| Flap 1 | Flap 2 |
| 2 tracts r/t Respiratory system | Upper & Lower respiratory tracts |
| Upper Respiratory Tract functions | Warms & Filters |
| Lower Respiratory Tract function | Gas exchange |
| Prominent function r/t Sinuses | Speech resonating chamber |
| Function r/t Larynx | Vocalization |
| Inspiration vs. Expiration r/t Length of respiratory cycle | I:third of cycle, E:two-thirds of cycle |
| Energy requirements r/t Inspiratory & Expiratory phases | I:requires energy, E:require very little energy |
| Energy requirement during expiration phase r/t COPD | Expiration requires energy |
| Lobes r/t Left lung | Left lung has Less lobes(2) |
| Physiologic dead space | 150 mL of air not involved in gas exchange |
| Type I vs. Type II vs. Type III alveolar cells | I:from alveolar wall, II:secrete surfactant, III:ingest foreign matter |
| Respiration | Gas exchange b/w air and blood, Gas exchange b/w blood and cells |
| Physical factors governing air flow | Air pressure variances, Air flow resistance, Lung compliance |
| Lung compliance factors | Alveolar surface tension, Connective tissue in lungs |
| Normal alveolar surface tension | Low d/t surfactant |
| Diffusion | oxygen-carbon dioxide exchange |
| Causes r/t Increased airway resistance | Bronchial contraction(asthma), Thickened mucosa(chronic bronchitis), Obstruction, Decreased lung elasticity(emphysema) |
| Pulmonary perfusion | Blood flow thru pulmonary circulation |
| Tidal volume | Volume of air inhaled/exhaled w/each breath |
| Expiratory reserve volume | Max volume exhaled forcibly after normal exhalation |
| Vital capacity vs. Functional residual capacity vs. Total lung capacity r/t COPD | VC:decreases, FRC & TLC:increases |
| V/Q imbalances d/t | Inadequate ventilation, Inadequate perfusion, Both |
| Main cause of hypoxia d/t Thoracic/Abd surgery & respiratory failure | Shunting |
| Normal V/Q ratio | 1:1 |
| Q > V | Shunt |
| V > Q | Dead space |
| Absence of V and Q | Silent unit |
| 2 ways O is carried in blood | Dissolved in plasma, Hemoglobin |
| Amount of dissolved O is directly proportional to | Partial pressure of O(PaO) |
| PaO = 150 mm Hg r/t Hemoglobin | 100% Saturation |
| PaO normal values | 80-100 mm Hg |
| Decreased CO r/t Oxygen delivery to tissues | Decreases |
| Medulla and pons function r/t Ventilation | Control rate and depth |
| Peripheral chemoreceptor locations | Aortic arch, Carotids |
| Chemoreceptor response r/t PaO, PaCO & pH | PaO first then PaCO then pH |
| Hering-Breuer reflex prevents | Overdistention of lungs |
| Respiratory function r/t Aging | Reduced surface area, elasticity & vital capacity, Increased dead space |
| Major S/Sx r/t Respiratory disease | Dyspnea, Sputum production, Chest pain, Clubbing, Hemoptysis, Cyanosis |
| Acute vs. Chronic lung diseases r/t Dyspnea severity | Acute are more severe |
| Sudden dyspnea r/t Immobilized Pt's | Pulmonary embolism |
| Orthopnea found in Pt's w/ | Heart disease, COPD |
| Dyspnea w/expiratory wheeze | COPD |
| Wheezing r/t Asthma | Present during inspiration and expiration |
| Other disorders that may cause dyspnea | Cardiac disease, Anaphylactic reactions, Severe anemia |
| Relief of dyspnea r/t Resting Pt's | High Fowler's(head elevation), Oxygen administration |
| Cough d/t | Irritation of mucous membranes in respiratory tracts |
| Coughing at night | LHF, Bronchial asthma |
| Cough in morning w/sputum | Bronchitis |
| Acute vs. Subacute vs. Chronic coughs | A:< 3 weeks, C:> 8 weeks |
| Purulent sputum d/t | Bacterial infection |
| Frothy, pink sputum d/t | Pulmonary edema |
| Sputum volume vs. Bronchial infection resistance r/t Smoking cessation | S:decreases, B:increases |
| Cleanses palate of sputum taste | Citrus juices |
| Pleuritic pain relief | Pt lies on effected side |
| Hemoptysis | Expectoration of blood |
| Blood coughed from lung | Bright red, Frothy, Mixed w/sputum |
| Blood color from stomach | Hematemesis(vomited), Dark(coffee grounds) |
| Late indicator of hypoxia | Cyanosis |
| Cyanosis r/t Anemia | Rarely manifested |
| Barrel chest d/t | Emphysema |
| Eupnea | Normal breathing pattern |
| Intracranial pressure & Brain injury r/t Breathing | Bradypnea |
| PaCO r/t Hyperventilation | Decreased levels |
| Hyperventilation r/t Severe acidosis | Kussmaul's respiration |
| Alternating episodes of apnea w/periods of deep and shallow breathing | Cheyne-Stokes respiration |
| Crackles(rales) | Discrete, noncontinuous sounds d/t reopening of deflated airways |
| Crackles(rales)usually heard during | Inspiration |
| Vesicular breath sounds | Inspiration > Expiration |
| Wheezes d/t | Bronchial wall oscillation, Changes in airway diameter |
| Wheezes usually heard during | Expiration |
| Letter E r/t Egophony distortion | Sounds like letter A |
| Minute ventilation | Volume of air expired per minute, Tidal volume(L) x Respiratory rate |
| Inspiratory force | Effort to breathe |
| Inspiratory force r/t Unconscious Pt's | Useful |
| Normal inspiratory pressure | 100 |
| Inspiratory pressure after 15 second less than 25 | Mechanical ventilation necessary |
| More conclusive- ABG vs. Pulse oximetry | ABG |
| Normal pulmonary tissue r/t X-ray | Radiolucent |
| Chest x-rays usually taken after | Full inspiration |
| Pt interventions b/f Bronchoscopy | Signed consent, NPO for 6 hrs |
| Pt cannot be discharged from recovery area until | Cough reflex & Respiratory status return |
