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46 Cards in this Set

  • Front
  • Back
what makes up the respiratory airways?
Resp Bronchioles
Alveolar ducts and sacs
how many segments are in the Right and Left lungs?
R-10
L-8
what are the contents of the superior mediastinum?
brachiocephalic veins
branches from the aortic arch
trachea
esophagus
when does pleurisy develop?
Atelectasis
Infection
what is tidal volume?
Is the volume of air inspired or expired with each normal breath

Air exchange is approx. 500ml
what is Inspiratory Reserve Volume (IRV)?
Is the extra volume of air that can be inspired over and above the normal tidal volume(ie. taking a deep breath just before you go underwater)

It is approx 3000ml
what is Expiratory Reserve Volume (ERV)
Is the extra amount of air that can be expired by forceful expiration after the end of a normal tidal expiration

Is approx 1100mL
what is the Residual Volume (RV)
Is the volume of air remaining in the lungs after the most forceful expiration

The air that you can not get out of your lungs
Gets bigger as you get older
This is approx 1200mL
what is the Inspiratory Capacity
This equals the tidal volume (TV) + Inspiratory reserve volume (IRV)
This is the amount of air a person can breathe beginning at the normal expiratory level and distending the lungs to the maximum amount
IC=TV+IRV
what is the Functional Residual Capacity (FRC)
Expiratory reserve volume (ERV) + Residual Volume (RV)
This is the amount of air that remains in the lungs at the end of a normal expiration
This is the volume of air in lungs before you start a new breath
resting state: FRC normally < 50% of Total Lung Capacity (TLC)
FRC=ERV+RV
what is the Total Lung Capacity (TLC)
Is the maximum volume to which the lungs can be expanded with the greatest possible inspiratory effort
Approx 5800mL
TLC=VC+RV
what is the Vital Capacity (VC)
Is the inspiratory reserve volume (IRV) + the tidal volume (TV) + Expiratory reserve volume (ERV)

It is the total lung capacity (TLC) – the residual volume (RV)
This is the maximum amount of air a person can expel from the lungs after first filling the lungs to their maximum extent and then expiring to the maximum extent

This is approx. b/t 3700-4600mL
what is Forced Expiratory Volume in one second (FEV1)
Deep breath, expire as hard and as fast as you can, the amount expired in 1 second is the FEV1
This is approx. 75-80% of the volume capacity
what is the most sensitive indicator of diseased state?
FEV1
what is the Intrapleural Pressure (PPL)compared to the atmospheric pressure?
Intrapleural Pressure (PPL)is lower than atmospheric (756 mm or -5 cm H2O vs atmospheric)
what is PA & Pa?
PA= intra-alveolar
Pa= intra-arteriolar
what is compliance?
the ease with which volume can be changed

C = change V /change P
Babies <37 weeks gestation can suffer from?
Respiratory Distress Syndrome (hyaline membrane disease)

Lack of surfactanct
Name the 3 forms of CO2 transport in blood
10% dissolved
30% bound to hemoglobin
60% as bicarbonate
what enzyme catalyzes the conversion of CO2 and H2O into H+ and HCO3-?
carbonic anhydase in RBC's
what controls the fine tuning pattern of breathing?
Medulla oblongata

If medulla is damaged, Kusmaul's, chain stokes and other irregular breathing patterns can happen
where are the respiratory sensors found?
Central
peripheral
chest wall
intrapulmonary
where is oxygen monitored?
carotid and aortic bodies
what is the normal PaO2? (arterial)
75-100 mmHg (altitude <3000 ft)
what test is used to test for carbon monoxide poisoning?
Carboxyhemoglobin test
what is the main respiratory regulator?
Carbon dioxide
what is the normal CO2 level?
40
At what levels of PCO2 do you start seeing CNS depression?
PCO2 above 70 - 80 mm depresses CNS; could cause acidosis
what happens if you give high O2 to COPD or Emphysema pts?
Pt will stop breathing; respiratory drive diminishes because their breathing drive depends on low O2 levels
The corotid bodies are activated by?
hypoxia
Low BP
What are the normal ABG values?
PO2 = 90 mm/Hg
PCO2 = 40 mm/Hg
pH = 7.40
Bicarb = 24
oxygen saturation of 90% is approx what PO2?
60 PO2
Ventilation – perfusion mismatch can cause these conditions
COPD
Atelectasis
Pneumonia
Pulmonary edema
Pulmonary fibrosis
Asbestosis
What pulmonary disease states can cause hypocapnia?
Sepsis
pulmonary embolus
pulmonary insufficiency
Causes of hypoventilation which can lead to Resp Acidosis?
1.Depression of resp center: CNS disorders, drugs, head trauma
2.Interruption of ventilatory motor nerves & muscles:Myasthenia gravis, drugs (muscle relaxants), severe kyphosis or scoliosis, severe arthritis (decreased ability to expand and contract intercostals)
3. Abnormal Lung Mechanism:
Pleural effusion, pneumonia, pulmonary fibrosis, pneumothorax, cancer, foreign body obstruction
In acid/base, if you have a respiratory pt what 2 values do you look at? (ie COPD pt)
pH and CO2
In acid/base, if you have a metabolic pt what 2 values do you look at?
pH and HCO3
what happens during respiratory compensation?
CO2 is either blown off or held depending on wether you're acidotic or alkolotic to try to get back to 7.4
what happens first, respiratory or metabolic compensation?
Respiratory(within the first couple of days)
what are the causes of metabolic acidosis?
Uncontrolled DM – ketoacidosis
ASA (aspirin) overdose
Renal failure – produces inadequate H+ excretion
Profuse diarrhea (unretractable)
Causes of metabolic alkalosis
Vomiting
NG suctioning
Diuretic overdose
Too much bicarbonate
How does hypercapnia and respiratory acidosis occur?
when impairment in ventilation occurs and the removal of CO2 by the lungs is less than the production of CO2 in the tissues

ie. asthma, COPD, hypoventilation
what are the causes of high anion gap(metabolic acidosis)?
MUDPILES:
Methanol
Uremia
Diabetic ketoacidosis
Paraldehyde
Iron, isoniazid (INH)
Lactic acid
Ethanol, ethylene glycol
Salicylates
How does increasing the CO2 affect the oxyhemoglobin dissociation curve?
There is a Left shift which increases O2 affinity
What factors will decrease O2 affinity causing a Right shift in the curve?
Fever
> in PCO2
2,3-DPG
< pH
T/F Inspired gas will tend to ventilate the bases more than the apices in the upright individual
TRUE

If not standing, ventilation will be greatest at the apices