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A+P II > Exam 3 > Flashcards

Exam 3 Flashcards

(78 cards)

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1
Q

Diaphragm

A

Primary muscle of respiration

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2
Q

Diaphragmatic Hernia

A

GI organs migrate into the thoracic cavity through esophageal hiatus

Dx: No heart sounds on one side of chest or may hear gut sounds

Tx: Sx- must use ventilator

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3
Q

Spinal Cord Injury

A

Cervical vertebrae

Can’t use phrenic nerve-innervates the diaphragm

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4
Q

Pleura

A

Serous membrane that lines the thoracic cavity
Lined with simple squamous epithelium- movement
Mucous/goblet cells reduce friction
Parietal: lines the thoracic wall
Visceral: lines the organs within the thoracic cavity

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5
Q

Mediastinum

A

Serous membrane that divides left and right side of lungs

Prevents both lungs from collapse and infection

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6
Q

Intrapleural Space

A

Necessary to inflate lungs
Negative pressure
Vacuum
No air (Shouldn’t contain anything in this space)

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7
Q

Trachea/Bronchial Tree

A

Airway

O2 inhaled, C02 exhaled

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8
Q

Aspiration Pneumonia

A

Inflammation of the lungs caused by inhalation of foreign substances

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9
Q

Bronchioles

A

Lined with smooth muscle-involuntary

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10
Q

Alveolar Sacs

A

Lined with simple squamous epithelium
Surrounded by yellow elastic connective tissue
Gas exchange occurs here

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11
Q

Emphysema

A

A condition in which the alveolar sacs are damaged resulting in a decrease in pulmonary compliance (measure of the lungs ability to stretch and expand)

Tx: Oxygen therapy –> only adds O2 to system but does not help flush out expired CO2

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12
Q

Respiration

A

Inhalation: active process, contraction of muscles, intercostal, diaphragm pulled caudal into abdomen

Exhalation: passive process, muscles relax, diaphragm pulled cranial (help force CO2 out)

Composition of Air:
>02=21%, N2=79%, CO2=<1% (300 ppm)

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13
Q

Acid/Base Balance

A

pH of blood: 7.35-7.45

Lungs: When CO2 is increased –> pH decreases –> K+ in blood

Kidneys: When NaHCO3 is increased –> K+ in blood –> HR decreases

*Hyperkalemia –> Bradycardia

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14
Q

Pneumotaxic Center

A

Nuclei in brain stem
Measures CO2 levels
CO2 is what drives respiration

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15
Q

Tidal Volume

A

10-15 ml/kg

Amount of air contained in one entire breathe

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16
Q

Minute Volume

A

Tidal vol. X RR

Amount of air contained one one minute worth of breathing

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17
Q

Gas Exchange in the Alveoli (Capillary)

A

Low in CO2:
-pO2- 40 mmHg

High in CO2
-pCO2- 46 mmHg

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18
Q

Gas Exchange in the Alveoli (Alveoli)

A

Low in CO2
-pCO2- 40 mmHg

High in CO2
-pO2- 100mmHg

*Termed ETCO2 (end tidal CO2)
Should be 25-45 mmHG

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19
Q

Respiratory Alkalosis

A

Respiratory alkalosis is a primary decrease in carbon dioxide partial pressure (Pco2) with or without compensatory decrease in bicarbonate (HCO3−); pH may be high or near normal.

*Eliminating too much CO2

High pH
Low pCO2
Low HCO3- kidneys excrete bicarbonate

Caused by: Hyperventilation, iatrogenically during anesthesia

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20
Q

Respiratory Acidosis

A

Respiratory acidosis is a condition that occurs when the lungs cannot remove all of the carbon dioxide the body produces. This causes body fluids, especially the blood, to become too acidic.

Not removing enough CO2

Low pH
High pCO2
High HCO3- tries to neutralize acid

Caused by: neurological, respiratory, paralysis

3 Types: Intrapleural, intraalveolar, misc.,

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21
Q

Intrapleural Causes

A 
AKA atelectasis (collapsing of alveolar sacs)
Something extra in plueral space
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22
Q

Intraalveolar Causes

A

Anything which causes no gas exchange

  • Drowning
  • Pneumonia
  • Pulmonary contusion
  • Pulmonary edema- fluid in lungs
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23
Q

Emphysema

A

Lungs loose elasticity
Hardening of yellow elastic connective tissue
Increase of CO2 in blood

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24
Q

Obstructed Airway Causes

A

Aspiration
Strangulation
Mucous plug in ET tube
Medications- OPIODS- extreme resp. depressants

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25
Asphyxiation
Deprivation of oxygen | NEVER leave pop-off valve closed
26
2 Main Reasons for Ventilating a Pt. on Anesthesia
1. Decrease excess CO2- prevent hypercapnia | 2. Prevent atelectasis- collapsing of alveolar sacs
27
4 Elements of Blood Gas
ph= 7.35-7.45 pCO2= 35-45 mmHg HCO3= 18-25 mmol/L Anion Gap= 12-24 meq/L
28
Metabolic Acidosis
``` Low pH (<7.35) Low HCO3 (bicarbonate) Caused by --> renal failure, ketoacidosis ```
29
Metabolic Alkalosis
``` High pH (>7.45) High HCO3 (bicarbonate) Caused by --> vomiting (decrease in HCl) ```
30
3 Functions of the Cardiovascular System
1. Transportation of O2, CO2, nutrients, hormones, vitamins, waste 2. Regulation of pH, fluid balance body temp. 3. Defense against foreign organisms
31
Plasma
Fluid portion of anti-coagulated blood | Contains clotting factors, has ability to clot
32
Serum
Fluid portion of coagulated blood | Does not contain clotting factors
33
Dissolved Substances
``` Proteins- albumin, clotting factors, antibodies Nutrients- glucose, oxygen Electrolytes- Na+, Cl-, K+ Waste Products- BUN, bilirubin Hormones and Enzymes Cells ```
34
Electrical Conduction System of the Heart
- Sinoatrial Node (SA node)- Right atrium - Atrial-Ventricular Node (AV node)- Septim between atria and ventricles - Bundle of His- Septum of ventricles (interventricular septum) - Purkinjie Fibers- Travel up right and left ventricular walls * Both atria contract simultaneously with SA node * Both ventricles contract simultaneously with AV node
35
Diastole
Relaxation of ventricles
36
Systole
Contraction of ventricles
37
Blood Flow Through the Heart
Vena Cava --> Right atrium --> Tricuspid valve --> Right ventricle --> Pulmonary valve --> Pulmonary artery --> Lungs --> Pulmonary vein --> Left atrium --> Bicuspid valve --> Left ventricle --> Aortic valve --> Aorta
38
Normal HR for Canines, Felines, and Equine
Canines: 60-160 bpm Felines: 140-220 bpm Equine: 30-40 bpm
39
Cardiac Output Formula
C.O= stroke volume (mls) X HR (bpm) *C.O has a direct impact on BP
40
Normal Pressure Values
Systolic: 100-160 mmHg Diastolic: 60-100 mmHg Mean: 80-120 mmHg
41
How to Control BP
Regulate vessel diameter with vasoconstrictors --> increase BP Control C.O with inotropic drugs (increase force of ventricular contraction) --> increase S.V Regulate blood volume with IV fluids --> increase BP *Give fluid bolus to pts. with low BP
42
Right Heart Failure (RHF)
Symptoms: ascites (fluid inside abd. cavity)
43
Left Heart Failure (LHF) | Congestive Heart Failure
*More common Symptoms: pulmonary edema, decreased BP due to tachycardia Treatment: O2, diuretic (draws fluid out of lungs), cardiac regulator (inotropic drugs)
44
Purpose of an ECG
Helps diagnose arrhythmias | Shows electrical activity of the heart
45
5 Leads to Attach to ECG
``` White: right axillary Black: left axillary Red: left inguinal Green: right inguinal Tan: sternum ```
46
5 Parts to an ECG
P wave: atrial depolarization (contraction, systole) QRS complex: ventricular depolarization (contraction, systole) T wave: ventricular repolarization (relaxation, diastole)_
47
6 Step Approach
1. Rate (bradycardia, tachycardia, normal) 2. R-R Interval (want to stay consistent) 3. P-wave for every QRS complex 4. QRS complex for every P-wave 5. QRS complex normal size and shape? (tall and thin) 6. T-waves normal? (no more than 25% of height of R wave)
48
Respiratory Sinus Arrhythmia
Common in large, deep chested breeds Can be normal variation in dogs HR will increase on inhalation and decrease on exhalation
49
Ventricular Premature Contraction (VPC)
Some ectopic force is causing the ventricle to beat prematurely If occasional --> OK Treatment: Lidocaine, Procainamide
50
Ventricular Tachycardia
More than 3 VPCs in consecutive sessions --> significant decrease in C.O Treatment: Lidocaine (IV), Procainamide
51
Ventricular Fibrillation (V-FIB)
Ventricle is not contracting in a normal fashion | Treatment: defibrillation
52
2nd Degree AV Block
Block in conduction between SA node and AV node --> bradycardia Treatment: anticholinergics (atropine sulfate) (IV)
53
3rd Degree AV Block
SA and AV node are not communicating P-wave and QRS complex are not coordinated Treatment: pace maker
54
Patent Ductus Arteriosus (Congenital)
*Most common defect in mammals Opening between the pulmonary artery and the aorta in fetal circulation (should normally close after birth) Causes machinery murmur (whoosh whoosh) Symptoms: lethargic upon exercise, cyanotic mm Treatment: sx, suture ductus closed (not open heart sx, trocharize thorax)
55
Patent Foramen Ovale (Congenital)
Opening between left and right atrium in fetal circulation (should normally close after birth) Treatment: open heart sx, suture a patch over foramen (dacron patch) Very expensive Can produce hypothermic pt. (85 degrees will allow for 45 min. without damage to cardiac muscle)
56
Aortic Stenosis
Due to scar tissue Causes dilation of left ventricle --> LHF Symptoms: pulmonary edema Treatment: dissect scar tissue (can create more scar tissue)
57
Pulmonic Stenosis
Causes dilation of right ventricle --> RHF Symptoms: ascites Treatment: dissect scar tissue
58
Ventricular Septal Defect (VSD)
Should never be an opening between right and left ventricle | Treatment: open heart sx- patch the foramen
59
A-V Insufficiency (Acquired)
Opposite of stenosis, valves hang open Valves should be closed during systole (contraction) Causes machine murmur More commonly effects left side Common Causes: dental dz, poorly performed prophylaxis Treatment: vasodilators, sx to repair mitral valve
60
Heartworm Dz (Acquired)
Microfilaria live in pulmonary artery (can cause obstruction) Blood will back up to right ventricle Most common in southern/eastern states Treatment: heartworm prevention meds
61
Vegetative Endocarditis (Acquired)
Bacterial colonies on heart valves Caused by: dental dz Symptoms: dyspnea, exercise intolerance, enlarged heart, coughing
62
Cardiomyopathy (Acquired)
1. Dilated Caused by weak muscle --> myocardial infarction (heart attack) Symptoms: wet cough Treatment: diuretics, cardiac regulators ``` 2. Hypertropic Caused by overwork of the heart muscle Common in maine coon cats (genetic test) Decrease HR Treatment: Anti-adrenergics- propranol ``` *Geriatric animals are predisposed to both
63
Cardiac Tamponade (Acquired)
Due to pericardial effusion (fluid build up in pericardial sac) Causes pressure build up in sac --> will collapse chambers of the heart, decrease C.O Dx: auscultation, very quiet heart beat Treatment: pericardial centesis
64
Atherosclerosis (Acquired)
Narrowing of vessels More common in humans due to diet Treatment: removal bypass
65
Hypovolemic Shock
AKA traumatic shock Acute blood loss (hemorrhaging, H2O loss) Treatment: IV fluids
66
Septic/Distributive Shock
Septicemia Bacterial endotoxins Caused by: injury to GI tract, dental dz, gram positive bacteria (release exotoxins) --> blood will get trapped by the sphincters Treatment: IV fluids, bacteriostatic antibiotics (tetracyclines)
67
Anaphylactic Shock
Can be caused by injectable vaccines or antibiotics Stimulates mast cells in resp. and GI tracts Release histamines --> vasodilation --> sphincters close Treatment: IV fluids, corticosteroids IV (reduce inflammation), +/- epinephrine
68
Neurogenic Shock
Neocortex overrides brainstem Mildest form: syncope (fainting) Can result from life threatening situations Humans are prone to this
69
Cardiogenic Shock
Caused by myocardial infection --> heart attack Humans are prone to this Failure of heart to pump blood adequately --> drastic decrease in C.O Treatment: cardiac regulator, inotropic drugs to increase C.O
70
Early Shock Signs
``` Tachycardia (up tp 240 bpm) Bounding pulses Bright mm Fast CRT Proper mentation (alert) ```
71
Compensatory Shock Signs
Tachycardia Pale mm Weak pulses Depressed mentation
72
Decompensatory Shock Signs
``` Variable HR Poor/absent pulses Prolonged CRT Pale mm Dull mentation (almost comotose) ```
73
Crystalloids
LRS, Normosol, 0.9% NaCL (PSS) | Cheaper
74
Colloids
Hetastarch- replacement blood product | Best option
75
Hypertonic Saline
7% NaCl
76
Pulse Sites for Equine
``` Transverse facial artery Facial artery (submandibular) Lateral/dorsal metatarsal artery (between hock and fetlock) *mostly anesthesia ```
77
Digital Arteries
Used to evaluate the condition of the horse's feet | Not used to palpate pulse
78
Venipuncture Sites for Equine
Jugular vein Transverse facial vein (should not be pulsating) Medial sacral vein ("tail bleeding", used in cattle)

A+P II (4 decks)

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