Calvin Shared "Pulm" - 77 Picmonics

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Pulm

Respiratory Anatomy
Characteristics
Nasal Cavity
Hair Filters
Mucus Filters and Moistens
Capillaries Warm
Pharynx (Throat)
Larynx (Voice Box)
Cilia Expel Mucus and Dust
Trachea
Bronchi
Alveoli
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2 mins
Alveolar Gas Exchange
Characteristics
Pulmonary Artery Blood is O2-Poor, CO2-Rich
Two-Cell Thick Air-Blood Barrier
CO2 Diffuses Into Air
O2 Diffuses Into Blood
Gases Equilibrate
Pulmonary Vein is O2-Rich, CO2-Poor
Thermoregulation
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2 mins
Physiologic Dead Space (VD)
Tidal Volume (VT)
Partial pressure of arterial CO2 (PaCO2)
Partial pressure of CO2 in expired air (PECO2)
VD = TV x (PaCO2-PECO2) / PaCO2
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2 mins
A-a Gradient
Partial pressure of alveolar oxygen (PAO2)
Partial Pressure of Arterial O2 (PaO2)
Normal 10 to 15 mmHg
Hypoxemia with an Abnormal A-a Gradient
Diffusion problem
Shunting (Low V/Q)
Dead space (high V/Q)
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1 min
Alveolar Gas Equation
Equation
Partial Pressure of Alveolar Oxygen (PAO2)
Partial Pressure of Oxygen in the Inspired Air (PIO2)
PIO2 Normally Approximated = 150 mmHg
Arterial Partial Pressure of CO2 (PaCO2)
Respiratory Quotient (R)
R Normally Approximated = 0.8
PAO2 = PIO2 - (PaCO2/R)
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1 min
Winter's Formula
Evaluates Respiratory Compensation
Used in Metabolic Acidosis
Equation
(HCO3 x 1.5 ) + 8 plus-minus 2 = PCO2
Steps
Bicarbonate (HCO3) x 1.5
+ 8
± 2
= Expected Value for PCO2
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1 min
Light's Criteria
Use
Determines Transudative vs. Exudative Source of Pleural Effusion
Exudate if (At Least One of the Following):
Effusion/Serum Protein Ratio > 0.5
Effusion/Serum LDH Ratio > 0.6
Effusion LDH > Two-thirds Upper Serum LDH Range
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2 mins
Lung Sounds - Wheezes
Location
Throughout Lung
Description
High Pitched
Sounds Like
Musical
Cause
Air Moving through Narrowed Airways
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37 secs
Lung Sounds - Crackles
Location
Lower Lobes
Description
Fine/Coarse
Sounds Like
Fine: Twisting Hair through Fingers
Coarse: Velcro
Cause
Collapsed Small Airways and Alveoli "Popping Open"
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1 min
Lung Sounds - Rhonchi
Location
Trachea and Bronchi
Description
Low Pitched Rumbling
Sounds Like
Gurgling
Cause
Narrowed Airway
Secretions or Bronchospasm
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48 secs
Lung Sounds - Pleural Friction Rub
Location
Anterior Lateral Lung
Description
Dry, Rubbing, or Squeaking
Sounds Like
Rubbing a Balloon with Finger
Cause
Inflamed Pleura
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49 secs
Theophylline
Indications
Asthma
Mechanism
Inhibits Phosphodiesterase
Increases cAMP
Side Effects
Cardiotoxicity
Neurotoxicity
Blocks Adenosine Action
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53 secs
Terbutaline (Brethine)
Mechanism of Action
Beta-2 Agonists
Indications
Asthma
Tocolytic
Side Effects
Hypotension
Tremor
Tachycardia
Pulmonary Edema
Hyperglycemia
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2 mins
Albuterol (Proventil)
Mechanism
Short-Acting Beta-2 Agonist
Indications
Bronchospasm
Asthma
Side Effects
Angina
Tachycardia
Tremor
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1 min
Cromolyn (Mast Cell Stabilizers)
Mechanism
Mast Cell Stabilizer
Indications
Asthma Prophylaxis
Bronchial Inflammation
Allergic Rhinitis
Side Effects
Cough
Bronchospasm
Consideration
Fixed Schedule Administration
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2 mins
Montelukast (Singulair)
Mechanism
Leukotriene Receptor Blocker
Indications
Allergic Rhinitis
Asthma Prophylaxis
Exercise Induced Bronchospasm
Side Effects
Fatigue
Headache
Mood Changes
Suicidal Thoughts
Considerations
Increased Risk of Churg Strauss
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2 mins
Restrictive vs. Obstructive Lung Diseases
Restrictive Lung Disease
Decreased Lung Volume
FEV1/FVC Ratio Normal to Increased
Obstructive Lung Disease
Increased Lung Volume
Decreased FEV1/FVC Ratio
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2 mins
Restrictive Lung Diseases
Poor Breathing Mechanics
Interstitial Lung Diseases
Goodpasture's Syndrome
Eosinophilic Granuloma
Granulomatosis with Polyangiitis
Sarcoidosis
Pneumoconiosis
Idiopathic Pulmonary Fibrosis
Drug Toxicity
Acute Respiratory Distress Syndrome (ARDS)
Neonatal Respiratory Distress Syndrome
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2 mins
Obstructive Lung Disease
Blocked Airflow
Increased residual volume
V/Q Mismatch
Decreased forced vital capacity (FVC)
Decreased FEV1/FVC ratio
Asthma
Bronchiectasis
Chronic bronchitis
Emphysema
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51 secs
COPD Overview (Chronic Obstructive Pulmonary Disease Overview)
Causes
Inhaled Toxins
Smoking
AAT Deficiency
Assessment
Emphysema
Chronic Bronchitis
Asthma
Considerations
Spirometry
Slow Progression
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2 mins

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