NCM112 oxy quiz 1

46問 • 1年前

問題一覧

➢ is a chemical element that is considered as essential to survival ➢ it is a primary requirement for cells to release energy during chemical reactions. ➢ is a combination of different processes that contribute to bringing the oxygen from the environment into the cells of the body

oxygen

➢ involves inspiration and exhalation. ➢ Air moves in and out of the lungs because intrathoracic pressure changes in relation to pressure and the airway opening. The cardiovascular, respiratory, and part of hematologic systems function to supply the body’s oxygen demands. If these systems are dysfunctional: heart failure, respiratory failure, hematologic system problems, it leads to O2 deprivation

ventilation

Processes needed to maintain adequate oxygenation

❖ Ventilation ❖ Pulmonary perfusion ❖ Diffusion

Important systems involved in oxygenation

➢ Cardiovascular ➢ Nervous ➢ Musculoskeletal ➢ Respiratory

Basic requirements for good ventilation

1. patent passageway 2. elastic and expansive lungs and tracheobronchial tree 3. adequate musculoskeletal apparatuses 4. pressure gradient

Normal protective mechanisms of the respiratory systems

• Nose-vibrissae • Mucuciliary clearance • Cough reflex • Reflex bronchoconstriction • Macrophages • Surfactant • Hering-Breuer reflex

risk factors modifiable

• Smoking • Sedentary lifestyle • Obesity • Diet • Stress • Substance abuse • Environmental factors

risk factors non modifiable

• Age • Gender • Race • Heredity/Genetics

procedures/tests common problems

o Chest pain o Dyspnea o Fatigue o Cough o Wheezing o Hoarseness o Palpitation o Body weakness o Intermittent claudication

PE findings associated with O2 problems - inspection

o Eyes o Xanthelasma/palpebrum o Xanthomas o Corneal arcus(arcus senilis) hyalinosis of the cornea o Pale conjunctiva o Cyanotic conjunctiva o Petichiae of the conjunctiva Mouth and lips o Cyanotic mucosa o Pursed lip breathing(chronic lung disease) Neck vein o Distention-CHF (congestive heart failure) Nose o Nasal flaring- air hunger, dyspnea Chest o Retractions-increased work of breathing o Assymmetry-chest wall injury o Barrel chest-chronic lung disease Skin o Peripheral cyanosis o Central cyanosis o Poor skin turgor o Pallor o Dependent edema o Redness o Gangrene o Bruises/petichiae

PE findings associated with O2 problems - palpation

o Thoracic Excursion o Areas of tenderness o Tactile fremitus/pectoral fremitus o Thrills o Heaves o Mass or lumps o Pulses o Skin temp o Pitting edema o Capillary refill

PE findings associated with O2 problems - percussion

o hyperresonance o hyporresonance

PE findings associated with O2 problems - auscultation

Adventitious breath sounds o Wheezes o Rales/crackles o Ronchi o pleural friction rub Abnormal heart sounds o S3 o S4 o Clicks o Snaps o Murmur o Pericardial friction rub o Bruits

is a combination of different processes that contribute to bringing the oxygen from the environment into the cells of the body

oxygenation

The cardiovascular, respiratory, and part of hematologic systems function to supply the body’s oxygen demands. If these systems are dysfunctional: heart failure, respiratory failure, hematologic system problems

o2 deprivation

ultrasound for the heart

Electrocardiogram

records hearts electrical activity over a specific period

Electrocardiogram

use of radioisotopes cardiac structure, perfusion and crontractility

scintigraphy

evaluate/visualize cardiac chamber, valves, great vessels, and coronary arteries

cardiac catheterization and angiography

determine the ability of the lungs to efficiently exchange oxygen and CO2

pulmonary function test

hydrogen ion concentration, partial pressure of CO2 and O2 concentration and oxyhemoglobin saturation

ABG analysis (arterial blood gas)

is done to assess for adequacy of collateral circulation of hand

allens test

Air passes through the airways namely

nose , pharynx, larynx, trachea, bronchi and broncheoles.

causes the mucous lining to produce mucus causing obstruction of the airway.

infections and inflammations

Infection can be

rhinitis, sinusitis, pharyngitis, tonsillitis, laryngitis, and bronchitis.

voicebox

larynx

windpipe

trachea

However, food and other substances will still tend to enter the airway causing

aspiration

Routing of food and air to the appropriate pathways happens within the

larynx

Bronchoconstriction can happen due to the release of chemical mediators

histamine, bradykinin, prostaglandin

is the exchange of gases between the pulmonary blood and alveoli.

external respiration

It is the exchange of gases between the cells and capillaries.

internal respiration

In any case that there is significant increase of pressure in the pulmonary vessels, membrane functioning can fail allowing fluids to pass through it causing accumulation of fluid within the alveolar space causing

pulmonary edema

If elastic recoil of the alveoli disappears, gases will be trapped causing accumulation of carbon dioxide and deficiency in O2. This happens in

emphysema

Bronchoconstriction can happen due to the release of chemical mediators histamine, bradykinin, prostaglandin causing sympatholytic response which usually happens in

bronchial asthma

There are also conditions that cause loss of surface tensions in the lungs causing collapse of the alveoli causing

atelectasis

Also, alveoli are efficient in their function as lung exchange site without any presence of infection. Infection can cause inflammation of lung parenchyma causing production of exudates thus, decreasing its functionality. This happens in

pneumonia

A significant decrease of the number of erythrocytes or abnormalities in the structure of the erythrocytes can hinder their ability to carry O2 in

anemia

Number of RBC’s can also be decreased when clotting mechanism becomes faulty because blood is allowed to escape elsewhere in conditions like thrombocytopenia. This condition consequently causes

shock

Erythrocytes follow the circulation, passing through the blood vessels in order to bring oxygen into the tissues. However, the current of flow may be disrupted due to overproduction of erythrocytes causing a sluggish flow in

polycythemia

Oxygen-rich erythrocytes then follow the respiratory gas transport process. Erythrocytes go to the pulmonary veins. As minute as they are, pulmonary capillaries are prone to obstruction. Presence of coagulation substance can hinder the flow of blood. This occurs in

pulmonary embolism

Moreover, myocardial tissues will die without adequate perfusion which happens in

myocardial infarction

However, before infarction, cardiac tissues will try to compensate by employing anaerobic metabolism which can cause irritation of tissues that happens in

angina pectoris

Blood flow along the arteries can also be obstructed due to presence of plaque and/or damage or inflammation of the blood vessel wall or vasoconstriction. This happens in

buerger’s disease and raynaud’s phenomenon.

However, this exchange can be altered due to increase in pressure causing escape of fluid from the cells into the interstitial spaces causing

edema

But, due to too much pressure and weakened blood vessel wall, veins become dilated allowing overdistention and accumulation of blood within them causing

varicosities, thrombosis and eventually phlebitis

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