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Oxygen and carbon dioxide move between the alveoli and blood by what process?
Diffusion.
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Upper Respiratory Tract Consist of:
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Lower Respiratory Trach Consist of:
- Lobar Bronchi
- Segmental Bronchi
- Lungs.
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The gas exchange portion of the lung is made up of millions of tiny sacs called
Alveoli
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How do lungs move?
Passively.
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The mechanical process of ventilation is the result of:
Volume and pressure changes in the chest cavity.
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During inspiration what muscles do what?
Diaphragm and external intercostal muscles contract.
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During exhalation what muscles do what?
Diaphragm and intercostal muscles relax
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When lungs expand what happens?
pressure drops in the airways.
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Blood transports oxygen to tissues in two forms. What are they?
- Small amounts are dissolved in plasma.
- Most is attached to hemoglobin molecules on red blood cells.
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Blood carries carbon dioxide in what forms?
- Dissolved state.
- Combine with some amino acides in form of carbamino compounds.
- Most important is in its dissociated form.
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The average adult moves how much air?
About 1/2 a L of air per breath
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When do fetus' have enought functional Aveoli?
- 24-25 weeks.
- 34-35 weeks fully functional.
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What is surfactant?
- Decreases surface tention and permits alveolar expansion.
- It is produced in late gestation.
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What are Chemical mediator sthat cause an inflammatory response?
Allergens.
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What is the Mucociliary Elevator?
Protects airway by constantly sweeping potentially harmful material out of lungs by ciliated cells.
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What is the purpose of the bicarbonate buffer system?
Maintains the body's acid-base balance.
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Process of ventilation is regulated how?
Through neural pathways.
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Factors of perfectly healthy lungs that do not expand fully are:
- Pain from surgical incision.
- high abdominal incision.
- Sever obesity.
- Chest or abdominal binders.
- Admoinal Distention.
- medicaitons or anesthesia
- Rib Injuries.
- Musculoskeletal Chest deformities.
- Severe weakness/neuromuscular disorders.
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What is important when a cough produces sputum?
- Establish source of sputum.
- Assess color.
- Assess Volume
- Assess Consistency
- Assess noteworthy characteristics.
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Primary components of the bicarbonate buffer system is:
- Water
- Carbon Dioxide.
- In water carbon dioxide dissolciates into bicarbonate ions.
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Which receptors are sensitive to circulating blood levels of Carbon dioxide & Hydrogen Ions?
- Peripheral and Central Chemoceptors in aortic arch.
- Carotid arteries (Peripheral Receptors)
- Medulla (Central Receptors)
- Decrease in the partial pressure of O2 in Arterial Blood (PaO2) stimulated Peripheral Receptors)
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What plays primary role in deteriming the Frequency & Depth of ventilation?
Carbon Dioxide
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5 Levels of Dyspnea are:
- I-Pt can walk 1 mile at own pace before SOB.
- II-Pt becomes SOB after walking 100 yards.
- III-Pt becomes SOB while performing ADL.
- IV-PT is SOB during periods of No Activity.
- Orthopena: SOB lying down.
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What are Crackles (fine)?
- Fine Rales.
- Discontinuous sounds
- Late inspiration assosicated with pnuemonia & CHF.
- Sound like hair rolling between fingers.
- Alveoli
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What are Coarse Crackles (Coarse Rales)?
- Coarse Rales.
- Bubling moist sounds.
- Early inspiration to early expiration.
- Periperal airways.
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What is wheeze (sonorous)?
- Ronchi (gurgles).
- low pitched snoring or moaning sounds.
- Expiration.
- Large airways.
- Bronchitis or single bronchus obstruction.
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What is wheeze (sibilant)?
- High-pitched musical sound.
- Expiration (may be inspiration)
- Large or small airways.
- Acute asthma or chronic emphysema.
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What is Pleural friction rub?
- Low pitched dry grating sound.
- Both inspiration and expiration.
- pleuritis.
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Respiratory Objective Data includes:
- Observe rate and pattern of respiration.
- Observe effort of respiration.
- Pt color
- Chest deformities, wounds, masses.
- Chest contour.
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Respiratory Palpations Objective Data:
- Swelling or tenderness.
- Extent or pattern of expansion.
- Position of the trachea.
- Vibrations.
- Fremitus (99)
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Breath sound classifications include:
- Bronchial
- Bronchovesicular
- Vesicular
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What is stridor?
- inspiratory wheeze.
- croup or epiglottitis.
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Sputum Assessment includes:
- Normal Color - clear or white.
- Normal Odor - none.
- Normal Consistancy - medium.
- Asthmatic - thickened egg white look.
- Pulmonary edema - frothy pick secretions.
- Infection - Yellow or green
- Infection Odor - Musty, putrid
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What does an AGB look at?
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What is Blood's acid-base balance Alkalosis?
pH above 7.45
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What is Blood's acid-base balance acidosis?
Arterial pH below 7.35
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Types of Coughs include:
- Deep Cough-inspire deeply, close glottis, expell air when opening glottis,
- Stacked Coughs-release several short blasts of air.
- Low-flow (huff)-COPD use inhale deeply, say huff 3-4 times.
- Quad Cough- nueromusclaur disease-inhale then hemelich.
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What is the purpose of pursed lip breathing?
pushing air against the small orifice made by pursed lips the client builds pressure backward throught the airways which prevents airway collapse.
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What is the purpose of chest physiotherapy?
- Percussion, vibration and postural drainage are techniques used for COPD, systic fibrosis, and pneumonia pt.
- Striking of pt chest wall with cupped hand.
- Compress hands on pt chest while pt exhales.
- Place pt in various gravitational positions-Trendelenburg
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