Term
|
Definition
|
|
Term
| What are the stages of patient-clinician interaction? |
|
Definition
| "Preinteraction stage, Introductory, Initial Assessment, Treatment, Follow-up" |
|
|
Term
|
Definition
| Review chart to identify important facts stated in the medical history |
|
|
Term
|
Definition
| "Introduce yourself, verify ID bracelet" |
|
|
Term
|
Definition
| "Identify health status, brief interview and physical examination" |
|
|
Term
| Treatment and monitoring stage |
|
Definition
| Provide treatment and monitor patient's response |
|
|
Term
|
Definition
| "Ask patient how he/she is feeling, ask if there's anything you can do and let patient know when you will return" |
|
|
Term
|
Definition
| "4-12 feet and is useful for intial intro, first step toward establishing a rapport" |
|
|
Term
|
Definition
| 18 in - 4 ft and is most useful for interview |
|
|
Term
|
Definition
| "0-18 inches and is typically only invaded once a rapport, no eye contact, useful for physical exam" |
|
|
Term
|
Definition
| "All records are confidential ""need to know"" basis and nothing discussed outside patient rooms" |
|
|
Term
|
Definition
| encourages patients to describe events as they seem them and promote better understanding of the problem |
|
|
Term
|
Definition
| Focuses on specific information and provides clarification |
|
|
Term
| What is the most common symptom of lung disease |
|
Definition
|
|
Term
| What is a powerful protective mechanism for the lung and airways |
|
Definition
|
|
Term
| What is a cough caused by? |
|
Definition
| "mechanical, chemical, inflammatory or thermal stimulatio of the cough receptors" |
|
|
Term
| What are the commonly accepted cough adjectives? |
|
Definition
| "Productive, Effective, Weak, Dry, Chronic productive" |
|
|
Term
|
Definition
| mucus is produced with the cough |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| patient produces phlegm most days for at least 3 weeks |
|
|
Term
| What are the causes of hemoptysis |
|
Definition
| "persistent strong coughing, acute infections, brochogenic carcinoma, cardiovascular disease, Trauma, Anticoagulant therapy" |
|
|
Term
| What is streaky hemoptysis |
|
Definition
| streaky refers to blood-tinged sputum |
|
|
Term
| What is massive hemoptysis |
|
Definition
| More than 400 mL in 3 hours or more than 600 mL in 24 hours |
|
|
Term
| What is the significance of hemoptysis vs hematemesis |
|
Definition
| Determining if the blood is from the lung vs the stomach is important |
|
|
Term
| What is blood from the lung associated with |
|
Definition
|
|
Term
| What is blood from the stomach associated with |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What patients often develop right heart failure |
|
Definition
| patients with chronic hypoxemia |
|
|
Term
| What does right heart failure often lead to |
|
Definition
| reduced venous return and increased hydrostatic pressure in the peripheral venous blood vessels especially in the dependent tissues like the ankles |
|
|
Term
| What can ankle edema or dependent edema be a sign of |
|
Definition
|
|
Term
| What is ankle edema a sign of if not pulmonary |
|
Definition
|
|
Term
| What is a sustained fever |
|
Definition
| continuously elevated that varies little during a 24-hour period |
|
|
Term
| What is a remittent fever |
|
Definition
| continuously elevated but has larger variations and spikes in a 24-hour period |
|
|
Term
| What is an intermittent fever |
|
Definition
| spikes in body temperature cycling with periods of normal or subnormal temperature |
|
|
Term
|
Definition
| may signal infection and increases oxygen consumption |
|
|
Term
| What pulmonary disorders are typically accompanied by fever |
|
Definition
| "pneumonia, lung abscess, tuberculosis, empyema which is infection within pleural space" |
|
|
Term
| Clinical presentation is part of which assessment? |
|
Definition
|
|
Term
| How is general clinical presentation accomplished |
|
Definition
| by observation of the patient's breathing pattern facial expression level of consciousness nutritional status etc. |
|
|
Term
| How is clinical presentation documented |
|
Definition
| a single statement about general presentation is included with the vital sign measurement for the initial evaluation of the patient |
|
|
Term
| How is level of consicousness or sensorium documented |
|
Definition
| "patients alert and oriented to time, place and person are said to be ""oriented x 3""" |
|
|
Term
| What is an abnormal sensorium indicative of? |
|
Definition
| inadequate cerebral oxygenation |
|
|
Term
| What is normal body temperature |
|
Definition
|
|
Term
| How is body temperature maintained |
|
Definition
| the hypothalamus maintains body temperature |
|
|
Term
| How does the respiratory system play a role in temperature regulation |
|
Definition
| by providing another mechanism of heat release |
|
|
Term
|
Definition
| abnormal elevation of body temperature due to disease |
|
|
Term
| What is the most common cause of fever |
|
Definition
|
|
Term
| What kind of patients may not exhibit a fever in the presence of infection |
|
Definition
| patients with poor immune systems |
|
|
Term
| What does elevated temperature due to oxygen consumption? |
|
Definition
|
|
Term
| Why is a fever a problem for those with lung disease |
|
Definition
| increases oxygen consumption and increases the demand for CO2 removal |
|
|
Term
| When is hypothermia present |
|
Definition
| When body temperature drops below normal |
|
|
Term
| What type of patients present with hypothermia |
|
Definition
| those with head injuries and those exposed to cold environment |
|
|
Term
|
Definition
| palpating radial or brachial impulse |
|
|
Term
| How long should pulse be measured |
|
Definition
| measured for 30 sec and multiplied by two |
|
|
Term
| How long should a pulse be measured if it is irregular |
|
Definition
|
|
Term
| How fast is rapid heart beat and what is it called |
|
Definition
| greater than 100 beats/min tachycardia |
|
|
Term
|
Definition
|
|
Term
| What could irregular pulse be a sign of? |
|
Definition
| serious heart disease and should be investigated |
|
|
Term
| What is weak peripheral pulse a sign of? |
|
Definition
|
|
Term
| What is extreme drops in the strength of the pulse with inspiration |
|
Definition
|
|
Term
| How is respiratory rate measured |
|
Definition
| without the patient being aware of measurement |
|
|
Term
| What is a good approach to meausuring respiratory rate without the patient knowing |
|
Definition
| watching chest rise while continuing to palpate radial pulse |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| What are the two components of arterial blood pressure |
|
Definition
| peak pressure that results during ventricular systole and the baseline pressure tha toccurs during ventricular diastole |
|
|
Term
| What is the peak pressure known as |
|
Definition
|
|
Term
| What is resting pressure known as |
|
Definition
|
|
Term
| What is the difference between systolic and diastolic pressure |
|
Definition
|
|
Term
| When is hypotension present |
|
Definition
|
|
Term
| When is hypertension present |
|
Definition
|
|
Term
| How Is blood pressure most commonly measured |
|
Definition
|
|
Term
| How is BP measured with a blood pressure cuff |
|
Definition
| "cuff is wrapped around patient arm and inflated to a pressure believed to be higher than the patient's systolic pressure, pressure is released slowly while monitoring a pressure monometer and the initial korotkoff sounds disapper which is when the diastolic pressure is noted" |
|
|
Term
| How does respiratory cycle affect blood pressure |
|
Definition
| "changes in blood pressure are very slight with breathing, systolic pressure drops slightly with normal inspiration and if drops significantly with inspiration, pulsus paradoxus is presnet which may be a sign of cardiac or respiratory problems like asthma" |
|
|
Term
|
Definition
|
|
Term
| What does it mean if trachea is deviated |
|
Definition
| unilateral lung problem such as atelactasis or pneumothorax that involves the upper lobe of one lung |
|
|
Term
| What is important in the the examination of neck beside trachea |
|
Definition
| status of jugular veins because patients with cor pulmonale jave jvd and use of accessory muscles suggest obstructive lung disease |
|
|
Term
| How is thoracic configuration determined |
|
Definition
|
|
Term
|
Definition
| enlarged A-P diameter which is consistent with COPD |
|
|
Term
|
Definition
| spine is bent laterally and from front to back which causes restrictive lung problem |
|
|
Term
|
Definition
| abnormal sternal protrusion |
|
|
Term
|
Definition
| depression of the sternum |
|
|
Term
| What portion of the stethoscope is used for lung sounds |
|
Definition
|
|
Term
| Describe lung auscultation technique |
|
Definition
| beginning at the lung bases and comparing side to side. At least one full respiratory cycle should be evaluated at each location |
|
|
Term
| What are normal sounds of breathing called |
|
Definition
|
|
Term
| Where are tracheal breath sounds heard |
|
Definition
| "directly over trachea and are loud, high-pitched and have equal inspiratory and expiratory components" |
|
|
Term
| Where are bronchovesicular breath sounds heard |
|
Definition
| around the sternum and between the scapulae and are softer and lower pitched than tracheal sounds |
|
|
Term
| What is the most common breath sound evaluated |
|
Definition
| normal breath sounds or vesicular breath sounds and are heard over lung parenchyma and are primarily an inspiratory sound |
|
|
Term
| What is a breath sound that is barely heard |
|
Definition
|
|
Term
| what is a breath sound that is louder than normal |
|
Definition
|
|
Term
| What are adventitious breath sounds |
|
Definition
| abnormal lung sounds superimposed on the breath sound |
|
|
Term
| how are adventitious breath sounds classified |
|
Definition
| classified as continuous or discontinuous |
|
|
Term
| What is another name for continuous ALS (adventitious lung sounds) |
|
Definition
|
|
Term
| What is another name for discontinuous ALS |
|
Definition
|
|
Term
|
Definition
| continuous ALS heard over neck |
|
|
Term
| How are normal breath sounds created |
|
Definition
| turbulent flow in main airways |
|
|
Term
| How are bronchial breath sounds heard |
|
Definition
| when lung attenuation is reduced as with consolidation |
|
|
Term
| When are diminished or absent breath sounds noted |
|
Definition
| when lung attenuation is increased as with emphysema |
|
|
Term
| What are crackles created by |
|
Definition
| sudden opening of collapsed peripheral airways |
|
|
Term
|
Definition
| vibration of airway walls as air passes through at high velocity. Polyphonic wheezes suggest that many airways are obstructed |
|
|
Term
| what is stridor caused by |
|
Definition
| upper airway narrowing and is life threatening |
|
|
Term
|
Definition
| surface of chest wall overlying the heart |
|
|
Term
| what is the precordium examined to assess |
|
Definition
|
|
Term
| Where does the base of the heart lie |
|
Definition
| directly beneath the middle portion of the sternum |
|
|
Term
| Where does the apex of the heart point |
|
Definition
| downward and to the left extending to midclavicular line near fifth rib |
|
|
Term
| why is the precordium palpated |
|
Definition
| to determine PMI point of maximal impulse which is created by left ventricular contraction |
|
|
Term
| What does right ventricular hypertrophy often cause with regard to inspection and palpation of precordium |
|
Definition
| a heave near the lower left sternal border |
|
|
Term
| What is the first heart sound S1 created by |
|
Definition
| closure of A-V valves during systole |
|
|
Term
| what is the second heart sound created by |
|
Definition
| closure of semilunar valves during diastole |
|
|
Term
| When does a split S1 or S2 occur |
|
Definition
| when the two sides of the heart are not in sync |
|
|
Term
| When can S3 or S4 sounds occur |
|
Definition
| when left ventricle is istended and as blood rapidly fills the ventricle during diastole. |
|
|
Term
|
Definition
|
|
Term
|
Definition
| filling to due atrial contraction and is called gallop rhythm |
|
|
Term
|
Definition
| When pulmonic valve closes with force |
|
|
Term
|
Definition
| in patients with pulmonary hypertension |
|
|
Term
|
Definition
| with incompetent or stenotic valves and are produced by rapid blood flow through the narrow valve |
|
|
Term
| When are systolic murmurs heard |
|
Definition
| when the semilunar valves are stenotic or when the AV valves are incompetent |
|
|
Term
| When are diastolic murmurs heard |
|
Definition
| when the AV valves are stenotic or when the semilunar valves are incompetent |
|
|
Term
| What is the primary role of WBC |
|
Definition
|
|
Term
| What are the five types of WBC |
|
Definition
| "neutrophil, basophil, eosinophil, lymphocyte, and monocyte" |
|
|
Term
| How much blood volume does the neutrophils take up |
|
Definition
|
|
Term
| Where are neutrophils produced |
|
Definition
| in bone marrow and have a life span of about 10 days |
|
|
Term
| When are neutrophils released into circulating blood stream |
|
Definition
| when acute infection is present |
|
|
Term
| What do neutrophils contain that destroy bacteria |
|
Definition
|
|
Term
| What percent of WBC is eosinophils |
|
Definition
|
|
Term
| When are eosinophils present |
|
Definition
| "with allergic reaction, present in sputum of asthmatics" |
|
|
Term
| What percent of WBC are basophils |
|
Definition
|
|
Term
| What is the purpose and percentage of lymphocytes |
|
Definition
| "fight against viral, fungal, and TB infections and make up 20% - 45% of circulating WBC" |
|
|
Term
| What are the two types of lymphocytes |
|
Definition
|
|
Term
| Why are T Cells important |
|
Definition
| antibody production and immunity |
|
|
Term
| What percentage of WBC are monocytes |
|
Definition
|
|
Term
| what does the monocyte become when in the tissue |
|
Definition
|
|
Term
| what is the primary role of a monocyte turned macrophage |
|
Definition
| phagocytosis of foreign material |
|
|
Term
|
Definition
| total white cell count is elevated |
|
|
Term
| What is leukocytosis that is caused by neutrophils called |
|
Definition
|
|
Term
| When is neutrophilia common |
|
Definition
| with bacterial pneumonia and other infections |
|
|
Term
| What is acute neutrophilia caused by |
|
Definition
| infection typically resulting in an increasein the immature netrophils known as bands and this is called a left shift |
|
|
Term
| What is pseudoneutrophilia |
|
Definition
| occurs when marginated cells are released into the circulation and is common with acute trauma and stress |
|
|
Term
|
Definition
| present whe total white cell count is reduced |
|
|
Term
| When is neutropenia common |
|
Definition
| lack of neutrophils and is common when bone marrow fails or when a severe infection is present and neutrophils are destroyed faster than they are produced and is an onimous sign |
|
|
Term
| when is lymphocytosis present |
|
Definition
| when the circulating lymphocytes are elevated in count |
|
|
Term
| What is lymphocytosis caused by |
|
Definition
| viral infections and infectious mononucleosis |
|
|
Term
| When is lymphocytopenia seen with |
|
Definition
| trauma and acute infection |
|
|
Term
| What is common with HIV patients |
|
Definition
|
|
Term
| What is monocytosis characteristic of |
|
Definition
| "chronic infections including TB, syphilis, typhoid fever, and subacute bacterial endocarditis. It is a sign of active disease in TB patients" |
|
|
Term
|
Definition
|
|
Term
| What is the life span of an RBC |
|
Definition
|
|
Term
| What is the shape and why |
|
Definition
| bioconcave disc to facilitate carrying oxygen |
|
|
Term
| What is RBC made up of mostly |
|
Definition
|
|
Term
| What is the portion of total blood volume mde up by the formed elements known as |
|
Definition
|
|
Term
| What is the hemoglobin count |
|
Definition
| amount of hemoglobin on the red cells |
|
|
Term
|
Definition
| abnormal decrease in RBC count |
|
|
Term
| what is microcytic anemia |
|
Definition
|
|
Term
| what is hypochromic anemia |
|
Definition
| when the cells have too little hemoglobin |
|
|
Term
| what is anemia with normal red cells |
|
Definition
| "normochromic, normocytic anemia and is common with acute blood loss" |
|
|
Term
| what is the most common cause of anemia |
|
Definition
|
|
Term
|
Definition
| abnormal increase in the red cell count |
|
|
Term
| What is primary polycythemia |
|
Definition
| uncommon and due to bone marrow disease |
|
|
Term
| What is secondary polycythemia |
|
Definition
| common and is a result of chronic hypoxemia i.e. in heavy smoking and COPD |
|
|
Term
|
Definition
| smalled formed elements that serve an important role in coagulation and should be checked before ABG puncture |
|
|
Term
| What is used to measure patient's ability to clot the blood |
|
Definition
| "platelet count, bleed time, APTT and PT/INR" |
|
|
Term
| "What are platelet count, bleed time, APTT and PT/INR useful for" |
|
Definition
| monitoring heparin therapy in the patient being treated for pulmonary embolism |
|
|
Term
| What are the four electrolytes commonly measured |
|
Definition
| "sodium, potassium, chloride and CO2" |
|
|
Term
|
Definition
| elevated sodium concentration |
|
|
Term
| What does hypernatremia often reflect |
|
Definition
| inadequate water intake and causes dry mouth and thirst |
|
|
Term
|
Definition
| decreased measured sodium concentration |
|
|
Term
| What is hyponatremia associated with |
|
Definition
| sodium loss as seen with diuretics and in extreme cases cause abnormal sensorium |
|
|
Term
|
Definition
| abnormal decrease in potassium concentration |
|
|
Term
| What is hypokalemia caused by |
|
Definition
| "vomiting, nasogastric suction, and diarrhea and is also seen with potassium shifts from extracellular to intracellular as in metabolic alkalosis" |
|
|
Term
| What does hypokalemia cuse |
|
Definition
| "muscle weakness, nausea, muscle cramps, confusion and arrhythmias" |
|
|
Term
| What is hyperkalemia most often associated with |
|
Definition
| increased potassium intake but is also seen in metabolic acidosis when hydrogen ions are exchanged for intracellular potassium ions to buffer acidosis |
|
|
Term
| When is hypochloremia seen with |
|
Definition
| prolonged vomiting and and chronic respiratory acidosis |
|
|
Term
| When is hyperchloremia seen |
|
Definition
| With prolonged diarrhea and certain kidney disease |
|
|
Term
| What does total CO2 measure |
|
Definition
| the amount of bicarb in the venous blood |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| helps determine cause of metabolic acidosis, normally 8 - 16 and is calculated by subtracting total of CO2 and bicarb from ABG from sodium level |
|
|
Term
| What is a good legitimate sputum sample |
|
Definition
| "few epithelial cells, little saliva and many leukocytes" |
|
|
Term
| What is bronchoalveolar lavage (BAL) |
|
Definition
| performed during bronchoscopy by injecting a large volume of sterile fluid into patient's lung which mixes with respiratory secretions deep in the lung and withdrawn for analysis |
|
|
Term
| What is the significance of organisms obtained by BAL |
|
Definition
| organisms obtained can help diagnose cause of pneumonia |
|
|
Term
| What is seen in congestive heart failure patients (medical microbiology) |
|
Definition
| low-protein pleural effusions (transudates) |
|
|
Term
|
Definition
| "high-protein effusions caused by cancer of pleura, infecions, lung infarctoin and chest wall trauma" |
|
|
Term
| What is urinalysis helpful in the diagnosis of |
|
Definition
| kidney disease and to screen for URI |
|
|
Term
| What does presence of protein in urine indicate |
|
Definition
|
|
Term
| What does ketones indicate |
|
Definition
|
|
Term
|
Definition
| study of fluids secretions and other body samples |
|
|
Term
| What is skin testing used for |
|
Definition
| "diagnosis of different things such as TB, sarcoidosis, and allergic disorders" |
|
|
Term
| What happens to skin 2-3 days after PPD injection in subcutaneous layer of skin if patient has been infected with TB |
|
Definition
|
|
Term
| What is the criteria for a positive TB skin test |
|
Definition
| varies because patients with compromised immunity may generagte a smaller nodule |
|
|
Term
| What symptoms indicate obtaining ABG |
|
Definition
| "acute dyspnea, chest pain, hemoptysis, cough fever, sputum consistent with pneumonia, CO poisoning - (clinical presentation ABG)" |
|
|
Term
| Past medical history indication for obtaining ABG |
|
Definition
| "COPD, cystic fibrosis, pulmonary fibrosis, exposure to environmental dust, diabetes with ketoacidosis significant smoking history 20 pack/years" |
|
|
Term
| physical examination indication for ABG |
|
Definition
| "cyanosis, crackles or wheezing, abnormal breathing pattern, heavy use of accessory muscles, unexplained confusion, evidence of chest trauma" |
|
|
Term
| lab data indication for ABG |
|
Definition
| "unexplained polycythemia, severe electrolyte abnormality" |
|
|
Term
| Chest radiograph indication for ABG |
|
Definition
| "diffuse infliltrates, hyperinflation, atelactasis, pneumothorax, pleural effusion, enlarged heart, lobar consolidation" |
|
|
Term
|
Definition
| function of amount of oxygen bound to hemoglobin and dissolved in plasma. |
|
|
Term
| what is most important parameter that reflects quantity of oxygen carried in arterial blood |
|
Definition
| CaO2 and an adequate hemoglobin concentration must be present fo rthis parameter to be normal |
|
|
Term
|
Definition
| alveolar-arterial oxygen difference and is measurement of pressure difference between alveoli and arterial blood of oxygen. |
|
|
Term
| What is P(A-a)O2 affected by |
|
Definition
| "FIO2, age and presence of pulmonary disease" |
|
|
Term
|
Definition
|
|
Term
| What is HbCo a reflection of |
|
Definition
| quantity of carbon monoxide bound to hemoglobin molecules and can be obtained only from co-oximeter. |
|
|
Term
| What does CO poisoning reduce |
|
Definition
| oxygen carrying capacity of hemoglobin and inhibits unloading of oxygen at the tissues |
|
|
Term
| What does assessment of oxygenation evaluate |
|
Definition
| ability of lungs to oxygenate the blood and the ability of cardiovascular system to distribute the blood |
|
|
Term
|
Definition
| hydrogen ion concentration |
|
|
Term
|
Definition
| performance of numerous blood buffers and how well the respiratory and renal systems are functioning |
|
|
Term
|
Definition
| partial pressure of arterial carbon dioxide |
|
|
Term
| What is PaCO2 a reflection of |
|
Definition
| respiratory component of acid-base status and it identifies the degree of ventilation in relation to metabolic rate |
|
|
Term
|
Definition
| arterial blood bicarbonate |
|
|
Term
| what is HCO3 a reflection of |
|
Definition
| metabolic component and is regulated by renal system. |
|
|
Term
|
Definition
| base excess or base deficit and is a measurement reflecting nonrespiratory portion of acid-base balance. Standard deviation of standard HCO3 that takes buffering capabilities of red blood cells into account |
|
|
Term
|
Definition
| tidal volume - 350 - 600 in normal adults |
|
|
Term
|
Definition
| minute volume - Ve = Vt x respiratory rate and is volume of gas expired over one minute |
|
|
Term
|
Definition
|
|
Term
| What is the best index of ventilation whe used in conjunction with ABG |
|
Definition
|
|
Term
|
Definition
| Vital capacity - maximal amount the patient can exhale after taking deepest breath possible |
|
|
Term
|
Definition
| forced vital capacity which is forcefully exhaling volume |
|
|
Term
| wHat can decrease VC and FVC |
|
Definition
| restrictive and obstructive |
|
|
Term
| how does restrictive lung disorder reduce FVC |
|
Definition
|
|
Term
| how does obstructive lung disorder decrese FVC |
|
Definition
| causing a slow rise in RV |
|
|
Term
| What is occurring if measured FVC is significntly smaller than SVC |
|
Definition
|
|
Term
| what is an important indicator of patient's ventilatory reserve |
|
Definition
| VC - significant reduction indicates patient is at higher risk for respiratory failure esp after surgery |
|
|
Term
|
Definition
|
|
Term
| What is TLC the function of |
|
Definition
|
|
Term
| what must be determined to meaure TLC |
|
Definition
|
|
Term
| What are the two ways to detrmine RV or FRC |
|
Definition
| body plethsmography or open-circuit nitrogen washout |
|
|
Term
| What is body plethsmography |
|
Definition
| measures all gas in the chest - cost is high |
|
|
Term
| what is open-circuit nitrogen washout |
|
Definition
| less costly - meausures amount of nitrogen washed out of the lungs upon exhalation |
|
|
Term
| closed-system helium dilution |
|
Definition
| helium is inert and not absorbed from lungs by blood therefore if known volume and concentration of helium are added to patient's respiratory system helium will be diluted in proportion to the size of the lung volume to which it is added |
|
|
Term
|
Definition
| Residual Volume and is the amount of gas left in the lung after the patient exhales all that is physically possible |
|
|
Term
| Which lung volume cannot be measured by the routine spirogram |
|
Definition
|
|
Term
| "With regard to residual volume, what is the normal percentage to TLC and VC" |
|
Definition
|
|
Term
| "If RV is greater than 33% of VC, what does this indicate?" |
|
Definition
| COPD is probably present and the percentages are normal in restrictive disease |
|
|
Term
|
Definition
| Expiratory Reserve Volume - volume that can be maximally exhaled following a passive exhalation |
|
|
Term
|
Definition
| by subtracting RV from FRV |
|
|
Term
| What is the clinical significance of ERV |
|
Definition
| "limited usefullness and is reduced in obese persons, those with poor efford and those with restrictive disease" |
|
|
Term
|
Definition
| Functional residual capacity - resting volume in lungs following exhalation of a Vt breath |
|
|
Term
|
Definition
|
|
Term
| What represents a balance between the expanding chest wall forces and the contractile rebound forces of lung tissue |
|
Definition
|
|
Term
| What causes FRC to be increased |
|
Definition
| Disorders that cause a loss of lung tissue (emphysema) |
|
|
Term
| What causes FRC to be reduced |
|
Definition
| disorders that cause partial or more complete collapse of lung (pneumothorax) |
|
|
Term
| What is the significance of IRV and IC |
|
Definition
| "inspiratory reserve volume and inspiratory capacity are measured by the routine spirogram, not used widely in evaluating pulmonary dysfunction because these measurements can be normal in restrictive and obstructive disease" |
|
|
Term
|
Definition
| forced expiratory volume at 1 second |
|
|
Term
|
Definition
| maximal volume of air exhaled during the first second of expiration |
|
|
Term
| What is the best indicator of obstructive disease |
|
Definition
| FEV1 it is a forced maneuver and highly significant |
|
|
Term
|
Definition
| flow characteristics in the larger airways |
|
|
Term
| How is FEV1 best expressed |
|
Definition
| as a percentage of the observed FVC (FEV1/FVC) |
|
|
Term
|
Definition
| 3 second point of expired curve and gives an indication of the flow in smaller airways and is not as reproducible and sensitive as FEV1 |
|
|
Term
|
Definition
| "forced expiratory flow, midexpiratory phase" |
|
|
Term
| What does FEF 25%-75% look at |
|
Definition
| middle 50% of curve's slope |
|
|
Term
| What does FEF 25%-75% reflect and what is its primary usefulness |
|
Definition
| reflects degree of airway patency and is useful in evaluating obstructive disorders |
|
|
Term
| What is FEF25%-75% an early indicator of |
|
Definition
| early indicator of obstructive dysfunction and can also be reduced in restrictive disorder |
|
|
Term
|
Definition
| Peak expiratory flow which is th emaximal flow rate achieved by the patient during the FVC maneuver |
|
|
Term
| What is PEF a popular maneuver for |
|
Definition
| in pulmonary function testing of patients with obstructive disease and asthmatic patients can use it to monitor their condition at home |
|
|
Term
| What does PEF correlate well with in ashtmatics |
|
Definition
| FEV1 and can be used to identify the severity of airway obstruction |
|
|
Term
| What are the benefits of PEF |
|
Definition
| provides objective data regarding patient's response to therapy and use of a portable device allows rapid and repeatabl assessment of PEF in a variety of clinical settings |
|
|
Term
|
Definition
| "the status of respiratory muscles, compliance of the thorax-lung complex and airway resistance Raw" |
|
|
Term
| What is clinically significant with MVV |
|
Definition
|
|
Term
|
Definition
| surgeons as a quick assessment of the state of the patient's lungs before surgery |
|
|
Term
| What does poor performance on the MVV suggest |
|
Definition
| that the patient may have significant respiratory problems postoperatively |
|
|
Term
| Why is the MVV of little use |
|
Definition
| because it is effort dependent |
|
|
Term
| What are Flow volume loops or Flow volume Curves |
|
Definition
| generated by integrating flow with volume on graph paper. Volume is plotted on the horizontal axis and flow on the vertical axis |
|
|
Term
| What is the significance of pulmonary function testing before and after aerosol bronchodilators |
|
Definition
| used to assess the reversibility of the airway obstructino seen on the initial spirogram |
|
|
Term
| What is the common drug used for PFT before and after bronchodilator |
|
Definition
| "B2 sympathomimetic drug, but not a specific one" |
|
|
Term
| What must happen for response to inhaled bronchodilator to be considered improved with regard to PFT before and after bronchodilator therapy? |
|
Definition
| "recommended that two out of the following three be improved FVC, FEV1, and FEF25%-75%" |
|
|
Term
| "What is the amount of improvement for FVC, FEV1, and FEF25%-75% in order to be considered?" |
|
Definition
| "FVC increase greater than 10%, FEV1 increase of 200 mL or 15% over baseline FEV1 and FEF25%-75% is 20% to 30% increase" |
|
|
Term
| What is thought to be most often predictive of subsequent usefulnes in asthmatic patients |
|
Definition
| positive response to bronchodilator |
|
|
Term
| What happens if there is no response to bronchodilator therapy |
|
Definition
| clinical control may be difficult |
|
|
Term
|
Definition
|
|
Term
|
Definition
| in determining the ability of the lungs to transfer gas to the blood |
|
|
Term
| What are the determinants of gas exchange across the membrane |
|
Definition
| "diffusion coefficient of the gas used, surface area of the membrane, thickness of membrane, blood volume and flow in pulmonary capillary tree, distribution of the inspired gas, hematocrit" |
|
|
Term
| What are the most common causes of reduced DlCO values |
|
Definition
| emphysema and pulmonary fibrosis |
|
|
Term
| How is diffusion most commonly measured |
|
Definition
| by using a single breath of carbon monoxide at minute levels |
|
|
Term
|
Definition
|
|
Term
| What reduces the number of red blood cells that remove CO from the closed system and thereby reduced DLCO |
|
Definition
|
|
Term
| If pulmonary capillary blood flow to an area is reduced what happens to the diffusion of CO |
|
Definition
| "diffusion of CO will not occur, thus reducing DLCO" |
|
|
Term
| What affects the results of DLCO |
|
Definition
| size of the individual because large individuals will have larger diffusion capacities |
|
|
Term
|
Definition
| respiratory quotient and it is the ratio of carbon dioxide produced to oxygen consumed |
|
|
Term
|
Definition
|
|
Term
| What is one of the most frequent uses of RQ |
|
Definition
| to assess which food group is being metabolized for energy |
|
|
Term
|
Definition
| a person who is being weaned from a ventilator |
|
|
Term
| What does knowledge of the patient's RQ allow intelligen tadjustment of |
|
Definition
| the patient's diet and may speed up th eprocess of weaning the patient from the ventilator |
|
|
Term
| What are common exercise tests that are used |
|
Definition
| "stress ECG, ventilatory capacity, blood gases, exercise challenge, anaerobic threshold, maximal oxygen uptake (VO2max) 6-minute walk test" |
|
|
Term
| What is done in smokers to reinforce the need for smoking cessation |
|
Definition
| PFT especially if considerable loss of lung function is documented |
|
|
Term
| What is the most useful single predictor of who will have cardiopulmonary disease as a result of smoking |
|
Definition
|
|
Term
|
Definition
| when electromagnetic waves radiate from a tube through which an electric current has passed which results in electrons being emitted |
|
|
Term
| "Once electrons hit a target device in the x-ray machine, what happens?" |
|
Definition
| They are transformed into x-rays |
|
|
Term
| What are x-rays able to penetrate |
|
Definition
| matter and the density of the matter determines the resulting degree of penetration |
|
|
Term
| What aborbs more x-rays and what absorbs little x-rays |
|
Definition
| dense objects such as bones abosorb more and air-filled objects absorb little |
|
|
Term
| What causes the film to turn dark (radiolucent) |
|
Definition
| x-rays that pass through low-density objects such as the lungs |
|
|
Term
| what cause the film to remain white or radiopaque |
|
Definition
| x-rays that are absorbed by high-density objects |
|
|
Term
| what are the four densities seen on the chest x-ray |
|
Definition
| "bone, water, fat and air" |
|
|
Term
| What is the standard radiographic view |
|
Definition
| patient standing and the x-ray passing from back to front which creates a P-A view. Heart magnification is minimal with the p-a view |
|
|
Term
| "In the standard chest x-ray exam, what is included to allow viewing of the lung tissue behind the heart" |
|
Definition
|
|
Term
| when would laterla decubitus view be obtained |
|
Definition
| when excesive pleural fluid may be present because this view allows better detection of the free fluid |
|
|
Term
| When is the apical lordotic view used |
|
Definition
| to evaluate the upper lung fields better. The x-ray tube is angled at approx 45 degrees from below midline |
|
|
Term
| when are oblique views helpful |
|
Definition
| in evaluating overlapping lesions |
|
|
Term
| what chest films are useful to detect a small pneumothorax |
|
Definition
|
|
Term
| when is portable chest film used |
|
Definition
| often needed in the ICU patient who is too ill to go to radiology |
|
|
Term
| how is the portable chest film generated |
|
Definition
| with the film cassette under the patient's back and with the x-ray machine in front of the patient thus thefilm is considered an A-P portable |
|
|
Term
| What does the portable chest x-ray result in |
|
Definition
| magnification of the heart and a larger heart shadow which can be misinterpreted as an enlarged heart |
|
|
Term
|
Definition
| computed tomography and results in very sharp images useful to detect and monitor lung and hed lesions but the cost is much higher than chest x-ray |
|
|
Term
| What conditions call for use of CT |
|
Definition
| "lung tumors, chronic interstitial lung disease, AIDS for pneumonia, pneumonia with certain lung infections that involve the pleura, bronchiectasis, COPD although not usually used" |
|
|
Term
| What value is MRI in evaluating lung disease |
|
Definition
|
|
Term
| what is MRI useful in imaging |
|
Definition
| hilar lymph node enlargement and is useful in certain types of lung cancer |
|
|
Term
| How is lung scanning accomplished |
|
Definition
| by injecting the patient with radiopharmaceuticals that lodge in the pulmonary circulatino and the patient also inhales a gas that is visible on x-ray |
|
|
Term
| what can be evaluated with lung scanning |
|
Definition
| degree of circulation and ventilation in each lung segment |
|
|
Term
| what is suggestive of pulmonary embolism when reviewing lung scan results |
|
Definition
| areas that have poor circulation but remain ventilated |
|
|
Term
| "When reviewing a chest radiograph, how is a good inspiratory effort verified?" |
|
Definition
| it results in 10 posterior ribs visible above the diaphragm. The depth f patint's inspiration is assessed to help determine the quality of chest film |
|
|
Term
| How is silhouette sign used |
|
Definition
| to determine if a pulmonary infiltrate is in contact with the heart border |
|
|
Term
| What is seen on the chest film with pneumothorax |
|
Definition
| pleural line may be seen on the lateral part of the chest and shift of mediastinal structures may be seen with tension pneumothorax |
|
|
Term
| With CHF what does the chest x-ray reveal |
|
Definition
| redistribution of pulmonary vasculature to the upper lobes |
|
|
Term
| What are disturbances in cardiac conduction called |
|
Definition
|
|
Term
| What is a key factor in reducing or eliminating cardiac irritability |
|
Definition
| application and improved delivery of oxygen |
|
|
Term
| What are some causes of arrythmias |
|
Definition
| "hypoxia, ischemia, sympathetic stimulation, drugs, electrolyte imbalances, rate and stretch" |
|
|
Term
| How many leads are used in order to obtain the most complete picture of electrical activity in the heart since it is a 3-dimentional organ |
|
Definition
|
|
Term
| What are the two groups the 12 leads are broken down into |
|
Definition
| 6 limb leads and 6 chest leads |
|
|
Term
| How are six limb leads obtained |
|
Definition
| two electrodes are placed on the patient's wrists and two on the ankles |
|
|
Term
| What are the six limb leads called |
|
Definition
| "I, II, III, aVr, aVL, and aVf" |
|
|
Term
| Which of the limb leads are bipolar |
|
Definition
|
|
Term
| What are the augmented limb leads |
|
Definition
|
|
Term
| What do the six limb leads view the heart in? |
|
Definition
| a vertical plane called a frontal plane |
|
|
Term
| What are the chest leads and how are they placed across the chest |
|
Definition
| "unipolar, V1, V2, V3, V4, V5 and V6 and they are placed across the chest in a horizontal plane" |
|
|
Term
| "Under normal conditions, where do the chest leads lie?" |
|
Definition
| V1 and V2 lie directly over right ventricle V3 and V4 lie over the interventricular septum and V5 and V6 lie over the left ventricle |
|
|
Term
| What does the QRS axis represent |
|
Definition
| general direction of current flow during ventricular depolarization |
|
|
Term
| "With the QRS axis, what is the normal mean axis " |
|
Definition
| somewhere between 0 and 90 degrees |
|
|
Term
| "with the QRS axis, what does right axis deviation indicate and what does left axis deviation indicate" |
|
Definition
| right axis deviation indicates that the right ventricle is enlarged and left axis deviation indicates left ventricle is enlarged |
|
|
Term
| What is the normal width of the QRS complex |
|
Definition
|
|
Term
| When is a Q wave considered normal |
|
Definition
| if it is less than 0.4 second wide and less than one third the amplitude of the R wave. |
|
|
Term
|
Definition
| normal sinus rhythm except heart rate whch is less than 60 beats/min |
|
|
Term
|
Definition
| when heart rate is 100 - 150 beats/min |
|
|
Term
|
Definition
| benign arrythmia that meets all other criteria for being considered normal except rhythm is irregular |
|
|
Term
|
Definition
| "paroxymal atrial tachycardia. Occurs when an ectopic focus in the atrium usurps the pacemaking function of the SA node and paces the heart, usually at an abnormally rapid rate of 160 - 240 beats per minute" |
|
|
Term
|
Definition
| produces very distinctive sawtooth pattern between normal-appearing QRS complexes |
|
|
Term
| What is atrial fibrillatin |
|
Definition
| electrical activity of the atria is completely chaotic without coordination and ECG tracing shows a chaotic baseline between QRS complexes with no regular pattern or organization |
|
|
Term
|
Definition
| "premature ventricular contraction which represent ectopic beats originating in one of the ventricles due to enhanced automaticity and they occur in normal and diseased heart and can be caused by anxiety, stimulants, etc" |
|
|
Term
|
Definition
| broad QRS complexes occurring at a rapid rate without identifiable P waves which originate from an ectopic focus in the ventricles and are associated with enhjaced automaticity or reentry |
|
|
Term
|
Definition
| chaotic completely unorganized electrical activity in the ventricular myocardial fibers |
|
|
Term
|
Definition
| cardiac standstill - straight and/or flatline |
|
|
Term
| ECG with chronic lung disease |
|
Definition
| COPD patients most likely have cardiac abnormality |
|
|
Term
| what do patients with chronic hypoxemic lung disease often have evidence of |
|
Definition
| right axis deviation on the ECG which is seen as a negative QRS in lead I |
|
|
Term
| "When is reduced voltage in the limb leads (I, II, III) seen" |
|
Definition
| when severe pulmonary hyperinflation (emphysema) is present |
|
|
Term
| What is the most common cause of auditory impairment in the US that affects 23% of adults 65-75 |
|
Definition
|
|
Term
| What is a quick way to assess hearing loss |
|
Definition
| whisper a simple question while stading about 2 feet away out of direct view |
|
|
Term
| What should you do to assess hearing loss compensation if hearing loss is suspected |
|
Definition
| face the patient and ask can you hear me? |
|
|
Term
| What can be used as an amplification device with a patient with hearing loss |
|
Definition
| use stethoscope by placing ear pieces in patient's ears and speaking through the bell |
|
|
Term
| What is the term used to describe the specific type of vision loss associated with adults over 40 with the characteristics of far sightedness |
|
Definition
|
|
Term
| What are some common eye disorders that frequently affect older patients |
|
Definition
| "cataracts, glaucoma, diabetic retinopathy, macular degeneration" |
|
|
Term
| Are RTs concerned with vision loss |
|
Definition
|
|
Term
| What are some compensations for vision loss with older adults |
|
Definition
| "verbal communication very important, keep everything in ""its place"", medcine bottles can be marked with large letter denoting the name of medicine" |
|
|
Term
| What are typical symptoms of pneumonia and do they differ in the elderly |
|
Definition
| "cough, fever, purulent sputum but these can be subtle in elderly specifically lack of an elevated temperature" |
|
|
Term
| Why is fever difficult to detect in the elderly |
|
Definition
| they have a lower base termperature and reduced ability to mount a febrile response |
|
|
Term
| What are some common extrapulmonary signs of pneumonia in the elderly patient |
|
Definition
| "nausea, vomiting, diarrhea, myalgia and arthralgia" |
|
|
Term
| What is the most sensitive sign of pneumonia in the elderly patient |
|
Definition
| increased respiratory rate (more than 28 breaths/min) |
|
|
Term
| "What is helpful in diagnosing the elderly patient's pneumonia, but not if they are dehydrated" |
|
Definition
| chest x-ray because the pneumonic infiltrate may be obscured by pulmonary edema or may not be detectable on the chest film until 24-48 hours after patient has rehydrated |
|
|
Term
| What is recommended in order to avoid empiric therapy wth a broad-spectrum antibiotic in the elderly patient with pneumonia |
|
Definition
| sputum specimens but a good sputum specimen from an older debilitated patient is difficult to obtain |
|
|
Term
| What is the major source of chronic disability in the US |
|
Definition
|
|
Term
| What percentage of patients who die from myocardian infarction are over 75 |
|
Definition
|
|
Term
| What is the most common symptom of myocardial infarction |
|
Definition
| "chest pain but the pain may be referred such as shoulder pain, throat and abdominal pain or even bilateral elbow pain" |
|
|
Term
| What should the clinician suspect if the older patient complains of dizziness |
|
Definition
| heart problems because of the degeneration of the cardiac conduction of fibers |
|
|
Term
| What could cough and wheezing indicate with an elderly patient |
|
Definition
| early left-sided heart failure |
|
|
Term
| what may hemoptysis be indicative of in the elderly patient |
|
Definition
| heart failure or pulmonary embolus |
|
|
Term
| What may be the only presenting complaint of heart failure in the elderly patient |
|
Definition
|
|
Term
| What could dyspnea and lethargy be symptoms of |
|
Definition
|
|
Term
| What percentages of the elderly have asthma |
|
Definition
| 5% older than 60 years old and 7% - 9% older than 70 |
|
|
Term
| What is often misdiagnosed and/or underdiagnosed in the older patient |
|
Definition
|
|
Term
| What is possible when asthma and COPD occur together |
|
Definition
| only the COPD is diagnosed and not the asthma |
|
|
Term
| What are classic symptoms of asthma |
|
Definition
| "shortness of breath, wheezing and cough which are lso common in chf, emphysema, chronic bronchitis, gastroesophageal reflux, and transbrochial tumors" |
|
|
Term
| When should a diagnosis of asthma be considered in an elderly patient |
|
Definition
|
|
Term
| When can inspection and palpation take place while assessing the elderly patient |
|
Definition
| "while taking a patient history, checking vital signs or auscultating lung sounds" |
|
|
Term
| What do the effects of pulmonary aging result in |
|
Definition
| "reduced vital capacity and expiratory flow rates, an increase in closing volume and reduced partial pressure of arterial oxygen" |
|
|
Term
| What is lung capacity in a 20 year old vs 70 year old |
|
Definition
| the closing capcity increases from about 30% of total lung capcity at 20 to 50% of total lung capacity at 70 |
|
|
Term
| "What happens to P(A-a)02 alveolar-arterial oxygen partial pressure as a consequence of either intrapulmonary shunting, diffusion lmitatino of oxygen/carbon dioxide gas exchange or V/Q abnormalities in the elderly" |
|
Definition
|
|
Term
| What is the most common cause of auditory impairment in the US that affects 23% of adults 65-75 |
|
Definition
|
|
Term
| What is a quick way to assess hearing loss |
|
Definition
| whisper a simple question while stading about 2 feet away out of direct view |
|
|
Term
| What should you do to assess hearing loss compensation if hearing loss is suspected |
|
Definition
| face the patient and ask can you hear me? |
|
|
Term
| What can be used as an amplification device with a patient with hearing loss |
|
Definition
| use stethoscope by placing ear pieces in patient's ears and speaking through the bell |
|
|
Term
| What is the term used to describe the specific type of vision loss associated with adults over 40 with the characteristics of far sightedness |
|
Definition
|
|
Term
| What are some common eye disorders that frequently affect older patients |
|
Definition
| "cataracts, glaucoma, diabetic retinopathy, macular degeneration" |
|
|
Term
| Are RTs concerned with vision loss |
|
Definition
|
|
Term
| What are some compensations for vision loss with older adults |
|
Definition
| "verbal communication very important, keep everything in ""its place"", medcine bottles can be marked with large letter denoting the name of medicine" |
|
|
Term
| What are typical symptoms of pneumonia and do they differ in the elderly |
|
Definition
| "cough, fever, purulent sputum but these can be subtle in elderly specifically lack of an elevated temperature" |
|
|
Term
| Why is fever difficult to detect in the elderly |
|
Definition
| they have a lower base termperature and reduced ability to mount a febrile response |
|
|
Term
| What are some common extrapulmonary signs of pneumonia in the elderly patient |
|
Definition
| "nausea, vomiting, diarrhea, myalgia and arthralgia" |
|
|
Term
| What is the most sensitive sign of pneumonia in the elderly patient |
|
Definition
| increased respiratory rate (more than 28 breaths/min) |
|
|
Term
| "What is helpful in diagnosing the elderly patient's pneumonia, but not if they are dehydrated" |
|
Definition
| chest x-ray because the pneumonic infiltrate may be obscured by pulmonary edema or may not be detectable on the chest film until 24-48 hours after patient has rehydrated |
|
|
Term
| What is recommended in order to avoid empiric therapy wth a broad-spectrum antibiotic in the elderly patient with pneumonia |
|
Definition
| sputum specimens but a good sputum specimen from an older debilitated patient is difficult to obtain |
|
|
Term
| What is the major source of chronic disability in the US |
|
Definition
|
|
Term
| What percentage of patients who die from myocardian infarction are over 75 |
|
Definition
|
|
Term
| What is the most common symptom of myocardial infarction |
|
Definition
| "chest pain but the pain may be referred such as shoulder pain, throat and abdominal pain or even bilateral elbow pain" |
|
|
Term
| What should the clinician suspect if the older patient complains of dizziness |
|
Definition
| heart problems because of the degeneration of the cardiac conduction of fibers |
|
|
Term
| What could cough and wheezing indicate with an elderly patient |
|
Definition
| early left-sided heart failure |
|
|
Term
| what may hemoptysis be indicative of in the elderly patient |
|
Definition
| heart failure or pulmonary embolus |
|
|
Term
| What may be the only presenting complaint of heart failure in the elderly patient |
|
Definition
|
|
Term
| What could dyspnea and lethargy be symptoms of |
|
Definition
|
|
Term
| What percentages of the elderly have asthma |
|
Definition
| 5% older than 60 years old and 7% - 9% older than 70 |
|
|
Term
| What is often misdiagnosed and/or underdiagnosed in the older patient |
|
Definition
|
|
Term
| What is possible when asthma and COPD occur together |
|
Definition
| only the COPD is diagnosed and not the asthma |
|
|
Term
| What are classic symptoms of asthma |
|
Definition
| "shortness of breath, wheezing and cough which are lso common in chf, emphysema, chronic bronchitis, gastroesophageal reflux, and transbrochial tumors" |
|
|
Term
| When should a diagnosis of asthma be considered in an elderly patient |
|
Definition
|
|
Term
| When can inspection and palpation take place while assessing the elderly patient |
|
Definition
| "while taking a patient history, checking vital signs or auscultating lung sounds" |
|
|
Term
| What do the effects of pulmonary aging result in |
|
Definition
| "reduced vital capacity and expiratory flow rates, an increase in closing volume and reduced partial pressure of arterial oxygen" |
|
|
Term
| What is lung capacity in a 20 year old vs 70 year old |
|
Definition
| the closing capcity increases from about 30% of total lung capcity at 20 to 50% of total lung capacity at 70 |
|
|
Term
| "What happens to P(A-a)02 alveolar-arterial oxygen partial pressure as a consequence of either intrapulmonary shunting, diffusion lmitatino of oxygen/carbon dioxide gas exchange or V/Q abnormalities in the elderly" |
|
Definition
|
|
Term
| What is the first type of sleep entered by healthy sleepers |
|
Definition
|
|
Term
| What are the stages of NREM recognized by |
|
Definition
| EEG changes during a sleep study |
|
|
Term
| What is the lightest stage of sleep and the person is easily roused |
|
Definition
|
|
Term
| What is the most common stage of sleep in adults |
|
Definition
|
|
Term
| What are the deepest stages of sleep |
|
Definition
|
|
Term
| What stage is the deepest and most difficult to rouse |
|
Definition
|
|
Term
| What is diminished during NREM sleep |
|
Definition
|
|
Term
| What is irregular in the initial stages of NREM but steadies during deeper stages |
|
Definition
|
|
Term
| "What besides sleep is diminished during NREM, especially during the deeper stages" |
|
Definition
|
|
Term
| When does the first cycle of REM sleep occur |
|
Definition
| 60 - 90 minutes after the onset of NREM |
|
|
Term
| What time of sleep does the sleeper dream |
|
Definition
|
|
Term
| How many episodes of REM does the sleeper experience each night |
|
Definition
| four or five REM episodes |
|
|
Term
| "During REM, which episodes of dreams are short and which are long" |
|
Definition
| initial episodes are short (5 minutes) and subsequent are long (60 min) |
|
|
Term
| What physiologic changes occur during REM sleep |
|
Definition
| "muscle tone is at a minimum, respiratory efforts are chaotic, heart rate is irregular" |
|
|
Term
|
Definition
|
|
Term
|
Definition
| airflow reduction of greater than 70% in the presence of respiratory effort |
|
|
Term
|
Definition
| upper airway resistance syndrome |
|
|
Term
| What is the definition of UARS |
|
Definition
| When the upper airway is abnormally narrowed during sleep but breathing is adequate to maintain normal gas exchange |
|
|
Term
| Changes in heart rate and cardiac dysrthymias are more common in which patients |
|
Definition
|
|
Term
| "In patients with OSA, what often occurs during the apneic period and is followed by tachycardia immediately after the apnea" |
|
Definition
|
|
Term
| What occur in approximately 20% of patients with OSA and are the most common dysrhythmias |
|
Definition
|
|
Term
| What occurs in about 10% of cases and usually lasts for only a few seconds |
|
Definition
|
|
Term
|
Definition
| central sleep apnea and occurs when there is a cessation of airflow resulting from alck of movement of the diaphragm and is loss of ventilatory drive or rhythmicity |
|
|
Term
| What is the body habitus of CSA |
|
Definition
|
|
Term
| does CSA occur most often with adults or children |
|
Definition
|
|
Term
| What is the cause of CSA in children |
|
Definition
| instability of breathing control centers in the brain is a possible primary factor |
|
|
Term
| "in children, various factors may play a role in precipitating an episode of CSA such as" |
|
Definition
| "cardiac, hematologic, infectious, metabolic, neurologic, hastrointestinal, neuromuscular abnormalities" |
|
|
Term
| What is the cause of SIDS |
|
Definition
|
|
Term
| what is the leading cuase of death in children under one year |
|
Definition
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