assessment of respiratory function Flashcards
upper respiratory tract includes
nose, paranasal sinuses, pharynx, tonsils, adenoids, larynx, trachea
function of the upper respiratory tract
warms and filters inspired air
lower respiratory tract includes
lungs, pleura (visceral & parietal), mediastinum, bronchi & bronchioles, alveoli
function of the lower respiratory tract
responsible for gas exchange
4 different paranasal sinuses
frontal (lower forehead), maxillary (cheekbones), ethmoid (beside upper nose), sphenoid (behind the nose)
3 types of alveoli
type 1 make up 95% surface area, type 2 make up the other 5% of surface area & produce type 1 cells and surfactant, type 3 contain macrophages
outer layer of the pleura cavity
parietal pleura and attaches to the chest wall
inner layer of the pleura cavity
visceral pleura and covers the lungs, blood vessels, nerves, and bronchi
what is surfactant
a substance that reduces the surface tension of a liquid in which it is dissolved. helps decrease surface tension at the air-liquid interface of the alveoli
the alveoli are the site of
gas exchange
oxygen transport
oxygen is supplied to cells and carbon dioxide is removed by the circulating blood
respiration takes place at what level
the cellular level, the use of oxygen
what is inspiration
active process, uses energy
what is expiration
passive process, no energy used
what is ventilation
movement of air in and out of the lungs
what is the diffusion in pulmonary diffusion and perfusion
oxygen and blood are exchanged at the air-blood interface
what is the perfusion in pulmonary diffusion and perfusion
blood flow through the pulmonary circulation
with pulmonary diffusion and perfusion what must happen
they must match/ balance
gas diffusion is decreased by
a decrease of oxygen in atmosphere, decrease in amount of alveolar ventilation, decrease in alveolar/ cap surface area, an increase of alveolar/ cap membrane thickness (carbon dioxide diffuses more easily than oxygen)
carbon dioxide transport
oxygen diffuse from the blood into the tissue, carbon dioxide diffuses from tissues to blood and is transported to the lungs
central chemical receptors in medulla respond to
change in CSF from chemical changes in blood from increase & decrease in pH to correct imbalance
peripheral chemical receptors in aortic arch and carotid arteries first responders to
changes in PaO2, then to PaCO2 and pH
mechanoreceptors in the lungs respond to
stretch, irritant, juxta capillary receptors (respond to changes in resistance) altered breathing pattern
proprioceptors in muscles and chest wall respond to
body movements, increased respiration
baroreceptors in aortic arch and carotid bodies respond to
increase & decrease in arterial blood pressure and cause either hypo or hyperventilation (Blood pressure)
resting respirations is controlled by
excitation of the muscles by the phrenic nerve
I & E centers (medulla oblongata and pons) control
rate and depth to meet demands
increased CO2 levels equals
decrease in pH
decreased O2 is referred to as
hypoxia (<70mmHg)
gerontologic considerations about respiratory function
gradual decline in respiratory function in mid adulthood (35-40), vital capacity changes (amount of air needed to survive/ gets smaller with age and longer to recover, catch breath), strength of respiratory muscles decrease, alveolar changes, chest wall stiffens, increased dead space(area in the lungs where nothing is happening), decreased diffusion capacity(decreased surface area, scars), decreased ability to rapidly move air in and out of lungs (can’t exchange gases as well, harder to get air in, out)
indications of respiratory problems
tachypnea, PaO2/FIO2 ratio, abnormal chest xray, restlessness/ anxiety, dyspnea, tachycardia
what is hypoxia
decrease of oxygen to tissue and cell
symptoms of hypoxia
change in mental status, tachycardia/ bradycardia, diaphoresis, hypertension, dusky color
hypoxemia
decrease oxygen in blood
respiratory acidosis = decreased ventilation which is (low RR)
increase of CO2
symptoms of respiratory acidosis
lethargy, flushed dry skin, narcosis
respiratory alkalosis = increased ventilation which is (high RR)
decreased carbon dioxide
symptoms of respiratory alkalosis
increased neuromuscular irritability, cardiac arrhythmias
pH level
7.35-7.45
PaCO2 level
35-45 (below 35 means alkalosis)(above 45 is acidosis)
HCO3 level
22-26
vital capacity is
the maximum volume of air that can be exhaled after a maximum inspiration; expressed as IRV +Vt+ ERV
4 types of hypoxia
hypoxemia, circulatory hypoxia, anemic hypoxia, histotoxic hypoxia
pulmonary function test
noninvasive test that shows how well the lungs are working, how air is going In and out of your lungs
ABGs
measures gas exchange at the cellular level
venous blood gases
measures the balance of oxygen used by tissues and amount of oxygen returning to right side of heart
end- tidal carbon dioxide
noninvasive method of monitoring partial pressure of CO2 at end exhalation
pulmonary artery carries what
deoxygenated blood
CT scan
may be done with or without contrast/ with the contrast you will get a warm sensation like you’re peeing
pulmonary angiography: pre-op
before you have to have consent, check allergies and coagulation studies, monitor renal function with dye, NPO for 8 hours before
pulmonary angiography during
test to see how blood flows through the lung. may get warm flushed feeling with administration of dye. dye is to be able to see the arteries
pulmonary angiography post op
monitor for bleeding, check pulses distal to site, monitor skin color/ temp, VS, level of consciousness, O2 sat
MRI (magnetic resonance imaging)
looking at tissues in more detailed manner
flouroscopy
tells how lungs are working, real time video of the movements inside a part of the body by passing xrays thorough the body
V/Q scan
do a chest xray before, inject radioactive dye (perfusion), takes about 20-40 mins, then inhale radioactive gas with oxygen (ventilation)
gallium scan
assess for inflammation in the lungs
PET scan
looks at nodules in lungs, before that avoid caffeine, alcohol, tobacco fro 24 hrs before, NPO for 4 hrs before, and empty bladder. post scan encourage fluids. Uses glucose injected into a vein
bronchoscopy pre op
NPO 4-8 hrs before, may need prophylactic antibiotic, remove dentures
bronchoscopy post op
NPO until gag reflex retunes, start with ice chips, no hot liquids for 24 hours due to throat being numbed
bronchoscopy
thin tube passed through your nose or mouth, does your throat into your lungs
thoracoscopy
examination of the inside of the chest(intercostal space to examine pleural cavity), used to diagnose or treat pleural lung disease. may have chest tube after
thoracentesis
removal of fluid/ air from the pleural space/ obtain species of fluid to test (needle into back to drain fluid, listen to lung sounds closely to make sure didn’t puncture a lung)
