyperkalemia in a patient with metabolic acidosis.
• It is very important to correct the acid/base problem before treating hyperkalemia. Sometimes when you correct the acid/base problem, the hyperkalemia resolves.
• The correct answer is: False
How would a 0.1 unit decrease in pH affect potassium (K+)?
K+ increased 0.6 meq
What is a normal anion gap?
8-12 meq/L
Anion gaps are measured in patients with what type of acid-base imbalance?
metabolic acidosis
What are causes of low anion gap?
• Hypermagnesemia
• Hypoalbuminemia
• Hyponatremia
• Paraproteinemia (Multiple Myeloma)
• Spurious Hyperchloremia (Bromide toxicity)
What are causes of a high anion gap?
Pneumonic: MUDPILES
• M - Methanol
• U - Uremia
• D - Diabetic ketacidosis
• P - Paraldehyde
• I - Iron, isoniazid (INH)
• L - Lactic Acid
• E - Ethanol, ethylene glycol
• S - Salicylates
What can induce metabolic alkalosis (at the ionic level)?
• a primary increase in serum bicarbonate (HCO3-) concentration
• occurs as a consequence of a loss of H+ from the body or a gain in HCO3-
What are causes of metabolic alkalosis?
• Diuretic overdose
• NG suctioning
• Too much bicarbonate
• Vomiting
What are causes of respiratory acidosis?
• occurs when impairment in ventilation occurs and the removal of CO2 by the lungs in less than the production of CO2 in the tissues (basically, retaining CO2)

• causes include hypoventilation, hypercapnia, asthma, COPD, kyphoscoliosis, etc...
What are causes of respiratory alkalosis?
• anxiety
• hyperventilation
• hypocapnia
• mechanical ventilation