What must be done in order to give Supplemental O2?
MD prescription
When is supplemental O2 needed for SaO2 (Arterial O2 saturation)? What does this number correspond to for PaO2?
<88%
58 mm Hg
Chest excursion - upper; middle; lower Thoracic excursion in health, measured at base of lungs from full inspiration to full expiration, is between:
Upper - 2-3 cm
Middle - 3-5 cm
Lower - 5-7 cm
bet 2-3"
Gravity-dependent & independent areas - shunt vs, dead space; Perfusion problem - involved side how? Ventilation problem - involve side how? Where is blood found in upright position?
Shunt = Gravity dependent
Dead space = Gravity-independent
Perfusion problem - involved side down
Ventilation problem - involved side up
Upright position - blood is found at base of lung
Ventilation (V) perfusion (blood flow - Q) ratio - V/Q; High V/Q ratio means what? Low V/Q ratio means what?
High V/Q ratio = Dead space BC gravity independent areas have lowest blood flow (Q)
Low V/Q ratio = Shunt BC gravity dependent areas have most blood flow (Q)
Cotomies - thoracotomy & midsternotomy - incision
Thoracotomy - follows path of 4th intercostal space
Midsternotomy -Sternum is cut in half lengthwise and rib cage is retracted
Peripheral edema seen in gravity-dependent areas and jugular venous distension indicates possible what?
Heart failure
Orthopnea is what?
Difficulty breathing except in the sitting or standing position
Inspiratory muscles - primary -2
External intercostals
Diaphragm
Inspiratory muscles - accessory - 3
SCM
Scalenes
Pectoralis minor
Expiratory muscles - 3
Internal intercostals
Abdominals
Quadratus lumborum
By fixing shoulder girdle, which mms can become muscles of inspiration? - 3
Trapezius
Pectorals
Serratus
During inhalation the upper two ribs are raised by what? - 2
Scalenes
SCM
Tactile fremitus & pleural effusion or pneumothorax - INC or DEC?
DEC
Tactile fremitus & consolidations - INC or DEC?
INC
Removal of chest tube - leads to what? why?
Pneumothorax
INC (+) P on lungs --> cannot inflate --> collapses
Trachea deviation TOWARD pathology - 1
Lung collapse or V loss phenomenon on R - would pull trachea over to R
Trachea deviation AWAY from pathology - 3
Pneumothorax
Hemothorax
Pleural effusion
Air (pneumothorax) /sterile fluid (effusion) /blood (hemothorax) in pleural space would push contents of that side hemithorax to opposite side, including trachea