lecture 4 (respiratory) Flashcards
(26 cards)
what are the structures found in respiratory system?
- upper airway (oesophagus, nasal cavity, pharynx, larynx)
- trachea
- bronchi
- bronchioles
- alveoli
- respiratory muscles
- connective tissue
- capillary bed
what are the two categories of respiratory diseases?
- obstructive airways disease
-restrictive lung disease
what occurs in obstructive airways disease?
- narrowing of airways
what are examples of obstructive airway diseases?
- asthma
- COPD
- chronic bronchitis
- emphysema
- bronchiectasis
- cystic fibrosis
what occurs in restrictive lung diseases?
- affect respiratory system outside of the airways
- lungs not expanding and contracting as they should
what are some examples of restrictive lung diseases?
- interstitial lung disease
- musculoskeletal diseases
- neuromuscular disease
- diaphragmatic weakness/paralysis
- obesity
what occurs during an asthma attack?
- smooth muscle in the airways becomes swollen and inflamed
- excessive mucus secretion
- blockage of airways
- reversible obstruction
what occurs in bronchiectasis?
- excess mucus secretion so blockage of airways
- damage airways and they become larger but more blocked with secretions
what is spirometry?
- physiological test to measure airflow through airways
what does spirometry assess and test?
- assesses respiratory health
- diagnoses respiratory diseases
what does spirometry measure?
- effect of respiratory disease on how well the lungs work
- responsiveness of airways to medication
- severity of airway disease and use for prognosis
- monitors disease progression over time
how do you prepare a spirometer?
- know your equipment so results are comparable
- calibration (check against known standard) and verification
- infection control (single use nose clips, ppe)
what patient checks are needed before participating in spirometry?
- haemoptysis (coughing up blood)
- pneumothorax (collapsed lung)
- recent heart attack
- recent pulmonary embolism
- thoracic, cerebral or abdominal aneurysms
- eye surgery
- nausea and vomiting
- recent thoracic surgery
- recent abdominal surgery
how is the patient prepared before the test?
- pre test: avoid smoking, alcohol, vigorous excersize, inhaler, large meal
- explain positioning and procedure
- age, height, birth sex, ethnicity
- type/dose/time of last medication
- smoker, non smoker, ex smoker
why is the procedure taken seated?
- safety so dont faint
- comparable rest values
- viable for everyone
how is the test performed?
- nose clip on, tidal breathing
- inhale to maximal Inspiration
- forced expiration to residual volume
- minimum of 2 attempts
what could occur if fast breathing was forced straight away?
- could trigger bronchoconstriction
- smooth muscle contraction and airway narrowing
- hard to breathe fast in respiratory diseases
what does spirometry measure?
- resting vital capacity (big breath in)
- peak expiratory flow
- forced expiratory volume (FEV1)
- forced vital capacity (FVC)
what is forced vital capacity?
- maximum volume of air exhaled with maximal forced effort from maximum inspiration
how are the results shown?
- volume time graph
- flow volume loop
what is in flow volume loop with normal conditions?
- sharp peak to top
- steady decline down
- round smooth curve at bottom
what does a flow volume loop look like in restrictive diseases?
- PEF normal/reduced (airways ok, disease elsewhere)
- FEV1 reduced
- FVC reduced
- raised FEV1:FVC ratio
- graph smaller than should be (smaller volume of air able to move)
what does a flow volume loop look like in obstructive diseases?
- scooped shape, no smooth decline (airway obstruction)
- PEF reduced
- FEV1 reduced
- FVC reduced (takes longer to expire)
- FEV1:FVC ratio reduced
what is dynamic airway compression?
-pressure surrounding airway exceeds pressure within airway lumen
