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Cardio AP final cont
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| Question | Answer |
|---|---|
| What is differential count used for? | Used to differentiate the category of infection; bacterial, viral, or parasitic |
| Your patient has a HR of 80 a RR 22 CO 5L and a blood pressure of 120/80' what is his stroke volume? | CO=SVxHR ; 5L = SVx80= 0.06L=60ml |
| Is the stroke volume of 60ml a normal stroke volume? | Yes because a normal stroke volume is between 40-80mL |
| List 3 conditions that would lead to a decreased v/q ratio? | Pulmonary shunting, decrease in ventilation, increase in perfusion! Obstructive lung disorders (emphysema, bronchitis, asthma) |
| Normal V/Q ratio is | 0.8 |
| 2 variables that affect the partial pressure of alveolar O2 | FiO2, PB, PaCO2 |
| Explain diffusion limited gas flow | Amnt of blood flow or the amnt of ventilation in the alveoli; something preventing oxygen from coming across |
| Define diastolic pressure | Blood pressure in arteries prior to contraction |
| Define preload | Amnt of stretch prior to contraction |
| Passive mechanisms affecting vascular resistance? | Blood volume, blood viscosity, lung volume, pul. Arterial press. Pg218 |
| How long is the adult trachea? | 11-13 cm |
| Name four factors that are known to slow the rate of the mucocillary transport | Smoking, dehydration, hypoxemia, general anasthetics |
| Describe the role of the gel layer in the mucous blanket | Trap foreign particles |
| What bony structure on the X-ray could he use to help him identify wheather the abnormality is within the apex of the lung or above the lung | The first rib |
| Name the airways in which gas exchange takes place | Alveolar ducts, alveolar sacs, resp. Bronchioles, |
| Where is the carina located | Bifurnication (split) of the trachea |
| Define tidal volume | The volume of air that normally moves into and out of the lungs in one quiet breath |
| What is the function of Clara cells | Not known |
| Normally an individuals tidal volume is about | 3-4 ml/pound |
| Which of the following forms the nasal septum? | Ethmoid bone and vomer bone |
| Which of the following prevents the aspiration of food and liquids? | Epiglottis |
| The canals of lambert are found in | Terminal bronchials |
| The eustachian tubes are found in the | Nasopharynx |
| When shunted non deoxygenated blood mixes with reoxygenated blood distal to the alveoli (venous admixture) the | PO2 of nonreoxygenated blood increases and the CaO2 of reoxygenated blood decreases |
| The lowest acceptable PaO2 for a 70 year old man is | 70 mmHg |
| In which of the following types of hypoxia is the oxygen pressure of the arterial blood normal? | Anemic hypoxia, circulatory hypoxia, and histotoxic hypoxia |
| Assuming that everything else remains the same, when the individual's cardiac output decreases the | C(a-v)O2 increases and SvO2 decreases |
| The advantage of the polycythemia begin to offset by the increase in blood viscosity when the hematocrit reaches about | 55-60% |
| All of the following are characteristics of HbS ( sickle cell) except | HbS has an increased oxygen carrying capacity |
| What level of shunt if considered to be life threatening for a patient who is cardiovascular compromised? | Greater than 20% |
| Metabolic alkalosis can develop from | Hypo kalmia and hypochloremia |
| Which he,oglobin has the greatest O2 carrot capacity? | Hb F fetal hemoglobin |
| When does the chloride shift occurs? | As excess HCO3 leaves the cell |
| Of the following HCO3 to H2C03 ratios reps | 18:1 and 12:1 |
| During acut alveolar hyperventilation the blood | H2Co3 decreases |
| Which statement is not a characteristic of polycythemia | It will decrease oxygen content |
| Which fthe following is believed to be responsible fr the basic rhythms of ventilation | Dorsal respiratory group |
| Which of the following are components f the pons? | Pneumotaxic center and apneustic center |
| Stroke volume index | SVI=SV/BSA =mL/beat/m^2 |
| What is the normal range for central venous pressure? | 0-8 mmHg |
| Value for right atrial pressure? | 0-8 mmHg |
| Normal range mean pulmonary artery pressure? | 9-18 mmHg |
| Normal range for pulmonary capillary wedge pressure? | 4-12 mmHg |
| Normal range for cardiac output? | 4-8 L/min |
| Normal range for stroke volume! | 60-130 mL |
| Normal range if cardiac index? | 2.5-4.2 L/min/m^2 |
| Normal range for Stroke volume index? | 30-65 mL/beat/m^2 |
| Normal range for pulmonary vascular resistance? | 20-120 dynes*sec*cm^-5 |
| Normal range for systemic vascular resistance? | 800-1500 dynes* sec*cm^-5 |
| Normal range for right ventricular stroke work index? | 7-12 g m/m^2 |
| As an individual grows older what happens to his lung volumes? | TLC stays the same; RV increases; ERV decreases;FRC increases; IC decreases; VC decreases; RV/TLC ratio increases; |
| Functional Residual Capacity | (FRC) is the volume of air present in the lungs, specifically the parenchyma tissues, at the end of passive expiration. FRC=RV+ERV |
| At what age of growth and development of the lungs complete? | 20 years |
| As an individual grows older what happens to their forced flows? | Decrease 20-30% of throughout avg adult life |
| At what age do lung function indices reach their maximum levels | between 20-25 years of age and then progressively decline |
| What happens to lung compliance with advancing age? | The elastic recoil of the lungs decrease causing lung compliance to increase. the decrease in lung elasticiity develops bc the alveoli progressively deteriorate and enlarge after the age 30. |
| What happens to chest wall compliance with advancing age? | with aging costal cartilage progressively calcify causing the ribs to slant downward. This causes the thorax to become less compliant |
| How do you estimate maximum heart rate? | 220-age |
| How much does diffusion capacity decrease with age? | falls about 20% over an adult life |
| How much does cardiac output decrease with age? | after age 20 it decreases about 1% per year. Between 30-80 cardiac output decreases about 40% in both men and women |
| What happens to blood pressure with increasing age? | increase |
| What happens to stroke volume with increasing age? | diminishes with age |
| What happens to cardiac output with increasing age? | declines |
| What happens to heart work with increasing age? | decreases approx 1% per year |
| What effect does aging have on acceptable PaO2? | after age 45 the PaO2 declines. The minimum low of PaO2 should be greater than 75 mmHg no matter the age |
| What is the anaerobic threshold? | the point at which anaerobic metabolism develops |
| How is increased alveolar ventilation during exercise mainly produced? | Increase depth of ventilation (Vt) rather than increase rate of ventialtion |
| What are the first 2 breathing stages during exercise? | First Stage: increase in alveolar ventilation within seconds after onset of exercise. Second stage: slow gradual and further increase in alveolar ventilation during the first 3 mins. Alveolar Ventilation increases linerally with the amount of work. |
| What is the last breathing stage during exercise? | Third stage:stabilizes |
| What changes do you see in arterial blood gases during exercise? | during heaving exercise when lactic acidosis is present both pH and PaCO2 decline and PaO2 is constant |
| What happens to oxygen diffusion capacity during exercise? | oxygen diffusion capacity increases linearly to increase oxygen consumption (VO2) |
| How do you calc maximun heart rate? | 220-age |
| How is increased stroke volume accomplished during exercise? | Vasodilation in the working muscles increases venous return to the heart and then pumps more oxygenated blood to the working muscles |
| What percentage of muscle capillaries are dilated at rest? | 20-25% |
| What percentage of muscle capillaries are dilated during heavy exercise? | all capillaries dilate to facilitate the distributions of blood. |
| What happens to overall peripheral vascular resistance during exercise? | decreases |
| What is the limiting factor on maximal exercise and why? | cardiovascular system; because there is more backup in the respiratory system |
| What are the symptoms of heat stroke? | sweating, weakness, exhaustion,muscle cramping, circulatory collapse |
| How do you treat heat stroke? | Spraying cool water on victims body; continually sponging victum with cool water; blowing air over the body with a strong fan or a combo of all 3 |
| What is the Cardiopulmonary rehabilitation? | a program to achieve and maintain the patient's max level of independence and functioning in the community |
| What are the steps of cardio rehab? | Phase 1: pretesting with a variety of test and patient is evaluated Phase 2: Patient and family education,exercises, and condition of cardiovascular system,graded Phase 3:follow up, care and long term maintenance |
| What would you expect the arterial blood gas of a patient with decreased renal function to look like and why? | cause a metabolic alkalosis partly or fully compensated and loose the ability to hold on to the hydrogen ions |
| The renal system is used to regulate the concentration of which electrolytes? | sodium, potassium, calcium, magnesium, phosphate |
| How is sodium ion concentration regulated? | when amount of sodium increases the H2O levels increase by kidney. 1.secretion of ADH causes water retention 2.stimulation of thirst |
| List symptoms of decreased potassium ion concentration | muscle weakness, metabolic alkalosis,diarrhea,tachycardia develop |
| Symptoms of increased potassium concentration? | muscle weakness, metabolic acidosis, life-threatening arrythmias |
| The natural tendency is for the | chest wall to move outward and the lungs to recoil inward |
| what is the normal tidal volume? | 7-9 ml/kg IDEAL body weight |
| which of the following is NOT an effect of stimulation of the parasympathetic nervous system? | widening of the pupils |
| the cavity that contains organs and tissues in the center of the thoracic cage between the right and left lungs is known as the | mediastinum |
| closing of the larynx during exhalation is called | Valsava's maneuver |
| the absence of breathing is called | apnea |
| which of the following causes inspiration to seize at very high lung volumes? | Hering-Bruer Inflation Reflex |
| A decreased systemic blood pressure causes the aortic and carotid sinus baroreceptors initiate reflexes that cause a | increased heart rate and increased ventilatory rate |
| Which of the following is in normal range for the central venous pressure? | 0-8 mmHg |
| The left stem bronchi angles off from the carina at what degree? | 40-60 degrees |
| The concha or turbinates are found in the? | nose |
| the average lung compliance in a healthy adult at rest is? | 0.1 L/cm H2O |
| Which of the following are released when the parasympathetic nerve fibers are stimulated? | Acetycholine |
| Which of the following are released when the sympathetic nerve fibers are stimulated? | norepinephrine and epinephrine |
| The horizontal fissure separates the? | the middle and upper lobes of the right lung |
| Cartilage is found in the following structures of the tracheobrochial tree? | segmental bronchi |
| What condition is characterized by air in the pleural cavity? | pneumothorax |
| when the lung compliance decreases the patient commonly has | decreased tidal volume and increase ventilatory rate |
| Which of the following hemodynamic values are directly obtained by means of the pulmonary artery catheter | CVP, RAP, PA,PCWP, CO |
| Which of the following do not contain cartlidge? | Terminal Bronchiles & alveolar ducts |
| The process that exhanges gases between the external enviornment and the alveoli is ? | Ventilation |
| The normal healthy adult produces how much mucus each day? | 100cc |
| Which of the following are causes of pulmonary surfactant deficiency? | Pneumonia, ARDS, IRDS, Acidosis |
| Under normal circumstances in the healthy adult how much oxygen is consumed by the tissues in a minute and how much carbon dioxide is produced? | O2= 250ml Co2=200ml |
| The PAO2 is determined by the balance between what 2 factors? | The amount of oxygen entering the alveoli and the amount diffused across the capillaries |
| Which of the following gas laws states that in a mixture of gases the total pressure is equal to the sum of the partial pressure of each gas? | Daltons Law |
| Two pulmonary disorders that increase V/Q ratio? | Emphysema, pulmonary emboli |
| Which of the following states that the rate of gas diffusion is inversely proportional to the weight of the gas? | Grahams Law |
| According to Frick's Law gas diffusion is? | directly proportional to the difference in partial pressure of the gas between two sides |
| What happens to systemic vascular resistance in response to increased blood volume? | increased systemic vascular resistance |
| Two pharmacological agents that relax the pulmonary vessels? | Oxygen & Calcium |
| If unrestrained which of the following causes a prolonged inspiration? | Apneustic Center |
| Which of the following cause the central chemoreceptors to transmit signals to the respiratory components in the medulla? | H+ (hydrogen) |
| When the blood PH decreases the oxygen dissociation curve shifts to? | The right and P50increases |
| The tricupsid valve is located in the ? | between the right atrium & right ventricle |
| What cartlidge is commonly called the adams apple? | Thyroid cartlidge |
| Where is the majority of mucuos that forms the mucous blanket produced? | submucosal glands |
| Which cartilaginous structure in the larynx covers the traches during swallowing? | epligottis |
| Which of the following is not a major accessory muscles of inspiration? | rectus abdominis muscles |
| Which of the following will readily diffuse across the blood brain barrier? | CO2 |
| Which of the following will cause a temporary cessation in breathing? | sudden pain & sudden cold |
| An alveolus is ventilated but not profused with pulmonary blood this is the definition of? | Alveolar dead space |
| The peripheral chemoreceptors are significantly activated when the PO2 decreases to about? | 60mmhg |
| When a patient is in-tubed the tip of the endotracheal tube should be located where? | 2cm ABOVE the carina |
| Beyond what point does air in the tracheal bronchial tree stop moving by flow and begin moving by molecular movement? | terminal bronchiales |
| Stimulation of the peripheral chemoreceptors can cause which of the following? | tachycardia, increased pulmonary vascular resistance, systemic arterial hypertension |
| What is the average surface area for gas exchange in an adult male lung? | 70square meters |
| The bony structures that make up the thorax include? | ribs, sternum, manubrium sterni, thoracic vertebrae, xiphoid process |
| During relaxation the diaphragm ? | becomes more curved and moves upward |
| How many pair of true ribs are there? | 7 true ribs |
| What is the major muscle of inspiration? | diaphragm |
| Over the past two days your patients lung compliance has increased would you expect the lungs to accept a greater volume or lesser volume of gas per unit of pressure change? | greater |
| What is the normal pressure in the left and right atrium? | left=5mmhg right=2mmhg |
| How do you calculate Mean Arterial Pressure? | MAP= SBP+2(DBP)/3 =mmhg |
| How is vascular resistance calculated? | MAP/CO |
| What is the average partial pressure of oxygen in the pulmonary artery? | 40mmhg |
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