Respiration Part Duex

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ambirc
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Respiration Part Duex
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2012-09-05 08:55:38
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Respiration Part Duex
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  1. Functional measurements to assess lung diseases
    • [1] Flow-volume loops 
    • [2] Pressure-volume 
    • [3] Oscillometry
    • [4] Arterial blood gas
  2. [a] Expiratory flow-volume relationship COPD
    • {a}FEV1/FVC- below normal
    • {b}Maximal flow rates- below normal
    • {c}RV- increased
    • {d}FRC- increased
    • {e}TLC- increased
  3. Expiratory flow-volume relationship RLD
    • {a}FEV1/FVC- normal or above normal
    • {b}Maximal flow rates- below normal
    • {c}RV- decreased
    • {d}FRC- decreased
    • {e}TLC- decreased
  4. Pressure-volume relationship 
    • [a]
    • Examines the lung elastic recoil or compliance (DV/DP)
    • {1}Compliance
    •      {a}COPD- lungs not stiff
    •      {b}RLD- lungs stiff
    • {2}TLC
    •      {a}COPD- increased
    •      {b}RLD- decreased
  5. Oscillometry
    • [a] Effort-independent and noninvasive
    • pulmonary function testing of airways resistance
    • [b] Uses superimposed sound waves over normal
    • breathing patterns to examine proximal and distal airway caliber
    • [c] Detects early pathological changes of the small
    • airways
    • [d] Examines effect of drug in different lung
    • regions
  6. Arterial blood gas -Parameters analyzed in arterial blood gas include
    • {1}Partial pressure of oxygen (PaO2)
    •     {a} Measures the pressure of dissolved O2 in the blood
    •     {b} How well O2 moves from lung airspaces into the blood
    • {2} Partial pressure of carbon dioxide (PaCO2)
    •     {a}Measures the pressure of dissolved CO2 in the blood
    •     {b} How well CO2 moves out of the body tissues into the blood
    • {3} pH (acidity)
    •     {a} Measures hydrogen ions (H+) in blood
    • {4} Bicarbonate (HCO3-)
    •     {a} HCO3- is a buffer that keeps the pH of blood from becoming too acidic or too basic
    • {5} Oxygen content
    •      {a}A measure of the amount of O2 in the blood
    • {6} Oxygen saturation
    •     {a} Measures how much of the hemoglobin in red blood cells is carrying O2
  7. Reasons to measure arterial blood gases
    • {1} Check for severe breathing problems and lung diseases
    •      {a}COPD -Asthma Chronic bronchitis Emphysema
    •      {b} RLD - Cystic fibrosis, Idiopathic fibrosis
    •      {c}Evaluate affect of treatment on lung disease
    •      {d} Determine need for extra O2 or help with breathing (mechanical ventilation)
    •      {e}Diagnose other non-pulmonary conditions which affect acid-base levels such as Heart failure, Kidney failure, Uncontrolled diabetes, Sleep disorders, Severe infections,  Drug overdose
  8. Other diagnostic procedures for lung diseases
    • [a]To permit visualization of lungs and diaphragm during respiration
    •     {1}Bronchoscopy
    •     {2}Chest x-ray
    •     {3}Computed tomography (CT) scan
    •     {4} Fluoroscopy
  9.  Sniff test
    <1> Checks for weakness of right and left diaphragms which can reduce the ventilatory capacity of the lungs

    <2> During inspiration, downward movement of the diaphragm on the intact side increases intraabdominal pressure and decreases intrathoracic pressure, leading to an upward movement of the paralyzed side
  10. Upper respiratory diseases -  Regardless of cause, common signs/symptoms include
    • [1] Inflammation/irritation
    •     [a] Sinuses
    •     [b] Nose
    •     [c] Throat
  11. Upper respiratory diseases Causes include
    • [1] Upper respiratory tract infections
    •     [a] Microorganisms -Bacterium, Fungus,Virus
    • [2] Allergies
    • [3] Nasal polyps 
    • [4] Snoring
    • [5]Obstructive sleep apnea
  12. Nasal polyps 
    • [a] Noncancerous sac-like growths of inflamed
    • tissue lining nasal mucosa or sinuses
    • [b] Persons with polyps often complain about having
    • a cold that has lasted for months or years
    • [c] Large polyps can block the sinuses or nasal
    • airways
  13. Nasal polyps Causes include
    • {1} Aspirin sensitivity
    • {2} Asthma
    • {3} Chronic sinus infections
    • {4} Cystic fibrosis
    • {5} Allergic rhinitis (hay fever)
  14. Nasal polyps  Symptoms include 
    • {1}Mouth breathing
    • {2}Nasal obstruction
    • {3} Reduced or complete loss of sense of smell
    •  {4} Runny nose
  15. Nasal polyps Treatments include
    • {1}Intranasal glucocorticosteroids
    • {2} Oral glucocorticosteroids
    • {3} Antibiotics
    • {4} Surgical removal
    •     {a} Reoccurrence of polyps may still recur
  16.  Snoring
    • [a]
    • An exaggerated breathing sound

    • {1} Causes include
    •     {a}Nasal congestion
    •     {b}Postnasal drip
    •     {c} Inflamed sinuses
  17. Obstructive sleep apnea
    • [a] A condition in which a person has episodes of blocked breathing during sleep
    • [b] It is the most common sleep disorder
    • [c] A person with obstructive sleep apnea often is not aware of the apneic episodes during the night
    • [d] Often, family members, especially spouses, witness the periods of apnea
  18. Pattern of sleep 
    • {1}Heavy snoring begins after falling to sleep
    • {2}Airways collapse or secession of breathing (>10 seconds)
    • {a} Apnea is followed by a sudden attempt to breathe and a change to a lighter stage of sleep
    • {3} Sleep is fragmented or disrupted, not restful
    • {4} Leads to daytime drowsiness
    • {5} Pattern repeats frequently throughout the night
  19. Obstructive sleep apnea  Diagnostic tests
    • {1}Polysomongraphy
    • {2}Arterial blood gases
    • {3}ECG
    • {4}Echocardiogram
    • {5} Thyroid function studies
  20. Obstructive sleep apnea Causes include
    • {1}Shape of the palate and jaw
    • {2}Large tonsils and adenoids in children
    • {3}Large neck or collar size
    • {4}Large tongue
    • {5}Nasal obstruction
    • {6}Obesity
    • {7}Alcohol and/or sedative usage
  21. Obstructive sleep apnea Main symptoms
    • {1} Abnormal daytime sleepiness including falling asleep at inappropriate times
    • {2}Awakening unrefreshed in the morning
  22. Obstructive sleep apnea Other symptoms
    • {1}Depression
    • {2}Memory difficulties
    • {3}Morning headaches
    • {4}Personality changes
    • {5}Poor concentration
    • {6}Restless and fitful sleep
    • {7}Frequent awaking during the night to urinate
    • {8}Insomnia
  23. Obstructive sleep apnea Treatments
    • {1}Lifestyle changes
    •     {a}Avoid alcohol or sedatives at bedtime
    •     {b}Avoid sleeping on back
    •     {c}Lose weight
    • {2}Surgical options
    •     {a}Uvulopalatopharyngoplasty (UPPP)
    •         <1>Removes excess tissue at the back of the throat
    •     {b}Tracheostomy
    •     {c}Endoscopic sinus surgery
    •     {d}Somnoplasty
    •         <1> Uses radiofrequency energy to shrink affected areas

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