________, or simply ventilation or breathing, is the mechanical process of moving air in and out of the lungs.
pulmonary ventilation
_______ is the gas exchange process that occurs between the alveoli and the surrounding pulmonary capillaries. alveoli/capillary gas exhange
external respirations
_______ is the gas exchange process that occurs between the cells and the systemic capillaries. cell/capillary gas exchange
internal respirations
________________, AKA aerobic metabolism, occurs in the cell.
cellular respiration and metabolism
_____ extends from the nose and mouth to the cricoid cartilage, the most inferior portion of the larynx
the upper airway
air is warmed, moistened, and filtered as it flows over the damp, sticky ______ lining in the nose.
mucous membrane
the ______ is a common cause of airway obstruction in the patient with an altered mental status.
tongue
the anterior portion of the larynx is composed of the large bulky _______, commonly known as the adam’s apple
thyroid cartilage
the _____ forms the most inferior portion of the larynx and is the only completely circular cartilaginous ring of the upper airway, found just below the adams apple.
cricoid cartilage
upper airway consists of:
naso/oropharynx
pharynx
epiglottis
larynx
lower airway consists of:
trachea
bronchi
bronchioles
lungs
the ______, commonly known as the windpipe, is the passageway for air entering the lungs.
trachea
at the inferior portion of the trachea. the location where the trachea bifurcates into the left and right mainstem bronchi
carina
two major branches of the trachea that extend from the carina into the lungs.
left and right mainstem bronchi
the ______ is the innermost covering of the lung.
visceral pleura
the ______ is a thicker, more elastic layer that adheres to the inner portion of the chest wall
parietal pleura
The tiny area between the two layers of the pleura (the thin covering that protects and cushions the lungs) between the lungs and chest cavity. This space is normally filled with a small amount of fluid.
pleural space
the pleural space contains a small amount of ________ that acts as a lubricant to reduce friction when the layers of the pleura rub against each other during breathing.
serous fluid
muscle that separates the chest cavity from the abdominal cavity. major muscle for breathing. is responsible for 60-70% of the effort of ventilation
diaphragm
inhalation is an ______ process because it requires energy to contract the muscles.
active
exhalation is a ______ process because the muscles relax and little energy is expended
passive
the ______ continuously monitor levels of 02, C02, and pH in the arterial blood and stimulate or decrease in impulses from the respiratory rhythm centers to control the rate and depth of ventilation.
chemoreceptors
category of conditions known as chronic obstructive pulmonary disease, which include:
emphysema
chronic bronchitis
_____ is the process by which the blood and the cells become saturated in oxygen.
oxygenation
_______ is a low oxygen content in arterial blood. typically occurs from a ventilation-perfusion mismatch. not enough O2 or not enough blood flow.
hypoxemia
_____ refers to an inadequacy in the amount of oxygen being delivered to the cells.
hypoxia
signs of mild to moderate hypoxia
tachypnea (increased RR) dyspnea (SOB) pale, cool, clammy tachycardia (increased HR) elevation in BP restless and agitation (from hypoxic brain cells) disorientation and confusion (high CO2) H/A
signs of severe hypoxia:
tachypnea dyspnea cyanosis tachycardia severe confusion loss of coordination sleepy appearance head bobbing slow reaction time altered mental status seizure
signs of an open airway:
air can be felt and heard moving in and out of the mouth and nose
the Pt is speaking in full sentences or with little difficulty
the sound of the voice is normal for the Pt
breathing sound that occurs when the upper airway is partially obstructed by the tongue or by relaxed tissues in the pharynx
snoring
breath sound that occurs when the muscles around the larynx spasm and narrow the opening to the trachea.
crowing
breath sound that usually indicates the presence of blood, vomitus, secretions, or other liquid in the airway.
gurgling
breath sound that is harsh, high-pithched and heard during inspiration. it is a characteristic of a significant upper airway obstruction from swelling in the larynx.
stridor
examples of PTs who require head-tilt, chin-lift maneuver:
unresponsive (no spinal trauma) cardiac arrest (not due to trauma) not breathing (no signs of trauma)
the ______ of air in the lungs between respirations.
residual volume
the amount of air breathed in that reaches the alveoli
alveolar ventilation
a condition where the Pt is working harder to breathe
respiratory distress
ventilation rate for child with a pulse:
once every 3-5sec
ventilation rate for adult with a pulse:
once every 5-6sec
ventilation rate for newborn infant with a pulse:
once ever 1-1.5sec
signs of inadequate breathing:
altered mental status
inadiquate RR
poor chest rise and fall
fatigue from increased work of breathing
the indications for CPAP (continueous positive airway pressre) for the Pt in moderate to sever respiratory distress or early respiratory failure, but who is alert and awake enough to obey commands, maintain his own airway, and continue to breathe on his own, include:
congestive heart failure (CHF)
pulmonary edema (fluid around and in the alveoli from a high hydrostatic pressure in the pulmonary capillaries)
chronic obstructive pulmonary disease (COPD)
asthma
pneumonia
CPAP is contraindicated in Pts with :
apnea, resp arrest, or agonal resp
GCS
FROPVD
flow-restricted, oxygen-powered ventilation device
a surgical opening in the front of the neck that may be permanent or temporary.
stoma
an incision in the windpipe made to relieve an obstruction to breathing
tracheostomy
a curved hollow tube made of rubber, plastic, or metal that is inserted into the stoma to help hold it open
tracheostomy tube
laryngectomy
all or part of the Pt’s larynx has been removed.