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Flashcards in Respiratory 1 Deck (98):
1

Capillaries occupy 70-80% of ______ surface area

alveolar

2

normal respiratory rate for newborn?

30-60

3

normal respiratory rate for early childhood?

20-40

4

normal respiratory rate for late childhood?

15-25

5

normal respiratory rate for adults

10-15

6

how many alveoli in the normal human lung?

300 million

7

what is an average tidal volume?

500 ccs

8

how much do we breathe per minutes?

6 Liters (similar to cardiac output)

9

what is the normal saturation?

100%

10

when do hear rales and crackles?

Will hear on inspiration

11

when do you hear rhonchi and wheezing?

Hear on expiration

12

if you hear wheezing on inspiration what type issue is it?

Upper airway

13

what is the I:E ratio?

1:2

14

do you breathe quicker in or out?

In

15

what does cobblestoning of pharynx indicate?

Allergies

16

why do people turn cyanotic

vasoconstriction; want to shunt all the blood to the brain

17

when percussion is dull, what can it be?

Flesh of the lung (full of crap, not air) consolidation
lots of fluid (pleural effusion)

18

If percussion is hyperessonance?

Lots of air (pneumothorax or emphysema)

19

when will you feel fremitus?

Consolidation

20

what are normal breath sounds?

Vesicular

21

when will you hear bronchial breath sounds?

Sounds like blowing through a hose
consolidation (pneumonia)

22

what does clubbing look like

convex nail (spoon)

23

what is clubbing a sign of?

chronic hypoxia

24

do you normally use other muscles besides the diaphragm to breath?

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