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43 Cards in this Set
- Front
- Back
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List accessory muscles used in respiration
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• SCM
• Trapezius • Platysma • Scalenes |
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List the order of air flow, from trachea to alveolar sacs
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Trachea » Bronchi » Bronchioles » Terminal bronchioles » Respiratory bronchioles » Alveolar ducts » Alveolar Sacs
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Which airways are conducting airways?
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• trachea
• bronchi • bronchioles • terminal bronchioles |
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Which airways are respiratory airways?
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• respiratory bronchioles
• alveolar ducts • alveolar sacs |
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How many lobes and segments are in the right and left lung?
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• Right lung has 3 lobes and 10 segments
• Left lung has 2 lobes and 8 segments |
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Name and describe the 4 volumes of the lungs
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• 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) |
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Name and describe the 4 lung capacities
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• 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) |
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Which lung volume increases with age?
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residual volume
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What is FEV1?
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• 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 |
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What is compliance?
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• the ease with which volume can be changed; distensibility
• C = change in volume/change in pressure |
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What is hyaline membrane disease?
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• respiratory distress syndrome in premature infants
• caused by a lack of surfactant |
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What are the 3 forms of CO2 in the blood?
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• dissolved CO2 (10%)
• bound to hemoglobin (30%) • bicarbonate (60%) |
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What do carotid and aortic bodies monitor?
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oxygen and H+ levels
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What is a normal PaO2 level?
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75-100 mm Hg
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What is the main respiratory regulator?
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carbon dioxide
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What is a normal PCO2?
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35-45
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What is the most common cause of acute V/Q mismatch? of chronic V/Q mismatch?
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• acute mismatch: pulmonary embolism
• chronic mismatch: COPD |
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What is a right shift on the oxygen-hemoglobin dissociation curve and what are some causes?
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• right shift represent decreased affinity of hemoglobin for oxygen
• caused by an increase in PCO2, fever, increased 2,3-DPG, & acidosis |
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What is a shift to the left in the oxygen dissociation curve and what are some causes?
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• shift to the left represents an increased affinity of hemoglobin for oxygen
• occurs in alkalosis, decreased body temperature, decreased PCO2, increased CO2 |
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What is the name of the bright red compound, when hemoglobin binds with carbon monoxide (CO)?
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carboxyhemoglobin
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What are causes of hypoventilation?
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• chest wall abnormalities
• drugs • neuromuscular disease • respiratory center structural damage |
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What are causes of abnormal diffusion?
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• 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) |
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What is hypercapnia?
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increase in PCO2
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What is the definition of respiratory failure?
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defined as hypoxia with or without hypercapnia
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Pulse oximetry of 90% is approximately equal to a PO2 = ____
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60
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What are things that effect PO2?
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• 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) |
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Hyperventilation will cause hypercapnia/hypocapnia?
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hypocapnia
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Hypoventilation will cause (hypercapnia or hypocapnia)?
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hypercapnia
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What pulmonary disease states can cause hypocapnia?
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• sepsis
• pulmonary embolus • pulmonary insufficiency |
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What are causes of hypoventilation (decreased PO2, increased PCO2)?
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• 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) |
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Severe acidemia is a pH below what level?
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• less than 7.2
• can cause decreased myocardial contractions, arrhythmias, CNS depression, high K+ |
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What can induce metabolic acidosis (at the ion level)?
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• 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 |
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List causes of metabolic acidosis
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• aspirin overdose
• profuse diarrhea (unretractable) • renal failure (produces inadequate H+ excretion) • uncontrolled DM (ketoacidosis) |
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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.
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• 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 |
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How would a 0.1 unit decrease in pH affect potassium (K+)?
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K+ increased 0.6 meq
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What is a normal anion gap?
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8-12 meq/L
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Anion gaps are measured in patients with what type of acid-base imbalance?
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metabolic acidosis
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What are causes of low anion gap?
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• Hypermagnesemia
• Hypoalbuminemia • Hyponatremia • Paraproteinemia (Multiple Myeloma) • Spurious Hyperchloremia (Bromide toxicity) |
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What are causes of a high anion gap?
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Pneumonic: MUDPILES
• M - Methanol • U - Uremia • D - Diabetic ketacidosis • P - Paraldehyde • I - Iron, isoniazid (INH) • L - Lactic Acid • E - Ethanol, ethylene glycol • S - Salicylates |
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What can induce metabolic alkalosis (at the ionic level)?
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• 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- |
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What are causes of metabolic alkalosis?
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• Diuretic overdose
• NG suctioning • Too much bicarbonate • Vomiting |
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What are causes of respiratory acidosis?
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• 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... |
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What are causes of respiratory alkalosis?
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• anxiety
• hyperventilation • hypocapnia • mechanical ventilation |
