Assessment of Respiratory Function Flashcards
Purpose of the Respiratory System
- Deliver oxygen to and expel carbon dioxide
from the body - Upper respiratory system warms and filters
air - Lower respiratory system accomplishes gas
exchange
6 Structures of the Upper Respiratory
Tract
- Nose
- Sinuses and nasal passages
- Pharynx
- Tonsils and adenoids
- Larynx: epiglottis, glottis, vocal
cords, and cartilages - Trachea
4 paranasal sinuses
frontal
ethmoid
sphenoid
maxillary
epithelium of the respiratory
pseudostratified ciliated columnar epithelium
2 functions ofthe sinus
to decrease the weigh of the skull, for phonation
type 1 alveoli function
repair structure
type 2 alveoli function
produces surfactant
this is where the gas exchange takes place
alveoli
2 arteries that is exception of carrying deoxygenated blood
pulmonary and umbilical artery
Lower Respiratory System Structures
Two lungs: five lobes
a. Left: upper and lower
b. Right: upper, middle, and lower
Pleura
Mediastinum
Bronchi and bronchioles
Alveoli
The inner layer that surrounds
the lung itself is called the?
Visceral Pleura
Gas exchange in the lungs
occurs in the?*
Alveolar sacs
is exchange of oxygen and carbon
dioxide at the alveolar–capillary membrane
Diffusion
- Process of gas exchange between the atmospheric air and the blood and between the
blood and cells of the body - Oxygen concentration in capillaries of the lungs is
lower than in the alveoli
Respiration
What is gas exchange between the lungs and blood, and between the blood and tissues?
Respiration
is flow of air in and out of the lungs
Ventilation
- Oxygen crosses the alveolar–capillary membrane into arterial
blood by diffusion, perfusion carries oxygenated blood to all
body tissues - Oxygen diffuses from areas of higher partial pressure to areas
of lower partial pressure - Oxygen is transported to the cells of the body by combining
with hemoglobin
Perfusion: Oxygen Transport
Clubbing—indicates ___
chronicity
____ is the end product of metabolic
combustion
* it crosses the alveolar–capillary
membrane into venous blood by diffusion, perfusion
carries deoxygenated blood back to the lungs
Carbon dioxide
is arterial/venous circulation filling
pulmonary capillaries with blood
Perfusion
3 Abnormal (adventitious) breath sounds:
a. Crackles
b. Wheezes
c. Friction rub
Subjective distress in breathing
During exercise, respiratory muscles may fatigue,
resulting in shallow, ineffective breathing
Dyspnea
- An increase in pulmonary ventilation that exceeds O2 needs of metabolism
- decreases PCO2
Hyperventilation
- Closing the glottis
following a full
inspiration while
maximally activating the
expiratory muscles - Causes increase in
intrathoracic pressure - Helps stabilize chest
during lifting
Valsalva Maneuver
3 Physiologic Consequences of Valsalva Maneuver
- An acute drop in BP may result from a prolonged Valsalva
maneuver. - Decreased venous return
- Decreased flow to brain—-→ Dizziness or fainting result
- Device ensures that a volume of air is
inhaled, and the patient takes deep
breathes. - Used to prevent or treat atelectasis.
- Nursing care
- Positioning of patient, teach and encourage use, set realistic
goals for the patient, and record the results.
Incentive Spirometer
assesses respiratory function
screening modality
assesses response to therapy
Pulmonary Function Test (PFT)
- Measurement of arterial
oxygenation and carbon dioxide
levels - Used to assess the adequacy of
alveolar ventilation and the ability of
the lungs to provide oxygen and
remove carbon dioxide - Also assesses acid–base balance
Assessing the ability of the lungs to provide O2
and remove CO2 - Radial, brachial or femoral artery
- Pain, infection and hemorrhage
Arterial Blood Gases
- A noninvasive method to monitor
the oxygen saturation of the blood - Does not replace ABGs
- Normal level is 95% to 100%
- May be unreliable
Pulse Oximetry
Causes of Inaccurate Results of pulse ox
- Anemia, Carbon monoxide level
- Dark skin, nail polish. Bright light (sunlight) , pt’s
movement e.g. shivering - not reliable detectors of hypoventilation if the
patient is receiving supplemental oxygen
- Anemia, Carbon monoxide level
- Dark skin, nail polish. Bright light (sunlight) , pt’s
movement e.g. shivering - not reliable detectors of hypoventilation if the
patient is receiving supplemental oxygen
tells us ventilation to lungs is occurring, that CO2
is being transported to lungs, exp. CO2 indicates
adequate ventilation
CO2 monitoring
- Thin, flexible that can be directed into the
segmental bronchi. - Excellent optical system that increase visualization
of the airways - Ideal for diagnosing pulmonary lesions.
- Allows biopsy & can be performed through ET or
ventilators
Fiberoptic bronchoscope
- More detailed diagnostic image
- Characterize pulmonary nodules, help stage
carcinoma - No metals
- Claustrophobia
Magnetic Resonance Imaging
- Investigate thromboembolic & vascular tree
diseases. - Injecting the radiopaque agent into a vein in
one or both arms (simultaneously) or into the
femoral vein with a needle or catheter. - Test for allergy
Pulmonary Angiography
- Scanning successive layers by a narrow-beam x-
ray. - Contrasts/distinguish body densities such as
bone, soft tissue - Define pulmonary nodules and small tumors
- Contrast agents are used
Computed Tomography (CT)
- Used to assist with invasive procedures (biopsy)
to identify lesions. - Study the movement of the chest, heart, and
diaphragm - Locate lung masses.
Fluoroscopic Studies
- Advanced diagnostic capabilities that is used to
evaluate lung nodules for malignancy. - Distinguish normal tissue from diseased tissue
- More accurate in detecting malignancies than CT
- Has equivalent accuracy in detecting malignancies
compared with thoracoscopy (invasive)
Positron Emission Tomography
- Examine tissues or collect secretions
- Determine the location and extent of the
pathologic process - Obtain a tissue sample for diagnosis (by biting,
cutting, curettage, or brush biopsy), - Determine whether a tumor can be resected
surgically - Diagnose bleeding sites (source of hemoptysis).
Bronchoscopy
The rigid bronchoscope
- Hollow metal tube with light at its end.
- Mainly for removing foreign substances
- Investigates hemoptysis
- Performed in the OR not at the bedside.
The rigid bronchoscope
- Hollow metal tube with light at its end.
- Mainly for removing foreign substances
- Investigates hemoptysis
- Performed in the OR not at the bedside.
- Diagnostic procedure in which the pleural cavity is
examined with an endoscope - Small incisions are made into the pleural cavity
- After any fluid is aspirated, the fiberoptic mediastinoscope
is inserted - After the procedure, a chest tube may be inserted, and the
pleural cavity is drained by negative-pressure water-seal
drainage.
Thoracoscopy
- Aspiration of fluid or air from the pleural space
- Diagnostic or therapeutic reasons
- For analysis, pleural biopsy, and instillation of
medication into the pleural space. - Can be performed under ultrasound guidance –less
complications
Thoracentesis
types of hypoxia
is a decreased oxygen level in the blood resulting in decreased oxygen diffusion into the tissues. It may be caused by hypoventilation, high altitudes ventilation-perfusion mismatch (as in pulmonary embolism) shunts in which the alveoli are collapsed and canngt provide oxygen to the blood (commonly caused by atelectasis), and pulmonary diffusion defects. It is corrected by increasing alveolar ventilation or providing supplemental oxygen
Hypoxemic hypoxia
types of hypoxia
is hypoxia resulting from inadequate capillary circulation. It may be caused by decreased cardiac output, local vascular obstruction, low-flow states such as shock, or cardiac arrest. Although tissue partial pressure of oxygen (PO,) is reduced, arterial oxygen (PaOz) remains normal. corrected by identifying and treating the underlying cause
Circulatory hypoxia
types of hypoxia
is a result of decreased effective hemoglo bin concentration, which causes a decrease in the oxygen-carrying capacity of the blood. It is rarely accompanied by hypoxemia. Carbon monoxide poisoning, because it reduces the oxygen-carrying capacity of hemoglobin, produces similar effects but is not strictly anemic hypoxia because hemoglobin levels may be normal.
Anemic hypoxia
types of hypoxia
occurs when a toxic substance, such as cyanide, interferes with the ability of tissues to use available oxygen.
Histotoxic hypoxia
