W2: Workshop Flashcards
What are the main cardiorespiratory impairments?
02 movement
C02 movement
Secretion clearance
Mobility impairment
**refer to notes for signs and symptoms
What are the main causes of 02 movement issues? DAVD
- Decreased alveolar ventilation
- Ventilation/perfusion mismatch
- Diffusion impairment (eg fibrosis)
What are the main causes of C02 movement issues? AR L & C
- Increased airway resistance
- Reduced lung compliance
- Decreased chest wall compliance
The above issues will increase respiratory load
What are the main causes of secretion clearance impairments? ARAOV
- Increased airway resistance
- Increased respiratory load
- Decreased alveolar ventilation
- Decreased 02 and C02 gas movement
- VQ mismatch
What positions reduce functional residual capacity?
Supine and anaesthetic
In the supine position, the FRC typically decreases due to increased abdominal pressure on the diaphragm and changes in lung mechanics. Less air left in the lungs after exhalation, which can impact gas exchange. Anesthesia can further reduce FRC. Anesthetics often relax the muscles, including the diaphragm and intercostal muscles, which can decrease lung volumes and alter respiratory patterns
Note: Functional residual capacity (FRC) refers to the volume of air remaining in the lungs after a normal exhalation.
In a subjective its important to gather information on….
Personal history
Occupation
Significant others/carers
Home environment
Social interests
Smoking & alcohol
Physical activity
Past medical history
What does slow goes low mean?
A slow big breath in will open alveoli at the bottom of the lungs
Why is mobility an important consideration following surgery?
Following a large surgery, the patient will likely have pain, altered weight-bearing status & also potential for them to decondition which will delay return to home.
Being in bed for too long will also hinder ventilation (FRC is reduced in supine and this can affect 02 movement?)
If someone has a virus eg pneumonia or influenza A what impairment can you assume they have? What flow on affect can this have?
Secretion clearance
As a result there may be low 02. They may require supplemental 02 so they have the capability to secrete.
What is PaC02 –> What would a high PaC02 indicate?
PaCO₂ stands for “partial pressure of carbon dioxide in arterial blood.” It measures the amount of carbon dioxide (CO₂) dissolved in the blood and reflects how well CO₂ is being eliminated from the body through the lungs.
What would a high PaC02 indicate?
High = Hypercapnia –> a reflection of inadequate alveolar ventilation. Indicates that CO₂ is not being removed effectively, which could be due to respiratory issues like hypoventilation (breathing too shallowly) or lung disease.
What factors increase respiratory load? What does a high respiratory load result in?
Decreased neurological control of breathing
Increased airway resistance (narrowing)
Decreased lung compliance (Stiff)
Decreased chest wall compliance
Increased respiratory load results in decreased gas movement (Ie higher PaC02 and lower Pa02)
What can affect neurological control of breathing?
- Depression of CNS by drugs
- Inflammation, trauma or haemorrhage in the brainstem
- Abnormal spinal cord pathway
- Disease of the motoneurones of the brain stem/spinal cord
- Disease of the nerves supplying the respiratory muscles
- Disease of the neuromuscular junction
What can cause decreased chest wall compliance? STM PC
- Severe obesity (BMI > 45)
- Pregnancy
- Thoracic deformities
- Constrictive bandages
- Muscle paralysis
What can affect airway resistance?
- Bronchospasm (muscles that line your bronchi ie airways in your lungs, tighten)
- Secretions
- Oedema/inflammation
- Tumours
