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CardioPulm > Ventilatory Pump Lecture > Flashcards

Ventilatory Pump Lecture Flashcards

1
Q

What constitutes an Airway Clearance problem?

A

Inability to clear secretions

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2
Q

How can you find evidence of retained secretions, infiltrate or consolidation?

A

Check breath sounds, Chest films, CT, MRI

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3
Q

What are some pathologies associated with chronic retained secretions?

A

CF, bronchiectasis and/or chronic bronchitis

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4
Q

What are breath sounds associated with secretions?

A

course crackles

low pitched wheezes

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5
Q

What are breath sounds associated with atelectasis?

A

fine crackles

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6
Q

What are breath sounds associated with airway constrictions?

A

high pitched wheezes

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7
Q

If you have decreased inspiratory or expiratory pressure, what does it mean?

A

you have decreased ventilatory muscle strength

vent pump problem

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8
Q

What is the usual A:P diameter?

A

1:1 ratio

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9
Q

With ventilatory pump issue, what postural assessment might you find?

A

greater A:P diameter than lateral

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10
Q

What happens to the subcostal angle?

A

it increases from 90*

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11
Q

What breathing pattern assessment tells us there is a vent pump issue?

A

Accessory muscle use at rest

Abnormal/uncoordinated/paradoxical breathing pattern (rest, position change, activity)

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12
Q

What tests tell us there is a ventilatory pump issue?

A

abnormal: PFTs, postural assessment, breathing pattern, decreased MIP or MEP

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13
Q

What is normal I:E (inspiration to expiration ratio) at rest?

A

1:2

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14
Q

What is normal I:E (inspiration to expiration ratio) with exercise?

A

1:1

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15
Q

What is a coordinated breathing pattern?

A

initial thoracic lift through anterior abdominal and lateral costal expansion

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16
Q

What is a discoordinated breathing pattern?

A

Paradoxical thoraco-abdominal motion

17
Q

What happens to I:E with COPD or chronic bronchitis?

A

1:3 or 1:4

expiration is 3 or 4 times longer than inspiration

18
Q

What is VC?

A

Vital Capacity

VC = IRV + ERV + VT

19
Q

What is FRC?

A

functional residual capacity

FRC = RV + ERV

20
Q

What is RV?

A

Residual volume

volume not available for use (amt increases with pathologies)

21
Q

What PFTs do we use to assess ventilatory mechanics or muscle strength?

A

Assess maximal inspiratory force (MIF or MIP)

Assess maximal expiratory force (MEF or MEP)

22
Q

What happens to VC during exercise

A

o Initial increase in volume, then rate
o < 50% of VC: more increased volume
o = 50% of VC: increased elastic load
o > 50% of VC: increased rate

23
Q

What is anatomical dead space?

A

non-conducting areas (trachea and upper bronchioles)

24
Q

What is physiological dead space?

A

air gets there, but no perfusion (ex: PE)

25
Q

What drives breathing?

A

CO2

26
Q

What is VE?

A

minute ventilation: Volume of air breathed in 1 minute (influenced by C02 levels)

27
Q

What % oxygen, FiO2, is room air?

A

Room air is 20.93% oxygen (21%) = 0.21

28
Q

What is the partial pressure of oxygen?

A

760 mmHg = total pressure at sea level

29
Q

What is PO2 at sea level?

A

PO2 = 760 mmHg x 0.21 = 159.6 mmHg
o 760 mmHg = total pressure at sea level
o 0.21 = is % of oxygen in room air at sea level

30
Q

CO2 diffuses ____ than O2.

A

quicker

31
Q

What is the normal pressure in the alveoli?

A

100-110 mmHg

32
Q

PAO2 formula

A

PAO2 = (713 mmHg) (FiO2) – 40 mmHg

FiO2 with RA = 0.21; can plug in values for supplemental oxygen

33
Q

For every 10% increase, PaCO2 should go up by

A

50 mmHg

34
Q

What does Ventilation- Perfusion (V/Q) indicate?

A

matching of blood flow to ventilation

35
Q

What is ideal Ventilation- Perfusion (V/Q)?

A

ideally ~1.0 ratio (mid lung zones)

36
Q

What happens at lung base and lung apex to Ventilation- Perfusion (V/Q)?

A

Lung base: generally overperfused (ratio < 1.0)

Lung apex: generally underperfused (ratio > 1.0)

37
Q

Ventilation- Perfusion (V/Q) is ________-dependent.

A

GRAVITY

38
Q

What causes decreased accuracy of Sp02?

A

o Decreased blood flow (Raynaud’s or poor peripheral blood flow)
o Mobility or when SpO2 70-80%
o Severe anemia (not always)
o Dark pigmented skin or nail polish

39
Q

When PaO2 = 60, what happens to SpO2?

A

SpO2 = 90

point at which oxygen starts dissociating faster from HgB

CardioPulm (13 decks)

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