Respiratory Flashcards
Ventilation
Respiration
- 2 segments?
Movement of gases (air) in and out of the lungs
Respiration is the exchange of oxygen and carbon dioxide
Pulmonay respiration - oxygen inhaled, carbon dioxide exhaled
Cellular respiration - breaking down glucose to produce ATP
An increase in compliance means an increase in stretch for the alveolar ducts like a ..
like a balloon after being blown up a bunch of time
Asthma is an example of an ________ form of ventilation condition
Obstructive
Intrapulmonary pressure
Lungs do not collapse because of
- the force exerted during respiration by the gases within alveoli of lungs
- intrapleural pressure
-Which is longer inspiration or expiration?
-95% of quiet breathing is …
-Inspiration involves the ____ intercostals
-Expiration involves the _____
intercostals
-What expands while breathing?
expiration 10-20% longer
diaphragm pressure
external (raises upper rib)
internal (depresses upper rib)
thoracic cavity
Body positioning is very important for ____ and ____ flow
What position is best if a pt has heart problems or is pregnant?
Which position is not so good? Why?
air and blood (overall ventilation)
supine
side-lying, the diaphragm impedes a little bit into the thoracic space, and makes breathing harder
- pleuritis aka pleurisy
- empyema
infection - pleura becomes inflamed
collection of pus in pleural cavity (migration of WBC)
__ is much slower than __ so it needs a driving force
O2, CO2
-O2 and CO2 crossing the membrane need ____ _____ in order to help with compliance (stretch)
-The 2 linings that are very thin
-What secretes surfactant
surfactant lining
alveolar epithelial membrane (very thin)
capillary epithelial membrane (even thinner)
Type 2 cell
99% of O2 is bound to ______
1% is _______
hemeglobin
unfunctional
10% of CO2 is dissolved in ____
20% CO2 combined with _____ to form ___________
70% H+ combines with _____ and makes
plasma
hemeglobin, carbinohemeglobin
hemeglobin, bicarbonate
Perfusion
in an upright position - higher structures are ________
lower structures are _______
bathing of tissue in blood
overventilated or underperfused (air higher)
underventilated or overperfused (blood pulled down by gravity)
Looking over top of someone is important when
Restrictive breathing is like ….
Obstructive breathing is like …..
-observing breathing
-getting a bear hug and trying to breathe
-taking 3 deep breathes and short outward breathing (hard to get breath out)
Clinical evidence for general restrictive lung conditions
Symptoms (2)
why is muscle wasting a symptom?
tachypnea (fast breathing)
hypoxia (lack of sufficient oxygen)
crackles can be heard
dyspnea - shortness of breath or difficulty breathing
non productive cough
they are taking lots of quick shallow breathes
2 categories of restrictive lung conditions
Intrinsic: pulm parenchyma (involvement of the lungs themselves)
Extrinsic: extrapulmonary (obesity or neuromuscular disorders)
primary vs secondary causes of pleural disruptions (such as pleuritis or pleurisy)
P: spontaneous
S: surgery, traumatic, infectious, lung fibrosis
a build up of too much fluid between the layers of the pleura
pleural effusion
Medical management of pneuomo/hemo-thorax
Antiobiotic,
Surgery
Symptoms of chronic obstructive pulmonary diseases
visible signs
dyspnea, pursed lips, bulging jugular veins, hypercapnia (CO2 levels rise because they aren’t being expelled), muscle atrophy
clubbed finger, weight loss, barrel chested
Top 2 types of COPD
what is emphysema
chronic bronchitis
emphysema
decrease in the respiratory membrane and elastin in the lungs (tear down is outpacing build up)
What occurs in chronic bronchitis
inflammation and increase in mucin
Causes of COPD
smoking
genetics
decrease in elastin. increase in collagen
Most common pulmonary function / breathing test
what does it measure
spirometry
respiratory volumes and capacities
Total amount of air that can be moved into and out of the lungs
Forced vital capacity
Ways to diagnose COPD
exercise tests and functional tests
From inspired air - alveolar air - oxygenated blood - tissue fluid, what increases what decreases?
From tissue fluid - deoxygenated blood - expired air what increases what decreases?
Where is each segment the highest?
PO2 decreases
PCO2 increases
PO2 increases
PCO2 decreases
PO2 is the highest in inspired air
PCO2 is the highest in tissue fluid
Clinical complications of COPD
skeletal muscle dysfunction
Osteoporosis
decrease in exercise tolerance
Medical management of COPD (4)
specific exercises
anti inflammatory - (corticosteroids or mast cell blocker)
nutrition
exercise (pulmonary rehab)
bronchodilation
Diaphragmatic breathing, pursed lip breathing, respiratory muscle trainers
Obstructive
vs
Restrictive
compliance
O: higher
R: lower
Ejection fraction
EDV-ESV (SV) /EDV x 100
collection of air outside lung but in pleural cavity
pneumothorax
collection of blood around pleural space
hemothorax
