Respiratory

Question 1

The most important part of the system is the

Answer 1

alveoli. That’s where there’s gas exchange. Everything else is just a conduit to the alveoli.

Question 2

alveoli: there are Type 1 and type 2

Type 2 cells are

Answer 2

especially important

Question 3

Surfactant is to

Answer 3

decrease surface tension so that the alveoli can expand, otherwise they’d be stuck together.

Question 4

Right side of heart has much lower pressure than left side, because

Answer 4

it just has to push blood to the lungs which shouldn’t have a lot of pressure (unless there’s disease).

Question 5

Oxygen does not go into solution, that’s why we need

Answer 5

hemoglobin

Question 6

CO2 however can go into

Answer 6

solution

Question 7

Under normal conditions alveoli and capillaries are in

Answer 7

direct contact.

Question 8

Cyanosis is a very very

Answer 8

late sign

Question 9

Dyspnea is subjective,

Answer 9

patient tells you if it happens.

Question 10

Orthopnea

Answer 10

dyspnea when they’re laying down.

Question 11

Paroxysmal nocturnal dyspnea-

Answer 11

wake up at night short of breath.

Question 12

Assessing for minor heart failure

Answer 12

You’re laying down and then all the blood comes up from your legs and can cause minor heart failure, so ask how many pillows do you need to sleep with and do you wake up short of breath.

Question 13

Kussmaul-

Answer 13

sign of metabolic acidosis - blowing off CO2

Question 14

Cheyne-stokes -

Answer 14

can see it in very old and all ____?

Question 15

Hyperthermia ____ the bond between hemoglobins and O2

Answer 15

weakens

Question 16

Larger the A-a gradient, the less likely it is the

Answer 16

O2 is gonna help them.

Question 17

tension pneumothorax.

Answer 17

This is when not only is the one lung shrinking, but it keeps getting pushed because the amount of air keep building which squashes the good lung and the great vessels. Trachea also shifts over. BP drops. Can happen in COPD, ventilator patients. treatment is to release the air that’s causing the continued tension.

Question 18

Friction rub is usually

Answer 18

inflammation of the pleura

Question 19

Flail chest

Answer 19

broken ribs causes a section of the chest to move parodoxically

Question 20

ARDS-

Answer 20

fluid accumulation to the lungs between alveolus and capillary, no surfactant production, so you have trouble ventilating, you can’t have O2 exchange.

Question 21

ARDS- you initially have

Answer 21

resp alkalosis but later get resp acidosis. There’s also a bunch of other manifestations.

Question 22

Absent BS on one side, shock, distended jugulars, tracheal deviation

Answer 22

Tension pneumothorax

Question 23

Multiple causes including nasal or tonsillar hypertrophy, obesity, genetic predisposition

Answer 23

obstructive sleep apnea

Question 24

Several contiguous ribs broken 2-3 or more places

Answer 24

flail chest

Question 25

Indication of LV failure, CHF

Answer 25

rales

Question 26

Due to decrease RR or decreased tidal volume, increased pCO2 (and hypoxia)

Answer 26

Hypoventilation

Question 27

Can cause respiratory failure (MG, GB, ALS, SCI, etc)

Answer 27

Neuromuscular patho

Question 28

Post-op atelectasis, aspiration pneumonia, Ventilator-associated pneumonia

Answer 28

Considered iatrogenic

Question 29

Interstitial edema, shunting, decreased compliance, decreased surfactant, refractory hypoxemia

Answer 29

Patho of ARDS

Question 30

Night sweats, cough, weight loss, hemoptysis, fever

Answer 30

Tuberculosis

Question 31

Air, blood, exudate between pleural layers

Answer 31

“Collapsed” lung

Question 32

heard first on expiration, worse if inspiration

Answer 32

Wheezing

Question 33

PE, CHF, hypoventilation, pneumonia, shock

Answer 33

Examples of V/Q mismatch

Question 34

Hypoxia, shock, fever, anxiety, pain, acidosis

Answer 34

Causes of hyperventilation

Question 35

Bronchial responsiveness increased, inflammation

Answer 35

Asthma

Question 36

Blood: right ventricle to left ventricle without adequate O2 uptake

Answer 36

Pulmonary shunting (physiologic)

Question 37

Increased mucus formation, air trapping in alveoli

Answer 37

Emphysema

Question 38

Bronchodilation, increased volume

Answer 38

SNS pulmonary effects

Question 39

Pulmonary fibrosis, COPD, ARDS, pneumonia, age

Answer 39

Cause decreased lung compliance

Question 40

Can be idiopathic or associated with lung diseases

Answer 40

Pulmonary hypertension

Question 41

Check ET tube placement; check perfusion

Answer 41

EtCO2 (capnography)

Question 42

200 times more affinity to Hbg than O2

Answer 42

Carbon monoxide (CO)