Rspt 1050 exam 3 Flashcards

obstructive lung disease
Terms Definitions
What is the definition of tidal volume?
The volume of air that normally moves in and out of the lungs in one "quiet" breath.
What is the inspiratory reserve volume (IRV)?
The maximum volume of air that can be inhaled after a normal tidal volume.
What is the expiratory reserve volume (ERV)?
The volume of air that can be exhaled after a normal tidal volume.
What is residual volume?
The amount of air remaining in the lung after a maximal exhalation.
What is the normal range for tidal volume?
5-8 ml/kg
What is the normal range for IRV?
3,100 ml
What is the normal range for ERV?
1200 ml
What is the normal range of RV?
1200 ml
What is vital capacity?
The maximum volume of air that can be exhaled after a maximal inspiration.
What is slow vital capacity?
Exhalation performed slowly
What is forced vital capacity?
Forced exhalation.
What is functional residual capacity?
The volume of air remaining in the lungs after a normal exhalation.
What is inspiratory capacity?
The volume of air that can be inhaled after a normal expiration.
What is the total lung capacity?
The maximum amount of air that the lungs can accommodate.
Directions for vt.
Breathe normally in and out.
Directions for IRV.
Inhale as much as you can from a normal inhalation.
Directions for ERV.
Exhale as much as you can from a normal exhalation.
Directions for RV.
This volume cannot be measured with normal spirometry.
Directions for SVC.
Take a deep breath in, as deep as you can, and then blow it out SLOWLY until you can't blow anymore.
Directions for FVC.
Take a deep breath in, as deep as you can, and then blow as hard and fast as you can until you can't blow out anymore.
Directions for IC.
Inhale as much as you an from a normal exhalation.
Directions for FRC.
This cannot be measured directly with simple spirometry.
Directions for TLC.
This volume cannot be measured with simple spirometry.
Is helium dilution a closed or ope circuit method?
Is nitrogen washout a closed or open circuit method?
What diseases are restrictive?
Pneumonia and ARDS
What diseases are obstructive?
Cystic fibrosis, bronchieactasis, asthma, bronchitis and emphysema CBABE
What is obstructive lung disease?
Difficulty getting air out, reduction in flow, associated with an increase in trapped gas at the end of a normal breath.
What is restrictive lung disease?
Trouble getting air in, reduced lung volumes, they have NORMAL flow measurements.
What is forced vital capacity?
Maximum volume of gas that can be exhaled forcefully and rapidly as possible after a maximal inspiration. It is the most commonly performed test. Equals SVC. It I'd decreased with obstructive lung disease.
Forced expiratory volume timed
Maximal amount of gas that can be exhaled within a specific time period. expressed at different time intervals .5, 1,2 and 3 seconds. It is decreased with obstructive lung disease. Your LUNG VOLUME.
Forced expiratory volume/forced vital capacity ratio
Ratio of volume of gas exhaled in a specific time to the total amount exhaled. The FEV1 is the most commonly used. A VOLUME BELOW 70% IS INDICATIVE OF A DISEASE.
What values are decreased when you have obstructive lung disease?
FVC and FEV1
What values are decreased in a restrictive disease?
Only the FVC is decreased.
Forced expiratory flow 25%-75%
Average flow rate that occurs during the MIDDLE 50% of an FVC
What is the normal FEF 25-75%
4.5L for men 3.5L for women
When is FEV25-75% decreased?
Age and obstructive lung disease
What airways does FEV25-75% reflect defects with?
Medium to small
What airways does FEF200-1200 effect?
Larger airways
Peak expiratory flow rate
The maximum flow rate that can be achieved during an FVC maneuver. It is the most common bedside measurement for evaluating acute lung disease. It is effort dependent.
What is the normal for PEFR?
10L/sec for men 7.5L/sec for women
When is PEFR reduced?
With age and obstructive lung disease.
Maximum voluntary ventilation
The largest volume of gas that can be breathed voluntarily in and out if the lungs in one minute. The test actually only lasts 12-15 seconds.
What is the normal for MVV?
170L/min in men. 110L/min in women
When is MVV decreased?
With age and obstructive disease
What kind of pattern does a flow-volume loop have when someone has obstructive disease?
Scooped out
Pre and post bronchodilator
12% or greater improvement in FEV and at least a 200 ml increase in FEV1.
Why do the smaller airways collapse?
Because they have no cartilage.
What happens to the intrapleural pressure after a forced exhalation?
It will be equal to the pressure in the airways.
Does weight have an impact on predicted volumes?
No, only height,age,gender and race have an impact.
What is blood composed of?
Plasma and cells
What is plasma?
The watery straw-colored fluid part of the lymph and the blood in which the cells are suspended.
What are the three cell types of blood?
Erythrocytes, leukocytes and thrombocytes.
Where do all blood cells arise from?
Stem cells in the marrow
Major portion of blood cells
What is the normal value of RBC?
Percentage of RBC in relation to the total blood volume
What is the normal hematocrit?
41-50% for males 35-46% for females
Where are red blood cells produced?
Bone marrow
What is the rate that red blood cells are produced?
2 million/second
What is the life span of erythrocytes?
120 days
What is anemia?
Reduced levels of RBC or hemoglobin
What is polycythemia?
Elevated levels of RBC or hemoglobin.
What does hemoglobin carry?
Each gram of hemoglobin carries how many mL of oxygen?
Are leukocytes more numerous or less numerous then RBC?
Less numerous.
Do leukocytes have nuclei?
What is the function of leukocytes?
To protect the body against invasion of bacteria and other foreign agents.
What are the two types of leukocytes?
Granulocytes and agranulocytes
What is the normal value of leukocytes?
What is leukocytosis?
Increased WBC count. Usually caused by infection. Increased with leukemia
What is leukopenia?
Decreased WBC count. Usually seen with bone marrow diseases as well as a side effect to some drugs.
What is diapedesis?
The movement of WBC from the capillaries when needed for inflammatory or immune responses. They move along the tissue cells toward the areas of damage or inflammation.
What is a differential count?
The determination of the percentage of each type of WBC.
What is the most numerous of WBC?
Are neutrophils larger or smaller then RBC?
What do neutrophils contain?
Small granules that produce antibiotic like proteins called defensins.
What does an elevated neutrophil count indicate?
What are banded neutrophils?
Immature WBC.
What does a long, overwhelming infection cause?
Low WBC count and a low number of neutrophils, which can lead to opportunistic infections.
Increased with allergic conditions or asthma
Attracted to site of infection and release chemical mediators that increase blood flow to the site of infection (swelling)
Increased in chronic infection. When they leave the blood and enter the tissue they become macrophages
Produce antibodies that inactivate antigens
What is the normal count for thrombocytes?
What are thrombocytes responsible for?
Blood coagulation
Thrombocytes contain serotonin. What does serotonin do?
It causes smooth muscle contraction and reduced blood flow.
What is thrombocytopenia?
Reduced levels of thrombocytes
What is plasma and what does it transport?
It is the straw colored liquid in which the blood cells are suspended. It transports materials needed by cells and materials that must be removed from cells.
How much of the blood volume is plasma?
What is serum?
Plasma minus the clotting factor
What is the normal value of Na?
135-145 mEq/ L
What is the normal value of K?
3.5-5 mEq/L
What is the normal value of Cl?
85-100 mEq/L
What is the normal value for bicarbonate?
How many chambers does the heart have?
4 chambers-2 atria and 2 ventricles
What separates the atriums?
Interatrial septum
What separates the ventricles?
Interventricular septum
What is the heart enclosed in?
Double-walled sac called the pericardium
What does the outer wall (fibrous pericardium) of the heart do?
Protect, anchor and prevent from overfilling.
What are the 3 layers of the heart muscle?
Epicardium, myocardium and endocardium
Left circumflex
Supplies left atrium and posterior wall of left ventricle
Anterior descending (interventricular)
Supplies anterior walls of both ventricles and interventricular septum
Right coronary artery
Supplies right atrium, right ventricle(lateral), and posterior wall of both ventricles
Venous blood from the anterior wall of the heart empties into the.......
Great cardiac veins
Venous blood from the posterior wall of the heart empties into the.......
Middle cardiac vein
The great and middle cardiac veins empty into the....
Coronary sinus in the posterior wall of the right atrium (venous to venous)
Venous blood collected by the.....
Thebesian vein empties into the right and left atrium (venous to arterial)
Pulmonary vascular system
Begins as blood leaves the right ventricle to left atrium
Systemic vascular system
Begins as blood leaves the left ventricle to right atrium.
What does the vascular system consist of?
Arteries, arterioles (resistance), capillaries, venues, veins (capacitance)
Intravascular pressure
Pressure within the lumen of the vessel
Transmural pressure
Pressure from inside to outside
Driving pressure
Pressure from start to finish
Arterial bloom pressure
Measured in branch of aorta, generates a pulse
Normal BP
Normal mean of BP
80-100 mm Hg
Pulse pressure
40 mm Hg
How do you calculate the mean of BP
Systolic + (2x diastolic) divided by 3
Arterial line
Catheter placed into an artery, used to continuously measure blood pressure and for the frequent arterial blood draws
Pulmonary blood pressure
Measured in pulmonary artery via a catheter
What is the normal pulmonary BP?
What is the normal mean of pulmonary BP?
10-20 mm Hg
Carotid sinus baroreptors
Glossopharyngeal nerve (9th cranial nerve)
Aortic sinus baroreceptors
Vagus nerve (10th cranial nerve)
Parasympathetic NS
Decrease heart rate and force contraction
Sympathetic NS
Increase heart rate and force if contraction
Ventricles (Perkinje fibers)
Contraction, systolic BP
Relaxation of heart, diastolic BP
P wave, P-R interval, QRS complex, ST SEGMENT, t wave
12 lead EKG
3 standard leads, 6 precordial leads, 3 augmented voltage leads
3 standard leads
Lead one, two and three
6 precordial leads
3 augmented voltage leads
aVR, aVL, aVF
P wave
Atrial depolarization
QRS complex
Ventricular depolarization
T wave
Atrial repolarization
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