Ch.1-6 Flashcards
(407 cards)
1
Q
What is the purpose of the patient history?
A
To gather pertinent historical subjective and objective data.
2
Q
The ___________ is a meeting between the respiratory care practitioner and the patient.
A
Interview
3
Q
What are the most important components of a successful interview?
A
Communication and understanding
4
Q
What is the art of viewing the world from the patient’s point of view while remaining separate from it?
A
Empathy
5
Q
___________ is defined as the patient’s capacity to obtain, process and understand basic health information and services and needed to make appropriate health decisions and follow instructions for treatment.
A
Health Literacy
6
Q
During the interview, what should the examiner observe?
A
- Patient’s body language
- Note patient’s facial expressions
- Eye movement
- Pain grimaces
- Restlessness and sighing
7
Q
Explain “white coat syndrome”
A
Anxiety patients get from simply being in the hospital and interacting with various professional staff members about health issues, test results and medical procedures. The patient can be intimidated to the point of shutting down and fail to ask questions or learn from the interview.
8
Q
What can be defined as the values, beliefs and practices shared by the majority in a group of people?
A
Culture
9
Q
What refers to a formalized system of belief and worship?
A
Religion
10
Q
_______ entails the spirit, or soul, and is an element of religion.
A
Spirituality
11
Q
__________ involves the knowledge of the patient’s history and ancestry and an understanding of the patient’s beliefs, artistic expressions, diets, celebrations and rituals.
A
Cultural awareness
12
Q
_______________ refers to refraining from using offensive language, respecting accepted and expected ways to communicate, and not speaking disrespectfully of a person’s cultural beliefs.
A
Cultural sensitivity
13
Q
_____________ refers to knowing the health care practitioner’s own values, attitudes, beliefs and prejudices, while at the same time, keeping an open mind and trying to view the world through the perspective of culturally diverse groups and people.
A
Cultural competence
14
Q
It is estimated that more than ___% of adults in the United States have basic or below acceptable basic health literacy. In other words, nearly 9 in 10 adults lack the skills needed to manage their health and prevent disease.
A
85
15
Q
What is used to echo the patient’s words?
A
Reflection
16
Q
The _____________ is the final overview of the examiner’s understanding of the patient’s statements.
A
Summary
17
Q
What is used when the patient’s choice of words is ambiguous or confusing?
A
Clarification
18
Q
To enhance the accuracy of written and oral information, what is the best strategy?
A
Plain language approach
19
Q
What type of question asks the patient to provide narrative information?
A
Open-ended questions
20
Q
_________ encourages patients to say more, to continue the story.
A
Facilitation
21
Q
____________ is affective after an open-ended question.
A
Silent attentiveness
22
Q
_______________ is the use of impersonal conversation that places space between a frightening topic and the speaker.
A
Distance
23
Q
When are open-ended questions commonly used?
A
- To begin interview
- Introduce a new section of questions
- To gather further information whenever the patient introduces a new topic
24
Q
What type of question is unbiased and allows the patient to answer in any way?
A
Open-ended questions
25
What type of question asks the patient for specific information?
Closed or direct questions
26
What type of questions speed up the interview process and are often useful in emergency situations when the patient is unable to speak in complete sentences?
Closed or direct questions
27
__________ is defined as the identification of oneself with another and the resulting capacity to feel or experience sensations, emotions or thoughts similar to those being experienced by another person.
Empathy
28
What are some examples of facilitating responses?
"Mm hmm", "Go on", "Continue", "Uh huh"
Nonverbal cues such as maintaining eye contact and shifting forward in the seat.
29
_________ communicates that the patient has time to think and organize what he or she wishes to say without interruption by the examiner.
Silence
30
In using ___________, the examiner notes a certain action, feeling, or statement made by the patient and focuses the patient's attention on it.
Confrontation
31
Nonverbal techniques include:
- Physical appearance
- Posture
- Gesture
- Facial expressions
- Eye contact
- Voice and touch
32
What type of position sends a defensive and anxious message?
Closed position, with arms and legs crossed
33
An open position shows ____________________.
relaxation, physical comfort and willingness to share information
34
Slow speech with long and frequent pauses, combined with a weak and monotonous tone voice suggests ___________.
Depression
35
What are the four major vital signs?
1. Body Temperature
2. Pulse
3. Respiratory Rate
4. Blood Pressure
36
In many patient care settings, what is considered to be the "fifth vital sign"?
Oxygen saturation as measured by pulse oximetry (SpO2)
37
Body temperature is routinely measured to assess for signs of what?
Inflammation or Infection
38
The temperature inside the body, the **core temperature** remains relatively constant - what is the temperature?
37°C (98.6°F)
39
What is the average cardiac output in the resting adult?
Approximately 5 L/min
40
Fast, deep respirations with (abrupt, irregular) pauses
Biot's respirations
41
When the chest is percussed over areas of trapped gas, what type of sound is heard?
Hyperresonant note
42
A decrease in body temperature causes ____________, which works to keep warmed blood closer to the center of the body, thus working to maintain the core temperature.
Vasoconstriction
43
According to estimates, for every 1°C increase in the body temperature, the patient's oxygen consumption increases about ______%
10
44
A patient who has a temperature within the normal range is said to be ______________.
Afebrile
45
A body temperature **above** normal range is called ______________.
Pyrexia or hyperthermia
46
When the body temperature rises above the normal range, the patient is said to have a ______________.
Fever, or they're febrile
47
An exceptionally high temperature, such as 41°C (105.8°F) is called what?
Hyperpyrexia
48
What are the four common types of fevers?
- Intermittent fever
- Remittent fever
- Relapsing fever
- Constant fever
49
When the patient's body temperature alternates at regular **intervals** between periods of fever or normal below-normal temperatures. What type of fever is this?
Intermittent fever
50
The patient has marked peaks and valleys (more than 2°C [3.6°F]) over a 24-hour period, all of which are above normal. What type of fever is this?
Remittent fever
51
This fever is present when the patient’s body temperature remains above normal with minimal or no fluctuation. What type of fever is this?
Constant fever.
52
When short febrile periods of a few days are interspersed with 1 or 2 days of normal temperature. What type of fever is this?
Relapsing fever
53
Hypothermia may occur as a result of what?
- Excessive heat loss
- Inadequate heat production to counteract heat loss
- Impaired hypothalamic thermoregulation
54
Describe the diaphragm when severe alveolar hyperinflation is present.
It is low and flat in position and has minimal excursion.
55
What are some clinical signs of _hypothermia?_
**(Up to 11 answers)**
- Below normal body temperature
- Decreased pulse and respiratory rate
- Severe shivering
- Patient indicating coldness and presence of chills
- Pale or bluish, cool waxy skin
- Hypotension
- Decreased urinary output
- Lack of muscle coordination
- Disorientation
- Coma
- Drowsiness or unresponsiveness
56
Accidental hypothermia is commonly seen in what type of patients?
- Those who have been immersed in a cold liquid environment for a prolonged time
- Those who have had an excessive exposure to a cold environment
- Has inadequate clothing, shelter or heat.
57
In clinical settings the pulse is usually assessed by what?
Palpatation
58
The characteristics of the pulse are described in terms of what?
Rate, rhythm and strength
59
What are the nine common pulse sites?
- Temporal
- Carotid
- Apical
- Brachial
- Radial
- Femoral
- Popliteal
- Pedal (Dorsalis pedis)
- Posterior tibial area
60
What is the normal pulse rate for an adult?
60-100 BPM
61
What is the primary muscle of respiration?
Diaphragm
62
What is defined as a systolic blood pressure that is more than 10 mmHg lower on inspiration than on expiration?
Pulsus paradoxus
63
What is used to establish an immediate baseline SpO2 value?
Oxygen saturation
64
**Tachycardia** may occur as a result of what?
- Hypoxemia
- Anemia
- Fever
- Anxiety
- Emotional stress
- Fear
- Hemorrhage
- Hypotension
- Dehydration
- Shock
**- Also a common side effect in patient receiving certain medications such as sympathomimetic agents**
65
Normally, the ventricular contraction is under the control of the ___________, which generates a normal rate and regular rhythm.
Sinus node in the atrium
66
In child and young adults, it is not uncommon for the heart rate to increase during inspiration and decrease during exhalation. What is this called?
Sinus arrhythmia
67
The quality of the pulse reflects the strength of what?
The left ventricular contraction and volume of blood flowing to the peripheral tissues
68
Pulsus paradoxus is common among patients experiencing what?
Severe asthmatic episodes
69
Where can bradycardia be seen?
- Patients with hypothermia
- In physically fit athletes
- It also may be lower than expected when the patient is at rest or asleep as a result of head injury, drugs such as beta- blockers, vomiting or advanced age.
70
What are some things that can cause the heart to beat irregularly?
Inadequate blood flow and oxygen supply to the heart or an electrolyte imbalance can cause heart to beat irregularly
71
Clinically, the strength of the pulse may be recorded on a scale of ________.
0 to 4+
72
What may be used for peripheral pulses that are difficult to detect by palpation?
ultrasonic Doppler device
73
Under normal conditions, ___________ is a passive process.
**Answer choices:**
1. Inspiration
2. Expiration
Expiration
74
Inspiration is an **active** process whereby the diaphragm contracts and causes ____________ to decrease.
Intrathoracic pressure
75
What happens at the end of inspiration?
Diaphragm relaxes and the natural lung elasticity causes the pressure in the lung to increase. This action causes air to flow out of the lung.
76
What is the normal RR for an adult?
12-20 breaths per min
77
Where is tachypnea commonly seen?
- Fever
- Metabolic acidosis
- Hypoxemia
- Pain
- Anxiety
78
Bradypnea may occur with what?
- Hypothermia
- Head injuries
- Drug overdose
79
What is the force exerted by the circulating volume of blood on the walls of the arteries?
Arterial blood pressure
80
The blood pressure measured during ventricular contraction (cardiac systole) is the ________________.
Systolic blood pressure
81
Blood flow is equal to _______________.
Cardiac output
82
During ventricular relaxation, blood pressure is generated by the elastic recoil of the arteries and arterioles. What is this called?
Diastolic blood pressure
83
Label the scale to rate pulse quality
0: Absent or no pulse detected
1+: Weak, thready, difficult to feel
2+: Pulse difficult to palpate
3+: Normal pulse
4+ Bounding, easily palpated and difficult to obliterate
84
Respirations that progressively become faster and deeper, followed by respirations that progressively become slower and shallower and ending with a period of apnea.
Cheyne-Stokes respiration
85
What is the normal _systolic_ blood pressure range for an adult?
110-140 mmHg
86
The numeric difference between the systolic and diastolic pressure is called the ________________________.
Pulse pressure
87
Blood pressure is the function of:
1. _________________________
2. _________________________
1. The blood flow generated by ventricular contraction
2. The resistance to blood flow caused by the vascular system
88
Cardiac output is equal to the product of what?
The volume of blood ejected from the ventricles during each heartbeat (stroke volume) multiplied by the heart rate.
**CO=SV x HR)**
89
**Decreased** rate and depth, which decreases alveolar ventilation and leads to an increased PaCO2
Hypoventilation
90
**Increased** rate and depth, which increases alveolar ventilation and leads to an decreased PaCO2
Hyperventilation
91
Increased depth and rate of breathing. Commonly considered normal during periods of exercise to meet metabolic needs.
Hyperpnea
92
Friction between the blood components and the vessel walls is inversely related to ____________________.
The dimensions of the vessel lumen (size).
93
What happens when the vessel lumen narrows or constricts?
Vascular resistance increases
94
An elevated blood pressure of an unknown cause is called ___________.
Primary hypertension
95
What are some factors associated with hypertension?
- Arterial disease
- Obesity
- High serum sodium level
- Pregnancy
- Obstructive sleep apnea
- Family history of high blood pressure
96
An elevated blood pressure **with a known cause** is called ___________.
Secondary hypertension
97
Hypertension may lead to what?
Congestive Heart Failure
98
Hypotension is said to be present when the patient's blood pressure falls below _________.
90/60 mmHg
99
What is hypotension associated with?
- Peripheral vasodilation
- Decreased vascular resistance
- Hypovalemia
- Left ventricular failure
100
_____________ occurs when blood pressure quickly drops as the individual rises to an upright position or stands.
Orthostatic hypotension or postural hypotension
101
What are some signs and symptoms of hypotension?
- Pallor
-Skin mottling
- Clamminess
- Blurred vision
- Confusion
- Dizziness
- Syncope
- Chest pain
- Increased heart rate
- Decreased urine output
102
What is orthostatic hypotension associated with?
- Decreased blood volume
- Anemia
- Dehydration
- Prolonged bed rest
- Antihypertensive medications
103
What is _normal_ SpO2 range values?
95-99%
104
What is _mild hypoxemia_ SpO2 range values?
91-94%
105
What is _moderate hypoxemia_ SpO2 range values?
86-90%
106
What is _severe hypoxemia_ SpO2 range values?
85% or LOWER!
107
Anteriorly, the first rib attached to the manubrium just beneath the ______________.
Clavicle
108
The __________ and its cartilage are attached to the sternum just above the xiphoid process.
sixth rib
109
What equally divides the anterior chest into the left and right hemithoraces?
The vertical midsternal line
110
________ runs parallel to the sternum, traditionally down through the male nipple.
Midclavicular lines
111
Posteriorly, the ___________ runs along the spinous processes of the vertebrae.
Vertebral line, also called the midspinal line
112
Anteriorly, the apex of the lung extends approximately _______ above the medial third of the clavicle.
2-4 cm
113
Under normal conditions the lungs extend down to about the level of the __________.
sixth rib
114
The right lung is separated into the upper, middle, and lower lobes by what?
- Horizontal fissure
- Oblique fissure
115
The left lung is separated into the upper and lower lobes by the _________.
Oblique fissure
116
The ______________ of the patient is an ongoing observational process that beings with the history and continues throughout the patient interview, taking vital signs and physical examination.
Inspection
117
_____________ is the process of touching the patient's chest to evaluate the symmetry of chest expansion, the position of the trachea, skin temperature, muscle tone, areas of tenderness, lumps, depressions and tactile fremitus and vocal fremitus.
Palpation
118
What are some abnormal pulmonary conditions that may cause the trachea to deviate from its normal position?
May push trachea to unaffected side:
- Tension pneumothorax
- Pleaural effusion
- Tumor mass
May push trachea towards affected side:
- Atelectasis
- Pulmonary fibrosis
119
The symmetry of chest expansion is evaluated by lightly placing each hand over the patient's posterolateral chest so that the thumbs meet at the midline at about __________________.
the T-8 to T-10 level.
120
With chest excursion, each thumb tip normally moves equally about _________ from the midline.
3-5 cm
121
Vibration that can be perceived by palpation over the chest is called _________.
Tactile fremitus, also known as rhonchial fremitus
122
Bilaterally decreased chest expansion may be caused by what?
Both an obstruction and restrictive lung disorder
123
An unequal chest expansion may occur when one or more of the following develop in or around one lung only:
- Alveolar consolidation
- Lobar atelectasis
- Pneumothorax
- Large pleural effusions
- Chest trauma
124
___________ over the chest wall is performed to determine the size, borders and consistency of air, liquid or solid material in the underlying lung.
Percussion
125
What is generated through the vascular system with each ventricular contraction of the heart (systole)?
A pulse
126
What are some factors that affect body temperature?
- Age
- Environment
- Time of day
- Exercise
- Stress
- Hormones
127
What are some common therapeutic interventions for hypothermia?
- Remove wet clothing
- Provide dry clothing
- Place patient in warm environment (slowly increase room temperature)
- Cover patient with warm blankets or electric heating blanket
- Apply warming pads
- Keep patient's limbs close to body
- Cover patient's head with cap or towel
- Supply warm oral or IV fluids
128
What is the term used to describe a core temperature below the normal range?
Hypothermia
128
_________________ refers to the _intentional_ lowering of a patient's body temperature to reduce the oxygen demand of the tissue cells.
Induced hypothermia
129
What is heard when the chest is percussed over areas of pleural thickening, pleural effusion, atelectasis and consolidation?
Dull percussion note
130
What is the other name for subcutaneous emphysema?
Crepitus
131
What are the three **normal** breath sounds called?
- Bronchial breath sounds
- Bronchovesicular breath sounds
- Vesicular breath sounds
132
What are some factors that affect blood pressure?
- Age
- Exercise
- Autonomic nervous system
- Stress
- Circulating blood volume
- Medications
- Normal fluctuations
- Race
- Obesity
- Diurnal - BP is usually lowest in the morning, when the metabolic rate is lowest.
133
____________ of the chest provides information about the heart, blood vessels, and air flowing in and out of the tracheobronchial tree and alveoli.
Auscultation
134
Abnormal lung sounds are also called ____________________.
Adventitious lung sounds
135
What type of breath sounds are auscultated directly over the trachea and are caused by the turbulent flow of gas through the upper airway?
Bronchial breath sounds
136
What type of breath sound are normal sounds of gas rustling or swishing through the small bronchioles and the alveoli?
Vesicular breath sounds
137
An **increase** in body temperature causes the blood vessels near the skin surface to dilate. What is this process called?
Vasodilation
138
When is induced hypothermia usually indicated?
- Before certain surgeries, such as heart or brain surgery or after ROSC after a cardiac arrest
139
Body temperature normally varies throughout the day, this phenomenon is called ___________.
Diurnal variation
140
What are the 4 commonly used sites for BP?
- Oral (Mouth)
- Rectum
- Axillary
- Tympanic (Ear)
141
Before taking an oral temperature, how long should the practitioner wait after a patient has ingested ice water?
15 minutes
142
Drinking ice water may lower a patient's oral temperature by how much?
0.2 to 1.6°F
143
In patients with irregular, abnormally slow, or fast cardiac rhythms, the pulse rates should be counted for how long?
1 minute
144
A increased heart rate combined with a large blood volume will generate what type of pulse?
Full, bounding pulse
145
A weak ventricular contraction combined with an inadequate blood volume will result in what type of pulse?
Weak, thready pulse
146
A normal left ventricular contraction with an inadequate blood volume will generate what type of pulse?
Strong, throbbing pulse
147
When the strength of a pulse varies every other beat while the rhythm remains regular. What is this called?
Pulsus alternans
148
During normal sinus rhythm, the heart rate can be obtained through auscultation by placing the stethoscope over ________________.
The apex of the heart
149
What monitors and regulates vascular tone?
Autonomic nervous system
150
The physical examination of the chest and lungs should be performed in a systemic and orderly fashion. What's the common sequence?
- Inspection
- Palpation
- Percussion
- Auscultation
151
To evaluate the position of the trachea, the examiner places an index finger over the ___________ and gently moves it from side to side.
Sternal notch
152
What condition is commonly caused by gas flowing through thick secretions that are partially obstructing the large airways?
Tactile fremitus
153
Where is fremitus sounds most promininent?
Between the scapulae and around the sternum, sites where the bronchi are closest to the chest wall
154
Which abnormal percussion note is similar to the sound produced by knocking on a full barrel?
A dull percussion note
155
Which type of note is elicited from air trapping in the patient with chronic obstructive pulmonary disease or pneumothorax?
**Remember air trapping!!**
- Lung hyperinflation (COPD)
- Lung collapse (pneumothorax)
- Air trapping (asthma)
Hyperresonant note
156
What would happen to the diaphragm in a patient with lobar collapse of one lung?
Diaphragm would be pull up affected side and reduce excursion.
157
What would happen to the diaphragm in a patient with a neuromuscular disease?
Diaphragm would be elevated and immobile
158
Where is the location of bronchial breath sounds?
Over the trachea
**Pitch:** High
**Intenstity:** Loud
159
Where is the location of bronchovesicular breath sounds?
Upper portion of anterior sternum, between scapulae
**Pitch:** Moderate
**Intenstity:** Moderate
160
Where is the location of vesicular breath sounds?
Peripheral lung regions
**Pitch:** High
**Intenstity:** Low
161
What type of breath sounds are auscultated directly over the mainstem bronchi and do **not** have a pause between the inspiratory and expiratory phase?
Bronchovesicular
162
Are vesicular breaths sounds heard primarily during inspiration or expiration?
Inspiration
163
What should be included when documenting ALS (abnormal lung sounds)?
- For intensity or loudness, use words like *faint, soft, moderate or loud*
- The part of the respiratory cycle
- Document the magnitude (small, scant or profuse crackles)
- **Always** include the precise location over the chest
164
What does stridor indicate?
Swollen larynx or airway
165
What does pleural friction rub indicate?
Inflammation of pleural membranes (pleurisy)
166
What does coarse crackles indicate?
Airway secretions
**Associated with the following pathologic conditions:**
- Severe COPD
- CF
- Bronchiectasis
- CHF (Pulmonary edema)
167
What does fine crackles indicate?
**- Atelectasis** (Loss of lung volume)
**- Alveolar fluid**
**- Interstitial fibrosis** (asbestosis)
- Early stage of CHF
- Interstitial edema (early pulmonary edema)
168
What does diminished breath sounds indicate?
Alveolar hyperinflation
169
What does wheezes indicate?
Smooth muscle constriction
170
What does bronchial breath sounds indicate?
Alveolar consolidation and/or collapse (atelectasis)
171
Voluntary decrease in tidal volume to decrease pain on chest expansion. What is this called?
Splinting
172
Leaning forward with arms and elbows supported on overbed table. What is this called?
Tripod position; inability to lie flat
173
An individual's normal breathing pattern is composed of:
(3 things)
- Tidal Volume (VT)
- Ventilatory rate
- I:E ratio
174
In normal adults, tidal volume is about _____________.
500 mL (7 to 9 mL/kg)
175
In normal adults, the ventilatory rate is about ____.
15 breaths per minute. (with a range of 12-18)
176
In normal adults, the I:E ratio is ______.
1:2
177
________ is defined as the "breathlessness" or "shortness of breath" or the "labored or difficult breathing" felt and described only by the patient.
Dyspnea
178
What are some signs of dyspnea?
- Audibly labored breathing
- Hyperventilation
- Tachypnea
- Retractions of intercostal spaces
- Use of accessory muscles
- Distressed facial expression
- Flaring of nostrils
- Paradoxical movements of the chest and abdomen
- Gasping
179
Dyspnea that occurs only when the patient is in the reclining position.
Positional dyspnea, also called orthopnea
180
Labored breathing caused by heart disease. What type of dyspnea is this?
Cardiac dyspnea
181
Dyspnea that is provoked by physical exercise or exertion
Exertional dyspnea
181
Difficulty breathing as a result of kidney disease
Renal dyspnea
182
A form of respiratory distress related to posture **(especially reclining while sleeping)** and is usually associated with CHF with pulmonary edema
Paroxysmal nocturnal dyspnea
183
What is the Modified (British) Medical Research Council Questionnaire used for?
Assessing the severity of breathlessness in those who can speak
184
What is the Borg Dyspnea scale used for?
Assessing the severity of breathlessness in those who cannot speak because of mouthpieces, endotracheal tubes, tracheostomies, etc
185
The ease with which the elastic forces of the lungs accepts a volume of inspired air is known as ________________.
Lung compliance
186
____________________ is defined as the pressure difference between the mouth and the alveoli divided by the flow rate.
Airway resistance
187
What determines how much air in liters the lungs will accommodate for each centimeter or water pressure change in distending pressure?
Compliance
188
A rapid rate of breathing and reduced tidal volume is commonly seen during ________ when the alveoli are overinflated.
Early stages of an acute asthmatic attack
189
Under normal conditions, what is the airway resistance (Raw) in the tracheobronchial tree?
About 1.0 to 2.0 cmH2O/L/s
190
In large airway obstructive diseases (e.g., bronchitis, asthma), is airway resistance high or low?
Extremely high
191
Even the slightest reduction in airway diameter can have a remarkable effect on the patient's ability to move in and out of the lungs. According to whose law?
Poisueille
192
In physics, work is defined as the force multiplied by _________.
The distanced moved. (work= force x distance)
193
In respiratory physiology, what may be used to quantify the work of breathing?
The change in pulmonary pressure (force) multiplied by the change in lung volume (distance)
**work= pressure x volume**
194
What is a major cause of dyspnea?
Hypoxemia and the stimulation of the peripheral chemoreceptors (also called carotid or aortic bodies)
195
In respiratory disease, a decrease arterial oxygen level is the result of what?
- Ventilation-perfusion ratio
- Pulmonary shunting
- Venous admixutre
196
Although the peripheral chemoreceptors are stimulated whenever the PaO2 is less than normal, they are generally most active when the PaO2 falls below _____.
60 mmHg (SaO2 <88%)
197
Suppression of peripheral chemoreceptors are seen when PaO2 falls below ____.
30 mmHg
198
Which two groups are responsible for coordinating respiration?
- Dorsal respiratory group (DRG)
- Ventral respiratory group (VRG)
199
It should be noted that in patients who have a ____________, the peripheral chemoreceptors are the primary receptor sites for the control of ventilation.
- Chronically high PaCO2
- Low PaO2
200
Both DRG and VRG are stimulated by an increase of ________________.
H+ concentration in the cerebrospinal fluid.
201
What is the H+ concentration monitored by?
Central chemoreceptors
202
When the lungs are compressed or deflated (atelectasis), what type of breathing is seen?
increased rate of breathing
203
When the lungs are compressed, deflated or exposed to noxious gases, which receptor is stimulated?
Irritant receptors
204
Fever is commonly associated with infectious diseases such as:
- Pneumonia
- Lung abscess
- TB
- Fungal disease
205
When the irritant receptors are activated, a reflex causes the ventilatory to increase or decrease?
Increase
May also cause a cough and bronchoconstriction
206
Stimulation of which receptors triggers raid, shallow breathing?
Juxtapulmonary-Capillary Receptors - J receptors
207
Abnormal ventilatory patterns that occur suddenly (minutes to hours maximum) are classified as ____________.
Acute onset conditions
208
Abnormal ventilatory conditions that develop slowly (days to months) are classified as _________.
Chronic conditions
209
What is the function of aortic and carotid sinus baroreceptors?
1. Decrease heart rate and ventilatory rate in response to increased systemic BP
2. Increase heart rate and ventilatory rate in response to decreased systemic BP
210
An increased RR may result from chest pain or fear and anxiety associated with _________________.
Inability to breathe
211
The Hering-Breur reflex does NOT occur when the bronchi and bronchioles are below what temperature?
8°C (46.4°F)
212
What are the major muscles of inspiration?
- Scalenes
- Sternocleiodomastoid
- Pectoralis major muscle groups
- Trapezius muscle groups
213
During the advanced stages of chronic obstructive pulmonary disease, the diaphragm ____________________.
*Explain what happens to the diaphragm*
The diaphragm becomes significantly depressed by the increased lung volumes. (RV, TLC and FRC)
214
_________ assist or largely replace the diaphragm in creating subatmospheric pressure in the pleural space during inspiration.
The accessory muscles of inspiration
215
When they are used as accessory muscles, their primary role is to elevate the first and second ribs and flex the neck.
Scalene muscles
216
What are the major accessory muscles of expiration?
- Rectus abdominis
- External oblique
- Internal oblique
- Tranversus abdominis
217
The ______________ are located on each side of the neck, where they rotate and support the head.
Sternocleidomastoids
218
Which muscle rotates the scapula, raises the shoulders and abducts and flexes the arm?
Trapezius
219
Pulling the upper part of the arm to the body in a hugging position is a function of the ________________.
Pectoralis major muscles
220
When used as an accessory muscle of inspiration, the _________ helps elevate the thoracic cage.
Trapezius
221
What are often recruited when airway resistance become significantly elevated?
Accessory muscles of expiration
222
When __________ is activated, the muscles assist in compressing the abdominal contents, which in turn push the diaphragm into the thoracic cage.
- Rectus abdominis
- Internal oblique
- External oblique (during exhalation)
223
Which muscle is the longest and most superficial of all the anterolateral muscles of the abdomen?
External Obliques
224
What happens when all four accessory muscles of expiration contract?
The abdominal pressure increases and drives the diaphragm into the thoracic cage. As the diaphragms moves during inhalation, the intrapleural pressure increases and enhances expiratory gas flow.
225
Pursed-lip breathing occurs in patients during _____________.
The advances stages of obstructive pulmonary disease
226
Where is nasal flaring commonly seen?
In infants experiencing respiratory distress
227
_______ is usually described as a sudden, sharp or stabbing pain.
Pleuritic chest pain
228
In an effort to overcome the low lung compliance, the patient must generate a greater-than-normal negative intrapleural pressure during inspiration.
Substernal and Intercostal retractions
228
Where is substernal and Intercostal retractions commonly seen?
Newborns with respiratory disorder like:
- RDS
- Meconium aspiration syndrome
- Transient tachypnea of newborn
- Bronchopulmonary dysplasia
- Congenital diaphragmatic hernia
229
When activated, the _______ pulls the alae laterally and widens the nasal aperture, providing a larger orifice for gas to enter the lungs during inspiration.
dilator naris
230
What is one of the most common complaints among patients with cardiopulmonary issues?
Chest pain
231
Severe resistance to taking a deep breath is called _____________.
Splinting
232
________________ is described as a constant pain that is usually located centrally.
Nonpleuritic chest pain
233
Nonpleuritic chest pain is associated with the following disorders:
- Myocardial ischemia
- Pericardial inflammation
- Pulmonary hypertension
- Esophagitis
- Local trauma or inflammation of the chest cage, muscles, bones or cartilage
234
When the normal 14-15 g/dL of hemoglobin is fully saturated, the PaO2 is about _________.
97-100 mmHg and about 20 mL/dL of O2 in the blood
235
In a typical cyanotic patient with one-third (5g/dL) of the hemoglobin reduced, the PaO2 is about _______.
30 mmHg and there is about 13 mL/dL of O2 in the blood
236
The recognition of cyanosis depends on:
- The acuity of the observer
- Light conditions in the examining room
- Pigmentation of the patient
237
Pleuritic chest pain is a characteristic feature of which respiratory diseases?
- Pneumonia
- Pleural effusion
- Pneumothorax
- Pulmonary infarction
- Lung cancer
- Pnuemoconiosis
- Fungal diseases
- TB
238
In a patient with polycythemia, cyanosis may be present at a PaO2 well above 30 mmHg because _________________________.
The amount of reduced hemoglobin is often greater than 5 g/dL in these pts, even when their oxygen content is within normal limits.
239
In respiratory diseases, cyanosis is the result of what?
- A decreased V/Q
- Pulmonary shunting
- Venous admixture
- Hypoxemia
240
What are some things associated with digital clubbing?
- Circulating vasodilators
- Chronic infection
- Unspecified toxins
- Arterial hypoxemia
- Local hypoxia
- Capillary stasis
241
Where is bilateral, dependent pitting edema commonly seen?
Patients with CHF, cor pulmonale and hepatic cirrhosis
242
The wall of the tracheobronchial tree is composed of what three layers?
- An epithelial lining
- Lamina propria
- Cartilaginous layer
243
What covers the epithelial lining of the tracheobronchial tree?
A mucous layer, commonly referred as the **mucous blanket**
244
How would a health care practitioner assess the presence and severity of pitting peripheral edema?
By placing a finger or fingers over the tibia or medial malleolus (2 to 4 inches above the foot), firmly depress the skin for seconds and then release. Normally there should be no indentation, but a pit may be seen if the person has been standing all day or is pregnant.
245
What scale is peripheral pitting edema measured on?
1+ (mild, slight depression) to 4+ (severe, deep depression)
246
The epithelial lining is separated from the lamina propria by a ____________________.
Basement membrane
247
What is the epithelial lining predominantly composed of?
Psuedostratified, ciliated columnar epithelium
248
The mucous blanket is ____% water.
95
249
The mucous blanket is produced by what?
Goblet cells and the submucosal, or bronchial glands
250
_________ is the coughing up of blood or blood-tinged sputum from the tracheobronchial tree.
Hemoptysis
251
A sudden, audible expulsion of air from the lungs
Cough
252
The ________ is an important cleansing mechanism of the tracheobroncial tree.
Mucous blanket
253
The submucosal glands are particularly numerous in the medium-sized bronchi and disappear in the _____________.
Bronchioles
254
The submucosal glands are innervated by parasympathetic nerve fibers and normally produced how much of clear, thin bronchial secretions per day?
100 mL
255
Sputum analysis: Brown/Dark
Old blood
256
Sputum analysis: Bright red (hemoptysis)
Fresh blood (bleeding tumor, tuberculosis)
257
Sputum analysis: Clear and translucent
Normal
258
Sputum analysis: Frank hemoptysis
Massive amount of blood
259
Sputum analysis: Green
Stagnant sputum or gram-negative bacteria
260
Sputum analysis: Pink and frothy
Pulmonary edema
260
Sputum analysis: Yellow or opaque
Presence of WBCs, bacterial infection
261
Sputum analysis: Viscous
Thick, sticky or glutinous
262
Sputum analysis: Mucoid (white/gray)
Asthma, chronic bronchitis
263
Sputum analysis: Green and foul smelling
Pseudomonas or anaerobic infection
264
Sputum analysis: Tenacious
Secretions that are sticky or otherwise tend to hold together.
264
The submucosal layer of the tracheobronchial tree is the ______________.
Lamina propria
265
Where is repeated expectoration of blood-streaked sputum seen?
- Chronic bronchitis
- Bronchiectasis
- CF
- PE
- Lung cancer
- Necrotizing infections
- TB
- Fungal diseases
266
A cough is preceded by:
1. Deep inspiration
2. Partial closure of glottis
3. Forceful contraction of accessory muscles of expiration to expel air from lungs.
267
What is defined as coughing up to **400 to 600 mL** of blood within a 24-hour period?
*Massive* hemoptysis
268
Blood that originates from the upper gastrointestinal tract, usually dark coffee-ground appearance
Hematemesis
268
A brassy cough may indicate what?
Tumor
269
A hoarse cough indicates what?
Croup
270
What are some common causes of NPC?
- Irritation of airway
- Inflammation of airway
- Mucous accumulation
- Tumors
- Irritation of pleura
271
What is the protective mechanism that clears the lungs, bronchi, or trachea of irritants and also prevents aspiration of foreign materials into the lungs?
Cough!
272
Cough is commonly seen in respiratory disease, especially in disorders that cause ______________.
Inflammation of the tracheobronchial tree
273
What should be apart of the objective finding in a good SOAP note?
Sputum volume, appearance, viscosity and odor
274
Where are irritant receptors located?
In the pharynx, larynx, trachea and large bronchi
275
Gas in the lungs is divided into how many volumes and capacities?
- 4 volumes
- 4 capacities
276
When the alveoli become overdistended with gas, what is this condition called?
Air trapping
277
Which lung volume cannot be exhaled?
RV - Residual volume.
278
The volume of gas that normally moves into and out of the lungs in one quiet breath.
Tidal Volume (500 mL)
279
The volume of air that can be _exhaled_ after a maximal inspiration
Vital Capacity (4800 mL)
280
The maximal amount of air that the lungs can accommodate.
Total Lung Capacity (6000 mL)
281
The amount of air remaining in the lungs after a forced exhalation
Residual Volume (1200 mL)
282
The volume of air that can be **forcefully** exhaled after a normal tidal volume exhalation
Expiratory Reserve Volume (1200 mL)
283
The volume of air that can be forcefully inspired after a normal tidal volume
Inspiratory Reserve Volume (3100 mL)
284
The lung volume at rest after a normal tidal volume exhalation
Functional Residual Capacity (2400 mL)
285
The volume of air that can be inhaled after a normal exhalation
Inspiratory Capacity (3600 mL)
286
______________________ are associated with pathologic conditions that alter the anatomic structures of the lungs distal to the terminal bronchioles.
Restrictive lung volumes and capacities
286
How can residual volume and the lung capacities that contain RV be obtained?
Measured indirectly by:
- Open circuit nitrogen washout
- Closed circuit helium dilution
- Body plethysmography
287
The total volume of gas that can be exhaled as forcefully and rapidly as possible after a maximal inspiration.
Forced Vital Capacity - FVC
288
The maximum volume of gas that can be exhaled over a specific period of time
Forced Expiratory Volume Timed (FEVT)
289
What is the total expiratory time necessary to perform an FVC in a healthy individual?
4-6 seconds
290
The maximum flow rate generated during an FVC maneuver
Peak Expiratory Flow Rate - PEFR
**10 L/s (600 L/min)**
291
The largest volume of gas that can be breathe voluntarily in and out of the lungs in 1 minute.
Maximum Voluntary Ventilation - MVV
**170 L/min**
292
In the normal individual the FVC equals the _____________.
Vital capacity
293
Clinically, the lungs are considered normal if the FVC and VC are within _______ of each other.
200 mL
294
What test is most commonly used to evaluate the patient’s respiratory muscle strength at the bedside?
MIP, MEP, FVC and MVV
295
The maximum inspiratory pressure the patient is able to generate against a closed airway
Maximum inspiratory pressure
296
What is the MIP in a normal healthy adult?
-80 to -100 cmH2O
297
Ideally, the MIP should be measured at the patient’s ______.
Residual volume - RV
298
The percentage of TLC occupied by the RV.
RV/TLC ratio
**1200/6000 = 20% (approx)**
299
Pathological conditions that alter the tracheobronchial tree
Obstructive lung disorders
300
Gas that enters the alveoli during inspiration is prevented from leaving the alveoli during expiration.
Obstructive lung disorders
301
What is the most precise method for measuring FRC and RV?
Body box
302
What can the body box measure?
- RV
- FRC
- Airway resistance
- Airway conductance
303
In a patient with an obstructive lung disorder, the FVC is lower than VC because of what?
Increased airway resistance and air trapping associated with maximal effort
304
**Question from the back of the book:**
What is the normal average compliance of the lungs and chest wall _combined_?
0.1 L/cmH2O
305
Series of discontinuous, short crackling and popping sounds, high-pitched sounds heard just before the end of inspiration.
Fine crackles
306
Continuous high-pitched whistling sound caused by rapid vibration of bronchial walls. First evident on expiration but also possibly evident on inspiration as obstruction of airway increases.
Wheezes
307
Series of discontinuous short, low-pitched bubbling or gurgling sounds caused by air passing through intermittently occluded by mucus, unstable bronchial wall, or fold of mucosa.
**Similar to blowing through a straw under water**
Coarse crackles
308
Medium-pitched sounds over areas that usually produce a resonant sound on chest percussion.
Dullness/flatness
309
What are some possible causes of digital clubbing?
- Chronic hypoxemia
- CF
- Lung cancer
- Bronchiectasis
310
What are possible causes of dull/flat percussion note?
**Increased density:** Pneumonia, large atelectasis
**Increased pleural space fluid:** pleural effusion
311
What are some causes of increased and decreased tactile fremitus?
**Increased**
- Pneumonia
- Atelectasis
- Pulmonary edema
**Decreased**
- Pleural effusion
- Lung hyperinflation
- Absent in pneumothorax
312
In which of the following pathological conditions is transmission of the whispered voice of a patient through a stethoscope usually unclear?
- Alveolar consolidation
- Atelectasis
313
In what pathologic conditions would you hear diminished breath sounds?
- COPD
- Drug overdose
- Major sedation
- Neuromuscular disease
- Flail chest
- Pleural effusion
- PTX
314
What are some possible causes of pleural friction rub?
- Pleurisy
- Pneumonia
**- Pulmonary fibrosis**
- PE
- Thoracic surgery
315
What is hypoxemia?
PaO2 ≤ 60 mmHg or SaO2 ≤88%
316
The inspection of a patient’s extremities should include the following:
- Altered skin color
- Presence or absence of digital clubbing
- Presence or absence of peripheral edema
- Presence or absence of distended neck veins
317
Wheezing is the characteristic sound produced by _________________.
Airway obstruction
318
What abnormal breath sound is a cardinal finding of bronchial asthma?
Wheezing
319
A harsh, hollow or tubular breath sound. They are loud, high in pitch and about equal duration during inspiration and expiration.
Bronchial breath sounds
320
Under normal conditions, what is the average DLCO value for a resting man?
25 mL/min/mmHg
321
A simple, noninvasive, effort independent test that applies oscillating pressure impulses to the lungs during normal passive breathing.
Impulse oscillosmetry (IOS)
322
The highest pressure that can be generated during a forceful expiratory effort against an occluded airway and is recorded as a **POSITIVE** number in either centimeters of water or millimeters of mercury.
Maximum expiratory pressure (MEP)
323
An MIP of ______ or greater (less negative) is a strong indicator of ventilatory support.
-20 cmH2O
324
Where are reduced MIP values commonly seen?
- Patients with neuromuscular disease
- Chest wall deformities
- Chronic Obstructive Pulmonary Disease (COPD)
325
Ideally, the MEP is measured at _____________.
Maximal inspiration (near total lung capacity)
326
It should be noted that a low MEP is associated with ________________.
Poor or inadequate cough effort
327
What measures the amount of carbon monoxide that moves across the alveolar capillary membrane?
Pulmonary Diffusion Capacity of Carbon Monoxide - DLCO
328
______________ result in a increased lung rigidity, which in turn decreases lung compliance.
Restrictive lung disorders
329
What are the most common measurements obtained from an FVC manuever?
- FEVT
- FEV1/FVC ratio
- FEF 200-1200
- FEF 25-75%
- PEFR
330
What are the most common measurements obtained from an FVC manuever?
- FEVT
- FEV1/FVC ratio
- FEF 200-1200
- FEF 25-75%
- PEFR
331
In obstructive lung disorders, why is the FEVT decrease?
The time necessary to exhale a certain volume forcefully is increased
332
What compares the amount of air exhaled in 1 second with the total amount exhaled during an FVC maneuver?
FEVT/FVC ratio
333
Because the FEV1/FVC ratio is expressed as a percentage, it is commonly referred as ________________.
Forced expiratory flow in 1 second percentage (FEV1%)
334
Airway obstruction is said to be present when the FEV1/FVC ratio is less than ______.
70%
335
What are commonly used to assess the severity of a patient’s pulmonary disorder and determine whether has an obstructive or restrictive lung disorder?
- FVC
- FEV1
- FEV 1%
336
When the patient has a normal hemoglobin concentration, pulmonary capillary blood volume, and ventilatory status, the only limiting factor to the diffusion of carbon monoxide is the _____________.
Alveolar-capillary membrane
337
Graphic representation of both a forced vital capacity maneuver and a forced inspiratory volume (FIV) maneuver.
Flow-volume loop
338
What measurements are _increased_ in a restrictive lung disorder?
- FEV1/FVC (Normal or increased)
- FEV 1% (Normal or increased)
339
What measurements are _decreased_ in a restrictive lung disorder?
And what’s normal?
**Volumes**
- VT (Normal or decreased)
- IRV
- ERV
- RV
- MVV (Normal or decreased)
- FEF 25%-75% (Normal or decreased)
- FEF 50% (Normal or decreased)
- FEV1/FVC
- PEFR (Normal or decreased)
- FEF 200-1200 (Normal or decreased)
- FEVT (Normal or decreased)
**Capacities**
- VC
- IC
- TLC
- FRC
- FVC
**NORMAL: RV/TLC**
340
What measurements are _decreased_ in a obstructive lung disorder?
**Volumes**
- IRV (Normal or decreased)
- ERV (Normal or decreased)
- MVV
**Capacities**
- IC (Normal or decreased)
- VC
- FVC
- FEF 50%
- FEVT
- FEF 200-1200
- PEFR
- FEV/FVC
- FEF 25-75%
341
What measurements are _increased_ in a obstructive lung disorder?
**Volumes**
- VT (Normal or increased)
- RV/TLC ratio (Normal or increased)
- RV
**Capacities**
- FRC
- TLC (Normal or increased)
342
What is used to evaluate the status of medium to small airways in obstructive lung disorders?
FEF 25%-75%
**4.5 L/s (270L/min)**
343
Normal FEF 200-1200 value for the average healthy man
8 L/s (480 L/min)
344
_______ provides a good assessment of the large upper airways.
Peak Expiratory Flow Rate
345
PEFR can be measure easily with what?
At the patient’s bedside with a hand-held peak flowmeter
346
________ is the average flow rate generated by the patient during the middle 50% of an FVC measurement.
FEF 25-75%
**4.5L/s (270 L/min)**
347
What measures the average flow rate between 200 and 1200 mL of an FVC.
Forced Expiratory Flow 200-1200
348
What does MIP primarily measure?
Inspiratory muscle strength — that is, the power of the diaphragm and external intercostal muscles
349
An MIP of -25 cmH2o or less (more negative) usually indicates _____________________.
Adequate muscle strength to maintain spontaneous breathing
350
What does MEP primarily measure?
Strength of the abdominal muscles — that is, the rectus abdominis muscles, external abdominis oblique muscles and internal abdominis oblique muscles, transversus abdominis muscles and internal intercostal muscles
351
The adult MEP is greater than ______ in males and greater than ______ in females
Males - 100 cm H2O
Females - 80 cm H2O
352
Where are unsatisfactory MEP values commonly seen?
- Patients with neuromuscular disease
- High cervical spine fractures
- COPD
353
________ involves treadmill or victor ergometer testing while a variety of physiologic parameters are measured and/or calculated.
Cardiopulmonary Exercise Test (CPET)
354
What are some useful ways of confirming diagnosis of asthma?
- Inhaled methacholine or histamine
- Indirect challenge test to inhaled mannitol
- Exercise or cold air challenge
355
Inhalation challenge tests can be performed only when the patient has a FEV1 of ___________, to avoid inducing asthma symptoms in an already compromised patient.
80% or greater
356
Impulse oscillometry is used to assess ______________________.
- Large and small airway obstructions
- Bronchodilator response
- Bronchoprovocation tesing
357
IOS can be performed in patients on ventilators and during sleep. T or F?
True
358
What are the two ways oxygen is carried in the blood?
1. Dissolved oxygen in the blood plasma
2. Oxygen bound to hemoglobin
359
In the healthy individual, over ________ of the oxygen that diffuses into the pulmonary capillary blood chemically combines with hemoglobin.
98 percent
360
What is the normal hemoglobin value for **men?**
14-16 g/dL
361
What is the normal hemoglobin value for **women?**
12-15 g/dL
362
Each gram of hemoglobin is capable of carrying about _______ of oxygen.
1.34 mL
363
Define (P[A-a]O2).
The oxygen tension difference between the alveoli and arterial blood.
Also known as the alveolar-arterial tension gradient.
364
_____________ is an S-shaped curve on a nonogram that illustrates the percentage of hemoglobin that is saturated with oxygen related to oxygen at a specific oxygen partial pressure.
Oxyhemoglobin dissociation curve, also called oxyhemoglobin equilibrium curve
365
a PO2 increase from 60 to 100 mm Hg only increases the total saturation of hemoglobin by ____.
7 percent
366
_________ is the ratio of carbon dioxide production divided by oxygen consumption.
RQ, the respiratory quotient
367
Under normal circumstances, about ______ of oxygen per minute is consumed by tissue cells.
250 mL
368
Under normal circumstances, about _____ of carbon dioxide is excreted in the lung per minute.
200
369
The normal P(A-a)O2 on room air at sea level ranges from _______ and **should not exceed 30 mm Hg.**
7-15 mm Hg
370
The normal value for P(A-a) O2 on 100% oxygen is between _____________.
What is the critical value?
25 and 65 mm Hg.
The critical value is greater than 350 mm Hg
371
P(A-a) O2 is normal when __________ is the cause of patient’s hypoxemia.
Alveolar hyperventilation
372
P(A-a) O2 increases in response to -
- Oxygen diffusion disorders
- Ventilation perfusion mismatching
- Right-to-left intracardiac shunting
- Age
373
What reflects the amount of alveolar oxygen that moves into the arterial blood?
PaO2/PAO2 ratio
374
What is the normal range for arterial-alveolar pressure ratio, for a young adult?
0.75 and 0.95
The critical value is less than 0.75
375
When is PaO2/PAO2 most reliable?
- When ratio is less than 0.55
- FiO2 greater than 0.30
- PaO2 less than 100 mm Hg
376
What is useful in determining the extent of lung diffusion defects?
PaO2/FiO2 ratio
377
___________ is the amount of oxygen delivered to the peripheral tissue cells
Total oxygen delivery (DO2)
378
__________ is the amount of oxygen consumed by the tissue cells divided by the total amount of oxygen delivered.
Oxygen extraction ratio
379
Normally, the oxygen consumption (VO2) is about _________ of oxygen per minute.
250 mL
380
Normally, the SVO2 (mixed venous oxygen saturation) is about _______.
75%
381
**What type of hypoxia is this?**
Inadequate oxygen at the tissue cell caused by low arterial oxygen tension (PaO2)
Hypoxic hypoxia
381
**What type of hypoxia is this?**
PaO2 is normal, but the oxygen-carrying capacity and thus the oxygen content of the blood is inadequate
Anemic hypoxia
382
**What type of hypoxia is this?**
Impaired ability of the tissue cells to metabolize oxygen
Histotoxic hypoxia
383
**What type of hypoxia is this?**
Blood flow to the tissue cells is inadequate; therefore adequate oxygen is not available to meet tissue needs
Circulatory hypoxia, also called stagnant or hypoperfusion hypoxia
384
An increased level of red blood cells is called ______________.
Polycythemia
385
What is defined as an inadequate level of **tissue** oxygenation?
Hypoxia
386
What is useful in assessing the patient’s cardiopulmonary status?
Arterial-venous oxygen content difference
(C[a-v]O2)
387
__________ is a good indicator of the patient’s oxygenation status
Arterial oxygen tension - PaO2
388
Normally, the DO2 is about ______ of oxygen per minute.
1000 mL
389
Normally, the VO2 (oxygen consumption) is about _________ of oxygen per minute.
250 mL
390
What is defined as an abnormally low arterial oxygen tension?
Hypoxemia
391
Hypoxia is characterized by:
- Tachycardia
- Hypertension
- Peripheral vasoconstriction
- Dizziness
- Mental confusion
392
Normally, the C(a-v)O2 is about _______.
5 mL/dL
393
______ is a term used to denote pulmonary arterial hypertension, right ventricular hypertrophy, increased right ventricular work and ultimately right ventricular failure.
Cor polmonale
394
When hypoxia exists, alternative anaerobic mechanisms are activated in the tissues that produce dangerous metabolites like _________.
Lactic acid
395
Clinically, the presence of mild hypoxemia generally stimulated the oxygen peripheral chemoreceptors to ____________.
Increase the patient’s breathing rate and heart rate
396
Red blood cell production is known as what?
Erythropoiesis
397
When pulmonary disorders produce chronic hypoxia, the renal cells release higher than normal amounts of the hormone **erythropoietin** which in turn stimulates __________.
The bone marrow to increase red blood cell production
398
At normal body temperature about _____ of oxygen will dissolve in each 100 mL of blood for every 1 mm Hg of PO2.
0.003 mL
399
Decrease DLCO is a hallmark clinical manifestation in ___________.
Emphysema
