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Pathophysiology Exam 2 > Chapter 23- Ventilation & Gas Exchange > Flashcards

Chapter 23- Ventilation & Gas Exchange Flashcards

(95 cards)

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1
Q

Ventilation?

A

Movement of air between the atmosphere and respiratory portion of the lungs

MOVEMENT

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2
Q

Perfusion?

A

Flow of blood through the lungs

BLOOD FLOW

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3
Q

Diffusion?

A

Transfer of gases between the air filled spaces in the lungs and the blood

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4
Q

Examples of perfusion?

A
  • thrombus in vessels

- severe anemia

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5
Q

When inserting an endotracheal tube, a medical professional will typically advance the tube where?

A

To the right, due to the nature of the trachea.

  • Right side of trachea into the lungs is a wider angle
  • left side of trachea into the lungs is a more narrow turn
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6
Q

Dissolved oxygen = _______ or _________?

A

PaO2 or PO2

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7
Q

What is the normal value of dissolved oxygen?

A

Normal value > 80mm Hg

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8
Q

Oxygen bound to hemoglobin = ?

A

Oxyhemoglobin

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9
Q

Normal Oxygen saturation value is ______ to _______?

A

94% to 100%

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10
Q

Dissolved carbon dioxide = _______ or _________?

A

PaCO2 or PCO2

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11
Q

Normal Carbon Dioxide value = ?

A

35-45 mm Hg

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12
Q

Carbon dioxide bound to hemoglobin =?

A

Carbaminohemoglobin

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13
Q

When you exhale you remove _______ from your blood?

A

CO2

  • you also decrease the amount of carbonic acid, raising your blood PH
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14
Q

Hypoxemia?

A

Reduced oxygenation of the arterial blood

  • PO2 <60mm Hg or Pox around 90%
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15
Q

What is Cyanosis?

A

Bluish discoloration

Of the skin & mucous membranes

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16
Q

Central Cyanosis is evident where?

A

In the tongue and lips

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17
Q

Peripheral Cyanosis is evident where?

A

On the extremities & tip of the nose and ears

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18
Q

Which is more serious, Peripheral cyanosis OR central cyanosis?

A

Central cyanosis

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19
Q

If a patient has hypoventilation, there building up _______ and not getting enough ________.

A

Building up: CO2

Not getting enough: O2

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20
Q

Signs and symptoms of Hypoxemia?

A
  • Tachypneic (fast breathing)

- SOB

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21
Q

Ways to diagnose Hypoxemia?

A
  • Pox
  • Arterial blood gas (ABG)
  • 92% —> nasal canula (2-3L/min)
  • 74% —> oxymask ALL THE WAY UP (15L/min)
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22
Q

Treatment for Hypoxemia?

A
  • Treat the underline cause
  • Oxygen via nasal cannula, mask, or nonrebreather

If No Improvement

  • continuous positive airway pressure (CPAP) (night)
  • Bilevel positive airway pressure (BIPAP) (on 1st)
  • Intubation
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23
Q

Atelectasis?

A

Incomplete expansion of the lung or portion of a lung

can be small segment or entire lung

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24
Q

Atelectasis is most commonly seen in who?

A

Postoperative patients

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25
What are the two early signs & symptoms of Atelectasis?
- Tachypnea (fast breathing) | - Tachycardia (fast HR)
26
Atelectasis signs and symptoms?
- Tacypnea - Tachycardia - Dyspnea - Cyanosis - Absence of breath sounds - Fever - Signs of infection
27
Treatment for Atelectasis?
- incentive spirometry - coughing - deep breathing
28
What is Hypercapnia?
Increased carbon dioxide in the arterial blood
29
Hypercapnia is PCO2 of ___________?
> 50mm Hg
30
Signs & Symptoms of Hypercapnia?
- Hypoventilation - decreased RR - Altered mental status
31
________________ covers the lungs?
Visceral pleura
32
____________ lines the thoracic wall and superior aspect of the diaphragm?
Parietal pleura
33
Pleural cavity is what?
Space between the two layers
34
_________ contains a thin layer of serous fluid?
Pleural cavity
35
Pleuritic Chest Pain originates from where?
Originates from parietal pleura involvement
36
Signs & Symptoms of Pleuritic Chest Pain?
- Sharp - Abrupt onset - Unilateral - Lower * Can be referred to shoulder * Worse with chest movement (Cough, deep breathing, movement)
37
Pleuritic chest pain results in what?
Rapid, shallow breaths, reflex splinting
38
What is Pleural Effusion?
Fluid in the Pleural Cavity
39
Hydrothorax: ?
Serous fluid
40
What is the most common cause of Hydrothorax?
Congestive Heart Failure (CHF)
41
Empyema: ?
Pus; s/s of infection
42
Causes of Empyema?
- Direct infection of pleural space - rupture of lung abscess - invasion from subdiaphragmatic infection - trauma
43
Hemothorax: ?
Blood
44
Causes of Hemothorax?
- Injury to chest - surgery - malignancy - rupture of great vessel
45
Signs and symptoms of Pleural Effusion?
- Dyspnea - Decreased breath sounds - Pleuritic chest pain - Mild Hypoxemia - Shift in mediastinal structures - Decreased lung expansion
46
Treatment of Pleural Effusion?
- directed towards cause - Drainage of fluid ( chest tube or multiple chest tubes) - possibly surgery
47
What is Pneumothorax?
Air enters the pleural cavity - Air takes up space, restricting lung expansion * can be partial or complete collapse of the affected lung
48
What are 2 types of pneumothorax?
1. Spontaneous pneumothorax | 2. Traumatic pneumothorax
49
What is spontaneous pneumothorax?
An air-filled blister on the lung ruptured
50
What is traumatic pneumothorax?
Air enters through chest injuries
51
What are 2 types of traumatic pneumothorax?
1. Tension pneumothorax | 2. Open pneumothorax
52
What is Tension pneumothorax?
Air enters pleural cavity through the wound on inhalation, but cannot leave on exhalation *Life Threatening*
53
What is Open pneumothorax?
Air enters pleural cavity through the wound on inhalation and leaves on exhalation
54
Air ________ in the lung?
Rises
55
Fun Fact: In patients with Tension Pneumothorax - place needle by 2nd rib. Pull out needle and the tubing serves as a way for air escape!
💉💉
56
Signs and symptoms of pneumothorax? | ( and also Hemothorax)
- Depends on size and lung response - Chest pain - Tachypnea - Tachycardia - Asymmetry of chest movement - Hypoxemia - Tracheal deviation with tension pneumothorax
57
Asymmetry of chest movement is seen more with what?
Car accidents & Trauma
58
Treatment of pneumothorax?
- Depends in cause - Removal of air with needle or chest tube - surgery if necessary
59
Tension Pneumothorax = ?
Needle Decompression
60
What is Hemothorax?
Blood within the pleural space
61
Causes of Hemothorax?
- Trauma - MVC - Gun shot - Stabbing - Assault - Fall
62
Where should a chest tube be placed in a patient with Hemothorax?
Lower in lung * since blood is heavier than air!
63
Tension pneumothorax is associated with what?
Tracheal deviation
64
What are chronic obstructive airway diseases?
- Chronic bronchitis - Emphysema - Bronchiectasis - Cystic Finrosis
65
What are Obstructive Airway Disorders?
- Bronchial asthma - Chronic obstructive airway diseases - Chronic bronchitis - Emphysema - Bronchiectasis - Cystic fibrosis
66
Asthma is due to what?
Airway inflammation
67
___________ makes Asthma worse in 10% of individuals?
- Over the counter meds (Anti-inflammatories) AVOID—> ibuprofen, aleve, aspirin
68
Signs and symptoms of MILD asthma?
- Chest tightness | - Expiratory wheezing
69
Signs and symptoms of SEVERE asthma?
- Dyspnea - Fatigue - Loud inspiratory & expiratory wheezing - accessory muscle use - Tripod position
70
What symptoms would there be in a patients with asthma whose airflow has significantly decreased?
- Breath sounds inaudible (Due to full occlusion) - Diminished wheezing - will lead to respiratory failure/arrest
71
High CO2 levels will cause what in COPD patients?
Unresponsiveness | - All other assessments will be normal! Vitals, etc.
72
What should you monitor with COPD patients?
CO2 Levels
73
In COPD patients they can’t get _____ in and cant blow off _______.
Can’t get O2 in | Can’t blow off CO2
74
In COPD patients there ABG will look _________ and there CO2 will be ________.
Good | Elevated
75
In COPD patients what does the saying Low & Slow mean?
Increase O2 1L at a time * usually don’t go above 3L *
76
What is Emphysema?
Enlargement of air spaces and destruction of lung tissue
77
What is the problem with Emphysema?
Major mechanism of airflow is limited due to the loss of elastic recoil ( allows air in the lungs during inspiration and prevents collapsing on exhalation)
78
Causes of Emphysema?
- smoking 🚬 | - genetics 🧬
79
What respiratory disease cause Mucus Hypersecretion ?
Chronic bronchitis
80
What is Chronic bronchitis?
- Chronic irritation, inflammation, and obstruction of airways
81
COPD & Chronic Bronchitis occur more in what sex?
More MEN | It can still occur in women, but it’s less likely
82
Chronic bronchitis occurs more in ______, __________, ___________________.
- Middle ages men - Smokers - Recurrent infection
83
What is a symptom of Chronic Bronchitis?
- Chronic, Persistent, productive cough
84
In somebody with COPD & Chronic Bronchitis, where do we want there Pox?
Where there Pox is normal, is where we want it to be!
85
Signs & Symptoms of Chronic Bronchitis ?
- Dyspnea - Decreasing exercise tolerance - Labored breathing (eventually even @ rest) - Prolonged expiatory phase - Hypoxemia - Hypercapnia - Cyanosis
86
Pursed Lips helps to do what?
Helps to blow off CO2 longer
87
Emphysema Signs & Symptoms
- Dyspnea - Increased ventilatory effort - use of accessory muscles - Barrel chest - Pursed lip breathing
88
What Labs to look for in COPD patients & why ?
- ABG - CBC * Low WBC’s = COPD exacerbation (breathing treat.) High WBC’s = Pneumonia (Antibiotics)
89
What is a Pulmonary Embolism?
Something blocking a branch of a pulmonary artery and obstructs flow (Thrombus, air, fat)
90
Pulmonary Embolisms almost always arise from ______________________________.
Deep Vein Thrombosis (DVT) OR Venous Thromboembolism (VTE)
91
What are complications of Pulmonary Embolisms?
- Pulmonary Hypertension ( increases pressure to try and push everything pass the blockage) - Right-sides heart failure develops
92
Fat emboli are common with what?
Common with large bone breaks | (Ex: Femur)
93
Pulmonary Embolism Signs & Symptoms ?
- Chest pain - Dyspnea - Tachycardia - Tachypnea - Low Pox - Hypoxemia without CO2 retention - Large emboli May be fatal
94
D-dimer testing can be used to diagnose what ?
Pulmonary Embolism
95
In patients with Pulmonary Embolisms, anticoagulants are used to prevent what ?
Prevents further growing of the thrombus

Pathophysiology Exam 2 (6 decks)

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