Dz: Ch.4 Respiratory System Flashcards
(30 cards)
Respiratory System Divisions
Upper: passageways that conduct air between atmosphere and lung
Lower: trachea, bronchioles, lungs - gas xchanges
Respiratory Mucosa
Mucous secreting cells: trap particles
Cilia: sweep mucous/debri out
Bronchodilation
Sympathetic stimulation = relax smooth mm
Bronchioles>alveolar ducts>alveoli
Alveoli
Single layer of squamous epithelial cells
Promotes diffusion of gasses
Surfactant
Decreases surface tension
Facilitates inspiration
Prevents collapse of alveoli when expires
Pulmonary Volumes
Forced Expiratory volume in 1 sec (FEV1) = (approx 80% of Vital Capacity) 3200ml Vital Capacity (VC) 4000ml: max amount of air that can be moved in/out lungs Residual Vol (1500ml) + Vital Capacity (4000ml) = total lung capacity (5500ml)
Control of Ventilation
Medulla: inspiration
Pons: coordination
Chest Imaging
Radiographs
CT
MRI
Pulmonary Diagnostic Testing
Spirometry: volumes/airflow Arterial blood gas: check O2, CO2, bicarbonate Exercise tolerance (COPD): monitor progress X-rays: tumors/infections Bronchoscopy: biopsy for lesion Peak expiratory flow (asthma) Acid base balance: 7.35-7.45 pH - Resp acidosis (pH low) - Resp alkalosis (pH high)
Upper Respiratory Disease
Infection causing cold S/S
Sreptococus Pneumoniae
Secondary Infection (occurs after initial infection) Inflamed, necrotic mucous membranes
Influenza
Upper and/or lower respiratory tract
Viruses mutate = different strands
Can get secondary infection
Pneumonia
Primary infection or secondary to another condition
Aspiration or inflammation of lung
Bacterial/Viral/Fungal
Labor Pneumonai: manifestations
Bronchopneumonia
Lower lobes
Pooled secretions
Severe Acute Respiratory Syndrome (SARS)
Spreads rapidly
High mortality rate
Risk factors: travel to China, Hong Kong, Taiwan
Tuberculosis (Ghon complexes)
Primary infection: upper lobe local inflammatory rctn
Miliary TB: progressive form, doesn’t respond well to treatment
Secondary: “active”
Treat 3 months to a year
Obstructive Lung Disease
Cystic Fibrosis
- Inherited
- Thick secretions = Obstructs lungs &
pancreas
- salty skin
- Diagnose: sweat testLung Cancer
90% lung cancer related to smoking
Bronchogenic carcinoma: Most common malignant lung tumor
Tumor: obstruction, inflammation, pleural effusion
Para neoplastic syndrome: secretes hormones (ADH)
Asthma
Severe/reversible bronchial obstruction
Extrinsic (type I hypersensitivity) factors to smoke, perfumes, strong smells, molds, dander
Intrinsic (nonimmune) factors to respiratory infx, exposure to cold, meds, psychological stress
Partial/Total obstruction of airway
Chronic: may develop irreversible damage (bronchial walls thicken)
Etiology: fmHx, air pollution
S/S: can lead to respiratory failure
Tx: allergy test, breathing techniques
Emphysema
"Pink puffer"
COPD
Breakdown alveolar walls
- Decrease support for small bronchi:
collapse walls
Fibrous thickening of bronchial walls
- Difficulty with passive expiration
Progressive problems with expiration
- Barrel chest
- Diaphragm flattened
Advanced emphysema
- Hypercapnia increases (really high O2)Emphysema (Etiology, S/S, Diagnostics,Tx)
Etiology: Genetics: alpha1 –antitrypsin: inhibits activity of proteases (present during inflammation), air pollution, cigarette smoking
S/S: Dyspnea on exertion (DOE) progress»_space;
rest, HTN (use of accessory muscles), Clubbed fingers
Diagnostics: Pulmonary function tests:
- Increased residual volume
- Increased total lung capacity
Tx: Pulmonary rehab: Pursed lip breathing
Chronic bronchitis
“Blue boater”
COPD
Constant irritation from smoking or industrial pollution
Inflammation of mucous
Low O2: may develop cyanosis (not a good early indicator of hypoxia)
S/S: Severe chroniccoughing, systemic edema
Tx: Low flow oxygen, Expectorants, bronchodilators, chest therapy (remove mucous)
Aspiration
Passage of fluid or food, vomitus, drugs, other foreign material into trachea and lungs
R-Lung most common: more vertical
Solid Object: ball-valve-effect (air in/little air out), fatty solids can cause inflammation (form
granuloma/fibrous tissue)
Liquid: acidic, etoh, or oils = dispenses quickly causing impaired gas diffusion
Aspiration (Etiology, S/S, Tx)
Etiology: young children (smooth round objects most dangerous), depressed swallowing or gag reflex (head trauma), adults (alcohol, eating/talking)
S/S: nasals flaring, choking (dyspnea)
Tx: heimlich maneuver
