week 6 - disorders of the respiratory system Flashcards

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1
Q

What are the 3 functions of the respiratory system?

A
  1. Breathing
  2. exchange of O2 and CO2
  3. Speech production
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2
Q

What is external respiration>?

A

exchange of gases across membrane of the lungs
Gas exchange at pulmonary capillaries
Ventilation occurs

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3
Q

what is ventilation?

A

exchange of air between lungs and atmosphere

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4
Q

What is internal respiration?

A

exchange of gases from blood into organs and tissues
gas exchange at cellular level
as all cells need oxygen for metabolism and need to remove carbon dioxide

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5
Q

What areas are part of the upper respiratory tract?

A

Nose and naval cavity - air in, smell

Pharynx - carries food and air to oesophagus

Larynx - breathing, prevents against breathing in food

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6
Q

What is the function of the upper respiratory tract?

A

moistens/warms incoming air
filters incoming air
passageway fir respiration

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7
Q

What areas are part of the lower respiratory tract?

A

Larynx - maintains open airway, routes food and air

Trachea - transports air to and from the lungs

Broinchi - branch into the lungs

Lungs - transport air to the alveoli for gas exchange

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8
Q

Describe the bronchi in more detail?

A

Consist of cartilage rings and smooth muscle
They divide into bronchioles
They stop at the alveoli

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9
Q

What is pleura?

A

The pleura covers the lung:
Parietal pleura - inner
Pleural cavity - middle
Visceral pleura - outer
The pleura lubricarte fluid

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10
Q

What is the diaphragm?

A

It is a muscle which separates the chest and the abdomen
Innervated (supplied with nerves) by phrenic nerve

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11
Q

Describe the alveoli/

A

They are air sacs in the lungs.
Their membranes are one cell thick and are surrounded by capillaries for efficient gaseous exchange

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12
Q

What are properties of the alveoli for efficient gas exchange?

A

Large surface area
Good blood supply
Short diffusion. pathway
Moist surfaces - the liquid on the surface of alveoli dissolves gases and facilitates diffusion

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13
Q

Describe gas exchange in brief?

A

Oxygen moves from lungs to the bloodstream while carbon dioxide passes from the bloodstream top the lungs

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14
Q

What is the partial pressure gradient?

A

Where a gas diffuses from a higher pressure to a lower pressure down the gradient

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15
Q

What are the 2 phases of the respiratory cycle?

A

Inspiration
Expiration

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16
Q

Describe the process of inspiration (breathing in)?

A

external intercostal muscles contract - so ribs move up and out

Diaphragm contracts and flattens

Chest cavity/wall and lungs expand as ribs expand

Lung volume increases - causing air pressure to fall so air can flow in

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17
Q

Describe the process of expiration (breathing out)?

A

external intercostal muscles relax - so ribs return back to normal

the diaphragm relaxes

chest cavity and lungs contract as ribs return back to normal

Lung volume decreases - causing air pressure to rise so air can flow out

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18
Q

How is breathing regulated via the central nervous system/

A
  1. Respiratory centre in MO establishes basic breathing pattern
  2. Chemoreceptors - monitor CO2, O2, H+ levels
  3. Medulla - sensitive to H+ in CSF resulting from co2 in blood
  4. Carotid/aortic bodies sensitive to co2, Ph, o2
  5. Conscious control in the brain
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19
Q

What is physiologic dead space (Vd) - a type of breathing measurement?

A

volume of air in respiratory zone that does not take part in gas exchange

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20
Q

What is tidal volume (Vt) - a type of breathing measurement?

A

The amount of air in and out of the lungs with each respiratory cycle (1 breath, expiration and inspiration)

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21
Q

What is respiratory rate (f) - type of breathing measurement?

A

Amount of breathes per minute

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22
Q

How can you calculate minute volume (Ve) (L/min) - a type of breathing measurement?

A

(Vt x f)

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23
Q

What is alveolar ventilation (Va) - a type of breathing measurement?
And how do you calculate it?

A

it is the amount of air that reaches the alveoli
Calculate it by (Vt-Vd) x f

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24
Q

What does Vd/Vt calculate/

A

the portion of Vt that does not exchange

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25
Q

What are the 3 ways to measure lung function?

A

Pulmonary function tests
Lung volumes and vital capacity
Gas transfer test

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26
Q

What is tidal volume (Vt) - a measurement of lung function?

A

Amount of air inhaled/exhaled during normal breathing

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27
Q

What is minute volume (MV) - a measurement of lung function?

A

The total air exhaled per minute

28
Q

What is vital capacity (VC) - a measurement of lung function?

A

The total volume of air exhaled after max inhaling

29
Q

What is functional residual capacity (FRC) - a measurement of lung function?

A

The amount of air left in the lungs after exhaling normally

30
Q

What is residual volume - a measurement of lung function?

A

The amount of air left in the lungs after exhaling max

31
Q

What is forced vital capacity (FVC) - a measurement of lung function?

A

The amount of air exhaled forcefully and quickly after inhaling max

32
Q

What is forced expiratory volume (FEV) - a measurement of lung function?

A

The amount of air expired during the 1st 2nd and 3rd seconds of the FVC test

33
Q

What is spirometry? - a measurement of lung function

A

Spirometry measures the amount an/or speed of air that can be inhaled and exhaled

Revise the spirometry graph

34
Q

Describe the process of the gas transfer test - measurement of lung function

A

Go over it

35
Q

What are the 4 respiratory processes?

A

Pulmonary ventilation
External respiration
Internal respiration
Cellular respiration

36
Q

What is pulmonary ventilation./

A

breathing

37
Q

What is external respiration?

A

The gas exchange between air in alveoli and the blood in capillaries

38
Q

What is internal inspiration?

A

The gas exchange between blood and cells/tissues of body

39
Q

What is cellular respiration?

A

The production of energy - ATP

40
Q

What are some disorders of the respiratory system ?

A

Asthma, emphysema, bronchitis
Infections like pneumonia, TB, botulism
Lung cancer
Congestive heart failure - CHF
Cystic fibrosis

41
Q

Lung capacity in disease slide

A
42
Q

What happens in a respiratory assessment/

A

Determine the adequacy of gas exchange routinely on the patient
If there is early recognition of respiratory disease, response is early

43
Q

What should a respiratory assessment include?

A

HIPPAA
History
Inspection/observation
Palpation
Percussion
Auscultation
Adjuncts - blood gas analysis, chest x ray, spirometry etc

44
Q

History
What are some history considerations in a respiratory assessment?

A

medical history
Sputum presence
employment history
exercise tolerance
reason for admission

45
Q

What is sputum?

A

It is a thick mucus produced in the lungs coughed up from the lower airways

46
Q

What are the types of sputum and what do they show?

A

Green, thick, foul - infection

Blood stained - TB, pleural effusion, lung cancer

White, thick - COPD, asthma

Pink and frothy - pulmonary oedema, HF

Brown/brick coloured - TB, infection

47
Q

Inspection/Observation
What measures should be inspected during a respiratory assessment on the patient?

A

Breathing rate
Quality of breathing
Breathing rhythm
Degree of effort to breathe
Cough
Mental status
Skin colour
Deformities

48
Q

What are some other breathing terms?

A

Tachypnoea - fast breathing rate
Bradypnoea - slow breathing rate
Orthopnoea - sensation of breathlessness
Dyspnoea - shortness of breath

49
Q

Palpitation?

A

Assess the bilateral movements of the chest

50
Q

Percussion

A

The chest should have a resonant/hollow percussion
Disease - hyper-resonant/flat notes
Pneumothorax/emphysema - high percussion note
Pleural effusion - low percussion note
Asthma - drum like sound

51
Q

Auscultation

A

This is where you listen to the chest with stethoscope to check for normal breathing sounds
Detect air entry throughout

52
Q

Learn the adventitious breath sounds

A
53
Q

What are some respiratory assessment tools

A

Pulse oximetry
Spirometry
Arterial blood gas analysis
Chest x-ray

54
Q

Describe pulse oximetry?

A

It is where you assess o2 saturation

55
Q

What are the potential problems with pulse oximetry?

A

Dark skin pigmentation, nail varnish etc can affect light emission
Thick skin can inhibit conduction
The monitor becomes unreliable if o2 saturation is below 85%
etc etc

56
Q

Important points on pulse oximetry?

A

Does not record co2
Does not indicate adequate ventilation
The position of the probe must be changed frequently to prevent pressure damage

57
Q

How does a chest x-ray assess any respiratory issues?

A

It identifies and diagnoses problems with the lungs

58
Q

What is arterial blood gas (ABG) sampling?

A

It is where blood is obtained from the patient when they are deemed acutely ill/at risk by direct arterial puncture/insertion of arterial line
Blood gas measured in kPa, 1 kPa = 7.5mmHg

59
Q

What does ABG help with?

A

Gives indication of respiratory function
Gives view of metabolic environment in patients body
Gives indication of bodies ability to maintain homeostasis

60
Q

What is a limitation of blood gases?

A

It must be examined alongside medical history, clinical symptoms/examonation

61
Q

Learn ABG analysis values?

A
62
Q

What conditions can be tested for via ABG?

A

hypoxia
Severe sepsis
Diabetic ketoacidosis - acidic blood
Renal tubular acidosis - kidneys do not remove acid

63
Q

What is Chronic Obstructive Pulmonary Disease? (COPD)

A

It is when there is a recurrent obstruction to airflow
Consists of a group of disorders like emphysema/bronchitis
Incurable

64
Q

What are the features of asthma? COPD

A

Bronchospasms, productive cough,

65
Q

What are the features of chronic bronchitis? COPD

A

Mucosal swelling, chest pain, cough

66
Q

What are the features of emphysema? COPD

A

Barrel chest, Dyspnoea, Orthopnoea

67
Q
A