P1.1: RESPIRATORY: INTRO-COPD Flashcards by Kyle Pacariem

Main Functions of Respiratory System

Respiration
Regulation of Blood PH
Voice Production
Olfaction
Innate Immunity

1:2 RATIO

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A term referring to the ability of the lungs to expand in response to inhalation

Luncg Compliance

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System that is primary responsible in replenishing oxygen supply in the body as well as in excreting carbon dioxide to the atmosphere through the process of respiration

RESPIRATORY SYSTEM

This system is generally divided into two tracts:
* Upper Respiratory Airways/Tracts
* Lower Respiratory Airways/Tracts

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It is the intrinsic characteristic of the lungs to deflate

Elastic Recoil

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Refers to the entire process of air flow between the human body and the atmosphere

Ventilation

Pulmonary ventilation (breathing)
Alveolar ventilation

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What are the different receptors in concern to lung compliance

Stetch Receptors
Chemoreceptors
Mechanoreceptors
Osmoreceptors

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What reflex is when once it reaches max expansion, it stops

It sends signal in medulla via venous nerces

Hering Breuer Reflex

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Obstructive Diseases affecting the Lower Airways

COPD
Bronchial Asthma

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Inflammatory Disorders

Pharyngitis
Laryngitis
Sinusitis

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WHAT IS THIS TRACT COMPOSED OF

Lower Respiratory Airways/Tracts

Trachea
Bronchi
Bronchioles
Alveoli

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Ventilation

Refers to the actual flow of gases into and out of the respiratory tract

Pulmonary ventilation (breathing)

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WHAT IS THIS TRACT COMPOSED OF

Upper Respiratory Airways/Tracts

Nose and sinuses
Pharynx
Larynx

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During inspiration, the diaphragm and accessory muscles enlarge the thoracic cavity, creating WHAT KIND OF PRESSURE within the chest.
Air is drawn into the lungs because the intrathoracic pressure (pressure of air within the chest) is (LESS THAN/MORE THAN) the atmospheric pressure (pressure of air in the environment).

Negative Pressure
Less Than

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Control of Ventilation

The control of respiration involves higher functions from various structures:

MEDULLA OBLONGATA
PONS
CEREBRAL CORTEX
CENTRAL CHEMORECEPTORS
PERIPHERAL CHEMORECEPTORS

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Ventilation

Refers to the exchange of gases across the alveolar membrane between the respiratory and circulatory tracts

Alveolar ventilation

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Controlled by the movement of the chest cavity, the compliance of the lungs and the surface tension within the alveoli

Pulmonary Ventilation

A single cycle of ventilation consists of inhalation (inspiration) followed by exhalation (expiration)

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Refers to the ease with which the lungs are inflated
Ability of the lungs to expand in response to inhalation

Lung Compliance

The force required to expand the lungs to a particular volume is referred to as WHAT

Compliance

Control of Ventilation

Responsible in the regulation of the rate and rhythm of respiration

PONS

Control of Ventilation

Responsible in the unconscious control of respiration

MEDULLA OBLONGATA

Control of Ventilation

Structure responsible in the conscious control of respiration but can be overridden by the medulla oblongata

CEREBRAL CORTEX

Control of Ventilation

These are chemoreceptors that are located in the carotid bodies and aortic arch and are very sensitive to changes in oxygen levels
May assume the primary chemorecptor’s responsibility in the event that the central chemoreceptors fail

PERIPHERAL CHEMORECEPTORS

Control of Ventilation

These are chemoreceptors that are located near the medulla and are very sensitive to changes in carbon dioxide levels
These are the primary chemoreceptors that regulate ventilation

CENTRAL CHEMORECEPTORS

FOUND IN BLOOD VESSELS

Explain the process of VENTILATION

Carbon dioxide readily crosses the blood brain barrier
↓
CO2 combines with water in the cerebrospinal fluid (CSF)
↓
the combination of CO2 and H2O results to the formation of carbonic acid which decreases the pH of the CSF
↓
in the event that there is an increase in the number of CO2 that crosses the BBB, the pH of the CSH gradually decreases
↓
This decrease in the pH of the CSF is detected by the central chemoreceptors
↓
The central chemoreceptors then send signal to the medulla hence respiration occurs

Significance: For normal individuals, high carbon dioxide is the main stimulus for breathing

Some of the common pre-sensations of certain respiratory disorders:

* Cough * Sputum production * Nasal secretions * Dyspnea * Wheezing * Pain

* It refers to the protective mechanism for clearing the airways * Can also be defined as the reflexive to irritating stimuli in the tracheobronchial tree or the larynx

Cough ## Footnote **Can be described according to onset as:** * **Acute**- sudden, short in duration * **Chronic**- gradual in onset and longer in duration * **Paroxysmal**- periodic forceful episodes that are difficult to control

# **Determine the grade using the DYSPNEA SCALE** Too breathless to leave the house or breathless when dressing

4 | **DEGREE:** VERY SEVERE

# **TYPE OF PAIN:** Pain caused by **inflammation of the pleural membranes**, is usually catching in nature and produced by movement of the thoracic cage; commonly unilateral and brought on by deep inspiration

Pleuritic pain

What/Who produces sputum

Sputum is produced by the **goblet cells** as well as the **submucosal glands** ## Footnote **Normal sputum is clear, thin and averages 100mL/day**

Sputum is described in terms of:

1. Color 2. Consistency 3. Amount

# **Determine the grade using the DYSPNEA SCALE** Troubled with shortness of breath when hurrying on level of ground or walking up slight hill

1 | **DEGREE:** SLIGHT

* A term used to describe the symptom of breathlessness and is a common presentation of respiratory problems * A subjective symptom and varies from person to person * Patients do not usually come in complaining of dyspnea but may describe it in a variety of ways

Dyspnea ## Footnote **May be described as: “difficulty catching my breath” or “I can’t seem to get enough air”**

# **TYPE OF PAIN:** Occurs at the **connection of the ribs and the cartilage** and can be elicited with pressure on the area

Costochondral pain

# **TYPE OF PAIN:** Transient in nature and worse during coughing

Intercostal pain

# Sputum is described in terms of: **Color** Creamy Yellow/Rusty = **???** Pink & Frothy = **???** Green = **???** | What causes them to produce such color?

**Creamy Yellow/Rusty** = Staphylococal Pneumonia **Pink & Frothy**= Pulmonary Edema **Green** = Pseudomonal Pneumonia

Sound produced when airways are constricted by **swelling**, secretions or bronchoconstriction and where exhalation requires effort | Airways are decreased/bronchoconstricted

Wheezing

# **Determine the grade using the DYSPNEA SCALE** Walks slower than people of same age because of breathlessness or has to stop for breath when walking at pace on level ground

2 | **DEGREE:** MODERATE

# **Determine the grade using the DYSPNEA SCALE** Not troubled with breathlessness except with strenuous exercise

0 | **DEGREE:** NONE

A condition characterized by increased A-P diameter, giving the chest a rounded appearance with the sternum pulled out

Barrel Chest

# **Determine the grade using the DYSPNEA SCALE** Stops for breath after walking approximately 100 yards after a few minutes on level ground

3 | **DEGREE:** SEVERE

Congenital depression of the sternum that decreases the A-P diameter

Funnel Chest (Pectus Excavatum)

A deformity of the chest wall in which the breastbone and ribs are pushed outward

Pigeon Chest (Pectus Carinatum)