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132 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Primary Purpose of the Respiratory System is?
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Gas Exchange
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Gas Exchange involves?
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The transfer of oxygen and carbon dioxide between the atmosphere and the blood
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The upper respiratory system includes?
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Nose,Nasal Passages,Sinuses,Pharynx, Adenoids, Tonsils, Epiglottis,Glottis, Larynx,Vocal cords, and trachea
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The lower respiratory system includes?
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Lungs, Pleura,Bronchi,Bronchioles, alveolar ducts, alveoli
(with exception to the right and left mainstem bronchi) |
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Where are the lower airway structures contained?
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The Lungs
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The right lung has how many lobes?
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3
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The left lung has how many lobes?
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2
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What structures in the chest wall are also essential to respirations?
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Nasopharynx, oropharynx, and the laryngopharynx
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What part of the Upper respiratory tract is responcible for protecting the lower airway/ causing a cough reflex?
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Larynx
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Is the air we breathe filtered and warmed with inspiration?
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Yes?
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Where is the Glottis located?
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It is the opening between the vocal cords and Larynx
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What dos the epiglottis do?
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It is a cartilage flap that covers the larynx for swallowing.
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What is cilia responcible for?
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It is a mucous membrane that filters and moistens the resp tract.
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Can bacteria be rid of by sneezing?
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Yes?
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What is the leading causes of Respiratory Infections/Disease?
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Smoking
Second hand smoke |
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What disease are related to the respiratory system due to smoking?
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COPD, Asthma, Influenza (URI), Heart Disease, Stroke, Cancer
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What happens to Hemoglobin with smokers?
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It can not carry O2 effectivly to the cells. Shifts to the right.
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Carbon Dioxide and Hemaglobin form?
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Carboxy Hemaglobin
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Where does gas exchange occur?
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Bronchioles and Alveolar ducts.
No o2 or CO2 until now. |
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What location does the trachea bifurcates into the right and left mainstream bronchi?
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Carina (angle of louis)
causes violent cough if hit during suctioning. |
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What gives better protection from bacteria mouth or nose breathing?
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Nose- provides protection for the lower airway.
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What conditions may alter swallowing ability and impair the function of the epiglottis- predisposing to aspiration?
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Stroke, Prolonged intubation, and altered LOC.
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Why is the Trachea U shaped?
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Keeps the trachea open but allows the ajacent esophagus to expand for swallowing.
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E tube sits where?
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3-5 cm above the carina
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Which Bronchi is straighter and wider the right or left?
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Right Bronchi
ETubes should not go into the right mainstem bronchus- means they were inseted to far. |
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How many ribs do we have and were do they connect?
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24 ribs?
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What lobes can be heard from the front of the body?
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Upper lobes
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What do the ribs do?
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Protect heart and lungs
(Thoracic Cage) |
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What is the fluid for between the parietal and visceral spaces
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Prevents friction and rubbing.
Negative Pressure 20-25 ml of fluid |
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Chest cavity in lined with what membrane?
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parietal pleura
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The lungs are lined with what membrane?
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visceral pleura
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More than 25ml of fluid in spaces is called
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Pleural Effusion
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Causes of Pleural Effusion are?
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CHF, Malignancy,Bacterial infections, and Trauma.
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During Inspiration, the diaphram contracts, increasing intrathoracic volume this causes the abdominal content up/down?
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Downward
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External Intercostal Muscles and scalene muscles contract this does what?
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Increases the lateral and anteroposterior dimension of the chest.
Causing intrathoracic pressre to decrease, so air enters the lungs. |
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Normal Tidal Volume
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500ml
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Normal Tidal Volume is?
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Volume of air exchanged with each breath
150/500 in dead space with no gas exchange. |
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3 Types of Calls?
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Epithelial- Structure
Surfactant- Prevent Collapse Endothelial- Macrophage- eat/engolf bacteria. |
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Ventilation
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Movement of air in and out of lungs
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Ventilation with inspiration-
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diaphram moves down
causes inflattion |
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Gas flows from an area of________ concentration to an area of ________ concentration
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high(atmospheric) to low(intrathoracic)
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What can limit chest wall expansion?
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nerve paralysis
rib fracture muscular disease Lungs do not fully inflate Gas exchange is impaired |
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Elastic Recoil
Contract/Relax |
Tendency for the lungs to recoil or reduce in volume after being stretched or expanded.
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3 Factors R/T Problems in Recoil
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Asthma Inflammation
Chronic Bronchitis- thickened secretions of mucous in bronchioles Loss of Lund Elasticity- Emphazema |
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When compliance is decreased?
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the lungs are more difficult to inflate.
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causes?
Increased fluid in the lungs |
Pulmonary edema, ARDS, pneumonia
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causes?
Conditions that make lung tissue less elastic or distensible? |
Pulmonary Fibrosis, Sarcoidosis
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Conditions that restrict Lung movement?
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Pleural effusion
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Increased compliance
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Loss of elasticity, over distended, emphysema, sarcodosis
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Decreased compliance
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Stiff, Pulmonary edema, pneumothorax, ARG
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Process of Gas echange is defined as?
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Diffusion
High concentration to low |
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Diffusion does what?
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Take air into arterial blood and Carbon dioxide from the arterial blood into the alveolar gas.
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(PaO2) stand for?
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Partial pressure of Oxygen
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(SAO2) stand for?
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Arterial oxygen saturation
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(PaO2) represents?
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the amount of O2 dissolved in the plasma
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(SaO2) represents?
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amount of O2 bound to hemoglobin in comparison with the amount of oxygen the hemoglobin can carry. Expressed as a %
Ex: 90% of the hemoglobin attachments for O2 have O2 bound to them |
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Atmospheric Level
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760ml/mercury
Nitrogen 79% O2 21% |
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Oxygen-hemoglobin dissociation curve
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see chart
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Mixed venous blood gases requires what kind of cath?
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Pulmonary Artery Cath
or called Swan Catheter |
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Impaired cardiac output?
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Inadequate tissue oxygen delivery or abnormal O2 consumption.
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A Swan Cath/PA cath measure what?
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Mixed venous Blood gases
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Mixed Venous Blood Gas may be drawn for what reason?
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Cardiac Output, Profussion problems, Critical Care
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What are the two methods for measuring gas transfer to lungs
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ABG, Pulse Ox
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Does well oxygenated blood and deoxygenized blood absorb light the same way?
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No, Well oxygen absorbs light differently.
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What determines the amount of light by the vascular bed and calculates the saturation?
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SPO2
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What disorders is an SPO2 not accurate?
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Anemia
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Who has a decreased SPO2?
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Elderly
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With decreased Hemoglobin what s/s might you see?
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Mixed and venous blood levels drop
Change respiratory pattern and rate, cardiac, and renal |
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The Two Controls of respiration are?
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Chemoreceptors and
Mechanical |
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____ is a receptor that responds to change in chemical composition (PaCO2 and pH) of the fluid around it.
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Chemoreceptor
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Increase in (H+) causes?
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acidosis
Increased RR Tidal Volume |
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Decrease in (H+) causes?
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alkalosis
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PaCO2 regulates?
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ventilation
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Chronic PaCO2 can be elevated d/t what condition?
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COPD
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Peripheral chemoreceptors are located?
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In the carotid bodies at the bifurcation of the common carotid arteries and in the aortic bodies above and below the aortic arch.
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The two neurologic factors that control breathing are?
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Medulla Oblangota and Pons
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What maintains Ph in the blood?
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Lungs and Kidneys
Fight to stabalize |
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Respiratory defense mechanisms consist of these 5 things?
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Filtration of air
Mucociliary clearance system Cough Reflex Reflex Bronchoconstriction Alveolar Macrophages (engolf Bacteria) |
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Effects of Aging on the Resspiratory system include?
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Decrease in elastic recoil
and chest wall and Cilia. stiffening of the chest wall Diminished cough/gag reflex Alveoli do not fx as well d/t age/disease |
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Respiratory System Subjective Data Includes What 3 important Questions?
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Past Medical History
Medications Surgery or other treatments |
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Questions to ask patient pertaining to Respiratory might include?
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Smoking, Work environent, Drinking, drugs, chewing hx
Past illnesses like Asthma, Bronchitis, Pneumonia, TB, O2 use. Vaccines |
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How often is the pneumonia vaccination given?
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Every 5 Years
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Health perception?
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Is what the patient preceives their health as
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When assessing nutritional status what info would you want to obtain?
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Eating habits, Weight loss or gain, Diabetes, What types of food cause problems such as increased secretions.
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What type of info is needed when asking a patient about elimination?
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Bowels- how often, consistancy, meds needed?
Urine Pattern |
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Activity and Exercise
What do we need to know? |
How often
Any problems during... Ex: SOB |
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Cognitive-Perceptual Pattern relate to?
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Pain, SOB, Restless, Irritable, Confusion
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Self perception means?
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Do the patients illness/disease affect there life
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What is the #1 Missed assessment
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Sexuality-Reproductive Patterns
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Value- Belief Patterns r/t?
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Why the pt thinks is causing his illness
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Coping stress Tolerance Pattern Example would be?
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Increases SOB would cause increased anxiety
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Breathlessness can be based on a 1-10 scale. What would
indicate Severe SOB |
5+
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When assessing respiratory status what 4 tasks must you do?
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Inspect
Palpate Percuss Auscultation |
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What Blood studies might be used in th respiratory system?
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ABG, CBC (WBC infection)
BMP (suspect COPD increased fluid) |
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A sputum study might be done to?
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Identify the organism and to determine which Antibiotic will treat that bacteria
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What is the most common culture taken?
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Rapid Strep
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What is a tell tell sign of Strep?
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Strawberry tongue and white patches on the throat
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Chest X-rays are used to?
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screen, diagnose, evaluate change, check for infiltrate and consolidation
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What is the most specific Study done to detect a Pulmonary Embolism?
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Pulmonary Angiography
injection of dye into the pulmonary artery |
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What test can detect lesion that in non invasive?
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Computed tomography
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A spiral CT is used to diagnose what?
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Pulmonary embolism
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What test can pick up bleeding ? What does it Diagnose?
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Magnetic resonance imaging
Diagnoses vasular structure |
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Positron emission tomography is used to determine?
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benign and malignant lung nodules
(isotope used) |
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ventilation-perfusion scans for?
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1:1 ratio of blood and air
checks ventilation and perfussion (isotope injected) |
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Bronchoscopy is used for?
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Inspect Larynx, Trachea, and Bronchi
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A small incision in the sternal notch to inspect lymph is called?
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Mediastinoscopy
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Thoracentesis
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Removes accumulated fluids
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A test to check Ventilation status is called?
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Pulmonary Function Test
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Excersise tests are used to?
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check stress with excercise
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what position should a patient be in when having a thoracentesis?
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Straight and leaning over
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If a patient is unable to run for 6 minutes during an exercise test a patient must take what two drug?
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persantine dabutamine
check spelling----------- |
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What is the normal Forced Expiratory Volume? (FEVI)
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70%
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While inspecting the nose what should you find?
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Pink, Moist, None inflammed tissue
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While inspecting he nose what should you NOT find?
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Deviated septum, Flaring, discharge
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Nasal drainage green or yellow in color could indicate what?
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Bacteria
Blocked Nasal Passages Impair the senses of smell and taste. |
Test?
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Inspection of the mouth consists of what areas?
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Pharynx,pink moist,no lesions
Tonsils- no cracks Tongue |
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Tongue should lye midline cranial nerve 9
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cranial nerve 9
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Tongue should move side to side
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Cranial nerve 12
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Uvula should rise when saying AHHH
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cranial nerve 10
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Swollen lymph nodes in the neck that are large and tendor indicate
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Infection
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Thorax and Lungs assessment
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chest should be symmetrical
No buldging/ retraction |
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Anterior and Posterior diameter should be in what ratio?
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2:1
1:2 indicates COPB barrel chest |
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Palpate the chest- an indication of movement over 1 inch would indicate?
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Pneumothorax
Thoracic expansion T9-T10 |
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Hyper inflatted lungs indicate
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COPD
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Medium inflatted lungs indicate
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Pleural effusion or pneumonia
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Wheeze is?
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narrowing of bronchi
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Rhonchi
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Bad drum, snore-
Chronic broncitis, COPD |
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Lungs sound should be heard when?
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Vestibular sounds of air in and out with full inspiration and expiration.
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How many marker are used whn listening to breathe sounds in the back
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8
Lowest point T-10-12 |
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Crackles with inspirtion
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Can be cleared
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Crackles with expiration indicate?
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COPD
Pneumonia |
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Where is the best place to hear a friction rub?
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lateral sides- inflammation of pleura
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