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APEX > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Triggers the end of inspiration by inhibiting the DRG.

Strong stimulus: rapid shallow breathing
Weak stimulus: slow and deep breathing

A

Pneumotaxic center

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2
Q

Antagonizes pneumotaxic center which causes inspiration
(Stimulates DRG)

A

Apneustic center

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3
Q

What inhibits the apneustic center?

A

Pulmonary stretch receptors (J receptors)

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4
Q

Causes inspiration (respiratory pacemaker)

A

Dorsal respiratory group

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5
Q

Causes expiration

A

Ventral respiratory group

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6
Q

____ drives the respiratory pacemaker in the DRG

A

H+

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7
Q

______ concentration in the CSF is the most important stimulus for the central chemoreceptor

A

Hydrogen ion

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8
Q

What drugs can be given down the ETT?

A

NAVEL:

Narcan
Atropine
Vasopressin
Epi
Lidocaine

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9
Q

In a patient undergoing pneumonectomy with OLV, crystalloid administration should be limited to?

A

< 3L in 24 hrs

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10
Q

Tracheal cuff pressure should be less than ___?

A

25 cmH20

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11
Q

How much cricoid pressure awake and after LOC?

A

Awake: 20 newtons ~ 2kg
After LOC: 40 newtons ~ 4kg

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12
Q

Peds ETT w/o cuff?

A

(Age/4) + 4

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13
Q

Peds ETT w/ cuff

A

(Age/4) + 3.5

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14
Q

Peds ETT depth

A

Internal diameter x 3

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15
Q

Max cuff pressure of LMA (not PPV pressure)

A

60 cmH20 (target = 40-60)

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16
Q

Anterior epiglottis supplied by:
Posterior epiglottis supplied by:

A

Glossopharyngeal (CN IX)
SLN (internal branch CN X)

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17
Q

Which pulmonary function test is the MOST sensitive indicator of small airway disease (obstruction)?

A

Forced expiratory flow at 25-75% vital capacity

18
Q

Volume of air that can be exhaled after a maximal inhalation.
Normal value?

A

FVC
Male= 4.8L
Female= 3.7L

19
Q

What FEV1/FVC ratio suggests obstructive dz?

A

<70%
(Normal with restrictive)

20
Q

Normal value of DLCO

A

17-25 ml/min/mmHg

21
Q
A
22
Q

Which drugs increase PVR?

A

Nitrous oxide, ketamine, Desflurane

23
Q

How does carbon monoxide affect the pulse ox?

A

May give a falsely elevated result

24
Q

What color is the pt with carbon monoxide poisoning?

A

cherry red appearance (not cyanotic)

25
Q

How does O2 supplementation affect carboxyhemoglobin?

A

Reduces t1/2 from 4-6 hrs on room air to 60-90 min with 100% O2. (O2 therapy continued until CoHgb < 5% or for 6 hrs)

26
Q

When is hyperbaric O2 needed for CO poisoning?

A

CoHgb > 25% or the pt is symptomatic

27
Q

What is the risk of carbon monoxide formation with soda lime greatest to least?

A

Des > Iso&raquo_space;» Sevo

28
Q

Strong indications for mechanical ventilation

A

Vital capacity < 15mL/kg
Inspiratory force < 25 cmH2O
PaO2 < 200 mmHg (on 100% FiO2)
A-a gradient > 450 mmHg (on 100% FiO2)
PaCO2 > 60 mmHg
RR > 40 or < 6 bpm

29
Q
A

bronchopleural fistula & pulmonary infection

30
Q

What are the best predictors of post pulmonary complications for pts undergoing pulmonary surgery?

A

FEV1 < 40% predicted
DLCO < 40% predicted
VO2 max < 15mL/kg/min

31
Q

What is the youngest age you can use a DLT? What size?

A

8-9 yrs
26F

32
Q
A
33
Q

What is the hallmark of ARDS?

A

hypoxemia despite increased supplemental oxygen

34
Q

What tidal volumes do we use for ARDS?

A

4-6 mL/kg (normal 6-8 mL/kg)

35
Q

What is the most common pulmonary etiology of ARDS?

A

pneumonia

36
Q

What is the most common extra-pulmonary etiology of ARDS?

A

sepsis

37
Q

What variable is reduced by dynamic hyperinflation?

A

Inspiratory capacity

38
Q

What lab value is a predictive marker for post-op pulmonary complications for non-thoracic surgery?

A

albumin

39
Q

What technique is the gold standard for managing the difficult airway?

A

Flexible fiberoptic bronchoscope with patient awake and spontaneous ventilation

40
Q
A
41
Q

In general, increased dead space affects _____ and increased shunt affects _____

A

PaCO2; PaO2

42
Q
A

APEX (29 decks)

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