Term
Acute Respiratory Distress Syndrome (ARDS)
Also known as respiratory distress syndrome (RDS) or adult respiratory distress syndrome (in contrast with IRDS) |
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Definition
What is a life threatening condition that adversely affects gas exchange in the lungs. It is a form of pulmonary edema caused by fluid accumulation in the interstitial space within the lungs?
A life-threatening reaction to injuries or acute infection to the lung. A severe lung syndrome (not a disease) with direct and indirect causes. Inflammation of the lung parenchyma leads to impaired gas exchange with systemic release of inflammatory mediators, causing inflammation, hypoxemia and frequently multiple organ failure. This condition has a 90% death rate in untreated patients. With treatment, (usually mechanical ventilation in an intensive care unit), the death rate is 50%.
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Term
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Definition
| Hemoglobin with Carbon Dioxide bound to it. |
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Term
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Definition
| Three bony prominences that mark the lateral wall of the nasal cavity? |
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Term
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Definition
| Rich supply of blood vessels in the lower nasal septum that warms the inspired air. |
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Term
The first cranial nerve
(CN-1 or the olfactory nerve) |
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Definition
| The superior portion of the nose contains nerve fibers derived from what nerve that pass through the thin cribiform plate that separates the nasal cavity from the cranial cavity? |
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Term
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Definition
Portion of the pharynx that is posterior to the nose and is the most superior aspect of the pharynx.
Filtering, humidification and warming of inspired air continue here. |
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Term
| Nasal cavity, Pharynx, Larynx |
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Definition
| What three structures comprise the upper airway? |
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Term
Pharyngeal Tonsils (adenoids): nasopharynx
Palatine Tonsils: Oropharynx
Lingual Tonsils: Oropharynx |
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Definition
| What are the three types of tonsils and their locations? |
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Term
(Arytenoid, Corniculate, Cuneiform)
The thyroid cartilage, the cricoid cartilage and the epiglottis. |
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Definition
| Three pairs of cartilage that make up the larynx? |
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Term
| trachea, Bronchi, Alveoli, Lungs |
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Definition
| What are the four components of the lower airway? |
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Term
22
Respiratory Bronchioles (where the airway shifts from being a conduit for air to an organ of gas exchange) |
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Definition
After approximately how many divisions do the bronchioles become terminal bronchioles?
What do the terminal bronchioles divide into? |
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Term
Respiratory Membrane
70m2 |
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Definition
| The alveolar lining, supportive tissue and capillaries make up the _____________. This gas exchange surface measures approximately _____? |
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Term
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Definition
| The alveoli are moistened and kept open because of the presence of an important chemical called ___________ that is secreted by Type II Cells found on the alveolar surface. |
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Term
| Hilum (the point at which the bronchi and blood vessels enter the lungs) |
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Definition
| What is the only point at which the pleura attaches to the lung? |
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Term
Visceral (no nerve fibers)
Parietal (contains nerve fibers) |
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Definition
| What are the two layers of the pleura and which of them contain nerve fibers? (or do they both) |
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Term
Bronchial Arteries branching from the aorta.
Bronchial Veins return blood to the vena cava. |
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Definition
| How does the lung tissue receive most of it's blood supply? |
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Term
| Ventilation, Diffusion, Perfusion |
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Definition
| What are the three processes that allow gas exchange to occur? |
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Term
| Decrease to approximately 1-2 mmHg below atmosphere |
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Definition
| Upon inspiration, the diaphragm contracts and teh intercostal muscles contract producing chest cavity expansion and produces a decrease in internal air pressure of ________? |
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Term
| Active, requiring energy. |
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Definition
| Inspiration is always an ___________ process? |
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Term
| 4-8 mmHg less than atmosphere. |
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Definition
| How nuch pressure difference between atmosphere and the pleural space? |
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Term
| Adequate blood volume, Intact pulmonary capillaries, Efficient pumping of blood by the heart. |
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Definition
| Lung perfusion is dependent upon what three factors? |
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Term
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Definition
| What is the name of the transport protein that carries oxygen in the blood? |
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Term
| 98% Bound to hemoglobin and less than 2% is dissolved in the plasma. |
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Definition
| Oxygen is transported in the bloodstream in one of two ways. What are they and what percentage of transport is each responsible for under normal conditions? |
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Term
Oxyhemoglobin
Deoxyhemoglobin |
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Definition
| What is the term for hemoglobin with oxygen bound to it? What is the term for hemoglobin without oxygen? |
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Term
Four iron containing heme molecules and a protien containing globin portion.
O2 binds to the heme portion. |
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Definition
| Hemoglobin is made up of what kind / number of molecules and to which part does the O2 bind? |
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Term
As bicarbonate ion (70%)
Bound to the globin portion of the hemoglobin (23%)
Dissolved in plasma (measured as PCO2) (7%) |
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Definition
| Carbon dioxide is transported from the cells to the lungs in one of three ways. What are they and what are the percentages? |
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Term
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Definition
| Hemoglobin with the carbon dioxide bound is called what? |
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Term
| Cheyne-stokes Respirations |
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Definition
| Ventilatory pattern with progressively increasing tidal volume, followed by declining volume and separated by periods of apnea at the end of expiration. (Typically seen in terminally ill older patients and brain injury) |
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Term
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Definition
| Deep rapid breaths that result as a corrctive measure against conditions such as diabetic ketoacidosis that produce metabolic acidosis. |
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Term
| Central Neurogenic Hyperventilation |
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Definition
| Produces deep rapid respirations that are caused by strokes or brainstem injury. In this pattern ther is loss of normal regulation of ventilatory controls and respiratory alkalosis is often seen. |
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Term
| Ataxic (Biot's) Respirations |
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Definition
| Respirations characterized by repeated episodes of gasping ventilations separated by periods of apnea. This pattern is seen in patients with increased intracranial pressure. |
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Term
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Definition
| Respirations characterized by long, deep breaths that are stopped during the inspiratory phase and separated by periods of apnea. This pattern is a result of stroke or severe central nervous disease. |
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Term
| accumulation of fluid and inflammatory cells in the interstitial space. |
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Definition
| Disease states that alter the thickness of the respiratory membrane will limit the diffusion of gases. What is the most common cause of this alteration? |
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Term
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Definition
| What is the term for when an area of lung tissue is appropriately ventilated but no capillary perfusion occurs, and available oxygen is not moved into the circulatory system? |
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Term
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Definition
| Impairment of ventilatory exchange of oxygen and carbon dioxide. |
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Term
| Chronic Obstructive Pulmonary Disease (COPD) |
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Definition
| Characterized by the presence of two diseases - emphysema and chronic bronchitis. |
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Term
| Reactive Oxygen Species (ROS) |
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Definition
| Chemicals formed due to hyperoxia that can damage body cells and tissues. |
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Term
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Definition
| Toxic chemicals caused by excessive oxygenation. |
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Term
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Definition
| Difficulty breathing while lying flat. |
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Term
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Definition
| A process in which cells and tissues are damaged by free radicals (reactive oxygen species). |
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Term
| Paroxysmal Nocturnal Dyspnea |
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Definition
| Difficulty Breathing at night. |
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Term
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Definition
| The negative logarithm of the H+ ion concentration used to measure the acidity or alkalinity of a liquid. |
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Term
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Definition
| The presence of air in the subcutaneous tissues. |
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Term
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Definition
| The vibration felt in the chest during vocalization. |
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Term
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Definition
| A compensatory breathing mechanism in which the accessory muscles of the neck are used to increase negative intrathoracic pressure and increase the volume of inspired air. |
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Term
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Definition
| True or False: The Trachea is not part of the upper airway? |
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Term
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Definition
| Characterized by long, deep breaths that are stopped during the inspiratory phase and separated by periods of apnea. |
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Term
Adequate blood volume,
efficient pumping of the heart
intact pulmonary capillaries |
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Definition
| Lung perfusion is dependent on what three factors? |
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Term
| E. Call for a hazardous materials team |
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Definition
Per the workbook: The most important action when you arrive on the scene and discover that a hazardous material is present is to:
A. Have supplemental oxygen available
B. Assure your own safety
C. Search for additional patients
D. Don your SCBA
E. Call for a hazmat team |
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Term
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Definition
Which of the following is the most ominous sign of possible life threatening respiratory distress?
A. Altered Mental Status
B. Audible Stridor
C. One to two word dyspnea
D. Tachycardia
E. Use of accessory muscles |
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Term
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Definition
Common physical attributes of a person with emphysema include all of the following except:
A. Chronic cough
B. barrel chest
c. clubbing of the fingers
d. pinkish tone to skin
e. thin build |
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Term
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Definition
Common physical attributes of a person with chronic bronchitis include all of the following except:
A. Chronic cough
B. Thin build
C. bluish, cyanotic skin
D. cough producing large amounts of sputum
E. Ankle edema |
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Term
| Sharp or tearing in character |
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Definition
| Pleuritic chest pain associated with pneumonia is described how? |
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Term
| E. While the patient displays signs and symptoms |
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Definition
The SARS patient is considered contagious during which time period?
A. 2-7 days after contact
B. 10-14 days after contact
C. 2-7 days after symptoms appear
D. 10-14 days after symptoms appear
E. While the patient displays signs and symptoms |
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Term
| B. Placement of ECG leads for cardiac monitoring |
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Definition
Std management of lung cancer includes all of the following EXCEPT:
A. checking for DNR orders
B. Placement of ECG leads for cardiac monitoring
C. Administration of supplemental oxygen
D. Airway and ventilatory support as needed
E. emotional support for patient and family |
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Term
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Definition
| True or False: The mortality rate for pulmonary emboli is greater than 50 percent? |
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Term
| C. Spontaneous Pneumo is more common in women than in men |
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Definition
Which of the following statements regarding spontaneous pneumothorax is FALSE?
A. Most patients have acute onset pain in the chest or shoulder region
B. Onset usuall follows heavy lifting or coughing
C. It is more common in women than in men
D. It is more common among smokers and COPD patients
E. Supplemental O2 is sufficient therapy for the majority of patients with Spontaneous Pneumo. |
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Term
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Definition
| True or False: Respiratory emergencies due to central nervous system dysfunction are relatively rare? |
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Term
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Definition
| True or False: Numerous peripheral nervous system conditions can cause respiratory compromise, including the diseases of polio and amyotrophic lateral sclerosis, as well as Guillian Barre syndrome? |
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Term
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Definition
| True or False: central nervous system dysfunction is a common cause of respiratory emergencies: |
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Term
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Definition
| True or False: All patients suffering from CO exposure should be transported emergently to a special care facility with a hyperbaric chamber? |
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Term
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Definition
| For what condition does treatment include correcting hypoxia, reversing bronchospasm and reducing inflammation? |
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Term
| Inhalation of a toxic substance |
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Definition
| For what emergency does treatment consist of ensuring the safety of emergency personnel, remove patient for transport, maintain open airway and deliver humidified high concentration O2? |
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Term
| Acute Respiratory Distress Syndrome |
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Definition
| For what condition would treatment consist of maintaining the airway and ventilation as needed; delivery of oxygen; establishing IV access; cardiac monitoring and pulse ox; and transport to a facility for care of an underlying condition? |
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Term
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Definition
| Treatment for this condition consists of maintaining the airway, ventilation and circulation as needed; delivery of oxygen, establishing IV access, cardiac monitoring, pulse ox, and checking of extremities during transport to appropriate care facility? |
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Term
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Definition
| Treatment for this condition includes maintaining the airway, ventilation as needed with the exception that examination of the throat should be avoided? |
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Term
| COPD - Either emphysema or chronic bronchitis |
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Definition
| Treatment of this condition consists of relieving hypoxia, reversing bronchoconstriction and assisting ventilations as needed? |
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Term
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Definition
| Treatment of this condition includes delivery of O2, support ventilation as allowed by orders or advance directive, correction of hypoxia as much as possible and provision of emotional support? |
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Term
Drop in BP
CPAP Keeps the alveoli open, creating some over pressurization. Creates pressure on the heart. BP Goes down. |
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Definition
| What is a caution you should be aware of when applying the CPAP, particularly in hypotensive patients? |
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Term
Increase in hydrostatic pressure
decrease in oncotic pull
increased vessel wall permeability
obstruction of lymph channel |
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Definition
| All edema can be placed in one of four categories. What are they? |
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Term
| Consider Bicarb (we won't use it, but we will consider it) |
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Definition
| What action will we take as paramedics in the case of an aspirin overdose? (case: child is in metabolic acidosis from aspirin, compensates by breathing fast and now is in respiratory alkalosis at the same time) |
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