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Terms in this set (74)
process of moving air in/out of trachea, bronchi and lungs
process of moving/ exchanging oxygen acquired during ventilation and carbon dioxide waste across the alveolar capillary membrane
process of supplying oxygenated blood to lungs and organs via blood vessels
process in which cells throughout body use oxygen aerobically to make energy
air travels from high to low pressure
removing carbon dioxide/ compression of the lungs creates higher pressure so air will move to lower pressure
ventilation rate and volume regulation
respiratory control center in brain
describe the lung receptors and their function
Epithelial tissue on smooth muscle of the airways
Sense irritants of which stimulate the cough reflex
stimulate expiration so that lungs don't overinflate
what are the two types of of chemoreceptors associated with ventilation
describe central receptors
found in/near respiratory center of the medulla
sensitive to PCO2 levels, sense change in pH of CSF
describe peripheral receptors
found in aorta and carotid arteries
sensitive to arterial blood oxygen (PAO2) must drop below 60 mmHg before they exert control
describe the respiratory control center
know the lung capacity measurement chart
alveolar capillary junctions
what are type II alveolar cells
occupy 5% of the inner surface area of alveolus
- secrete surfactant a lubricant which repels fluid accumulation due to its hydrophobic properties
- progenitor for type 1 and type 2 cells
** secrete surfactant
what is surfactant
A detergent like complex, reduces surface tension and helps keep the alveoli from collapsing.
what are type 1 alveolar cells
they occupy 95% of the inner surface area of alveolus
Don't have a capacity to regenerate
Function: provide structure and air exchange
What two processes are occurring during diffusion?
oxygen trying to get in
CO2 is trying to get out
What does diffusion depend on?
Pressure - of O2 and CO2
Solubility - of O2 and CO2
Membranes - their thickness/ surface area (of the alveolar capillary junctions)
What is the normal PAO2 for healthy people?
How much oxygen is soluble in plasma?
What is the PAO2 influenced by?
Amount of O2 available
How is PAO2 measured?
ABG panel (blood test)
What is the normal range for PCO2 in a healthy individual?
How is PCO2 measured?
ABG panel (blood test)
What is PCO2 influenced by?
Metabolic Activity of RBC
How many heme groups does hemoglobin have?
What is the O2 sat when it leaves the heart (initially)?
What is the O2 sat at the right side of the heart (venous return)
What are the factors for increased affinity of O2 with Hemoglobin?
Decreased PCO2 ( alkalosis)
decreased metabolic activity of RBC
What are the factors for decreased affinity of O2 with hemoglobin?
Increased PCO2 (acidosis)
Increased Metabolic activity of RBC
2,3 - DPG
What are the causes decreased affinity of O2 with hemoglobin?
chronic lung disease
How much CO2 is dissolved in the plasma?
How much CO2 is bound to hemoglobin?
How much CO2 is diffused into the RBC (bicarbonate)?
Does hemoglobin have a high or low affinity for CO2
What are the causes of compression or narrowing of airways?
Accumulation of exudate
What are the causes of disruption of neuronal transmissions?
Injury to medulla
Injury to Cervical nerves
Injury to thoracic nerves
normal breathing pattern
rapid, shallow breathing; more than 24 breaths per minute. Caused by needing to release CO2. Response to exercise, fear, pneumonia or injury to respiratory center
an absence of breathing. caused by brain injury, premature birth or obstructive process during sleep
increase in depth and rate of breathing responsive to PaO2/ PaCO2. caused by excess CO2 being released due to exertion, fear, diabetic ketoacidosis, aspirin overdose, brain injury
slow breathing, fewer than 10 breaths per minute, caused by drugs depression of respiratory center, increased ICP, diabetic coma
combination of hyperpnea and apnea could have ICP causing nervous system problems, drug-induced respiratory depression, heart failure, uremia
crackles / rales (new term)
snapping, popping, bubbling sounds caused by fluid accumulation in airways
what causes crackles in lungs
fluid in the lungs
continuous, high-pitched whistling sound it is significant for obstruction or tightness in the small airways
Coarse, low-pitched breath sounds heard in patients with chronic mucus in the upper airways.
high-pitched, creaking sound which is significant for obstruction in the upper airway especially of the trachea or larynx
Diminished breath sounds
used to describe quieter breath sounds that are barely audible; this is significant for complete obstruction in one or more airways
absent breath sounds
no air movement through the lungs
non-invasive can't determine absolute deficiency, hemorrhaging can have for a time an acceptable pulse ox
invasive test used to determine diffusion capacity
cloudiness of lungs; fluid build up (ex. people w/ pneumonia would have consolidation)
measurements of the ventilation capability of the lung using a spirometer
the visual examination of the bronchi using a bronchoscope
used to detect structural problems presence of consolidation obstruction or cavitation in the airways and lung tissue
Nuclear (V/Q) lung scan
detects pulmonary embolism and lung disease like emphysema and COPD uses contrast and imaging
Culture and sensitivity tests
determines and type of microorganisms in the blood and/or sputum the results dictate the appropriate antibiotic treatment if indicated
the surgical puncture of the chest wall with a needle to obtain fluid from the pleural cavity determines presence of malignant cells and microorganisms
what are the general treatment measures for altered ventilation and diffusion?
- Anti-inflammatory meds
- chest physiotherapy
- o2 supplementation
- mechanical ventilation
What is chest physiotherapy?
percussion, vibration, postural drainage
what is the difference in symptoms between influenza and pneumonia
describe atypical pneumonia
caused by mycoplasma/legionnaires
symptoms: cough but not productive
no hospitalization and may not be required
what are the typical pneumonia manifestations
consolidation can be localized to r/l up or down
What are the 4 drugs used to treat TB?
what is regimented / DOT therapy
have to go to doctor to take drug to ensure that patient takes medication
Infection process of TB
Organism gets into lungs then secondary immune response kicks in
walls of infection develop into (foci/granulomas)
secondary granulomas spread to another place in the lungs
what is the COPD triad ?
what happens to the alveolar sacs in emphysema
the alveolar sacs become fibrotic with no ability to recoil so air becomes trapped inside
What is FEV1
forced expiratory volume in 1 second
Does FEV1 become smaller or bigger with emphysema
becomes smaller as disease progresses
What do ABGs show in Emphysema?
Hypercapnia with increased CO2
what is the major difference between chronic bronchitis and emphysema?
chronic bronchitis has no involvement of the alveoli just narrowing of the bronchioles
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