Respiratory System

Question 1

What is the definition of hypoxemia?

Answer 1

A PaO2 of less than 80 mmHg (decreased oxygen content in the blood)

Question 2

What constitutes severe hypoxia?

Answer 2

A PaO2 of 60 mmHg or less (decreased oxygen content in the tissues)

Question 3

The atmosphere is made up of what percentage of oxygen?

Answer 3

21%

Question 4

The atmosphere is made up of what percentage of nitrogen?

Answer 4

78%

Question 5

The volume of gas normally inspired with a given breath is known as what?

Answer 5

Tidal volume (Vt)

Question 6

What is a patients appropriate tidal volume?

Answer 6

Between 10-20mL/kg (slightly less with a cat)

Question 7

What does the following equation represent?

Ve = Vt x Vf

Answer 7

Minute volume (total ventilation) equals the patients tidal volume times their frequency (rate of breathing)

Question 8

What diseases can be associated with dull or absent lung sounds?

Answer 8

Pleural space disease; severe lung consolidation of lung parenchyma, pleural effusion, pneumothorax

Question 9

What are possible causes of increased breath sounds, wheezes or crackles?

Answer 9

Pulmonary parenchymal diseases: aspiration pneumonia, ALI, ARDS, fluid overload, congestive heart failure, and pulmonary thromboembolism.

Question 10

Risks factors for the development of ALI or ARDS include:

Answer 10

SIRS, sepsis, infection, smoke inhalation, near drowning, severe trauma.

Question 11

What percentage an SpO2 constitutes hypoxemia?

Answer 11

An SpO2 of less than 95% or a partial pressure of oxygen (PaO2) of less than 80 mm Hg

Question 12

Acute lung injury or ARDS can be identified using what formula?

Answer 12

PaO2 to FiO2 ratio

Question 13

ALI may be suspected is patients with a PaO2 to FiO2 ratio of what?

Answer 13

< 300

Question 14

ARDS may be suspected in patients with a PaO2 to FiO2 ratio of what?

Answer 14

< 200

Question 15

How is a shock index calculated?

Answer 15

Heart rate divided by blood pressure

Question 16

What shock index result can identify shock in both dogs and cats?

Answer 16

Shock index of > 1 in dogs and > 1.6 in cats.

Question 17

What is the normal inspiration to expiration ratio?

Answer 17

1:2 meaning a patient exhales twice as long as it inhales in normal breathing

Question 18

Increased inspiration time can be an indication of what?

Answer 18

Upper airway obstruction or extrathoracic pathology

Question 19

Increased expiration time can be an indication of what?

Answer 19

Lung pathology like pneumonia or intrathoracic pathology

Question 20

What type of breathing is associated with the chest and abdomen moving together?

Answer 20

Synchronous breathing

Question 21

What type of breathing is associated with the chest and abdomen moving opposite of one another?

Answer 21

Asynchronous breathing

Question 22

Asynchronous breathing is often a sign of pathology located where?

Answer 22

In the pleural space

Question 23

Synchronous breathing is often a sign of pathology located where?

Answer 23

Inside the lungs

Question 24

Define restrictive breathing patterns and when you might see it.

Answer 24

Short and shallow breaths indicating pleural space disease

Question 25

Define Kussmaul breathing and when you might see it.

Answer 25

Slower very deep breathing pattern. May see this is diseases causing severe metabolic acidosis like DKA or renal disease.

Question 26

Define stridor

Answer 26

A high pitched sound produced by turbulent airflow through the UPPER airway (partial airway obstruction).

Question 27

Define stertor

Answer 27

Abnormal low pitched sound produced lower in the airway (partial airway obstruction)

Question 28

How much hemoglobin is required in the body to show physical signs of cyanosis?

Answer 28

5g/dL

Question 29

Define hypoxia

Answer 29

When metabolic demand EXCEEDS oxygen delivery

Question 30

What is the oxygen flow rate range for nasal cannulas?

Answer 30

50-150mL/kg/min

Question 31

Hypocapnia can commonly be caused by what?

Answer 31

Decreased cardiac output

Question 32

Under normal circumstances, a patient that has an EtCO2 of 40 mmHg is expected to have a PaCO2 of approximately:

Answer 32

42-47 mmHg.

EtCO2 will be 2-5 mmHg less than PaCO2.

Question 33

What are common causes of HYPOcapnia?

Answer 33

Hyperventilation, decreased cardiac output and carbon dioxide production, and metabolic acidemia resulting in respiratory alkalosis.

Question 34

What are common causes of HYPERcapnia?

Answer 34

Hypoventilation, rebreathing of carbon dioxide, or increased carbon dioxide production.

Question 35

What are consequences of HYPERcapnia?

Answer 35

Systemic vasodilation, increased cardiac output, increased heart rate, increased blood pressure, respiratory acidemia, metabolic alkalosis, electrolyte changes, neurological dysfunction, cerebral vasodilation, increased cerebral blood flow and increased intracranial pressure, narcosis and death.

Question 36

What are consequences of HYPOcapnia?

Answer 36

Vasoconstriction of cerebral blood vessels resulting in decreased intracranial pressure (can be positive). If too low, can also compromise cerebral blood flow and cerebral oxygen delivery.

Question 37

What is the name of the acupuncture point that’s attempting to be stimulated to encourage respiration called?

Answer 37

Governing Vessel 26 (GV 26) located between the nares at the top of the nasal philtrum.

Question 38

Expired carbon dioxide is directly proportional to what?

Answer 38

Pulmonary blood flow.

Capnograph: Ideal monitor for measuring effectiveness of chest compressions during CPR.