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116 Cards in this Set
- Front
- Back
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Respiration
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The act of breathing.
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Inhalation or inspiration
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The intake of air into the lungs.
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Exhalation or expiration
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Breathing out or the movement of gases form the lungs to the atmosphere.
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Ventilation
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The movement of air in and out of the lungs.
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Costal (thoracic) breathing
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Breathing that involves the external intercostal muscles and other accessory muscles, such as the sternocleidomastoid muscles.
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Diaphragmatic (abdominal) breathing
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Breathing that involves the contraction and relaxation of the diaphragm, and it is observed by the movement of the abdomen, which occurs as a result of the diaphragm's contraction and downward movement.
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The process of inhalation
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1. The diaphragm contracts (flattens).
2. The ribs move upward and outward. 3. The sternum moves outward, thus enlarging the thorax and permitting the lungs to expand. |
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The process of exhalation
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1. The diaphragm relaxes.
2. The ribs move downward and inward. 3. The sternum moves inward, thus decreasing the size of the thorax as the lungs are compressed. |
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How long does a normal adult inspiration last?
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1 to 1.5 seconds
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How longs does a normal adult expiration last?
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2 to 3 seconds
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What controls respiration?
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Respiration is controlled by:
1. Respiratory centers in the medulla oblongata and the pons of the brain 2. Chemoreceptors located centrally in the medulla and peripherally in the carotid and aortic bodies. -These centers and receptors respons to changes in the concentrations of O2 , CO2 and hydrogen in the arterial blood. |
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Eupnea
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Breathing that is normal in rate and depth.
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Bradypnea
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Abnormally slow respirations.
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Tachypnea or polypnea
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Abnormally fast respirations.
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Apnea
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The absence of breathing.
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What are some causes of increased respiratory rate?
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-exercise
-stress -increased environmental temperature -lowered O2 concentration at increased altitudes |
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What some causes of decreased respiratory rate?
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-decreased environmental temperature
-certain medications -increased intracranial pressure. |
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How is respiratory depth described?
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-normal
-shallow -deep |
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During a normal inspiration and expiration, how much air does an adult take in?
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500 mL of air; this is called tidal volume
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Tidal volume
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The volume of air that is normally inhaled and exhaled.
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Hyperventilation
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Overexpansion of the lungs characterized by deep and rapid respirations.
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Hypoventilation
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Underexpansion of the lungs characterized by shallow respirations.
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Cheyne-strokes breathing
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Rhythmic waxing and awning of respirations, from very deep to very shallow breathing and temporary apnea.
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Dyspnea
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Difficult and labored breathing during which the individual has a persistent, unsatisfied need for air and feels distressed.
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Orthopnea
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Ability to breathe only in upright sitting or standing positions.
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Stridor
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A SHRILL, HARSH sound heard during INSPIRATION with laryngeal obstruction.
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Stertor
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SNORING or SONOROUS respiration, usually due to a partial obstruction of the upper airway.
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Wheeze
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CONTINUOUS, HIGH-PITCHED musical SQUEAK or WHISTLING sound occuring on EXPIRATION and sometimes on INSPIRATION when air oves through a narrowed or partially obstructed airway.
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Bubbling
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GURGLING sounds heard as air passes through moist secretions in the respiratory tract.
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Intercostal retractions
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Indrawing between the ribs.
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Substernal retraction
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Indrawing beneath the breastbone.
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Suprasternal retraction
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Indrawing above the clavicles.
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Hemoptysis
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The presence of blood in the sputum.
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Productive cough
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A cough accompanied by expectorated secretions.
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Nonproductive cough
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A dry, harsh cough without secretions.
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Respiratory rhythm
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The regularity of the expirations and the inspirations.
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How is respiratory rhythm described?
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-regular
-irregular |
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Respiratory quality or character
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Those aspects of breathing that are different from normal, effortless breathing such as the amount of effort a client must exert to breathe and the sound of breathing.
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Arterial blood pressure
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A measure of the pressure exerted by the blood as it flows through the arteries.
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Systolic pressure
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The pressure of the blood as a result of contraction of the ventricles, that is, the pressure of the height of the blood wave.
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Diastolic pressure
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The pressure when the ventricles are at rest.
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Pulse pressure
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The difference between the diastolic and the systolic pressures.
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Arteriosclerosis
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A condition in which the elastic and muscular tissues of the arteries are replaced with fibrous tissue.
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Pulse oximeter
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A noninvasive device that estimates a client's arterial blood oxygen saturation (SaO2) by means of a sensor attached to the client's finger, toe, nose, earlobe, or forehead. The pulse oximeter can detect hypoxemia before clinical signs and symptoms develop.
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What is normal SaO2?
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95% to 100%
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What is below normal SaO2 level?
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Anything below 95% is low. Below 70% is life threatening.
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What are some factors that affect pulse ox (SaO2)?
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-Hemoglobin
-Circulation -Activity -Carbon monoxide poisoning |
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What is normal SaO2 for babies?
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80% is normal for infants.
Below 80% is low. |
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Flatness
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An extremely dull sound produced by very dense tissue, such as muscle or bone.
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Dullness
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A thudlike sound produced by dense tissue such as the liver, spleen or heart.
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Resonance
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A hollow sound such as that produced by lungs filled with air.
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Hyperresonance
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Not produced in the normal body. BOOMING sound that can be heard over an emphysematous lung.
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Tympany
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A musical or drumlike sound produced form an air-filled stomach.
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Which sinuses are present at birth?
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The ethmoid and maxillary sinuses.
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When do the frontal sinuses begin to develop?
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1 to 2 years of age.
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When do the sphenoid sinuses begin to develop?
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Later in childhood.
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Where is the angle of Louis located?
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The junction between the body of the sternum (breastbone) and the manubrium (the handlelike superior part of the sternum that joins with the clavicles).
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When the client flexes the neck, a prominent can be observed and palpated. What is this spinous process?
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It is the spinous process of the 7th cervical vertebrae (C7).
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What is the normal shape for the thorax?
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The thorax should be an oval shape.
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Pectus carinatum
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Pigeon chest- a permanent deformity that may be caused by rickets. A narrow traverse diameter anteroposterior diameter, and a protruding sternum characterize pigeon chest.
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Pectus excavatum
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Funnel chest- a congenital defect, is the opposite of pigeon chest in that the sternum is depressed, narrowing the anteroposterior diameter.
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Barrel chest
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The ratio of the anteroposterior to transverse diameter is 1 to 1, is seen in clients with thoracic kyphosis (excessive convex curvature of the thoracic spine) and emphysema.
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Emphysema
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Chronic pulmonary condition in which the air sacs, or alveoli, are dilated and distended.
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Adventitious breath sounds
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Abnormal breath sounds.
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Crepitations
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crackles
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Vesicular breath sounds
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Best heard on INSPIRATION. Soft-intensity, low pitched, "gentle sighing" sounds created by air moving through smaller airways (bronchioles and alveoli).
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Broncho-vesicular sounds
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Can be heard on both INSPIRATION AND EXPIRATION. Moderate-intensity and moderate -pitched "blowing" sounds created by air moving through larger airway (bronchi).
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Bronchial (tubular)
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Louder than vesicular sounds; have a short INSPIRATORY phase and long EXPIRATORY phase. High-pitched, loud, "harsh" sounds created by air moving through the trachea.
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Crackles (rales)
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Fine, short, interrupted crackling sounds; alveolar rales are high pitched. Best heard on INSPIRATION but can be heard on expiration. Most commonly heard in the bases of the lower lung lobes.
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Gurgles (rhonchi)
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Continuous, low-pitched, coarse, gurgling, harsh, louder sounds with a moaning or snoring quality. May be altered by coughing. Predominantly heard over the trachea and bronchi.
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Friction rub
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Superficial grating or creaking sounds heard during INSPIRATION and EXPIRATION. Not relieved by coughing. Usually heard in areas of greatest thoracic expansion.
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Wheeze
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Continuous, high-pitched, squeaky musical sounds. Best heard on EXPIRATION. Not usually altered by coughing. Can be heard over all lung fields.
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Tactile fremitus
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Fremitus is a palpable vibration on the human body. Ex: ask the client to repeat the work 99 and palpate the vibrations on the back.
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What 3 components does the process of respiration involve?
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1. Pulmonary ventilation or breathing
2. Gas exchange, which involves diffusion of O2 and CO2 b/w the alveoli and pulmonary capillaries. 3. Transport of O2 from the lungs to the tissues, and CO2 from the tissues to the lungs. |
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What is the larynx?
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A cartilaginous structure that can be identified externally as the Adam's apple. It is important for maintaining airway patency and protecting the lower airways from swallowed food and fluids.
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What lines the trachea and bronchi?
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mucosal epithelium
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What do mucosal epithelium produce?
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They produce a thin layer of mucus, the "musous blanket," that traps pathogens and microscopic particulate matter.
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Respiratory membrane?
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The alveolar and capillary walls form the respiratory membrane. Gas exchange occurs b/w the air on the alveolar side and the blood on the capillary side.
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What is the parietal pleura?
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The parietal pleura lines the thorax and surface of the diaphragm.
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What is pleural fluid?
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A serous lubricating solution that prevents friction during the movements of breathing and serves to keep the layers adherent through its surface tension.
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What does adequate ventilation require?
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-clear airways
-an intact central nervous system and respiratory center -an intact thoracic cavity capable of expanding and contracting -adequate pulmonary compliance and recoil |
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What is intrapleural pressure?
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Pressure in the pleural cavity surrounding the lungs. It is always slightly negative in relation to atmospheric pressure. This negative pressure is essential bc it creates the suction that holds the visceral pleura and the parietal pleura together as the chest cage expands and contracts. It also causes the pleura to adhere together.
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What is intrapulmonary pressure?
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Pressure within the lungs. It always exualizes with atmospheric pressure.
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What is lung compliance?
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The expansibility or stretchability of lung tissue. It plays a significant role in the ease of ventilation.
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What is atelectasis?
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A condition that occurs when ventilation is decreased and pooled secretions accumulate in a dependent area of a bronchiole and block it; collapsed portion of the lung.
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What is lung recoil?
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The tendency of lungs to collapse away from the chest wall.
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What is surfactant?
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A lipoprotein produced by specialized alveolar cells. It acts like a detergent, reducing the surface tension of alveolar fluid. Without surfactant, lung expansion is exceedingly difficult and the lungs collapse.
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Diffusion
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The movement of gases or other particles from an area of greater pressure or concentration to an area of lower pressure or concentration.
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What is partial pressure?
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The pressure exerted by each individual gas in a mixture according to its % concentration in the mixture.
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What is torr?
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Millimeters of mercury.
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Hemoglobin
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The red pigment in red blood cells that carries oxygen.
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Oxyhemoglobin
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The compound of oxygen and hemoglobin.
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What factors affect the rate of O2 transport from the lungs to the tissues?
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1. Cardiac output
2. # of erythrocytes and blood hematocrit 3. Exercise |
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Erythrocytes
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Red blood cells or RBC's
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Hematocrit
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The % of the blood that is erythrocytes.
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At what age do the lungs reach full inflation?
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At about 2 weeks of age.
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Hypoxia
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A condition of insufficient O2 anywhere in the body, from the inspired gas to the tissues.
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Hypercarbia (hypercapnia)
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A condition in which CO2 accumulates in the blood.
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Hypoxemia
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Reduced O2 in the blood.
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Cyanosis
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Bluish discoloration of the skin and mucous membranes caused by reduced O2 in the blood.
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What is one cause of hypoxia?
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Clubbed fingers and toes.
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Kussmaul's breathing
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Hyperventilation that accompanies metabolic acidosis in which the body attempts to compensate (give off excess body acids) by blowing off CO2 through deep and rapid breathing.
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Biot's (cluster) respirations
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Shallow breaths interrupted by apnea; may be seen in clients with CNS disorders.
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Sputum
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Coughed up material. Ex: phlegm
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Humidifier
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Devices that add water vapor to inspired air.
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Incentive spirometer
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Device that measures the flow of air inhaled through the mouthpiece and are used to: improve pulmonary ventilation, counteract the effects of anesthesia or hypoventilation, loosen respiratory secretions, facilitate respiratory gaseous exchange and expand collapsed alveoli.
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Percussion (clapping)
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Forceful striking of the skin with cupped hands. Percussion over congested lung areas can mechanically dislodge tenacious secretions from the bronchial walls.
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Vibration
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A series of vigorous quiverings produced by hands that are placed flat against the client's chest wall. Vibration is used after percussion to increase the turbulence of the exhaled air and thus loosen thick secretions.
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Postural drainage
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The drainage by gravity of secretions from various lung segments. Postural drainage treatments are scheduled two or three times daily, depending on the degree of lung congestion. The best times include before breakfast, before lunch, in the late afternoon and before bedtime.
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Nasal cannula
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Nasal prongs. Most common and inexpensive. It delivers 24% to 45% at flow rates of 2 to 6 L per minute.
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Face mask
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Covers the client's nose and mouth; may be used for oxygen inhalation. Exhalation ports on the sides of the mask allow exhaled carbon dioxide to escape. It delivers 40% to 60% at liter flows of 5 to 8 L per minute.
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Partial rebreather mask
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The oxygen reservoir mask that is attached allows the client to rebreathe about the first 1/3 of the exhaled air in conjunction with O2. The bag must not totally deflate during inspiration to avoid CO2 buildup. It delivers 60% to 90% at liter flows of 6 to 10 per minute.
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Nonrebreather mask
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One-way valves on the mask and between the reservoir bag and the mask prevent the room air and the client's exhaled air from entering the bag so only the O2 in the bag is inspired. The bag must not deflate to prevent CO2 buildup. It delivers 95% to 100% at liter flows of 10 to 15 L per minute.
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Venturi mask
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Has a wide bore tubing and color-coded jet adapters that correspond to a precise O2 concentration and liter flow. It delivers 24% to 40% or 50% at liter flows of 4 to 10 L per minute.
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Face tent
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Can replace O2 masks when mask are poorly tolerated by clients. It delivers 30% to 50% of O2 at 4 to 8 L per minute.
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Huff cough
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When the client leans forward and exhales sharply with a ''huff'' sound. This technique helps keep your airways open while moving secretions up and out of the lungs.
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