Respiratory

Question 1

Shunt vs. Alveolar dead space

Answer 1

Shunt: perfusion without ventilation
Alveolar Dead Space: Ventilation without perfusion. Area where alveoli are ventilated
but not perfused

Question 2

Pneumothorax

Answer 2

Air in the pleural cavity.
Causes: Spontaneous, ruptured blebs, emphysema, trauma, tension.
Partial or complete collapse of the affected lung

Spontaneous: an air-filled blister on the lung ruptures

Traumatic: air enters through chest injuries

Tension: air enters pleural cavity through the wound on inhalation but cannot leave on exhalation, FATAL

Open: air enters pleural cavity through the wound on inhalation and leaves on exhalation, medical emergency

Question 3

Emphysema

Answer 3

Loss of lung elasticity, permanent enlargement of the air spaces, destruction of the alveolar walls & capillary beds, with hyperinflation of the lungs (The respiratory tissues)
Bleb/Bulla can lead to pneumothorax

Pink Puffer: Increase respiration to maintain oxygen levels
Dyspnea; increased ventilatory effort
Use accessory muscles; pursed-lip breathing (“puffers”)

Question 4

Chronic Bronchitis

Answer 4

inflammation of major and small airways and excessive mucous production in the large airways (The conducting airways)

“Blue Bloater”: show evidence of hypoxemia, cyanosis/edema

Question 5

Asthma

Answer 5

Chronic inflammatory disorder of the bronchial mucosa.

Causes bronchial hyperresponsiveness, constriction of the airways and variable airflow obstruction that is reversible.

Question 6

Pulmonary Edema

Answer 6

Excess water in the lung from disturbances of capillary hydrostatic pressure, capillary oncotic pressure, or capillary permeability
Most common cause of pulmonary edema: Left-sided heart disease

Clinical manifestations
Dyspnea, orthopnea, hypoxemia, and increased work of breathing, cough with pink/frothy sputum

Question 7

Pulmonary Emboli

Answer 7

Obstruction of the pulmonary artery or one of its branches by a thrombus/clot
Virchow’s Triad!! Venous Stasis, Hypercoagulability, and Venous Endothelial Disease

S/S:
Dyspnea is most frequent symptom
Chest pain
Pleuritic in origin
Sudden onset
May mimic MI (heart attack), angina, bronchopneumonia or heart failure

Question 8

Pneumothorax S/S

Answer 8

Chest pain (ipsilateral)
Tachypnea: rapid/shallow respirations
Dyspnea
Tachycardia
Asymmetrical chest movement
Hyperresonant chest percussion (a lot of air)
Decreased or absent BS on affected side
Hypoxemia

Question 9

ABG System

Answer 9

Use ROME
Respiratory= Opposite:
- pH is high, PCO2 is down (Alkalosis).
- pH is low, PCO2 is up (Acidosis).

Metabolic= Equal:

• pH is high, HCO3 is high (Alkalosis).
• pH is low, HCO3 is low (Acidosis).

Question 10

S/S of Emphysema

Answer 10

Dyspnea
Accessory muscle use 
Pursed-lip breathing
Prolonged exhalation
Barrel chest 
Weight loss

Question 11

S/S of Chronic Bronchitis

Answer 11

Dyspnea
↓exercise tolerance
Expiratory wheezes & crackles
Hypoxemia, hypercapnia
Cyanosis
Polycythemia
Peripheral edema