2011 NEMCC Ch19 Resp

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Anonymous
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62619
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2011 NEMCC Ch19 Resp
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2011-01-28 12:49:01
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NEMCC
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Ch 19
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  1. The upper airway system structures
    nose, sinuses, turbinates, phyrynx and larynx
  2. The nasal cavities are warmed and humidified by this
    vasular and ciliated mucous membranes
  3. Cilia move mucous to
    the back of the throat
  4. Nasal mucosa contain _____ cells
    olfactory sensory
  5. Paranasal sinuses (location)
    surrounding facial bones (4)
  6. Frontal sinuses (location)
    in front of the frontal bone and extend above the orbital cavities(2)
  7. Ethmoidal sinuses (location)
    honeycomb of small spaces b/w the eyes
  8. Sphendiodal sinuses (location)
    behind the nasal cavity
  9. maxillary sinuses (location)
    on either side of the nose
  10. The ___ sinuses are the largest and most accessible
    maxillary
  11. Turbinates (define)
    bones that change the flow of inspired air to moisturize and warm it better
  12. Pharynx
    (throat) carries air from nose to larynx
  13. Pharynx is divided into 3 areas: name in order
    nasopharynx, oropharynx and laryngeal pharynx
  14. Eustachian tubes
    connect the phaynx to the middle earand are the means by which upper resp. infections spread to the middle ear
  15. Tonsils and adenoids ___ contribute to the resp system but instead protect against ____
    • do not
    • infection
  16. Larynx
    voice box, cartilaginous framework b/w pharynx and trachea
  17. epiglottis
    closes over the larynx during swallowing
  18. glottis
    opening b/w vocal cords
  19. The lower resp. system consists of :
    trachea, bronchi, bronchioles, lungs and alveoli
  20. carnia
    the end of the trachea
  21. hilus
    entrance of the bronchi
  22. Site of CO2 exchange
    alveoli and capillaries in the lung
  23. There are 3 types of cells in alveoli. Type I does____.
    • Type II does____. Type III does___.
    • Type I lines most alveolar surfaces.
    • Type II produces surfactant.
    • Type III destroy foreign material such as bacteria.
  24. Surfactant
    phospholipid that alters the suface tension of alveoli, preventing their colapse and limiting their expansions during inspration.
  25. Changes to what resp. structures influence the fact that older adults are at increased risk of resp. disease?
    • Cartilage in nasal septum increases and hardens. Thinning alveolar walls.
    • Fewer capillaries at alveoli, Lungs loose elasticity. Muscle tone, cough reflex and cilia decrease.
  26. mediastinum
    wall that divides the thoracic cavity into halves
  27. respiration
    exchange of O2 and CO2 b/w atmospheric air and the blood and b/w blood and the cells
  28. ventilation
    actual movement of air in and out
  29. diffusion
    exchange of CO2 across alveolar-capillary membrane at the cellular level
  30. perfusion
    flow of blood in the pulmonary circulation
  31. distribution
    delivery of atmospheric air to the separate gas exchange untis in the lungs
  32. The resp. center is located in the ___
    medulla oblongata
  33. the ___ control the rate and depth of respirations
    Pons
  34. ____ determines the amount of CO2 in the body
    alveolar respiration
  35. In the critacally ill client, the body attempts to maintain normal pH by:
    The lungs eliminate carbonic acid by releasing CO2 and reabsorbing HCO3. The kidneys excrete more bicarbonate.
  36. Disturbance in the pH that involve the lungs are considered ___.
    respiratory
  37. Disturbance in the pH that involves other mechanisms (not lungs) are considered ___.
    metabolic
  38. Oxygen transport happens 2 ways:
    small amount is dissolved in water in the plasma and a greater portion combines with heme in RBC
  39. pulmonary artery
    transports venous blood from the right ventricle to the lungs
  40. what 3 things effect pulmonary perfusion
    gravity,alveolar pressure and pulmonary artery pressure
  41. Clients with ____ and ___ disease may have decreased pulmonary perfusion
    • lung
    • cardiovascular
  42. ventilation/perfusion ratio
    indicates the effectiveness of airflow within ventilation and perfusion
  43. A narrowed airway results from ___, ____ or ____
    thick mucous, bronchospasm or edema
  44. hypoxia
    decrease oxygen in the inspired air (tissue level)
  45. hypoxemia
    decreased oxygen in the blood
  46. hypercapnia
    increased CO2 in the blood
  47. hypocapnia
    decreased CO2 in the blood
  48. Crackles
    static sound or the sound made by hair rubbing together near your ear. Results from the delayed opening of of deflated airways. May be present b/c of inflammation or congestion, may indicate pulmonary edema or fluid in alveoli.
  49. wheezes
    hissing or whistling sound. Musical sounds that can be heard during inspiration and expiration. Heard in clients with increased secretion.
  50. rhonchi (sonorous wheezes)
    low pitched sounds from trachea and bronchi
  51. friction rubs
    are heard as crakling or grating sounds on ispiration or expiration. Occur when pleural surfaces are inflammed.
  52. ABG (arterial blood gases)
    • determine the blood's pH, oxygen-carrying capacity,levels of O2 &CO2 and
    • HCO3
  53. blood gas samples are obtained from ___,___ or____ artery
    brachial, femoral or radial
  54. Normal value of PaCO2 for ABG
    35-45 mm Hg
  55. Normal value of PaO2 for ABG
    80-100 mm Hg
  56. Normal value of SaO2 for ABG
    95-100%
  57. Normal value of HCO3 for ABG
    22-26 mm Hg
  58. Pulmonary function study
    measure the functional ability of the lungs. Done to diagnose pulmonary conditions and to assess preoperative respiratory status. May also be used to screen employees or determine effectivness of bronchiodialtors.
  59. Pulmonary function is obtained with the use of a ____
    spirometer
  60. tidal volume
    volume of air inhaled and exhaled with a normal breath
  61. inspiratory reserve
    max volume of air that normally can be inspired
  62. expiratory reserve
    max volume of air that normally can be exhaled by force
  63. residual volume
    volume of air left in lungs after max expiration
  64. vital capacity
    max amount of air that can be expired after max inspired
  65. forced vital capacity
    amount of air exhaled forcefully and rapidly after max inspiration
  66. inspratory capacity
    max amount of air that can be inhaled after normal expiration
  67. functional residual capacity
    amount of air left in lungs after normal expiration
  68. total lung capacity
    total volume of air in the lungs when max inflated
  69. Sputum studies
    sputum specimens are studied for pathogens and cancer cells
  70. radiography
    show shape, size and position of lungs and other structures in thorax
  71. CT may be used to view and detect ____
    view the lungs to detect tumors and other lung disorders during early stages
  72. pulmonary angiography
    radioisotope study that allows the dr to assess arterial circulation of the lungs, particularly to detect pulmonary emboli
  73. V-Q scan
    uses radioisotopes to detect patterns of blood flow through the lungs and patterns of air distribution in the lungs. Used to diagnoes COPD, lung cancer and pulmonary emboli
  74. Gallium scan
    used to determine is any inflammatory conditions exhist within the lungs of if abscesses, adgesions or tumors are present
  75. PET
    allows examiner to differentiate normal and abnormal tissue and view metabolic changes in lung tissue
  76. bronchoscopy
    allows for direct visualization, used to treat, diagnose or evaluate lung disease. Also used to obtain biopsy or perform pulmonary cleansing.
  77. thoracentesis
    the aspiration of excess pleural fluid by inserting a needle into the chest wall
  78. Signs and symptoms of respiratory disease include
    dyspnea, persistent cough, increased sputum production, wheezing or other abnormal respirations, cyanosis, and hemoptysis.
  79. After the client has a bronchoscopy, it is most important to assess the client’s
    breathing, any difficulty breathing (dyspnea), if the client is coughing up blood (hemoptysis), presence of cough reflex, and ability to swallow.
  80. For a client who has undergone thoracentesis, a chest radiograph is done after the procedure to rule out a ____
    pneumothorax
  81. ____,____ and ___ are complications that may follow thoracentesis, but a chest radiograph is not done specifically to look for any of them.
    Subcutaneous emphysema, pulmonary edema, and cardiac distress
  82. What nursing intervention is the most important during a lung scan?
    During inhalation, the client may need to hold his or her breath for short periods because scanning images are obtained
  83. The client receives medication before bronchoscopy—a sedative or narcotic to _____.
    depress the vagus nerve.

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