Term
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Definition
| Abnormally low oxygen in blood, tissues, and or lungs. Leads to decreased organ function and/or cellular damage |
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Term
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Definition
| Insufficient blood oxygen levels to meet metabolic requirements |
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Term
| 3 Goals of respiratory adjustment as a response to hypoxemia |
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Definition
Improve oxygenation
Assist in CO2 removal
Improve oxygen delivery to tissues |
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Term
| 4 compensatory signs of respiratory distress |
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Definition
Increased ventilatory drive
Increased work of breathing
Increased cardiac rate
Increased cardiac contractility |
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Term
| 7 possible signs of ventilatory failure |
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Definition
| Use of accessory muscles, intercostal retraction, cyanosis, paradoxical respiration, tachycardia, narcosis, coma |
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Term
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Definition
| Bluish-purplish color in the tissues due to an increased amount of deoxygenated hemoglobin |
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Term
| What 3 hypoxemic conditions might be difficult to detect cyanosis with? |
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Definition
Shock (due to vasoconstriction)
CO2 poisoning (MM appear bright red)
Methoglobinemia (MM dark/brownish) |
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Term
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Definition
| Inadequate inspired oxygen, Alveolar hypoventilation, ventilation-perfusion mismatch, diffusion impairment, shunt, and abnormal hemoglobin |
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Term
| Which causes of hypoxemia respond to oxygen supplementation? |
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Definition
| Inadequate inspired O2, ventilation perfusion mismatch, diffusion impairment, some shunts, |
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Term
| Which causes of hypoxemia do not respond to oxygen supplementation? |
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Definition
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Term
| When does inadequate inspired O2 commonly occur? |
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Definition
| High altitude, anesthetic mistakes |
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Term
| What is alveolar hypoventilation? |
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Definition
| Oxygen flow to the alveoli is decreased |
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Term
| What causes alveolar hypoventilation? |
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Definition
| neuromuscular failure, increased dead space, airway obstruction, primary pulmonary disease, pleural space disorders, severe brain disorders, muscular fatigue, muscular paralysis |
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Term
| What is the most common cause of hypoxemia? |
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Definition
| Ventilation-perfusion mismatch |
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Term
| Where is the V/Q ratio highest? Lowest? |
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Definition
| Top of the lungs, Bottom of the lungs |
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Term
| What is the immediate cause of diffusion impairment? |
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Definition
| Thickened alveolar barrier |
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Term
| What etiologies can cause a diffusion impairment? |
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Definition
| Edema, fibrosis, pneumonia, COPD, Neoplasia |
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Term
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Definition
| Venous blood bypasses oxygenation in lungs and mixes with arteria blood, deceasing PaO2 |
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Term
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Definition
| Collapsed lung lobes, PDA, patent foramen ovale, other ASDs and VSDs |
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Term
| Causes of methemoglobinemia |
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Definition
| methemoglobin reductase deficiencies, oxidizing agents |
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Term
| How should you evaluate airway patency? |
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Definition
| Observing breathing pattern- a non-patent airway= prolonged inspiration with little/no air movement |
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Term
| 4 things to do in respiratory crisis (in order of importance) |
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Definition
| Give oxygen, start invasive ventilation measures, catheterize, draw blood |
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Term
| 3 signs of paradoxical respiration |
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Definition
Inward collapse of intercostal spaces
Inward collapse of abdomen
Inward movement of ribs
(all during inspiration) |
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Term
| 5 (6?) anatomic locations of respiratory problems |
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Definition
| Upper airways, Lower airways, Pulmonary parenchyma, pleural space, thoracic wall (cardiac?) |
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Term
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Definition
| High pitched inspiratory noise localized to upper airways |
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Term
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Definition
| Snoring/crackling noise associated with the upper airways |
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Term
| Clinical signs of upper airway obstruction |
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Definition
| stridor, stertor, cyanosis, head/neck extension, orthopnea, exercise intolerance, choking, retching, collapse, clawing at face/neck, honking sounds |
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Term
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Definition
| Inability to breath in a recumbent position |
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Term
| Clinical sign of lower airway disorders |
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Definition
| forceful expiratory effort |
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Term
| Clinical signs associated with parenchymal disorders |
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Definition
| open mouth breathing, paradoxical resp. cyanosis, nasal flare, coughing, gagging, dyspnea, anxiety, orthopnea, hemoptysis, fever, tachypnea, tachycardia, weakness, depression, anorexia, nasal discharge, panting |
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Term
| What signs are associated with pulmonary parenchymal disorders related to congestive heart failure? |
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Definition
| Crackles, heart murmurs, and arrhythmias |
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Term
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Definition
| Coughing up blood or bloody foam |
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Term
| What defines the pleural space? |
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Definition
| Visceral and parietal pleurae |
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Term
| Why is there normally a small amount of fluid in the pleural cavity? |
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Definition
| Allows for low friction sliding of the pleurae and instantaneous volume changes |
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Term
| What happens if there is a loss of negative pleural pressure? |
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Definition
| The lungs collapse due to elastic recoil |
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Term
| Clinical signs of pleural space disorders |
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Definition
| short shallow breaths, tachypnea, open mouth breathing, cyanosis, dull lung sounds, auscultable fluid line, muffled cardiac sounds, GI sounds |
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Term
| What types of injuries could cause a thoracic wall respiratory disorder? |
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Definition
| rib fractures, flail chest, sucking and penetrating chest wounds, neurologic, muscular, and orthopedic disease of the thorax |
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Term
| Why might thoracic wall disease, parenchymal, and pleural diseases be closely related? |
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Definition
| chest wall injuries can also have pleural effusions, lung contusions, pneumothorax, and hernias associated with them |
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Term
| What are some clinical signs of thoracic wall disorders? |
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Definition
| Signs of resp. distress, cyanosis, increased chest wall movement, segments of ribs that move independently, lack of abdominal/diaphragmatic movement, lack of intercostal muscle movement. |
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Term
| What should serial physical exams assess in patients with respiratory distress? |
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Definition
| respiratory rate & effort, mucous membrane color, auscultation, pulse quality, and capillary refill time |
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Term
| What is the most objective way to measure oxygenation and ventilation? |
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Definition
| Arterial blood gas analysis |
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Term
| Besides arterial blood gases, what are other ways to monitor ventilation? |
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Definition
| Pulse oximetry and end-tidal CO2 |
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