Exam 3 Part 2 RESP 132.txt

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Exam 3 Part 2 RESP 132.txt
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2011-11-11 02:15:14
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RESP 132 Exam
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Part 2 of Exam 3
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  1. These scans of the lungs are superior to the conventional chest x0ray films in the visualization of pneumonias and related pathologic changes in the hila and pleura.
    CT scan.
  2. is caused by an infection around the airway. Causes scaring and puylls the airways widely open. Shows up as a very characteristic pattern with the blood vessel appearing to be small stone set against the much larger ring of bronchial tissue.
    Bronchiectasis
  3. the diagnosis of emphysema or COPD cia conventional radiography based on pulmonary hyperexpansion and bullae formation is how accurate?
    65-80%
  4. Ct scans are how accurate in diagnosis of emphysema or COPD?
    90%
  5. The role of MRI in the diagnosis of intrathoracic lung disease has been limited by breathing artifacts caused by?
    slow cameras
  6. The one area that MRI is better than a CT sacn is in the evauation of?
    Mediastinal and hilar masses. (EX: hilar lymph node enlargement from enlarged hilar blood vessels.)
  7. Is MRI better than CT scan in the evaluation of the invasion of lung cancer to the cell wall?
    Yes, can determine precise positioning of the tumors and involment of surrounding areas.
  8. These are obtained by measuring gamma radiationemitted from the chest after radiopharmaceuticals are injected into the bloodstream and inhaled into the lung.
    Radionuclide Lung Scanning.
  9. Lung scans are useful in for studying the distribution of ?
    vetilation and perfusion
  10. what is the major clinical application of lung scanning?
    pulmonary embolism
  11. Lung scanning: distribution of perfusion is measured by attaching radioactive particles to albumin molecules that are so large the cannot get through?
    lung capillaries.
  12. lung scanning: Distribution of ventilation is measured by having the patient breathe a?
    radioactive gas.
  13. Uses a glucose analog attached to a prositron emitter. Patient fasts for several hours, injected with the raidopharmaceutical labeled sugar water, and then is allowed ti remain suopine and perfectly quiet for about an hour. Metabol. active tissue will take up the surgar and show up hot/black on film. Tumors and infections have high metabolism.
    Positron emmision tomography
  14. in evaulating x-rays a system on using the alphabet a-z has been recomened to remind the examiner which parts of the chest film to?
    study
  15. is a useful primarily in determinung whether a pulmonary infiltrate is in anatomic contact with a heart border or the diaphram.
    Silhouette sign
  16. infiltrates in the lung will blur the edges of the heart or the diaphragm where the infiltrate touches them. this observation helps to locate the infiltrate in tthe lung.
    Silhouette sign
  17. Interstitial fibrosis causes a decrease in lung compliance that results in the patient breathing with a smaller ____.
    VT
  18. As the VT decreases, the respiratory rate must increase to maintain?
    adequate ventilation
  19. Usually identifies fine inspiratory crackles that do not clear with deep breaths or changes in position. The crackles are more noticble over the lower lobes.
    Auscltation
  20. Final diagnosis of interstitial lung disease often requires?
    an open lung biopsy
  21. Redistribution of pulmonary vasculature with engorgement of the upper lobe vessels, fluid collection in the dependent portions of the lung, an increase in the ratio of the width of the heart at its greatest span to the width of the thorax: the cardiothoracic ratio (C/T), and development of kerley's B lines cause changes in chest film with?
    Early CHF
  22. Infections, occupational, neoplastic, congential or familial, metabolic, physical agents, circulatory, immunologic cause?
    Interstitial lung diseases
  23. During edit
    place in Box 10-2
  24. These lines are usually seen in the right base, are less than 1mm thick and approx. 1-2 cm in length. They are horizontal and start at the periphery, extanding into the lung approx. 1-2 cm. tthey are pleural lymphatic vessels filled with fluid.
    Kerley's B Lines
  25. Minimal loss of volume, Usually lobar or segmental distribution, homogeneous density, air bronchogram is the airway leading to the consolidated area is open are what?
    Raidographic signs of consolodation
  26. Reduced resonance to percussion over the involved area, bronchophony and bronchial breath sounds, crackles often heard over the involved area, whispered voice sounds increased/egophony present, tachypnea, and fever are?
    physical findings associated with consolidation in a lung
  27. Lung consolidation is most often caused by ___________ that fills the lung tissue with fluid so that there is little loss of volume/atelectasis.
    Bacterial pneumonia
  28. When the patient has signs and symptoms suggestive of an acute or chronic disorder such as mycardial infarction or congestive heart failure you should?\
    obtain and ECG
  29. often used as a screening tool to determine the patient's health status before major surgery.
    ECG
  30. Depolarization of the ventricles is represented by?
    the QRS complex
  31. The QRS is taller than the?
    P Wave
  32. Ventricular repolarization is seen as?
    the T wave
  33. This wave is normal upright and rounded.
    T wave
  34. Just after the T wave, but before the next p wave, a small deflection occurs know as?
    U wave
  35. this wave is thought to represent the final phase of ventricular repolarization. In most cases it is not seen/
    U wave
  36. usually consist of several distinct waves, each of which has a ltter assigned to it as a label.
    QRS complexes.
  37. If the first deflection of the QRS complex is downward ( negative) it is labeled as?
    A Q wave.
  38. the initial upward (possitive) deflection on a QRS is called?
    An R wave
  39. The first negative deflection following an R wave is called?
    an S wave.
  40. If the QRS complex has a second positive deflection it is labeled?
    R' R Prime. The same for all second waves.
  41. A negative deflection can only be called a Q wave only if it is _______?
    The first wave of the complex.
  42. In clinical practice, each ventricular depolarization complex is called?
    QRS complex (whether it has all three waves or not)
  43. the QRS complex is important to evaluate in the ECG because it reflects the electrical activity of?
    the ventricles
  44. The steps to follow when interpreting ECG:
    identify the heart rate, evaluate the rhythm, Note P waves, Measure the PR interval and width of QRS complex, Inspect the ST segment in all leads, Identify the mean QRS axis, and Assess the waveform morphology
  45. Heart rythms that are lower than 60 beats/min.
    bradycardia
  46. heart rythms that are over 100 beats/min.
    tachycardia
  47. Atrial flutter, Atrial fibrillation, second dgree AV block, third degree AV block can do what to the P waves?
    The casue can make more P waves preceeding the QRS complex.
  48. ST segement elevation may indicate?
    Mycocardial injury
  49. ST segement depression may indicate?
    Myocardial ischemia
  50. The ST segment is measured from the?
    J Point
  51. the junction between the QRS complex and the ST segement.
    J Point
  52. is a benign dysrhythmia that meets all teh criteria for normal sinus rhythm except that the rhythm is irregular. it usually does not produce symptoms in the patient and requires no treatment.
    Sinus Dysrhythmia
  53. Systematic evaluation: Rate = 60-100 beats ( maybe <60), Rhythm = irregular, P waves = normal; each followed by QRS, PR interval =
    Sinus Dysrhythmia
  54. This occurs when an ectopic focus in the atrium usurps the pacemaking function of the SA node and paces the heart, usually at an abnormally rapid rate of 160-249 beats/min.
    Paroxysmal Atrial Tachycardia (PAT)
  55. This appears on the monitor as a series of normal looking QRS complexes, each assosiated with a P wave. P wave may be obscured by the preceding T wave.
    PAT (Paroxysmal Atrial Tachycardia)
  56. PAT is seen in what two kinds of patients?
    W/ and W/o heart disease
  57. Emotional Stress, mitral valve disease, rheumatic Heart disease, digitalis toxicity, or the use of alcohol, caffine, or nicotine couse cause?
    PAT
  58. Systematic Evaluation: Rate = 160-240 beats/min, Rhythm = regular, P Waves = abnormal configuration, PR interval = usually not measureable, QRS complex = < 0.20 sec. in width.
    PAT
  59. is a dysrhythmia that produces a very distinctive ECG pattern, usually caused by a rapidly firing ectopic site in the atria that presents as a characteristic sawtooth pattern between normal-appearing QRS complexes.
    Atrial Flutter
  60. Results in diminished atrial filling time, which results in minimal atrial assitance in filling the ventricles.
    Atrial Flutter
  61. Appears on the monitor as a series of broad QRS complexes, occuring at a rapid rate, each without an identifiable P wave. Condition originates from an ectopic focus in the ventricles associated with enhanced automaticity ir reentry. It is a run of three or more consecutive PVC's.
    Ventricular Tachycardia
  62. Sytematic Evaluation: Rate = 140-300 beats/min, Rhythm = regular, P waves = not associated with the QRS complex, PR interval = not measureable, QRS complex = abnormal and > 0.12 sec. in width
    Ventricular Tachycardia
  63. Is the presence of chaotic, completely unorganized electrical activity in the ventricular myocardial fibers. Produces a characteristic wavy, irregular pattern on the ECG monitor.
    Ventricular Fibrillation
  64. Systematic Evaluation: Rate = none, Rhythm = irregular and chaotic waves, PR interval = none, QRS complex = no waves appear with regularity on tthe ECG tracing.
    Ventricular Fibrillation
  65. is cardiac standstill and is invariably fatal unless an acceptable rhythm is rapidly restored. is one criteria used for determination of clinical death, Reconized on the ECG monitor as a straight or almost straight line.
    Asytole
  66. is not a discrete dysrhythmia but rather an electromechanical condition that can be diagnosed clinically. there is a dissociation of the electrical and the mechanical activity of the heart.
    Pulseless electrical Activity (PEA)
  67. Tension pneumothorax, cardiac trauma, hypothermia, and severe electrolyte or acid-base disturbances are among the most common causes of what?
    PEA
  68. Is any rhythm that does not produce a pulse with the exceptin of ventricular tachycardia, ventricular fibrillation, and asytole.
    PEA

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