Card Set Information

2014-01-28 16:04:16
Anesthesia Surgery

key points
Show Answers:

  1. Respiration
    oxygen is supplied to and used by body cells, carbon dioxide is eliminated
  2. Ventilation
    movement of gas in and out of the alveoli
  3. 1 gram of hemoglobin carries how much oxygen at max?
    1.36 mL
  4. TV
    Tidal Volume
  5. Tidal Volume
    vol of gas passing into&out of lungs in one normal respiration
  6. this measures CO2 level as animal breathes out
  7. CO2 range

    • below 18= too alkaline (shock)
    • above 40= too acidic
  8. prevents friction and reduces heat from excess movement around the lungs
    pleural fluid
  9. general anesthetics will always suppress
    • respiration
    • cardiovascular function
  10. eupnea
    normal quiet breathing
  11. dyspnea
    labored breathing
  12. hyperpnea
    fast and or deep respiration
  13. polypnea
    rapid, shallow, panting
  14. apnea
    non-permanent cessation of breathing
  15. hypopnea
    slow and or shallow breathing
  16. apneustic respiration
    long, gasping inspirations w/ several subsequent ineffective exhalations

    commonly seen with Ketamine
  17. biot respiration
    sequences of gasps, apnea, and several deep gasps
  18. cheyne-stokes respiration
    increase in rate and depth, then becomes slower, followed by brief period of apnea
  19. kussmaul respirations
    regular, deep respirations w/out pause
  20. SPO2
    concentration of oxygen attached to hemoglobin

    (idea of how well oxygen is being distributed to the body)
  21. PO2
    concentration of oxygen free in the plasma
  22. PCO2
    concentration of CO2 free in plasma
  23. DO2
    adequate O2 delivery
  24. VO2
    reduced O2 consumption
  25. Inspiratory Reserve Volume
    vol of air that can be inspired over and above normal tidal vol (deep breath before going under water)
  26. IRV
    inspiratory reserve volume
  27. Expiratory Reserve Volume
    amount of air that can be expired by forceful expiration after a normal tidal expiration (air expelled to sit at bottom of pool)
  28. ERV
    expiratory reserve volume
  29. Residual Volume
    air remaining in lungs after most forceful expiration (cause body to float to top of water)

    no matter how hard the animal tries, lungs cannot be completely emptied of air--residual vol always remains
  30. RV
    residual vol
  31. normal tidal vol
    5-10 mL/#
  32. Minute Volume
    amount of gas moved per min

    150-250 mL/kg/min
  33. Minute Volume=
    RPM x TV
  34. PPV
    partial pressure ventilation

    breathing for the animal
  35. RQ
    respiratory quotient

    RQ= CO2/ O2
  36. Inspiratory Capacity
    amount of air that a person can breathe beginning at the normal expiratory level and distending lungs to the max amount
  37. IC
    inspiratory capacity
  38. Functional Residual Capacity
    amount of air remaining in lungs at end of normal expiration
  39. FRC
    functional residual capacity
  40. Vital Capacity
    max amount of air can expel from lungs after first filling the lungs to max extent then expiring to max extent
  41. VC
    vital capacity
  42. Total Lung Capacity
    max vol to which lungs can expand with greatest possible inspiratory effort
  43. TLC
    total lung capacity
  44. inspiratory capacity=
    IC= TV + IRV
  45. functional residual vol=
    FRC= ERV + RV
  46. vital capacity =
    VC= IRV + TV +ERV
  47. total lung capacity=
    TLC= VC + RV
  48. phonation
    voice production
  49. secondary functions of respiratory system
    • voice production (phonation)
    • body temp regulation
    • acid-base balance
  50. what happens to the environment the higher the CO2?
    more acidic (lower pH)
  51. what happens to the environment the lower the CO2 levels?
    more alkaline (higher pH)
  52. hyperventilation creates what kind of environment?
  53. alkalosis
  54. acidosis
  55. body's methods to maintain neutral state
    • blood buffers (release sodium bicarbonate via pancreas)
    • respiration (brings in more O2 than CO2)
    • kidney (retains more + ions like Na, excretes - ions like H and Cl)
  56. causes of metabolic acidosis (pH lower)
    • diarrhea (loss of sodium bicarbonate)
    • ketosis (starvation)
    • severe infectious diseases (septicemia)
    • renal insufficiencies (CIN)
    • admin of acid drugs (antibiotics)
    • shock
  57. respiratory acidosis (pH lower)
    increase in CO2 resulting from hypoventilation with retention of CO2
  58. excess CO2 in blood
  59. body attempts to correct acidosis (H&CO2 retention, bicarbonate ion loss) by increasing respirations to:
    • remove CO2
    • conserve bicarbonate ions
    • excrete hydrogen ions
  60. metabolic alkalosis (pH higher)
    increase in 02 and sodium bicarbonate
  61. metabolic alkalosis (pH higher) causes
    • vomiting (loss of Cl ions, retention of Na ions)
    • corticosteroid overdose
  62. body will attempt to correct metabolic alkalosis by:
    slowing respiration allowing kidneys to excrete bicarbonate ions and retain H ions
  63. respiratory alkalosis (pH higher)
    increase in O2

    causes: hyperventilation=abnormally low loss of CO2
  64. atmospheric air
    • 79% Nitrogen (78.08)
    • 20% Oxygen (20.95)
    • 0.03% Carbon dioxide
  65. passage of gas from alveoli to RBC
    • surfactant lining is phospholipid produced by inner lining of alveoli
    • alveoli epithelium
    • capillary endothelium intercellular clefts
    • plasma
    • RBC membrane

    *distance from surfactant lining to RBC is less than 1 micron, very small distance allowing for rapid movement of CO2&CO2 as they are both lipophilic
  66. inspired air
    • O2= 20.95
    • CO2= 0.03
    • RQ= 0.002 (approx. 700/1)
  67. expired air
    • O2= 16.30
    • CO2= 4.5
    • RQ= 0.276 (approx. 4/1)
  68. partial pressure
    pressure of each individual gas

    abbreviated by putting a P before the chemical symbol for the gas (P02)
  69. exchange of gas in alveoli
    passive diffusion (higher concentration to lower)
  70. these are the central respiratory centers located in the medulla and pons
    • cardioinhibitory center
    • vasomotor center
  71. peripheral chemoreceptors/pressoreceptors located at
    aortic arch and carotid sinus

    chemoreceptors- measure concentrations of 02&CO2

    pressoreceptors- measure BP
  72. pulmonary reflexes
    Hering-Breuer Reflex
  73. chemoreceptors respond to
    • to LACK of oxygen, increase in CO2 
    • thus, increase respiration
  74. pressoreceptors respond to
    BP, usually to inhibit respiration
  75. pulmonary stimuli
    • modify respirations if necessary
    • located in walls of bronchi primarily
    • they are stretch receptors
    • when over stretched/under inflated will transmit signals through vagus to central respiratory center
  76. Hering-Breuer INFLATION reflex
    • initiated by receptors in the BRONCHI
    • stimulation of receptors and passage of impulses by vagus to central respiratory center will TERMINATE INFLATION.
    • tidal vol exceed 1 L to activate HBI reflex
  77. "protective mechanism for preventing excess lung inflation" *BURSTING*
    Hearing-Breuer Inflation Reflex
  78. Hering-Breuer DEFLATION reflex
    • initiated by receptors in ALVEOLI
    • stretch receptors send impulses via vagus to central respiratory center to ACCELERATE BREATHING.
    • deflation receptors responsible for increased respiratory activity associated w/ lung collapse or diaphragmatic hernias
  79. manual stimulation of HB reflex
    • slap the chest
    • "run the ribs"
  80. immediate responses to hypoxia
    • unconsciousness
    • respiratory increase
    • elevated pulse
    • increase in cardiac output
    • vomiting/nausea
    • reduced RBC
    • dilated pupils (terminal sign of death)
  81. how do we measure cardiac output?
    stroke vol x BPM
  82. chronic responses to hypoxia
    • no dramatic change in coronary/cerebral vessels
    • fall in pulse rate and pressure
    • slow decrease in cardiac output

    *usually seen in heart failure, kidney disease, diabetes, etc seen with geriatric cases
  83. disorders of pleural cavity
    • pneumothorax (air)
    • pyothorax (pus)
    • chylothorax (lymph)
    • neoplastic effusion (tumors)
  84. types of pneumothorax
    • open- penetrating object
    • closed- no open wound (crushed lung)
  85. paradoxical respiration
    collapsed, exposed lung becomes smaller on inspiration and larger on expiration
  86. ABCD (resuscitation)
    • Airway: ensure patent airway w/ endotracheal tube
    • Breathing: PPV 12 breaths/min (every 5 sec)
    • Cardiac: 60 compressions/min (over IC space 3, 4 compressions then breath, repeat)
    • Drugs: wait 1 min before starting IV

    *animal lying on R side*