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Core Curriculum for Critical Care Nursing PULMONARY


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What are the structural components involved in ventilation?
The Lung, Nose, Pharynx, Larynx, Trachea, Major bronchi and bronchioles, Terminal bronchioles
How is Atmospheric O2 consumed by the body?
Through Cellular aerobic metabolism, which supplies the energy for life.
How is CO2 eliminated?
A by-product of aerobic metabolism, it is eliminated primarily through lung ventilation.
What is the respiratory circuit?
The respiratory circuit includes all structures and processes involved in the transfer of oxygen between room air and the individual cell and the transfer of CO2 between the cell and room air
What is Cellular Respiration?
Though it can't be directly measured, it is estimated by the amount of CO2 produced (Vco2) and O2 consumed (Vo2)
What is the ratio of these two values called? (Vco2 and Vo2)
Respiratory quotient (RQ)
What is the normal respiratory quotient?
0.8 but changes according to the nutritional substrate being burned (i.e. proteins, fats, or carbs.)
What happens to the patient's RQ that is maintained on IV glucose alone.
The patient will have a RQ approaching 1.0 as a result of the metabolic end product, CO2.
What is the respiratory exchange ratio (R)?
The exchange of O2 and CO2 at the alveolar-capillary level (external respiration)This the ratio of CO2 produced to O2 taken up per minute.
In homeostasis, the respiratory exchange ratio (R)is the same as the respiratory quotient (RQ), 0.8? Yes or No?
Proper functioning of the respiratory circuit requires what?
Efficient interaction of the respiratory, circulatory, and neuromuscular systems.
What does the lung do in addition to O2 and CO2 exchange?
It also carries out metabolic and endocrine functions as a source of hormones and a site of hormone metabolism. Additionally, the lung is a target of hormonal actions from other organs.
What is Ventilation?
Volume change, or the process of moving air between atmosphere and the lung alveoli and distributing air within the lungs to maintain appropriate concentrations of O2 and CO2 in the alveoli
Physiologic Anatomy
-Pulmonary System exists for...
exists for the purpose of gas exchange, o2 and co2 and exchanged between atmosphere and alveoli, pulmonary capillary blood and systemic capillary blood and all the cells of the body.
What are the anatomic divisions of the Lung?
Right Lung -->Three lobes
Left lung -->Two lobes.
Lobes are divided into bronchopulmonary segments R->10, L->9
The segments are divided into secondary lobules.
What is the anatomy of the lobule and it function?
It is the smallest gross anatomic unit of lung tissue, and contains the primary functional units of the lung. Lymphatics surround the lobule, and keep the lung free of excess fluid and remove inhaled particles from distal areas of the lung.
What is the entire area from the nose to the terminal bronchioles where gas flows but isn't exchanged is called?
anatomic dead space
How is the VDanat (anatomic dead space) calculated?
2ml per kg body weight
What does the nose do to inhaled air?
It preconditions air by action of the cilia, mucosal cells and turbinate bones. Warms are to within 2%-3% of body temp and humidifies it to full saturation. Filters by trapping partials larger than 6¾m in diameter.
What does the pharynx area do?
Separation of food from air is controlled by local nerve reflexes. Regulates middle ear pressure by opening eustachian tube. Lymphatic tissues control infection.
What is the narrowest part of the conducting airways in adults?
What part of the brain is speech controlled by?
By the temporal and parietal lobes of the cerebral cortex.
Where is the cough reflex present?
In the trachea, especially at the point of tracheal bifurcation (carina).
Terminal bronchioles are sensitive to CO2 levels. What do they do to inc. or dec. levels?
Inc levels induce bronchiolar dilation. Dec. levels constriction.

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