CI Terminology

Question 1

Tidal volume (Vt)

Answer 1

Air inhaled or exhaled during a single normal breath

Question 2

Inspiratory reserve volume (IRV)

Answer 2

Maximum amount of air that can be inspired on top of a normal tidal inspiration

Question 3

Expiratory reserve volume (ERV)

Answer 3

Maximum amount of air that can be exhaled following a normal tidal expiration

Question 4

Residual volume (TLC)

Answer 4

Volume of air remaining in the lungs after a maximal expiration

Question 5

Total lung capacity (TLC)

Answer 5

Total volume of lungs at the end of maximal inspiration

Question 6

Vital capacity (VC)

Answer 6

Maximum amount of air that can be inspired and expired in a single breath

Question 7

Functional residual capacity (FRC)

Answer 7

Volume of air remaining in the lungs at the end of normal tidal expiration

Question 8

Costophrenic angle

Answer 8

Where the diaphragm meets the ribs

Question 9

Abnormal breath sounds (bronchial breathing)

Answer 9

Occurs when air is replaced by solid tissue, which transmits sound more clearly. e.g, consolidation, areas of collapse, pleural effusion

Question 10

Diminished breath sounds

Answer 10

If air entry is compromised by an obstruction or decreased airflow. e.g. pneumothorax, pleural effusion, emphysema, collapse, obesity, difficulty breathing

Question 11

Crackles

Answer 11

Occur when airways that have been narrowed or closed (usually by secretions) are suddenly forced open on inspiration.

Question 12

Fine crackles

Answer 12

Crackles originating from small, distal airways

Question 13

Coarse crackles

Answer 13

Crackles originating from large, proximal airways

Question 14

Wheeze

Answer 14

Caused by air being forced through narrowed or compressed airways. e.g. bronchospasm, muscosal oedema, sputum retention.

Question 15

Pleural rub

Answer 15

Sound heard when pleural surfaces are inflamed or infected, or become rough and rub together. Creates creaking or grating sound heard equally in inspiration and expiration.

Question 16

Respiratory acidosis (uncompensated)

Answer 16

Decreased pH, increased PaCO2

Question 17

Metabolic acidosis (uncompensated)

Answer 17

Decreased pH, decreased HCO3

Question 18

Respiratory alkalosis (uncompensated)

Answer 18

Increased pH, decreased PaCO2

Question 19

Metabolic alkalosis (uncompensated)

Answer 19

Increased pH, increased HCO3

Question 20

Controlled mechanical ventilation (CMV)

Answer 20

Ventilator performs all work of breathing with breathing parameters preset

Question 21

Central venous pressure (CVP)

Answer 21

Measured near right atrium within the superior vena cava. Information about circulating blood volume, effectiveness of heart pump, vascular tone and venous return.

Question 22

Cerebral perfusion pressure (CPP)

Answer 22

Pressure required to ensure adequate blood supply to the brain. MAP - ICP

Question 23

Ejection fraction

Answer 23

Stroke volume as a % of total volume of the ventricle before systolic contraction

Question 24

Intracranial pressure (ICP)

Answer 24

Pressure from the brain tissue, CSF and blood volume within the skull and meninges. Rises in ICP cause decreased blood supply to the brain.

Question 25

Mean arterial pressure (MAP)

Answer 25

Average pressure of blood being pushed through the circulatory system. Relates to cardiac output, systemic vascular resistance and tissue perfusion pressure.

Question 26

Benefits of lung positioning

Answer 26

Maximize lung volumes, increase lung compliance, improve ventilation/perfusion ratio, reduce work of breathing, aid secretion removal and cough. Bad lung up!

Question 27

Entry options for airway suction

Answer 27

1) nose - nasopharyngeal 2) mouth - oropharyngeal 3) tracheostomy

Question 28

Steroids

Answer 28

Reduce inflammatory response | e.g. hydrocortisone

Question 29

Mucolytics

Answer 29

Break down proteins within sputum, thereby reducing viscosity and enhancing clearance e.g. pulmozyme

Question 30

Diuretics

Answer 30

Cause increased urine production to reduce total body fluid load e.g. fruzemide

Question 31

Anti-hypertensives

Answer 31

Reduce blood pressure through vasodilation | e.g, captopril

Question 32

Sedatives

Answer 32

Reduce the alertness of the patient, often used in conjunction with analgesia e.g. midazolam, diazepam

Question 33

Antibiotics

Answer 33

Directly fight bacterial infections | e.g. penicillin

Question 34

Inotropes

Answer 34

Increase blood pressure through enhanced contractility of the heart or widespread vasoconstriction e.g. adrenaline, noradrenaline, dobutamine

Question 35

Anti-coagulants

Answer 35

Reduce the clotting levels of the blood | e.g. warfarin, heparin

Question 36

Bronchodilators

Answer 36

Relax the smooth muscle of the airways | e.g. salbutamol, ventolin

Question 37

Anti-arrhythmics

Answer 37

Stabilize the cardiac muscle to control abnormal rhythms (e.g. atrial flutter) e.g. amiodarone, metoprolol (a beta blocker)

Question 38

Anti-emetics

Answer 38

Reduce nausea, specifically vomiting | e.g. maxolon

Question 39

Analgesics

Answer 39

Interfere with the reception of pain signals | e.g. oxycodone, endone, aspirin, morphine

Question 40

Reason for diminished breath sounds

Answer 40

Hyper inflation, small pleural effusion, shallow breathing, small pneumothorax, obesity

Question 41

Reasons for absent breath sounds

Answer 41

No air entry - large pnemothorax, obesity, obstruction, severe bronchospasm

Question 42

Reason for bronchial breath sounds

Answer 42

Loss of normal air/alveolar interface, i.e. lung becomes solid = Darth Vader sound - pneumonia, lung contusion, segmental collapse, consolidation, collapse of peripheral bronchi.

Question 43

Reasons for coarse crackles

Answer 43

Sputum, secretions

Question 44

Reasons for coarse or fine crackles

Answer 44

Collapse, pulmonary oedema, surgical emphysema, interstitial fibrosis

Question 45

Reasons for wheezes

Answer 45

Bronchospasms, secretions or sputum plug, tumour obstructing airway, diffuse airway obstruction

Question 46

SIMV

Answer 46

Synchronised intermittent mandatory ventilation - boosts spontaneous breaths of patient whilst maintaining minimums for breathing

Question 47

4 criteria of extubation

Answer 47

1) Can the patient breathe on command 2) Does the patient have a strong cough (including in response to suction) 3) Does the patient have excess secretions 4) Is the patient alert and able to cooperate with PT 2/4 = borderline.