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131 Cards in this Set
- Front
- Back
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Decreased breath sounds, dullness to percussion on affected side. Respiratory distress and hypotension is the Essentials of Diagnosis in what
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Hemothorax
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What are the essentials of diagnosis for Hemothorax?
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decreased breath sounds, dullness to percussion on affected side, respiratory distress and hypotension
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What is most commonly secondary to penetrating injury disrupting pulmonary or systemic blood vessels
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Hemothorax
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Injury to chest wall, great vessels, or lung can cause
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intrapleural bleeding or
hemothorax |
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What lab/imaging findings would you see with a patient with a Hemothorax?
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diagnois is confirmed by chest x-ray. volumes of blood as low as 200-300 mL may be seen on upright x-ray
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What is the likely diagnosis for;
- injury to the chest wall, great vessels, or lungs - most commonly secondary to penetrating injury disrupting pulmonary or systemic blood vessels - in great vessel injury, 50% die immediately, 25% will live 5-10 min, and 25% will live 30 mins or longer - effect on respirations depends on blood loss - affected lung becomes collapsed |
Hemothorax
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What is the treatment for a Hemothorax?
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- ensure patient has an intact airway
- O2 to correct hypoxia - provide suctioning and intubation if necessary - tube thoracostomy with a 36 or 40 french chest tube |
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The following clinical findings are likely to be diagnosed as;
- respiratory distress, tachypnea, variable degrees of hypoxia - dullness to percussion, decreased breath sounds, on affected side - hypotension and flattened neck veins depending on the degree of blood loss. pulse pressure narrowing - smaller hemothoraces may be difficult to detect in supine patients |
Hemothorax
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What are the complications of a Hemothorax?
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hypovelemia due to blood loss
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What is the disposition for a Hemothorax?
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MEDEVAC
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What is the difference between primary pneumothorax and secondary pneumothorax?
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- Primary pneumothorax occurs without clinically apparent lung disease (Typically young, tall, men age 20-40)
- Secondary pneumothorax occurs as a complication of a preexisting underlying pulmonary disease (COPD, pneumonia, CF, asthma, TB, pneumocystis carinii pneumonia infection) |
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What are the essentials of diagnosis for Pneumothorax?
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absent or decresed breath sounds, Hyperresonance to percussion
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What are the classifications of Pneumothorax?
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- spontaneous (primary or secondary)
- traumatic (chest trauma or iatrogenic) |
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What is the most common cause of a Pneumothorax?
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Traumatic pneumothorax
- must always be considered in trauma patients - consider some invasive procedures (subclavian line placement, thoracentesis, lung or pleural biopsies, barotrauma from positive pressure ventilation) |
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What is the likely diagnosis for the following;
- Pleuritic chest pain, tachypnea, tachycardia - Chest pain ranging from minimal to severe and dyspnea occur in almost all patients |
Pneumothorax
Note: - Small pneumothorax physical findings may be minimal - Larger pneumothorax: dimminished breath sounds, decreased tactile fremitus, decreased chest movement, hyperresonance on affected side |
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What are the lab/imaging findings of a pneumothorax?
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- Chest x-ray will reveal most pneumothoraces
- Arterial blood gas can assist with assessment of repiratory insufficiency but is not necessary |
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What is the treatment for a patient with Pneumothorax?
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- ensure airway is intact
- provide suctioning and intubation if necessary - many small pneumothoraces resolve spontaneously as air is absorbed from the pleural space - supplemental O2 may increase rate of reabsorption - treat symmptomatically for cough and chest pain |
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What is the criteria for and what are you rechecking during treatment of a stable patient with Pneumothorax?
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- VS: RR < 24/min, HR 60-120/min, BP normal, O2 sat >90
- Able to speak in sentences - Obtain chest x-ray in 3-6 hours and compare with arrival chest x-ray. |
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What is necessary for a large pneumothoraces or an unstable patient?
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Re-exspansion of the lungs.
- Large bore chest tube with water seal drainage and suction may be necessary for secondary, tension, severe symptoms, or pneumothorax on mechanical ventilation - Placement of a small bore chest tube attached to a Heimlich valve may permit observation from home with close f/u |
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What is the disposition for a patient with Pneumothorax?
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MEDEVAC
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What are the complications of a Pneumothorax?
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Tension pneumothorax
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During pt education,what should you tell a patient with a hx of Pneumothorax to avoid?
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- non pressurized aircraft
- altitude - SCUBA - should refrain from smoking - risk of recurrence is 50% |
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What are the essentials of diagnosis for Tension Pneumothorax?
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Tracheal deviation away from the pneumothorax with respiratory distress and hypotension
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What is the likely diagnosis for the following general considerations;
- developes when a one way valve air leak occurs from either the lung or the chest wall - Air enters the pleural space but cannot escape - increased intrapleural pressure - collasped lung - shift of the mediastinal contents to the opposite side |
Tension Pneumothorax
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What is the likely diagnosis for the following physical findings;
- Respiratory distress, tachypnea, tachycardia - Hyperresonance to percussion - decreased or absent breath sounds on auscultation - Trachea may be deviated away from the affected side - Neck veins may be distended except in the hypovolemic patient |
Tension Pneumothorax
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What are the lab/imaging findings of a Tension Pneumothorax?
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Diagnosis is clinical.
Do not delay immediate treatment waiting to obtain x-ray! |
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What is the treatment for a patient with a Tension Pneumothorax?
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- Ensure airway is intact
- Use O2 to correct hypoxia (2 -15 lpm based on O2 saturation), use caution in long term use with chronic COPD/Emphysema - Provide suctioning and intubation if necessary - Immediatie needle thoracostomy: 16g or larger catheter inserted at the second intercostal space at the midclavicular line |
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During pt education, what should you alert a patient about that has a hx of Tension Pneumothorax?
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- discontinue smoking
- future exposure to high altitudes - flying non-pressurized aircraft - SCUBA diving - Risk of recurrence is 50% |
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What is the disposition for a patient with Tension Pneumothorax?
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MEDEVAC
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What are the complications of a Tension Pneumothorax?
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- Pneumo-mediastinum
- Subcutaneous emphysema - Also consider rupture of esophagus or bronchus |
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What is the likely diagnosis for the following general considerations;
- Occurs when a segment of the chest does not have bony contiguity with the rest of the thoracic cage - Usually a significant blunt force is required (MVA or Fall from height) - Negative intrathorcic pressure is gernerated on inspiration, the flail segment moves inward, thus reducing tidal volume - The major problem is respiratory failure due to the underlying pulomary injury |
Flail Chest
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What is the likely diagnosis for the following physical findings
- pain and respiration (major symptoms) - Tachypnea with shallow respirations - paradoxical chest wall movement may not be seen in a conscious patient due to splinting of the chest wall - crepitus is often present - patient may be able to compensate initially for the reduced tidal volume by hyperventalating - when fatigue or underlying pulmonary injurydevelops, frank respiratory failure may supervene |
A patient that has a flail chest
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What are the lab/imaging findings for a patient with a flail chest?
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non contributory - diagnosis made based on history and physical exam
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What is the treatment for a patient with a flail chest?
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- supplemental O2 is the first line tx (used to correct hypoxia, caution in longterm use with chronic COPD/ Emphysema)
- pain control w/ IV morphine or fentanyl should be instituted early - Consider early intubation and mechanical ventilation (50% will need early intubation) - External chest wall supports (taping, sandbags) not indicated (may reduce pain but will also reduce vital capacity) |
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What is the disposition of a patient with a flail chest?
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MEDEVAC
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What is the likely diagnosis for the following general considerations;
- injuries to the lung parencyhma with hemorrhage and edema without associated laceration - most frequently intrathoracic injuries in nonpenetrating chest trauma - occurs in approximately 30-75% of patients with significant blunt chest trauma - typically occur at the site of impact - often associated with other thoracic injuries such as rib fractures and flail chest, although may occur alone - a risk factor for the development of acute respiratory distress syndrome and long-term disability |
A pulmonary contusion
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What is the most common complication of a pulmonary contusion?
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Pneumonia
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What is the likely diagnosis for the following physical findings;
- often silent during the initial trauma evaluation - significant traumatic mechanism and presence of other associated thoracic and extrathoracic injuries should raise suspicion - most important sign is hypoxia - dyspnea, hemoptysis, tachycardia - evidence of a chest injury: palpable rib fractures, chest wall bruising, decreased breath sounds, crakles on auscultation |
Pulmonary Contusion
Note: (the degree of hypoxia is relatied to the size of the contusion) - large contusions will lead to significant respiratory distress |
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What are the lab/ imaging findings of a Pulmonary Contusion?
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- chest x-rays may range from patchy interstitial infiltrates to complete lobar opacification
- chest x-ray will initially miss a substanial number of contusions - as a result of ongoing hemorrhage and edema, contusions will appear on x-rays within 6 hours of injury - thoracic CT may provide additional useful information |
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What is the treatment for a patient with a Pulmonary Contusion?
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- Use caution with IV fluids
- O2 (used to correct hypoxia, use caution with long term use with chronic COPD/ Emphysema patients) - chest physiotherapy - if severe, use mechanical ventilation with positive end-expiratory pressure |
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What is the disposition for a patient with a Pulmonary Contusion?
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- MEDEVAC
- Should be admitted for monitoring and respiratory support |
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What is the likely diagnosis for the following general considerations;
- have been reported in 1-5% of patient sustaining blunt trauma or abdominal trauma - direct violation of the diaphragm - significant intra-abdominal or intrathoracic pressure applied to the diaphragm resulting in rupture - right side is 3 times less likely to be infected than the left due to it being well protected by the liver - up to 50% are missed during initial trauma evaluation - delayed presentation may not be significant until the abdominal contents through the diaphragm result in: obstruction, incarceration, strangulation, perforation, death - tear will not heal spontaneously - can show signs up to 50 years past after primary traumatic event. |
A Diaphragmatic Hernia
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What are the physical findings for a patient with a diaphragmatic hernias?
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- may be asymptomatic, particularly in the acute phase, or may present with symptoms of bowel obstruction
- since early diagnosis is difficult to establish, delayed presentation is common with nonspecific respiratory or bowel complaints |
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What are the lab/imaging findings for a patient with a diaphragmatic hernias?
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- Chest x-ray is a valuable screening tool
- 50% of initial x-rays will be interreted as normal but will be abnormal in almost 100% of delayed presentations |
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Findings on an upright chest x-ray suggestive of a diaphragmatic rupture include what?
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- Elevation or irregularity of the diaphragmatic border
- Unilateral pleural thickening - Obvious herniation of abdominal contents into the chest cavity - Presence of a nasogastric tube in the chest cavity |
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What is the treatment for a patient with a diaphragmatic hernias?
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- Find and treat penetrating and blunt trauma
- Surgical reduction of the hernia and repair of the diaphragm in all patients - Care should taken to avoid abdominal injury when placing a chest tube in patients with concomitant hemothorax and pneumothorax |
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What is the disposition for a patient with a diaphragmatic hernia?
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MEDEVAC
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What is the likely diagnosis for the following general considerations;
- Injury to the trachea or bronchus as a result blunt trauma is uncommon but can be quite severe - Approximately 80% of patients will die before they reach a hospital - usually the result of a MVA and crush injuries - right-sided bronchial injuries occur more commonly and are typically more severe, almost 80% occur within 2 cm of the carina - diagnosis is missed in at least 25% of patients during initial evaluation |
Tracheobronchial Injury
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What is the most likely diagnosis for the following physical findings;
- Most common clinical signs and symptoms: dyspnea, subcutaneous emphysema of neck and upper thoracic region, hoarseness, hemoptysis, hypoxia, persistant pneumothorax dispite tube thoracostomy - Failure to recognize during initial eval is common - May be comfortable on room air or may present in acute respiratory distress |
Tracheobronchial injury
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What are the lab/imaging findings for a patient with a Tracheobronchial injury?
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- Chest x-ray findings indicative of injury: subcutaneous emphysema, pneumomediastinum, pneumothorax, peribronchial air
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What is the treatment for a patient with a Tracheobronchial injury?
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- If they are in respiratory distress should be endotracheally intubated (preferably with a bronchoscope)
- Stable patients should undergo a bronchoscope immediately to evaluate and locate injury. Operate to repair - cricothyroidotomy if needed |
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What is the disposition for a patient with a Tracheobronchial injury?
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MEDEVAC
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What is the likely diagnosis for the following physical findings;
- Pronounced stridorous respirations. - Retractions of the supraclavicular and suprasternal areas of the chest - May not be able to breathe or speak - Patients may have a visible swelling or mass in the neck. - The tongue may be swollen, as may other structures in the mouth. |
acute upper airway obstruction
- Laryngoscopy may reveal a foreign body, tumor, or other obstruction in the larynx or trachea. |
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Upper airway obstruction is most often due to what?
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Soft tissue swelling secondary to infection or angioedema
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What is the immediate treatment for an acute upper airway obstruction
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1. Obstructing liquids - rigid suction
2. Foreign bodies - Heimlich maneuver -Direct laryngoscopy coupled with the use of forceps 3. infection or angioedema - reduce the edema either by cooling or by vasoconstriction and treating the underlying infection or allergy -Epinephrine topically, by inhalation, or parentally, is the most effective medication for angioedema |
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Patients with easy, uncomplicated removal of an obstructing foreign body may be sent home following a period of observation with what instructions
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1) Eat more slowly
2) Chew more thoroughly, 3) Swallow more carefully |
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What is the likely diagnosis for the following general considerations;
- patient with severe respiratory distress has vomitus with particulate matter in the oropharynx - Vomitus, tube feedings, or particulate food particles may be observed in the oropharynx or suctioned from the airway |
Aspiration
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What is a complication of aspiration
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Infection in the lung (i.e. Peumonia)
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What is the likely diagnosis for the following physical findings;
- dyspnea and respiratory distress - Cough, wheezing on auscultation - Tachypnea - Tachycardia - Cyanosis - Chest hyperexpansion - Globally diminished breath sounds - Intercostal retractions, nasal flaring, and tripod position may be noted |
Asthma or Chronic Obstructive Pulmoary disease
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What is the treatment for Asthma
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Oxygen
1) Used to correct hypoxia. Raise arterial saturation to at least 95% In adults, b-adrenergic sympathomimetic bronchodilators should be given in aerosol. 1) Albuterol, 0.2-0.3 mL in 3 mL normal saline, delivered by nebulizer every 20 to 30 minutes. 2) b-agonists may be nebulized in combination with ipratropium bromide (0.5 mg, up to three doses). parenteral therapy includes a) Epinephrine, 0.2-0.3 mL (1:1000 dilution) every 20-30 minutes subcutaneously, b) Terbutaline, 0.25 mg subcutaneously every 2-4 hours. 2) Parenteral therapy may have value in younger patients with severe exacerbation. 3) Parenteral administration of sympathomimetics can produce marked tachycardia and may induce myocardial ischemia Especially in elderly patients Corticosteroids should be given early to patients who do not respond adequately to nebulized or parenteral b-adrenergic agents. 1) methylprednisolone, 125 mg intravenously initially, or prednisone, 60 mg orally. |
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A continuous, high-pitched, musical sound (whistle-like) heard during inspiration or expiration
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wheezes
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What does the respiratory system consist of?
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- Upper respiratory system: nose, pharynx, and associated structures
- Lower respiratory system: larynx, trachea, bronchi, and lungs |
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What is the likely diagnosis for the following:
Cause localized pain, crepitus, pain with inspiration, and dyspnea - Can cause pneumothorax or hemothorax - Mortality rate increases with the numer of ribs involved - Pain may lead to hypoventiliation, atelectasis, retained secretion and pneumonia |
rib fracture
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What is external respiration (pulmonary gas exchange)?
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It is the diffusion of O2 from air in the alveoli of the lungs to blood in the pulmonary capillaries and the diffusion of CO2 in the opposite direction
Occurs in the lungs |
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What is the most common cause of a Pneumothorax?
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Traumatic pneumothorax
- must always be considered in trauma patients - consider some invasive procedures (subclavian line placement, thoracentesis, lung or pleural biopsies, barotrauma from positive pressure ventilation) |
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What occurs when there is a defect in one or more of the normal host defense mechanisms or when a very large infectious inoculum or a highly virulent pathogen overwhelms the host
- Bacteria are more commonly identified than viruses. - Most common bacterial pathogen identified is S Pneumonia, accounts for approximately 2/3 thirds of bacterial isolates - Common viral causes are Influenza virus, respiratory syncytial virus, adenovirus,parainfluenza |
Community-acquired pneumonia
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What is the disposition for a patient with Pneumothorax?
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MEDEVAC
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What are the four groups of sinuses?
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- Frontal
- Maxillary (largest) - Sphenoid - Ethmoidal |
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What is the likely diagnosis for the following;
- Presents with severe dyspnea, production of pink, frothy sputum, diaphoresis, cyanosis - Rales are present in all lung fields, as are generalized wheezing and rhonchi - May appear acutely or subacutely in the setting of chronic heart failure - May be the first manifestation of cardiac disease - Less severe decompensations usually present with dyspnea at rest and rales and other evidence of fluid retention but without severe hypoxia |
pulmonary edema
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What does the following describing;
Lung exspansion causes air molecules inside the lungs to occupy a larger volume, causing the air pressure inside to decrease - When lung volume decreases, the alveolar pressure increases - At rest just before inhalaiton, air pressure inside the lungs is the same as the pressure of the atmosphere (760 mm Hg at sea level) - As the volume of lungs increase, the alveolar pressure decreases from 760 to 756 mm Hg - As the volume of the lungs decrease, the alveolar pressure rises from 760 to 762 mm Hg |
pressure changes during ventilation:
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What is the likely diagnosis for the following physical findings;
- Onset is often abrupt and one or more of the DVT risk factors is almost always present - Dyspnea, cough, anxiety, and chest pain - Hemoptysis, tachycaria, and tachypnea are common - Low grade fever, hypotension, cyanosis, DVT signs, pleural friction rub may be present |
pulmonary embolism
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What are the two pairs of vocal cords?
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- False vocal cords: upper pair; does not produce sound
- True vocal cords: lower pair; produces sound during speaking and singing |
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What is the treatment for a patient with bronchitis?
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- Acute bronchitis rarely needs aggressive management
- Symptomatic treatment if needed: antipyretics, cough suppressants (Benzonatate 100-200mg tid), Short acting beta agonists (Albuterol, Levalbuterol), Expectorants (guaifenesin, robitussin, mucinex), Dextromethorphan 10-20mg q4h, 30mg q6-8h, 60mg q12 |
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What does the following describe;
- Additional air expired after a normal inhalation - About 1200 mL in males or 700 mL in females |
Expiratory reserve volume
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What is a Spasmodic contraction of the diaphragm followed by spasmodic closure of the larynx
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hiccupping
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What is the treatment for a patient with pleuritis?
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- Main goal is to detect and treat the underlying lesion or cause
- Analgesic/ Antipyretic/ NSAID (Indomethacin 25mg bid-tid) |
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What is Deeper, more rumling, more pronounced during expiration and less discrete than crackles
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ronchi
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What does the following describe;
The sum of inspiratory reserve volume, tidal volume and expiratory resersve volume 4800 mL in males and 3100 mL in females |
vital capacity
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What is Spasmodic contraction of muscles of exhalation that forcefully expels air through the nose and usually from an irritation of nasal mucosa
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sneezing
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What does the following describe;
- Precipitated by discontinuation of medications - Excessive salt intake - Myocardial ischemia - Tachyarrhythmias - Intercurrent infection - Worsening edema and progressive SOB |
acute or subacute deterioration of chronic heart failure
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What does the following describe;
The volume of air that remains even after expiratory reserve volume is expelled - About 1200 mL in males and 1100 mL in females |
residual volume
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What does the following describe;
- may be asymptomatic, particularly in the acute phase, or may present with symptoms of bowel obstruction - since early diagnosis is difficult to establish, delayed presentation is common with nonspecific respiratory or bowel complaints |
diaphragmatic hernias
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What is A deficiency in O2, falls from the normal levels
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Hypoxia
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What are the two zones of basic respiratory function?
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- The conducting zone: consists of a series of interconnecting cavities and tubes that conduct air into the lungs
- The respiratory zone: consists of tissues within the lungs where gas exchange occurs |
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What are the primary bronchis lined with?
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pseudostratified ciliated columnar epithelium
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What is A series of convulsive inhalation followed by a single long exhalation
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sobbing
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What is - Abnormal sound heard more often during inspiration and characterized by discrete discontuinuous sounds
- May be fine, medium or coarse, and will not be not be cleared by coughing |
crackles
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What is Same as crying but different facial expressions
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laughing
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What is the likely diagnosis for the following physical findings;
- Hypoxia - Tachypnea - Respiratory distress - Fever and tachycardia frequently occur - Hypotension may develop |
massive aspiration
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What medications are used for treating a patient with pulmonary edema?
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- Morphine (2-8mg IV) is highly effective and may help lessen severe decompensations
- Diuretics: Furosemide 20-80 mg IV/IO/PO; Bumetanide 1 mg - Nitrate therapy accelerates clinical improvement |
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What is A long-drawn deep inhalation followed by a strong exhalation
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coughing
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What is A deep inhalation through a widely opened opened mouth, producing an exaggerated depression of the mandible
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yawning
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What is pulmonary ventilation?
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The flow of air between the atmosphere and the lungs, occurs due to differences in air pressure
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How does carbon dioxide travel through the blood?
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Transported in 3 main forms: Dissolved CO2 (smallest percent 7% dissolved in blood plasma), Bound to amino acids (about 23% combines with the amino group), and Bicarbonate ions (largest 70%)
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What is A long-drawn and deep inhalation immediately followed by a shorter but forceful exhalation
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sighing
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What is An inhalation followed by many short convulsive exhalations, vocal cords vibrate, charteristic facial expressions
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crying
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What are the functions of the nose?
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- Filtering, warming and moistening incoming air
- Detecting olfactory (smell) stimuli - Modifying the vibrations of speech sounds |
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What does the following describe;
Total volume of air inhaled and exhaled each minute (BPM x TV) MV = 12 breaths/min x 500 mL/breath |
minute ventilation
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What is internal respiration ( systemic gas exchange)?
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The exchange of O2 and CO2 between system capillaries and tissue throughout the body
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What does the following describe;
- Occurs outside the respiratory tree, it has a dry, crackly, low pitched sound and is heard in both expiration and inspiration - Respiratory rub disappears when breath is held but a cardiac rub does not |
Friction rubs
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What is An increase in the arterial PCO2 above the normal 40mm Hg
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Hypercapnia
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What doe sthe following describe;
- Additional air that is inhaled beyond the normal 500 mL TV - About 3100 mL in males and 1900 in females |
Inspiratory Reserve volume
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What is the likely diagnosis for the follow;
- Chest wall pain located in a specific point - Typically costochondral or costosternal junctions - Reproducable by palpation |
costochondritis
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Air pressure is the sum of partial pressure in what gases?
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- Nitrogen
- Oxygen - Water vapor - Carbon dioxide - Pother gases |
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What are the areas of the respiratory center?
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- Medullary Rhythmicity area: located in medulla and controls basic rhthym of respiration
- Inspiratory area: generates nerve impulses that establish the basic rhythm of breathing - Expiratory Area: Neurons of this area supply nerve impulses for forceful exhalation - Pneumotaxic Area: located in the upper pons, helps turn off the inspriatory area to shorten the duration of inhalation and to increase the breathing rate - Apneustic area: Located in the lower pons, sends excitatory impulses to the inspiratory area that activate it and prolong inhalation |
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Depending on the size of the pulmonary embolism, what can possibly occur?
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- Small to medium emboli: Obstruction of the pulmonary vasculature, local atelectasis, ventilation-perfusion scan abnormalities, hypoxia
- Massive embolism: acute pulmonary hypertension, right heart strain, systemic hypotension, and shock |
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What is - A short tube of cartilage lined by mucous membrane that connect the pharynx with the trachea
- Lies midline of the neck anterior to the 4th,5th and 6th cervical vertebrae - Contains the thryoid cartilage, epiglottis, cricoid cartilage, and arytenid cartilages |
larynx
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What is - A funnel-shape tube that starts at the internal nares and extends partway down the neck
- Lies just posterior to the nasal and oral cavities and just anterior to the cervical vertebrae - Composed of skeletal muscle and lined with mucous membrane |
pharynx
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What are the layers that cover the outside and inside of the lungs?
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- Parietal pleura: outer layer attached to the wall of the thoracic cavity and diagphragm
- Visceral pleura: inner layer that is attached to the lungs |
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What does the following describe;
- Elevation or irregularity of the diaphragmatic border - Unilateral pleural thickening - Obvious herniation of abdominal contents into the chest cavity - Presence of a nasogastric tube in the chest cavity |
Findings on an upright chest x-ray suggestive of a diaphragmatic rupture
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What controls how quickly or how deeply we breathe?
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-Chemorecptors: sensory nerves that are respond to chemical levels
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What is - A cup-shaped outpouching of an alveolar sac
- Main sites for gas exchange |
the Alveoli
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What percentage of tidal volume actually reaches the respiratory bronchioles and alveolar sacs?
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- About 70% or 350 mL
- The other 30% reamins in the conduction airways |
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What is The volume of one breath, 500 mL of air into and out of the lungs
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tidal volume
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What is - The area from which nerve impulses are sent to the respiratory muscles to control respiratory rate
- Located in both the Pons and Medulla Oblongata |
the respiratory center?
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What are the cortical influences on respiration?
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Cerebral cortex has connections to the inspiratory center, allows us to hold our breath voluntarily
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What are the muscles that are used during forced exhalation?
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- Internal intercostals
- External oblique - Internal oblique - Transverses abdominis - Rectus Abdominis |
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What are some complications from pneumonia?
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Empyema, endocarditis, pericarditis, cavitation, necrotizing pneumonia, skin rashes, bacteremia, sepsis, respiratory failure, ARDS, and death
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How is oxygen transported through the body?
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- About 98.5% is bound to hemoglobin in RBC's
- Oxygen and deoxyhemoglobin (Hb) bind in a reversible reaction to form oxyhemoglobin Hb + O2> Hb - O2 - When blood PO2 is high, HGB binds with large amounts of O2 and is fully saturated - When blood PO2 is low, HGB releases O2 |
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What are the classifications of Pneumothorax?
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- spontaneous (primary or secondary)
- traumatic (chest trauma or iatrogenic) |
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What does the following describe;
The sum of residual volume and expiratory reserve volume 1200 mL + 1200 mL = 2400 mL in males 1100 mL + 700 mL = 1800 mL in females |
Functional residual capacity
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What does the following describe;
- The size of tidal volume and inspiratory reserve volume 500 mL + 3100 mL = 3600 mL in male 500 mL + 1900 mL = 2400 mL in females |
Inspiratory capacity
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What are the different breathing patterns?
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- Eupnea
- Costal Breathing - Diaphramic Breathing |
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What are the complications of a Hemothorax?
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hypovelemia due to blood loss
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What is - A tubular passageway fro air that is located anterior to the esophagus
- Extends from the larynx to the upper part of the fifth thoracic vertebra - Divides into R/L primary bronchi at the T-5 |
trachea
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What are other influences on respiration?
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- Propriocepter stimulation of respiration
- Temperature - Pain - Irritation of airways - Inflation reflex |
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What are the 3 components to the pharynx?
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- Nasopharynx: upper part; exchanges air with the nasal cavities and recieves mucus-dust packages
- Oropharynx: middle portion; opens into the mouth and nasopharynx and has 2 pairs of tonsils - Laryngopharynx: connects with both the esophagus and larynx |
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What is the difference between primary pneumothorax and secondary pneumothorax?
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- Primary pneumothorax occurs without clinically apparent lung disease (Typically young, tall, men age 20-40)
- Secondary pneumothorax occurs as a complication of a preexisting underlying pulmonary disease (COPD, pneumonia, CF, asthma, TB, pneumocystis carinii pneumonia infection) |
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What muscles are used during quiet (unforced) inhalation and exhalation?
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- Diaphragm: responsible for 75% of the air that enters the lungs
- External Intercostals |
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What does the following describe;
The sum of vital capacity and residual volume - 4800 mL + 1200 mL= 6000 mL in males - 3100 mL + 1100 mL = 4200 mL in females |
total lung capacity
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What is When arterial PCO2 falls below 40 mmHg, the central and peripheral chemoreceptors are not stimulated and no impulses are sent
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Hypocapnia
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