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VTS ECC Study Cards 2025 > Ventilation & Respiratory > Flashcards

Ventilation & Respiratory Flashcards

(93 cards)

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1
Q

Tidal Volume

A

Volume of air inspired with a given breath (10-20mL/kg)

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2
Q

Functional Residual Capacity

A

Volume of air that remains in the lung after normal expiration

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3
Q

Minute Volume

A

patients tidal volume x respiratory rate

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4
Q

Dorsal respiratory group

A

cells responsible for inspiration

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5
Q

Ventral respiratory group

A

cells responsible for expiration

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6
Q

Pneumotaxic center

A

Upper pons –> volume and rate

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7
Q

Limbic system

A

alter pattern of breathing

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8
Q

Chemoreceptors

A

responde to change in extracellular fluid H ion concentration
Increased H = stimulates ventilation
Decreased H = inhibits ventilation

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9
Q

Beta 2 receptors

A

Relax smooth muscle in the bronchi
Beta 2 agonists - bronchodilation

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10
Q

Haldane effect

A

Oxygenation of blood in lungs displaces CO2 from hemoglobin and increased removal of CO2
Left shift of oxygen-hemoglobin dissociation curve

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11
Q

Bohr effect

A

Tissue in need of O2 - has higher CO2 concentration and local pH = decrease in oxygen affinity from Hb and oxygen unloading = increased affinity for CO2 to Hb
(Right shift)

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12
Q

Hypoxia

A

Inadequate oxygen delivery to meet tissue metabolic demand = inadequate tissue perfusion, metabolic disturbances, lack of oxygen supply
5 types

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13
Q

5 types of Hypoxia

A

Hypoxemic
Hypemic
Stagnant/Circulatory
Histiotoxic
Metabolic

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14
Q

Hypoxemia

A

PaO2 < 80mmHg
Severe <60mmHg
Five categories

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15
Q

5 categories of hypoxemia

A

V/Q mismatch (elevated A-a gradient)
FiO2 decreased
Shunt (elevated A-a gradient) - responds poorly to oxygen supplementation
Hypoventilation
Diffusion Impairment (elevated A-a gradient)

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16
Q

Cheyne- Stokes breathing

A

brief periods of apnea followed by brief periods of hyerventilation (brain disease, cardiac disease, hypoxemia)

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17
Q

Kussmaul respirations

A

Increased depth of breathing with either slower or faster rate in response to metabolic acidemia (attempting to expire CO2 and correct acidosis) (DKA, late stage chronic kidney disease)

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18
Q

Apneustic respirations

A

Deep inspiration with a pause followed by brief expiration. (Ketamine in cats) (central neurologic disease (TBI))

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19
Q

5 times inspired rule

A

Healthy patients are said to have a PaO2 of approximately 5x what they inspire
(5xFiO2)

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20
Q

What does an increased A-a gradient indicate?

A

A problem getting oxygen from alveoli into the blood
Increases in states of V/Q mismatch, diffusion impairment, right to left shunting, increased age

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21
Q

Laryngeal Paralysis

A

Laryngeal nerve is disrupted, resulting in complete or partial failure of the arytenoid cartilages and vocal folds to abduct on inspiration and adduct on expiration

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22
Q

Collapsing Trachea

A

Progressive degenerative condition of tracheal cartilage resulting in excessive collapsibility of the trachea and ultimate flattening and thus narrowing of the tracheal lumen

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23
Q

Brachycephalic Airway Syndrome

A

Combination of stenotic nares, elongated soft palate, everted laryngeal saccules, hypoplastic narrow trachea

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24
Q

Pulmonary Contusions

A

Injury to lung capillaries usually after blunt force trauma that causes hemorrhage into alveoli and bronchioli

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25
Pneumonia vs pneumonitis
Pneumonia - inflammation of pulmonary parenchyma secondary to infection Pneumonitis - inflammation of pulmonary parenchyma in absence of infectious source
26
Feline Asthma
Hypersensitivity reaction in cats characterized by pulmonary bronchoconstriction, eosinophilic airway inflammation and airway edema
27
Bronchodilators
Albuterol Terbutaline Aminophylline
28
Aspiration pneumonia location
Right cranial or right middle lung lobe
29
Acute Respiratory Distress Syndrome (ARDS)
Acute inflammatory lung response that may be described as pulmonary manifestation of multiple organ dysfunction seen in critical illness
30
ARDS criteria
1. acute onset condition 2. bilateral opacities consistent with pulmonary edema on chest rads/CT 3. P/F ration <300 4. signs not explained by cardiac failure or fluid overload
31
ARDS severity
Mild 200-300 Moderate 100-200 Severe < 100
32
Lung Protective strategies
Low tidal volumes (6-8mL/kg) Low airway plateau pressure (<30cmH2O) Higher respiratory rates (35bpm) Higher peep (> or equal to5 cmH2O)
33
Pneumothorax
Accumulation of air in pleural space in sufficient quantity to increase pressure within pleural space and impede the lungs ability to expand and participate in gas exchange
34
Pleural effusion
accumulation of excess fluid within the pleural space
35
Effusion classifications
Pure transudate - low TP and cell count (hypoalbuminemia) Modified transudate - moderate TP and cells (HF, neoplasia, DH, lung lobe torsions) Exudate - High TP and cell count (hemorrhage, chylothorax, pyothorax)
36
Which is the most common cause of hypoxemia in cats and dogs
V/Q Mismatch
37
When listening to lung sounds, wheezing is indicative of what disorder
Narrowed respiratory passages
38
Which condition can cause a patient to have a normal PaO2 value but have impaired delivery of oxygen to tissues
IMHA
39
Which value represents a normal PF ratio
At sea level > or equal to 500
40
An effusion that has a total solids value of 2.9^g/dL would be classified as what type of effusion
Modified transudate
41
Conducting zone
trachea, bronchi, segmental bronchi, terminal bronchi (No alveoli, only delivers air)
42
Respiratory zone
Terminal bronchioles, respiratory bronchioles, alveolar ducts (lined with alveoli)
43
Lung Compliance
change in volume for the amount of pressure involved Elasticity or tendency for a structure to return to its original form Decreased compliance = stiffer lungs Increased compliance = looser lungs
44
Resistance
45
Indications for mechanical ventilation
1. severe hypoxemia despite oxygen supplementation 2. severe hypercapnia despite therapy 3. excessive respiratory effort and risk of respiratory fatigue or arrest 5
46
Control variables
Mode of inspiration Pressure, volume, flow, time of breath
47
Pressure controlled
Ventilator achieving a certain pressure in which the gas is pushed into the lungs over a set amount of time Pressure constant - volume and flow change
48
Volume controlled
Achieving a specified tidal volume over a set course of time Volume and flow constant - pressure created will depend on lungs
49
Phase variables
Initiation of inspiration, inspiration, termination of inspiration, expiration
50
Triggering
time triggered - vent is set a specific time interval patient triggered - when patients given effort in spontaneous breathing in which is detectable by vent
51
Pressure triggering
relies on a drop in airway pressure from patients efforts (creates a negative pressure in the chest)
52
Flow triggering
drop in expiratory flow through the vent is detected
53
Volume triggering
interprets a drop in airway circuit volume as air moving into the patient from spontaneous effort to initiate a breath
54
Manual triggering
the ability to deliver a breath outside of the set timings
55
Limiting
ability to limit values without ending the breath
56
Pressure limiting
Prevents pressure from rising above a set limit (useful in preventing lung tissue from being exposed to an excessive pressure)
57
Volume limiting
Prevents excessive tidal volumes
58
Cycling
the method by which the vent determines when to terminate the breath
59
Volume cycled
ends the breath when a set volume has been delivered
60
Time cycled
ends the inspiration phase based on time
61
Flow cycled
terminates when gas flow decreases to a set value
62
Pressure cycled
Ends inspiration when a preset value of pressure in the airway is reached
63
PEEP
positive end-expiratory pressure Prevent early airway closure
64
Spontaneous breaths
Initiated and cycled by the patient leading to determination of tidal volume by the patient
65
Mandatory breaths
breaths triggered and/or cycled by the vent, removing the choice of timing or size by the patient
66
Assisted breaths
breaths which the vent produces all or part of the breath to reduce the work of breathing
67
Breath modes
Continuous mandatory ventilation Intermittent mandatory ventilation Spontaneous ventilation modes
68
Continuous mandatory ventilation
Every breath given to a patient is a mandatory breath - Controlled ventilation - all breaths time triggered and do not take patient effort into consideration - Assist/control - trigger mandatory breaths at minimum breathing rate + provide patient triggered mandatory breaths in addition - Provides maximum ventilatory support used with most severe pulmonary disease
69
Intermittent Mandatory Ventilation
Time triggered mandatory breaths + pt is allowed to take spontaneous breaths - Synchronous intermittent mandatory ventilation - sync mandatory breaths to patient effort to prevent breath stacking
70
Continuous Spontaneous Ventilation
CPAP - positive pressure is applied to the airway throughout the breathing cycle (improve oxygenation, increase functional residual capacity and compliance) Spontaneous breathing Pressure support ventilation - Vent supplies constant pressure to airways during inspiratory phase of breathing (adequate resp drive but compromised strength)
71
What are the goals of mechanical ventilation?
Achieve arterial blood gas levels compatible with life (PaO2 80-100mmHg and PaCO2 35-50mmHg) with the lease harmful settings possible
72
Scalars
One value is traced over time 6 waveforms -
73
Loops
2 variables are traced against each other
73
Pressure waveforms
square when in pressure control exponential rise pattern when in volume control
73
Flow waveforms
Show positive values during inspiration Negative values during expiration
73
Maximum pressure in ET tube?
30cmH20- obstruct mucosal blood flow within the trachea
74
How long does it take for diaphragm to atrophy?
18 hours - allowing spontaneous breaths through a spontaneous breath trial to allow the stimulation of the diaphragm
75
Barotrauma
healthy tissues - PIP exceeds 30cmH20
76
Volutrauma
healthy tissues - TV exceeds 40mL/kg
77
Cardiovascular complications on vent
PPV compresses intrathoracic vessels and reduces venous return PEEP stretches pulmonary capillaries interlaced with pulmonary tissues increasing resistance against blood flow Reduced myocardial perfusion - compresses coronary vessels which reduces coronary perfusion pressure
78
Which part of the heart must overcome resistance of PPV and PEEP?
Right ventricles
79
What criteria are set for a spontaneous breathing trial?
Improvement of primary disease process P/F ratio >200 on 40%o2 or less PEEP <5cmH2O Adequate respiratory drive Hemodynamically stable Absence of major organ failure
80
Failure of spontaneous breathing trial
Tachypnea Severe hypoxemia Severe hypercapnia Tidal volume <7ml/kg Tachycardia Hypertension Hyperthermia or increase of> 1 degree C Anxiety Clinical judgement
81
Methods of exposing pt to increased work of breathing
Spontaneous breathing trial SIMV PSV
82
Stretch receptors
Airway smooth muscle when lung is distended - receptors active and result in a brief period of decreased respiration and potential apnea (Hering-Breuer reflex)
83
Irritant receptors
Stimulated by irritants such as smoke, cold, dust, noxious gases = rapid bronchoconstriction and hyperpnea
84
J receptors
line alveolar walls - active role in patients with dyspnea
85
Figure 8 tracing
Patient triggered a breath
86
Broken PV loop
Volume not returning to zero = leak in the circuit
87
Beaking
PV loop with pointed, narrowed inflection towards end of inspiratory = overdistension of lungs
88
Ventilator Induced Lung Injury
Higher pressure gradient outside the thoracic cavity than inside
89
90

VTS ECC Study Cards 2025 (13 decks)

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