Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Med-Surg > Determinants and Assessment of Pulmonary Function > Flashcards

Determinants and Assessment of Pulmonary Function Flashcards

(116 cards)

Start Studying
1
Q

What does the surfactant layer consist of and what does it do?

A

Type 2 cells secrete surfactant which is a lipoprotein that lines the inner wall of alveoli, reducing surface tension to precent alveolar collapse. SURFACTANT KEEPS ALVEOLI OPEN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is anaerobic metabolism?

A

The making of energy (glucose) in an environment absent of O2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What happens to our muscles when anaerobic metabolism occurs?

A

Our muscles get sore because there is not enough air which leads to lactic acid build up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Define Ventillation

A

It is the actual work of breathing and movement of air from outside to inside the lung tissues. (the amount go gas reaching alveoli)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Define Diffusion

A

Exchange of gases at the alveolar membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Define Perfusion

A

Pumping of blood to organs and tissues, systemic and pulmonary systems. (the blood flow in pulmonary capillaries)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the 3 determinants of O2 status?

A

PaO2, SaO2, Hemoglobin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is PAO2

A

partial pressure of oxygen in alveoli
normal range 100-105 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is PaO2

A

partial pressure of O2 dissolved in arterial blood
normal range 75-100 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is PvO2

A

partial pressure of O2 dissolved in venous blood
normal range 40 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is tidal volume

A

amount of air that moves in and out of lungs with each normal breath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is vital capacity

A

maximum amount of air expired after a maximal inspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is SaO2

A

O2 saturation; the measure of the % of O2 combined with hemoglobin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Why is SaO2 important

A

degree of saturation is important in determining amount of O2 available for delivery to tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is hemoglobin

A

major carrier of O2 in blood and an important factor in tissue oxygenation - composed of protein and heme and a major component of RBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the normal range for hemoglobin?

A

females 12-15 g/dL
males 13.5-17 g/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What does abnormally low hemoglobin indicate?

A

that tissue perfusion is also low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

In the oxyhemoglobin dissociation curve what is a left shift?

A
  • alkalosis; increase pH, decrease PaCO2 (hypocapnia)
  • increased affinity to hmg in O2; in lungs hmg binds to O2
  • at tissues hmg does not readily release O2
  • ABG increased SaO2, O2 sat increased, increased SvO2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

In the oxyhemoglobin dissociation curve what is a right shift?

A
  • acidosis; decrease pH, increased PaCo2 (hypercapnia)
  • decreased affinity of hmg for O2; in lungs hmg does not easily bind with O2
  • at tissues hmg readily releases O2
  • ABG decreased SaO2, decreased SpO2, decreased SvO2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Pulmonary Vascular Resistance

A

measures the resistance to blood flow in pulmonary vascular system, a low-resistance system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What 3 main factors determine pulmonary resistance

A

length of vessels
radius of vessels
viscosity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Cor Pulmonae

A

R ventricular hypertrophy and dilation secondary to pulmonary disease - is a complication of both restrictive and obstructive pulmonary diseases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Oxygenation occurs as a result of what 3 processes

A

O2 intake
O2 delivery
use of O2 for metabolic processes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is the VQ ratio

A

ventilation (v) must match perfusion (Q)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What happens when VQ ratio is mismatched
impaired gas exchange
26
Why is nutritional history important when assessing respiratory system
malnutrition can contribute to developing respiratory failure
27
where do you hear vesicular sounds on auscultation
peripheral fields
28
where do you hear bronchial sounds on auscultation
trachea and larynx
29
where do you hear bronchovesicular sounds on auscultation
all lobes near major airways
30
What is orthopnea
state in which pt assumes a head up position to relieve dyspnea
31
Difference between cardiogenic pain and pleuritic chest pain
Cardiogenic pain is unaffected by breathing, pleuritic pain is sharp pains on inhalation
32
What is capnography
noninvasive measurement of CO2 concentration in expired gases
33
Arterial Blood Gases
provide valuable information on pts acid-base and oxygenation status
34
Kidney function
is a slow but powerful response
35
Lung function
is a rapid but limited response
36
normal pH
7.35-7.45
37
normal PaCO2
35-45
38
normal HCO3
24-28
39
normal PaO2
80-100
40
normal SaO2
greater than 95%
41
Compensation occurs when
another value is outside its normal range
42
No compensation occurs when
other value is within normal range
43
buffer systems prevent
major changes in H+
44
in respiratory/metabolic acidosis increased ____ is attempt to get rid of _____
respiration; CO2
45
in respiratory/metabolic alkalosis decreased ___ is to retain _____
respirations; CO2
46
kidneys regulate ____ level in ECF
HCO3-
47
in respiratory/metabolic acidosis the kidneys
excrete hydrogen ions and conserve HCO3 to restore balance
48
in respiratory/metabolic alkalosis the kidneys
retain hydrogen ions and excrete HCO3 ions to restore balance
49
uncompensated =
abnormal pH with one abnormal value and one normal value
50
partially compensated =
abnormal pH with 2 abnormal values
51
compensated (chronic) =
normal pH with 2 abnormal values
52
corrected =
normal pH and 2 normal values. No acid-base disturbance currently exists
53
common causes of acute respiratory acidosis
respiratory depression, decreased ventilation, altered diffusion/ventilation/perfusion mismatch
54
restrictive pulmonary disease =
reduced total lung capacity
55
obstructive pulmonary disease
air moves in and out at reduced rate
56
pneumonia arises from
micro-aspiration of colonized organisms in the upper airway
57
pneumonia infection results in
pulmonary inflammation -> congestion
58
red hepatization of pneumonia
blood vessels and capillaries dilate and fill with exudate and organisms
59
grey hepatization of pneumonia
blood flow decreases and leukocytes and fibrin consolidate
60
resolution of pneumonia
exudate becomes lysed and macrophages clean up
61
consolidation in grey hepatization means
worsening, not a bad things but shown progression
62
signs and symptoms of pneumonia
cough, fever, pleuritic chest pain, weight loss, muscle aches and pains, fatigue, decreased air entry, hemoptysis, night sweats, crackles/congestion on auscultation
63
goals in pneumonia pt
improve gas exchange and improve airway patency
64
clinical manifestations of restrictive pulmonary disorders
increased resp rate, decrease tidal volume, SOB, cough, chest pain/discomfort, fatigue, history of weight loss
65
types of COPD
emphysema, chronic bronchitis, cystic fibrosis, asthma
66
pathophysiology of obstructive disorders (COPD)
air is able to flow into lungs but then becomes trapped, difficult to exhale so air moves in and out at a decreased rate
67
respiratory insufficiency
maintains oxygenation, acid base imbalance persists, normal pH + increased PaCO2 and increased HCO3 = compensated respiratory acidosis - live with impeding respiratory failure
68
COPD is characterized by
exacerbations caused by triggers
69
clinical features of obstructive pulmonary disorders (COPD)
bronchospasm, bronchoconstriction, airway obstruction
70
physical findings of obstructive pulmonary disorders (COPD)
diminished breath sounds (often related to pneumonia), increased accessory muscle use, rhonchi, wheezes, prolonged expiration, increased sputum production, pursed lip breathing, cough, crackles not cleared by coughing and deep breathing
71
COPD treatment is aimed at
(1) improving airway obstruction (2) providing relief of symptoms (3) modifying or preventing exacerbations (4) altering disease progression
72
using O2 therapy in pts with COPD increases risk for
hypoxemia
73
pharmacotherapy for pulmonary disorders
beta 2 agonsits, anti cholinergic bronchodilators, corticosteroids, mucolytics, pulmonary vasodilators
74
NPPV is
noninvasive positive pressure ventilation
75
what is NPPV for
reduces intubation, used in exacerbations and ICU setting
76
BREATH AIR acronym
Bronchospasm Rales Effusions Airway obstruction Thick secretions Hemoglobin (low) Anxiety Interpersonal issues Religious concerns
77
external respiration
bulk flow of air into and out of the lungs
78
internal respiration
capillary gas exchange in body tissues
79
alveolar gas exchange
1. surface area 2. partial pressure gradient of gases 3. matching of ventilation and perfusion
80
in emphysema alveoli are ____________, surface area is _______, and ________ _________
gradually reduced; reduced; diffusion decreases
81
gas exchange in lungs happens at the
alveoli-capillary membrane
82
alveoli-capillary membrane has a large surface area for
efficient gas exchange
83
ARDS is
acute respiratory distress syndrome aka acute lung injury
84
pathophysiology of ARDS
widespread damage to alveolar capillary membrane causes widespread inflammatory event, can be fatal
85
acute respiratory failure
cardiopulmonary system fails to maintain gas exchange - oxygenation failure and ventilation failure
86
ARDS can affect all organs because of
hypoxemia
87
if ARDS is accompanied by decreased CO2 it can lead to
hypoperfusion and shock
88
ventilatory failure can result in
hypercapnia and respiratory acidosis
89
ARDS can be ____ stage of someone with COPD and/or penumonia
end stage
90
clinical manifestations of pt in respiratory failure
cyanotic, pallor, high resps, breath sounds diminished, high BP, high pulse, increased temp (due to infection), CXR would show consolidation
91
acute respiratory failure =
oxygenation failure
92
in acute respiratory failure PO2 is less than
60
93
CO2 can diffuse ____ times faster than O2
20 times
94
acute respiratory failure causes
acute respiratory acidosis, alveolar hypoventilation, build up of CO2
95
complications of respiratory failure
oxygenation failure and ventilation failure
96
oxygenation failure
organ hypoxia, hypoperfusion/hypoxic organ
97
ventilation failure
severe hypercapnia, severe respiratory acidosis
98
pulmonary embolism
large thrombi obstructs perfusion in the pt artery or its branches
99
small PE
may be asymptomatic
100
large PE
lodge in main pulmonary artery - severe, immediate symptoms
101
may have several ____________ cause obstruction of multiple tiny pulmonary vessels
micro-emboli
102
blockage in pulmonary artery causes
increased pulmonary pressure, increased resistance to blood flow in right ventricle = increased R ventricle workload and decreased lung perfusion
103
if R ventricle cannot pump against the pressure
right heart failure occurs
104
inflammatory response is
increased neutrophils and increased platelet activating factors (clots)
105
manifestations of pulmonary embolism
hypotension, hypoxemia, SOB, dyspnea, wheezing, pleuritic pain, orthopnea
106
common outcome of pulmonary embolism
impaired gas exchange
107
___% of those with a PE have pre-existing confirmed DVT
44%
108
types of emboli
thromboembolism, fat embolism, amniotic, venous air embolism
109
thromboembolism
110
fat embolism
111
amniotic
112
venous air embolism
113
more than 80% if PE originates as DVT in the ___ ______
lower extremities
114
management of PE includes
anticoagulant therapy, vena cava filter, thromboembolytic therapy, embolectomy
115
ABGs for PE would look like
low PaO2 and low PCO2 because no exchange of CO2 and/or O2 happens
116
catheter directed thrombolysis
thrombolytic agent is administered directly into the pulmonary artery via a pulmonary artery catheter, the usual thrombolytic agent is full dose heparin

Med-Surg (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions