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CCT Respiratory

QuestionAnswer
Diaphram is innervated by... a branch of the phrenic nerve originating at C3-C5.
Diapram is... -Primary muscle of inspiration -Contracts and flattens during inspiration, increasing intrathoracic Volume -responsible for 75% of TV during normal inspiration, quiet breathing -Divided into left and right "leaves"
Intercostals... -Important secondary muscles of inspiration Elevates the ribs, increasing anterior-posterior diameter and volume of thorax -Innervated by intercostal nerves which originate at T1-T11
Scalenes and Sternocleidomastoid -Accessory muscles of inspiration -Lift sternum and ribs upward and out, increasing intrathoracic volume
Explain the passive act of inspiration: The diaphram draws downward and this action
Explain the act of expiration: Recoil of the chest decreases the intrathoracic volume and increase pressure.
Oxyhemoglobin dissociation curve: Graphic (sigmoidal curve) representation of the relationship between Hb saturation and the partial pressure of O2 (PaO2). - determined in "normal" blood with a pH of 7.4 and a temperature of 37c
Right shift: -More O2 released from teh hemoglobin, resulting in greater O2 delivery to tissue Right shift causes: -Increase of PCO2 -Increased temperature -Increased 2,3-DPG -Decreased pH (acidosis)
Left shift: -O2 released by the hemoglobin at significantly lower PO2 resulting in decreased O2 delivery to tissues -Left shift causes: -Decrease in PCO2 -Decreased temperature -Decreased 2,3-DPG -Increased pH (alkalosis) Carbon monoxide poisoning
History and Physical Exam...pay particular to what? Cardiac and respiratory histories
History and Physical Exam: Determine if the patient has ever required the following: -Intubation -Mechanical ventilation -Hospitalization -Home oxygen use
COPD defined clinically as the presence of a productive cough for: for three months out of the year for two years in a row
Radiogragh: -A/P and lateral films -Hyperinflation...what will you see? -Flattened, low diaphragm -Hyperlucent lung fields -Wide intercostals spaces -Long, narrow heart shadow -Dimished vascular markings -dilated bronchioles -Bullae, blebs
COPD and pulse oximetry... -Cannot identify hypercapnia or acid based disturbances -Useful and conveinient for assessing oxygenation and monitoring oxygen saturation during treatment *Instant feedback on patient status *<90% requires aggressive therapy
Chronic bronchitis: is what?
Chronic bronchitis and pulse oximetry... -Useful and conveinient for assessing oxygenation and monitoring oxygen saturation during treatment *Instant feedback on patient status *<90% requires aggressive therapy
Chronic bronchitis and EKG you would use to evaluate what? to evaluate hypoxia-induced ischemia
Chronic bronchitis and blood glucose, you would see what possibly? -Hyperglycemia secondary to: *Stress *Use of B-agonists, corticosteroids -Hypoglycemia *Increased work *Poor stores
COPD treatment: -Aimed at achieving *PaO2 >60 mmHg *SaO2 >90% -monitor ABG to rule out developing hypercapnia secondary to O2 administration -Humidified O2 to assist in the mobilization of secretions
page 10
Created by: robillard.james
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