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gas exchange (emily)

what does the upper resp. tract consist of

nose, mouth, sinuses, pharynx, epiglottis, larynx

what is the function of the upper resp. system

provides passage for air to be breathed in/out of lungs

where do we see gas exchange happen

in the lower resp. system

how many lobes are in the right lung

3

how many lobes in the left lung

2

what does the lower resp. tract consist of

trachea and bronchi

what lines the trachea

pseudostratified ciliated epithelium with c-shaped cartilage rings

the trachea branches into:

R&L primary bronchi, secondary bronchi, bronchioles, terminal bronchioles, respiratory bronchioles, alveolar ducts, alveoli

what is the function of surfactant

prevents collapsing, lubricates, and reduces surface tension

what lines the alveoli

simple squamous epithelium and surfactant

what structure is the end point for inspired air and the site of gas exchange

alveoli

what is ischemia

insufficient blood flow of oxygenated blood to tissues

what is hypoxemia

reduced oxygen in arterial blood

what is known as the respiratory centre

medulla oblongata

what does the medulla oblongata control

RR, blood pH, change in O2 and CO2

what are the 3 dependents for oxygen delivery

temperature, pH, [of 2, 3-bisphosphoglycerate]

what is the function of 2,3-bisphosphoglycerate

supplies O2 to tissues, and located in erythrocytes

what are 2 forms that oxygen is transported in blood

binding to Hgb in RBC or dissolved in plasma

in pulmonary circulation, what kind of blood is gathered from the heart to be replaced with oxygen from the lungs

deoxygenated

where does inhaled oxygen move to from the alveoli

to blood and into capillaries

what is the pathway of carbon dioxide and water to get to the alveloi

from the blood in the capillaries to the air in the alevoli

what are 3 causes of impairment of gas exchange

ineffective ventilation, reduced capacity for gas transportation, and inadequate perfusion

what is the process of moving gases in and out of the lungs

ventilation

what process is dependent on the availability of hemoglobin

transport

what is the function of oxygen in transport

carried by hemoglobin from alveoli to cells for metabolism

what is the function of carbon dioxide in transport

produced by metabolism and is carried by hemoglobin from cells to alveoli to be eliminated

what is perfusion

blood transporting O2 containing Hb to cells, returning CO@ containing Hb to alveoli

what are factors that increase the metabolic rate

pregnancy, fever, infection

dehydration and decreased blood volume can cause:

hypovolemia

what is myocardial ischemia

insufficient flow from coronary artery to myocardium

what is impaired valvular function

acquired disorder of a cardiac valve caused by stenosis or regurgitation

what causes disturbances in conduction

electrical impulses that dont originate from the SA node

insufficient volume ejected into the system and pulmonary circulation, and left & right sided heart failure alter:

cardiac output

what is hyperventilation

exhaling more carbon dioxide

what is hypoventilation

slow breathing preventing sufficient amounts of O2 and CO2

what do etiologies that cause upper airway obstruction involve

inflammation, infection, or trauma of airway structures

comprimised airflow of which structures to the lungs can cause upper airway obstruction

nasopharnyx and oropharnyx

what are examples of anatomical obstruction

foreign body, tumor, or anatomical anomalies

what are examples of physiological obstructions

mucous plugs, swelling, bronchospasm

how would a patient present with an airway obstruction

acute distress, altered LOC, or signs of ability to move air

what is ventilation-perfusion mismatch

less oxygen entering alveoli and less carbon dioxide removed

what are the physiological effects of ventilation-perfusion mismatch

hypoxia, hypercapnia, and respiratory acidosis

if someone is wheezing, using accessory muscles, has cyanosis, and stridor, they may have:

an airway obstruction

what are the 2 intubations that can relieve an airway obstruction

nasotracheal and endotracheal

tracheostomy and cricothyroidotomy are ways to relieve:

airway obstruction

what is the pathway of clinical judgement

noticing, interpreting, responding, and reflecting

true or false all interactions require clinical judgement

false

in what cases would you notify a provider

emergency, admission, change in condition, and for clarification of orders or direction

what conditions increase the risk for respiratory failure

congenital heart defects and chronic pulmonary diseases

why is it important to be aware of enirvonmental conditions if a patient is recieving oxygen therapy at home

hazards, gas stove, kerosene space heaters, or present smokers

true or false oxygen is considered a medication

true

what administration routes of oxygen is delivered in high-flow

venturi mask and high-flow nasal cannula

what administration routes of oxygen is delivered in low-flow

low-flow nasal cannula, simple face mask, partial rebreather masks, and non-rebreather masks

what range of oxygen and flow rate does the standard nasal cannula deliver oxygen

24-44% at 6L/min

what oxygen delivery device delivers oxygen up to 60L/min

high-flow nasal cannula

what range of oxygen and flow rate does a simple face mask deliver oxygen

35-50% at 6-12L/min

what range of oxygen and flow rate does a non-rebreather mask deliver oxygen

60-90% at 10-15L/min

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