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30 Cards in this Set
- Front
- Back
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List 7 potential impacts of decreased ventilation |
1. low lung volumes 2. hypoxaemia / hypercapnia 3. atelectasis 4. V/Q mismatch 5. reduced surfactant spread 6. reduced mobilisation of secretions 7. reduced strength of cough |
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Where is perfusion of thelung the best? |
the most gravity dependent portion |
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List 4 potential impacts oflow lung volumes. |
1. impaired oxygenation 2. impaired airway clearance or ineffective cough 3. increased WOB 4. dyspnoea on exertion
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Restrictive lung disease is achronic decrease in lung volume. Outline 5 diseases / major contributing conditions. |
1. Interstitial lung disease 2. kyphoscoliosis (decreased chest wall compliance) 3. spinal cord injury 4. obesity 5. neuro-muscular weakness |
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Outline two main clinicalconsequences of reduced lung volumes (hint: think capacities and ventilation). |
1. reduction in TV & TLC 2. reduction in FRC (pt unable to sustain alveolar ventilation) |
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V/Q matching in adults is best in which portions of the lungs? |
gravity dependent portions |
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In childhood, in which portions is ventilation best matched? |
non dependent portions |
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In childhood, in which portions is perfusion best matched? |
non dependent portions |
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Adult ventilation distribution is best in whichregions and why? Compare Apices to bases in the upright adult lung. |
lower regions ventilate better due to the weight of the lungs. The bases require small expanding pressure, have a small resting volume and have large changes on inspiration. The apices have a large expansion pressure, big resting volume an a small change in volume in inspiration |
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Explain how the adult ventilation distribution is like a slinky off a step. |
the weight at the bottom pulls the top open |
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what do normal breath sounds sound like? |
soft low pitched rustling quality during inspiration even softer on expiration
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What's the mechanism behind normal breath sounds? |
inflated lung muffles sound
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what do reduced breath sounds sound like? |
lower intensity less full or robust than normal |
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List 8 causes of reduced breath sounds |
1 small TV's 2. segmental atelectasis 3. small pleaural effusion 4. shallow breathing 5. frailty 6. elderly 7. obesity 8. highly muscular
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List 4 mechanisms behind small TV's. |
1. ARDS 2. Asynchronus breathing 3. decreased compliance 4. obesity |
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List the mechanism behind segmental atelectasis |
airway is blocked by sputum or foreign body & can't enter alveoli; alveolar air is absorbed out of the segment |
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List 8 mechanisms behind a small plural effusion |
1. CHF 2. kidney failure 3. infection 4. malignancy 5. PE 6. hypolabuminemia 7. cirrhosis 8. trauma |
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List 3 causes for no or absent breath sounds |
1. lobar atelectasis 2. pneumothorax 3. large plural effusion |
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Whats the cause of crackles? (think gas pressures) |
sudden equalisation of pressures in small airways and alveoli |
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Crackles indicate the presence of what? |
oedema |
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Course breath sounds indicate the presence of what? |
sputum |
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Where are bronchial breath sounds considered normal? |
over trachea |
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Wheezing is a high pitched musical sound caused by the vibrational pattern of almost touching airways. List 4 potential reasons for this. |
1. Smooth m spasm 2. mucous / oedema 3. tumour 4. foreign body |
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Define Inspiratory Capacity (IC). |
A maximal inhalation from the end of a normal expiration. |
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Define RV (residual volume). |
The volume of air left in the lungs at the end of a maximal expiration.
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Define FRC. |
The volume of air left in the lungs at the end of a normal VT expiration. |
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Define VC (vital capacity). |
The volume of air from maximal expiration to maximal inspiration. |
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Define IRV (inspiratory reserve volume). |
The residual volume from a tidal volume inspiration to maximal inspiration. |
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Outline and define TLC (total lung capacity). |
The total volume of air that the lungs can maximally hold at any one time, including residual volume (dead space). |
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Outline 5 reasons foracute decreases in lung volumes. |
1. Atelectasis 2. Pain 3. Pneumothorax 4. Pleural effusion (compliancy decreased) 5. chest trauma / rib #'s
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