CCT Respiratory
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| Diaphram is innervated by... | a branch of the phrenic nerve originating at C3-C5.
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| 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"
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| 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
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| Scalenes and Sternocleidomastoid | -Accessory muscles of inspiration
-Lift sternum and ribs upward and out, increasing intrathoracic volume
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| Explain the passive act of inspiration: | The diaphram draws downward and this action
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| Explain the act of expiration: | Recoil of the chest decreases the intrathoracic volume and increase pressure.
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| 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
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| 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)
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| 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
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| History and Physical Exam...pay particular to what? | Cardiac and respiratory histories
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| History and Physical Exam: Determine if the patient has ever required the following: | -Intubation
-Mechanical ventilation
-Hospitalization
-Home oxygen use
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| COPD defined clinically as the presence of a productive cough for: | for three months out of the year for two years in a row
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| 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
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| 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
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| Chronic bronchitis: | is what?
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| 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
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| Chronic bronchitis and EKG you would use to evaluate what? | to evaluate hypoxia-induced ischemia
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| Chronic bronchitis and blood glucose, you would see what possibly? | -Hyperglycemia secondary to:
*Stress
*Use of B-agonists, corticosteroids
-Hypoglycemia
*Increased work
*Poor stores
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| 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
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| page 10 |
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Created by:
robillard.james
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