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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? |
Gas Exchange |
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Gas Exchange involves? |
The transfer of oxygen and carbon dioxide between the atmosphere and the blood |
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The upper respiratory system includes? |
Nose,Nasal Passages,Sinuses,Pharynx, Adenoids, Tonsils, Epiglottis,Glottis, Larynx,Vocal cords, and trachea |
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The lower respiratory system includes? |
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? |
The Lungs |
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The right lung has how many lobes? |
3 |
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The left lung has how many lobes? |
2 |
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What structures in the chest wall are also essential to respirations? |
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? |
Larynx |
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Is the air we breathe filtered and warmed with inspiration? |
Yes? |
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Where is the Glottis located? |
It is the opening between the vocal cords and Larynx |
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What dos the epiglottis do? |
It is a cartilage flap that covers the larynx for swallowing. |
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What is cilia responcible for? |
It is a mucous membrane that filters and moistens the resp tract. |
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Can bacteria be rid of by sneezing? |
Yes? |
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What is the leading causes of Respiratory Infections/Disease? |
Smoking Second hand smoke |
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What disease are related to the respiratory system due to smoking? |
COPD, Asthma, Influenza (URI), Heart Disease, Stroke, Cancer |
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What happens to Hemoglobin with smokers? |
It can not carry O2 effectivly to the cells. Shifts to the right. |
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Carbon Dioxide and Hemaglobin form? |
Carboxy Hemaglobin |
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Where does gas exchange occur? |
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? |
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? |
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? |
Stroke, Prolonged intubation, and altered LOC. |
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Why is the Trachea U shaped? |
Keeps the trachea open but allows the ajacent esophagus to expand for swallowing. |
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E tube sits where? |
3-5 cm above the carina |
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Which Bronchi is straighter and wider the right or left? |
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? |
24 ribs? |
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What lobes can be heard from the front of the body? |
Upper lobes |
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What do the ribs do? |
Protect heart and lungs (Thoracic Cage) |
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What is the fluid for between the parietal and visceral spaces |
Prevents friction and rubbing. Negative Pressure 20-25 ml of fluid |
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Chest cavity in lined with what membrane? |
parietal pleura |
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The lungs are lined with what membrane? |
visceral pleura |
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More than 25ml of fluid in spaces is called |
Pleural Effusion |
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Causes of Pleural Effusion are? |
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? |
Downward |
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External Intercostal Muscles and scalene muscles contract this does what? |
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 |
500ml |
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Normal Tidal Volume is? |
Volume of air exchanged with each breath 150/500 in dead space with no gas exchange. |
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3 Types of Calls? |
Epithelial- Structure Surfactant- Prevent Collapse Endothelial- Macrophage- eat/engolf bacteria. |
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Ventilation |
Movement of air in and out of lungs |
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Ventilation with inspiration- |
diaphram moves down causes inflattion |
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Gas flows from an area of________ concentration to an area of ________ concentration |
high(atmospheric) to low(intrathoracic) |
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What can limit chest wall expansion? |
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 |
Asthma Inflammation Chronic Bronchitis- thickened secretions of mucous in bronchioles Loss of Lund Elasticity- Emphazema |
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When compliance is decreased? |
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? |
Pleural effusion |
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Increased compliance |
Loss of elasticity, over distended, emphysema, sarcodosis |
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Decreased compliance |
Stiff, Pulmonary edema, pneumothorax, ARG |
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Process of Gas echange is defined as? |
Diffusion High concentration to low |
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Diffusion does what? |
Take air into arterial blood and Carbon dioxide from the arterial blood into the alveolar gas. |
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(PaO2) stand for? |
Partial pressure of Oxygen |
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(SAO2) stand for? |
Arterial oxygen saturation |
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(PaO2) represents? |
the amount of O2 dissolved in the plasma |
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(SaO2) represents? |
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 |
760ml/mercury Nitrogen 79% O2 21% |
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Oxygen-hemoglobin dissociation curve |
see chart |
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Mixed venous blood gases requires what kind of cath? |
Pulmonary Artery Cath or called Swan Catheter |
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Impaired cardiac output? |
Inadequate tissue oxygen delivery or abnormal O2 consumption. |
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A Swan Cath/PA cath measure what? |
Mixed venous Blood gases |
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Mixed Venous Blood Gas may be drawn for what reason? |
Cardiac Output, Profussion problems, Critical Care |
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What are the two methods for measuring gas transfer to lungs |
ABG, Pulse Ox |
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Does well oxygenated blood and deoxygenized blood absorb light the same way? |
No, Well oxygen absorbs light differently. |
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What determines the amount of light by the vascular bed and calculates the saturation? |
SPO2 |
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What disorders is an SPO2 not accurate? |
Anemia |
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Who has a decreased SPO2? |
Elderly |
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With decreased Hemoglobin what s/s might you see? |
Mixed and venous blood levels drop Change respiratory pattern and rate, cardiac, and renal |
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The Two Controls of respiration are? |
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. |
Chemoreceptor |
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Increase in (H+) causes? |
acidosis Increased RR Tidal Volume |
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Decrease in (H+) causes? |
alkalosis |
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PaCO2 regulates? |
ventilation |
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Chronic PaCO2 can be elevated d/t what condition? |
COPD |
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Peripheral chemoreceptors are located? |
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? |
Medulla Oblangota and Pons |
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What maintains Ph in the blood? |
Lungs and Kidneys Fight to stabalize |
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Respiratory defense mechanisms consist of these 5 things? |
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? |
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? |
Past Medical History Medications Surgery or other treatments |
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Questions to ask patient pertaining to Respiratory might include? |
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? |
Every 5 Years |
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Health perception? |
Is what the patient preceives their health as |
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When assessing nutritional status what info would you want to obtain? |
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? |
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? |
Pain, SOB, Restless, Irritable, Confusion |
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Self perception means? |
Do the patients illness/disease affect there life |
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What is the #1 Missed assessment |
Sexuality-Reproductive Patterns |
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Value- Belief Patterns r/t? |
Why the pt thinks is causing his illness |
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Coping stress Tolerance Pattern Example would be? |
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? |
Inspect Palpate Percuss Auscultation |
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What Blood studies might be used in th respiratory system? |
ABG, CBC (WBC infection) BMP (suspect COPD increased fluid) |
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A sputum study might be done to? |
Identify the organism and to determine which Antibiotic will treat that bacteria |
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What is the most common culture taken? |
Rapid Strep |
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What is a tell tell sign of Strep? |
Strawberry tongue and white patches on the throat |
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Chest X-rays are used to? |
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? |
Pulmonary Angiography injection of dye into the pulmonary artery |
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What test can detect lesion that in non invasive? |
Computed tomography |
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A spiral CT is used to diagnose what? |
Pulmonary embolism |
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What test can pick up bleeding ? What does it Diagnose? |
Magnetic resonance imaging Diagnoses vasular structure |
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Positron emission tomography is used to determine? |
benign and malignant lung nodules (isotope used) |
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ventilation-perfusion scans for? |
1:1 ratio of blood and air checks ventilation and perfussion (isotope injected) |
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Bronchoscopy is used for? |
Inspect Larynx, Trachea, and Bronchi |
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A small incision in the sternal notch to inspect lymph is called? |
Mediastinoscopy |
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Thoracentesis |
Removes accumulated fluids |
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A test to check Ventilation status is called? |
Pulmonary Function Test |
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Excersise tests are used to? |
check stress with excercise |
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what position should a patient be in when having a thoracentesis? |
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? |
persantine dabutamine check spelling----------- |
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What is the normal Forced Expiratory Volume? (FEVI) |
70% |
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While inspecting the nose what should you find? |
Pink, Moist, None inflammed tissue |
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While inspecting he nose what should you NOT find? |
Deviated septum, Flaring, discharge |
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Nasal drainage green or yellow in color could indicate what? |
Bacteria Blocked Nasal Passages Impair the senses of smell and taste. |
Test? |
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Inspection of the mouth consists of what areas? |
Pharynx,pink moist,no lesions Tonsils- no cracks Tongue |
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Tongue should lye midline cranial nerve 9 |
cranial nerve 9 |
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Tongue should move side to side |
Cranial nerve 12 |
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Uvula should rise when saying AHHH |
cranial nerve 10 |
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Swollen lymph nodes in the neck that are large and tendor indicate |
Infection |
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Thorax and Lungs assessment |
chest should be symmetrical No buldging/ retraction |
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Anterior and Posterior diameter should be in what ratio? |
2:1 1:2 indicates COPB barrel chest |
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Palpate the chest- an indication of movement over 1 inch would indicate? |
Pneumothorax Thoracic expansion T9-T10 |
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Hyper inflatted lungs indicate |
COPD |
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Medium inflatted lungs indicate |
Pleural effusion or pneumonia |
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Wheeze is? |
narrowing of bronchi |
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Rhonchi |
Bad drum, snore- Chronic broncitis, COPD |
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Lungs sound should be heard when? |
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 |
8 Lowest point T-10-12 |
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Crackles with inspirtion |
Can be cleared |
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Crackles with expiration indicate? |
COPD Pneumonia |
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Where is the best place to hear a friction rub? |
lateral sides- inflammation of pleura |
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