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EMT > Chapter 8 > Flashcards

Chapter 8 Flashcards

1
Q

Glycolysis

A

Glucose crosses the cell membrane and broken down into pyruvic acid molecules -

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2
Q

ATP

A

Adenosine TriPhosphate - energy source required by cells to release more energy and needed for cells to function

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3
Q

What are the by-products of aerobic metabolism?

A

heat
carbon dioxide
water

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4
Q

What are the by-products of anaerobic metabolism?

A

lactic acid and small amounts of ATP -
lack of oxygen doesn’t allow pyruvic acid to continue the process of metabolism inside mitochondria of the cell and is converted into lactic acid

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5
Q

What happens when the sodium/potassium pump fails?

A

Sodium collects inside the cell, water follows sodium, swells and eventually will rupture and die

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6
Q

What is needed for adequate perfusion?

A 
ambient air
patent airways
ventilation
ventilation/perfusion ratio
oxygen and carbon dioxide transport
blood volume
pump function of heart
systemic vascular resistance
microcirculation
blood pressure
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7
Q

What is considered ambient air?

A

78% nitrogen, 21% oxygen, 1 % argon, .03% Carbon dioxide

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8
Q

What concentration of oxygen must be available?

A

21%

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9
Q

What may cause cellular hypoxia?

A

low amount of oxygen (need at least 21%)

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10
Q

FiO2

A

fraction of INSPIRED air -on own

.21

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11
Q

FDO2

A

fraction of DELIVERED air - with support or device - .95-.98 in non breather mask

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12
Q

What would happen if patient was breathing poisoned air?

A

may be breathing oxygen but the toxic gases would prevent it from being 21% and not being used effectively and would cause hypoxia

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13
Q

What would happen if a patient has a blocked airway?

A

lower amount of oxygen would cause hypoxia and eventually death.

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14
Q

Boyle’s Law

A

volume of gas is inversely proportionate to pressure - increasing size, decreases pressure
increase pressure will decrease volume of gas
decrease in pressure will increase volume of gas
(squeezing a container)

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15
Q

Which is active and passive process of breathing?

A

inhaling - active - pull out and down to allow in

exhaling - passive - relaxes and pushes air out

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16
Q

Compliance

A

measure of the ability of the chest wall and lungs to stretch, distend and expand, decrease in compliance makes it more difficult to breath in and out

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17
Q

Minute Ventilation

A

amount (volume) of air moved in and out of the lungs in one minute
Tidal volume x frequency

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18
Q

What is the average size adult tidal volume?

A

500 mL

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19
Q

What is the average adult size minute ventilation?

A

500 mL per breath x 12/min= 6,000mL

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20
Q

What would hyperventilating cause?

A

lower volume decreases minute ventilation, decreasing air to alveoli, decreasing gas exchange leading to hypoxia.

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21
Q

Alveolar Ventilation

A

amount of air moved in and out of Alveoli in one minute (dead air space) so (500-150) x 12/min

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22
Q

Dead air space

A

area of the respiratory tract where air is collected during inhalation however no gas exchange occurs…approx 150 mL

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23
Q

Chemoreceptors

A

monitor the pH, carbon dioxide and oxygen in arterial blood

24
Q

Where are chemoreceptors most sensitive to carbon dioxide and changes in pH?

A

Central chemoreceptors near respiratory center in medulla

25
Q

What is the relationship between Carbon dioxide and acid?

A

greater CO2 in the blood, the greater amount of acid

lesser CO2, the less amount of acid

26
Q

What is the response of ventilation to stimulation of chemoreceptors from changes in CO2?

A

increase in CO2 increases number of pH, increases in rate and depth of respiration to blow off more CO2
decrease in CO2 decreases pH, decrease in rate and depth to blow off less CO2

27
Q

Hypoxic Drive

A

decreased oxygen becomes the stimulate ventilation due to CO2 chronically being high and lessen sensitivity of chemoreceptors (COPD)

28
Q

Hypercapnic or Hypercarbic drive

A

amount of CO2 in blood affecting rate and depth of ventilation (chemoreceptors)

29
Q

Irritant receptors

A

irritating gasses , aerosols and particles stimulate a cough, bronchoconstriction and increase ventilation

30
Q

Stretch receptors

A

detect size and volume of the lungs and stimulate a decrease in rate and volume of ventilation when stretched by high tidal volumes to protect over inflating

31
Q

J Receptors

A

in alveoli sensitive to increase of pressure in capillary stimulate rapid shallow ventilation

32
Q

VRG

A

Ventral Respiratory Group - Stimulate the eternal intercostal muscles and diaphragm causing them to contract which results in inhalation (in brain stem), send nerve impulses to spinal cord to diaphragm

33
Q

DRG

A

Dorsal Respiratory Group - further input on depth and rate of respiration

34
Q

Pontine respirator center

A

pneumotaxic center, send impulses to turn off inhalation

35
Q

Ventilation/Perfusion Ratio

A

relationship between the amount of ventilation the alveoli receives and the amount of perfusion thru the capillaries, should be equal

36
Q

oxyhemoglobin

A

oxygen has attached to hemoglobin

37
Q

deoxyhemoglobin

A

a hemoglobin molecule that has no oxygen attached

38
Q

How is carbon dioxide transported in blood?

A

small amount dissolves in plasma, larger amount attaches to hemoglobin, the largest amount diffuses into red blood cells and combines with water to form carbonic acid (bicarbonate)

39
Q

Albumin

A

large molecule in blood that does not pass easily through a capillary, major role in maintaining the fluid balance in blood

40
Q

Where is the majority of blood housed?

A

within the venous system 64%

next is arteries 13%, pulmonary vessels 9%, capillaries 7% and heart 7%

41
Q

What is normal output for adult at rest?

A

5 liters/minute - ventricles pump entire bloo volume through the vascular system in 1 minute

42
Q

pulmonary edema

A

fluid in and around the alveoli in the lung

43
Q

pulmonary embolism

A

blockage in the pulmonary artery of the lung

44
Q

Plasma oncotic pressure

A

“pull” of fluid inside the vessels by large plasma proteins - not enough pull leads to edema

45
Q

Hydrostatic pressure

A

“push” of fluid outside the vessels, too much leads to edema

46
Q

Preload

A

pressure generated in the left ventricle at the end of diastole

47
Q

Frank-Starling law of the heart

A

the stretch of the muscle fiber at the end of diastole determines the force available to eject the blood from the ventricle (automatically generates a contraction forceful enough to eject it)

48
Q

Afterload

A

resistance in the aorta that must be overcome by contraction of the left ventricle to eject the blood (whats left)

49
Q

Systematic Vascular Resistance (SVR)

A

resistance that is offered to blood flow through a vessel
decreased vessel size increases SVR, increased vessel size decreases SVR
Basic measure is diastolic blood pressure

50
Q

pulse pressure

A

the difference between the systolic and diastolic blood pressures - narrow means systolic is decreasing and/or diastolic is increasing - normal is 25% of systolic blood pressure

51
Q

Microcirculation

A

movement of blood through the smallest blood vessels

52
Q

Systolic blood pressure

A

measure of cardiac output

53
Q

Diastolic blood pressure

A

measure of systemic vascular resistance

54
Q

Baroreceptors

A

stretch sensitive receptors in aortic arch and carotid sinuses, detect change in pressure

55
Q

Chemoreceptor in blood pressure

A

stimulation from chemoreceptors by monitoring oxygen, carbon dioxide or pH in arterial blood

EMT (7 decks)

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