Volume 4 Chapter 10

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amerelman
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68953
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Volume 4 Chapter 10
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2011-02-26 11:42:49
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Volume 4 Chapter 10
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  1. Tracheobronchial Tree
    Structures of the trachea and bronchi
  2. Co-morbidity
    Associated disease process
  3. Xiphisternal Joint
    Union between xiphoid process and body of sternum
  4. Thoracic Skeleton
    • 12 pairs of ribs
    • - 1-7 true ribs
    • - 8-10 join to 7th rib anteriorly
    • - 11-12 no anterior attachment

    • Sternum
    • -manubrium
    • -body
    • -xiphoid process
  5. Diaphragm
    Muscular dome shaped muscle which seperates the thoracic cavity from the abdomen. Muscle of breathing. The aorta, esophagus, inferior vena cava travel through it.
  6. Pulmonary Hilum
    Central medial region of the lung where the bronchi and pulmonary vasculature enter the lung
  7. Lung Volumes
    Tidal Volume: Volume of air entering and leaving lungs with each breath. (500mL)

    Residual Volume: Volume of gas left in the lungs after a forced maximal expiration. (1,200 mL)

    Expiratory Reserve Volume: Volume of gas expelled during a forced maximal exhalation starting at the end of normal tidal expiration. (1,200 mL)

    Inspiratory Reserve Volume: Volume of gas inhaled into the lungs duing a forced maximal inhalation starting at the end of a normal tidal inspiration. (3,600 mL)
  8. Standard Lung Capacities
    Total Lung Capacity: Volume of air in the lungs after maximal inspiratory effort and is the sum of all four lung volumes. (6,500 mL)

    Vital Capacity: Volume of air forcefully exhaled after maximal forced inspiration.
  9. Other Lung Volumes and Spaces
    Minute Volume: Volume of air exhaled in 1 minute. Tidal volume x RR

    Anatomical Dead Space: Volume of air that remains in the tracheobronchial tree and does not reach the alveoli for gas exchange

    Alveolar Dead Space: Volume of air in the alvoli that is not perfused and has no gas exchange

    Physiological Dead Space: Sum of both of above dead spaces
  10. Hypoxic Drive
    Mechanism that increases respiratory stimulation when PaO2 falls and inhibits respiratory stimulation when PaO2 rises.
  11. Control of Respiration
    Medulla Oblongata: CO2 receptors. Sets basic rate and depth of breathing

    Pons: Modifies rate and depth of breathing

    Internal Carotid Arteries: CO2, O2 and BP receptors

    Aorta: CO2, O2 and BP receptors

    Lungs: Stretch receptors
  12. Atelectasis
    Collapse of a lung or part of a lung
  13. Great Vessels
    Large arteries and veins located in the mediastinum that enter and exit the heart
  14. Pericardium
    Fibrous sac that surrounds the heart
  15. Epicardium
    Serous membrane covering the outer surface of the heart. Visceral pericardium
  16. Myocardium
    Muscle tissue of heart
  17. Ligamentum Arteriousum
    Cordlike remnant of fetal vessel connecting the pulmonary artery to the aorta at the aortic isthmus
  18. Signs and Symptoms of Chest Wall Injury
    ribs 4-8 most commonly fractured

    • Blunt or penetrating trauma to chest
    • Erythema
    • Ecchymosis
    • Dyspnea
    • Pain on breathing
    • Limited breath sounds
    • Hypoventilation
    • Crepitus
    • Paradoxical chest wall movement
  19. Flail Chest
    Defect in chest wall that allows for free movement of a segment. Breathing will cause paradoxical chest wall motion
  20. Pneumothorax
    Air in pleural space
  21. S/S of Pneumothorax
    • Trauma to chest
    • CP on inspiration
    • Hyperinflation of chest
    • Diminished breath sounds on affected side
  22. S/S of Open Pneumothorax
    • Penetrating chest trauma
    • Sucking chest wound
    • Frothy blood at wound site
    • Dyspnea
    • Hypovolemia
  23. Tension Pneumothorax
    Buildup of air under pressure within the thorax. Resulting compression of the lung severely reduces effectivenss of respirations.
  24. S/S of Tension Pneumothorax
    • Chest trauma
    • Severe dyspnea
    • Ventilation/perfusion mismatch
    • Hypoxemia
    • Hyperinflation of affected side of chest
    • Hyperressonance of affected side
    • Dimished/absent breath sounds on affected side
    • Cyanosis
    • Diaphoresis
    • AMS
    • JVD
    • Hypotension
    • Hypovolemia
  25. Hemothorax
    Blood within pleural space
  26. Hemopneumothorax
    Blood and air within pleural space
  27. S/S of Hemothorax
    • Blunt or pentrating chest trauma
    • S/S of shock
    • Dyspnea
    • Dull sounds over affect side of chest
    • NO JVD
  28. S/S of Pulmonary Contusion
    • Blunt or pentrating chest trauma
    • Increasing dyspnea
    • Hypoxia
    • Increasing crackles
    • Diminishing breath sounds
    • Hemoptysis
    • S/S of shock
  29. Hemoptysis
    Coughing of blood that originates in the respiratory tract
  30. S/S of Blunt Cardiac Injury
    • Blunt injury to chest
    • Bruising of chest wall
    • Rapid HR, maybe irregular
    • Severe nagging CP
  31. Precordium
    Area of the chest wall overlying the heart
  32. Commotio Cordis
    Damage to the heart caused by an abrupt nonpentrating blow to an adjacent body surface causing ventricular fibrillation.
  33. Pericardial Tamponade
    A restriction to cardiac filling caused by fluid in the pericardial sack
  34. S/S of Pericardial Tamponade
    • Penetrating trauma
    • Dyspnea
    • Cyanosis
    • JVD
    • Weak, thready pulse
    • Decreasing blood pressure
    • Shock
    • Narrowing pulse pressure
  35. Beck's Triad
    • Signs of pericardial tamponade
    • -JVD
    • -Distant heart tones
    • -Hypotension
  36. Pulsus Paradoxus
    Alternating strong and weak pulse
  37. Pulsus Alternans
    Drop of greater than 10 mmHg in systolic BP during the inspiratory phase of respiration that occurs in patients with pericardial tamponade
  38. Electrical Alternans
    Alternating amplitude of complexes on EKG as heart swings in a pendulum like fashion in pericardial tamponade
  39. Aneurysm
    A weakening or ballooing in the wall of a blood vessel

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