Chapter 22 Respiratory Clinical questions:

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End of chapter clinical questions 1-4

Harry, the swimmer with the fastest time on the Springfield College swim team, routinely hyperventilates before a meet, as he says, "to sock some more oxygen into my lungs so I can swim longer without having to breathe." First of all, what basic fact about oxygen loading has Harry forgotten (a lapse leading to false thinking)? Second, how is Harry jeopardizing not only his time but his life?

Harry has forgotten that It's the CO2 level, and not the O2 level, that causes a person to have the urge to breathe. In other words, once the CO2 level in the blood is high enough, the brain will trigger a breathing response, causing the person to try to gasp for air. Harry is jeopardizing his time and life because Hyperventilation itself reduces the carbon dioxide concentration of the blood to below its normal level, raising the bloods ph value, initiating constriction of the blood vessels which supply the brain, and preventing the transport of certain electrolytes necessary for the function of the nervous system.

A member of the "Blues" gang was rushed into an emergency room after receiving a knife wound in the left side of his thorax. The diagnosis was pneumothorax and a collapsed lung. Explain exactly (a) why the lung collapsed, and (b) why only one lung (not both) collapsed.

The lung collapsed as atmospheric air entered the pleural cavity as a result of the stab injury causing pressure on the lung . The lung can normally expand when there is negative pressure within the pleural cavity but as there is communication with outside air the negative pressure could not be maintained.The answer to 2nd part is as the other lung is separated from the affected one by mediastinum atmospheric air could not enter there to cause it to collapse.

A surgeon removed three adjacent bronchopulmonary segments from the left lung of a patient with TB. Almost half of the lung was removed, yet there was no severe bleeding and relatively few blood vessels had to be cauterized (closed off). Why was the surgery so easy to perform?

The vascular supply to each bronchopulmonary segment arrives via a single separate point of entry, the hilus, so it is easy to ligate. The vessels out in the spongy lung tissue itself are few and tiny. Each segment is surrounded by connective tissue.

after a week of scuba divingin the bahamas, mary ann boards an airplane. During her flight home she develops aching joints, nausea and dyspnea, which disappear on lainding. During the flight, the cabin pressure was equivalent to an altitude of 8000 feet. explain he problems?

Decompression sickness or the bends. One is not supposed SCUBA and fly in the same 24 hour period. Another name is the bends and is the name given to a variety of symptoms suffered by a person exposed to a decrease (nearly always after a big increase) in the pressure around the body. The body must adapt to the pressure following a rapid ascent. or after diving and flying in a short period of time. These situations cause excess inert gases, which have dissolved in body liquids and tissues while the gas was being inhaled at higher pressure, to come out of physical solution as the pressure reduces and form gas bubbles within the body. The main inert gas for those who breathe air is nitrogen. The bubbles result in the symptoms of decompression sickness

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