Term
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Definition
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Term
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Definition
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Definition
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Term
| a disturbance in the acid/base balance can be caused by what (2) |
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Definition
respiratory system (altered CO2)
metabolic system (ketoacidosis from fat metabolism) |
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Term
| CO2 and pH have what kind of relationship |
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Definition
| inverse. as CO2 rises, pH goes down, becoming acidic |
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Term
| HCO3-and pH have what kind of relationship |
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Definition
| direct. if HCO3- goes up, pH goes up and becomes basic |
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Term
| when the body compensates for a pH balance, what will the compensating compound do |
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Definition
| the compensating compound will move in the same direction as the compound that caused the problem |
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Term
| clinical respiratory failure pressure values |
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Definition
CO2 >=55 mmHg
O2 <=60 mmHg |
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Definition
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Definition
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Definition
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Term
| acute respiratory acidosis: pH |
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Definition
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Term
| acute respiratory acidosis: CO2 |
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Definition
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Term
| acute respiratory acidosis: HCO3 |
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Definition
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Term
| acute respiratory alkalosis: pH |
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Definition
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Term
| acute respiratory alkalosis: CO2 |
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Definition
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Term
| acute respiratory alkalosis: HCO3 |
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Definition
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Term
| acute metabolic alkalosis: pH |
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Definition
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Term
| acute metabolic alkalosis: CO2 |
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Definition
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Term
| acute metabolic alkalosis: HCO3 |
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Definition
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Term
| acute metabolic acidosis: pH |
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Definition
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Term
| acute metabolic acidosis: CO2 |
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Definition
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Term
| acute metabolic acidosis: HCO3 |
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Definition
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Term
| compensated respiratory acidosis: pH |
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Definition
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Term
| compensated respiratory acidosis: CO2 |
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Definition
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Term
| compensated respiratory acidosis: HCO3 |
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Definition
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Term
| compensated respiratory alkalosis: pH |
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Definition
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Term
| compensated respiratory alkalosis: CO2 |
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Definition
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Term
| compensated respiratory alkalosis: HCO3 |
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Definition
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Term
| compensated metabolic acidosis: pH |
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Definition
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Term
| compensated metabolic acidosis: CO2 |
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Definition
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Term
| compensated metabolic acidosis: HCO3 |
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Definition
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Term
| compensated metabolic alkalosis: pH |
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Definition
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Term
| compensated metabolic alkalosis: CO2 |
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Definition
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Term
| compensated metabolic alkalosis: HCO3 |
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Definition
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Term
| causes of respiratory acidosis (holding onto CO2) |
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Definition
anything that will cause you to breathe less
alveolar hypoventilation from head injury (anoxia), drug overdose |
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Term
| Symptoms/presentation of respiratory acidosis (6) |
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Definition
unconscious
anxiety
headache
dyspnea
confusion
coma |
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Term
| causes of respiratory alkalosis |
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Definition
anything that increases RR as it will decrease CO2
alveolar hyperventilation
panic attack |
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Term
| symptoms/presentation of respiratory alkalosis (3) |
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Definition
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Term
| causes of metabolic acidosis (3) |
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Definition
diabetic ketoacidosis
lactic/uremic acidosis
prolonged diarrhea (drops metabolic bicarbonate) |
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Term
| symptoms/presentation of metabolic acidosis (4) |
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Definition
vomiting
dysarrhythmias
lethargy
coma |
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Term
| causes of metabolic alkalosis (3) |
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Definition
bicarbonate ingestion
too much diuresis causing dehydration
vomiting |
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Term
| symptoms/presentation of metabolic alkalosis (3) |
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Definition
signs of dehydration
tetany
mental dullness |
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Term
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Definition
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Term
| what is the resting level for TLC |
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Definition
| point of expiration at rest |
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Term
| normal resting expiration is what % of TLC |
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Definition
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Term
| residual volume for obstructive lung disorders |
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Definition
| increased (air in "stuck" in the lung) |
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Term
| resting balance point for lung inflation in obstructive disorders |
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Definition
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Term
| Loss of ____ _____ _____ and increased ______ eventually erodes functional long volumes in obstructive disorders |
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Definition
| lung tissue recoil and increased compliance |
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Term
| first effects of an obstructive lung disorder are seen in what volume |
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Definition
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Term
| what FEV1 values are considered obstructive |
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Definition
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Term
| what happens with energy expenditure with obstructive disorders? why |
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Definition
| increased energy to push the extra air out |
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Term
| increased energy needs for OLD leads to what |
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Definition
| hypertrophy of the accessory mm in an attempt to normalize lung volumes |
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Term
| what procedure has resluted in improvement in lung funtion for individuals with lung damage caused by chronic over inflation |
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Definition
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Term
| with restrictive disorders how are the volumes affected |
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Definition
| decreased in all lung volumes (TLC, VC, Inspiratory Capacity, IRV) |
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Term
| what is the problem with restrictive disorders |
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Definition
| pt has difficulty getting air in, so increased work of inspiration, cost of expiration is still 0 |
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Term
| Obstructive disorders leads to these 2 impairemnts |
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Definition
mechanical function (primarily reduced FEV1)
Gas exchange |
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Term
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Definition
emphysema
chronic bronchitis |
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Term
| Emphysema: smoking inhibits what |
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Definition
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Term
| Emphysema: inhibition of alpha 1-antitrypsin results in what |
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Definition
| destruction of the alveolar wall |
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Term
| Emphysema: smoking also produces this chronic condition |
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Definition
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Term
| Emphysema: WBC are released to get rid of the vapor particles from smoking but end up doing what instead |
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Definition
| destroying the alveolar wall because of the lack of alpha 1-antitrypsin |
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Term
| COPD: early airway closure results in what |
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Definition
| onver inflation of the alveoli which will cause decreased alveoalr ventilation and ultimtaely V/Q mismatch |
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Term
| COPD: permament enlargement of what structures |
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Definition
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Term
| COPD: loss of elastic recoil of (3) |
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Definition
alveoli
lungs
thoracic cage |
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Term
| COPD: overinflation of the alveoli will increase this volume |
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Definition
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Term
| COPD: overinflation of the alveoli and increased RV will caused an increase in what (2) |
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Definition
increased compliance of the lungs
increased resting size |
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Term
| COPD: changes in rib orientation |
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Definition
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Term
| COPD: changes in the diaphragm |
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Definition
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Term
| COPD: all changes as a result of COPD cause what |
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Definition
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Term
| COPD: decreased gas exchange leads to hypoxemia, if hypoexemia persists what can deevelop |
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Definition
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Term
| COPD: in the most advanced cases a change in diaphragm positioning results in what |
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Definition
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Term
| COPD: S/S breath/breathing related (8) |
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Definition
SOB
DOE (dyspnea on exertion)
orthopnea
prolonged expiration (may see grunting)
decreased FEV1
WHeezing
Decreased breath sounds
INcreased RR |
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Term
| COPD: general symptoms (3) |
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Definition
chronic cough
malaise
weight loss |
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Term
| COPD: peripheral changes (2) |
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Definition
peripheral cyanosis
digital clubbing |
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Term
| COPD: s/s bony/muscular changes (3) |
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Definition
elbow roughness and bony changes secondary to UE support to allow accessory mm use
Barrel chest (increased A-P diameter)
Use/hypertrophy of accessory mm |
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Term
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Definition
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Term
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Definition
breathing techniques (pursed lip breathing)
upper extremity stabilize education for accessory mm use
energy conservation
maintain or improve functional endurance as possible |
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Term
| COPD: important to explain about the Tx |
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Definition
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Term
| COPD: potential medical mgmt |
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Definition
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Term
| COPD: grading system for risk stratification of pts with COPD |
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Definition
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Term
| COPD: what do the abbreviations for BODE index stand for |
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Definition
B: BMI
O: degree of airflow obstruciton (using FEV1)
D: dyspnea using modified Medical Research councial dyspnea scale (MMRC)
E: exercise capacity - measured by 6 MWT |
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Term
| COPD: how does scoring of the BODe work |
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Definition
| the higher the score the greater the risk of death |
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Term
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Definition
| productive cough for 3 consecutive months for at least 2 years |
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Term
| Bronchitis: what do we see with bronchitis (2) |
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Definition
excess mucus secretions from hyperplasia at goblet cells and mucous glands
vasoconstriction at lungs secondary to decreased ventilation |
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Term
| Bronchitis: vasoconstriciton at lungs secnodary to decreased ventilatoin leads to these 3 things |
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Definition
| increased pulmonary pressure leading to R sided CHF therefore pt is bloated |
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Term
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Definition
productive cough
bloated appearance
peripheral cyanosis
SOB |
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Term
| Bronchitis: interventions (4) |
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Definition
cough techniques
energy conservation
maintain/improve functional endurance
Meds |
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Term
| Cystic Fibrosis: what is it |
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Definition
| genetic condition that causes increases mucus production, secretions block the small airways, actual airways have chronic inflammation. Increases risk of infection |
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Term
| Cystic Fibrosis: 3 hallmark signs |
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Definition
increased mucus production
secretions block the small airways
actual airways have chronic inflammation |
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Term
| Cystic Fibrosis: increased risk of infeciton is d/t what |
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Definition
| result of the 3 hallmark signs of CF |
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Term
| Cystic Fibrosis: what is the ultimate result of CF |
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Definition
| destruction of alveolar wall |
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Term
| Cystic Fibrosis: what happens as a result of destruction of alveolar walls |
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Definition
| hyperinflation causes decreased gas exchange and ultimately hypoxemia |
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Term
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Definition
hyperinflation on xray
increased RR
rales
wheezes
productive cough with thick secretions
decreased endurance |
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Term
| Cystic Fibrosis: interventions (3) |
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Definition
bronchial hygiene
encourage activity
meds |
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Term
| Cystic Fibrosis: interventions: bronchial hygiene (2) |
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Definition
ventilation
percussion to clear secretions |
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Term
| only OLD in which PT's encourage activity |
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Definition
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Term
| Cystic Fibrosis: why is activity good for CF pt's |
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Definition
| more movement helps to break up the secretions |
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Term
| Asthma S/S durign an attack (3) |
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Definition
FEV1 decreased
Adventitious sounds: wheezes
Breath sounds: decreased |
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Term
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Definition
figure out and avoid triggers
maintain or improve functional endurance
breathing techniques during attacks
meds
stay below threshold for exercise induced |
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Term
| Verbalization of Observations: general appearance refers to what (6) |
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Definition
pallor
cyanosis
normal coloring
blanching of nail beds
digital clubbing
JVD (jugular vein distension) |
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Term
| Verbalization of Observations: mediastinum |
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Definition
| centered or off to one side |
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Term
| Verbalization of Observations: bony thorax refers to what (6) |
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Definition
gross abnormality and symmetery
signs of anterior displacement of sternum
kyphosis/scoliosis
flail chest
pectus excavtum
pectus carniatum |
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Term
| Verbalization of Observations: musculature refers to what |
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Definition
normal development and symmetery
signs of splinting |
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Term
| Verbalization of Observations: breathing pattern refers to what (9) |
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Definition
1:2 ratio of inspiration:expiration
lateral costal breathing
apical breathing
paradoxical breathing
prolonged expiration
fish mouthed
cheyne-stokes
apneustic
doorstop |
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Term
| how to perform Fremitus exam |
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Definition
| Have subject say “99” while using the ulnar border of your hands, check large areas of lung systematically for quality of resonance. Check - bilaterally moving from apex to base, anterior to posterior. |
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Term
| how to perform mediate percussion |
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Definition
| Firmly place distal joint of the middle finger of your non-dominant hand on the chest wall, and strike briskly with the distal end of the third finger of your dominant hand. The quality of the sound gives an indication of the density of the underlying tissue. |
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Term
| pallor or cyanosis at the tips of ears and nose would suggest what |
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Definition
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|
Term
| slow return of pink color in nail beds after compression is indicative of what |
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Definition
| peripheral vascular disease |
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Term
| signs of digital clubbing indicative of what |
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Definition
| long standing high CO2 retention |
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Term
| mediastinum shifted to one side could mean in regards to the opposite side |
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Definition
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|
Term
| mediastinum shifted to one side could mean what for that side |
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Definition
| partial colapse or under development of lung tissue on the same side |
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Term
| inspection of the mediastinum results in seeing a tracheal tug (trachea pulling down during inspiration), this would occur with what |
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Definition
long standing COPD
hyperinflation of the lungs
use of accessory to elevate the clavicle and sternum at rest |
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Term
| a barrel chest would be indicative of what |
|
Definition
over inflation of lungs
larger than normal residual volume as a result of chronic obstructive lung disease; or gross asymmetry from kyphosis or scoliosis that could suggest low ventilatory capacity |
|
|
Term
| atrophy or undervelopment of musculature is suggestive of what |
|
Definition
| neuromusculature problems |
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|
Term
| increased muscular activity without hypertrophy suggests what |
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Definition
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Term
|
Definition
|
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Term
|
Definition
|
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Term
|
Definition
|
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Term
| describe lateral costal breathing |
|
Definition
| expansion is more lateral without enough anterior expansion |
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Term
| describe apical breathing |
|
Definition
| expansion is more anterior without enough lateral expansion |
|
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Term
| described prolonged expiraiton |
|
Definition
| normally 1:2 ratio for inhalation:expiration, increase in expiration |
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Term
| describe fish mouthed breathing |
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Definition
| opens and closes mouth as a result of breathing |
|
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Term
| describe cheyne-stokes breathing |
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Definition
changing depths of respiration with a period of apnea
increasing tidal volumes followed by decreasing tidal volumes followed by apnea
seen in really severe TBI injuries |
|
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Term
| describe apneustic breathing |
|
Definition
slow rate
shallow depth of breath
period of apnea
irregular rhythm while they try and cover |
|
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Term
|
Definition
| normal rate and rhythm til somethign stops it (pain, restriction), recover, and then normal breathing returns |
|
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Term
|
Definition
productive
non productive
nonfunctional
weak
effective |
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Term
| how much explosive volume is required to produce an effective cough |
|
Definition
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|
Term
| hyporesonance with fremitus is associated with what (3) |
|
Definition
low ventilatory effort
air trapping
fluid accumulation |
|
|
Term
| hyperresonant fremitus is associated with what |
|
Definition
| increased tissue density such as pneumonia |
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|
Term
| an elevated diaphragm can be a result of what (4) |
|
Definition
atelectasis
increased abdominal pressure from gas, pregnancy, or even subphrenic abcess |
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|
Term
| dull mediate percussion would indicate what |
|
Definition
| low inflation of underlying tissue |
|
|
Term
| dull mediate percussion indicates low inflation of underlying tissue which may be the result of what (4) |
|
Definition
low ventilatory effort
fluid accumulation
accumulation of mucous
pneumonia |
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|
Term
| flat mediate percussion is heard over what tissue |
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Definition
|
|
Term
| tympanic or hyper-resonant mediate percussion sounds are heard when |
|
Definition
| when the lungs are over inflated such as the case in COPD |
|
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Term
|
Definition
| words are louder than clearer than should be |
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Term
| what could bronchophony be d/t (2) |
|
Definition
pneumonia
pleural effusion |
|
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Term
|
Definition
| e sounds sound like an A sound |
|
|
Term
| egophony can be d/t what (2) |
|
Definition
pneumonia
pleural effusion |
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Term
| what is whispered pectoriloquy |
|
Definition
| whispered sounds sound like a normal voice |
|
|
Term
| what is whispered pectoriloquy d/t |
|
Definition
| small areas of atelectasis |
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|
