Physics Exam 3

What is a critical value?

A result significantly outside of the reference range, represents a pathophysiologic condition.

What is a WBC count above normal called?

Leukocytosis

What is a WBC count below normal called?

Leukopenia

What is a RBC count above normal called?

Polycythemia

What is a RBC count below normal called?

Anemia

What do neutrophils do?

Removes and destroys bacteria, cellular debris, and solid particles

What do eosinophils do?

destroy protozoa and parasitic worms, release anti-inflammatory substances in antigen-antibody reactions. Increased eosinophil count commonly seen in asthma

What do basophils do?

contains histamine and heparin. Histamine = vasodilation and attracts other WBC to inflamed sit. Heparin inhibits blood clotting

What do monocytes do?

Phagocytize bacteria, dead cells, cell fragments, and viral-infected cells

What do lymphocytes do?

Function in immune response by acting against virus-infected cells and tumors (T lymphocytes), produce antibodies (B lymphocytes)

What do neutrophils consist of?

Neutrophilia, neutropenia, bands, segmented neutrophils

What are electrolytes?

Charged ions influencing the function of enzymes; disturbances may disrupt normal cellular function

What are enzymes?

proteins regulating all chemical reactions occurring within cells (metabolism, protein synthesis)

What enzyme tests are commonly performed?

Liver function test - liver damage assessed by abnormal increased in hepatic enzymes

Pancreatic enzyme tests - pancreatitis will have abnormal levels of lipase and amylase

Muscle enzyme tests - Ischemic damage to the heart, brain & skeletal muscle tissue will have elevated CPK

What is included in a basic chemistry panel?

Glucose, anion gap, lactate, sodium, potassium, chloride, bicarbonate,

What is a gram stain?

Test that can determine if the offending organism is gram positive or gram negative and its shape. Suspected infection in lungs or airways may benefit from analysis of a sputum sample (sputum gram stain)

What are indications for PFTs?

Evaluate pulmonary causes of dyspnea, Differentiate between obstructive and restrictive pulmonary disorders, Assess the severity of the pathophysiologic impairment

How is tidal volume evaluated?

500

breathe normally for one minute then divide by RR

How is inspiratory capacity evaluated?

3600

inhale maximally at the end of a normal exhalation

How is inspiratory reserve volume evaluated?

3100

breathe in normally then exhale maximally

How is expiratory reserve capacity evaluated?

1200

breathe normally for a few breaths and then exhale maximally

How is vital capacity evaluated?

4800

Exhale maximally then inhale as deeply as possible

What does residual volume show?

1200

gauges air trapping

What does functional reserve capacity show?

2400

Quantifies hyperinflation

What does total lung capacity show?

6000

Identifies restrictive patterns

What is forced expiratory volume timed?

maximum volume of gas that can be exhaled over a specific time period

What equipment is needed for a chest tube setup?

Tube/thoracic catheter and drainage device

What is the chest tube drainage system?

Includes collection chamber, water seal (2cm H2O), and suction contorl chamber (20cm H2O)

Indications for chest tubes?

Hemothorax, pleural effusion, tension pneumothorax

When should you perform a bronchoscopy?

Either diagnostic or therapeutic. Therapeutic for suctioning of excessive secretions, removal of foreign bodies, and selective lavage

When should a thoracentesis be performed?

Procedure in which excess fluid accumulation (pleural effusion) between the chest cavity and lungs (pleural space) is aspirated through a needle inserted through the chest wall. Diagnostic thoracentesis may be performed to identify the cause of a pleural effusion.

What are the 3 types of pneumothoraces?

Open, closed, tension

What is an open pneumothorax?

Penetrating wound. Air can move freely in and out of the pleural space through the hole in the chest

What is a closed pneumothorax?

Blunt force trauma, intra-alveolar trauma. Chest wall intact. Air can enter pleural space, can’t escape as easily

What is a tension pneumothorax?

Air leaks into pleural space and has no means of escape, creates rapid buildup of positive pressure. UNABLE TO SUSTAIN LIFE. Must needle aspirate or place chest tube

What are the indications of HFNC?

Severe oxygenation issues, high inspiratory flow demand, assistance needed with CO2 removal

What are the benefits of HFNC?

improves oxygenation by washing CO2 from end expiration, reduces dead space, provides PEEP

What interfaces are available for HFNC use?

Nasal cannula, mask, trach attachment

What are the 2 common HFNC devices?

Optiflow/airvo and vapotherm

What is commonly associated with HFNC failure?

Delayed application of NIV and intubation

Normal RBC count in adults?

4.35 to 5.65 million cells/mcL for men

3.92 to 5.13 million cells/mcL for women

Normal WBC count in adults?

4,500-11,00 cells/mcL

What does increased BNP show?

Heart failure

Pressure inside the thoracic cavity drops to what during spontaneous inspiration?

-8 inspiration, -4 exhalation

T/F: Anemia is usually seen in individuals with chronic lung disease.

False

An individual with normal lungs should be able to expire what amount in the first second (FEV1)?

80%

Total Lung Capacity is made up of which of the following?

VT+ERV+IRV+RV

T/F: After a thoracentesis, it is important to watch the pt for signs of a pneumothorax.

True

Therapeutic bronchoscopy is used to

Remove a foreign body

Diagnostic bronchoscopy is used to

Obtain a tissue sample

After normal exhalation, what capacity remains in the lungs?

Functional residual capacity

T/F: To remove air, a chest tube should be placed at the base of the chest

False

Sweat chloride tests for?

Cystic fibrosis

Acid-fast staining tests for

TB

Troponin-I tests for

Possibility of recent MI

Percentages of WBCs?

Neutrophils 40-75%

Eosinophils 0-6%

Basophils 0-1%

Monocytes 2-10%

Lymphocytes 20-45%