Respiratory system Flashcards
(111 cards)
1
Q
Name 2 products of Oxidation
A
- Water
- Carbon Dioxide
2
Q
What are the 4 principle functions of the respiratory system?
A
- Extract o2 from atmosphere and transfer it to the bloodstream and the lungs
- Excrete water vapour and co2
- Maintain the normal acid base status of the blood
- Ventilate lungs
3
Q
What are the 5 components of Inspired air?
A
- 79% Nitrogen
- 20% o2
- 0.04% co2
- 1% inert Gases
- Water vapour (variable)
4
Q
What are the 5 components of expired air?
A
- 79% Nitrogen
- 16% o2
- 4% co2
- 1% Inert gases
- Water vapour increased amount to saturation
5
Q
Is expired air resuscitation effective? If so why?
A
-Yes, because expired air still contains 16% o2
6
Q
What are the 8 components of the respiratory tract?
A
- Nose
- Pharynx
- Larynx
- Trachea
- Bronchi
- Bronchioles
- Alveolar ducts
- Alveoli
7
Q
What is the top of the larynx protected by?
A
-The epiglottis
8
Q
What is the function of the epiglottis?
2
A
- Opens for breathing
- Shuts when food/fluid being swallowed by upward movement of the larynx
9
Q
When does the protective mechanism of the epiglottis not operate?
A
-When PTs are unconscious
10
Q
Which part of the respiratory tract divides into the Bronchi?
A
-The trachea
11
Q
Which Bronchus is shorter?
A
The right is shorter than the left
12
Q
What do the bronchi branch into?
A
-Bronchioles (smaller tubes)
13
Q
What do the Bronchioles lead to?
A
-Alveolar ducts which end in air sacs (Alveoli)
14
Q
What surrounds the Alveoli?
A
A fine network of capillaries
15
Q
What happens in the network of capillaries that surround the alveoli?
A
An exchange of gases takes place across the endothelium (capillary wall)
16
Q
What are the lungs comprised of?
2
A
Alveoli
Connective tissue
17
Q
How many lobes does each lung have?
A
Left has 2
Right has 3
18
Q
What is the outer surface of the lung called?
A
The pleura
19
Q
What is the pleura continuous with?
A
The membrane lining of the inner surfaces of chest wall
20
Q
What moves over each other as the lung expands and relaxes?
A
The pleura and inner membrane lining of chest wall
21
Q
Where does external respiration take place?
A
In the lungs
22
Q
Where does internal respiration take place?
A
In the tissues
23
Q
Where does diffusion take place?
A
Internal and external respiration
24
Q
What is the process of diffusion?
A
Dissolved substances cross a semi permeable membrane from high to low concentration.
If two gases of different composition come into contact intermingling of gases takes place until composition is both the same.
25
What are the 2 things that happen in external respiration?
- o2 from inhaled air is absorbed into the blood via capillaries of the lung
- co2 is released from the blood into lungs & exhaled
26
What 2 things happen on internal respiration?
- blood and circulatory system carries o2 to body cells
| - O2 is given off for use by cells. Co2 is absorbed by the blood which is carried to lungs
27
How would you describe the process of normal quiet breathing?
Active, process involving muscle activity
28
How would you describe expiration?
Passive, relies on elastic recoil of lungs
29
What happens to the chest cavity when inspiration takes place?
It is enlarged
30
What happens when the chest cavity is enlarged by process of inspiration?
The pressure within it causes air to enter lungs via airways.
31
What change causes air to be drawn in?
The change of pressure in the chest cavity
32
What are the 2 main factors that enlarge the chest cavity?
- flattening downward movement of the diaphragm
| - upward and outward movement of ribs, caused by action of intercostal muscles
33
Where is voluntary control of respiration controlled?
Cerebral cortex
34
When would an example of voluntary respiration control take place?
(2)
Speaking and singing
35
What is voluntary control of respiration overriden by?
| 2
Chemical and nervous activity
36
What is involuntary respiration controlled by?
| 3
- Nerve cells in brain stem
- Respiratory centre in the Medulla oblongata
- Pneumotaxic centre in pons varolii
37
The cells in the respiratory centre are covered with what?
Inspiration
38
What is concerned with the inhibition of inspiration?
The cells of the pneumotaxic centre
39
With regards to nerves how does inspiration take place?
Nerve impulses originating In respiratory centre pass via phrenic nerves to diaphragm via intercostal nerves to intercostal muscles resulting in contraction
40
How does expiration happen?
Nerve endings in the lungs sensitive to stretch are stimulated when lungs are inflated, impulses are passed to pneumotaxic centre
41
Where are chemoreceptors situated?
Walls of aorta
| Carotid bodies
42
What are chemoreceptors sensitive to?
Partial pressure of co2 in blood
| Partial pressure of o2 in blood
43
Chemoreceptors and respiratory centre are stimulated by what?
An increase in partial pressure of co2 in blood
44
In chemoreceptors, what does an increase in partial pressure of co2 in blood result in
Increased ventilation
45
What does a small reduction in the partial pressure of o2 do?
Increase ventilation
46
What does a substantial reduction of partial pressure of o2 do?
Depressive effect (decrease ventilation)
47
What happens to patients suffering COPD in hypoxic drive?
They become insensitive to level of co2. The brain uses hypoxia as stimulus to breathe
48
What is the normal adult breathing rate?
16-20
49
What is the normal infant/child respiratory rate?
24-40
50
What are the 4 examples of when breathing rates increase?
Exercise
Fever
Conditions affecting normal functions of lung (pneumonia, bronchitis)
Shock
51
What are the 2 occasions where respiratory rate is decreased?
Brain conditions
Head injury
CVA
Drugs (morphine, barbiturates)
52
What are abnormal respiratory conditions?
Dyspnoea
Apnoea
Hypoxia
Hypercarbia
53
How does respiratory compromise occur?
When blood contained in capillaries of both lungs stops or interrupts it's normal process of o2 absorption
54
What 3 things does respiratory compromise affect?
```
Respiratory tract (air passage)
Respiratory mechanism (ribs, muscles, diaphragm)
Respiratory centre
```
55
What are the 5 causes of respiratory compromise?
```
Obstruction of air passages
Chest or lung trauma
Paralysis of respiratory nerves and muscles
Non o2 atmospheres
Lung disease and illness
```
56
What 8 factors can cause obstruction of air passages?
Tongue during unconsciousness
Maxillo facial injs
Blood and vomit
Inhaled foreign bodies (food, false teeth)
Suffocation
Extreme pressure to neck (hanging, suffocation)
Drowning
Internal swelling of throat tissues (burns, scalds, stings, disease)
57
What 2 things can chest trauma be caused by?
```
External compression (sand, masonry, vehicle damage, crowd pressure)
Blast injuries
```
58
How may paralysis of respiratory nerves and muscles occur? 5
```
Electrocution
Head/spinal injuries
Poisons (cyanide, weed killers, toxic fumes)
Drugs (barbiturates, morphine)
Diseases (tetanus, poliomyelitis)
```
59
What 4 things can result from non o2 atmospheres?
Gases
Chemical fumes
Smoke
Altitude
60
In Lung diseases, what examples can lead to chronic respiratory failure? 5
```
Emphysema
Pulmonary oedema
Acute pneumonia
Asthma/bronchitis
Continuous fits
```
61
What 6 signs would you notice in respiratory compromise of an obstructive or mechanical origin?
```
Difficult/noisy breathing
Cyanosis
Dilated pupils
Congestion of veins of head/neck
Fits
Gradual LOC
Petechial haemorrhages
```
62
What 4 signs would you notice when dealing with respiratory compromise of paralytic origin?
Progressive deterioration in rate/depth of breathing (quiet unless obstructed by tongue)
Increasing cyanosis
Dilated pupils
Gradual LOC
63
What 5 ways would you manage respiratory compromise?
```
Open airway
CPR if necessary
High concentration o2
Recovery position of unconscious. Semi recumbent if conscious
Reassurance
```
64
What 2 ways do respiratory conditions cause hypoxia?
Airway obstruction
| Impaired perfusion of alveoli
65
What are the 2 main obstructive airway conditions!
Asthma
| COPD
66
What happens in obstructive airway compromise caused by COPD and asthma?
Pulmonary tissue causes obstruction to free flow of air into lungs
67
What are the 2 types of COPD?
Chronic bronchitis
| Emphysema
68
What is the definition of bronchitis?
Inflammatory condition affecting the airways
69
Describe acute bronchitis
Viral or bacterial. short lived experienced mainly by elderly and young children
70
Describe chronic bronchitis
Bronchial mucosal glands secrete excess mucous which PT coughs up but obstructs airways.
71
Least 3 things can result from chronic bronchitis?
Lung damage may result in
Right heart failure
Peripheral oedema
Cyanosis
72
What are the 14 possible signs of COPD
```
Productive cough
Cyanosis (blue bloaters)
Tachycardia
Tachypnoea
Dyspnoea
Accessory muscle useage
Dilated pupils and slow to react
If hypoxia severe LOC reduced
Oedema
Normal BP or slightly raised
Slow cap refill
Reduced sats
Rhonchi and wheezes
Domicillary o2 useage
```
73
How would you manage COPD? 9
```
Open airway using suction if necessary
Salb for acute exacerbation
O2
Patient in most comfortable position (upright)
Prepare to ventilate/CPR
Encourage cough, collect examples of sputum
Monitor condition
Document treatment and measures
Smooth journey to hosp
```
74
What 2 things happen in emphysema?
Distension of alveoli
| Destructive changes in their membranes
75
Describe what happens in emphysema
Lung tissue loses their elasticity and airway loses muscular integrity and collapses. Leading to air not entering alveoli.
76
What are the 14 signs of emphysema
```
Thin
Normal skin colour (pink puffer)
Tachycardia
Tachypnoea
Dyspnoea
Use of accessory muscles and difficulty exhaling
Bp elevated
Cyanosis in acute attack
Pursed lips on expiration
Confusion and anxiety due to hypoxia
Wheezing and crackles mainly on inhalation
Abnormal large chest
Cardiac dysrhythmias develop
Oedema
```
77
How would you manage emphysema? 8
```
Open airway
Salb for acute exacerbation
O2
Most comfortable position (usually upright)
Prepare to ventilate/CPR
Monitor condition
Documenting treatment and measures
Smooth drive
```
78
What is the definition of asthma
Narrowing of medium-small sized airways due to muscle spasm, oedema and blockage by inflammatory cells
79
What are the 4 signs of acute asthma
Unable to complete sentences
Resps >25
Pulse >110
Peak flow 33-50% of predicted best value
80
What are the 10 signs of life threatening asthma attack
```
Exhaustion
Confusion
Coma
Silent chest
Cyanosis
Feeble resp effort
Bradycardia
Hypotension
Peak flow
```
81
How would you manage asthma 13
```
Open airway
Upright positioning
O2 high concentration to relieve hypoxia. O2 given from home to amb due to cold air exposure risk.
O2 94+
Salb
Calming and resting
Peak flow before and after
Consider causes of intrinsic and extrinsic or mixed and remove cause
Coach resps
Monitor changes
Rapid and smooth drive
Complete documentation
Professional handover
```
82
What is a good way of measuring airflow obstruction?
Peak flow meters
83
With regards to peak flow measurements, can a patient use different methods of using peak flow scale?
Yes
84
After how many minutes post salbutamol would you retest peak flow?
20mins
85
By how much % is an acceptable increase in peak flow considered post treatment?
15%
86
What does salbutamol/terbutaline serve to do?
Reverses bronchospasm in acute asthma attack, smoke inhalation & acute exacerbation of COPD.
87
How much salbutamol can you give an adult as initial dose?
5mg
88
How much salbutamol can you give a 6-12 year old on initial dose?
5mg
89
How much salbutamol can you give ages 0-6years?
2.5mg
90
What is there a risk of in COPD patients and being given salbutamol?
Acidosis
91
How many minutes do you give a neb to a COPD Patient and why?
6 mins.
| Limits risk of hypercapnic respiratory failure
92
What conditions cause impaired perfusion of the alveoli?
| 4
Pneumonia
Pulmonary embolism
Pleurisy
TB
93
What industrial ling diseases cause impaired perfusion of alveoli?
4
Pneumoconiosis
Silicosis
Asbestosis
Byssinosis
94
What is pleurisy?
Acute inflammation of lungs caused by viruses or bacteria. Follows a cold especially on elderly or chronic bronchitis sufferers.
95
What are the signs of pneumonia?
| 4
Breathing increased/shallow
Cough up blood stained sputum
Coughing and attempts to breathe deeply cause distressing chest pain
Temp rises rapidly and patient flushed
96
What are the three methods of managing pneumonia?
Ensure open airway
O2 to relieve hypoxia
Monitor vitals
97
What is pleurisy?
Inflammation of pleura caused by bacterial infection. Occurs most often with pneumonia
98
How is pleurisy treated?
Same as pneumonia
Open airway
O2 to relieve hypoxia
Monitor vitals
99
What is a pulmonary embolism?
Blood clot blocking pulmonary artery depriving part of the ling of blood supply.
100
What is a PE a result of?
DVT
101
What can PE result in?
Pulmonary infarction
102
Who is at greatest risk of PE?
| 5
```
Elderly
Bedridden
After childbirth
After abdo surgery
Contraceptive pill
```
103
What are the 8 signs of PE?
```
Dyspnoea
Tachypnoea
Pleuritic pain
Apprehension
Tachycardia
Cough
Haemoptysis
Leg pain/clinical DVT
```
104
How do you manage PE?
Ensure open airway
O2 or NOO
Prepare to perform CPR
105
What is TB?
Chronic lung infection which can persist for several years. Patient may not have symptoms
106
What are the 4 signs of TB?
Fever
Weight loss
Cough
Haemoptysis
107
What are HIV and homeless people susceptible to?
TB
108
How would you define hyperventilation syndrome?
Rate of breathing in excess of metabolic needs and higher than that needed to maintain normal co2 levels In blood.
109
When can hyperventilation syndrome occur?
| 4
PE
DIABETIC KETOACIDOSIS
ASTHMA
HYPOVOLAEMIA
110
What are the 6 signs of hyperventilation syndrome?
```
Acute anxiety
Tetany (cramps) including sharp vending of wrist and ankle joints
Numbness and tingling of mouth/lips
Carpopedal spasm
Aching chest muscles
Light headed
```
111
How would you manage hyperventilation syndrome?
| 5
```
Open airway
If signs of cyanosis reduced loc or reduced o2, give o2 and treat underlying cause
Calm approach
Coach resps
DO NOT ENCOURAGE PAPER BAG
```
