Respiratory 1 Flashcards
(98 cards)
1
Q
Capillaries occupy 70-80% of ______ surface area
A
alveolar
2
Q
normal respiratory rate for newborn?
A
30-60
3
Q
normal respiratory rate for early childhood?
A
20-40
4
Q
normal respiratory rate for late childhood?
A
15-25
5
Q
normal respiratory rate for adults
A
10-15
6
Q
how many alveoli in the normal human lung?
A
300 million
7
Q
what is an average tidal volume?
A
500 ccs
8
Q
how much do we breathe per minutes?
A
6 Liters (similar to cardiac output)
9
Q
what is the normal saturation?
A
100%
10
Q
when do hear rales and crackles?
A
Will hear on inspiration
11
Q
when do you hear rhonchi and wheezing?
A
Hear on expiration
12
Q
if you hear wheezing on inspiration what type issue is it?
A
Upper airway
13
Q
what is the I:E ratio?
A
1:2
14
Q
do you breathe quicker in or out?
A
In
15
Q
what does cobblestoning of pharynx indicate?
A
Allergies
16
Q
why do people turn cyanotic
A
vasoconstriction; want to shunt all the blood to the brain
17
Q
when percussion is dull, what can it be?
A
Flesh of the lung (full of crap, not air) consolidation
lots of fluid (pleural effusion)
18
Q
If percussion is hyperessonance?
A
Lots of air (pneumothorax or emphysema)
19
Q
when will you feel fremitus?
A
Consolidation
20
Q
what are normal breath sounds?
A
Vesicular
21
Q
when will you hear bronchial breath sounds?
A
Sounds like blowing through a hose
consolidation (pneumonia)
22
Q
what does clubbing look like
A
convex nail (spoon)
23
Q
what is clubbing a sign of?
A
chronic hypoxia
24
Q
do you normally use other muscles besides the diaphragm to breath?
A
No
25
is hypoxia usually a late or early finding of respiratory failure?
Late sign
26
what is low pO2 in tissues?
Hypoxia
27
what is low oxygen in the blood?
Hypoxemia (see on ABGs)
28
what is normal p)2
70-80 mm Hg
29
what does the last number of the pH usually correlate with?
Carbon dioxide level
30
how much percentage of the air is oxygen?
21%
31
5 causes of hypoxia?
V/Q mismatch
altitude (rare unless lungs not working well)
alveolar hypoventilation (end stage process)
decreased diffusion (problem w/ alveoli and vessel)
Shunt (anatomic)
32
3 main parts of the lungs?
Bronchus
Alveoli
Capillaries
33
things that cause decreased diffusion
pulmonary fibrosis
| emphysema
34
what is V/Q mismatch
too much blood, not enough air
| too much air, not enough blood
35
what does 90 hemoglobin saturation correspond to a PO2 of?
60
36
is there a lot of difference b/w 90-100 hemoglobin saturation?
No, corresponds to about 60 and above O2
37
No problem with lung parenchyma
Not moving air in and out
Elevated pCO2, decreased pO2
Alveolar hypoventilation
38
when do you mostly see alveolar hypoventilation?
Drugs
obesity
CNS injury
neuromuscular weakness
39
blood flow goes through without having a chance at being oxygenated?
Shunt
40
does increased FIO2 help with shunts?
No
41
2 diseases causing shunts
Intracardiac defects
| Dense consolidated pneumonia
42
when can you see V/Q mismatch
PE
COPD
pneumonia
asthma
43
The relative ventilation and perfusion of all alveoli determines the PO2 of the blood.
V/Q mismatch
44
does delivering oxygen help with V/Q mismatch
yes
45
what is FVC?
forced vital capacity
| Amount of air able to expire
46
what is FEV1?
Amount of air able to expire in 1 sec
47
what is RV?
residual volume
| Amount of air left in lung after exhalation
48
What is TLC?
Total lung volume
49
what fall under the category of restrictive lung disease? flesh of the lung problem
Pulmonary fibrosis
| Obesity
50
What fall under the category of obstructive lung dz?airway problem
Asthma
| COPD
51
how much of the air should come out in expiration in the first second?
75% of the air
52
what is (forced) vital capacity?
as much of the air you can possibly empty out
| forced- where you push the air out
53
Caused by a variety of lung diseases
| Interstitial Lung Diseases, silicosis
Restrictive Defect
54
what diseases do you see in New Mexico a lot scarring lung disease?
mining
55
If you have a normal lung volume, can you have a restrictive lung disease?
No
56
If obstructive lung disease FEV1 decreases more than....
FVC
57
In an restrictive lung dz what are low?
FEV1
| FVC
58
why do you look at/ count the posterior ribs?
fixed to the spine
59
where does the film go on the x-ray?
on the anterior aspect and beam goes from the back
60
Air in pleural space; visceral pleural line
Pneumothorax
61
who is at greatest risk of a pneumothorax?
tall thin males
smokers
62
what can also mimic a pnuemothorax?
COPD (hyper-lucent) air within lung
63
tx for a pneumothorax?
chest tube placement
64
after a tension pneumothorax what are patients placed on?
vents
65
don't see diaphragm on x-ray, structures being pushed away from the slide.
pleural effusion
66
local problems, usually only found on one side of the chest
pus, cancer, blood
67
the higher the LDH the more what?
cell dying; if this is high in a fluid it is probably from cell dying in that system
68
1 of what categories must you have for exudates?
LDH fl/s ratio 0.6
protein fl/s ratio >0.5
pleural fluid LDH >2/3 upper limit normal LDH
69
what is empyema?
pus in pleural
70
what must you have to qualify a hemothorax?
Hct of fluid (in pleura) >50% serum Hct value
71
what can cause pulmonary fibrosis?
```
scarring of lung due to injury
chronic aspiration
inhalation injury
ARDS
Infection
occupational exposures
collagen-vascular related (lupus, RA, vasculitis)
```
72
Person presents with dyspnea and desaturation w/ exercise. Have nonproductive cough, clubbing
**"Velcro rales" at bases** on inspiration
Pulmonary fibrosis
73
what is a VQ scan good for?
rule out pulmonary embolism
74
what does a VQ scan show?
inhale nuclear stuff
put nuclear stuff in IV
see if they match or not
75
what must you compare the VQ scan to?
chest x-ray (look for mass)
76
what can provide false positives of VQ scans?
asthma
obstructie airway
obstructing tumors
77
when should you not do a V/Q scan?
severe obstructive lung dz
78
what is the best test for patients w/ abnormal CXR?
Spiral CT
79
what is a good way to look for clots of the lower extremities (where 75% of PEs come from)?
doppler
80
are pulmonary arteriograms used?
No, spiral CTs are used; however this is the gold standard
81
how long does tx for a PE last?
at least 6 months
82
drugs used to treat PE?
Heparin/ lovenox followed by Coumadin
83
to evaluate persistent infiltrates on CXR or mass.
Bronchoscopy (only in the bronchi)
84
to evaluate upper airway, vocal cord problems
laryngoscopy
85
to biopsy mediastinal nodes in CA work up. Cut and go behind the sternum
Mediastinoscopy
86
to evaluate type of pleural effusion
Thoracentesis
87
Used primarily in evaluating nodules, masses for malignancy.
PET scan; if it lights up then it may be malignant
88
what type lung dz will there be with obesity
restrictive lung disease
89
if something very sudden happen what problem is it usually?
Vascular
90
causes of acute dyspnea (cardiac)?
Acute MI
CHF
Cardiac tamponade
91
High pressure on the right side of the heart
Pulmonary HTN
92
when will you hear wheezing?
Any narrowing of the airway
| PE
93
wheeze heard on one side of the chest, heard on inspiration and expiration.
endobronchial obstruction
94
How do you make a diagnosis of vocal cord dysfunction
Diagnosis of VCD is from indirect or direct vocal cord visualization during an episode, during which abnormal adduction can be documented
95
what is the number one reason to see a doctor in U.S.?
Cough
96
what are the 4 most common reasons for chronic cough?
Asthma
GERD
allergic rhinitis
Lisinopril
97
most common reason on hemoptysis?
Bronchitis
bronchogenic carcinoma
bronchiectasis
98
red, frothy, mixed with sputum.
| Alkaline
Hemoptysis
