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Cardio AP final cont


What is differential count used for? Used to differentiate the category of infection; bacterial, viral, or parasitic
Your patient has a HR of 80 a RR 22 CO 5L and a blood pressure of 120/80' what is his stroke volume? CO=SVxHR ; 5L = SVx80= 0.06L=60ml
Is the stroke volume of 60ml a normal stroke volume? Yes because a normal stroke volume is between 40-80mL
List 3 conditions that would lead to a decreased v/q ratio? Pulmonary shunting, decrease in ventilation, increase in perfusion! Obstructive lung disorders (emphysema, bronchitis, asthma)
Normal V/Q ratio is 0.8
2 variables that affect the partial pressure of alveolar O2 FiO2, PB, PaCO2
Explain diffusion limited gas flow Amnt of blood flow or the amnt of ventilation in the alveoli; something preventing oxygen from coming across
Define diastolic pressure Blood pressure in arteries prior to contraction
Define preload Amnt of stretch prior to contraction
Passive mechanisms affecting vascular resistance? Blood volume, blood viscosity, lung volume, pul. Arterial press. Pg218
How long is the adult trachea? 11-13 cm
Name four factors that are known to slow the rate of the mucocillary transport Smoking, dehydration, hypoxemia, general anasthetics
Describe the role of the gel layer in the mucous blanket Trap foreign particles
What bony structure on the X-ray could he use to help him identify wheather the abnormality is within the apex of the lung or above the lung The first rib
Name the airways in which gas exchange takes place Alveolar ducts, alveolar sacs, resp. Bronchioles,
Where is the carina located Bifurnication (split) of the trachea
Define tidal volume The volume of air that normally moves into and out of the lungs in one quiet breath
What is the function of Clara cells Not known
Normally an individuals tidal volume is about 3-4 ml/pound
Which of the following forms the nasal septum? Ethmoid bone and vomer bone
Which of the following prevents the aspiration of food and liquids? Epiglottis
The canals of lambert are found in Terminal bronchials
The eustachian tubes are found in the Nasopharynx
When shunted non deoxygenated blood mixes with reoxygenated blood distal to the alveoli (venous admixture) the PO2 of nonreoxygenated blood increases and the CaO2 of reoxygenated blood decreases
The lowest acceptable PaO2 for a 70 year old man is 70 mmHg
In which of the following types of hypoxia is the oxygen pressure of the arterial blood normal? Anemic hypoxia, circulatory hypoxia, and histotoxic hypoxia
Assuming that everything else remains the same, when the individual's cardiac output decreases the C(a-v)O2 increases and SvO2 decreases
The advantage of the polycythemia begin to offset by the increase in blood viscosity when the hematocrit reaches about 55-60%
All of the following are characteristics of HbS ( sickle cell) except HbS has an increased oxygen carrying capacity
What level of shunt if considered to be life threatening for a patient who is cardiovascular compromised? Greater than 20%
Metabolic alkalosis can develop from Hypo kalmia and hypochloremia
Which he,oglobin has the greatest O2 carrot capacity? Hb F fetal hemoglobin
When does the chloride shift occurs? As excess HCO3 leaves the cell
Of the following HCO3 to H2C03 ratios reps 18:1 and 12:1
During acut alveolar hyperventilation the blood H2Co3 decreases
Which statement is not a characteristic of polycythemia It will decrease oxygen content
Which fthe following is believed to be responsible fr the basic rhythms of ventilation Dorsal respiratory group
Which of the following are components f the pons? Pneumotaxic center and apneustic center
Stroke volume index SVI=SV/BSA =mL/beat/m^2
What is the normal range for central venous pressure? 0-8 mmHg
Value for right atrial pressure? 0-8 mmHg
Normal range mean pulmonary artery pressure? 9-18 mmHg
Normal range for pulmonary capillary wedge pressure? 4-12 mmHg
Normal range for cardiac output? 4-8 L/min
Normal range for stroke volume! 60-130 mL
Normal range if cardiac index? 2.5-4.2 L/min/m^2
Normal range for Stroke volume index? 30-65 mL/beat/m^2
Normal range for pulmonary vascular resistance? 20-120 dynes*sec*cm^-5
Normal range for systemic vascular resistance? 800-1500 dynes* sec*cm^-5
Normal range for right ventricular stroke work index? 7-12 g m/m^2
As an individual grows older what happens to his lung volumes? TLC stays the same; RV increases; ERV decreases;FRC increases; IC decreases; VC decreases; RV/TLC ratio increases;
Functional Residual Capacity (FRC) is the volume of air present in the lungs, specifically the parenchyma tissues, at the end of passive expiration. FRC=RV+ERV
At what age of growth and development of the lungs complete? 20 years
As an individual grows older what happens to their forced flows? Decrease 20-30% of throughout avg adult life
At what age do lung function indices reach their maximum levels between 20-25 years of age and then progressively decline
What happens to lung compliance with advancing age? The elastic recoil of the lungs decrease causing lung compliance to increase. the decrease in lung elasticiity develops bc the alveoli progressively deteriorate and enlarge after the age 30.
What happens to chest wall compliance with advancing age? with aging costal cartilage progressively calcify causing the ribs to slant downward. This causes the thorax to become less compliant
How do you estimate maximum heart rate? 220-age
How much does diffusion capacity decrease with age? falls about 20% over an adult life
How much does cardiac output decrease with age? after age 20 it decreases about 1% per year. Between 30-80 cardiac output decreases about 40% in both men and women
What happens to blood pressure with increasing age? increase
What happens to stroke volume with increasing age? diminishes with age
What happens to cardiac output with increasing age? declines
What happens to heart work with increasing age? decreases approx 1% per year
What effect does aging have on acceptable PaO2? after age 45 the PaO2 declines. The minimum low of PaO2 should be greater than 75 mmHg no matter the age
What is the anaerobic threshold? the point at which anaerobic metabolism develops
How is increased alveolar ventilation during exercise mainly produced? Increase depth of ventilation (Vt) rather than increase rate of ventialtion
What are the first 2 breathing stages during exercise? First Stage: increase in alveolar ventilation within seconds after onset of exercise. Second stage: slow gradual and further increase in alveolar ventilation during the first 3 mins. Alveolar Ventilation increases linerally with the amount of work.
What is the last breathing stage during exercise? Third stage:stabilizes
What changes do you see in arterial blood gases during exercise? during heaving exercise when lactic acidosis is present both pH and PaCO2 decline and PaO2 is constant
What happens to oxygen diffusion capacity during exercise? oxygen diffusion capacity increases linearly to increase oxygen consumption (VO2)
How do you calc maximun heart rate? 220-age
How is increased stroke volume accomplished during exercise? Vasodilation in the working muscles increases venous return to the heart and then pumps more oxygenated blood to the working muscles
What percentage of muscle capillaries are dilated at rest? 20-25%
What percentage of muscle capillaries are dilated during heavy exercise? all capillaries dilate to facilitate the distributions of blood.
What happens to overall peripheral vascular resistance during exercise? decreases
What is the limiting factor on maximal exercise and why? cardiovascular system; because there is more backup in the respiratory system
What are the symptoms of heat stroke? sweating, weakness, exhaustion,muscle cramping, circulatory collapse
How do you treat heat stroke? Spraying cool water on victims body; continually sponging victum with cool water; blowing air over the body with a strong fan or a combo of all 3
What is the Cardiopulmonary rehabilitation? a program to achieve and maintain the patient's max level of independence and functioning in the community
What are the steps of cardio rehab? Phase 1: pretesting with a variety of test and patient is evaluated Phase 2: Patient and family education,exercises, and condition of cardiovascular system,graded Phase 3:follow up, care and long term maintenance
What would you expect the arterial blood gas of a patient with decreased renal function to look like and why? cause a metabolic alkalosis partly or fully compensated and loose the ability to hold on to the hydrogen ions
The renal system is used to regulate the concentration of which electrolytes? sodium, potassium, calcium, magnesium, phosphate
How is sodium ion concentration regulated? when amount of sodium increases the H2O levels increase by kidney. 1.secretion of ADH causes water retention 2.stimulation of thirst
List symptoms of decreased potassium ion concentration muscle weakness, metabolic alkalosis,diarrhea,tachycardia develop
Symptoms of increased potassium concentration? muscle weakness, metabolic acidosis, life-threatening arrythmias
The natural tendency is for the chest wall to move outward and the lungs to recoil inward
what is the normal tidal volume? 7-9 ml/kg IDEAL body weight
which of the following is NOT an effect of stimulation of the parasympathetic nervous system? widening of the pupils
the cavity that contains organs and tissues in the center of the thoracic cage between the right and left lungs is known as the mediastinum
closing of the larynx during exhalation is called Valsava's maneuver
the absence of breathing is called apnea
which of the following causes inspiration to seize at very high lung volumes? Hering-Bruer Inflation Reflex
A decreased systemic blood pressure causes the aortic and carotid sinus baroreceptors initiate reflexes that cause a increased heart rate and increased ventilatory rate
Which of the following is in normal range for the central venous pressure? 0-8 mmHg
The left stem bronchi angles off from the carina at what degree? 40-60 degrees
The concha or turbinates are found in the? nose
the average lung compliance in a healthy adult at rest is? 0.1 L/cm H2O
Which of the following are released when the parasympathetic nerve fibers are stimulated? Acetycholine
Which of the following are released when the sympathetic nerve fibers are stimulated? norepinephrine and epinephrine
The horizontal fissure separates the? the middle and upper lobes of the right lung
Cartilage is found in the following structures of the tracheobrochial tree? segmental bronchi
What condition is characterized by air in the pleural cavity? pneumothorax
when the lung compliance decreases the patient commonly has decreased tidal volume and increase ventilatory rate
Which of the following hemodynamic values are directly obtained by means of the pulmonary artery catheter CVP, RAP, PA,PCWP, CO
Which of the following do not contain cartlidge? Terminal Bronchiles & alveolar ducts
The process that exhanges gases between the external enviornment and the alveoli is ? Ventilation
The normal healthy adult produces how much mucus each day? 100cc
Which of the following are causes of pulmonary surfactant deficiency? Pneumonia, ARDS, IRDS, Acidosis
Under normal circumstances in the healthy adult how much oxygen is consumed by the tissues in a minute and how much carbon dioxide is produced? O2= 250ml Co2=200ml
The PAO2 is determined by the balance between what 2 factors? The amount of oxygen entering the alveoli and the amount diffused across the capillaries
Which of the following gas laws states that in a mixture of gases the total pressure is equal to the sum of the partial pressure of each gas? Daltons Law
Two pulmonary disorders that increase V/Q ratio? Emphysema, pulmonary emboli
Which of the following states that the rate of gas diffusion is inversely proportional to the weight of the gas? Grahams Law
According to Frick's Law gas diffusion is? directly proportional to the difference in partial pressure of the gas between two sides
What happens to systemic vascular resistance in response to increased blood volume? increased systemic vascular resistance
Two pharmacological agents that relax the pulmonary vessels? Oxygen & Calcium
If unrestrained which of the following causes a prolonged inspiration? Apneustic Center
Which of the following cause the central chemoreceptors to transmit signals to the respiratory components in the medulla? H+ (hydrogen)
When the blood PH decreases the oxygen dissociation curve shifts to? The right and P50increases
The tricupsid valve is located in the ? between the right atrium & right ventricle
What cartlidge is commonly called the adams apple? Thyroid cartlidge
Where is the majority of mucuos that forms the mucous blanket produced? submucosal glands
Which cartilaginous structure in the larynx covers the traches during swallowing? epligottis
Which of the following is not a major accessory muscles of inspiration? rectus abdominis muscles
Which of the following will readily diffuse across the blood brain barrier? CO2
Which of the following will cause a temporary cessation in breathing? sudden pain & sudden cold
An alveolus is ventilated but not profused with pulmonary blood this is the definition of? Alveolar dead space
The peripheral chemoreceptors are significantly activated when the PO2 decreases to about? 60mmhg
When a patient is in-tubed the tip of the endotracheal tube should be located where? 2cm ABOVE the carina
Beyond what point does air in the tracheal bronchial tree stop moving by flow and begin moving by molecular movement? terminal bronchiales
Stimulation of the peripheral chemoreceptors can cause which of the following? tachycardia, increased pulmonary vascular resistance, systemic arterial hypertension
What is the average surface area for gas exchange in an adult male lung? 70square meters
The bony structures that make up the thorax include? ribs, sternum, manubrium sterni, thoracic vertebrae, xiphoid process
During relaxation the diaphragm ? becomes more curved and moves upward
How many pair of true ribs are there? 7 true ribs
What is the major muscle of inspiration? diaphragm
Over the past two days your patients lung compliance has increased would you expect the lungs to accept a greater volume or lesser volume of gas per unit of pressure change? greater
What is the normal pressure in the left and right atrium? left=5mmhg right=2mmhg
How do you calculate Mean Arterial Pressure? MAP= SBP+2(DBP)/3 =mmhg
How is vascular resistance calculated? MAP/CO
What is the average partial pressure of oxygen in the pulmonary artery? 40mmhg
Created by: 1197414121