Control of Resipratory Function Chapter 21 Flashcards
Dyspena
“a subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity”
Involuntary breathing is controlled by
Controlled by Medulla (ANS) - specifically the Respiratory Center (located within the Brain Stem, innervated by Vagus Nerve)
Voluntary
breathing is when the
Cortex - Overrides
an example would be holding your breath if needed.
What position would give the patient better circulation and better air
high fowlers
In the apex, the alvioli are
less in number but are bigger
What are conducting airways lined with?
mucous membranes
What do conducting airways do
Move air into lungs
Warm and humidify air
Trap inhaled particles
gas is exchanged within the
alveoli
True or false
The right bronchus is larger than the left
true
What is the smallest functional unit of the lung
globule
Does co2 drive respiratory rate?
No, expecially not for COPD people
Ventilation=
alvioli
Profusion=
blood
The interstitial space is
the area between the basement membranes where gas exchange occurs
Lung structure/airways
Type I cells are?
Alveolar cells
Most cells are these cells
Type II cells are?
also Alveolar cells known as Pneumocytes
What do Pneumocytes do
they produce surfactant
What is surfactant
surfactant helps reduce surface tention to keep alvioli inflated.
babies that are born early may not have enough surfactant and they could die
What is the main function of the lungs?
Gas exchange
Moves o2 into the blood
and co2 our of the blood
What is required for gas exchange
ventilation and profusion
What are the other functions of the lung other than gas exchange?
Blood storage
Regulates vasoconstricting (angiotension II) and vasodilating substances…(andiotensin I is converted to angiotensin II which is a blood constrictor)
Maintain PH (C02 up or down)
Eliminates water through breathing
maintain normal body temp
immune responses (antibacterial properties)
hormone secretion
metabolism
What components must a normal lung have in order to stay alive
Adequate inspired O2 – (FiO2) Ventilation and perfusion of alveoli A permeable alveolocapillary membrane Adequate blood flow Ability to transport O2 Ability to Eliminate CO2
What is Fio2
a fraction of inspired o2, the amount of the oxygen content in the air you breathe
r/a
room air = 21% o2
what would happen if you didn’t have adequate oxygen
hypoxia
1 liter of oxygen =
24%
2 litter of oxygen =
28% increase in 4% incriments starting at 24%
what is ventilation
exchange of gas and air between the lungs and the atmosphere so that oxygen can be exchanged for carbon dioxide in the alveoli
Specifically Alveolar Ventilation is-
the effective ventilation within the ALVEOLI
What are the early symptoms of hypoxia
RAT
restlessness
anxiety
Tachycardia/tachypenea
What are the late symptoms of hypoxia
BED
bradycardia
extreme restlessness
dyspnea (severe)
True or false
It is not within the nurses scope of practice to start oxygen
false, it is within the scope of practice for a nurse to start oxygen
What happens in the event of a non ventilated alveolar shunt
blood would pass without getting oxygen
What causes a non ventilated alveolar shunt
Obstruction
Constriction
Allergies
Mucus
Would increasing the oxygen to someone that had an alveolar shunt help them?
yes, it will make up the deficit
A normal lung has a permeable membrane which is a site for the gasous exchange called the
permeable alveolocapillary membrane
What picks up the oxygen in the lungs
RBC’s, because of hemoglobin
Blood flow=
profusion
Why do hypoxic people get tired
because they breathe harder, respirate more, which causes exaustion.
What does profusion of Alvioli mean
bloodflow to the alvioli
What is perfusion
Perfusion is the delivery of the blood to the capillary bed
Specifically Alveolar Perfusion is the
delivery of blood to the capillary bed that supplies the Alveoli - to be delivered to other organs and body tissues
What if you were breathing air and it got into the Alveoli, but there was no blood to pick up the Oxygen?
alveolar dead space
What Might cause this type of problem?
Would increasing the amount of delivered oxygen help?
hypertension
yes
dead space
dead space refers to the air that must be moved with each breath but does not particupate in gas exchange
What if you had Ventilation and Perfusion - but not enough Hemoglobin or altered ability to carry Hemoglobin?
usually happens with Anemias
What if Hemoglobin was attached to Carbon Monoxide?
happens with car exaust suicide
red blood cells are taken up by co2
Shunt ventilation=
obtruction
contriction
allergies
mucus
dead space perfusion
heart failure
clots
blood loss
shunt is bloodflow without o2 and dead space is
o2 without bloodflow to it
What if you were unable to elimate o2, this would be reffered to as
hypercapnea
if you had no _____ you could not get rid of co2
perfusion
if you had decreased ________ you may hold onto excess co2
ventilation
What is lung compliance
The ease with which the lungs can be inflated
What does lung compliance depend on
Elastic Properties
Water Content
Surface Tension
What happened if the lungs became stiff
Collagen fibers of scar Tissue have replaced Elastin Fibers
Elastic Properties
how much it stretches and gives
Water Content
in the lungs is
reduced area for oxygen exchange
surface tension in the lungs involves
surfactant
high surfactant = hard to inflate
What changes the elastic properties in the lungs
If they are CONGESTED OR EDEMATOUS
Reversible Decrease in Compliance
mean
after mucus is gone, the lung goes back to normal
Increased water content in the lung usually means
heart failures
high elevations can also cause pulmonary edema
Elastic Properties - Recoil
If they are ALREADY STRETCHED OUT - more compliant
Unable to go back to original state
Easy to inflate, but hard to deflate
Surface Tension
in lung compliance means
Surfactant
Lowers surface Tension- increases compliance
Prevents Pulmonary Edema
If you do not have approximately equal
Ventilation and Perfusion it is called:
Ventilation/Perfusion Mismatch (V/Q)
if Ventilation and Perfusion are not matched properly what happens
hypoxia
ventilation down means
no o2 in the alvioli, shunt or deadspace
A nurse remembers a low ventilation perfusion ratio results in
shunting
