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BSNC 1000 > Module 5 > Flashcards

Module 5 Flashcards

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1
Q

Ventilation

A

physiological process of breathing

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2
Q

Gas exchange

A

process of oxygen transport from lungs to tissue cells and carbon dioxide from tissue cells to lungs

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3
Q

How does gas exchange occur?

A

Diffusion across pressure gradients

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4
Q

Respiratory membrane

A

capillary membrane, basement membrane, alveolar wall

typically it is very thin

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5
Q

Anoxia

A

total depletion of oxygen in the tissues. will lead to cellular death

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6
Q

Hypoxia

A

depletion of oxygen levels in the tissues.

can be caused by impaired perfusion or low oxygen in arterial blood

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7
Q

Hypoxemia

A

reduced oxygen levels in arterial blood

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8
Q

Types of chemoreceptors

A

Central

Peripheral

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9
Q

Central Chemoreceptors

A

Located in the medulla oblongata of the brainstem

Monitor CO2 levels in cerebrospinal fluid

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10
Q

Peripheral Chemoreceptors

A

Located in the arch of the aorta + carotid bodies

Monitor O2 levels in cerebrospinal fluid

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11
Q

What stimulates breathing?

A

Indirectly: Carbon dioxide oxygen
Directly: Hydrogen ions

reduction in pH triggers breathing due to the carbonic anhydrase equation

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12
Q

Normal Inspiratory Muscles

A

Diaphragm

External Intercostal Muscles

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13
Q

Forced Expiratory Muscles

A 
Abdominal Muscles (transverse, oblique)
Internal Intercostal Muscles
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14
Q

Forced Inspiratory Muscles

A

Sternocleidomastoid

Scalene

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15
Q

Types of alveolar cells

A

Type 1 - provide surface area
Type 2 - produce surfactant
Macrophages - phagocytocize cellular debris

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16
Q

Anatomy of bronchial tree

A

Trachea + bronchi/larger bronchioles are smooth tissue with cartilagenous rings –> plates

Smaller bronchioles + alveoli = smooth muscle

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17
Q

Alveoli anatomy

A

Alveoli = singular sac
Alveolar septum = tissue that separates alveoli (contributes to surface area)
Alveolar sac = cluster of alveoli
Alveolar duct = continuous with respiratory bronchiole

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18
Q

Bronchial Tree

A 
Major Bronchi (right/left)
Lobar Bronchi
Segmental Bronchi
Bronchioles
Terminal Bronchioles
Respiratory Bronchioles
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19
Q

Two Respiratory Zones

A

Conducting -> move air

Respiratory -> participate in gas exchange

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20
Q

Conducting Zone

A 
nose
pharynx
larynx
trachea
bronchi
terminal bronchioles
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21
Q

Respiratory Zone

A

respiratory bronchioles
alveolar duct
alveoli

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22
Q

Methods of Oxygen transport

A

dissolved in plasma - 3%

bonded with heme in hemoglobin - 97%

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23
Q

Methods of Carbon Dioxide transport

A

dissolved in plasma - 7%
bonded with heme in hemoglobin - 20%
bicarbonate ions - %

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24
Q

Carbonic Anhydrase Equation

A

carbon dioxide diffuses across plasma membrane of red blood cells and enters cytosol

in cytosol CO2 + H2O –> H2CO3 (carbonic acid) –> H+ & HCO3 (bicarbonate)

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25
Enzyme that catalyzes water and carbon dioxide
Carbonic anhydrase
26
Factors increasing oxygen affinity
low temperature high pH high partial pressure of oxygen low partial pressure of carbon dioxide
27
Factors decreasing oxygen affinity
high temperature low pH low partial pressure of oxygen high partial pressure of carbon dioxide
28
Atmospheric air
a combination of gases 70% Nitrogen 21% Oxygen Water Vapor Other gases
29
Pneumothorax
Collapsed lung | Occurs when there is a change in the intrapleural pressure
30
Anemia
a collection of disorders characterized by low red blood cells
31
Polycythemia
creation of new blood cells
32
What is Sp02
oxygen saturation 95-100% measures the saturation of available hemoglobin
33
What is PaO2
partial pressure of oxygen in arterial blood normally 80 mm Hg measures amount of oxygen dissolved in blood plasma
34
4 Processes of Respiration
Alveolar Ventilation Alveolar Perfusion Alveolar-capillary diffusion Gas transport in circulation
35
Factors impairing ventilation
Damage to CNS --> respiratory muscles require continuous innervation Disorder to nasopharynx/lungs Reduction in pulmonary/alveolar elasticity Changes in atmospheric O2 (less O2 at higher altitudes) Narrowed airways - inflammation, occlusion Pulmonary edema
36
Right-sided Heart Failure
occurs due to increased pulmonary blood pressure right ventricle has to work harder to pump blood which leads to ventricular hypertrophy inefficient pumping of blood causes blood to backflow into vena cava causing peripheral edema
37
Pulmonary edema
caused by left-sided heart failure trauma to chest pneumonia
38
Pulmonary embolism
blockage in the pulmonary artery | usually caused by deep vein thrombosis in the legs
39
Clinical Manifestations of COPD
``` fatigue confusion high blood pressure high respiratory rate increased work of breathing hypoxia/hypoxemia hypercapnia --> acidosis cyanosis clubbing of nails due to prolonged hypoxia barrel chest (emphysema) productive cough asymmetric thorax ```
40
Normal Respiratory Rate
10-20 breaths/minute
41
Problem-Based History
``` cough dyspnea (shortness of breath) especially on exertion chest pain while breathing productive cough fatigue anxiety ```
42
Cues of Impaired Ventilation/Gas exchange
tripod position anxiety changes in mentation
43
Innervation of diaphragm
Phrenic Nerve - Cervical spine
44
Innervation of external intercostal muscles
Nerves originating from Thoracic spine
45
Lung Sounds
Stridor - bronchoconstriction Rhonchi - blockages in airway Crackles - fluid in lungs Wheezes
46
Diagnostic Tests
Lab tests (arterial blood gases, complete blood count, sputum exam, skin test, pathologic) Radiologic Pulmonary Function Tests
47
Treatment
``` Oxygen Therapy Pulmonary respiratory community groups Rest therapy Respiratory muscle training Medication Nutrition therapy Diaphragmatic breathing Works simplification ```
48
Respiratory center
located in the medulla oblongata/pons
49
Dorsal Respiratory Center
controls rhythm of breathing
50
Ventral Respiratory Center
controls inhalation
51
Respiratory lobule
terminal bronchiole, alveolar duct, alveoli, pulmonary blood vessels + lymphatic vessels
52
Factors contributing to alveolar-capillary diffusion
surface area of alveoli thinness of respiratory membrane diffusion distance pressure gradients
53
Parasympathetic Effects on Respiratory System
airway constriction | vasodilation
54
Sympathetic Effects on Respiratory System
airway dilation | vasoconstriction
55
Factors Affecting Lung Ventilation
Chest Wall Compliance | Lung Compliance
56
Lung Volumes and Capacities
Tidal Volume Vital Capacity Forced Expiratory volume
57
Factors Affecting Lung Compliance
elastin and collagen fibers water content surface tension (surfactant)
58
Forced Expiratory Capacity
75-85% of vital capacity in one second maximum amount of air you can exhale in one second
59
Types of emphysema
Panacinar | Centriacinar
60
Causes of COPD
Smoking Environmental pollutants (physical, chemical) Genetic (lack of production of alpha-1 anti-trypsin) Frequent childhood respiratory infections Age
61
Hypercapnia
Elevated levels of CO2 in the blood
62
COPD Treatment
``` Rest therapy Oxygen therapy Diet (reduced carbohydrates) Respiratory muscle retraining Medication ```
63
Pack years
used to measure how much a person has smoked over time
64
Pack year equation
packs/day x years OR of cigarettes smoked per day/20 x years (1 pack = 20 cigarettes)
65
What is PaCO2
35-45 mm HG normally
66
Ventilation Perfusion Ratio
Ventilation/Perfusion can be affected by reduced ventilation or reduced perfusion Ideally this number should be 1 for optimal function
67
Causes of hypoxemia
hypoventilation mismatch between ventilation/perfusion impaired perfusion impaired ventilation
68
SpO2 of COPD patients
88-92%
69
COPD
chronic disease that causes obstruction to expiration leads to hypoxemia and hypercapnia includes two diseases: chronic bronchitis and emphysema
70
Chronic Bronchiits
``` inflammation of the airways hypertrophy of the mucus glands/goblet cells lead to an overproduction of mucus fibrosis of bronchiolar wall clogs the airway impeding ventilation V/Q mismatch --> hypoxemia, cyanosis chronic productive cough (sputum) repeated respiratory infections ```
71
Emphysema
destruction of elastic tissue distal to the terminal bronchioles caused by elastase digesting elastin fibers --> weakens alveolar wall, alveolar duct, alveolar septum reduces surface area/compliance of alveoli inhibiting ventilation no V/Q mismatch pursed light breathing increased anteroposterior thorax (barrel chest) increased work of breathing
72
Tidal Volume
amount of hear inhaled/exhaled in one breath | ~500 mL
73
Forced Vital Capacity
maximal amount of air you can exhale after maximal inhalation
74
Residual volume
amount of air remaining in lungs following exhalation
75
Forced expiratory volume
amount of air you can exhale in 1 sec | should be 75-85% of expiratory reserve volume
76
What is lung compliance
lung compliance is the ability of the lungs to expand during inspiration
77
Three factors decreasing lung compliance
water content in alveoli (infection) increased surface tension in lungs (reduced surfactant) loss of elastin, collagen fibers
78
Factors affecting alveolar-capillary diffusion
surface area concentration gradient of gases diffusion distance (thinness of respiratory membrane, edema)
79
Consequences of impaired gas exchange
increased work of breathing hypoxemia/hypercapnia hypoxic cell injury
80
Compensatory Mechanisms
increased respiratory rate polycythemia increased heart rate --> increased blood pressure redistribution of blood from peripheral extremities to core systems
81
Normal PaCO2
35-45 mm HG
82
Recommended nutrition for COPD patients
high calorie high protein smaller meals if dyspneic

BSNC 1000 (10 decks)

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