pulmonary disorders (S.G)

Question 1

what does a high spinal cord injury affect in the respiratory system?

Answer 1

The phrenic nerve which controls diaphragm breathing

- will need to be on a ventilator

Question 2

how much does diaphragm help you breath?

Answer 2

diaphragm breathing accounts for 80% of breathing

Question 3

Define compliance

Answer 3

lungs ability to expand and inflate (more compliant=easier to breath)

Question 4

Dz with DECREASED compliance

Answer 4

ARDS: stiff lung with 02 support

Question 5

Dz with INCREASED compliance

Answer 5

COPD: easy to bring in air but hard to get rid of it

Question 6

Negative Intrapleural Pressure

Answer 6

keeps lungs inflated

Question 7

What happens if there is an increase in pressure in the pleural space?

Answer 7

pneumothroax

Question 8

total lung volume

Answer 8

5500-6000cc

Question 9

Tidal volume

Answer 9

amount of air inhaled and exhaled in one breath

Question 10

Normal tidal volume

-if compromised?

Answer 10

500-800 ml or 6-10 ml/kg

4-8 ml/kg

Question 11

Functional residual capacity (FRC)

Answer 11

the amount of air left in the lungs AFTER a normal exhalation

Question 12

FRC equation

Answer 12

expiratory reserve volume + residual volume

3-5 cm (PEEP opens airway)

Question 13

conducting airways

Answer 13

No gas exchange. just a PASSAGEWAY
-prevents foreign material from passing
“dead space”

Question 14

Type 1 epithelial cells

Answer 14

GAS EXCHANGE

Question 15

Type 2 epithelial cells

Answer 15

produces SURFACTANT

Question 16

role of surfactant

Answer 16

decreases surface tension of alveoli and eases work of breathing

Question 17

Low ventilation & High Perfusion

Answer 17

LOW V/Q ratio

Question 18

Low ventilation & High Perfusion causes

Answer 18

“clogged up”

pneumonia, mucus plug

Question 19

High ventilation & Low perfusion

Answer 19

HIGH V/Q ratio

Question 20

High ventilation & Low perfusion causes

Answer 20

cardiogenic shock, MI

-pump not working, no perfusion but still breathing

Question 21

Oxyhemoglobin curve

Answer 21

relationship between dissolved O2 (PaO2) and hgb bound O2 (SaO2)

Question 22

Critical zone

Answer 22

PaO2

Question 23

Shift to the LEFT

Answer 23

GOOD

Question 24

Shift to the LEFT patho

Answer 24

high O2 sats, increased hgb affinity for O2

-tissues dont need as much d/t low energy use

Question 25

Shift to the LEFT 3 s/s

Answer 25

- hypothermia - alkalosis - low PaCO2

Question 26

Shift to the RIGHT

Answer 26

BAD

Question 27

Shift to the RIGHT patho

Answer 27

low O2 sats, low hgb affinity for O2 - need O2!! excessive energy use - lose too much O2 too quickly

Question 28

Shift to the RIGHT 3 s/s

Answer 28

- hyperthermia - acidosis - high PaCO2

Question 29

Hypoxemia: PaO2 normal values

Answer 29

80-100 if

Question 30

PaO2 values if older than 60

Answer 30

``` -Age-60= x 80-x= new PaO2 value ```

Question 31

compensatory mechanisms for hypoxemia

Answer 31

- polycythemia | - increased C.O

Question 32

Is hypoxemia ok for COPD patients

Answer 32

hypoxemia is their stimulus to breathe. | Hyperoxygenation will cause a loss of respiratory drive

Question 33

Oxygen toxicity S/S

Answer 33

dyspnea, SOB , chest pain, dry cough

Question 34

early sign on oxygen toxicity

Answer 34

substernal chest pain with deep breaths

Question 35

cause of oxygen toxicity

Answer 35

breathing O2 >50% for more than 24 hours

Question 36

what to put patients on if FiO2 >50%

Answer 36

PEEP

Question 37

converting L of air to FiO2

Answer 37

(4 x # L of air) +20 ex) 5 L of air (4 x 5) + 20= 40 % FiO2

Question 38

room air FiO2 %

Answer 38

21%

Question 39

normal values: - pH - paCO2 - HCO3

Answer 39

-7.35-7.45 35-45 22-26

Question 40

Respiratory Alkalosis

Answer 40

DECREASED CO2

Question 41

Respiratory alkalosis causes

Answer 41

anxiety pregnancy hyperventilation -anything that causes you to INCR. excretionof CO2

Question 42

Respiratory alkalosis txt

Answer 42

give sedative breath in paper bag decrease anxiety decrease tidal volume rate

Question 43

Respiratory Acidosis

Answer 43

INCREASED CO2

Question 44

Respiratory acidosis causes

Answer 44

COPD pneumonia anything that decreases your bodies ability to excrete CO2

Question 45

Respiratory acidosis txt

Answer 45

Bronchodilators mucolytics suction increase tidal volume rate

Question 46

Metabolic Alkalosis

Answer 46

INCREASED HCO3

Question 47

Metabolic Alkalosis causes

Answer 47

vomiting | NG suction

Question 48

Metabolic Alkalosis tx

Answer 48

replace electrolytes | GIVE DIAMOX

Question 49

Metabolic Acidosis

Answer 49

DECREASED HCO3

Question 50

Metabolic Acidosis causes

Answer 50

diarrhea | DKA - kidneys not working

Question 51

Metabolic Acidosis tx

Answer 51

Insuline Bicarb Dialysis for renal failure

Question 52

if it exists your body by going DOWN (diarrhea)

Answer 52

pH goes DOWN- ACIDOSIS

Question 53

if it exits your body by going UP (vomit)

Answer 53

pH goes UP- ALKALOSIS